IV

103D CONGRESS

2D SESSION H. RES. 508

Making in order, in the consideration by the House of Representatives of

H.R. 3600 (the ‘‘Health Security Act’’), an amendment-in-the-natureof-a-substitute consisting of the text of H.R. 3080 and including a

title providing for assistance for the purpose of health insurance.

IN THE HOUSE OF REPRESENTATIVES

AUGUST 4, 1994

Mr. MCMILLAN submitted the following resolution; which was referred to the

Committee on Rules

RESOLUTION

Making in order, in the consideration by the House of Representatives of H.R. 3600 (the ‘‘Health Security Act’’),

an amendment-in-the-nature-of-a-substitute consisting of

the text of H.R. 3080 and including a title providing

for assistance for the purpose of health insurance.

1 Resolved,

2 SECTION 1. CONSIDERATION OF CERTAIN AMENDMENTS

3 TO H.R. 3600.

4 (a) IN GENERAL.—In the consideration of the bill

5 (H.R. 3600), to ensure individual and family security

6 through health care coverage for all Americans in a man7 ner that contains the rate of growth in health care costs
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1 and promotes responsible insurance practices, to promote

2 choice in health care, and to ensure and protect the health

3 care of all Americans, in the Committee of the Whole—

4 (1) an amendment-in-the-nature-of-a-substitute

5 consisting of the text of H.R. 3080, as introduced in

6 the 103d Congress and the amendments described in

7 subsection (b), if offered by Mr. Michel of Illinois,

8 (or his designee), shall be made in order,

9 (2) any points of order against such amend10 ment are hereby waived, and

11 (3) the amendment shall not be subject to

12 amendment or to a demand for a division of the

13 question in the House or in the Committee of the

14 Whole.

15 (b) AMENDMENTS DESCRIBED.—The amendments

16 described in this subsection are specified in the following

17 paragraphs:

18 (1) LIMITATIONS ON UNDERWRITING.—Strike

19 part 2 of subtitle A of title I and insert the follow20 ing:

21 ‘‘PART 2—RESTRICTIONS ON UNDERWRITING

22 ‘‘SEC. 1011. LIMITATIONS ON UNDERWRITING.

23 ‘‘(a) GUARANTEED ISSUE.—Subject to permissible

24 plan restrictions based on capacity, as specified under

25 rules established by the Secretary, each group health plan
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1 or health insurance plan that provides standard coverage

2 described in section 1102(c) must accept for enrollment

3 every individual who resides in the area covered by the

4 plan and who seeks such enrollment, without regard to

5 health status or the need for health services.

6 ‘‘(b) GUARANTEED RENEWABILITY.—Each group

7 health plan and health insurance plan that provides such

8 coverage may not deny renewal of a policy other than on

9 the basis of—

10 ‘‘(1) fraud or material misrepresentation, or

11 ‘‘(2) nonpayment of premiums.

12 ‘‘(c) ELIMINATION OF PRE-EXISTING CONDITION

13 EXCLUSIONS.—A group health plan or health insurance

14 plan that provides such coverage may not restrict, limit,

15 or exclude coverage of items or services included in the

16 standard coverage because of health status, the need for

17 health services, or existing (or pre-existing) medical condi18 tions.’’

19 (2) STANDARD BENEFIT PACKAGE.—Insert

20 after section 1102 the following new sections:

21 ‘‘SEC. 1102A. STANDARD BENEFIT PACKAGE.

22 ‘‘(a) IN GENERAL.—Subject to the cost-sharing de23 scribed in section 1102B or section 1102C applicable to

24 the items and services involved, notwithstanding section
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1 1102(c), the standard coverage described in such section

2 shall include benefits for—

3 ‘‘(1) the acute care items and services described

4 in subsection (b), and

5 ‘‘(2) the long-term care services described in

6 subsection (c)(1) for an individual determined to be

7 eligible for such services under subsection (c)(2) pro8 vided pursuant to a plan of care.

9 ‘‘(b) ACUTE CARE.—

10 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

11 the acute care items and services described in this

12 subsection include the following (as specified in reg13 ulations of the Secretary):

14 ‘‘(A) INPATIENT CARE.—

15 ‘‘(i) Inpatient hospital care (other

16 than mental health and substance abuse

17 treatment services).

18 ‘‘(ii) Inpatient surgical and medical

19 care (other than mental health and sub20 stance abuse treatment services), including

21 dental services required due to injury re22 quiring surgery.

23 ‘‘(B) OUTPATIENT CARE.—
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1 ‘‘(i) Outpatient hospital care (other

2 than mental health and substance abuse

3 treatment services).

4 ‘‘(ii) Outpatient surgical and medical

5 care (other than mental health and sub6 stance abuse treatment services), including

7 dental services required due to injury re8 quiring surgery.

9 ‘‘(C) OUTPATIENT PRESCRIPTION DRUG

10 BENEFITS.—Outpatient prescription drugs, in11 cluding biologicals and insulin.

12 ‘‘(D) DENTAL CARE.—Periodic teeth clean13 ing and preventive dental care.

14 ‘‘(2) LIMITATIONS ON MENTAL HEALTH AND

15 SUBSTANCE ABUSE TREATMENT BENEFITS.—

16 ‘‘(A) ANNUAL LIMIT FOR SUBSTANCE

17 ABUSE TREATMENT SERVICES.—Subject to sub18 paragraph (B), a health plan providing stand19 ard coverage is not required to provide for pay20 ment for more than $3,000 in any year for any

21 individual for substance abuse treatment serv22 ices.

23 ‘‘(B) LIFETIME LIMIT.—Such a health

24 plan is not required to provide for payment for

25 either mental health or substance abuse treat-
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1 ment services for an individual once the plan

2 (or another such plan) has provided for pay3 ment of $50,000 for such services for the indi4 vidual in the individual’s lifetime.

5 ‘‘(C) INDEXING.—The dollar amounts

6 specified in subparagraphs (A) and (B) of this

7 paragraph shall be increased for each year after

8 1994 by the same percentage as the percentage

9 increase in the consumer price index for all

10 urban consumers (U.S. city average) between

11 September of the previous year and September

12 1993. Any such increase that is not a multiple

13 of $10 or $100, respectively, shall be rounded

14 to the nearest multiple of $10 or $100.

15 ‘‘(c) LONG-TERM CARE SERVICES.—

16 ‘‘(1) SERVICES.—

17 ‘‘(A) IN GENERAL.—Subject to subpara18 graph (B), the long-term care services described

19 in this paragraph include the following (as spec20 ified in regulations of the Secretary):

21 ‘‘(i) NURSING FACILITY SERVICES.—

22 ‘‘(I) IN GENERAL.—Nursing fa23 cility services.

24 ‘‘(II) BED RESERVATION.—Pay25 ment for reservation of a bed in a
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1 nursing facility during a period of

2 temporary hospitalization (not to ex3 ceed 21 days of continuous hos4 pitalization).

5 ‘‘(ii) HOME CARE SERVICES.—Home

6 care services, including—

7 ‘‘(I) home health services pro8 vided by a registered nursing or li9 censed practical nurse,

10 ‘‘(II) professional services of a li11 censed physical, occupational, res12 piratory, or speech therapist,

13 ‘‘(III) adult day care,

14 ‘‘(IV) home health aide and per15 sonal care attendant services,

16 ‘‘(V) homemaker services, and

17 ‘‘(VI) chore services.

18 ‘‘(B) BENEFIT PERIOD AND LIMITATION.—

19 Benefits for long-term care services are limited

20 to—

21 ‘‘(i) a consecutive period of 2 years

22 (beginning on the first date benefits are

23 first covered),

24 ‘‘(ii) $150 per day, and
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1 ‘‘(iii) $60,000 for an individual in a

2 lifetime.

3 Subsection (b)(2)(C) shall apply to the dollar

4 amounts under clauses (ii) and (iii) of this sub5 paragraph in the same manner as it applies to

6 the dollar amounts under subparagraphs (A)

7 and (B) of subsection (b)(2), except that for

8 this purpose any reference to $10 is deemed a

9 reference to $1.

10 ‘‘(2) ELIGIBILITY.—An individual is eligible for

11 long-term care services described in paragraph (1)

12 only if a physician certifies that the individual—

13 ‘‘(A) cannot perform at least 2 of 5 of the

14 following activities of daily living without on15 hand help from some else when performing the

16 activity: dressing, eating, continence, toileting,

17 and transferring from a chair or bed; or

18 ‘‘(B) is dependent upon another person be19 cause of cognitive impairment.

20 ‘‘SEC. 1102B. COST-SHARING FOR LONG-TERM CARE SERV21 ICES.

22 ‘‘(a) REQUIRED DEDUCTIBLE.—No benefits are pay23 able under standard coverage with respect to long-term

24 care services for an individual until the individual has sat25 isfied a deductible under subsection (b). Once such deduct-
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1 ible has been satisfied, benefits are covered for long-term

2 care services until there has elapsed 180 consecutive days

3 on which no covered long-term care benefits are provided.

4 Not more than $150 per day may be counted toward the

5 deductible and only expenses incurred in a consecutive pe6 riod of 90 days may be counted toward the deductible.

7 The dollar amount under the previous sentence is subject

8 to annual increases in the same manner as the dollar

9 amount under section 1102A(c)(1)(B)(ii) is subject to an10 nual increases under section 1102A(c)(1)(B).

11 ‘‘(b) DEDUCTIBLE.—The amount of the long-term

12 care deductible shall be based on the income of the family

13 of which the individual is a member (expressed as a per14 centage of the applicable poverty line) as follows:

15 ‘‘(1) $450, if family income is less than 100

16 percent of the applicable poverty line.

17 ‘‘(2) $1,250, if family income is at least 100

18 percent, but less than 200 percent, of the applicable

19 poverty line.

20 ‘‘(3) $4,500, if family income is at least 200

21 percent, but less than 300 percent, of the applicable

22 poverty line.

23 ‘‘(4) $6,750, if family income is at least 300

24 percent of the applicable poverty line.
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1 ‘‘(c) INDEXING.—The dollar amounts specified in

2 subsection (b) shall be increased for each year after 1994

3 by the same percentage as the percentage increase in the

4 consumer price index for all urban consumers (U.S. city

5 average) between September of the previous year and Sep6 tember 1993. Any such increase that is not a multiple of

7 $10 shall be rounded to the nearest multiple of $10.

8 ‘‘SEC. 1102C. INCOME RELATED COST SHARING FOR ACUTE

9 CARE SERVICES.

10 ‘‘(a) DEDUCTIBLE.—Subject to subsections (d) and

11 (e)—

12 ‘‘(1) INDIVIDUAL DEDUCTIBLE.—The individual

13 deductible under a health plan that provides stand14 ard coverage for an individual shall be based on the

15 income of the family of which the individual is a

16 member (expressed as a percentage of the applicable

17 poverty line) in accordance with the following table

18 (subject to subsection (e)):

‘‘INDIVIDUAL DEDUCTIBLE

‘‘[Based on Family Income (Expressed as a Percent of Poverty Line)]

‘‘Income (Expressed as a Percent of Applicable Poverty Line): Individual Deductible

Less than 100% of Applicable Poverty Line $100

At least 100%, but less than 120%, of Applicable Poverty Line $140

At least 120%, but less than 140%, of Applicable Poverty Line $180

At least 140%, but less than 160%, of Applicable Poverty Line $220

At least 160%, but less than 180%, of Applicable Poverty Line $260

At least 180%, but less than 200%, of Applicable Poverty Line $300
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‘‘INDIVIDUAL DEDUCTIBLE—Continued

‘‘[Based on Family Income (Expressed as a Percent of Poverty Line)]

‘‘Income (Expressed as a Percent of Applicable Poverty Line): Individual Deductible

At least 200%, but less than 220%, of Applicable Poverty Line $340

At least 220%, but less than 240%, of Applicable Poverty Line $380

At least 240%, but less than 260%, of Applicable Poverty Line $420

At least 260%, but less than 280%, of Applicable Poverty Line $460

At least 280%, but less than 300%, of Applicable Poverty Line $500

At least 300%, but less than 320%, of Applicable Poverty Line $540

At least 320%, but less than 340%, of Applicable Poverty Line $580

At least 340%, but less than 360%, of Applicable Poverty Line $620

At least 360%, but less than 380%, of Applicable Poverty Line $660

At least 380%, but less than 400%, of Applicable Poverty Line $700

At least 400% of Applicable Poverty Line $740

1 ‘‘(2) MAXIMUM OF 2 DEDUCTIBLES FOR A FAM2 ILY.—The deductible shall be considered to have

3 been met with respect to a family when the family

4 has incurred expenses, that are countable with re5 spect to covered items and services, equal to twice

6 the individual deductible described in paragraph (1).

7 ‘‘(b) COPAYMENTS AND COINSURANCE.—Subject to

8 subsections (d) and (e)—

9 ‘‘(1) SMALL COPAYMENTS FOR FAMILIES WITH

10 INCOME BELOW THE POVERTY LINE.—In the case of

11 an individual with family income that is less than

12 the applicable poverty line, a health plan that pro13 vides standard coverage shall only impose cost-shar14 ing for acute care benefits in the form of a
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1 copayment of $5 for each item or service provided

2 (as identified in accordance with rules established by

3 the Secretary).

4 ‘‘(2) COINSURANCE FOR OTHER FAMILIES.—In

5 the case of any other individual, such a plan shall

6 impose cost-sharing for acute care benefits in the

7 form of coinsurance, based on the income of the

8 family of which the individual is a member (ex9 pressed as a percentage of the applicable poverty

10 line) in accordance with the percentage specified in

11 the following table:

‘‘COINSURANCE PERCENTAGE

‘‘[Based on Family Income (Expressed as a Percent of Applicable

Poverty Line)]

‘‘Income (Expressed as a Percent of Applicable Poverty Line): Coinsurance

At least 100%, but less than 200%, of Applicable Poverty Line 10 percent

At least 200%, but less than 300%, of Applicable Poverty Line 15 percent

At least 300%, but less than 400%, of Applicable Poverty Line 20 percent

At least 400% of Applicable Poverty Line 25 percent

12 ‘‘(c) CATASTROPHIC LIMIT ON OUT-OF-POCKET EX13 PENSES.—The catastrophic limit on out-of-pocket ex14 penses under a health plan that provides standard cov15 erage for an individual shall be based on the income of

16 the family of which the individual is a member (expressed

17 as a percentage of the applicable poverty line) in accord18 ance with the following table (subject to subsection (e)):
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‘‘CATASTROPHIC LIMIT ON OUT-OF-POCKET EXPENSES

‘‘[Based on Family Income (Expressed as a Percent of Applicable

Poverty Line)]

‘‘Income (Expressed as a Percent of Applicable Poverty Line):Catastrophic Limit on Out-ofPocket Expenses

Less than 100% of Applicable Poverty Line $2,000

At least 100%, but less than 120%, of Applicable Poverty Line $2,400

At least 120%, but less than 140%, of Applicable Poverty Line $2,800

At least 140%, but less than 160%, of Applicable Poverty Line $3,200

At least 160%, but less than 180%, of Applicable Poverty Line $3,600

At least 180%, but less than 200%, of Applicable Poverty Line $4,000

At least 200%, but less than 220%, of Applicable Poverty Line $4,400

At least 220%, but less than 240%, of Applicable Poverty Line $4,800

At least 240%, but less than 260%, of Applicable Poverty Line $5,200

At least 260%, but less than 280%, of Applicable Poverty Line $5,600

At least 280%, but less than 300%, of Applicable Poverty Line $6,000

At least 300%, but less than 320%, of Applicable Poverty Line $6,400

At least 320%, but less than 340%, of Applicable Poverty Line $6,800

At least 340%, but less than 360%, of Applicable Poverty Line $7,200

At least 360%, but less than 380%, of Applicable Poverty Line $7,600

At least 380%, but less than 400%, of Applicable Poverty Line $8,000

At least 400% of Applicable Poverty Line $8,400

1 ‘‘(d) SPECIAL RULES.—Under a plan providing

2 standard coverage:

3 ‘‘(1) NO COPAYMENTS OR COINSURANCE FOR

4 INPATIENT HOSPITAL SERVICES.—There shall be no

5 copayments or coinsurance imposed for inpatient

6 hospital services.

7 ‘‘(2) NO COST-SHARING FOR MATERNITY SERV8 ICES.—There shall be no cost-sharing imposed for

9 maternity services.
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1 ‘‘(3) NO COST-SHARING FOR HOSPITAL AND

2 PHYSICIAN EMERGENCY CARE FOR TREATMENT OF

3 INJURIES WITHIN 72 HOURS OF ONSET OF IN4 JURY.—There shall be no cost-sharing imposed for

5 hospital and physician emergency care for treatment

6 of injuries within 72 hours of onset of injury.

7 ‘‘(4) NO DEDUCTIBLE FOR DENTAL CARE.—

8 The deductible under subsection (a) shall not apply

9 to coverage of dental services described in section

10 1102A(b)(1)(D) (relating to periodic dental cleaning

11 and dental preventive care).

12 ‘‘(5) MENTAL HEALTH SERVICES.—In the case

13 of mental health and substance abuse treatment

14 services (whether inpatient or outpatient):

15 ‘‘(A) SEPARATE PER PERSON ANNUAL DE16 DUCTIBLE.—There shall be a separate calendar

17 year deductible of $250 per individual, without

18 regard to the income of the family of which the

19 individual is a member.

20 ‘‘(B) HIGHER COINSURANCE.—A plan pro21 viding standard coverage may impose coinsur22 ance of 40 percent, without regard to the in23 come of the family of which the individual is a

24 member.
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1 ‘‘(e) INDEXING VALUES.—The dollar amounts speci2 fied in subsections (a), (c), and (d)(5)(A) shall be in3 creased for each year after 1994 by the same percentage

4 as the percentage increase in the consumer price index for

5 all urban consumers (U.S. city average) between Septem6 ber of the previous year and September 1993. Any such

7 increase that is not a multiple of $10, $100, or $10, re8 spectively, shall be rounded to the nearest multiple of $10,

9 $100, or $10.’’

10 (3) PREMIUMS.—Strike sections 1104 and 1005

11 and insert the following:

12 ‘‘SEC. 1104. ESTABLISHMENT OF PREMIUMS.

13 ‘‘(a) IN GENERAL.—Each group health plan or

14 health insurance plan that provides coverage of standard

15 benefits described in section 1102(c) shall establish pre16 miums on a per capita basis that vary within a premium

17 rating area (as defined by the Secretary) only based on

18 age of the individual and income classification (within the

19 same classes of age and income used for the reference per

20 person annual premium amount under section 1703(a))

21 and may vary among such classes only in the same ratios

22 as the reference amounts under such section vary among

23 such classes.

24 ‘‘(b) FAMILY RATE AS SUM OF INDIVIDUAL

25 RATES.—The premium imposed by such a plan with re-
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1 spect to members of a family shall be the sum of the per

2 capita rates established under subsection (a) with respect

3 to all the members of the family.’’

4 (4) INCOME-RELATED TAX DEDUCTIONS.—

5 Amend subtitle D of title I to read as follows:

6 ‘‘Subtitle B—Tax Provisions

7 ‘‘SEC. 1301. ELIMINATION OF EXCLUSION FROM INCOME

8 FOR EMPLOYER-PROVIDED HEALTH CARE.

9 ‘‘(a) IN GENERAL.—The text of section 106 of the

10 Internal Revenue Code of 1986 (relating to contributions

11 by employer to accident and health plans) is amended to

12 read as follows:

13 ‘‘ ‘(a) IN GENERAL.—Gross income of an employee

14 does not include employer-provided coverage under an ac15 cident or health plan.

16 ‘‘ ‘(b) TERMINATION.—Gross income of an employee

17 shall include employer-provided coverage under an acci18 dent or health plan if such coverage is provided after De19 cember 31, 1995.’

20 ‘‘(b) EMPLOYMENT TAX TREATMENT.—

21 ‘‘(1) SOCIAL SECURITY TAX.—

22 ‘‘(A) Subsection (a) of section 3121 of

23 such Code is amended by inserting after para24 graph (21) the following new sentence:
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1 ‘Nothing in paragraph (2) shall exclude from the term

2 ‘‘wages’’ any amount which is required to be included in

3 gross income under section 106(b).’

4 ‘‘(B) Subsection (a) of section 209 of the

5 Social Security Act is amended by inserting

6 after paragraph (21) the following new sen7 tence:

8 ‘Nothing in paragraph (2) shall exclude from the term

9 ‘‘wages’’ any amount which is required to be included in

10 gross income under section 106(b) of the Internal Revenue

11 Code of 1986.’

12 ‘‘(2) RAILROAD RETIREMENT TAX.—Paragraph

13 (1) of section 3231(e) of such Code is amended by

14 adding at the end thereof the following new sen15 tence: ‘Nothing in clause (i) of the second sentence

16 of this paragraph shall exclude from the term ‘‘com17 pensation’’ any amount which is required to be in18 cluded in gross income under section 106(b).’

19 ‘‘(3) UNEMPLOYMENT TAX.—Subsection (b) of

20 section 3306 of such Code is amended by inserting

21 after paragraph (16) the following new sentence:

22 ‘Nothing in paragraph (2) shall exclude from the term

23 ‘‘wages’’ any amount which is required to be included in

24 gross income under section 106(b).’
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1 ‘‘(4) WAGE WITHHOLDING.—Subsection (a) of

2 section 3401 of such Code is amended by adding at

3 the end thereof the following new sentence:

4 ‘Nothing in the preceding provisions of this subsection

5 shall exclude from the term ‘‘wages’’ any amount which

6 is required to be included in gross income under section

7 106(b).’

8 ‘‘(c) EFFECTIVE DATE.—

9 ‘‘(1) INCOME TAX.—The amendment made by

10 subsection (a) shall apply to taxable years ending

11 after December 31, 1995.

12 ‘‘(2) EMPLOYMENT TAX.—The amendments

13 made by subsection (b) shall apply to remuneration

14 paid after December 31, 1995.

15 ‘‘SEC. 1302. LIMITATION ON EMPLOYER DEDUCTION FOR

16 HEALTH CARE PROVIDED TO EMPLOYEES.

17 ‘‘(a) IN GENERAL.—Section 162 of the Internal Rev18 enue Code of 1986 (relating to trade or business expenses)

19 is amended by redesignating subsection (o) as subsection

20 (p) and by inserting after subsection (n) the following new

21 subsection:

22 ‘‘ ‘(o) DENIAL OF DEDUCTION FOR CERTAIN

23 HEALTH CARE COVERAGE PROVIDED TO EMPLOYEE.—

24 No deduction shall be allowed under this chapter to an

25 employer for coverage provided to an employee (or the
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1 spouse or any dependent of an employee) under an acci2 dent or health plan unless such plan provides standard

3 coverage in accordance with the applicable provisions of

4 the Affordable Health Care Now Act of 1993.’

5 ‘‘(b) EFFECTIVE DATE.—The amendment made by

6 this section shall apply to coverage for periods after De7 cember 31, 1995, in taxable years ending after such date.

8 ‘‘SEC. 1303. NON-ITEMIZED DEDUCTION FOR PREMIUMS

9 FOR QUALIFIED HEALTH PLANS AND FOR

10 CONTRIBUTIONS TO MEDICAL SAVINGS AC11 COUNTS BY TAXPAYERS COVERED UNDER

12 CATASTROPHIC COVERAGE HEALTH PLANS.

13 ‘‘(a) IN GENERAL.—Part VII of subchapter B of

14 chapter 1 of the Internal Revenue Code of 1986 (relating

15 to additional itemized deductions for individuals), as

16 amended by section 2202, is amended by redesignating

17 section 221 as section 222 and by inserting after section

18 220 the following new section:

19 ‘‘ ‘SEC. 221. CERTAIN PAYMENTS FOR HEALTH COVERAGE.

20 ‘‘ ‘(a) IN GENERAL.—In the case of an individual,

21 there shall be allowed as a deduction for the taxable year

22 an amount equal to the qualified health expenses paid by

23 the taxpayer during the taxable year.

24 ‘‘ ‘(b) QUALIFIED HEALTH EXPENSES.—For pur25 poses of this section:
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1 ‘‘ ‘(1) IN GENERAL.—The term ‘‘qualified

2 health expenses’’ means expenses for coverage of the

3 taxpayer and the spouse and dependents (as defined

4 in section 152) of the taxpayer under a qualified

5 health plan.

6 ‘‘ ‘(2) TAXPAYERS COVERED UNDER CATA7 STROPHIC COVERAGE HEALTH PLAN.—In the case of

8 a taxpayer who is covered (and whose spouse and

9 dependents are covered) under a qualified health

10 plan which is a catastrophic coverage health plan,

11 the term ‘‘qualified health expenses’’ includes

12 amounts contributed by or on behalf of such tax13 payer to a medical savings account (as defined in

14 section 220(d)(1)(A)) for the benefit of such tax15 payer.

16 ‘‘ ‘(c) LIMITATION.—The amount allowed as a deduc17 tion under subsection (a) for the taxable year shall not

18 exceed the excess (if any) of—

19 ‘‘ ‘(1) the maximum voucher amount that would

20 have been provided to the taxpayer under subtitle A

21 of title I of the Affordable Health Care Now Act of

22 1993 for the calendar year ending with or within

23 such taxable year if the taxpayer’s family income

24 were zero for such calendar year, over
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1 ‘‘ ‘(2) the voucher amount provided to the tax2 payer under such subtitle A for such calendar year.

3 ‘‘ ‘(d) DEFINITIONS.—For purposes of this section—

4 ‘‘ ‘(1) the term ‘‘qualified health plan’’ means a

5 MedAccess plan or other health plan that provides

6 standard coverage consistent with the applicable re7 quirements of the Affordable Health Care Now Act

8 of 1993; and

9 ‘‘ ‘(2) the term ‘‘catastrophic coverage health

10 plan’’ has the meaning given such term in section

11 220(c)(2).’

12 ‘‘(b) CLERICAL AMENDMENT.—The table of sections

13 for part VII is amended by striking the last item and in14 serting the following new items:

‘‘ ‘Sec. 221. Certain payments for health coverage.

‘‘ ‘Sec. 222. Cross reference.’

15 ‘‘(c) EFFECTIVE DATE.—The amendments made by

16 this section shall apply to coverage for periods after De17 cember 31, 1995, in taxable years ending after such date.’’

18 (5) INDIVIDUAL MANDATE AND INCOME-RELAT19 ED VOUCHERS.—Strike subtitles G and H of title I

20 and insert the following:

21 ‘‘Subtitle G—Individual Mandate

22 ‘‘SEC. 1601. REQUIREMENT.

23 ‘‘(a) IN GENERAL.—Each individual who is lawfully

24 in the United States shall obtain health insurance cov-
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1 erage under a health plan that is a MedAccess plan or

2 a plan that benefits equivalent to the benefits provided in

3 a MedAccess plan.

4 ‘‘(b) EXCEPTIONS.—An individual who is a member

5 of the Uniformed Services of the United States on active

6 duty or is entitled to benefits under the CHAMPUS pro7 gram or title 38, United States Code, is deemed to have

8 satisfied the requirement of subsection (a).

9 ‘‘(c) ENFORCEMENT.—Each individual who fails to

10 meet the requirement of subsection (a) shall be enrolled,

11 in a manner specified by the Secretary, in a plan described

12 in such subsection and is liable for the premiums other13 wise payable during the period in which the individual

14 failed to be enrolled, plus a penalty or interest as specified

15 by the Secretary. Amounts so owed may be collected by

16 the Secretary through garnishment, withholding of tax re17 funds owed, or other appropriate means.

18 ‘‘Subtitle H—Income-Related

19 Vouchers

20 ‘‘SEC. 1701. ELIGIBILITY.

21 ‘‘(a) ELIGIBILITY.—

22 ‘‘(1) IN GENERAL.—Each qualified family (as

23 defined in subsection (b)) is entitled to be provided

24 financial assistance toward the cost of the premium
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1 for a health plan that provides standard coverage ei2 ther—

3 ‘‘(A) in the form of a voucher under para4 graph (2) in the amount specified in section

5 1702(a), or

6 ‘‘(B) in the form of a non-itemized deduc7 tion against taxes otherwise payable, in accord8 ance with section 221 of the Internal Revenue

9 Code of 1986.

10 ‘‘(2) USE OF VOUCHER.—

11 ‘‘(A) IN GENERAL.—Subject to subpara12 graph (B), a voucher provided to a family

13 under this subtitle shall be remitted by any in14 dividual in such family to the health plan, the

15 exempted multiple employer health plan (as de16 fined in section 701 of the Employee Retire17 ment Income Security Act of 1974), or, in the

18 case of an employment-related health plan, to

19 the employee’s employer, as the case may be,

20 for payment by the Secretary. The health plan,

21 multiple employer health plan, or employer shall

22 make proper adjustments in billing statements

23 to reflect such family’s remaining premium obli24 gations (if any).
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1 ‘‘(B) ELECTION OF TAX CREDIT.—A fam2 ily may elect, in a manner specified by the Sec3 retary in consultation with the Secretary of the

4 Treasury, to be provided the voucher in the

5 form of a credit against income taxes payable

6 by members of the family.

7 ‘‘(b) QUALIFIED FAMILY.—For purposes of this sub8 title, except as provided in subsection (c), the term ‘quali9 fied family’ means an individual and dependents (as de10 fined in section 1023).

11 ‘‘(c) SPECIAL TREATMENT OF MEDICARE BENE12 FICIARIES.—

13 ‘‘(1) INDIVIDUALS CURRENTLY 60 YEARS OF

14 AGE OR OLDER.—In the case of individuals who are

15 60 years of age or older on the date of the enact16 ment of this Act, the individual shall only be consid17 ered to be a member of a qualified family if the indi18 vidual elects to be eligible for benefits under this

19 subtitle instead of any entitlement to benefits under

20 the medicare program under title XVIII of the So21 cial Security Act. Such election shall be made at

22 such time and in such manner as the Secretary

23 specifies. Once such an election is made with respect

24 to an individual it is irrevocable.
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•HRES 508 IH

1 ‘‘(2) OTHER INDIVIDUALS.—In the case of eligi2 ble individuals not described in paragraph (1), the

3 individuals are entitled to benefits under this title

4 instead of entitlement to benefits under the medicare

5 program under title XVIII of the Social Security

6 Act.

7 ‘‘(3) MEDICARE PAYMENTS.—In the case of an

8 individual who, under paragraph (1) or (2), is enti9 tled to benefits under this title instead of entitle10 ment to benefits under the medicare program, the

11 Secretary shall provide for payment on behalf of the

12 individual for premiums under health plans that pro13 vide benefits for the individual in an amount equal

14 to the amount that would be payable under section

15 1876 of the Social Security Act if the individual had

16 been enrolled under a risk-sharing contract with an

17 eligible organization under such section (but sub18 stituting 100 percent for 95 percent in subsection

19 (a)(2)(C) of such section).

20 ‘‘(d) SPECIAL TREATMENT OF MEDICAID BENE21 FICIARIES.—

22 ‘‘(1) STATE OPTIONS FOR ACUTE CARE.—Each

23 State that has a medicaid plan approved under title

24 XIX of the Social Security Act shall elect one of the

25 following options in relation to such plan with re-
26

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1 spect to medical assistance with respect to acute

2 care services:

3 ‘‘(A) CONTRIBUTION OPTION.—The State

4 may pay an amount equivalent to the product

5 of—

6 ‘‘(i) 1 minus the Federal medical as7 sistance percentage for the State (as de8 fined in section 1905(b) of the Social Secu9 rity Act), and

10 ‘‘(ii) the Federal subsidies provided

11 under this subtitle for individuals residing

12 in the State who have family incomes

13 below the applicable poverty line for a fam14 ily of the size involved.

15 ‘‘(B) CAPITATION OPTION.—The State

16 may assume responsibility for providing

17 (through capitated plans or otherwise) benefits

18 under standard coverage (described in section

19 1102A) for all individuals described in subpara20 graph (A) and the State is entitled to receive

21 from the Federal Government an amount equal

22 to the Federal subsidies that otherwise would

23 have been provided under this subtitle for such

24 individuals reduced by the amount the State

25 would have been required to pay under subpara-
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1 graph (A) if the option under such subpara2 graph had been elected.

3 ‘‘(2) TRANSITIONAL LONG-TERM CARE SERV4 ICES.—

5 ‘‘(A) ELIMINATION OF CURRENT MEDICAID

6 COVERAGE FOR TRANSITIONAL SERVICES.—An

7 individual who first becomes entitled to and re8 ceives transitional long-term care services under

9 a State medicaid plan on or after the effective

10 date of this subtitle shall not be entitled to

11 medical assistance with respect to such services

12 under the plan, but shall receive benefits with

13 respect to such services under the standard

14 benefit package or under the State option de15 scribed in paragraph (1)(B).

16 ‘‘(B) GRANDFATHERING OF LONG-TERM

17 CARE MEDICAID RECIPIENTS.—An individual

18 who is entitled to and is receiving, as of the ef19 fective date of this subtitle, transitional long20 term care services under a State medicaid plan

21 shall continue to be entitled to medical assist22 ance with respect to such services and States

23 may not change the benefits made available

24 under such plans with respect to such individ25 uals.
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1 ‘‘(C) TRANSITIONAL LONG-TERM CARE

2 SERVICES.—In this subsection, the term ‘transi3 tional long-term care services’ means, with re4 spect to an individual, long-term care services

5 furnished to the individual during the 2-year

6 period beginning on the date such services are

7 first furnished to the individual.

8 ‘‘(3) EXTENDED LONG-TERM CARE SERVICES.—

9 With respect to coverage of long-term care services

10 other than transitional long-term care services under

11 a State medicaid plan, on and after the effective

12 date of this subtitle the Federal medical assistance

13 percentage shall be equal to 100 percent.

14 ‘‘(e) ADDITIONAL SPECIAL RULES.—

15 ‘‘(1) ACTIVE DUTY MILITARY NOT ELIGIBLE.—

16 An individual who is a member of the Uniformed

17 Services of the United States on active duty is not

18 eligible for benefits under this section.

19 ‘‘(2) ELECTION BY INDIVIDUALS ELIGIBLE FOR

20 CHAMPUS AND VETERANS BENEFITS.—An individual

21 who is receiving benefits under the CHAMPUS pro22 gram or under title 38, United States Code, as of

23 the effective date of this subtitle shall only be eligi24 ble for benefits under this section if the individual

25 elects, on a 1-time basis, to waive the rights to bene-
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1 fits under such program or title and instead receive

2 benefits described in subsection (a).

3 ‘‘SEC. 1702. AMOUNT OF VOUCHER.

4 ‘‘(a) IN GENERAL.—The amount of a voucher speci5 fied in this subsection for a qualified family for a year

6 is the sum of the voucher amounts for each member of

7 the family in the year. The voucher amount for each mem8 ber of a family in the year is the lesser of—

9 ‘‘(1) the annual premium paid by or on behalf

10 of the family member for such year for coverage

11 under a health plan that provides standard coverage

12 in which the member is enrolled, or

13 ‘‘(2) the voucher percentage (specified in sub14 section (b)) of the sum, for all months in the year,

of 1 15 ⁄12 of the reference per person annual premium

16 amount (specified under section 1703) for that

17 member for that year.

18 Paragraph (2) shall be applied to a member based on the

19 age, income class, family status, and geographic location

20 of the member as of the first day of the month.

21 ‘‘(b) VOUCHER PERCENTAGE.—

22 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

23 for a qualified family, the voucher percentage is the

24 percentage specified in the following table, based on

25 the income (expressed as a percent of the applicable
30

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1 poverty line for a family of the size involved) of the

2 family of which the individual is a member:

‘‘VOUCHER PERCENTAGE

‘‘[Based on Family Income (Expressed as a Percent of Applicable

Poverty Line)]

‘‘Income (Expressed as a Percent of Applicable Poverty Line): Voucher Percentage

Less than 100% of Applicable Poverty Line 100%

At least 100%, but less than 110%, of Applicable Poverty Line 90%

At least 110%, but less than 120%, of Applicable Poverty Line 80%

At least 120%, but less than 130%, of Applicable Poverty Line 70%

At least 130%, but less than 140%, of Applicable Poverty Line 60%

At least 140%, but less than 160%, of Applicable Poverty Line 60%

At least 160%, but less than 160%, of Applicable Poverty Line 60%

At least 160%, but less than 170%, of Applicable Poverty Line 55%

At least 170%, but less than 220%, of Applicable Poverty Line 50%

At least 220%, but less than 240%, of Applicable Poverty Line 40%

At least 240% of Applicable Poverty Line 0%

3 ‘‘(2) TREATMENT OF ELDERLY INDIVIDUALS.—

4 In the case of an individual who is 65 years of age

5 or older as of the first day of a month and whose

6 family income (expressed as a percent of applicable

7 poverty line) is at least 240 percent of the applicable

8 poverty line, the voucher percentage is 20 percent.

9 ‘‘(c) DEFINITIONS AND DETERMINATION OF IN10 COME.—For purposes of this subtitle:

11 ‘‘(1) APPLICABLE POVERTY LINE.—The term

12 ‘applicable poverty line’ means the income official

13 poverty line (as defined by the Office of Manage14 ment and Budget, and revised annually in accord-
31

•HRES 508 IH

1 ance with section 673(2) of the Omnibus Budget

2 Reconciliation Act of 1981) applicable to a family of

3 the size involved. Such poverty line shall be revised

4 as of October 1 of each year for the next succeeding

5 year.

6 ‘‘(2) DETERMINATIONS OF INCOME.—

7 ‘‘(A) IN GENERAL.—Subject to paragraph

8 (3), the term ‘income’ means adjusted gross in9 come (as defined in section 62(a) of the Inter10 nal Revenue Code of 1986)—

11 ‘‘(i) determined without regard to sec12 tions 135, 162(l), 911, 931, and 933 of

13 such Code; and

14 ‘‘(ii) increased by—

15 ‘‘(I) the amount of interest re16 ceived or accrued which is exempt

17 from tax, plus

18 ‘‘(II) the amount of social secu19 rity benefits (described in section

20 86(d) of such Code) which is not in21 cludible in gross income under section

22 86 of such Code.

23 ‘‘(B) FAMILY INCOME.—The term ‘family

24 income’ means, with respect to a family, the

25 sum of the income for all members of the fam-
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•HRES 508 IH

1 ily, not including the income of a dependent

2 child with respect to which no return is re3 quired under the Internal Revenue Code of

4 1986.

5 ‘‘(C) FAMILY SIZE.—The family size to be

6 applied under this section, with respect to fam7 ily income, is the number of individuals in8 cluded in the family for purposes of coverage

9 under a health plan that provides standard cov10 erage.

11 ‘‘(3) SPECIAL RULE WHERE LOSS OF EARNED

12 INCOME DURING A YEAR.—

13 ‘‘(A) IN GENERAL.—In the case of a fam14 ily described in subparagraph (B), the family

15 may elect to have the voucher amount under

16 this subtitle computed based only on other,

17 nonearned income (and attributable amounts

18 described in subparagraph (C)).

19 ‘‘(B) FAMILY DESCRIBED.—A family de20 scribed in this subparagraph is a family—

21 ‘‘(i) that has a significant loss of

22 wages or earned income (as defined by the

23 Secretary) during a year, and
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•HRES 508 IH

1 ‘‘(ii) has net assets (as determined in

2 accordance with rules specified by the Sec3 retary) of less than $500,000.

4 ‘‘(C) ATTRIBUTABLE AMOUNTS.—In apply5 ing subparagraph (A), any nonexempt assets of

6 a family shall be deemed to provide income at

7 a rate of not less than the interest rate applica8 ble to long-term obligations of the United

9 States (as determined by the Secretary of the

10 Treasury).

11 ‘‘SEC. 1703. REFERENCE PER PERSON ANNUAL PREMIUM

12 AMOUNT.

13 ‘‘(a) IN GENERAL.—Subject to the succeeding provi14 sions of this section, for purposes of this subtitle, the ref15 erence per person annual premium amount for an individ16 ual is the following amount for standard coverage, based

17 on the age of the individual and the income (expressed

18 as a percent of the applicable poverty line for a family

19 of the size involved) of the family of which the individual

20 is a member in accordance with the following table:
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‘‘REFERENCE PER PERSON ANNUAL PREMIUM AMOUNT FOR STANDARD COVERAGE

‘‘[Based on Family Income (Expressed as a Percent of Applicable Poverty Line) and Based on Age of Individual]

‘‘Income Expressed as a

Percent of Applicable

Poverty Line):

Under 18 18–34 35–49 50–64 Over 64

Less than 100% of Applicable

Poverty Line

$1,568 $2,613 $3,714 $5,057 $13,233

At least 100%, but less than

200%, of Applicable Poverty

Line

$776 $1,293 $1,839 $2,503 $8,537

At least 200% of Applicable

Poverty Line

$644 $1,074 $1,526 $2,078 $7,086

1 ‘‘(b) UPDATE.—The reference per person annual pre2 mium amounts specified in subsection (a) shall be updated

3 annually by the Secretary, based on estimates of changes

4 in the actuarial value for the different classes based on

5 income and age of the standard benefit package between

6 1993 and the year involved.

7 ‘‘(c) GEOGRAPHIC ADAPTATION.—

8 ‘‘(1) IN GENERAL.—The reference per person

9 annual premium amounts specified in subsection (a)

10 and updated under subsection (b) shall be adjusted

11 by the Secretary for each geographic area so they re12 flect variations in costs of the standard benefit pack13 age in different areas.

14 ‘‘(2) METHODOLOGY.—The Secretary shall

15 make such adjustment using methodology (and

16 areas) similar to the methodology and areas used for

17 establishing the average annual per capita cost for
35

•HRES 508 IH

1 payments to eligible organizations under section

2 1876 of the Social Security Act.

3 ‘‘(d) APPLICATION ON MONTHLY BASIS.—The ref4 erence per person annual premium amounts under this

5 section shall be computed for a family on a monthly basis,

6 to take into account the age, income class, and family sta7 tus as of the first day of the month involved.

8 ‘‘SEC. 1704. APPLICATION FOR VOUCHER.

9 ‘‘(a) TIME OF FILING.—

10 ‘‘(1) NOVEMBER 1 OF PREVIOUS YEAR.—Not

11 later than November 1 of each year (beginning with

12 1995), each family desiring to obtain a voucher

13 under this subtitle shall submit to the Secretary (in

14 such form and manner as the Secretary may require,

15 in consultation with the Secretary of the Treasury)

16 an estimate of the individual’s family income antici17 pated for the taxable year ending with or within the

18 following calendar year, to be used to determine ini19 tially whether the individual is eligible for a voucher

20 under this subtitle, and the amount of such a vouch21 er, for such following calendar year.

22 ‘‘(2) SPECIAL RULE FOR FIRST YEAR OF COV23 ERAGE.—For the first year in which an individual is

24 eligible for such a voucher, the individual shall sub25 mit to the Secretary (at such time and in such form
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•HRES 508 IH

1 and manner as the Secretary may require, in con2 sultation with the Secretary of the Treasury) an es3 timate of the individual’s family income anticipated

4 for the taxable year ending with December 31 of

5 such year, to be used to determine initially whether

6 the individual is eligible for a voucher under this

7 subtitle, and the amount of such a voucher, for such

8 following calendar year.

9 ‘‘(3) SUBSEQUENT APPLICATIONS.—Under

10 rules established by the Secretary, applications for a

11 voucher may also be filed at other times during a

12 year.

13 ‘‘(b) FORM.—

14 ‘‘(1) USE OF SIMPLE FORM.—The Secretary

15 shall use an application which shall be as simple in

16 form as possible and understandable to the average

17 individual. The application may require attachment

18 of such documentation as deemed necessary by the

19 Secretary in order to ensure eligibility for assistance.

20 The Secretary shall use, as deemed practicable by

21 the Secretary, any existing forms employed for Fed22 eral income tax filings as an application for assist23 ance.

24 ‘‘(2) AVAILABILITY OF FORMS.—The Secretary

25 shall make application forms available through
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•HRES 508 IH

1 health care providers and plans, public assistance of2 fices, public libraries, and at other locations (includ3 ing post offices) accessible to a broad cross-section

4 of families.

5 ‘‘(3) SUBMISSION OF APPLICATION FORM.—An

6 application form under this section may be submit7 ted in such manner as the Secretary shall provide.

8 ‘‘(c) PERMITTING SUBMISSION OF REVISED APPLI9 CATION.—During a year, a family may submit a revised

10 application to reflect changes in the estimated income of

11 the family, including changes in employment status of

12 family members, during the year. The voucher amount

13 shall be revised to reflect such a revised application.

14 ‘‘(d) ENROLLMENT AT POINT OF APPLICATION.—To

15 the extent practicable, the Secretary shall provide for the

16 option of enrollment in a health plan that provides stand17 ard coverage as part of the application and approval proc18 ess for assistance under this subtitle. In providing for such

19 an option, the Secretary may require the State of resi20 dence to provide such information and assistance regard21 ing such plans as may be necessary.

22 ‘‘SEC. 1705. DETERMINATION OF ELIGIBILITY AND AMOUNT

23 OF VOUCHER.

24 ‘‘(a) IN GENERAL.—Upon receiving an application

25 for a voucher under section 1804, the Secretary shall pro-
38

•HRES 508 IH

1 vide in a prompt manner for notice of the determination

2 of eligibility for, and amount of, a voucher under this sub3 title.

4 ‘‘(b) ELECTION WITH RESPECT TO INCOME DETER5 MINATION.—As elected by a family at the time of submis6 sion of an application for a voucher under section 1804,

7 the family income shall be determined either—

8 ‘‘(1) by multiplying by a factor of 4 the income

9 for the 3-month period immediately preceding the

10 month in which the application is made, or

11 ‘‘(2) based upon estimated income for the entire

12 year in which the application is submitted.

13 ‘‘(c) DISCLOSURE OF CERTAIN TAX INFORMATION

14 BY SECRETARY OF TREASURY.—

15 ‘‘(1) IN GENERAL.—Subsection (l) of section

16 6103 of the Internal Revenue Code of 1986 (relating

17 to confidentiality and disclosure of returns and re18 turn information) is amended by adding at the end

19 thereof the following new paragraph:

20 ‘‘ ‘(14) DISCLOSURE OF RETURN INFORMA21 TION.—

22 ‘‘ ‘(A) IN GENERAL.—The Secretary shall,

23 upon written request from the Secretary of

24 Health and Human Services, disclose to the of25 ficers and employees of the Department of
39

•HRES 508 IH

1 Health and Human Services return information

2 necessary to determine the family income (as

3 defined in section 1702(c)(2)(B) of the Afford4 able Health Care Now Act of 1993) of any indi5 vidual to be used to determine whether the indi6 vidual is eligible for a voucher under subtitle I

7 of title I of such Act, and the amount of such

8 a voucher.

9 ‘‘ ‘(B) RESTRICTION ON USE OF DIS10 CLOSED INFORMATION.—Any officer or em11 ployee of the Department of Health and

12 Human Services receiving return information

13 under subparagraph (A) shall use such informa14 tion only for purposes of, and to the extent nec15 essary in, establishing the family income (as so

16 defined) for such purpose.’

17 ‘‘(2) CONFORMING AMENDMENTS.—Paragraphs

18 (3)(A) and (4) of section 6103(p) of such Code are

19 each amended by striking ‘or (13)’ each place it ap20 pears and inserting ‘(13), or (14)’.

21 ‘‘(3) EFFECTIVE DATE.—The amendments

22 made by paragraphs (1) and (2) shall apply with re23 spect to information for taxable years beginning

24 after the date of the enactment of this Act.
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1 ‘‘SEC. 1706. RECONCILIATION.

2 ‘‘(a) NOTICE OF VOUCHER AMOUNTS PROVIDED.—

3 In the case of a qualified family that has received a vouch4 er under this subtitle for any month in a year, the Sec5 retary shall, not later than January 31 of the following

6 year, notify such family of the total amount of the vouch7 ers that such family received during the year.

8 ‘‘(b) FILING OF NOTICE.—

9 ‘‘(1) IN GENERAL.—A family that receives a no10 tice under subsection (a) shall attach such notice to

11 the tax return filed by such family for the year in12 volved. The Secretary of the Treasury shall establish

13 a procedure to enable a family that is not required

14 to file a tax return for the year involved to file the

15 notice received under subsection (a).

16 ‘‘(2) INSTRUCTIONS FOR FILING NOTICE.—The

17 Secretary shall provide instructions for filing the no18 tice described in paragraph (1) (in such form as the

19 Secretary prescribes) no later than January 31 of

20 the year following the year involved.

21 ‘‘(c) RECONCILIATION OF ASSISTANCE BASED ON

22 ACTUAL INCOME.—

23 ‘‘(1) IN GENERAL.—Based on and using the in24 formation contained in the notice filed under sub25 section (b) with respect to a family, the Secretary of

26 the Treasury shall compute the amount of the
41

•HRES 508 IH

1 voucher that should have been provided under this

2 subtitle with respect to the family in the year in3 volved.

4 ‘‘(2) OVERPAYMENT OF VOUCHER.—If the

5 amount of the voucher provided was greater than

6 the amount computed under paragraph (1), the ex7 cess amount shall be treated as an underpayment of

8 a tax imposed by chapter 1 of the Internal Revenue

9 Code of 1986 and paid by the Secretary of the

10 Treasury to the family involved.

11 ‘‘(3) UNDERPAYMENT OF VOUCHER.—If the

12 amount computed under paragraph (1) is greater

13 than the amount of the voucher provided, the

14 amount of the difference shall be treated as an over15 payment of tax imposed by such chapter, or in the

16 event such family is entitled to a refund of such a

17 tax, subject to the provisions of section 6402(d) of

18 such Code.

19 ‘‘(d) FAILURE TO FILE.—In the case of any family

20 that is required to file a notice under subsection (b) for

21 a year and that fails to file such a notice by the deadline

22 specified by the Secretary, the entire amount of the vouch23 er provided in such year shall be considered the excess

24 amount under subsection (c)(2). The Secretary shall waive

25 the application of this subsection if the family establishes,
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•HRES 508 IH

1 to the satisfaction of the Secretary, good cause for the

2 failure to file the notice on a timely basis.

3 ‘‘SEC. 1707. PENALTIES FOR FALSE INFORMATION.

4 ‘‘Any individual who knowingly makes a material mis5 representation of information in an application for a

6 voucher under this subtitle, shall be liable to the Federal

7 Government for excess payments made based on such mis8 representation and interest on such excess payments at

9 a rate specified by the Secretary, and, in addition, shall

10 be liable to the Federal Government for $1,000 or, if

11 greater, 3 times the excess payments made based on such

12 misrepresentation.

13 ‘‘SEC. 1708. ADMINISTRATION.

14 ‘‘(a) IN GENERAL.—Except as provided in this sec15 tion, this subtitle shall be administered by the Secretary

16 of Health and Human Services.

17 ‘‘(b) ADMINISTRATION BY A STATE.—Upon applica18 tion of a State, the Secretary may provide for the adminis19 tration of this subtitle in a State through an appropriate

20 State agency.’’

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