I 

117TH CONGRESS 

1ST SESSION H. R. 1868 

To prevent across-the-board direct spending cuts, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 12, 2021 

Mr. YARMUTH (for himself, Mr. NEAL, Mr. PALLONE, and Mr. DAVID SCOTT

of Georgia) introduced the following bill; which was referred to the Committee on the Budget, and in addition to the Committees on Energy and 

Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions 

as fall within the jurisdiction of the committee concerned 

A BILL 

To prevent across-the-board direct spending cuts, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. PREVENTING PAYGO SEQUESTRATION. 

4 (a) STATUTORY PAYGO SCORECARDS.—The budg5 etary effects of this Act and the American Rescue Plan 

6 Act of 2021 (Public Law 117–2) shall not be counted on 

7 either PAYGO scorecard maintained pursuant to section 

8 4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 

9 U.S.C. 933(d)). 


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1 (b) SENATE PAYGO SCORECARDS.—The budgetary 

2 effects of this Act shall not be counted on any PAYGO 

3 scorecard maintained for purposes of section 4106 of H. 

4 Con. Res. 71 (115th Congress). 

5 SEC. 2. EXTENSION OF TEMPORARY SUSPENSION OF MEDI6 CARE SEQUESTRATION. 

7 (a) IN GENERAL.—Section 3709(a) of division A of 

8 the CARES Act (2 U.S.C. 901a note) is amended by strik9 ing ‘‘March 31, 2021’’ and inserting ‘‘December 31, 

10 2021’’. 

11 (b) EFFECTIVE DATE.—The amendment made by 

12 subsection (a) shall take effect as if enacted as part of 

13 the CARES Act (Public Law 116–136). 

14 SEC. 3. TECHNICAL CORRECTIONS. 

15 (a) DISREGARD OF CERTAIN ADDITIONAL COM16 PENSATION FOR PURPOSES OF MEDICAID AND CHIP.— 

17 Section 2104(h) of the CARES Act (15 U.S.C. 9023(h)) 

18 is amended by striking ‘‘Federal pandemic unemployment 

19 compensation’’ and inserting ‘‘Federal Pandemic Unem20 ployment Compensation or Mixed Earner Unemployment 

21 Compensation’’. 

22 (b) RURAL HEALTH CLINIC PAYMENTS.— 

23 (1) IN GENERAL.—Section 1833(f)(3) of the 

24 Social Security Act (42 U.S.C. 1395l(f)(3)) is 

25 amended— 


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1 (A) in subparagraph (A)— 

2 (i) in clause (i), by striking subclauses 

3 (I) and (II) and inserting the following: 

4 ‘‘(I) with respect to a rural health 

5 clinic that had a per visit payment amount 

6 established for services furnished in 

7 2020— 

8 ‘‘(aa) the per visit payment 

9 amount applicable to such rural 

10 health clinic for rural health clinic 

11 services furnished in 2020, increased 

12 by the percentage increase in the MEI 

13 applicable to primary care services 

14 furnished as of the first day of 2021; 

15 or 

16 ‘‘(bb) the limit described in para17 graph (2)(A); and 

18 ‘‘(II) with respect to a rural health 

19 clinic that did not have a per visit payment 

20 amount established for services furnished 

21 in 2020— 

22 ‘‘(aa) the per visit payment 

23 amount applicable to such rural 

24 health clinic for rural health clinic 

25 services furnished in 2021; or 


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1 ‘‘(bb) the limit described in para2 graph (2)(A); and’’; and 

3 (ii) in clause (ii)(I), by striking 

4 ‘‘under clause (i)(I)’’ and inserting ‘‘under 

5 subclause (I) or (II) of clause (i), as appli6 cable,’’; and 

7 (B) in subparagraph (B)— 

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

9 by striking ‘‘2019, was’’ and inserting 

10 ‘‘2020’’; 

11 (ii) in clause (i), by inserting ‘‘was’’ 

12 after ‘‘(i)’’; and 

13 (iii) by striking clause (ii) and insert14 ing the following: 

15 ‘‘(ii)(I) was enrolled under section 1866(j) 

16 (including temporary enrollment during the 

17 emergency period described in section 

18 1135(g)(1)(B) for such period); or 

19 ‘‘(II) submitted an application for enroll20 ment under section 1866(j) (or requested such 

21 a temporary enrollment for such period) that 

22 was received not later than December 31, 

23 2020.’’. 

24 (2) EFFECTIVE DATE.—The amendments made 

25 by this subsection shall take effect as if included in 


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1 the enactment of the Consolidated Appropriations 

2 Act, 2021 (Public Law 116–260). 

3 (c) ELIGIBILITY FOR REEMPLOYMENT SERVICES.— 

4 Section 306(a) of the Social Security Act (42 U.S.C. 

5 506(a)) is amended— 

6 (1) by striking ‘‘individuals referred to reem7 ployment services as described in section 303(j)’’ 

8 and inserting ‘‘claimants for unemployment com9 pensation, including claimants referred to reemploy10 ment services as described in section 303(j),’’; and 

11 (2) by striking ‘‘such individuals’’ and inserting 

12 ‘‘such claimants’’. 

13 (d) ADDITIONAL AMOUNT FOR CERTAIN HOSPITALS

14 WITH HIGH DISPROPORATIONATE SHARE.—Effective as 

15 if included in the enactment of section 203(a) of title II 

16 of division CC of Public Law 116–260, subsection (g) of 

17 section 1923 of the Social Security Act (42 U.S.C. 1396r– 

18 4) amended by such section 203(a) is amended by adding 

19 at the end the following new paragraph: 

20 ‘‘(3) ADDITIONAL AMOUNT FOR CERTAIN HOS21 PITALS WITH HIGH DISPROPORATIONATE SHARE.— 

22 ‘‘(A) IN GENERAL.—In the case of a hos23 pital with high disproportionate share (as de24 fined in subparagraph (B)) located in a State 

25 referenced in subsection (e) of section 4721 of 


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1 the Balanced Budget Act of 1997, a payment 

2 adjustment during a State fiscal year shall be 

3 considered consistent with subsection (c) if the 

4 payment adjustment does not exceed 175 per5 cent of the costs of furnishing hospital services 

6 during the year, but only if the Governor of the 

7 State certifies to the satisfaction of the Sec8 retary that the hospital’s applicable minimum 

9 amount is used for health services during the 

10 year. In determining the amount that is used 

11 for such services during a year, there shall be 

12 excluded any amounts received under the Public 

13 Health Service Act, title V, title XVIII, or from 

14 third party payors (not including the State plan 

15 under this title) that are used for providing 

16 such services during the year. 

17 ‘‘(B) HOSPITAL WITH HIGH

18 DISPROPORATIONATE SHARE DEFINED.—In 

19 subparagraph (A), a hospital is a ‘hospital with 

20 high disproportionate share’ if— 

21 ‘‘(i) the hospital is owned or operated 

22 by the State (or by an instrumentality or 

23 a unit of government within the State); 

24 and 

25 ‘‘(ii) the hospital— 


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1 ‘‘(I) meets the requirement de2 scribed in subparagraphs (A) or (B) 

3 of subsection (b)(1); or 

4 ‘‘(II) has the largest number of 

5 inpatient days attributable to individ6 uals entitled to benefits under the 

7 State plan of any hospital in such 

8 State for the previous fiscal year. 

9 ‘‘(C) APPLICABLE MINIMUM AMOUNT DE10 FINED.—In subparagraph (A), the ‘applicable 

11 minimum amount’ for a hospital for a fiscal 

12 year is equal to the difference between the 

13 amount of the hospital’s payment adjustment 

14 for the fiscal year and the costs to the hospital 

15 of furnishing hospital services described in 

16 paragraph (1)(A) during the fiscal year.’’. 

Æ 


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