To amend the Patient Protection and Affordable Care Act to establish a public health insurance option.

Amends the Patient Protection and Affordable Care Act to require the Secretary of Health and Human Services (HHS) to offer through Exchanges a health benefits plan (public health insurance option) that ensures choice, competition, and stability of affordable, high-quality coverage throughout the United States. Declares that the Secretary's primary responsibility is to create a low-cost plan without compromising quality or access to care.

Sets forth provisions related to the establishment and governance of the public health insurance option, including that such plan: (1) may be made available only through Exchanges; (2) must comply with requirements applicable to other health benefits plans offered through such Exchanges, including requirements related to benefits, benefit levels, provider networks, notices, consumer protections, and cost sharing; and (3) must offer bronze, silver, and gold plan levels.

Requires the Secretary to: (1) establish an office of the ombudsman for the public health insurance option; (2) collect such data as may be required to establish premiums and payment rates; (3) establish geographically adjusted premiums at a level sufficient to fully finance the costs of the health benefits provided and administrative costs related to the operation of the plan; and (4) establish payment rates and provide for greater payment rates for the first three years.

Requires repayment of start-up costs for the public health insurance option.

Authorizes the Secretary to utilize innovative payment mechanisms and policies to determine payments for items and services under the public health insurance option.

Written by the nonpartisan Congressional Research Service. All summary versions on Congress.gov