Sec. 103. State alternative option
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In the case of a State that elects under section 102(a)(2) the alternative option under this section, subject to subsection
(d)and section 107, the following shall apply: The individual and employer health care responsibilities under the amendments made by title I of PPACA (including under sections 5000A and 4980H of the Internal Revenue Code of 1986) shall no longer apply pursuant to section 101 with respect to individuals who are residents of such State and with respect to individuals who are employed in such State, respectively. Except as specifically provided in this title, the requirements under title I of PPACA (including amendments made by such title) relating to health insurance coverage offered in the State shall not apply except to the extent specified by the State. Deposit qualifying residents (as defined in subsection (b)(2)) who are residing in the State are eligible for a deposit to a Roth HSA that may be used for premiums and cost-sharing for health insurance coverage in accordance with subsection (b). In making the election under this subsection, a State shall specify whether the State will carry out subsection
(b)or if such subsection shall be carried out by means of the credit under section 36C of the Internal Revenue Code of 1986. A patient-grant electing State (as defined in section 100(1)) is entitled to receive additional funding under subsection
(c)for population health initiatives. The subsidies described in subsection (a)(3) for an electing State shall be furnished for each deposit qualifying resident through the deposit of a contribution into a Roth HSA of the individual in the amount determined under section 104. For purposes of the Internal Revenue Code of 1986, the amount of any contribution to a Roth HSA made under this paragraph shall be included in the gross income of the individual for whose benefit the Roth HSA was established. In this title, the term deposit qualifying resident means, with respect to a State and a month, an individual— who is a qualified resident (as defined in section 100(14)) of the State as of the first day of the month (or such other day in the month as the Secretary may specify); with respect to whom a Roth HSA has been established, which Roth HSA may have been established by the State in carrying out this section; who is enrolled in qualified health plan coverage (as defined in section 100(13)), which enrollment may have been effected by the State in carrying out this section; and who is not eligible for coverage under Medicare, is not enrolled for benefits under Medicaid or CHIP, and is not enrolled for benefits under chapter 55 of title 10, United States Code (relating to TRICARE), or title 39 of such Code (relating to veterans’ benefits) or chapter 89 of title 5 of such Code (relating to the Federal Employees Health Benefits Program). In the case of an electing State that elects to carry out this subsection through the State, the Secretary shall provide for payment to the State in amounts and in a time and manner sufficient to permit the State to make timely monthly contributions to Roth HSAs under this subsection. The Secretary may provide for payment to the State using the payment methodology described in subsection
(d)of section 1903 of the Social Security Act for payments under subsection
(a)of such section (applied without regard to any State matching requirement) and may condition such payments upon the provision of such information as the Secretary may require to ensure the proper payments under this subsection. As a condition of receiving payment under this section, a State shall submit such information, in such form, and manner, as the Secretary shall specify, including information necessary to make the computations of amounts under this section. In the case of a State electing to carry out this subsection other than through the State, subsidies described in subsection (a)(3) shall be provided through a refundable tax credit under section 36C of the Internal Revenue Code of 1986. Nothing in this subsection shall be construed— to prevent an individual from affirmatively electing not to have a Roth HSA established on the individual’s behalf and not to be enrolled in health insurance coverage; subject to subparagraph (A), to prevent a State from establishing a Roth HSA for each deposit qualifying resident who does not otherwise have a Roth HSA; subject to subparagraph (A), to prevent a State from establishing a mechanism whereby individuals who would be deposit qualifying residents but for paragraph (2)(C) are enrolled in health insurance coverage; and to prevent a State from changing its State Medicaid plan to eliminate coverage under section 1902(a)(10)(A)(i)(VIII) of the Social Security Act ( 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) ), in order that individuals otherwise covered under such section may qualify for subsidies under this section. In the case of an electing State for a year, the State is entitled to receive payment from the Secretary after the end of such year in an amount equal to 2 percent of the actual aggregate amount deposited under subsection
(b)into Roth HSAs for residents of the State for the year. Amounts paid to a State under paragraph
(1)may only be used for population health initiatives (as defined by the Secretary). Paragraph
(1)constitutes budget authority in advance of appropriations Acts and represents the obligation of the Federal Government to provide for the payment to States of amounts provided under such paragraph. As a condition for a State’s election of the alternative option under this section, the State must provide, through its department of insurance or equivalent agency, for establishment of rules to carry out section 1867(j)(1)(A)(ii) of the Social Security Act, as added by section 121(a)(2).
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Sec. 103
State alternative option
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