Page:United States Statutes at Large Volume 124.djvu/213

 124 STAT. 187 PUBLIC LAW 111–148—MAR. 23, 2010 (2) ENFORCEMENT AUTHORITY.—The provisions of section 2736(b) of the Public Health Services Act shall apply to the enforcement under paragraph (1) of requirements of subsection (a)(1) (without regard to any limitation on the application of those provisions to group health plans). (d) NO INTERFERENCE WITH STATE REGULATORY AUTHORITY.— Nothing in this title shall be construed to preempt any State law that does not prevent the application of the provisions of this title. (e) PRESUMPTION FOR CERTAIN STATE-OPERATED EXCHANGES.— (1) IN GENERAL.—In the case of a State operating an Exchange before January 1, 2010, and which has insured a percentage of its population not less than the percentage of the population projected to be covered nationally after the implementation of this Act, that seeks to operate an Exchange under this section, the Secretary shall presume that such Exchange meets the standards under this section unless the Secretary determines, after completion of the process estab- lished under paragraph (2), that the Exchange does not comply with such standards. (2) PROCESS.—The Secretary shall establish a process to work with a State described in paragraph (1) to provide assist- ance necessary to assist the State’s Exchange in coming into compliance with the standards for approval under this section. SEC. 1322. FEDERAL PROGRAM TO ASSIST ESTABLISHMENT AND OPER- ATION OF NONPROFIT, MEMBER-RUN HEALTH INSUR- ANCE ISSUERS. (a) ESTABLISHMENT OF PROGRAM.— (1) IN GENERAL.—The Secretary shall establish a program to carry out the purposes of this section to be known as the Consumer Operated and Oriented Plan (CO–OP) program. (2) PURPOSE.—It is the purpose of the CO–OP program to foster the creation of qualified nonprofit health insurance issuers to offer qualified health plans in the individual and small group markets in the States in which the issuers are licensed to offer such plans. (b) LOANS AND GRANTS UNDER THE CO–OP PROGRAM.— (1) IN GENERAL.—The Secretary shall provide through the CO–OP program for the awarding to persons applying to become qualified nonprofit health insurance issuers of— (A) loans to provide assistance to such person in meeting its start-up costs; and (B) grants to provide assistance to such person in meeting any solvency requirements of States in which the person seeks to be licensed to issue qualified health plans. (2) REQUIREMENTS FOR AWARDING LOANS AND GRANTS.— (A) IN GENERAL.—In awarding loans and grants under the CO–OP program, the Secretary shall— (i) take into account the recommendations of the advisory board established under paragraph (3); (ii) give priority to applicants that will offer quali- fied health plans on a Statewide basis, will utilize integrated care models, and have significant private support; and (iii) ensure that there is sufficient funding to estab- lish at least 1 qualified nonprofit health insurance 42 USC 18042. Determination. Applicability.