I 

112TH CONGRESS 

1ST SESSION H. R. 1286 

To provide for fiscal accountability for new direct funding under the Patient 

Protection and Affordable Care Act by converting its direct funding 

into authorizations of appropriations and by rescinding unobligated direct 

funding. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 31, 2011 

Mrs. BACHMANN (for herself, Mr. KINGSTON, Mr. GOHMERT, Mr. 

HENSARLING, Mr. BROUN of Georgia, Mr. REHBERG, Mr. NEUGEBAUER, 

Mr. FRANKS of Arizona, Mr. GRAVES of Missouri, Mr. TIPTON, Mr. 

SCALISE, Mr. STUTZMAN, Mr. RIBBLE, Mr. DESJARLAIS, Mr. MANZULLO, Mr. PEARCE, Mr. LAMBORN, Mr. FLEMING, Mr. BENISHEK, Mr. 

FLORES, Mr. FORTENBERRY, Mr. CANSECO, Mr. HUIZENGA of Michigan, 

Mr. WALBERG, Mr. PENCE, Mr. DUNCAN of South Carolina, Mr. 

SOUTHERLAND, Mr. HARRIS, Mrs. HARTZLER, and Mr. SCHWEIKERT) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and 

Means and Education and the Workforce, 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 provide for fiscal accountability for new direct funding 

under the Patient Protection and Affordable Care Act 

by converting its direct funding into authorizations of 

appropriations and by rescinding unobligated direct funding. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Healthcare Fiscal Ac3 countability Act of 2011’’. 

4 SEC. 2. CONVERTING PPACA DIRECT FUNDING TO AUTHOR5 IZATIONS OF APPROPRIATIONS AND RE6 SCINDING UNOBLIGATED PPACA DIRECT 

7 FUNDING. 

8 (a) IN GENERAL.—Notwithstanding any other provi9 sion of law, for each provision described in column 1 in 

10 the table specified in subsection (b), the following rules 

11 shall apply: 

12 (1) DIRECT APPROPRIATIONS.— 

13 (A) CONVERSION TO AUTHORIZATIONS OF

14 APPROPRIATIONS.—For each such provision 

15 that provides for a direct appropriation of funds 

16 for fiscal year 2012 or a subsequent fiscal year 

17 and for which special rule #1 or special rule 

18 #2 does not apply under column 3 of such 

19 table, such appropriation is deemed only to be 

20 an authorization of appropriations and amounts 

21 are available under such provision only pursu22 ant to appropriations made after the date of the 

23 enactment of this Act. 

24 (B) RESCISSION OF UNOBLIGATED APPRO25 PRIATIONS.—Of the funds available pursuant to 

26 a direct appropriation under such provision for 


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1 which special rule #1 or special rule #2 does 

2 not apply under column 3 of such table, the un3 obligated balance is rescinded. 

4 (2) FUND TRANSFERS.— 

5 (A) CONVERSION TO AUTHORIZATION OF

6 TRANSFER SUBJECT TO APPROPRIATIONS.—For 

7 each such provision that provides for a transfer 

8 of funds for fiscal year 2012 or a subsequent 

9 fiscal year, such transfer is deemed only to be 

10 an authorization of such transfer in such 

11 amounts as are provided in advance in appro12 priations acts enacted after the date of the en13 actment of this Act. 

14 (B) RESTORATION OF TRANSFERRED

15 FUNDS.—Amounts transferred under such pro16 vision which have not been obligated as of the 

17 date of the enactment of this Act shall be re18 stored to the Trust Fund or other fund from 

19 which they were transferred. 

20 (3) SPECIAL RULES.— 

21 (A) SPECIAL RULE #1 FOR CERTAIN EX22 TENSIONS OF APPROPRIATIONS BEGINNING

23 AFTER FISCAL YEAR 2011.—For each such pro24 vision for which column 3 of such table specifies 

25 that special rule #1 applies, the amendment (or 


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1 amendments) made by the section in column 2 

2 is repealed and such provision is restored as if 

3 PPACA had not been enacted. 

4 (B) SPECIAL RULE #2 FOR CERTAIN EX5 TENSIONS OF APPROPRIATIONS BEGINNING BE6 FORE FISCAL YEAR 2012.—For each such provi7 sion for which column 3 of such table specifies 

8 that special rule #2 applies— 

9 (i) the amendment (or amendments) 

10 made by the section in column 2 is re11 pealed and such provision is restored as if 

12 PPACA had not been enacted, except that 

13 such repeal shall not apply to fiscal year 

14 2010 or fiscal year 2011; and 

15 (ii) of the funds available pursuant to 

16 the operation of such amendment (or 

17 amendments) for fiscal year 2010 or fiscal 

18 year 2011, the unobligated balance is re19 scinded. 

20 (b) TABLE.—The table specified in this subsection is 

21 as follows (with provisions listed in the order in which 

22 they, or the section amending such provision, appear in 

23 PPACA, followed by provisions in HCERA): 


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Column 1: Provision 

containing direct appropriation or transfer 

Column 2: Amendatory 

section (if any) in 

PPACA or other law 

Column 3: Special rule 

(if any) that applies 

Section 2793(e)(1) of 

PHSA 

as added by 1002 of 

PPACA 

Section 2974(c)(2)(A) 

of PHSA 

as added by 1003 of 

PPACA 

Section 1101(g)(1) of 

PPACA 

Section 1102(e) of 

PPACA 

Section 1311(a)(1) of 

PPACA 

Section 1322(g) of 

PPACA 

Section 1323(c)(1) of 

PPACA 

as inserted by 1204(a) 

of HCERA 

Section 6071(h) of the 

Deficit Reduction Act 

of 2005 (Public Law 

109–171) 

as amended by section 

2403(a)(1) of 

PPACA 

Section 2405 of PPACA 

Section 1139B(e) of 

SSA 

as inserted by 2701 of 

PPACA 

Section 2707(e)(1)(A) 

of PPACA 

Section 1900(f)(3) of 

SSA 

as added by section 

2801(a)(5)(C) of 

PPACA 

Section 511(j)(1) of 

SSA 

as added by section 

2951 of PPACA 

Section 513(f) of SSA as added by section 

2953 of PPACA 

Section 510(d) of SSA as amended by section 

2954 of PPACA 

special rule #2 

Section 3014(c) of 

PPACA 

Section 1115A(f) of 

SSA 

as inserted by section 

3021(a) of PPACA 

Section 1866E(h) of 

SSA 

as inserted by section 

3024 of PPACA 

Section 3026(f) of 

PPACA 


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Column 1: Provision 

containing direct appropriation or transfer 

Column 2: Amendatory 

section (if any) in 

PPACA or other law 

Column 3: Special rule 

(if any) that applies 

Section 5007(f)(1) of 

the Deficit Reduction 

Act of 2005 (Public 

Law 109–171) 

as amended by section 

3027(b)(1) of 

PPACA 

Section 3113(e) of 

PPACA 

Section 119(a)(1)(B) of 

the Medicare Improvements for Patients and Providers 

Act of 2008 (Public 

Law 110–275) 

as amended by section 

3306(a) of PPACA 

Section 119(b)(1)(B) of 

the Medicare Improvements for Patients and Providers 

Act of 2008 (Public 

Law 110–275) 

as amended by section 

3306(b) of PPACA 

Section 119(c)(1)(B) of 

the Medicare Improvements for Patients and Providers 

Act of 2008 (Public 

Law 110–275) 

as amended by section 

3306(c) of PPACA 

Section 119(d)(2) of the 

Medicare Improvements for Patients 

and Providers Act of 

2008 (Public Law 

110–275) 

as amended by section 

3306(d) of PPACA 

Section 1899A(m) of 

SSA 

as added by section 

3403 and amended 

by section 10320(a) 

of PPACA 

Section 4002(b) of 

PPACA 

Section 4101(a)(5) of 

PPACA 

Section 4108(f) of 

PPACA 

Section 4202(b)(4) of 

PPACA 

Section 4204(e)(3) of 

PPACA 

Section 1139A(e)(8) of 

SSA 

as amended by section 

4306 of PPACA 

Section 2008(c)(1) of 

SSA 

as added by section 

5507(a) of PPACA 


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Column 1: Provision 

containing direct appropriation or transfer 

Column 2: Amendatory 

section (if any) in 

PPACA or other law 

Column 3: Special rule 

(if any) that applies 

Section 501(c)(1)(A) of 

SSA 

as amended by section 

5507(b) of PPACA 

special rule #2 

Section 340H(g) of the 

PHSA 

as added by section 

5508(c) of PPACA 

Section 5509(d)(1) of 

PPACA 

Section 6201(b)(2) of 

PPACA 

Section 1183(a) of SSA as added by section 

6301(d) of PPACA 

Section 9511(b)(1) of 

the Internal Revenue 

Code of 1986 

as added by section 

6301(e)(1)(A) of 

PPACA 

Section 1817(k)(7) of 

SSA 

as added by section 

6402(i) of PPACA 

Section 6021(d)(3) of 

the Deficit Reduction 

Act of 2005 (Public 

Law 107–171) 

as amended by section 

8002(d)(2) PPACA 

special rule #2 

Section 9023(e)(10) of 

PPACA 

Section of 2104(a) of 

SSA 

as amended by section 

10203(d)(1) of 

PPACA 

special rule #1 

Section 2104(n)(2)(A) 

of SSA 

as amended by section 

10203(d)(2)(B) of 

PPACA 

special rule #1 

Section 2113(g) of SSA as amended by section 

10203(d)(2)(E)(ii) of 

PPACA 

special rule #1 

Section 10214 of 

PPACA 

Section 1881A (b)(7) of 

SSA 

as inserted by section 

10323(a) of PPACA 

Section 2009(e)(1) of 

SSA 

as added by section 

10323(b) of PPACA 

Section 10502(a) of 

PPACA 

Section 10503(b) of 

PPACA 

Section 10503(c) of 

PPACA 

Section 1005(b) of 

HCERA 


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Column 1: Provision 

containing direct appropriation or transfer 

Column 2: Amendatory 

section (if any) in 

PPACA or other law 

Column 3: Special rule 

(if any) that applies 

Section 1817(k)(8) of 

SSA 

as added by section 

1303(a) of HCERA 

1 (c) DEFINITIONS.—In this section: 

2 (1) The term ‘‘PPACA’’ means the Patient 

3 Protection and Affordable Care Act (Public Law 

4 111–148). 

5 (2) The term ‘‘HCERA’’ means the Health 

6 Care and Education Reconciliation Act of 2010 

7 (Public Law 111–152). 

8 (3) The term ‘‘SSA’’ means the Social Security 

9 Act. 

10 (4) The term ‘‘PHSA’’ means the Public 

11 Health Service Act. 

Æ 


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