I 

115TH CONGRESS 

1ST SESSION H. R. 1436 

To provide for reconciliation pursuant to title II of the concurrent resolution 

on the budget for fiscal year 2017. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 8, 2017 

Mr. JORDAN (for himself and Mr. MEADOWS) introduced the following bill; 

which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 reconciliation pursuant to title II of the 

concurrent resolution on the budget for fiscal year 2017. 

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

3 TITLE I—HEALTH, EDUCATION, 

4 LABOR, AND PENSIONS 

5 SEC. 101. THE PREVENTION AND PUBLIC HEALTH FUND. 

6 (a) IN GENERAL.—Subsection (b) of section 4002 of 

7 the Patient Protection and Affordable Care Act (42 

8 U.S.C. 300u–11), as amended by section 5009 of the 21st 

9 Century Cures Act, is amended— 


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1 (1) in paragraph (2), by adding ‘‘and’’ at the 

2 end; 

3 (2) in paragraph (3)— 

4 (A) by striking ‘‘each of fiscal years 2018 

5 and 2019’’ and inserting ‘‘fiscal year 2018’’; 

6 and 

7 (B) by striking the semicolon at the end 

8 and inserting a period; and 

9 (3) by striking paragraphs (4) through (8). 

10 (b) RESCISSION OF UNOBLIGATED FUNDS.—Of the 

11 funds made available by such section 4002, the unobli12 gated balance is rescinded. 

13 SEC. 102. COMMUNITY HEALTH CENTER PROGRAM. 

14 Effective as if included in the enactment of the Medi15 care Access and CHIP Reauthorization Act of 2015 (Pub16 lic Law 114–10, 129 Stat. 87), paragraph (1) of section 

17 221(a) of such Act is amended by inserting ‘‘, and an ad18 ditional $422,000,000 for fiscal year 2017’’ after ‘‘2017’’. 

19 SEC. 103. TERRITORIES. 

20 Section 1323(c) of the Patient Protection and Afford21 able Care Act (42 U.S.C. 18043(c)) is amended by adding 

22 at the end the following: 

23 ‘‘(3) NO FORCE AND EFFECT.—Effective Janu24 ary 1, 2018, this subsection shall have no force or 

25 effect.’’. 


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1 SEC. 104. REINSURANCE, RISK CORRIDOR, AND RISK AD2 JUSTMENT PROGRAMS. 

3 (a) TRANSITIONAL REINSURANCE PROGRAM FOR IN4 DIVIDUAL MARKET.—Section 1341 of the Patient Protec5 tion and Affordable Care Act (42 U.S.C. 18061) is amend6 ed by adding at the end the following: 

7 ‘‘(e) NO FORCE AND EFFECT.—Effective January 1, 

8 2018, the Secretary shall not collect fees and shall not 

9 make payments under this section.’’. 

10 SEC. 105. SUPPORT FOR STATE RESPONSE TO SUBSTANCE 

11 ABUSE PUBLIC HEALTH CRISIS AND URGENT 

12 MENTAL HEALTH NEEDS. 

13 (a) IN GENERAL.—There are authorized to be appro14 priated, and are appropriated, out of monies in the Treas15 ury not otherwise obligated, $750,000,000 for each of fis16 cal years 2017 and 2018, to the Secretary of Health and 

17 Human Services (referred to in this section as the ‘‘Sec18 retary’’) to award grants to States to address the sub19 stance abuse public health crisis or to respond to urgent 

20 mental health needs within the State. In awarding grants 

21 under this section, the Secretary may give preference to 

22 States with an incidence or prevalence of substance use 

23 disorders that is substantial relative to other States or to 

24 States that identify mental health needs within their com25 munities that are urgent relative to such needs of other 


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1 States. Funds appropriated under this subsection shall re2 main available until expended. 

3 (b) USE OF FUNDS.—Grants awarded to a State 

4 under subsection (a) shall be used for one or more of the 

5 following public health-related activities: 

6 (1) Improving State prescription drug moni7 toring programs. 

8 (2) Implementing prevention activities, and 

9 evaluating such activities to identify effective strate10 gies to prevent substance abuse. 

11 (3) Training for health care practitioners, such 

12 as best practices for prescribing opioids, pain man13 agement, recognizing potential cases of substance 

14 abuse, referral of patients to treatment programs, 

15 and overdose prevention. 

16 (4) Supporting access to health care services 

17 provided by federally certified opioid treatment pro18 grams or other appropriate health care providers to 

19 treat substance use disorders or mental health 

20 needs. 

21 (5) Other public health-related activities, as the 

22 State determines appropriate, related to addressing 

23 the substance abuse public health crisis or respond24 ing to urgent mental health needs within the State. 


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1 TITLE II—FINANCE 

2 SEC. 201. RECAPTURE EXCESS ADVANCE PAYMENTS OF 

3 PREMIUM TAX CREDITS. 

4 Subparagraph (B) of section 36B(f)(2) of the Inter5 nal Revenue Code of 1986 is amended by adding at the 

6 end the following new clause: 

7 ‘‘(iii) NONAPPLICABILITY OF LIMITA8 TION.—This subparagraph shall not apply 

9 to taxable years ending after December 31, 

10 2016, and before January 1, 2019.’’. 

11 SEC. 202. PREMIUM TAX CREDIT AND COST-SHARING SUB12 SIDIES. 

13 (a) REPEAL OF PREMIUM TAX CREDIT.—Subpart C 

14 of part IV of subchapter A of chapter 1 of the Internal 

15 Revenue Code of 1986 is amended by striking section 

16 36B. 

17 (b) REPEAL OF COST-SHARING SUBSIDY.—Section 

18 1402 of the Patient Protection and Affordable Care Act 

19 is repealed. 

20 (c) REPEAL OF ELIGIBILITY DETERMINATIONS.— 

21 The following sections of the Patient Protection and Af22 fordable Care Act are repealed: 

23 (1) Section 1411 (other than subsection (i), the 

24 last sentence of subsection (e)(4)(A)(ii), and such 

25 provisions of such section solely to the extent related 


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1 to the application of the last sentence of subsection 

2 (e)(4)(A)(ii)). 

3 (2) Section 1412. 

4 (d) PROTECTING AMERICANS BY REPEAL OF DIS5 CLOSURE AUTHORITY TO CARRY OUT ELIGIBILITY RE6 QUIREMENTS FOR CERTAIN PROGRAMS.— 

7 (1) IN GENERAL.—Paragraph (21) of section 

8 6103(l) of the Internal Revenue Code of 1986 is 

9 amended by adding at the end the following new 

10 subparagraph: 

11 ‘‘(D) TERMINATION.—No disclosure may 

12 be made under this paragraph after December 

13 31, 2018.’’. 

14 (e) EFFECTIVE DATES.— 

15 (1) PREMIUM TAX CREDIT.—The amendment 

16 made by subsection (a) shall apply to taxable years 

17 beginning after December 31, 2018. 

18 (2) COST-SHARING SUBSIDIES AND ELIGIBILITY

19 DETERMINATIONS.—The repeals in subsections (b) 

20 and (c) shall take effect on December 31, 2018. 

21 (3) PROTECTING AMERICANS BY RESCINDING

22 DISCLOSURE AUTHORITY.—The amendments made 

23 by subsection (d) shall take effect on December 31, 

24 2018. 


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1 SEC. 203. SMALL BUSINESS TAX CREDIT. 

2 (a) IN GENERAL.—Section 45R of the Internal Rev3 enue Code of 1986 is amended by adding at the end the 

4 following new subsection: 

5 ‘‘(j) SHALL NOT APPLY.—This section shall not 

6 apply with respect to amounts paid or incurred in taxable 

7 years beginning after December 31, 2018.’’. 

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

9 this section shall apply to amounts paid or incurred in tax10 able years beginning after December 31, 2018. 

11 SEC. 204. INDIVIDUAL MANDATE. 

12 (a) IN GENERAL.—Section 5000A(c) of the Internal 

13 Revenue Code of 1986 is amended— 

14 (1) in paragraph (2)(B) by striking clauses (ii) 

15 and (iii) and inserting the following: 

16 ‘‘(ii) Zero percent for taxable years 

17 beginning after 2015.’’, and 

18 (2) in paragraph (3)— 

19 (A) by striking ‘‘$695’’ in subparagraph 

20 (A) and inserting ‘‘$0’’, 

21 (B) by striking ‘‘and $325 for 2015’’ in 

22 subparagraph (B), and 

23 (C) by striking subparagraph (D). 

24 (b) EFFECTIVE DATE.—The amendments made by 

25 this section shall apply to months beginning after Decem26 ber 31, 2015. 


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1 SEC. 205. EMPLOYER MANDATE. 

2 (a) IN GENERAL.— 

3 (1) Paragraph (1) of section 4980H(c) of the 

4 Internal Revenue Code of 1986 is amended by in5 serting ‘‘($0 in the case of months beginning after 

6 December 31, 2015)’’ after ‘‘$2,000’’. 

7 (2) Paragraph (1) of section 4980H(b) of the 

8 Internal Revenue Code of 1986 is amended by in9 serting ‘‘($0 in the case of months beginning after 

10 December 31, 2015)’’ after ‘‘$3,000’’. 

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

12 this section shall apply to months beginning after Decem13 ber 31, 2015. 

14 SEC. 206. FEDERAL PAYMENTS TO STATES. 

15 (a) IN GENERAL.—Notwithstanding section 504(a), 

16 1902(a)(23), 1903(a), 2002, 2005(a)(4), 2102(a)(7), or 

17 2105(a)(1) of the Social Security Act (42 U.S.C. 704(a), 

18 1396a(a)(23), 1396b(a), 1397a, 1397d(a)(4), 

19 1397bb(a)(7), 1397ee(a)(1)), or the terms of any Med20 icaid waiver in effect on the date of enactment of this Act 

21 that is approved under section 1115 or 1915 of the Social 

22 Security Act (42 U.S.C. 1315, 1396n), for the 1-year pe23 riod beginning on the date of enactment of this Act, no 

24 Federal funds provided from a program referred to in this 

25 subsection that is considered direct spending for any year 

26 may be made available to a State for payments to a proVerDate Sep 11 2014 01:13 Mar 15, 2017 Jkt 069200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1436.IH H1436

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1 hibited entity, whether made directly to the prohibited en2 tity or through a managed care organization under con3 tract with the State. 

4 (b) DEFINITIONS.—In this section: 

5 (1) PROHIBITED ENTITY.—The term ‘‘prohib6 ited entity’’ means an entity, including its affiliates, 

7 subsidiaries, successors, and clinics— 

8 (A) that, as of the date of enactment of 

9 this Act— 

10 (i) is an organization described in sec11 tion 501(c)(3) of the Internal Revenue 

12 Code of 1986 and exempt from tax under 

13 section 501(a) of such Code; 

14 (ii) is an essential community provider 

15 described in section 156.235 of title 45, 

16 Code of Federal Regulations (as in effect 

17 on the date of enactment of this Act), that 

18 is primarily engaged in family planning 

19 services, reproductive health, and related 

20 medical care; and 

21 (iii) provides for abortions, other than 

22 an abortion— 

23 (I) if the pregnancy is the result 

24 of an act of rape or incest; or 


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1 (II) in the case where a woman 

2 suffers from a physical disorder, phys3 ical injury, or physical illness that 

4 would, as certified by a physician, 

5 place the woman in danger of death 

6 unless an abortion is performed, in7 cluding a life-endangering physical 

8 condition caused by or arising from 

9 the pregnancy itself; and 

10 (B) for which the total amount of Federal 

11 and State expenditures under the Medicaid pro12 gram under title XIX of the Social Security Act 

13 in fiscal year 2014 made directly to the entity 

14 and to any affiliates, subsidiaries, successors, or 

15 clinics of the entity, or made to the entity and 

16 to any affiliates, subsidiaries, successors, or 

17 clinics of the entity as part of a nationwide 

18 health care provider network, exceeded 

19 $350,000,000. 

20 (2) DIRECT SPENDING.—The term ‘‘direct 

21 spending’’ has the meaning given that term under 

22 section 250(c) of the Balanced Budget and Emer23 gency Deficit Control Act of 1985 (2 U.S.C. 900(c)). 


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1 SEC. 207. MEDICAID. 

2 The Social Security Act (42 U.S.C. 301 et seq.) is 

3 amended— 

4 (1) in section 1108(g)(5), by striking ‘‘2019’’ 

5 and inserting ‘‘2018’’; 

6 (2) in section 1902— 

7 (A) in subsection (a)(10)(A), in each of 

8 clauses (i)(VIII) and (ii)(XX), by inserting 

9 ‘‘and ending December 31, 2018,’’ after ‘‘Janu10 ary 1, 2014,’’; 

11 (B) in subsection (a)(47)(B), by inserting 

12 ‘‘and provided that any such election shall cease 

13 to be effective on January 1, 2019, and no such 

14 election shall be made after that date’’ before 

15 the semicolon at the end; and 

16 (C) in subsection (l)(2)(C), by inserting 

17 ‘‘and ending December 31, 2018,’’ after ‘‘Janu18 ary 1, 2014,’’; 

19 (3) in each of sections 1902(gg)(2) and 

20 2105(d)(3)(A), by striking ‘‘September 30, 2019’’ 

21 and inserting ‘‘September 30, 2018’’; 

22 (4) in section 1905— 

23 (A) in the first sentence of subsection (b), 

24 by inserting ‘‘(50 percent on or after January 

25 1, 2019)’’ after ‘‘55 percent’’; 


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1 (B) in subsection (y)(1), by striking the 

2 semicolon at the end of subparagraph (B) and 

3 all that follows through ‘‘thereafter’’; and 

4 (C) in subsection (z)(2)— 

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

6 ‘‘each year thereafter’’ and inserting 

7 ‘‘through 2018’’; and 

8 (ii) in subparagraph (B)(ii), by strik9 ing the semicolon at the end of subclause 

10 (IV) and all that follows through ‘‘100 per11 cent’’; 

12 (5) in section 1915(k)(2), by striking ‘‘during 

13 the period described in paragraph (1)’’ and inserting 

14 ‘‘on or after the date referred to in paragraph (1) 

15 and before January 1, 2019’’; 

16 (6) in section 1920(e), by adding at the end the 

17 following: ‘‘This subsection shall not apply after De18 cember 31, 2018.’’; 

19 (7) in section 1937(b)(5), by adding at the end 

20 the following: ‘‘This paragraph shall not apply after 

21 December 31, 2018.’’; and 

22 (8) in section 1943(a), by inserting ‘‘and before 

23 January 1, 2019,’’ after ‘‘January 1, 2014,’’. 


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1 SEC. 208. REPEAL OF DSH ALLOTMENT REDUCTIONS. 

2 Section 1923(f) of the Social Security Act (42 U.S.C. 

3 1396r–4(f)) is amended by striking paragraphs (7) and 

4 (8). 

5 SEC. 209. REPEAL OF THE TAX ON EMPLOYEE HEALTH IN6 SURANCE PREMIUMS AND HEALTH PLAN 

7 BENEFITS. 

8 (a) IN GENERAL.—Chapter 43 of the Internal Rev9 enue Code of 1986 is amended by striking section 4980I. 

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

11 subsection (a) shall apply to taxable years beginning after 

12 December 31, 2018. 

13 SEC. 210. REPEAL OF TAX ON OVER-THE-COUNTER MEDICA14 TIONS. 

15 (a) HSAS.—Subparagraph (A) of section 223(d)(2) 

16 of the Internal Revenue Code of 1986 is amended by strik17 ing ‘‘Such term’’ and all that follows through the period. 

18 (b) ARCHER MSAS.—Subparagraph (A) of section 

19 220(d)(2) of the Internal Revenue Code of 1986 is amend20 ed by striking ‘‘Such term’’ and all that follows through 

21 the period. 

22 (c) HEALTH FLEXIBLE SPENDING ARRANGEMENTS

23 AND HEALTH REIMBURSEMENT ARRANGEMENTS.—Sec24 tion 106 of the Internal Revenue Code of 1986 is amended 

25 by striking subsection (f). 

26 (d) EFFECTIVE DATES.— 


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1 (1) DISTRIBUTIONS FROM SAVINGS AC2 COUNTS.—The amendments made by subsections (a) 

3 and (b) shall apply to amounts paid with respect to 

4 taxable years beginning after December 31, 2016. 

5 (2) REIMBURSEMENTS.—The amendment made 

6 by subsection (c) shall apply to expenses incurred 

7 with respect to taxable years beginning after Decem8 ber 31, 2016. 

9 SEC. 211. REPEAL OF TAX ON HEALTH SAVINGS ACCOUNTS. 

10 (a) HSAS.—Section 223(f)(4)(A) of the Internal 

11 Revenue Code of 1986 is amended by striking ‘‘20 per12 cent’’ and inserting ‘‘10 percent’’. 

13 (b) ARCHER MSAS.—Section 220(f)(4)(A) of the In14 ternal Revenue Code of 1986 is amended by striking ‘‘20 

15 percent’’ and inserting ‘‘15 percent’’. 

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

17 this section shall apply to distributions made after Decem18 ber 31, 2016. 

19 SEC. 212. REPEAL OF LIMITATIONS ON CONTRIBUTIONS TO 

20 FLEXIBLE SPENDING ACCOUNTS. 

21 (a) IN GENERAL.—Section 125 of the Internal Rev22 enue Code of 1986 is amended by striking subsection (i). 

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

24 this section shall apply to taxable years beginning after 

25 December 31, 2016. 


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1 SEC. 213. REPEAL OF TAX ON PRESCRIPTION MEDICA2 TIONS. 

3 Subsection (j) of section 9008 of the Patient Protec4 tion and Affordable Care Act is amended to read as fol5 lows: 

6 ‘‘(j) REPEAL.—This section shall apply to calendar 

7 years beginning after December 31, 2011, and ending be8 fore January 1, 2017.’’. 

9 SEC. 214. REPEAL OF MEDICAL DEVICE EXCISE TAX. 

10 (a) IN GENERAL.—Chapter 32 of the Internal Rev11 enue Code of 1986 is amended by striking subchapter E. 

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

13 this section shall apply to sales in calendar quarters begin14 ning after December 31, 2016. 

15 SEC. 215. REPEAL OF HEALTH INSURANCE TAX. 

16 Subsection (j) of section 9010 of the Patient Protec17 tion and Affordable Care Act is amended to read as fol18 lows: 

19 ‘‘(j) REPEAL.—This section shall apply to calendar 

20 years beginning after December 31, 2014, and ending be21 fore January 1, 2017.’’. 

22 SEC. 216. REPEAL OF ELIMINATION OF DEDUCTION FOR 

23 EXPENSES ALLOCABLE TO MEDICARE PART D 

24 SUBSIDY. 

25 (a) IN GENERAL.—Section 139A of the Internal Rev26 enue Code of 1986 is amended by adding at the end the 


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1 following new sentence: ‘‘This section shall not be taken 

2 into account for purposes of determining whether any de3 duction is allowable with respect to any cost taken into 

4 account in determining such payment.’’. 

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

6 this section shall apply to taxable years beginning after 

7 December 31, 2016. 

8 SEC. 217. REPEAL OF CHRONIC CARE TAX. 

9 (a) IN GENERAL.—Subsection (a) of section 213 of 

10 the Internal Revenue Code of 1986 is amended by striking 

11 ‘‘10 percent’’ and inserting ‘‘7.5 percent’’. 

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

13 this section shall apply to taxable years beginning after 

14 December 31, 2016. 

15 SEC. 218. REPEAL OF MEDICARE TAX INCREASE. 

16 (a) IN GENERAL.—Subsection (b) of section 3101 of 

17 the Internal Revenue Code of 1986 is amended to read 

18 as follows: 

19 ‘‘(b) HOSPITAL INSURANCE.—In addition to the tax 

20 imposed by the preceding subsection, there is hereby im21 posed on the income of every individual a tax equal to 1.45 

22 percent of the wages (as defined in section 3121(a)) re23 ceived by such individual with respect to employment (as 

24 defined in section 3121(b)).’’. 


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1 (b) SECA.—Subsection (b) of section 1401 of the In2 ternal Revenue Code of 1986 is amended to read as fol3 lows: 

4 ‘‘(b) HOSPITAL INSURANCE.—In addition to the tax 

5 imposed by the preceding subsection, there shall be im6 posed for each taxable year, on the self-employment in7 come of every individual, a tax equal to 2.9 percent of the 

8 amount of the self-employment income for such taxable 

9 year.’’. 

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

11 this section shall apply with respect to remuneration re12 ceived after, and taxable years beginning after, December 

13 31, 2016. 

14 SEC. 219. REPEAL OF TANNING TAX. 

15 (a) IN GENERAL.—The Internal Revenue Code of 

16 1986 is amended by striking chapter 49. 

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

18 this section shall apply to services performed on or after 

19 December 31, 2016. 

20 SEC. 220. REPEAL OF NET INVESTMENT TAX. 

21 (a) IN GENERAL.—Subtitle A of the Internal Rev22 enue Code of 1986 is amended by striking chapter 2A. 

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

24 this section shall apply to taxable years beginning after 

25 December 31, 2016. 


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1 SEC. 221. REMUNERATION. 

2 Paragraph (6) of section 162(m) of the Internal Rev3 enue Code of 1986 is amended by adding at the end the 

4 following new subparagraph: 

5 ‘‘(I) TERMINATION.—This paragraph shall 

6 not apply to taxable years beginning after De7 cember 31, 2016.’’. 

8 SEC. 222. ECONOMIC SUBSTANCE DOCTRINE. 

9 (a) IN GENERAL.—Subsection (o) of section 7701 of 

10 the Internal Revenue Code of 1986 is repealed. 

11 (b) PENALTY FOR UNDERPAYMENTS.—Paragraph 

12 (6) of section 6662(b) of the Internal Revenue Code of 

13 1986 is repealed. 

14 (c) INCREASED PENALTY FOR NONDISCLOSED

15 TRANSACTIONS.—Subsection (i) of section 6662 of the In16 ternal Revenue Code of 1986 is repealed. 

17 (d) REASONABLE CAUSE EXCEPTION FOR UNDER18 PAYMENTS.—Paragraph (2) of section 6664(c) of the In19 ternal Revenue Code of 1986 is repealed. 

20 (e) REASONABLE CAUSE EXCEPTION FOR NONDIS21 CLOSED TRANSACTIONS.—Paragraph (2) of section 

22 6664(d) of the Internal Revenue Code of 1986 is repealed. 

23 (f) ERRONEOUS CLAIM FOR REFUND OR CREDIT.— 

24 Subsection (c) of section 6676 of the Internal Revenue 

25 Code of 1986 is repealed. 


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1 (g) EFFECTIVE DATE.—The repeals made by this 

2 section shall apply to transactions entered into, and to un3 derpayments, understatements, or refunds and credits at4 tributable to transactions entered into, after December 31, 

5 2016. 

6 SEC. 223. BUDGETARY SAVINGS FOR EXTENDING MEDI7 CARE SOLVENCY. 

8 As a result of policies contained in this Act, the Sec9 retary of the Treasury shall transfer to the Federal Hos10 pital Insurance Trust Fund under section 1817 of the So11 cial Security Act (42 U.S.C. 1395i) $lllllll 

12 (which represents the full amount of on-budget savings 

13 during the period of fiscal years 2017 through 2026) for 

14 extending Medicare solvency, to remain available until ex15 pended. 

Æ 


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