Page:United States Statutes at Large Volume 124.djvu/166

124 STAT. 140 PUBLIC LAW 111–148—MAR. 23, 2010 and consistent with the provisions of subsection (a)(2), shall monitor premium increases of health insurance coverage offered through an Exchange and outside of an Exchange. ‘‘(B) CONSIDERATION IN OPENING EXCHANGE.—In deter- mining under section 1312(f)(2)(B) of the Patient Protection and Affordable Care Act whether to offer qualified health plans in the large group market through an Exchange, the State shall take into account any excess of premium growth outside of the Exchange as compared to the rate of such growth inside the Exchange. ‘‘(c) GRANTS IN SUPPORT OF PROCESS.— ‘‘(1) PREMIUM REVIEW GRANTS DURING 2010 THROUGH 2014.— The Secretary shall carry out a program to award grants to States during the 5-year period beginning with fiscal year 2010 to assist such States in carrying out subsection (a), including— ‘‘(A) in reviewing and, if appropriate under State law, approving premium increases for health insurance cov- erage; and ‘‘(B) in providing information and recommendations to the Secretary under subsection (b)(1). ‘‘(2) FUNDING.— ‘‘(A) IN GENERAL.—Out of all funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary $250,000,000, to be available for expenditure for grants under paragraph (1) and subparagraph (B). ‘‘(B) FURTHER AVAILABILITY FOR INSURANCE REFORM AND CONSUMER PROTECTION.—If the amounts appropriated under subparagraph (A) are not fully obligated under grants under paragraph (1) by the end of fiscal year 2014, any remaining funds shall remain available to the Sec- retary for grants to States for planning and implementing the insurance reforms and consumer protections under part A. ‘‘(C) ALLOCATION.—The Secretary shall establish a for- mula for determining the amount of any grant to a State under this subsection. Under such formula— ‘‘(i) the Secretary shall consider the number of plans of health insurance coverage offered in each State and the population of the State; and ‘‘(ii) no State qualifying for a grant under para- graph (1) shall receive less than $1,000,000, or more than $5,000,000 for a grant year.’’. SEC. 1004. EFFECTIVE DATES. (a) IN GENERAL.—Except as provided for in subsection (b), this subtitle (and the amendments made by this subtitle) shall become effective for plan years beginning on or after the date that is 6 months after the date of enactment of this Act, except that the amendments made by sections 1002 and 1003 shall become effective for fiscal years beginning with fiscal year 2010. (b) SPECIAL RULE.—The amendments made by sections 1002 and 1003 shall take effect on the date of enactment of this Act. 42 USC 300gg–11 note.