IA 

115TH CONGRESS 

2D SESSION H. J. RES. 125 

Making an extension of continuing appropriations for fiscal year 2018, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 16, 2018 

Mr. FRELINGHUYSEN submitted the following joint resolution; which was referred to the Committee on Appropriations, and in addition to the Committees on Ways and Means, and the Budget, 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 

JOINT RESOLUTION 

Making an extension of continuing appropriations for fiscal 

year 2018, and for other purposes. 

1 Resolved by the Senate and House of Representatives

2 of the United States of America in Congress assembled, 

3 DIVISION B—EXTENSION OF CONTINUING 

4 APPROPRIATIONS ACT, 2018 

5 SEC. 2001. The Continuing Appropriations Act, 2018 

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

7 (1) by striking the date specified in section 

8 106(3) and inserting ‘‘February 16, 2018’’; and 

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


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1 ‘‘SEC. 148. Funds appropriated by the Department 

2 of Defense Missile Defeat and Defense Enhancements Ap3 propriations Act, 2018 (division B of Public Law 115– 

4 96) may be obligated and expended notwithstanding sec5 tion 504(a)(1) of the National Security Act of 1947 (50 

6 U.S.C. 3094(a)(1)). 

7 ‘‘SEC. 149. Amounts made available by section 101 

8 for ‘Department of Agriculture—Food and Nutrition 

9 Service—Child Nutrition Programs’ to carry out section 

10 749(g) of the Agriculture Appropriations Act of 2010 

11 (Public Law 111–80) may be apportioned up to the rate 

12 for operations necessary to ensure that the program can 

13 be fully operational by May 2018. 

14 ‘‘SEC. 150. Amounts made available by section 101 

15 for ‘National Aeronautics and Space Administration—Ex16 ploration’ may be apportioned up to the rate for oper17 ations necessary to maintain the planned launch capability 

18 schedules for the Space Launch System launch vehicle, 

19 Exploration Ground Systems, and Orion Multi-Purpose 

20 Crew Vehicle programs. 

21 ‘‘SEC. 151. Amounts made available by section 101 

22 for ‘Department of Energy—Energy Programs—Office of 

23 the Inspector General’ may be apportioned up to the rate 

24 for operations necessary to sustain staffing levels achieved 

25 on June 30, 2017. 


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1 ‘‘SEC. 152. Amounts made available by section 101 

2 for ‘Small Business Administration—Business Loans Pro3 gram Account’ may be apportioned up to the rate for oper4 ations necessary to accommodate increased demand for 

5 commitments for general business loans authorized under 

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

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

8 Urban Development may make temporary adjustments to 

9 the Section 8 housing choice voucher annual renewal fund10 ing allocations and administrative fee eligibility determina11 tions for public housing agencies in an area for which the 

12 President declared a disaster in 2017 or 2018 under title 

13 IV of the Robert T. Stafford Disaster Relief and Emer14 gency Assistance Act (42 U.S.C. 5170 et seq.), to avoid 

15 significant adverse funding impacts that would otherwise 

16 result from the disaster and that would otherwise prevent 

17 a public housing agency from leasing up to its authorized 

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

19 upon request by and in consultation with a public housing 

20 agency and supported by documentation as required by 

21 the Secretary that demonstrates the need for the adjust22 ment.’’. 

23 SEC. 2002. The Further Additional Continuing Ap24 propriations Act, 2018 (division A of Public Law 115–96) 

25 is amended by striking section 1002. 


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1 This division may be cited as the ‘‘Extension of Con2 tinuing Appropriations Act, 2018’’. 

3 DIVISION C—HEALTHY KIDS ACT 

4 SEC. 3001. SHORT TITLE. 

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

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

7 Keeping Insurance Delivery Stable Act’’ or the 

8 ‘‘HEALTHY KIDS Act’’. 

9 SEC. 3002. SIX-YEAR FUNDING EXTENSION OF THE CHIL10 DREN’S HEALTH INSURANCE PROGRAM. 

11 (a) FUNDING.— 

12 (1) IN GENERAL.—Section 2104(a) of the So13 cial Security Act (42 U.S.C. 1397dd(a)), as amend14 ed by section 3201(a) of the CHIP and Public 

15 Health Funding Extension Act (division C of Public 

16 Law 115–96), is amended— 

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

18 and’’ and inserting a semicolon; and 

19 (B) by striking paragraph (21) and insert20 ing the following new paragraphs: 

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

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

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

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


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

2 and 

3 ‘‘(26) for fiscal year 2023, for purposes of mak4 ing two semi-annual allotments— 

5 ‘‘(A) $2,850,000,000 for the period begin6 ning on October 1, 2022, and ending on March 

7 31, 2023; and 

8 ‘‘(B) $2,850,000,000 for the period begin9 ning on April 1, 2023, and ending on Sep10 tember 30, 2023.’’. 

11 (2) PREVENTION OF DUPLICATE APPROPRIA12 TIONS FOR FISCAL YEAR 2018.—Notwithstanding any 

13 other provision of law, insofar as funds have been 

14 appropriated under subsection (a)(21) of section 

15 2104 of the Social Security Act (42 U.S.C. 1397dd), 

16 as such subsection is in effect on the day before the 

17 date of the enactment of this Act, to provide allot18 ments to States under the State Children’s Health 

19 Insurance Program established under title XXI of 

20 the Social Security Act (42 U.S.C. 1397aa et seq.) 

21 (whether implemented under title XIX, XXI, or 

22 both, of the Social Security Act) for fiscal year 

23 2018— 

24 (A) any amounts that are so appropriated 

25 that are not so allotted and obligated before the 


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1 date of the enactment of this Act, are re2 scinded; and 

3 (B) any amount provided for CHIP allot4 ments to a State under this section (and the 

5 amendments made by this section) for such fis6 cal year shall be reduced by the amount of such 

7 appropriations so allotted and obligated before 

8 such date. 

9 (b) ALLOTMENTS.— 

10 (1) IN GENERAL.—Section 2104(m) of the So11 cial Security Act (42 U.S.C. 1397dd(m)), as amend12 ed by section 3201(b) of the CHIP and Public 

13 Health Funding Extension Act (division C of Public 

14 Law 115–96), is amended— 

15 (A) in paragraph (2)(B)— 

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

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

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

19 2017’’ and inserting ‘‘, 2017, and 2023’’; 

20 and 

21 (iii) in clause (ii)— 

22 (I) in the matter preceding sub23 clause (I), by striking ‘‘and paragraph 

24 (10)’’; and 


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

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

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

4 (i)’’; 

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

6 and inserting ‘‘2023’’; 

7 (C) in paragraph (7)— 

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

9 ‘‘2017’’ and inserting ‘‘2023’’; 

10 (ii) in subparagraph (B), in the mat11 ter preceding clause (i), by inserting ‘‘(or, 

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

13 than the date that is 60 days after the 

14 date of the enactment of the HEALTHY 

15 KIDS Act)’’ after ‘‘before the August 31 

16 preceding the beginning of the fiscal year’’; 

17 and 

18 (iii) in the matter following subpara19 graph (B), by striking ‘‘or fiscal year 

20 2016’’ and inserting ‘‘fiscal year 2016, fis21 cal year 2018, fiscal year 2020, or fiscal 

22 year 2022’’; 

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

24 and inserting ‘‘2023’’; and 


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1 (E) by amending paragraph (10) to read 

2 as follows: 

3 ‘‘(10) FOR FISCAL YEAR 2023.— 

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

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

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

7 subsection (a) for the semi-annual period de8 scribed in such subparagraph, increased by the 

9 amount of the appropriation for such period 

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

11 KIDS Act, the Secretary shall compute a State 

12 allotment for each State (including the District 

13 of Columbia and each commonwealth and terri14 tory) for such semi-annual period in an amount 

15 equal to the first half ratio (described in sub16 paragraph (D)) of the amount described in sub17 paragraph (C). 

18 ‘‘(B) SECOND HALF.—Subject to para19 graphs (5) and (7), from the amount made 

20 available under subparagraph (B) of paragraph 

21 (26) of subsection (a) for the semi-annual pe22 riod described in such subparagraph, the Sec23 retary shall compute a State allotment for each 

24 State (including the District of Columbia and 

25 each commonwealth and territory) for such 


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1 semi-annual period in an amount equal to the 

2 amount made available under such subpara3 graph, multiplied by the ratio of— 

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

5 such State under subparagraph (A); to 

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

7 the allotments made available under such 

8 subparagraph. 

9 ‘‘(C) FULL YEAR AMOUNT BASED ON

10 REBASED AMOUNT.—The amount described in 

11 this subparagraph for a State is equal to the 

12 Federal payments to the State that are attrib13 utable to (and countable towards) the total 

14 amount of allotments available under this sec15 tion to the State in fiscal year 2022 (including 

16 payments made to the State under subsection 

17 (n) for fiscal year 2022 as well as amounts re18 distributed to the State in fiscal year 2022), 

19 multiplied by the allotment increase factor 

20 under paragraph (6) for fiscal year 2023. 

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

22 ratio described in this subparagraph is the ratio 

23 of— 

24 ‘‘(i) the sum of— 


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1 ‘‘(I) the amount made available 

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

3 ‘‘(II) the amount of the appro4 priation for such period under section 

5 3002(b)(2) of the HEALTHY KIDS 

6 Act; to 

7 ‘‘(ii) the sum of— 

8 ‘‘(I) the amount described in 

9 clause (i); and 

10 ‘‘(II) the amount made available 

11 under subsection (a)(26)(B).’’. 

12 (2) ONE-TIME APPROPRIATION FOR FISCAL

13 YEAR 2023.—There is appropriated to the Secretary 

14 of Health and Human Services, out of any money in 

15 the Treasury not otherwise appropriated, 

16 $20,200,000,000 to accompany the allotment made 

17 for the period beginning on October 1, 2022, and 

18 ending on March 31, 2023, under paragraph 

19 (26)(A) of section 2104(a) of the Social Security Act 

20 (42 U.S.C. 1397dd(a)) (as added by subsection (a)), 

21 to remain available until expended. Such amount 

22 shall be used to provide allotments to States under 

23 paragraph (10) of section 2104(m) of such Act (as 

24 added by paragraph (1)) for the first 6 months of 

25 fiscal year 2023 in the same manner as allotments 


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1 are provided under subsection (a)(26)(A) of such 

2 section 2104 and subject to the same terms and con3 ditions as apply to the allotments provided from 

4 such subsection (a)(26)(A). 

5 (c) EXTENSION OF THE CHILD ENROLLMENT CON6 TINGENCY FUND.—Section 2104(n) of the Social Security 

7 Act (42 U.S.C. 1397dd(n)) is amended— 

8 (1) in paragraph (2)— 

9 (A) in subparagraph (A)(ii)— 

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

11 2013, 2014, and 2016’’ and inserting 

12 ‘‘2010 through 2014, 2016, and 2018 

13 through 2022’’; and 

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

15 fiscal year 2017’’ and inserting ‘‘fiscal 

16 years 2015, 2017, and 2023’’; and 

17 (B) in subparagraph (B)— 

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

19 2013, 2014, and 2016’’ and inserting 

20 ‘‘2010 through 2014, 2016, and 2018 

21 through 2022’’; and 

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

23 fiscal year 2017’’ and inserting ‘‘fiscal 

24 years 2015, 2017, and 2023’’; and 


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1 (2) in paragraph (3)(A), in the matter pre2 ceding clause (i), by striking ‘‘or a semi-annual allot3 ment period for fiscal year 2015 or 2017’’ and in4 serting ‘‘or in any of fiscal years 2018 through 2022 

5 (or a semi-annual allotment period for fiscal year 

6 2015, 2017, or 2023)’’. 

7 (d) EXTENSION OF QUALIFYING STATES OPTION.— 

8 (1) IN GENERAL.—Section 2105(g)(4) of the 

9 Social Security Act (42 U.S.C. 1397ee(g)(4)) is 

10 amended— 

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

12 2017’’ and inserting ‘‘THROUGH 2023’’; and 

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

14 ‘‘2017’’ and inserting ‘‘2023’’. 

15 (2) TECHNICAL AMENDMENTS.—Section 

16 2104(f)(2)(B)(ii) of the Social Security Act (42 

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

18 3201(c) of the CHIP and Public Health Funding 

19 Extension Act (division C of Public Law 115–96), is 

20 amended— 

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

22 month (as defined in subclause (II))’’ and in23 serting ‘‘(as defined in subclause (II)) for the 

24 month’’; 


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

2 effect on the day before the date of the enact3 ment of the HEALTHY KIDS Act,’’ after ‘‘sec4 tion 2105(g)(4)(A)’’; and 

5 (C) in subclause (VI)— 

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

7 day before the date of the enactment of the 

8 HEALTHY KIDS Act’’ after ‘‘, section 

9 2105(g)(4)’’; and 

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

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

12 (e) EXTENSION OF EXPRESS LANE ELIGIBILITY OP13 TION.—Section 1902(e)(13)(I) of the Social Security Act 

14 (42 U.S.C. 1396a(e)(13)(I)) is amended by striking 

15 ‘‘2017’’ and inserting ‘‘2023’’. 

16 (f) ASSURANCE OF AFFORDABILITY STANDARD FOR

17 CHILDREN AND FAMILIES.— 

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

19 Social Security Act (42 U.S.C. 1397ee(d)(3)) is 

20 amended— 

21 (A) in the paragraph heading, by striking 

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

23 ‘‘THROUGH SEPTEMBER 30, 2023’’; and 

24 (B) in subparagraph (A), in the matter 

25 preceding clause (i)— 


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

2 ‘‘2023’’; and 

3 (ii) by striking ‘‘The preceding sen4 tence shall not be construed as preventing 

5 a State during such period’’ and inserting 

6 ‘‘During the period that begins on October 

7 1, 2019, and ends on September 30, 2023, 

8 the preceding sentence shall only apply 

9 with respect to children in families whose 

10 income does not exceed 300 percent of the 

11 poverty line (as defined in section 

12 2110(c)(5)) applicable to a family of the 

13 size involved. The preceding sentences shall 

14 not be construed as preventing a State 

15 during any such periods’’. 

16 (2) CONFORMING AMENDMENTS.—Section 

17 1902(gg)(2) of the Social Security Act (42 U.S.C. 

18 1396a(gg)(2)) is amended— 

19 (A) in the paragraph heading, by striking 

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

21 ‘‘THROUGH SEPTEMBER 30, 2023’’; and 

22 (B) by striking ‘‘September 30, 2019,’’ 

23 and inserting ‘‘September 30, 2023 (but during 

24 the period that begins on October 1, 2019, and 

25 ends on September 30, 2023, only with respect 


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1 to children in families whose income does not 

2 exceed 300 percent of the poverty line (as de3 fined in section 2110(c)(5)) applicable to a fam4 ily of the size involved)’’. 

5 (g) CHIP LOOK-ALIKE PLANS.— 

6 (1) BLENDING RISK POOLS.—Section 2107 of 

7 the Social Security Act (42 U.S.C. 1397gg) is 

8 amended by adding at the end the following: 

9 ‘‘(g) USE OF BLENDED RISK POOLS.— 

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

11 any other provision of Federal law) shall be con12 strued as preventing a State from considering chil13 dren enrolled in a qualified CHIP look-alike pro14 gram and children enrolled in a State child health 

15 plan under this title (or a waiver of such plan) as 

16 members of a single risk pool. 

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

18 In this subsection, the term ‘qualified CHIP look19 alike program’ means a State program— 

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

21 the age of 19 and are not eligible to receive 

22 medical assistance under title XIX or child 

23 health assistance under this title may purchase 

24 coverage through the State that provides bene25 fits that are at least identical to the benefits 


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1 provided under the State child health plan 

2 under this title (or a waiver of such plan); and 

3 ‘‘(B) that is funded exclusively through 

4 non-Federal funds, including funds received by 

5 the State in the form of premiums for the pur6 chase of such coverage.’’. 

7 (2) COVERAGE RULE.— 

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

9 the Internal Revenue Code of 1986 is amended 

10 in subparagraph (A)(iii), by inserting ‘‘or under 

11 a qualified CHIP look-alike program (as de12 fined in section 2107(g) of the Social Security 

13 Act)’’ before the comma at the end. 

14 (B) EFFECTIVE DATE.—The amendment 

15 made by subparagraph (A) shall apply with re16 spect to taxable years beginning after December 

17 31, 2017. 

18 (h) AVAILABILITY OF UNUSED FISCAL YEAR 2018 

19 REDISTRIBUTION AMOUNTS.—Any amounts that have 

20 been redistributed to States under subsection (f) of section 

21 2104 of the Social Security Act (42 U.S.C. 1397dd) for 

22 fiscal year 2018 that are not, or will not be, expended by 

23 the end of that fiscal year shall be— 

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

25 fiscal year 2018 to reflect an updated estimate of 


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

2 and 

3 (2) available for redistribution under subsection 

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

5 SEC. 3003. EXTENSION OF CERTAIN PROGRAMS AND DEM6 ONSTRATION PROJECTS. 

7 (a) CHILDHOOD OBESITY DEMONSTRATION

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

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

10 (1) by striking ‘‘and $10,000,000’’ and insert11 ing ‘‘, $10,000,000’’; and 

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

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

14 through 2023’’. 

15 (b) PEDIATRIC QUALITY MEASURES PROGRAM.— 

16 Section 1139A(i) of the Social Security Act (42 U.S.C. 

17 1320b–9a(i)) is amended— 

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

19 following: 

20 ‘‘(1) IN GENERAL.—Out of any’’; 

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

22 and inserting ‘‘there is appropriated— 

23 ‘‘(A) for each’’; 

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

25 the period’’ and inserting ‘‘; 


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1 ‘‘(B) for the period’’; 

2 (4) by striking ‘‘. Funds appropriated under 

3 this subsection shall remain available until ex4 pended.’’ and inserting ‘‘; and’’; and 

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

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

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

8 carrying out this section (other than sub9 sections (e), (f), and (g)). 

10 ‘‘(2) AVAILABILITY.—Funds appropriated 

11 under this subsection shall remain available until ex12 pended.’’. 

13 SEC. 3004. EXTENSION OF OUTREACH AND ENROLLMENT 

14 PROGRAM. 

15 (a) IN GENERAL.—Section 2113 of the Social Secu16 rity Act (42 U.S.C. 1397mm) is amended— 

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

18 inserting ‘‘2023’’; and 

19 (2) in subsection (g)— 

20 (A) by striking ‘‘and $40,000,000’’ and in21 serting ‘‘, $40,000,000’’; and 

22 (B) by inserting after ‘‘2017’’ the fol23 lowing: ‘‘, and $120,000,000 for the period of 

24 fiscal years 2018 through 2023’’. 


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1 (b) MAKING ORGANIZATIONS THAT USE PARENT

2 MENTORS ELIGIBLE TO RECEIVE GRANTS.—Section 

3 2113(f) of the Social Security Act (42 U.S.C. 1397mm(f)) 

4 is amended— 

5 (1) in paragraph (1)(E), by striking ‘‘or com6 munity-based doula programs’’ and inserting ‘‘, com7 munity-based doula programs, or parent mentors’’; 

8 and 

9 (2) by adding at the end the following new 

10 paragraph: 

11 ‘‘(5) PARENT MENTOR.—The term ‘parent 

12 mentor’ means an individual who— 

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

14 one child who is an eligible child under this title 

15 or title XIX; and 

16 ‘‘(B) is trained to assist families with chil17 dren who have no health insurance coverage 

18 with respect to improving the social deter19 minants of the health of such children, includ20 ing by providing— 

21 ‘‘(i) education about health insurance 

22 coverage, including, with respect to obtain23 ing such coverage, eligibility criteria and 

24 application and renewal processes; 


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1 ‘‘(ii) assistance with completing and 

2 submitting applications for health insur3 ance coverage; 

4 ‘‘(iii) a liaison between families and 

5 representatives of State plans under title 

6 XIX or State child health plans under this 

7 title; 

8 ‘‘(iv) guidance on identifying medical 

9 and dental homes and community phar10 macies for children; and 

11 ‘‘(v) assistance and referrals to suc12 cessfully address social determinants of 

13 children’s health, including poverty, food 

14 insufficiency, and housing.’’. 

15 (c) EXCLUSION FROM MODIFIED ADJUSTED GROSS

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

17 U.S.C. 1396a(e)) is amended— 

18 (1) in the first paragraph (14), relating to in19 come determined using modified adjusted gross in20 come, by adding at the end the following new sub21 paragraph: 

22 ‘‘(J) EXCLUSION OF PARENT MENTOR

23 COMPENSATION FROM INCOME DETERMINA24 TION.—Any nominal amount received by an in25 dividual as compensation, including a stipend, 


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1 for participation as a parent mentor (as defined 

2 in paragraph (5) of section 2113(f)) in an activ3 ity or program funded through a grant under 

4 such section shall be disregarded for purposes 

5 of determining the income eligibility of such in6 dividual for medical assistance under the State 

7 plan or any waiver of such plan.’’; and 

8 (2) by striking ‘‘(14) EXCLUSION’’ and insert9 ing ‘‘(15) EXCLUSION’’. 

10 SEC. 3005. EXTENSION AND REDUCTION OF ADDITIONAL 

11 FEDERAL FINANCIAL PARTICIPATION FOR 

12 CHIP. 

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

14 1397ee(b)) is amended in the second sentence by inserting 

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

16 and ends on September 30, 2020, the enhanced FMAP 

17 determined for a State for a fiscal year (or for any portion 

18 of a fiscal year occurring during such period) shall be in19 creased by 11.5 percentage points’’ after ‘‘23 percentage 

20 points,’’. 

21 SEC. 3006. MEDICAID IMPROVEMENT FUND. 

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

23 1396w–1) is amended— 

24 (1) in subsection (a), in the first sentence, by 

25 inserting before the period at the end the following: 


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1 ‘‘, and, in accordance with subsection (b)(3), for the 

2 purposes of subparagraph (B) of such subsection’’; 

3 and 

4 (2) in subsection (b)— 

5 (A) in paragraph (2)— 

6 (i) in the first sentence, by inserting 

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

8 Fund’’; 

9 (ii) by inserting after the first sen10 tence the following sentence: ‘‘Amounts in 

11 the Fund pursuant to paragraph (3) shall 

12 be available in advance of appropriations 

13 but only if the total amount obligated from 

14 the Fund does not exceed the amount 

15 available to the Fund under such para16 graph (3).’’; and 

17 (iii) in the last sentence, by striking 

18 ‘‘sentence’’ and inserting ‘‘sentences’’; and 

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

20 paragraph: 

21 ‘‘(3) ADDITIONAL FUNDING FOR STATE ACTIVI22 TIES RELATING TO MECHANIZED CLAIMS SYS23 TEMS.— 

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

25 amount made available under paragraph (1), 


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1 there shall be available to the Fund, for expend2 itures from the Fund in accordance with sub3 paragraph (B), for fiscal year 2023 and there4 after, $980,000,000, to remain available until 

5 expended. 

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

7 amounts made available to the Fund under sub8 paragraph (A) to pay to each State which has 

9 a plan approved under this title, for each quar10 ter beginning during or after fiscal year 2023 

11 an amount equal to— 

12 ‘‘(i) 100 percent minus the percent 

13 specified in clause (i) of section 

14 1903(a)(3)(A) of so much of the sums ex15 pended by the State during such quarter 

16 as are attributable to the activities de17 scribed in such clause; 

18 ‘‘(ii) 100 percent minus the Federal 

19 medical assistance percentage applied 

20 under clause (iii) of such section of so 

21 much of the sums expended during such 

22 quarter (as found necessary by the Sec23 retary under such clause) by the State as 

24 are attributable to the activities described 

25 in such clause; and 


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1 ‘‘(iii) 100 percent minus the percent 

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

3 much of the sums expended by the State 

4 during such quarter as are attributable to 

5 the activities described in such section.’’. 

6 DIVISION D—SUSPENSION OF 

7 CERTAIN HEALTH-RELATED 

8 TAXES 

9 SEC. 4001. EXTENSION OF MORATORIUM ON MEDICAL DE10 VICE EXCISE TAX. 

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

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

13 31, 2017’’ and inserting ‘‘December 31, 2019’’. 

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

15 this section shall apply to sales after December 31, 2017. 

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

17 HIGH COST EMPLOYER-SPONSORED HEALTH 

18 COVERAGE. 

19 Section 9001(c) of the Patient Protection and Afford20 able Care Act is amended by striking ‘‘December 31, 

21 2019’’ and inserting ‘‘December 31, 2021’’. 

22 SEC. 4003. SUSPENSION OF ANNUAL FEE ON HEALTH IN23 SURANCE PROVIDERS. 

24 (b) IN GENERAL.—Section 9010(j) of the Patient 

25 Protection and Affordable Care Act is amended— 


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

2 (1); 

3 (2) by striking the period at the end of para4 graph (2) and inserting ‘‘, and ending before Janu5 ary 1, 2019, and’’; and 

6 (3) by adding at the end the following new 

7 paragraph: 

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

9 (c) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to calendar years beginning after 

11 December 31, 2018. 

12 DIVISION E—BUDGETARY 

13 EFFECTS 

14 SEC. 5001. BUDGETARY EFFECTS. 

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

16 C and each succeeding division shall not be entered on 

17 either PAYGO scorecard maintained pursuant to section 

18 4(d) of the Statutory Pay-As-You-Go Act of 2010. 

19 (b) SENATE PAYGO SCORECARDS.—The budgetary 

20 effects of division C and each succeeding division shall not 

21 be entered on any PAYGO scorecard maintained for pur22 poses of section 4106 of H. Con. Res. 71 (115th Con23 gress). 

24 (c) CLASSIFICATION OF BUDGETARY EFFECTS.— 

25 Notwithstanding Rule 3 of the Budget Scorekeeping 


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1 Guidelines set forth in the joint explanatory statement of 

2 the committee of conference accompanying Conference Re3 port 105–217 and section 250(c)(8) of the Balanced 

4 Budget and Emergency Deficit Control Act of 1985, the 

5 budgetary effects of division C and each succeeding divi6 sion shall not be estimated— 

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

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

9 3 of the Statutory Pay-As-You-Go Act of 2010 as 

10 being included in an appropriation Act. 

Æ 


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