; and (3) whether the Secretary conducted targeted outreach to specific demographic groups and geographic areas. 21048. GAO report Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a study that analyzes the costs and benefits of the establishment of State-administered health insurance plans to be offered in the insurance market of such States that choose to administer and offer such a plan. 21049. Report on the effects of website maintenance during open enrollment Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report examining whether the Department of Health and Human Services has been conducting maintenance on the website commonly referred to as Healthcare.gov during annual open enrollment periods (as described in section 1311(c)(6)(B) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(c)(6)(B) ) in such a manner so as to minimize any disruption to the use of such website resulting from such maintenance. 3 Budgetary Effects 21051. Determination of budgetary effects The budgetary effects of this subtitle, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled Budgetary Effects of PAYGO Legislation for this subtitle, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to the vote on passage. J Resident Physician Shortage Reduction 21101. Short title This subtitle may be cited as the Resident Physician Shortage Reduction Act of 2020 . 21102. Distribution of additional residency positions (a) In general Section 1886(h) of the Social Security Act ( 42 U.S.C. 1395ww(h) ) is amended— (1) in paragraph (4)(F)(i), by striking paragraphs (7) and (8) and inserting paragraphs (7), (8), and (9)