Title VI, SEC. 6104. PREMIUM DISCOUNT BASED ON INCOME. 
      (a) In General. 

        (1) Enrollees in regional alliance health plans. Each family enrolled 
      with a regional alliance health plan is entitled to a premium discount 
      under this section, in the amount specified in subsection (b), if the 
      family 

          (A) is an AFDC or SSI family, 

          (B) is determined, under subpart B of part 2 of subtitle B of title D 
        of title I, to have family adjusted income below 150 percent of the 
        applicable poverty level, or 

          (C) is a family described in subsection (c)(3) for which the family 
        obligation amount under this subsection for the year would otherwise 
        exceed a specified percent of family adjusted income described in such 
        subsection. 

        (2) Enrollees in corporate alliance health plans. 

          (A) In general. Subject to subparagraph (B), each family enrolled 
        with a corporate alliance health plan in a class of family enrollment 
        by virtue of the full-time employment of a low-wage employee (as 
        defined in subparagraph (B)) is entitled to a premium discount under 
        this section in the amount (if any) by which 

            (i) 95 percent of the premium (specified in section 1364) for the 
          least expensive corporate alliance health plan that is offered to the 
          employee and that is a low or combination cost sharing plan (as 
          defined in section 1903( )) for that class, exceeds 

            (ii) the alliance credit under section 6103 for that class. 

          (B) Low-wage employee defined. 

            (i) In general. In this paragraph, the term ``low-wage employee'' 
          means, with respect to an employer, an employee who is employed on a 
          full-time basis and who is receiving wages (as defined in section 
          1902( )) for employment for the employer, as determined under clause 
          (ii), at an annual rate of less than $15,000 (as adjusted under 
          clause (ii)). 

            (ii) Indexing. For a year after 1994, the dollar amount specified 
          in clause (i) shall be increased or decreased by the same percentage 
          as the percentage increase or decrease by which the average CPI 
          (described in section 1902( )) for the 12-month-period ending with 
          August 31 of the preceding year exceeds such average for the 12-month 
          period ending with August 31, 1993. 

          (C) Timing of determination. 

            (i) In general. The determination of whether or not an employee is 
          a low-wage employee shall be made, in accordance with rules of the 
          Secretary of Labor, at the time of initial enrollment and shall also 
          be made at the time of each subsequent open enrollment period, on the 
          basis of the wages payable by the employer at that time. 

            (ii) Effective date. Such determination shall apply as of the 
          effective date of the initial enrollment, or, in the case of an open 
          enrollment period, as of the effective date of changes in enrollment 
          during such period. 

        (3) No liability for indians and certain veterans and military 
      personnel. 

          (A) In general. In the case of an individual described in 
        subparagraph (B), because the applicable health plan does not impose 
        any premium for such an individual, the individual is not eligible for 
        any premium discount under this section. 

          (B) Individuals described. An individual described in this 
        subparagraph is 

            (i) an electing veteran (as defined in section 1012(d)(1)) who is 
          enrolled under a health plan of the Department of Veterans Affairs 
          and who, under the laws and rules as in effect as of December 31, 
          1994, has a service-connected disability or who is unable to defray 
          the expenses of necessary care as determined under section 1722(a) of 
          title 38, United States Code, 

            (ii) active duty military personnel (as defined in section 
          1012(d)(2)), and 

            (iii) an electing Indian (described in section 1012(d)(3)). 

      (b) Amount of Premium Discount for Regional Alliance Health Plans. 

        (1) In general. Subject to the succeeding paragraphs of this 
      subsection, the amount of premium discount under this subsection for a 
      family enrolled in a regional alliance health plan under a class of 
      family enrollment is equal to 

          (A) 20 percent of the weighted average premium for regional alliance 
        health plans offered by the regional alliance for that class of 
        enrollment, increased by any amount provided under paragraph (2); 
        reduced (but not below zero) by 

          (B) the sum of 

            (i) the family obligation amount described in subsection (c), and 

            (ii) the amount of any employer payment (not required under part 2) 
          towards the family share of premiums for covered members of the 
          family. 

        (2) Increase to assure enrollment in lower-than-average-cost plan. If a 
      regional alliance determines that a family eligible for a discount under 
      this section is unable to enroll in a lower-than-average-cost plan (as 
      defined in paragraph (3)) that serves the area in which the family 
      resides, the amount of the premium discount under this subsection is 
      increased but only to such amount as will permit the family to enroll in 
      a regional alliance health plan without the need to pay a family share of 
      premium under this part in excess of the sum described in paragraph 
      (1)(B). 

        (3) Lower-than-average-cost plan defined. In this section, the term 
      ``lower-than-average-cost plan'' means a regional alliance health plan 
      the premium for which does not exceed, for the class of family enrollment 
      involved, the weighted average premium for the regional alliance. 

      (c) Family Obligation Amount. 

        (1) Determination. Subject to paragraphs (2) and (3), the family 
      obligation amount under this subsection is determined as follows: 

          (A) No obligation if income below income threshold amount or if afdc 
        or ssi family. If the family adjusted income (as determined under 
        section 1332(a)) of the family is less than the income threshold amount 
        (specified in paragraph (4)) or if the family is an AFDC or SSI family, 
        the family obligation amount is zero. 

          (B) Income above income threshold amount. If such income is at least 
        such income threshold amount and the family is not an AFDC or SSI 
        family, the family obligation amount is the sum of the following: 

            (i) For income (above income threshold amount) up to the poverty 
          level. The product of the initial marginal rate (specified in 
          paragraph (2)(A)) and the amount by which 

          (I) the family adjusted income (not including any portion that 
        exceeds the applicable poverty level for the class of family involved), 
        exceeds 

          (II) such income threshold amount. 

            (ii) Graduated phase out of discount up to 150 percent of poverty 
          level. The product of the final marginal rate (specified in paragraph 
          (2)(B)) and the amount by which the family adjusted income exceeds 
          100 percent (but is less than 150 percent) of the applicable poverty 
          level. 

        (2) Marginal rates. In paragraph (1) 

          (A) Individual marginal rates. For a year for an individual class of 
        enrollment 

            (i) Initial marginal rate. The initial marginal rate is the ratio 
          of 

          (I) 3 percent of the applicable poverty level for the individual 
        class of enrollment for the year, to 

          (II) the amount by which such poverty level exceeds such income 
        threshold amount. 

            (ii) Final marginal rate. The final marginal rate is the ratio of 

          (I) the amount by which the general family share (as defined in 
        subparagraph (C)) for an individual class of enrollment exceeds 3 
        percent of the applicable poverty level (for an individual class of 
        enrollment for the year); to 

            (ii) 50 percent of such poverty level. 

          (B) Family marginal rates. For a year for a family class of 
        enrollment (as defined in section 1011(c)(2)(A)) 

            (i) Initial marginal rate. The initial marginal rate is the ratio 
          of 

          (I) 3 percent of the applicable poverty level for a dual parent class 
        of enrollment for the year, to 

          (II) the amount by which such poverty level exceeds such income 
        threshold amount. 

            (ii) Final marginal rate. The final marginal rate is the ratio of 

          (I) the amount by which the general family share (as defined in 
        subparagraph (C)) for a dual parent class of enrollment exceeds 3 
        percent of the applicable poverty level (for such a class for the 
        year); to 

            (ii) 50 percent of such poverty level. 

          (C) General family share. In subparagraphs (A) and (B), the term 
        ``general family share'' means, for a class, the weighted average 
        premium for the class minus the alliance credit (determined without 
        regard to this section). 

        (3) Limitation to 3.9 percent for all families. 

          (A) In general. In the case of a family with family adjusted income 
        of less than $40,000 (adjusted under subparagraph (B)) for a year, in 
        no case shall the family obligation amount under this subsection for 
        the year exceed 3.9 percent (adjusted under subparagraph (C)) of the 
        amount of such adjusted income. 

          (B) Indexing of dollar amounts. 

            (i) In general. For a year after 1994, the dollar amounts specified 
          in subparagraph (A) and in section 6113(d)(1)(B) shall be increased 
          or decreased by the same percentage as the percentage increase or 
          decrease by which the average CPI (described in section 1902( )) for 
          the 12-month-period ending with August 31 of the preceding year 
          exceeds such average for the 12-month period ending with August 31, 
          1993. 

            (ii) Rounding. The dollar amounts adjusted under this subparagraph 
          shall be rounded each year to the nearest multiple of $100. 

          (C) Indexing of percentage. 

            (i) In general. The percentage specified in subparagraph (A) shall 
          be adjusted for any year after 1994 so that the percentage for the 
          year bears the same ratio to the percentage so specified as the ratio 
          of 

          (I) 1 plus general health care inflation factor (as defined in 
        section 6001(a)(3)) for the year, bears to 

          (II) 1 plus the percentage increase or decrease specified in section 
        1136(b) (relating to indexing of dollar amounts related to cost 
        sharing) for the year. 

            (ii) Rounding. Any adjustment under clause (i) for a year shall be 
          rounded to the nearest multiple of \1/10\ of 1 percentage point. 

        (4) Income threshold amount. 

          (A) In general. For purposes of this subtitle, the income threshold 
        amount specified in this paragraph is $1,000 (adjusted under 
        subparagraph (B)) . 

          (B) Indexing. For a year after 1994, the income threshold amount 
        specified in subparagraph (A) shall be increased or decreased by the 
        same percentage as the percentage increase or decrease by which the 
        average CPI (described in section 1902( )) for the 12-month-period 
        ending with August 31 of the preceding year exceeds such average for 
        the 12-month period ending with August 31, 1993. 

          (C) Rounding. Any increase or decrease under subparagraph (B) for a 
        year shall be rounded to the nearest multiple of $10.