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LegalText 42 U.S.C. § 18043 Funding for the territories us united_states_code code_section 42 THE PUBLIC HEALTH AND WELFARE 157 QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS 18043 42 U.S.C. § 18043 current 119-100 2026-06-26 official https://uscode.house.gov/download/releasepoints/us/pl/119/100/xml_usc42@119-100.zip /us/usc/t42/s18043 data/legal/raw/us/code/title-42/usc42.xml 57a69ed501b16c76f869aa2a8db7764d0233613e550b1e75a56383fb31750fb2 644321055a08eb1f260a6a3e31ac157fa024756abf612a9fd6857e7e400cf24e b56ad50cd11d23505ca8330a7f84e18e04bf9655815881dc15a811df9aceea52 2026-07-04 official
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42 U.S.C. § 18043 - Funding for the territories

Text

(a) In general A territory that—

(1) elects consistent with subsection (b) to establish an Exchange in accordance with part B of this subchapter and establishes such an Exchange in accordance with such part shall be treated as a State for purposes of such part and shall be entitled to payment from the amount allocated to the territory under subsection (c); or

(2) does not make such election shall be entitled to an increase in the dollar limitation applicable to the territory under subsections (f) and (g) of section 1108 of the Social Security Act (42 U.S.C. 1308) for such period in such amount for such territory and such increase shall not be taken into account in computing any other amount under such subsections.

(b) Terms and conditions An election under subsection (a)(1) shall—

(1) not be effective unless the election is consistent with section 18041 of this title and is received not later than October 1, 2013; and

(2) be contingent upon entering into an agreement between the territory and the Secretary that requires that—

(A) funds provided under the agreement shall be used only to provide premium and cost-sharing assistance to residents of the territory obtaining health insurance coverage through the Exchange; and

(B) the premium and cost-sharing assistance provided under such agreement shall be structured in such a manner so as to prevent any gap in assistance for individuals between the income level at which medical assistance is available through the territorys Medicaid plan under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] and the income level at which premium and cost-sharing assistance is available under the agreement.

(c) Appropriation and allocation (1) Appropriation Out of any funds in the Treasury not otherwise appropriated, there is appropriated for purposes of payment pursuant to subsection (a) $1,000,000,000, to be available during the period beginning with 2014 and ending with 2019.

(2) Allocation The Secretary shall allocate the amount appropriated under paragraph (1) among the territories for purposes of carrying out this section as follows:

(A) For Puerto Rico, $925,000,000.

(B) For another territory, the portion of $75,000,000 specified by the Secretary.

(Pub. L. 111148, title I, § 1323, as added Pub. L. 111152, title I, § 1204(a), Mar. 30, 2010, 124 Stat. 1055.)

Notes

Editorial Notes

References in TextThe Social Security Act, referred to in subsec. (b)(2)(B), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

Prior ProvisionsA prior section 18043, Pub. L. 111148, title I, § 1323, Mar. 23, 2010, 124 Stat. 192, which related to establishment of community health insurance option, was repealed by Pub. L. 111148, title X, § 10104(m), Mar. 23, 2010, 124 Stat. 902.