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42 U.S.C. § 18083 — Streamlining of procedures for enrollment through an Exchange and State medicaid, CHIP, and health subsidy programs
Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** The Secretary shall establish a system meeting the requirements of this section under which residents of each State may apply for enrollment in, receive a determination of eligibility for participation in, and continue participation in, applicable State health subsidy programs. Such system shall ensure that if an individual applying to an Exchange is found through screening to be eligible for medical assistance under the State medicaid plan under title XIX 11 So in original. Probably should be followed by “of the Social Security Act”. [[42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq.], or eligible for enrollment under a State children’s health insurance program (CHIP) under title XXI of such Act [[42 U.S.C. 1397aa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397aa&num=0&edition=prelim) et seq.], the individual is enrolled for assistance under such plan or program.
**(b) Requirements relating to forms and notice**
(1) **Requirements relating to forms**
(A) *In general* — The Secretary shall develop and provide to each State a single, streamlined form that—
(i) may be used to apply for all applicable State health subsidy programs within the State;
(ii) may be filed online, in person, by mail, or by telephone;
(iii) may be filed with an Exchange or with State officials operating one of the other applicable State health subsidy programs; and
(iv) is structured to maximize an applicant’s ability to complete the form satisfactorily, taking into account the characteristics of individuals who qualify for applicable State health subsidy programs.
(B) *State authority to establish form* — A State may develop and use its own
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Source file: Laws/federal/codes/united-states-code/title-42/section-18083-streamlining-of-procedures-for-enrollment-through-an-exchange-and-state--41ebbc6d01.md
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Source location: Title 42, Chapter 157, § 18083; chapter-157-quality-affordable-health-care-for-all-americans.md
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**(a) In general** The Secretary shall establish a system meeting the requirements of this section under which residents of each State may apply for enrollment in, receive a determination of eligibility for participation in, and continue participation in, applicable State health subsidy programs. Such system shall ensure that if an individual applying to an Exchange is found through screening to be eligible for medical assistance under the State medicaid plan under title XIX 11 So in original. Probably should be followed by “of the Social Security Act”. [[42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq.], or eligible for enrollment under a State children’s health insurance program (CHIP) under title XXI of such Act [[42 U.S.C. 1397aa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397aa&num=0&edition=prelim) et seq.], the individual is enrolled for assistance under such plan or program.
**(b) Requirements relating to forms and notice**
(1) **Requirements relating to forms**
(A) *In general* — The Secretary shall develop and provide to each State a single, streamlined form that—
(i) may be used to apply for all applicable State health subsidy programs within the State;
(ii) may be filed online, in person, by mail, or by telephone;
(iii) may be filed with an Exchange or with State officials operating one of the other applicable State health subsidy programs; and
(iv) is structured to maximize an applicant’s ability to complete the form satisfactorily, taking into account the characteristics of individuals who qualify for applicable State health subsidy programs.
(B) *State authority to establish form* — A State may develop and use its own single, streamlined form as an alternative to the form developed under subparagraph (A) if the alternative form is consistent with standards promulgated by the Secretary under this section.
(C) *Supplemental eligibility forms* — The Secretary may allow a State to use a supplemental or alternative form in the case of individuals who apply for eligibility that is not determined on the basis of the household income (as defined in [section 36B of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section36B&num=0&edition=prelim)).
(2) **Notice** — The Secretary shall provide that an applicant filing a form under paragraph (1) shall receive notice of eligibility for an applicable State health subsidy program without any need to provide additional information or paperwork unless such information or paperwork is specifically required by law when information provided on the form is inconsistent with data used for the electronic verification under paragraph (3) or is otherwise insufficient to determine eligibility.
**(c) Requirements relating to eligibility based on data exchanges**
(1) **Development of secure interfaces** — Each State shall develop for all applicable State health subsidy programs a secure, electronic interface allowing an exchange of data (including information contained in the application forms described in subsection (b)) that allows a determination of eligibility for all such programs based on a single application. Such interface shall be compatible with the method established for data verification under [section 18081(c)(4) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18081/c/4&num=0&edition=prelim).
(2) **Data matching program** — Each applicable State health subsidy program shall participate in a data matching arrangement for determining eligibility for participation in the program under paragraph (3) that—
(A) provides access to data described in paragraph (3);
(B) applies only to individuals who—
(i) receive assistance from an applicable State health subsidy program; or
(ii) apply for such assistance—
(I) by filing a form described in subsection (b); or
(II) by requesting a determination of eligibility and authorizing disclosure of the information described in paragraph (3) to applicable State health coverage subsidy programs for purposes of determining and establishing eligibility; and
(C) consistent 22 So in original. Probably should be preceded by “is”. with standards promulgated by the Secretary, including the privacy and data security safeguards described in section 1942 of the Social Security Act [[42 U.S.C. 1396w–2](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396w-2&num=0&edition=prelim)] or that are otherwise applicable to such programs.
(3) **Determination of eligibility**
(A) *In general* — Each applicable State health subsidy program shall, to the maximum extent practicable—
(i) establish, verify, and update eligibility for participation in the program using the data matching arrangement under paragraph (2); and
(ii) determine such eligibility on the basis of reliable, third party data, including information described in sections 1137, 453(i), and 1942(a) of the Social Security Act [[42 U.S.C. 1320b–7](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b-7&num=0&edition=prelim), 653(i), 1396w–2(a)], obtained through such arrangement.
(B) *Exception* — This paragraph shall not apply in circumstances with respect to which the Secretary determines that the administrative and other costs of use of the data matching arrangement under paragraph (2) outweigh its expected gains in accuracy, efficiency, and program participation.
(4) **Secretarial standards** — The Secretary shall, after consultation with persons in possession of the data to be matched and representatives of applicable State health subsidy programs, promulgate standards governing the timing, contents, and procedures for data matching described in this subsection. Such standards shall take into account administrative and other costs and the value of data matching to the establishment, verification, and updating of eligibility for applicable State health subsidy programs.
**(d) Administrative authority**
(1) **Agreements** — Subject to [section 18081 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18081&num=0&edition=prelim) and section 6103(l)(21) of title 26 and any other requirement providing safeguards of privacy and data integrity, the Secretary may establish model agreements, and enter into agreements, for the sharing of data under this section.
(2) **Authority of exchange to contract out** — Nothing in this section shall be construed to—
(A) prohibit contractual arrangements through which a State medicaid agency determines eligibility for all applicable State health subsidy programs, but only if such agency complies with the Secretary’s requirements ensuring reduced administrative costs, eligibility errors, and disruptions in coverage; or
(B) change any requirement under title XIX 1 that eligibility for participation in a State’s medicaid program must be determined by a public agency.
**(e) Applicable State health subsidy program** In this section, the term “applicable State health subsidy program” means—
(1) the program under this title 33 See References in Text note below. for the enrollment in qualified health plans offered through an Exchange, including the premium tax credits under [section 36B of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section36B&num=0&edition=prelim) and cost-sharing reductions under [section 18071 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18071&num=0&edition=prelim);
(2) a State medicaid program under title XIX of the Social Security Act [[42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq.];
(3) a State children’s health insurance program (CHIP) under title XXI of such Act [[42 U.S.C. 1397aa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397aa&num=0&edition=prelim) et seq.]; and
(4) a State program under [section 18051 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18051&num=0&edition=prelim) establishing qualified basic health plans.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Purpose** Except with respect to the rural health transformation program established in [section 1397ee(h) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee/h&num=0&edition=prelim), the purpose of this subchapter is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner that is coordinated with other sources of health benefits coverage for children. Such assistance shall be provided primarily for obtaining health benefits coverage through—
(1) obtaining coverage that meets the requirements of [section 1397cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397cc&num=0&edition=prelim), or
(2) providing benefits under the State’s medicaid plan under subchapter XIX,
or a combination of both.
**(b) State child health plan required** A State is not eligible for payment under subsection (a) or (g) of [section 1397ee of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee&num=0&edition=prelim) unless the State has submitted to the Secretary under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim) a plan that—
(1) sets forth how the State intends to use the funds provided under this subchapter to provide child health assistance to needy children consistent with the provisions of this subchapter, and
(2) has been approved under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim).
**(c) State entitlement** This subchapter constitutes budget authority i
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397aa
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** In the case of an applicable taxpayer, there shall be allowed as a credit against the tax imposed by this subtitle for any taxable year an amount equal to the premium assistance credit amount of the taxpayer for the taxable year.
**(b) Premium assistance credit amount** For purposes of this section—
(1) **In general** — The term “premium assistance credit amount” means, with respect to any taxable year, the sum of the premium assistance amounts determined under paragraph (2) with respect to all coverage months of the taxpayer occurring during the taxable year.
(2) **Premium assistance amount** — The premium assistance amount determined under this subsection with respect to any coverage month is the amount equal to the lesser of—
(A) the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer, the taxpayer’s spouse, or any dependent (as defined in section 152) of the taxpayer and which were enrolled in through an Exchange established by the State under 1311 11 So in original. Probably should be preceded by “section”. of the Patient Protection and Affordable Care Act, or
(B) the excess (if any) of—
(i) the adjusted monthly premium for such month for the applicable second lowest cost silver plan with respect to the taxpayer, over
(ii) an amount equal to 1/12 of the product of the applicable percentage and the taxpayer’s household income for the taxable year.
(3) **Other terms and rules relating to premium assistance amounts** — For purposes of paragraph (2)—
(A) *Applicable percentage*
(i) *In general* — Except as provided in clause (ii), the applicable percentage for any taxable year shall be the percentage such that the applicable percentag
Source: Supplied U.S. Code snapshot — release unconfirmed · 26 U.S.C. § 36B
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Establishment** There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as “MACPAC”).
**(b) Duties**
(1) **Review of access policies for all States and annual reports** — MACPAC shall—
(A) review policies of the Medicaid program established under this subchapter (in this section referred to as “Medicaid”) and the State Children’s Health Insurance Program established under subchapter XXI (in this section referred to as “CHIP”) affecting access to covered items and services, including topics described in paragraph (2);
(B) make recommendations to Congress, the Secretary, and States concerning such access policies;
(C) by not later than March 15 of each year (beginning with 2010), submit a report to Congress containing the results of such reviews and MACPAC’s recommendations concerning such policies; and
(D) by not later than June 15 of each year (beginning with 2010), submit a report to Congress containing an examination of issues affecting Medicaid and CHIP, including the implications of changes in health care delivery in the United States and in the market for health care services on such programs.
(2) **Specific topics to be reviewed** — Specifically, MACPAC shall review and assess the following:
(A) *Medicaid and CHIP payment policies* — Payment policies under Medicaid and CHIP, including—
(i) the factors affecting expenditures for the efficient provision of items and services in different sectors, including the process for updating payments to medical, dental, and health professionals, hospitals, residential and long-term care providers, providers of home and community based services, Federally-qualified health centers and rural health clinics, managed care entities, and providers of ot
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** In the case of an eligible insured enrolled in a qualified health plan—
(1) the Secretary shall notify the issuer of the plan of such eligibility; and
(2) the issuer shall reduce the cost-sharing under the plan at the level and in the manner specified in subsection (c).
**(b) Eligible insured** In this section, the term “eligible insured” means an individual—
(1) who enrolls in a qualified health plan in the silver level of coverage in the individual market offered through an Exchange; and
(2) whose household income exceeds 100 percent but does not exceed 400 percent of the poverty line for a family of the size involved.
In the case of an individual described in [section 36B(c)(1)(B) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section36B/c/1/B&num=0&edition=prelim), the individual shall be treated as having household income equal to 100 percent for purposes of applying this section.
**(c) Determination of reduction in cost-sharing**
(1) **Reduction in out-of-pocket limit**
(A) *In general* — The reduction in cost-sharing under this subsection shall first be achieved by reducing the applicable out-of pocket 11 So in original. Probably should be “out-of-pocket”. limit under [section 18022(c)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18022/c/1&num=0&edition=prelim) in the case of—
(i) an eligible insured whose household income is more than 100 percent but not more than 200 percent of the poverty line for a family of the size involved, by two-thirds;
(ii) an eligible insured whose household income is more than 200 percent but not more than 300 percent of the poverty line for a family of the size involved, by one-half; and
(iii) an eligible in
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18071
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Federal law — U.S. Code and appendices · legal_authorities
This chapter may be cited as the “Social Security Act”.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Establishment of program**
(1) **In general** — The Secretary shall establish a basic health program meeting the requirements of this section under which a State may enter into contracts to offer 1 or more standard health plans providing at least the essential health benefits described in [section 18022(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18022/b&num=0&edition=prelim) to eligible individuals in lieu of offering such individuals coverage through an Exchange.
(2) **Certifications as to benefit coverage and costs** — Such program shall provide that a State may not establish a basic health program under this section unless the State establishes to the satisfaction of the Secretary, and the Secretary certifies, that—
(A) in the case of an eligible individual enrolled in a standard health plan offered through the program, the State provides—
(i) that the amount of the monthly premium an eligible individual is required to pay for coverage under the standard health plan for the individual and the individual’s dependents does not exceed the amount of the monthly premium that the eligible individual would have been required to pay (in the rating area in which the individual resides) if the individual had enrolled in the applicable second lowest cost silver plan (as defined in [section 36B(b)(3)(B) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section36B/b/3/B&num=0&edition=prelim)) offered to the individual through an Exchange; and
(ii) that the cost-sharing an eligible individual is required to pay under the standard health plan does not exceed—
(I) the cost-sharing required under a platinum plan in the case of an eligible individual with household income not
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18051
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Establishment of program** The Secretary shall establish a program meeting the requirements of this section for determining—
(1) whether an individual who is to be covered in the individual market by a qualified health plan offered through an Exchange, or who is claiming a premium tax credit or reduced cost-sharing, meets the requirements of sections 18032(f)(3), 18071(e), and 18082(d) of this title and [section 36B(e) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section36B/e&num=0&edition=prelim) that the individual be a citizen or national of the United States or an alien lawfully present in the United States;
(2) in the case of an individual claiming a premium tax credit or reduced cost-sharing under [section 36B of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section36B&num=0&edition=prelim) or [section 18071 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18071&num=0&edition=prelim)—
(A) whether the individual meets the income and coverage requirements of such sections; and
(B) the amount of the tax credit or reduced cost-sharing;
(3) whether an individual’s coverage under an employer-sponsored health benefits plan is treated as unaffordable under sections 36B(c)(2)(C) and 5000A(e)(2) of title 26; 11 See References in Text note below. and
(4) whether to grant a certification under [section 18031(d)(4)(H) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18031/d/4/H&num=0&edition=prelim) attesting that, for purposes of the individual responsibility requirement under [section 5000A of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section5000A&num=0&edition=prelim), a
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18081
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Condition for participation in Medicaid** As a condition of the State plan under this subchapter and receipt of any Federal financial assistance under [section 1396b(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396b/a&num=0&edition=prelim) for calendar quarters beginning after January 1, 2014, a State shall ensure that the requirements of subsection (b) is 11 So in original. Probably should be “are”. met.
**(b) Enrollment simplification and coordination with State health insurance exchanges and CHIP**
(1) **In general** — A State shall establish procedures for—
(A) enabling individuals, through an Internet website that meets the requirements of paragraph (4), to apply for medical assistance under the State plan or under a waiver of the plan, to be enrolled in the State plan or waiver, to renew their enrollment in the plan or waiver, and to consent to enrollment or reenrollment in the State plan through electronic signature;
(B) enrolling, without any further determination by the State and through such website, individuals who are identified by an Exchange established by the State under [section 18031 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18031&num=0&edition=prelim) as being eligible for—
(i) medical assistance under the State plan or under a waiver of the plan; or
(ii) child health assistance under the State child health plan under subchapter XXI;
(C) ensuring that individuals who apply for but are determined to be ineligible for medical assistance under the State plan or a waiver or ineligible for child health assistance under the State child health plan under subchapter XXI, are screened for eligibility for enrollment in qualified health pl
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1396w–3
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Assistance to States to establish American Health Benefit Exchanges**
(1) **Planning and establishment grants** — There shall be appropriated to the Secretary, out of any moneys in the Treasury not otherwise appropriated, an amount necessary to enable the Secretary to make awards, not later than 1 year after March 23, 2010, to States in the amount specified in paragraph (2) for the uses described in paragraph (3).
(2) **Amount specified** — For each fiscal year, the Secretary shall determine the total amount that the Secretary will make available to each State for grants under this subsection.
(3) **Use of funds** — A State shall use amounts awarded under this subsection for activities (including planning activities) related to establishing an American Health Benefit Exchange, as described in subsection (b).
(4) **Renewability of grant**
(A) *In general* — Subject to subsection (d)(4), the Secretary may renew a grant awarded under paragraph (1) if the State recipient of such grant—
(i) is making progress, as determined by the Secretary, toward—
(I) establishing an Exchange; and
(II) implementing the reforms described in subtitles A and C (and the amendments made by such subtitles); and
(ii) is meeting such other benchmarks as the Secretary may establish.
(B) *Limitation* — No grant shall be awarded under this subsection after January 1, 2015.
(5) **Technical assistance to facilitate participation in SHOP Exchanges** — The Secretary shall provide technical assistance to States to facilitate the participation of qualified small businesses in such States in SHOP Exchanges.
**(b) American Health Benefit Exchanges**
(1) **In general** — Each State shall, not later than January 1, 2014, establish an American Health Benefit Exchange (
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18031
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Federal law — U.S. Code and appendices · legal_authorities
**(a) No effect on antitrust laws** Nothing in this title 11 See References in Text note below. (or an amendment made by this title) 1 shall be construed to modify, impair, or supersede the operation of any of the antitrust laws. For the purposes of this section, the term “antitrust laws” has the meaning given such term in subsection (a) of [section 12 of title 15](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section12&num=0&edition=prelim), except that such term includes [section 45 of title 15](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section45&num=0&edition=prelim) to the extent that such section 45 applies to unfair methods of competition.
**(b) Rule of construction regarding Hawaii’s Prepaid Health Care Act** Nothing in this title 1 (or an amendment made by this title) 1 shall be construed to modify or limit the application of the exemption for Hawaii’s Prepaid Health Care Act (Haw. Rev. Stat. §§ 393–1 et seq.) as provided for under [section 1144(b)(5) of title 29](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1144/b/5&num=0&edition=prelim).
**(c) Student health insurance plans** Nothing in this title 1 (or an amendment made by this title) 1 shall be construed to prohibit an institution of higher education (as such term is defined for purposes of the Higher Education Act of 1965 [[20 U.S.C. 1001](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1001&num=0&edition=prelim) et seq.]) from offering a student health insurance plan, to the extent that such requirement is otherwise permitted under applicable Federal, State or local law.
**(d) No effect on existing requirements** Nothing in this title 1 (or an amendment made by this title,1 unless specified by di
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18118
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