Title I, SEC. 1223. SPECIAL RULES FOR STATES OPERATING STATEWIDE SINGLE-PAYER SYSTEM. (a) In General. In the case of a State operating a Statewide single-payer system (1) the State shall operate the system throughout the State through a single alliance; (2) except as provided in subsection (b), the State shall meet the requirements for participating States under part 1; and (3) the State shall assume the functions described in subsection (c) that are otherwise required to be performed by regional alliances in participating States that do not operate a Statewide single-payer system. (b) Exceptions to Certain Requirements for Participating States. In the case of a State operating a Statewide single-payer system, the State is not required to meet the following requirements otherwise applicable to participating States under part 1: (1) Establishment of alliances. The requirements of section 1202 (relating to the establishment of alliances). (2) Health plans. The requirements of section 1203 (relating to health plans), other than the requirement of subsection (f) of such section (relating to coordination of workers' compensation services and automobile liability insurance). (3) Financial solvency. The requirements of section 1204 (relating to the financial solvency of health plans in the State). (c) Assumption by State of Certain Requirements Applicable to Regional Alliances. A State operating a Statewide single-payer system shall be subject to the following requirements otherwise applicable to regional alliances in other participating States: (1) Enrollment; issuance of health security cards. The requirements of subsections (a) and (c) of section 1323 and section 1324 shall apply to the State, eligible individuals residing in the State, and the single-payer system operated by the State in the same manner as such requirements apply to a regional alliance, alliance eligible individuals, and regional alliance plans. (2) Reductions in cost sharing for low-income individuals. The requirement of section 1371 shall apply to the State in the same manner as such requirement applies to a regional alliance. (3) Data collection; quality. The requirements of section 1327(a) shall apply to the State and the single-payer system operated by the State in the same manner as such requirement applies to a regional alliance and health plans offered through a regional alliance. (4) Anti-discrimination; coordination. The requirements of section 1328 shall apply to the State in the same manner as such requirements apply with respect to a regional alliance. (d) Financing. (1) In general. A State operating a Statewide single-payer system shall provide for the financing of the system using, at least in part, a payroll-based financing system that requires employers to pay at least the amount that the employers would be required to pay if the employers were subject to the requirements of subtitle B of title VI. (2) Use of financing methods. Such a State may use, consistent with paragraph (1), any other method of financing. (e) Single-Payer State Defined. In this Act, the term ``single-payer State'' means a State with a Statewide single-payer system in effect that has been approved by the Board in accordance with this part.