1. Short title This Act may be cited as the State Allowance for a Variety of Exchanges Act or the SAVE Act . 2. Preserving State option to implement health care marketplaces (a) In general Section 1311 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031 ) is amended— (1) in subsection (a)— (A) in paragraph (4)(B), by striking under this subsection and inserting under this paragraph or paragraph (1) ; and (B) by adding at the end the following new paragraph: (6) Additional planning and establishment grants (A) In general There shall be appropriated to the Secretary, out of any moneys in the Treasury not otherwise appropriated, $200,000,000 to award grants to eligible States for the uses described in paragraph (3). (B) Duration and renewability A grant awarded under subparagraph (A) shall be for a period of 2 years and may not be renewed. (C) Limitation A grant may not be awarded under subparagraph (A) after December 31, 2022. (D) Eligible State defined For purposes of this paragraph, the term eligible State means a State that, as of the date of the enactment of this paragraph, is not operating an Exchange. ; and (2) in subsection (d)(5)(A)— (A) by striking In establishing an Exchange under this section and inserting the following: (i) In general In establishing an Exchange under this section (other than in establishing an Exchange pursuant to subsection (a)(6))