In the House of Representatives, U. S., January 18, 2018.

Resolved, That the House agree to the amendment of the

Senate to the bill (H.R. 195) entitled ‘‘An Act to amend title

44, United States Code, to restrict the distribution of free

printed copies of the Federal Register to Members of Con-

gress and other officers and employees of the United States,

and for other purposes.’’, with the following

HOUSE AMENDMENT TO SENATE AMENDMENT:

In lieu of the matter proposed to be inserted by the

amendment of the Senate, insert the following:

DIVISION B—EXTENSION OF CONTINUING 1

APPROPRIATIONS ACT, 2018 2

SEC. 2001. The Continuing Appropriations Act, 2018 3

(division D of Public Law 115–56) is amended— 4

(1) by striking the date specified in section 5

106(3) and inserting ‘‘February 16, 2018’’; and 6

(2) by adding after section 147 the following: 7

‘‘SEC. 148. Funds appropriated by the Department of 8

Defense Missile Defeat and Defense Enhancements Appro-9

priations Act, 2018 (division B of Public Law 115–96) may 10

be obligated and expended notwithstanding section 11

504(a)(1) of the National Security Act of 1947 (50 U.S.C. 12

3094(a)(1)). 13

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‘‘SEC. 149. Amounts made available by section 101 for 1

‘Department of Agriculture—Food and Nutrition Service— 2

Child Nutrition Programs’ to carry out section 749(g) of 3

the Agriculture Appropriations Act of 2010 (Public Law 4

111–80) may be apportioned up to the rate for operations 5

necessary to ensure that the program can be fully oper-6

ational by May 2018. 7

‘‘SEC. 150. Amounts made available by section 101 for 8

‘National Aeronautics and Space Administration—Explo-9

ration’ may be apportioned up to the rate for operations 10

necessary to maintain the planned launch capability sched-11

ules for the Space Launch System launch vehicle, Explo-12

ration Ground Systems, and Orion Multi-Purpose Crew Ve-13

hicle programs. 14

‘‘SEC. 151. Amounts made available by section 101 for 15

‘Department of Energy—Energy Programs—Office of the 16

Inspector General’ may be apportioned up to the rate for 17

operations necessary to sustain staffing levels achieved on 18

June 30, 2017. 19

‘‘SEC. 152. Amounts made available by section 101 for 20

‘Small Business Administration—Business Loans Program 21

Account’ may be apportioned up to the rate for operations 22

necessary to accommodate increased demand for commit-23

ments for general business loans authorized under section 24

7(a) of the Small Business Act (15 U.S.C. 636(a)). 25

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‘‘SEC. 153. For 2018, the Secretary of Housing and 1

Urban Development may make temporary adjustments to 2

the Section 8 housing choice voucher annual renewal fund-3

ing allocations and administrative fee eligibility deter-4

minations for public housing agencies in an area for which 5

the President declared a disaster in 2017 or 2018 under 6

title IV of the Robert T. Stafford Disaster Relief and Emer-7

gency Assistance Act (42 U.S.C. 5170 et seq.), to avoid sig-8

nificant adverse funding impacts that would otherwise re-9

sult from the disaster and that would otherwise prevent a 10

public housing agency from leasing up to its authorized 11

level of units under contract (but not to exceed such level), 12

upon request by and in consultation with a public housing 13

agency and supported by documentation as required by the 14

Secretary that demonstrates the need for the adjustment.’’. 15

SEC. 2002. The Further Additional Continuing Appro-16

priations Act, 2018 (division A of Public Law 115–96) is 17

amended by striking section 1002. 18

This division may be cited as the ‘‘Extension of Con-19

tinuing Appropriations Act, 2018’’. 20

DIVISION C—HEALTHY KIDS ACT 21

SEC. 3001. SHORT TITLE. 22

This division may be cited as the ‘‘Helping Ensure 23

Access for Little Ones, Toddlers, and Hopeful Youth by 24

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Keeping Insurance Delivery Stable Act’’ or the 1

‘‘HEALTHY KIDS Act’’. 2

SEC. 3002. SIX-YEAR FUNDING EXTENSION OF THE CHIL-3

DREN’S HEALTH INSURANCE PROGRAM. 4

(a) FUNDING.— 5

(1) IN GENERAL.—Section 2104(a) of the Social 6

Security Act (42 U.S.C. 1397dd(a)), as amended by 7

section 3201(a) of the CHIP and Public Health 8

Funding Extension Act (division C of Public Law 9

115–96), is amended— 10

(A) in paragraph (20)(B), by striking ‘‘; 11

and’’ and inserting a semicolon; 12

(B) by striking paragraph (21) and insert-13

ing the following new paragraphs: 14

‘‘(21) for fiscal year 2018, $21,500,000,000; 15

‘‘(22) for fiscal year 2019, $22,600,000,000; 16

‘‘(23) for fiscal year 2020, $23,700,000,000; 17

‘‘(24) for fiscal year 2021, $24,800,000,000; 18

‘‘(25) for fiscal year 2022, $25,900,000,000; and 19

‘‘(26) for fiscal year 2023, for purposes of mak-20

ing two semi-annual allotments— 21

‘‘(A) $2,850,000,000 for the period begin-22

ning on October 1, 2022, and ending on March 23

31, 2023; and 24

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‘‘(B) $2,850,000,000 for the period begin-1

ning on April 1, 2023, and ending on September 2

30, 2023.’’. 3

(2) PREVENTION OF DUPLICATE APPROPRIATIONS 4

FOR FISCAL YEAR 2018.—Notwithstanding any other 5

provision of law, insofar as funds have been appro-6

priated under subsection (a)(21) of section 2104 of the 7

Social Security Act (42 U.S.C. 1397dd), as such sub-8

section is in effect on the day before the date of the 9

enactment of this Act, to provide allotments to States 10

under the State Children’s Health Insurance Program 11

established under title XXI of the Social Security Act 12

(42 U.S.C. 1397aa et seq.) (whether implemented 13

under title XIX, XXI, or both, of the Social Security 14

Act) for fiscal year 2018— 15

(A) any amounts that are so appropriated 16

that are not so allotted and obligated before the 17

date of the enactment of this Act, are rescinded; 18

and 19

(B) any amount provided for CHIP allot-20

ments to a State under this section (and the 21

amendments made by this section) for such fiscal 22

year shall be reduced by the amount of such ap-23

propriations so allotted and obligated before such 24

date. 25

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(b) ALLOTMENTS.— 1

(1) IN GENERAL.—Section 2104(m) of the Social 2

Security Act (42 U.S.C. 1397dd(m)), as amended by 3

section 3201(b) of the CHIP and Public Health Fund-4

ing Extension Act (division C of Public Law 115–96), 5

is amended— 6

(A) in paragraph (2)(B)— 7

(i) in the matter preceding clause (i), 8

by striking ‘‘(19)’’ and inserting ‘‘(25)’’; 9

(ii) in clause (i), by striking ‘‘and 10

2017’’ and inserting ‘‘, 2017, and 2023’’; 11

and 12

(iii) in clause (ii)— 13

(I) in the matter preceding sub-14

clause (I), by striking ‘‘and paragraph 15

(10)’’; and 16

(II) in subclause (I), by inserting 17

‘‘(or, in the case of fiscal year 2018, 18

under paragraph (4))’’ after ‘‘clause 19

(i)’’; 20

(B) in paragraph (5), by striking ‘‘2018’’ 21

and inserting ‘‘2023’’; 22

(C) in paragraph (7)— 23

(i) in subparagraph (A), by striking 24

‘‘2017’’ and inserting ‘‘2023’’; 25

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(ii) in subparagraph (B), in the mat-1

ter preceding clause (i), by inserting ‘‘(or, 2

in the case of fiscal year 2018, by not later 3

than the date that is 60 days after the date 4

of the enactment of the HEALTHY KIDS 5

Act)’’ after ‘‘before the August 31 preceding 6

the beginning of the fiscal year’’; and 7

(iii) in the matter following subpara-8

graph (B), by striking ‘‘or fiscal year 2016’’ 9

and inserting ‘‘fiscal year 2016, fiscal year 10

2018, fiscal year 2020, or fiscal year 2022’’; 11

(D) in paragraph (9), by striking ‘‘2018’’ 12

and inserting ‘‘2023’’; and 13

(E) by amending paragraph (10) to read as 14

follows: 15

‘‘(10) FOR FISCAL YEAR 2023.— 16

‘‘(A) FIRST HALF.—Subject to paragraphs 17

(5) and (7), from the amount made available 18

under subparagraph (A) of paragraph (26) of 19

subsection (a) for the semi-annual period de-20

scribed in such subparagraph, increased by the 21

amount of the appropriation for such period 22

under section 3002(b)(2) of the HEALTHY 23

KIDS Act, the Secretary shall compute a State 24

allotment for each State (including the District 25

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of Columbia and each commonwealth and terri-1

tory) for such semi-annual period in an amount 2

equal to the first half ratio (described in sub-3

paragraph (D)) of the amount described in sub-4

paragraph (C). 5

‘‘(B) SECOND HALF.—Subject to para-6

graphs (5) and (7), from the amount made 7

available under subparagraph (B) of paragraph 8

(26) of subsection (a) for the semi-annual period 9

described in such subparagraph, the Secretary 10

shall compute a State allotment for each State 11

(including the District of Columbia and each 12

commonwealth and territory) for such semi-an-13

nual period in an amount equal to the amount 14

made available under such subparagraph, multi-15

plied by the ratio of— 16

‘‘(i) the amount of the allotment to 17

such State under subparagraph (A); to 18

‘‘(ii) the total of the amount of all of 19

the allotments made available under such 20

subparagraph. 21

‘‘(C) FULL YEAR AMOUNT BASED ON 22

REBASED AMOUNT.—The amount described in 23

this subparagraph for a State is equal to the 24

Federal payments to the State that are attrib-25

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•HR 195 EAH

utable to (and countable towards) the total 1

amount of allotments available under this section 2

to the State in fiscal year 2022 (including pay-3

ments made to the State under subsection (n) for 4

fiscal year 2022 as well as amounts redistributed 5

to the State in fiscal year 2022), multiplied by 6

the allotment increase factor under paragraph 7

(6) for fiscal year 2023. 8

‘‘(D) FIRST HALF RATIO.—The first half 9

ratio described in this subparagraph is the ratio 10

of— 11

‘‘(i) the sum of— 12

‘‘(I) the amount made available 13

under subsection (a)(26)(A); and 14

‘‘(II) the amount of the appro-15

priation for such period under section 16

3002(b)(2) of the HEALTHY KIDS 17

Act; to 18

‘‘(ii) the sum of— 19

‘‘(I) the amount described in 20

clause (i); and 21

‘‘(II) the amount made available 22

under subsection (a)(26)(B).’’. 23

(2) ONE-TIME APPROPRIATION FOR FISCAL YEAR 24

2023.—There is appropriated to the Secretary of 25

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•HR 195 EAH

Health and Human Services, out of any money in the 1

Treasury not otherwise appropriated, $20,200,000,000 2

to accompany the allotment made for the period be-3

ginning on October 1, 2022, and ending on March 31, 4

2023, under paragraph (26)(A) of section 2104(a) of 5

the Social Security Act (42 U.S.C. 1397dd(a)) (as 6

added by subsection (a)), to remain available until 7

expended. Such amount shall be used to provide allot-8

ments to States under paragraph (10) of section 9

2104(m) of such Act (as added by paragraph (1)) for 10

the first 6 months of fiscal year 2023 in the same 11

manner as allotments are provided under subsection 12

(a)(26)(A) of such section 2104 and subject to the 13

same terms and conditions as apply to the allotments 14

provided from such subsection (a)(26)(A). 15

(c) EXTENSION OF THE CHILD ENROLLMENT CONTIN-16

GENCY FUND.—Section 2104(n) of the Social Security Act 17

(42 U.S.C. 1397dd(n)) is amended— 18

(1) in paragraph (2)— 19

(A) in subparagraph (A)(ii)— 20

(i) by striking ‘‘2010, 2011, 2012, 21

2013, 2014, and 2016’’ and inserting ‘‘2010 22

through 2014, 2016, and 2018 through 23

2022’’; and 24

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•HR 195 EAH

(ii) by striking ‘‘fiscal year 2015 and 1

fiscal year 2017’’ and inserting ‘‘fiscal 2

years 2015, 2017, and 2023’’; and 3

(B) in subparagraph (B)— 4

(i) by striking ‘‘2010, 2011, 2012, 5

2013, 2014, and 2016’’ and inserting ‘‘2010 6

through 2014, 2016, and 2018 through 7

2022’’; and 8

(ii) by striking ‘‘fiscal year 2015 and 9

fiscal year 2017’’ and inserting ‘‘fiscal 10

years 2015, 2017, and 2023’’; and 11

(2) in paragraph (3)(A), in the matter preceding 12

clause (i), by striking ‘‘or a semi-annual allotment 13

period for fiscal year 2015 or 2017’’ and inserting 14

‘‘or in any of fiscal years 2018 through 2022 (or a 15

semi-annual allotment period for fiscal year 2015, 16

2017, or 2023)’’. 17

(d) EXTENSION OF QUALIFYING STATES OPTION.— 18

(1) IN GENERAL.—Section 2105(g)(4) of the So-19

cial Security Act (42 U.S.C. 1397ee(g)(4)) is amend-20

ed— 21

(A) in the heading, by striking ‘‘THROUGH 22

2017’’ and inserting ‘‘THROUGH 2023’’; and 23

(B) in subparagraph (A), by striking 24

‘‘2017’’ and inserting ‘‘2023’’. 25

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(2) TECHNICAL AMENDMENTS.—Section 1

2104(f)(2)(B)(ii) of the Social Security Act (42 2

U.S.C. 1397dd(f)(2)(B)(ii)), as amended by section 3

3201(c) of the CHIP and Public Health Funding Ex-4

tension Act (division C of Public Law 115–96), is 5

amended— 6

(A) in subclause (I), by striking ‘‘for the 7

month (as defined in subclause (II))’’ and insert-8

ing ‘‘(as defined in subclause (II)) for the 9

month’’; 10

(B) in subclause (II), by inserting ‘‘, as in 11

effect on the day before the date of the enactment 12

of the HEALTHY KIDS Act,’’ after ‘‘section 13

2105(g)(4)(A)’’; and 14

(C) in subclause (VI)— 15

(i) by inserting ‘‘, as in effect on the 16

day before the date of the enactment of the 17

HEALTHY KIDS Act’’ after ‘‘, section 18

2105(g)(4)’’; and 19

(ii) by inserting ‘‘, as so in effect’’ 20

after ‘‘under section 2105(g)(4)’’. 21

(e) EXTENSION OF EXPRESS LANE ELIGIBILITY OP-22

TION.—Section 1902(e)(13)(I) of the Social Security Act 23

(42 U.S.C. 1396a(e)(13)(I)) is amended by striking ‘‘2017’’ 24

and inserting ‘‘2023’’. 25

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(f) ASSURANCE OF AFFORDABILITY STANDARD FOR 1

CHILDREN AND FAMILIES.— 2

(1) IN GENERAL.—Section 2105(d)(3) of the So-3

cial Security Act (42 U.S.C. 1397ee(d)(3)) is amend-4

ed— 5

(A) in the paragraph heading, by striking 6

‘‘UNTIL OCTOBER 1, 2019’’ and inserting 7

‘‘THROUGH SEPTEMBER 30, 2023’’; and 8

(B) in subparagraph (A), in the matter pre-9

ceding clause (i)— 10

(i) by striking ‘‘2019’’ and inserting 11

‘‘2023’’; and 12

(ii) by striking ‘‘The preceding sen-13

tence shall not be construed as preventing a 14

State during such period’’ and inserting 15

‘‘During the period that begins on October 16

1, 2019, and ends on September 30, 2023, 17

the preceding sentence shall only apply with 18

respect to children in families whose income 19

does not exceed 300 percent of the poverty 20

line (as defined in section 2110(c)(5)) ap-21

plicable to a family of the size involved. The 22

preceding sentences shall not be construed as 23

preventing a State during any such peri-24

ods’’. 25

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(2) CONFORMING AMENDMENTS.—Section 1

1902(gg)(2) of the Social Security Act (42 U.S.C. 2

1396a(gg)(2)) is amended— 3

(A) in the paragraph heading, by striking 4

‘‘UNTIL OCTOBER 1, 2019’’ and inserting 5

‘‘THROUGH SEPTEMBER 30, 2023’’; and 6

(B) by striking ‘‘September 30, 2019,’’ and 7

inserting ‘‘September 30, 2023 (but during the 8

period that begins on October 1, 2019, and ends 9

on September 30, 2023, only with respect to chil-10

dren in families whose income does not exceed 11

300 percent of the poverty line (as defined in sec-12

tion 2110(c)(5)) applicable to a family of the 13

size involved)’’. 14

(g) CHIP LOOK-ALIKE PLANS.— 15

(1) BLENDING RISK POOLS.—Section 2107 of the 16

Social Security Act (42 U.S.C. 1397gg) is amended 17

by adding at the end the following: 18

‘‘(g) USE OF BLENDED RISK POOLS.— 19

‘‘(1) IN GENERAL.—Nothing in this title (or any 20

other provision of Federal law) shall be construed as 21

preventing a State from considering children enrolled 22

in a qualified CHIP look-alike program and children 23

enrolled in a State child health plan under this title 24

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•HR 195 EAH

(or a waiver of such plan) as members of a single risk 1

pool. 2

‘‘(2) QUALIFIED CHIP LOOK-ALIKE PROGRAM.— 3

In this subsection, the term ‘qualified CHIP look-alike 4

program’ means a State program— 5

‘‘(A) under which children who are under 6

the age of 19 and are not eligible to receive med-7

ical assistance under title XIX or child health 8

assistance under this title may purchase coverage 9

through the State that provides benefits that are 10

at least identical to the benefits provided under 11

the State child health plan under this title (or a 12

waiver of such plan); and 13

‘‘(B) that is funded exclusively through non- 14

Federal funds, including funds received by the 15

State in the form of premiums for the purchase 16

of such coverage.’’. 17

(2) COVERAGE RULE.— 18

(A) IN GENERAL.—Section 5000A(f)(1) of 19

the Internal Revenue Code of 1986 is amended in 20

subparagraph (A)(iii), by inserting ‘‘or under a 21

qualified CHIP look-alike program (as defined 22

in section 2107(g) of the Social Security Act)’’ 23

before the comma at the end. 24

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(B) EFFECTIVE DATE.—The amendment 1

made by subparagraph (A) shall apply with re-2

spect to taxable years beginning after December 3

31, 2017. 4

(h) AVAILABILITY OF UNUSED FISCAL YEAR 2018 RE-5

DISTRIBUTION AMOUNTS.—Any amounts that have been re-6

distributed to States under subsection (f) of section 2104 7

of the Social Security Act (42 U.S.C. 1397dd) for fiscal year 8

2018 that are not, or will not be, expended by the end of 9

that fiscal year shall be— 10

(1) adjusted by the Secretary before the end of 11

fiscal year 2018 to reflect an updated estimate of 12

shortfalls under subsection (f)(2)(A) of such section; 13

and 14

(2) available for redistribution under subsection 15

(f) of such section for subsequent fiscal years. 16

SEC. 3003. EXTENSION OF CERTAIN PROGRAMS AND DEM-17

ONSTRATION PROJECTS. 18

(a) CHILDHOOD OBESITY DEMONSTRATION 19

PROJECT.—Section 1139A(e)(8) of the Social Security Act 20

(42 U.S.C. 1320b–9a(e)(8)) is amended— 21

(1) by striking ‘‘and $10,000,000’’ and inserting 22

‘‘, $10,000,000’’; and 23

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(2) by inserting after ‘‘2017’’ the following: ‘‘, 1

and $30,000,000 for the period of fiscal years 2018 2

through 2023’’. 3

(b) PEDIATRIC QUALITY MEASURES PROGRAM.—Sec-4

tion 1139A(i) of the Social Security Act (42 U.S.C. 1320b– 5

9a(i)) is amended— 6

(1) by striking ‘‘Out of any’’ and inserting the 7

following: 8

‘‘(1) IN GENERAL.—Out of any’’; 9

(2) by striking ‘‘there is appropriated for each’’ 10

and inserting ‘‘there is appropriated— 11

‘‘(A) for each’’; 12

(3) by striking ‘‘, and there is appropriated for 13

the period’’ and inserting ‘‘; 14

‘‘(B) for the period’’; 15

(4) by striking ‘‘. Funds appropriated under this 16

subsection shall remain available until expended.’’ 17

and inserting ‘‘; and’’; and 18

(5) by adding at the end the following: 19

‘‘(C) for the period of fiscal years 2018 20

through 2023, $90,000,000 for the purpose of 21

carrying out this section (other than subsections 22

(e), (f), and (g)). 23

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‘‘(2) AVAILABILITY.—Funds appropriated under 1

this subsection shall remain available until ex-2

pended.’’. 3

SEC. 3004. EXTENSION OF OUTREACH AND ENROLLMENT 4

PROGRAM. 5

(a) IN GENERAL.—Section 2113 of the Social Security 6

Act (42 U.S.C. 1397mm) is amended— 7

(1) in subsection (a)(1), by striking ‘‘2017’’ and 8

inserting ‘‘2023’’; and 9

(2) in subsection (g)— 10

(A) by striking ‘‘and $40,000,000’’ and in-11

serting ‘‘, $40,000,000’’; and 12

(B) by inserting after ‘‘2017’’ the following: 13

‘‘, and $120,000,000 for the period of fiscal years 14

2018 through 2023’’. 15

(b) MAKING ORGANIZATIONS THAT USE PARENT MEN-16

TORS ELIGIBLE TO RECEIVE GRANTS.—Section 2113(f) of 17

the Social Security Act (42 U.S.C. 1397mm(f)) is amend-18

ed— 19

(1) in paragraph (1)(E), by striking ‘‘or commu-20

nity-based doula programs’’ and inserting ‘‘, commu-21

nity-based doula programs, or parent mentors’’; and 22

(2) by adding at the end the following new para-23

graph: 24

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‘‘(5) PARENT MENTOR.—The term ‘parent men-1

tor’ means an individual who— 2

‘‘(A) is a parent or guardian of at least one 3

child who is an eligible child under this title or 4

title XIX; and 5

‘‘(B) is trained to assist families with chil-6

dren who have no health insurance coverage with 7

respect to improving the social determinants of 8

the health of such children, including by pro-9

viding— 10

‘‘(i) education about health insurance 11

coverage, including, with respect to obtain-12

ing such coverage, eligibility criteria and 13

application and renewal processes; 14

‘‘(ii) assistance with completing and 15

submitting applications for health insur-16

ance coverage; 17

‘‘(iii) a liaison between families and 18

representatives of State plans under title 19

XIX or State child health plans under this 20

title; 21

‘‘(iv) guidance on identifying medical 22

and dental homes and community phar-23

macies for children; and 24

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‘‘(v) assistance and referrals to success-1

fully address social determinants of chil-2

dren’s health, including poverty, food insuf-3

ficiency, and housing.’’. 4

(c) EXCLUSION FROM MODIFIED ADJUSTED GROSS 5

INCOME.—Section 1902(e) of the Social Security Act (42 6

U.S.C. 1396a(e)) is amended— 7

(1) in the first paragraph (14), relating to in-8

come determined using modified adjusted gross in-9

come, by adding at the end the following new sub-10

paragraph: 11

‘‘(J) EXCLUSION OF PARENT MENTOR COM-12

PENSATION FROM INCOME DETERMINATION.— 13

Any nominal amount received by an individual 14

as compensation, including a stipend, for par-15

ticipation as a parent mentor (as defined in 16

paragraph (5) of section 2113(f)) in an activity 17

or program funded through a grant under such 18

section shall be disregarded for purposes of deter-19

mining the income eligibility of such individual 20

for medical assistance under the State plan or 21

any waiver of such plan.’’; and 22

(2) by striking ‘‘(14) EXCLUSION’’ and inserting 23

‘‘(15) EXCLUSION’’. 24

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SEC. 3005. EXTENSION AND REDUCTION OF ADDITIONAL 1

FEDERAL FINANCIAL PARTICIPATION FOR 2

CHIP. 3

Section 2105(b) of the Social Security Act (42 U.S.C. 4

1397ee(b)) is amended in the second sentence by inserting 5

‘‘and during the period that begins on October 1, 2019, and 6

ends on September 30, 2020, the enhanced FMAP deter-7

mined for a State for a fiscal year (or for any portion of 8

a fiscal year occurring during such period) shall be in-9

creased by 11.5 percentage points’’ after ‘‘23 percentage 10

points,’’. 11

SEC. 3006. MEDICAID IMPROVEMENT FUND. 12

Section 1941 of the Social Security Act (42 U.S.C. 13

1396w–1) is amended— 14

(1) in subsection (a), in the first sentence, by in-15

serting before the period at the end the following: ‘‘, 16

and, in accordance with subsection (b)(3), for the pur-17

poses of subparagraph (B) of such subsection’’; and 18

(2) in subsection (b)— 19

(A) in paragraph (2)— 20

(i) in the first sentence, by inserting 21

‘‘pursuant to paragraph (1)’’ after ‘‘in the 22

Fund’’; 23

(ii) by inserting after the first sentence 24

the following sentence: ‘‘Amounts in the 25

Fund pursuant to paragraph (3) shall be 26

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•HR 195 EAH

available in advance of appropriations but 1

only if the total amount obligated from the 2

Fund does not exceed the amount available 3

to the Fund under such paragraph (3).’’; 4

and 5

(iii) in the last sentence, by striking 6

‘‘sentence’’ and inserting ‘‘sentences’’; and 7

(B) by adding at the end the following new 8

paragraph: 9

‘‘(3) ADDITIONAL FUNDING FOR STATE ACTIVI-10

TIES RELATING TO MECHANIZED CLAIMS SYSTEMS.— 11

‘‘(A) IN GENERAL.—In addition to the 12

amount made available under paragraph (1), 13

there shall be available to the Fund, for expendi-14

tures from the Fund in accordance with sub-15

paragraph (B), for fiscal year 2023 and there-16

after, $980,000,000, to remain available until ex-17

pended. 18

‘‘(B) PURPOSES.—The Secretary shall use 19

amounts made available to the Fund under sub-20

paragraph (A) to pay to each State which has 21

a plan approved under this title, for each quar-22

ter beginning during or after fiscal year 2023 an 23

amount equal to— 24

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‘‘(i) 100 percent minus the percent 1

specified in clause (i) of section 2

1903(a)(3)(A) of so much of the sums ex-3

pended by the State during such quarter as 4

are attributable to the activities described in 5

such clause; 6

‘‘(ii) 100 percent minus the Federal 7

medical assistance percentage applied under 8

clause (iii) of such section of so much of the 9

sums expended during such quarter (as 10

found necessary by the Secretary under such 11

clause) by the State as are attributable to 12

the activities described in such clause; and 13

‘‘(iii) 100 percent minus the percent 14

specified in section 1903(a)(3)(B) of so 15

much of the sums expended by the State 16

during such quarter as are attributable to 17

the activities described in such section.’’. 18

24

•HR 195 EAH

DIVISION D—SUSPENSION OF 1

CERTAIN HEALTH-RELATED 2

TAXES 3

SEC. 4001. EXTENSION OF MORATORIUM ON MEDICAL DE-4

VICE EXCISE TAX. 5

(a) IN GENERAL.—Section 4191(c) of the Internal 6

Revenue Code of 1986 is amended by striking ‘‘December 7

31, 2017’’ and inserting ‘‘December 31, 2019’’. 8

(b) EFFECTIVE DATE.—The amendment made by this 9

section shall apply to sales after December 31, 2017. 10

SEC. 4002. DELAY IN IMPLEMENTATION OF EXCISE TAX ON 11

HIGH COST EMPLOYER-SPONSORED HEALTH 12

COVERAGE. 13

Section 9001(c) of the Patient Protection and Afford-14

able Care Act is amended by striking ‘‘December 31, 2019’’ 15

and inserting ‘‘December 31, 2021’’. 16

SEC. 4003. SUSPENSION OF ANNUAL FEE ON HEALTH IN-17

SURANCE PROVIDERS. 18

(b) IN GENERAL.—Section 9010(j) of the Patient Pro-19

tection and Affordable Care Act is amended— 20

(1) by striking ‘‘and’’ at the end of paragraph 21

(1), 22

(2) by striking the period at the end of para-23

graph (2) and inserting ‘‘, and ending before January 24

1, 2019, and’’, and 25

25

•HR 195 EAH

(3) by adding at the end the following new para-1

graph: 2

‘‘(3) beginning after December 31, 2019.’’. 3

(c) EFFECTIVE DATE.—The amendments made by this 4

section shall apply to calendar years beginning after De-5

cember 31, 2018. 6

DIVISION E—BUDGETARY 7

EFFECTS 8

SEC. 5001. BUDGETARY EFFECTS. 9

(a) IN GENERAL.—The budgetary effects of division C 10

and each succeeding division shall not be entered on either 11

PAYGO scorecard maintained pursuant to section 4(d) of 12

the Statutory Pay-As-You-Go Act of 2010. 13

(b) SENATE PAYGO SCORECARDS.—The budgetary ef-14

fects of division C and each succeeding division shall not 15

be entered on any PAYGO scorecard maintained for pur-16

poses of section 4106 of H. Con. Res. 71 (115th Congress). 17

(c) CLASSIFICATION OF BUDGETARY EFFECTS.—Not-18

withstanding Rule 3 of the Budget Scorekeeping Guidelines 19

set forth in the joint explanatory statement of the committee 20

of conference accompanying Conference Report 105–217 21

and section 250(c)(8) of the Balanced Budget and Emer-22

gency Deficit Control Act of 1985, the budgetary effects of 23

division C and each succeeding division shall not be esti-24

mated— 25

26

•HR 195 EAH

(1) for purposes of section 251 of such Act; and 1

(2) for purposes of paragraph (4)(C) of section 2

3 of the Statutory Pay-As-You-Go Act of 2010 as 3

being included in an appropriation Act. 4

Attest:

Clerk.

11

5T

HC

ON

GR

ES

S

2D

SE

SS

ION

H

.R. 195

HO

USE AMENDM

ENT TO

SENATE AMENDM

ENT