; Roth HSA The terms Roth health savings account and Roth HSA mean a Roth HSA established under section 530A of the Internal Revenue Code of 1986. (16) Secretary The term Secretary means the Secretary of Health and Human Services. (17) State The term State means the 50 States and the District of Columbia. (18) Uninsured The term uninsured means, with respect to an individual, that the individual does not have creditable coverage. A Insurance market reform 101. Ending the one size fits all ACA approach; continuing consumer protection policies by covering adult children, protecting individuals with preexisting conditions, and not applying lifetime or annual limits (a) In general Subject to subsections (b) and (c), title I of the Patient Protection and Affordable Care Act (including the amendments made by such title) shall not apply (and the provisions of law amended by such title are restored as if such title had not been enacted) in the case of any State that does not have in effect the election described in section 102(a)(1). (b) Continuation of policies for extension of dependent coverage for adult children and prohibition of lifetime and annual coverage limits