H. R. 195 

One Hundred Fifteenth Congress 

of the 

United States of America 

AT THE SECOND SESSION 

Begun and held at the City of Washington on Wednesday, 

the third day of January, two thousand and eighteen 

An Act 

Making further continuing appropriations for the fiscal year ending September 

30, 2018, and for other purposes. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

DIVISION A—FEDERAL REGISTER 

PRINTING SAVINGS ACT OF 2017 

SECTION 1. SHORT TITLE. 

This division may be cited as the ‘‘Federal Register Printing 

Savings Act of 2017’’. 

SEC. 2. RESTRICTIONS ON DISTRIBUTION OF FREE PRINTED COPIES 

OF FEDERAL REGISTER TO MEMBERS OF CONGRESS AND 

FEDERAL EMPLOYEES. 

(a) RESTRICTIONS.—Section 1506 of title 44, United States Code, 

is amended— 

(1) by striking ‘‘The Administrative Committee’’ and 

inserting ‘‘(a) COMPOSITION; DUTIES.—The Administrative Committee’’; 

(2) in subsection (a)(4), by striking ‘‘the number of copies’’ 

and inserting ‘‘subject to subsection (b), the number of copies’’; 

and 

(3) by adding at the end the following new subsection: 

‘‘(b) RESTRICTIONS ON DISTRIBUTION OF FREE PRINTED COPIES

TO MEMBERS OF CONGRESS AND OFFICERS AND EMPLOYEES OF THE

UNITED STATES.— 

‘‘(1) PROHIBITING SUBSCRIPTION TO PRINTED COPIES WITHOUT

REQUEST.—Under the regulations prescribed to carry out subsection (a)(4), the Director of the Government Publishing Office 

may not provide a printed copy of the Federal Register without 

charge to any Member of Congress or any other office of the 

United States during a year unless— 

‘‘(A) the Member or office requests a printed copy of 

a specific issue of the Federal Register; or 

‘‘(B) during that year or during the previous year, 

the Member or office requested a subscription to printed 

copies of the Federal Register for that year, as described 

in paragraph (2). 

‘‘(2) ADMINISTRATION OF SUBSCRIPTIONS.—The regulations 

prescribed to carry out subsection (a)(4) shall include— 
H. R. 195—2 

‘‘(A) provisions regarding notifications to offices of 

Members of Congress and other offices of the United States 

of the restrictions of paragraph (1); 

‘‘(B) provisions describing the process by which Members and other offices may request a specific issue of the 

Federal Register for purposes of paragraph (1)(A); and 

‘‘(C) provisions describing the process by which Members and other offices may request a subscription to the 

Federal Register for purposes of paragraph (1)(B), except 

that such regulations shall limit the period for such a 

subscription to not longer than 1 year.’’. 

(b) EFFECTIVE DATE.—The amendment made by subsection (a) 

shall take effect January 1, 2018. 

DIVISION B—EXTENSION OF CONTINUING 

APPROPRIATIONS ACT, 2018 

SEC. 2001. The Continuing Appropriations Act, 2018 (division 

D of Public Law 115–56) is amended— 

(1) by striking the date specified in section 106(3) and 

inserting ‘‘February 8, 2018’’; and 

(2) by adding after section 147 the following: 

‘‘SEC. 148. Funds appropriated by the Department of Defense 

Missile Defeat and Defense Enhancements Appropriations Act, 2018 

(division B of Public Law 115–96) may be obligated and expended 

notwithstanding section 504(a)(1) of the National Security Act of 

1947 (50 U.S.C. 3094(a)(1)). 

‘‘SEC. 149. Amounts made available by section 101 for ‘Department of Agriculture—Food and Nutrition Service—Child Nutrition 

Programs’ to carry out section 749(g) of the Agriculture Appropriations Act of 2010 (Public Law 111–80) may be apportioned up 

to the rate for operations necessary to ensure that the program 

can be fully operational by May 2018. 

‘‘SEC. 150. Amounts made available by section 101 for ‘National 

Aeronautics and Space Administration—Exploration’ may be apportioned up to the rate for operations necessary to maintain the 

planned launch capability schedules for the Space Launch System 

launch vehicle, Exploration Ground Systems, and Orion Multi-Purpose Crew Vehicle programs. 

‘‘SEC. 151. Amounts made available by section 101 for ‘Department of Energy—Energy Programs—Office of the Inspector General’ 

may be apportioned up to the rate for operations necessary to 

sustain staffing levels achieved on June 30, 2017. 

‘‘SEC. 152. Amounts made available by section 101 for ‘Small 

Business Administration—Business Loans Program Account’ may 

be apportioned up to the rate for operations necessary to accommodate increased demand for commitments for general business loans 

authorized under section 7(a) of the Small Business Act (15 U.S.C. 

636(a)). 

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

Development may make temporary adjustments to the Section 8 

housing choice voucher annual renewal funding allocations and 

administrative fee eligibility determinations for public housing 

agencies in an area for which the President declared a disaster 

in 2017 or 2018 under title IV of the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act (42 U.S.C. 5170 et seq.), 

to avoid significant adverse funding impacts that would otherwise 
H. R. 195—3 

result from the disaster and that would otherwise prevent a public 

housing agency from leasing up to its authorized level of units 

under contract (but not to exceed such level), upon request by 

and in consultation with a public housing agency and supported 

by documentation as required by the Secretary that demonstrates 

the need for the adjustment. 

‘‘SEC. 154. (a) Employees furloughed as a result of any lapse 

in appropriations which begins on or about January 20, 2018, 

shall be compensated at their standard rate of compensation, for 

the period of such lapse in appropriations, as soon as practicable 

after such lapse in appropriations ends. 

‘‘(b) For purposes of this section, ‘employee’ means: 

‘‘(1) a federal employee; 

‘‘(2) an employee of the District of Columbia Courts; 

‘‘(3) an employee of the Public Defender Service for the 

District of Columbia; or 

‘‘(4) a District of Columbia Government employee. 

‘‘(c) All obligations incurred in anticipation of the appropriations 

made and authority granted by this division for the purposes of 

maintaining the essential level of activity to protect life and property and bringing about orderly termination of Government functions, and for purposes as otherwise authorized by law, are hereby 

ratified and approved if otherwise in accord with the provisions 

of this division. 

‘‘SEC. 155. (a) If a State (or another Federal grantee) used 

State funds (or the grantee’s non-Federal funds) to continue carrying 

out a Federal program or furloughed State employees (or the 

grantee’s employees) whose compensation is advanced or 

reimbursed in whole or in part by the Federal Government— 

‘‘(1) such furloughed employees shall be compensated at 

their standard rate of compensation for such period; 

‘‘(2) the State (or such other grantee) shall be reimbursed 

for expenses that would have been paid by the Federal Government during such period had appropriations been available, 

including the cost of compensating such furloughed employees, 

together with interest thereon calculated under section 6503(d) 

of title 31, United States Code; and 

‘‘(3) the State (or such other grantee) may use funds available to the State (or the grantee) under such Federal program 

to reimburse such State (or the grantee), together with interest 

thereon calculated under section 6503(d) of title 31, United 

States Code. 

‘‘(b) For purposes of this section, the term ‘State’ and the 

term ‘grantee’ shall have the meaning as such term is defined 

under the applicable Federal program under subsection (a). In 

addition, ‘to continue carrying out a Federal program’ means the 

continued performance by a State or other Federal grantee, during 

the period of a lapse in appropriations, of a Federal program that 

the State or such other grantee had been carrying out prior to 

the period of the lapse in appropriations. 

‘‘(c) The authority under this section applies with respect to 

any period in fiscal year 2018 (not limited to periods beginning 

or ending after the date of the enactment of this division) during 

which there occurs a lapse in appropriations with respect to any 

department or agency of the Federal Government which, but for 

such lapse in appropriations, would have paid, or made reimbursement relating to, any of the expenses referred to in this section 
H. R. 195—4 

with respect to the program involved. Payments and reimbursements under this authority shall be made only to the extent and 

in amounts provided in advance in appropriations Acts.’’. 

SEC. 2002. The Further Additional Continuing Appropriations 

Act, 2018 (division A of Public Law 115–96) is amended by striking 

section 1002. 

SEC. 2003. For the purposes of division D of Public Law 115– 

56, the time covered by such division shall be considered to include 

the period which began on or about January 20, 2018, during 

which there occurred a lapse in appropriations. 

This division may be cited as the ‘‘Extension of Continuing 

Appropriations Act, 2018’’. 

DIVISION C—HEALTHY KIDS ACT 

SEC. 3001. SHORT TITLE. 

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

for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance 

Delivery Stable Act’’ or the ‘‘HEALTHY KIDS Act’’. 

SEC. 3002. SIX-YEAR FUNDING EXTENSION OF THE CHILDREN’S 

HEALTH INSURANCE PROGRAM. 

(a) FUNDING.— 

(1) IN GENERAL.—Section 2104(a) of the Social Security 

Act (42 U.S.C. 1397dd(a)), as amended by section 3201(a) of 

the CHIP and Public Health Funding Extension Act (division 

C of Public Law 115–96), is amended— 

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

inserting a semicolon; 

(B) by striking paragraph (21) and inserting the following new paragraphs: 

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

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

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

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

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

‘‘(26) for fiscal year 2023, for purposes of making two semiannual allotments— 

‘‘(A) $2,850,000,000 for the period beginning on October 

1, 2022, and ending on March 31, 2023; and 

‘‘(B) $2,850,000,000 for the period beginning on April 

1, 2023, and ending on September 30, 2023.’’. 

(2) PREVENTION OF DUPLICATE APPROPRIATIONS FOR FISCAL

YEAR 2018.—Notwithstanding any other provision of law, insofar 

as funds have been appropriated under subsection (a)(21) of 

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

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

of the enactment of this Act, to provide allotments to States 

under the State Children’s Health Insurance Program established under title XXI of the Social Security Act (42 U.S.C. 

1397aa et seq.) (whether implemented under title XIX, XXI, 

or both, of the Social Security Act) for fiscal year 2018— 

(A) any amounts that are so appropriated that are 

not so allotted and obligated before the date of the enactment of this Act, are rescinded; and 
H. R. 195—5 

(B) any amount provided for CHIP allotments to a 

State under this section (and the amendments made by 

this section) for such fiscal year shall be reduced by the 

amount of such appropriations so allotted and obligated 

before such date. 

(b) ALLOTMENTS.— 

(1) IN GENERAL.—Section 2104(m) of the Social Security 

Act (42 U.S.C. 1397dd(m)), as amended by section 3201(b) of 

the CHIP and Public Health Funding Extension Act (division 

C of Public Law 115–96), is amended— 

(A) in paragraph (2)(B)— 

(i) in the matter preceding clause (i), by striking 

‘‘(19)’’ and inserting ‘‘(25)’’; 

(ii) in clause (i), by striking ‘‘and 2017’’ and 

inserting ‘‘, 2017, and 2023’’; and 

(iii) in clause (ii)— 

(I) in the matter preceding subclause (I), by 

striking ‘‘and paragraph (10)’’; and 

(II) in subclause (I), by inserting ‘‘(or, in the 

case of fiscal year 2018, under paragraph (4))’’ 

after ‘‘clause (i)’’; 

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

‘‘2023’’; 

(C) in paragraph (7)— 

(i) in subparagraph (A), by striking ‘‘2017’’ and 

inserting ‘‘2023’’; 

(ii) in subparagraph (B), in the matter preceding 

clause (i), by inserting ‘‘(or, in the case of fiscal year 

2018, by not later than the date that is 60 days after 

the date of the enactment of the HEALTHY KIDS 

Act)’’ after ‘‘before the August 31 preceding the beginning of the fiscal year’’; and 

(iii) in the matter following subparagraph (B), by 

striking ‘‘or fiscal year 2016’’ and inserting ‘‘fiscal year 

2016, fiscal year 2018, fiscal year 2020, or fiscal year 

2022’’; 

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

‘‘2023’’; and 

(E) by amending paragraph (10) to read as follows: 

‘‘(10) FOR FISCAL YEAR 2023.— 

‘‘(A) FIRST HALF.—Subject to paragraphs (5) and (7), 

from the amount made available under subparagraph (A) 

of paragraph (26) of subsection (a) for the semi-annual 

period described in such subparagraph, increased by the 

amount of the appropriation for such period under section 

3002(b)(2) of the HEALTHY KIDS Act, the Secretary shall 

compute a State allotment for each State (including the 

District of Columbia and each commonwealth and territory) 

for such semi-annual period in an amount equal to the 

first half ratio (described in subparagraph (D)) of the 

amount described in subparagraph (C). 

‘‘(B) SECOND HALF.—Subject to paragraphs (5) and (7), 

from the amount made available under subparagraph (B) 

of paragraph (26) of subsection (a) for the semi-annual 

period described in such subparagraph, the Secretary shall 

compute a State allotment for each State (including the 

District of Columbia and each commonwealth and territory) 
H. R. 195—6 

for such semi-annual period in an amount equal to the 

amount made available under such subparagraph, multiplied by the ratio of— 

‘‘(i) the amount of the allotment to such State 

under subparagraph (A); to 

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

made available under such subparagraph. 

‘‘(C) FULL YEAR AMOUNT BASED ON REBASED AMOUNT.— 

The amount described in this subparagraph for a State 

is equal to the Federal payments to the State that are 

attributable to (and countable towards) the total amount 

of allotments available under this section to the State 

in fiscal year 2022 (including payments made to the State 

under subsection (n) for fiscal year 2022 as well as amounts 

redistributed to the State in fiscal year 2022), multiplied 

by the allotment increase factor under paragraph (6) for 

fiscal year 2023. 

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

in this subparagraph is the ratio of— 

‘‘(i) the sum of— 

‘‘(I) the amount made available under subsection (a)(26)(A); and 

‘‘(II) the amount of the appropriation for such 

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

KIDS Act; to 

‘‘(ii) the sum of— 

‘‘(I) the amount described in clause (i); and 

‘‘(II) the amount made available under subsection (a)(26)(B).’’. 

(2) ONE-TIME APPROPRIATION FOR FISCAL YEAR 2023.—There 

is appropriated to the Secretary of Health and Human Services, 

out of any money in the Treasury not otherwise appropriated, 

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

period beginning on October 1, 2022, and ending on March 

31, 2023, under paragraph (26)(A) of section 2104(a) of the 

Social Security Act (42 U.S.C. 1397dd(a)) (as added by subsection (a)), to remain available until expended. Such amount 

shall be used to provide allotments to States under paragraph 

(10) of section 2104(m) of such Act (as added by paragraph 

(1)) for the first 6 months of fiscal year 2023 in the same 

manner as allotments are provided under subsection (a)(26)(A) 

of such section 2104 and subject to the same terms and conditions as apply to the allotments provided from such subsection 

(a)(26)(A). 

(c) EXTENSION OF THE CHILD ENROLLMENT CONTINGENCY

FUND.—Section 2104(n) of the Social Security Act (42 U.S.C. 

1397dd(n)) is amended— 

(1) in paragraph (2)— 

(A) in subparagraph (A)(ii)— 

(i) by striking ‘‘2010, 2011, 2012, 2013, 2014, and 

2016’’ and inserting ‘‘2010 through 2014, 2016, and 

2018 through 2022’’; and 

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

2017’’ and inserting ‘‘fiscal years 2015, 2017, and 2023’’; 

and 

(B) in subparagraph (B)— 
H. R. 195—7 

(i) by striking ‘‘2010, 2011, 2012, 2013, 2014, and 

2016’’ and inserting ‘‘2010 through 2014, 2016, and 

2018 through 2022’’; and 

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

2017’’ and inserting ‘‘fiscal years 2015, 2017, and 2023’’; 

and 

(2) in paragraph (3)(A), in the matter preceding clause 

(i), by striking ‘‘or a semi-annual allotment period for fiscal 

year 2015 or 2017’’ and inserting ‘‘or in any of fiscal years 

2018 through 2022 (or a semi-annual allotment period for fiscal 

year 2015, 2017, or 2023)’’. 

(d) EXTENSION OF QUALIFYING STATES OPTION.— 

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

Act (42 U.S.C. 1397ee(g)(4)) is amended— 

(A) in the heading, by striking ‘‘THROUGH 2017’’ and 

inserting ‘‘THROUGH 2023’’; and 

(B) in subparagraph (A), by striking ‘‘2017’’ and 

inserting ‘‘2023’’. 

(2) TECHNICAL AMENDMENTS.—Section 2104(f)(2)(B)(ii) of 

the Social Security Act (42 U.S.C. 1397dd(f)(2)(B)(ii)), as 

amended by section 3201(c) of the CHIP and Public Health 

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

amended— 

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

defined in subclause (II))’’ and inserting ‘‘(as defined in 

subclause (II)) for the month’’; 

(B) in subclause (II), by inserting ‘‘, as in effect on 

the day before the date of the enactment of the HEALTHY 

KIDS Act,’’ after ‘‘section 2105(g)(4)(A)’’; and 

(C) in subclause (VI)— 

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

the date of the enactment of the HEALTHY KIDS 

Act’’ after ‘‘, section 2105(g)(4)’’; and 

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

section 2105(g)(4)’’. 

(e) EXTENSION OF EXPRESS LANE ELIGIBILITY OPTION.—Section 

1902(e)(13)(I) of the Social Security Act (42 U.S.C. 1396a(e)(13)(I)) 

is amended by striking ‘‘2017’’ and inserting ‘‘2023’’. 

(f) ASSURANCE OF AFFORDABILITY STANDARD FOR CHILDREN AND

FAMILIES.— 

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

Act (42 U.S.C. 1397ee(d)(3)) is amended— 

(A) in the paragraph heading, by striking ‘‘UNTIL

OCTOBER 1, 2019’’ and inserting ‘‘THROUGH SEPTEMBER 30, 

2023’’; and 

(B) in subparagraph (A), in the matter preceding clause 

(i)— 

(i) by striking ‘‘2019’’ and inserting ‘‘2023’’; and 

(ii) by striking ‘‘The preceding sentence shall not 

be construed as preventing a State during such period’’ 

and inserting ‘‘During the period that begins on 

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

the preceding sentence shall only apply with respect 

to children in families whose income does not exceed 

300 percent of the poverty line (as defined in section 

2110(c)(5)) applicable to a family of the size involved. 
H. R. 195—8 

The preceding sentences shall not be construed as preventing a State during any such periods’’. 

(2) CONFORMING AMENDMENTS.—Section 1902(gg)(2) of the 

Social Security Act (42 U.S.C. 1396a(gg)(2)) is amended— 

(A) in the paragraph heading, by striking ‘‘UNTIL

OCTOBER 1, 2019’’ and inserting ‘‘THROUGH SEPTEMBER 30, 

2023’’; and 

(B) by striking ‘‘September 30, 2019,’’ and inserting 

‘‘September 30, 2023 (but during the period that begins 

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

only with respect to children in families whose income 

does not exceed 300 percent of the poverty line (as defined 

in section 2110(c)(5)) applicable to a family of the size 

involved)’’. 

(g) CHIP LOOK-ALIKE PLANS.— 

(1) BLENDING RISK POOLS.—Section 2107 of the Social Security Act (42 U.S.C. 1397gg) is amended by adding at the end 

the following: 

‘‘(g) USE OF BLENDED RISK POOLS.— 

‘‘(1) IN GENERAL.—Nothing in this title (or any other provision of Federal law) shall be construed as preventing a State 

from considering children enrolled in a qualified CHIP lookalike program and children enrolled in a State child health 

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

of a single risk pool. 

‘‘(2) QUALIFIED CHIP LOOK-ALIKE PROGRAM.—In this subsection, the term ‘qualified CHIP look-alike program’ means 

a State program— 

‘‘(A) under which children who are under the age of 

19 and are not eligible to receive medical assistance under 

title XIX or child health assistance under this title may 

purchase coverage through the State that provides benefits 

that are at least identical to the benefits provided under 

the State child health plan under this title (or a waiver 

of such plan); and 

‘‘(B) that is funded exclusively through non-Federal 

funds, including funds received by the State in the form 

of premiums for the purchase of such coverage.’’. 

(2) COVERAGE RULE.— 

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

Revenue Code of 1986 is amended in subparagraph (A)(iii), 

by inserting ‘‘or under a qualified CHIP look-alike program 

(as defined in section 2107(g) of the Social Security Act)’’ 

before the comma at the end. 

(B) EFFECTIVE DATE.—The amendment made by 

subparagraph (A) shall apply with respect to taxable years 

beginning after December 31, 2017. 

(h) AVAILABILITY OF UNUSED FISCAL YEAR 2018 REDISTRIBUTION

AMOUNTS.—Any amounts that have been redistributed to States 

under subsection (f) of section 2104 of the Social Security Act 

(42 U.S.C. 1397dd) for fiscal year 2018 that are not, or will not 

be, expended by the end of that fiscal year shall be— 

(1) adjusted by the Secretary before the end of fiscal year 

2018 to reflect an updated estimate of shortfalls under subsection (f)(2)(A) of such section; and 

(2) available for redistribution under subsection (f) of such 

section for subsequent fiscal years. 
H. R. 195—9 

SEC. 3003. EXTENSION OF CERTAIN PROGRAMS AND DEMONSTRATION 

PROJECTS. 

(a) CHILDHOOD OBESITY DEMONSTRATION PROJECT.—Section 

1139A(e)(8) of the Social Security Act (42 U.S.C. 1320b–9a(e)(8)) 

is amended— 

(1) by striking ‘‘and $10,000,000’’ and inserting ‘‘, 

$10,000,000’’; and 

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

$30,000,000 for the period of fiscal years 2018 through 2023’’. 

(b) PEDIATRIC QUALITY MEASURES PROGRAM.—Section 1139A(i) 

of the Social Security Act (42 U.S.C. 1320b–9a(i)) is amended— 

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

‘‘(1) IN GENERAL.—Out of any’’; 

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

‘‘there is appropriated— 

‘‘(A) for each’’; 

(3) by striking ‘‘, and there is appropriated for the period’’ 

and inserting ‘‘; 

‘‘(B) for the period’’; 

(4) by striking ‘‘. Funds appropriated under this subsection 

shall remain available until expended.’’ and inserting ‘‘; and’’; 

and 

(5) by adding at the end the following: 

‘‘(C) for the period of fiscal years 2018 through 2023, 

$90,000,000 for the purpose of carrying out this section 

(other than subsections (e), (f), and (g)). 

‘‘(2) AVAILABILITY.—Funds appropriated under this subsection shall remain available until expended.’’. 

SEC. 3004. EXTENSION OF OUTREACH AND ENROLLMENT PROGRAM. 

(a) IN GENERAL.—Section 2113 of the Social Security Act (42 

U.S.C. 1397mm) is amended— 

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

‘‘2023’’; and 

(2) in subsection (g)— 

(A) by striking ‘‘and $40,000,000’’ and inserting ‘‘, 

$40,000,000’’; and 

(B) by inserting after ‘‘2017’’ the following: ‘‘, and 

$120,000,000 for the period of fiscal years 2018 through 

2023’’. 

(b) MAKING ORGANIZATIONS THAT USE PARENT MENTORS

ELIGIBLE TO RECEIVE GRANTS.—Section 2113(f) of the Social Security Act (42 U.S.C. 1397mm(f)) is amended— 

(1) in paragraph (1)(E), by striking ‘‘or community-based 

doula programs’’ and inserting ‘‘, community-based doula programs, or parent mentors’’; and 

(2) by adding at the end the following new paragraph: 

‘‘(5) PARENT MENTOR.—The term ‘parent mentor’ means 

an individual who— 

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

who is an eligible child under this title or title XIX; and 

‘‘(B) is trained to assist families with children who 

have no health insurance coverage with respect to 

improving the social determinants of the health of such 

children, including by providing— 

‘‘(i) education about health insurance coverage, 

including, with respect to obtaining such coverage, 
H. R. 195—10 

eligibility criteria and application and renewal processes; 

‘‘(ii) assistance with completing and submitting 

applications for health insurance coverage; 

‘‘(iii) a liaison between families and representatives 

of State plans under title XIX or State child health 

plans under this title; 

‘‘(iv) guidance on identifying medical and dental 

homes and community pharmacies for children; and 

‘‘(v) assistance and referrals to successfully address 

social determinants of children’s health, including poverty, food insufficiency, and housing.’’. 

(c) EXCLUSION FROM MODIFIED ADJUSTED GROSS INCOME.— 

Section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) 

is amended— 

(1) in the first paragraph (14), relating to income determined using modified adjusted gross income, by adding at 

the end the following new subparagraph: 

‘‘(J) EXCLUSION OF PARENT MENTOR COMPENSATION

FROM INCOME DETERMINATION.—Any nominal amount 

received by an individual as compensation, including a 

stipend, for participation as a parent mentor (as defined 

in paragraph (5) of section 2113(f)) in an activity or program funded through a grant under such section shall 

be disregarded for purposes of determining the income 

eligibility of such individual for medical assistance under 

the State plan or any waiver of such plan.’’; and 

(2) by striking ‘‘(14) EXCLUSION’’ and inserting ‘‘(15) EXCLUSION’’. 

SEC. 3005. EXTENSION AND REDUCTION OF ADDITIONAL FEDERAL 

FINANCIAL PARTICIPATION FOR CHIP. 

Section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) 

is amended in the second sentence by inserting ‘‘and during the 

period that begins on October 1, 2019, and ends on September 

30, 2020, the enhanced FMAP determined for a State for a fiscal 

year (or for any portion of a fiscal year occurring during such 

period) shall be increased by 11.5 percentage points’’ after ‘‘23 

percentage points,’’. 

SEC. 3006. MEDICAID IMPROVEMENT FUND. 

Section 1941 of the Social Security Act (42 U.S.C. 1396w– 

1) is amended— 

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

before the period at the end the following: ‘‘, and, in accordance 

with subsection (b)(3), for the purposes of subparagraph (B) 

of such subsection’’; and 

(2) in subsection (b)— 

(A) in paragraph (2)— 

(i) in the first sentence, by inserting ‘‘pursuant 

to paragraph (1)’’ after ‘‘in the Fund’’; 

(ii) by inserting after the first sentence the following sentence: ‘‘Amounts in the Fund pursuant to 

paragraph (3) shall be available in advance of appropriations but only if the total amount obligated from 

the Fund does not exceed the amount available to 

the Fund under such paragraph (3).’’; and 
H. R. 195—11 

(iii) in the last sentence, by striking ‘‘sentence’’ 

and inserting ‘‘sentences’’; and 

(B) by adding at the end the following new paragraph: 

‘‘(3) ADDITIONAL FUNDING FOR STATE ACTIVITIES RELATING

TO MECHANIZED CLAIMS SYSTEMS.— 

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

available under paragraph (1), there shall be available 

to the Fund, for expenditures from the Fund in accordance 

with subparagraph (B), for fiscal year 2023 and thereafter, 

$980,000,000, to remain available until expended. 

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

made available to the Fund under subparagraph (A) to 

pay to each State which has a plan approved under this 

title, for each quarter beginning during or after fiscal year 

2023 an amount equal to— 

‘‘(i) 100 percent minus the percent specified in 

clause (i) of section 1903(a)(3)(A) of so much of the 

sums expended by the State during such quarter as 

are attributable to the activities described in such 

clause; 

‘‘(ii) 100 percent minus the Federal medical assistance percentage applied under clause (iii) of such section of so much of the sums expended during such 

quarter (as found necessary by the Secretary under 

such clause) by the State as are attributable to the 

activities described in such clause; and 

‘‘(iii) 100 percent minus the percent specified in 

section 1903(a)(3)(B) of so much of the sums expended 

by the State during such quarter as are attributable 

to the activities described in such section.’’. 

DIVISION D—SUSPENSION OF CERTAIN 

HEALTH-RELATED TAXES 

SEC. 4001. EXTENSION OF MORATORIUM ON MEDICAL DEVICE EXCISE 

TAX. 

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

of 1986 is amended by striking ‘‘December 31, 2017’’ and inserting 

‘‘December 31, 2019’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to sales after December 31, 2017. 

SEC. 4002. DELAY IN IMPLEMENTATION OF EXCISE TAX ON HIGH COST 

EMPLOYER-SPONSORED HEALTH COVERAGE. 

Section 9001(c) of the Patient Protection and Affordable Care 

Act is amended by striking ‘‘December 31, 2019’’ and inserting 

‘‘December 31, 2021’’. 

SEC. 4003. SUSPENSION OF ANNUAL FEE ON HEALTH INSURANCE PROVIDERS. 

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

Affordable Care Act is amended— 

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

(2) by striking the period at the end of paragraph (2) 

and inserting ‘‘, and ending before January 1, 2019, and’’, 

and 
H. R. 195—12 

(3) by adding at the end the following new paragraph: 

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

(c) EFFECTIVE DATE.—The amendments made by this section 

shall apply to calendar years beginning after December 31, 2018. 

DIVISION E—BUDGETARY EFFECTS 

SEC. 5001. BUDGETARY EFFECTS. 

(a) IN GENERAL.—The budgetary effects of division C and each 

succeeding division shall not be entered on either PAYGO scorecard 

maintained pursuant to section 4(d) of the Statutory Pay-As-YouGo Act of 2010. 

(b) SENATE PAYGO SCORECARDS.—The budgetary effects of division C and each succeeding division shall not be entered on any 

PAYGO scorecard maintained for purposes of section 4106 of H. 

Con. Res. 71 (115th Congress). 

(c) CLASSIFICATION OF BUDGETARY EFFECTS.—Notwithstanding 

Rule 3 of the Budget Scorekeeping Guidelines set forth in the 

joint explanatory statement of the committee of conference accompanying Conference Report 105–217 and section 250(c)(8) of the 

Balanced Budget and Emergency Deficit Control Act of 1985, the 

budgetary effects of division C and each succeeding division shall 

not be estimated— 

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

(2) for purposes of paragraph (4)(C) of section 3 of the 

Statutory Pay-As-You-Go Act of 2010 as being included in an 

appropriation Act. 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate.