SEC. 222. PREMIUMS AND FINANCING.

[a] Establishment of Premiums-

[1] IN GENERAL- The Secretary shall establish geographically-adjusted premium rates for the public health insurance option in a manner--

[A] that complies with the premium rules established by the Commissioner under section 113 for Exchange-participating health benefit plans; and

[B] at a level sufficient to fully finance the costs of--

[i] health benefits provided by the public health insurance option; and

[ii] administrative costs related to operating the public health insurance option.

[2] CONTINGENCY MARGIN- In establishing premium rates under paragraph [1], the Secretary shall include an appropriate amount for a contingency margin.

[b] Account-

[1] ESTABLISHMENT- There is established in the Treasury of the United States an Account for the receipts and disbursements attributable to the operation of the public health insurance option, including the start-up funding under paragraph [2]. Section- 1854[g] of the Social Security Act shall apply to receipts described in the previous sentence in the same manner as such section applies to payments or premiums described in such section.

[2] START-UP FUNDING-

[A] IN GENERAL- In order to provide for the establishment of the public health insurance option there is hereby appropriated to the Secretary, out of any funds in the Treasury not otherwise appropriated, $2,000,000,000. In order to provide for initial claims reserves before the collection of premiums, there is hereby appropriated to the Secretary, out of any funds in the Treasury not otherwise appropriated, such sums as necessary to cover 90 days worth of claims reserves based on projected enrollment.

[B] AMORTIZATION OF START-UP FUNDING- The Secretary shall provide for the repayment of the startup funding provided under subparagraph [A] to the Treasury in an amortized manner over the 10-year period beginning with Y1.

[C] LIMITATION ON FUNDING- Nothing in this section shall be construed as authorizing any additional appropriations to the Account, other than such amounts as are otherwise provided with respect to other Exchange-participating health benefits plans.