In the House of Representatives, U. S., 

January 18, 2018. 

Resolved, That the House agree to the amendment of the 

Senate to the bill (H.R. 195) entitled ‘‘An Act to amend title 

44, United States Code, to restrict the distribution of free 

printed copies of the Federal Register to Members of Congress and other officers and employees of the United States, 

and for other purposes.’’, with the following 

HOUSE AMENDMENT TO SENATE AMENDMENT: 

In lieu of the matter proposed to be inserted by the 

amendment of the Senate, insert the following: 

1 DIVISION B—EXTENSION OF CONTINUING 

2 APPROPRIATIONS ACT, 2018 

3 SEC. 2001. The Continuing Appropriations Act, 2018 

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

5 (1) by striking the date specified in section 

6 106(3) and inserting ‘‘February 16, 2018’’; and 

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

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

9 Defense Missile Defeat and Defense Enhancements Appro10 priations Act, 2018 (division B of Public Law 115–96) may 

11 be obligated and expended notwithstanding section 

12 504(a)(1) of the National Security Act of 1947 (50 U.S.C. 

13 3094(a)(1)). 
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1 ‘‘SEC. 149. Amounts made available by section 101 for 

2 ‘Department of Agriculture—Food and Nutrition Service— 

3 Child Nutrition Programs’ to carry out section 749(g) of 

4 the Agriculture Appropriations Act of 2010 (Public Law 

5 111–80) may be apportioned up to the rate for operations 

6 necessary to ensure that the program can be fully oper7 ational by May 2018. 

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

9 ‘National Aeronautics and Space Administration—Explo10 ration’ may be apportioned up to the rate for operations 

11 necessary to maintain the planned launch capability sched12 ules for the Space Launch System launch vehicle, Explo13 ration Ground Systems, and Orion Multi-Purpose Crew Ve14 hicle programs. 

15 ‘‘SEC. 151. Amounts made available by section 101 for 

16 ‘Department of Energy—Energy Programs—Office of the 

17 Inspector General’ may be apportioned up to the rate for 

18 operations necessary to sustain staffing levels achieved on 

19 June 30, 2017. 

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

21 ‘Small Business Administration—Business Loans Program 

22 Account’ may be apportioned up to the rate for operations 

23 necessary to accommodate increased demand for commit24 ments for general business loans authorized under section 

25 7(a) of the Small Business Act (15 U.S.C. 636(a)). 
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1 ‘‘SEC. 153. For 2018, the Secretary of Housing and 

2 Urban Development may make temporary adjustments to 

3 the Section 8 housing choice voucher annual renewal fund4 ing allocations and administrative fee eligibility deter5 minations for public housing agencies in an area for which 

6 the President declared a disaster in 2017 or 2018 under 

7 title IV of the Robert T. Stafford Disaster Relief and Emer8 gency Assistance Act (42 U.S.C. 5170 et seq.), to avoid sig9 nificant adverse funding impacts that would otherwise re10 sult from the disaster and that would otherwise prevent a 

11 public housing agency from leasing up to its authorized 

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

13 upon request by and in consultation with a public housing 

14 agency and supported by documentation as required by the 

15 Secretary that demonstrates the need for the adjustment.’’. 

16 SEC. 2002. The Further Additional Continuing Appro17 priations Act, 2018 (division A of Public Law 115–96) is 

18 amended by striking section 1002. 

19 This division may be cited as the ‘‘Extension of Con20 tinuing Appropriations Act, 2018’’. 

21 DIVISION C—HEALTHY KIDS ACT 

22 SEC. 3001. SHORT TITLE. 

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

24 Access for Little Ones, Toddlers, and Hopeful Youth by 
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1 Keeping Insurance Delivery Stable Act’’ or the 

2 ‘‘HEALTHY KIDS Act’’. 

3 SEC. 3002. SIX-YEAR FUNDING EXTENSION OF THE CHIL4 DREN’S HEALTH INSURANCE PROGRAM. 

5 (a) FUNDING.— 

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

7 Security Act (42 U.S.C. 1397dd(a)), as amended by 

8 section 3201(a) of the CHIP and Public Health 

9 Funding Extension Act (division C of Public Law 

10 115–96), is amended— 

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

12 and’’ and inserting a semicolon; 

13 (B) by striking paragraph (21) and insert14 ing the following new paragraphs: 

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

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

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

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

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

20 ‘‘(26) for fiscal year 2023, for purposes of mak21 ing two semi-annual allotments— 

22 ‘‘(A) $2,850,000,000 for the period begin23 ning on October 1, 2022, and ending on March 

24 31, 2023; and 
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1 ‘‘(B) $2,850,000,000 for the period begin2 ning on April 1, 2023, and ending on September 

3 30, 2023.’’. 

4 (2) PREVENTION OF DUPLICATE APPROPRIATIONS

5 FOR FISCAL YEAR 2018.—Notwithstanding any other 

6 provision of law, insofar as funds have been appro7 priated under subsection (a)(21) of section 2104 of the 

8 Social Security Act (42 U.S.C. 1397dd), as such sub9 section is in effect on the day before the date of the 

10 enactment of this Act, to provide allotments to States 

11 under the State Children’s Health Insurance Program 

12 established under title XXI of the Social Security Act 

13 (42 U.S.C. 1397aa et seq.) (whether implemented 

14 under title XIX, XXI, or both, of the Social Security 

15 Act) for fiscal year 2018— 

16 (A) any amounts that are so appropriated 

17 that are not so allotted and obligated before the 

18 date of the enactment of this Act, are rescinded; 

19 and 

20 (B) any amount provided for CHIP allot21 ments to a State under this section (and the 

22 amendments made by this section) for such fiscal 

23 year shall be reduced by the amount of such ap24 propriations so allotted and obligated before such 

25 date. 
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1 (b) ALLOTMENTS.— 

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

3 Security Act (42 U.S.C. 1397dd(m)), as amended by 

4 section 3201(b) of the CHIP and Public Health Fund5 ing Extension Act (division C of Public Law 115–96), 

6 is amended— 

7 (A) in paragraph (2)(B)— 

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

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

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

11 2017’’ and inserting ‘‘, 2017, and 2023’’; 

12 and 

13 (iii) in clause (ii)— 

14 (I) in the matter preceding sub15 clause (I), by striking ‘‘and paragraph 

16 (10)’’; and 

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

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

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

20 (i)’’; 

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

22 and inserting ‘‘2023’’; 

23 (C) in paragraph (7)— 

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

25 ‘‘2017’’ and inserting ‘‘2023’’; 
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1 (ii) in subparagraph (B), in the mat2 ter preceding clause (i), by inserting ‘‘(or, 

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

4 than the date that is 60 days after the date 

5 of the enactment of the HEALTHY KIDS 

6 Act)’’ after ‘‘before the August 31 preceding 

7 the beginning of the fiscal year’’; and 

8 (iii) in the matter following subpara9 graph (B), by striking ‘‘or fiscal year 2016’’ 

10 and inserting ‘‘fiscal year 2016, fiscal year 

11 2018, fiscal year 2020, or fiscal year 2022’’; 

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

13 and inserting ‘‘2023’’; and 

14 (E) by amending paragraph (10) to read as 

15 follows: 

16 ‘‘(10) FOR FISCAL YEAR 2023.— 

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

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

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

20 subsection (a) for the semi-annual period de21 scribed in such subparagraph, increased by the 

22 amount of the appropriation for such period 

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

24 KIDS Act, the Secretary shall compute a State 

25 allotment for each State (including the District 
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1 of Columbia and each commonwealth and terri2 tory) for such semi-annual period in an amount 

3 equal to the first half ratio (described in sub4 paragraph (D)) of the amount described in sub5 paragraph (C). 

6 ‘‘(B) SECOND HALF.—Subject to para7 graphs (5) and (7), from the amount made 

8 available under subparagraph (B) of paragraph 

9 (26) of subsection (a) for the semi-annual period 

10 described in such subparagraph, the Secretary 

11 shall compute a State allotment for each State 

12 (including the District of Columbia and each 

13 commonwealth and territory) for such semi-an14 nual period in an amount equal to the amount 

15 made available under such subparagraph, multi16 plied by the ratio of— 

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

18 such State under subparagraph (A); to 

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

20 the allotments made available under such 

21 subparagraph. 

22 ‘‘(C) FULL YEAR AMOUNT BASED ON

23 REBASED AMOUNT.—The amount described in 

24 this subparagraph for a State is equal to the 

25 Federal payments to the State that are attrib-
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1 utable to (and countable towards) the total 

2 amount of allotments available under this section 

3 to the State in fiscal year 2022 (including pay4 ments made to the State under subsection (n) for 

5 fiscal year 2022 as well as amounts redistributed 

6 to the State in fiscal year 2022), multiplied by 

7 the allotment increase factor under paragraph 

8 (6) for fiscal year 2023. 

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

10 ratio described in this subparagraph is the ratio 

11 of— 

12 ‘‘(i) the sum of— 

13 ‘‘(I) the amount made available 

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

15 ‘‘(II) the amount of the appro16 priation for such period under section 

17 3002(b)(2) of the HEALTHY KIDS 

18 Act; to 

19 ‘‘(ii) the sum of— 

20 ‘‘(I) the amount described in 

21 clause (i); and 

22 ‘‘(II) the amount made available 

23 under subsection (a)(26)(B).’’. 

24 (2) ONE-TIME APPROPRIATION FOR FISCAL YEAR

25 2023.—There is appropriated to the Secretary of 
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1 Health and Human Services, out of any money in the 

2 Treasury not otherwise appropriated, $20,200,000,000 

3 to accompany the allotment made for the period be4 ginning on October 1, 2022, and ending on March 31, 

5 2023, under paragraph (26)(A) of section 2104(a) of 

6 the Social Security Act (42 U.S.C. 1397dd(a)) (as 

7 added by subsection (a)), to remain available until 

8 expended. Such amount shall be used to provide allot9 ments to States under paragraph (10) of section 

10 2104(m) of such Act (as added by paragraph (1)) for 

11 the first 6 months of fiscal year 2023 in the same 

12 manner as allotments are provided under subsection 

13 (a)(26)(A) of such section 2104 and subject to the 

14 same terms and conditions as apply to the allotments 

15 provided from such subsection (a)(26)(A). 

16 (c) EXTENSION OF THE CHILD ENROLLMENT CONTIN17 GENCY FUND.—Section 2104(n) of the Social Security Act 

18 (42 U.S.C. 1397dd(n)) is amended— 

19 (1) in paragraph (2)— 

20 (A) in subparagraph (A)(ii)— 

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

22 2013, 2014, and 2016’’ and inserting ‘‘2010 

23 through 2014, 2016, and 2018 through 

24 2022’’; and 
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1 (ii) by striking ‘‘fiscal year 2015 and 

2 fiscal year 2017’’ and inserting ‘‘fiscal 

3 years 2015, 2017, and 2023’’; and 

4 (B) in subparagraph (B)— 

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

6 2013, 2014, and 2016’’ and inserting ‘‘2010 

7 through 2014, 2016, and 2018 through 

8 2022’’; and 

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

10 fiscal year 2017’’ and inserting ‘‘fiscal 

11 years 2015, 2017, and 2023’’; and 

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

13 clause (i), by striking ‘‘or a semi-annual allotment 

14 period for fiscal year 2015 or 2017’’ and inserting 

15 ‘‘or in any of fiscal years 2018 through 2022 (or a 

16 semi-annual allotment period for fiscal year 2015, 

17 2017, or 2023)’’. 

18 (d) EXTENSION OF QUALIFYING STATES OPTION.— 

19 (1) IN GENERAL.—Section 2105(g)(4) of the So20 cial Security Act (42 U.S.C. 1397ee(g)(4)) is amend21 ed— 

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

23 2017’’ and inserting ‘‘THROUGH 2023’’; and 

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

25 ‘‘2017’’ and inserting ‘‘2023’’. 
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1 (2) TECHNICAL AMENDMENTS.—Section 

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

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

4 3201(c) of the CHIP and Public Health Funding Ex5 tension Act (division C of Public Law 115–96), is 

6 amended— 

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

8 month (as defined in subclause (II))’’ and insert9 ing ‘‘(as defined in subclause (II)) for the 

10 month’’; 

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

12 effect on the day before the date of the enactment 

13 of the HEALTHY KIDS Act,’’ after ‘‘section 

14 2105(g)(4)(A)’’; and 

15 (C) in subclause (VI)— 

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

17 day before the date of the enactment of the 

18 HEALTHY KIDS Act’’ after ‘‘, section 

19 2105(g)(4)’’; and 

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

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

22 (e) EXTENSION OF EXPRESS LANE ELIGIBILITY OP23 TION.—Section 1902(e)(13)(I) of the Social Security Act 

24 (42 U.S.C. 1396a(e)(13)(I)) is amended by striking ‘‘2017’’ 

25 and inserting ‘‘2023’’. 
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1 (f) ASSURANCE OF AFFORDABILITY STANDARD FOR

2 CHILDREN AND FAMILIES.— 

3 (1) IN GENERAL.—Section 2105(d)(3) of the So4 cial Security Act (42 U.S.C. 1397ee(d)(3)) is amend5 ed— 

6 (A) in the paragraph heading, by striking 

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

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

9 (B) in subparagraph (A), in the matter pre10 ceding clause (i)— 

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

12 ‘‘2023’’; and 

13 (ii) by striking ‘‘The preceding sen14 tence shall not be construed as preventing a 

15 State during such period’’ and inserting 

16 ‘‘During the period that begins on October 

17 1, 2019, and ends on September 30, 2023, 

18 the preceding sentence shall only apply with 

19 respect to children in families whose income 

20 does not exceed 300 percent of the poverty 

21 line (as defined in section 2110(c)(5)) ap22 plicable to a family of the size involved. The 

23 preceding sentences shall not be construed as 

24 preventing a State during any such peri25 ods’’. 
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1 (2) CONFORMING AMENDMENTS.—Section 

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

3 1396a(gg)(2)) is amended— 

4 (A) in the paragraph heading, by striking 

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

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

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

8 inserting ‘‘September 30, 2023 (but during the 

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

10 on September 30, 2023, only with respect to chil11 dren in families whose income does not exceed 

12 300 percent of the poverty line (as defined in sec13 tion 2110(c)(5)) applicable to a family of the 

14 size involved)’’. 

15 (g) CHIP LOOK-ALIKE PLANS.— 

16 (1) BLENDING RISK POOLS.—Section 2107 of the 

17 Social Security Act (42 U.S.C. 1397gg) is amended 

18 by adding at the end the following: 

19 ‘‘(g) USE OF BLENDED RISK POOLS.— 

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

21 other provision of Federal law) shall be construed as 

22 preventing a State from considering children enrolled 

23 in a qualified CHIP look-alike program and children 

24 enrolled in a State child health plan under this title 
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1 (or a waiver of such plan) as members of a single risk 

2 pool. 

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

4 In this subsection, the term ‘qualified CHIP look-alike 

5 program’ means a State program— 

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

7 the age of 19 and are not eligible to receive med8 ical assistance under title XIX or child health 

9 assistance under this title may purchase coverage 

10 through the State that provides benefits that are 

11 at least identical to the benefits provided under 

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

13 waiver of such plan); and 

14 ‘‘(B) that is funded exclusively through non15 Federal funds, including funds received by the 

16 State in the form of premiums for the purchase 

17 of such coverage.’’. 

18 (2) COVERAGE RULE.— 

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

20 the Internal Revenue Code of 1986 is amended in 

21 subparagraph (A)(iii), by inserting ‘‘or under a 

22 qualified CHIP look-alike program (as defined 

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

24 before the comma at the end. 
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1 (B) EFFECTIVE DATE.—The amendment 

2 made by subparagraph (A) shall apply with re3 spect to taxable years beginning after December 

4 31, 2017. 

5 (h) AVAILABILITY OF UNUSED FISCAL YEAR 2018 RE6 DISTRIBUTION AMOUNTS.—Any amounts that have been re7 distributed to States under subsection (f) of section 2104 

8 of the Social Security Act (42 U.S.C. 1397dd) for fiscal year 

9 2018 that are not, or will not be, expended by the end of 

10 that fiscal year shall be— 

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

12 fiscal year 2018 to reflect an updated estimate of 

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

14 and 

15 (2) available for redistribution under subsection 

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

17 SEC. 3003. EXTENSION OF CERTAIN PROGRAMS AND DEM18 ONSTRATION PROJECTS. 

19 (a) CHILDHOOD OBESITY DEMONSTRATION

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

21 (42 U.S.C. 1320b–9a(e)(8)) is amended— 

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

23 ‘‘, $10,000,000’’; and 
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1 (2) by inserting after ‘‘2017’’ the following: ‘‘, 

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

3 through 2023’’. 

4 (b) PEDIATRIC QUALITY MEASURES PROGRAM.—Sec5 tion 1139A(i) of the Social Security Act (42 U.S.C. 1320b– 

6 9a(i)) is amended— 

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

8 following: 

9 ‘‘(1) IN GENERAL.—Out of any’’; 

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

11 and inserting ‘‘there is appropriated— 

12 ‘‘(A) for each’’; 

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

14 the period’’ and inserting ‘‘; 

15 ‘‘(B) for the period’’; 

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

17 subsection shall remain available until expended.’’ 

18 and inserting ‘‘; and’’; and 

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

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

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

22 carrying out this section (other than subsections 

23 (e), (f), and (g)). 
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1 ‘‘(2) AVAILABILITY.—Funds appropriated under 

2 this subsection shall remain available until ex3 pended.’’. 

4 SEC. 3004. EXTENSION OF OUTREACH AND ENROLLMENT 

5 PROGRAM. 

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

7 Act (42 U.S.C. 1397mm) is amended— 

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

9 inserting ‘‘2023’’; and 

10 (2) in subsection (g)— 

11 (A) by striking ‘‘and $40,000,000’’ and in12 serting ‘‘, $40,000,000’’; and 

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

14 ‘‘, and $120,000,000 for the period of fiscal years 

15 2018 through 2023’’. 

16 (b) MAKING ORGANIZATIONS THAT USE PARENT MEN17 TORS ELIGIBLE TO RECEIVE GRANTS.—Section 2113(f) of 

18 the Social Security Act (42 U.S.C. 1397mm(f)) is amend19 ed— 

20 (1) in paragraph (1)(E), by striking ‘‘or commu21 nity-based doula programs’’ and inserting ‘‘, commu22 nity-based doula programs, or parent mentors’’; and 

23 (2) by adding at the end the following new para24 graph: 
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1 ‘‘(5) PARENT MENTOR.—The term ‘parent men2 tor’ means an individual who— 

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

4 child who is an eligible child under this title or 

5 title XIX; and 

6 ‘‘(B) is trained to assist families with chil7 dren who have no health insurance coverage with 

8 respect to improving the social determinants of 

9 the health of such children, including by pro10 viding— 

11 ‘‘(i) education about health insurance 

12 coverage, including, with respect to obtain13 ing such coverage, eligibility criteria and 

14 application and renewal processes; 

15 ‘‘(ii) assistance with completing and 

16 submitting applications for health insur17 ance coverage; 

18 ‘‘(iii) a liaison between families and 

19 representatives of State plans under title 

20 XIX or State child health plans under this 

21 title; 

22 ‘‘(iv) guidance on identifying medical 

23 and dental homes and community phar24 macies for children; and 
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1 ‘‘(v) assistance and referrals to success2 fully address social determinants of chil3 dren’s health, including poverty, food insuf4 ficiency, and housing.’’. 

5 (c) EXCLUSION FROM MODIFIED ADJUSTED GROSS

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

7 U.S.C. 1396a(e)) is amended— 

8 (1) in the first paragraph (14), relating to in9 come determined using modified adjusted gross in10 come, by adding at the end the following new sub11 paragraph: 

12 ‘‘(J) EXCLUSION OF PARENT MENTOR COM13 PENSATION FROM INCOME DETERMINATION.— 

14 Any nominal amount received by an individual 

15 as compensation, including a stipend, for par16 ticipation as a parent mentor (as defined in 

17 paragraph (5) of section 2113(f)) in an activity 

18 or program funded through a grant under such 

19 section shall be disregarded for purposes of deter20 mining the income eligibility of such individual 

21 for medical assistance under the State plan or 

22 any waiver of such plan.’’; and 

23 (2) by striking ‘‘(14) EXCLUSION’’ and inserting 

24 ‘‘(15) EXCLUSION’’. 
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1 SEC. 3005. EXTENSION AND REDUCTION OF ADDITIONAL 

2 FEDERAL FINANCIAL PARTICIPATION FOR 

3 CHIP. 

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

5 1397ee(b)) is amended in the second sentence by inserting 

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

7 ends on September 30, 2020, the enhanced FMAP deter8 mined for a State for a fiscal year (or for any portion of 

9 a fiscal year occurring during such period) shall be in10 creased by 11.5 percentage points’’ after ‘‘23 percentage 

11 points,’’. 

12 SEC. 3006. MEDICAID IMPROVEMENT FUND. 

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

14 1396w–1) is amended— 

15 (1) in subsection (a), in the first sentence, by in16 serting before the period at the end the following: ‘‘, 

17 and, in accordance with subsection (b)(3), for the pur18 poses of subparagraph (B) of such subsection’’; and 

19 (2) in subsection (b)— 

20 (A) in paragraph (2)— 

21 (i) in the first sentence, by inserting 

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

23 Fund’’; 

24 (ii) by inserting after the first sentence 

25 the following sentence: ‘‘Amounts in the 

26 Fund pursuant to paragraph (3) shall be 
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1 available in advance of appropriations but 

2 only if the total amount obligated from the 

3 Fund does not exceed the amount available 

4 to the Fund under such paragraph (3).’’; 

5 and 

6 (iii) in the last sentence, by striking 

7 ‘‘sentence’’ and inserting ‘‘sentences’’; and 

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

9 paragraph: 

10 ‘‘(3) ADDITIONAL FUNDING FOR STATE ACTIVI11 TIES RELATING TO MECHANIZED CLAIMS SYSTEMS.— 

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

13 amount made available under paragraph (1), 

14 there shall be available to the Fund, for expendi15 tures from the Fund in accordance with sub16 paragraph (B), for fiscal year 2023 and there17 after, $980,000,000, to remain available until ex18 pended. 

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

20 amounts made available to the Fund under sub21 paragraph (A) to pay to each State which has 

22 a plan approved under this title, for each quar23 ter beginning during or after fiscal year 2023 an 

24 amount equal to— 
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1 ‘‘(i) 100 percent minus the percent 

2 specified in clause (i) of section 

3 1903(a)(3)(A) of so much of the sums ex4 pended by the State during such quarter as 

5 are attributable to the activities described in 

6 such clause; 

7 ‘‘(ii) 100 percent minus the Federal 

8 medical assistance percentage applied under 

9 clause (iii) of such section of so much of the 

10 sums expended during such quarter (as 

11 found necessary by the Secretary under such 

12 clause) by the State as are attributable to 

13 the activities described in such clause; and 

14 ‘‘(iii) 100 percent minus the percent 

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

16 much of the sums expended by the State 

17 during such quarter as are attributable to 

18 the activities described in such section.’’. 
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1 DIVISION D—SUSPENSION OF 

2 CERTAIN HEALTH-RELATED 

3 TAXES 

4 SEC. 4001. EXTENSION OF MORATORIUM ON MEDICAL DE5 VICE EXCISE TAX. 

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

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

8 31, 2017’’ and inserting ‘‘December 31, 2019’’. 

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

10 section shall apply to sales after December 31, 2017. 

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

12 HIGH COST EMPLOYER-SPONSORED HEALTH 

13 COVERAGE. 

14 Section 9001(c) of the Patient Protection and Afford15 able Care Act is amended by striking ‘‘December 31, 2019’’ 

16 and inserting ‘‘December 31, 2021’’. 

17 SEC. 4003. SUSPENSION OF ANNUAL FEE ON HEALTH IN18 SURANCE PROVIDERS. 

19 (b) IN GENERAL.—Section 9010(j) of the Patient Pro20 tection and Affordable Care Act is amended— 

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

22 (1), 

23 (2) by striking the period at the end of para24 graph (2) and inserting ‘‘, and ending before January 

25 1, 2019, and’’, and 
25 

•HR 195 EAH 

1 (3) by adding at the end the following new para2 graph: 

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

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

5 section shall apply to calendar years beginning after De6 cember 31, 2018. 

7 DIVISION E—BUDGETARY 

8 EFFECTS 

9 SEC. 5001. BUDGETARY EFFECTS. 

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

11 and each succeeding division shall not be entered on either 

12 PAYGO scorecard maintained pursuant to section 4(d) of 

13 the Statutory Pay-As-You-Go Act of 2010. 

14 (b) SENATE PAYGO SCORECARDS.—The budgetary ef15 fects of division C and each succeeding division shall not 

16 be entered on any PAYGO scorecard maintained for pur17 poses of section 4106 of H. Con. Res. 71 (115th Congress). 

18 (c) CLASSIFICATION OF BUDGETARY EFFECTS.—Not19 withstanding Rule 3 of the Budget Scorekeeping Guidelines 

20 set forth in the joint explanatory statement of the committee 

21 of conference accompanying Conference Report 105–217 

22 and section 250(c)(8) of the Balanced Budget and Emer23 gency Deficit Control Act of 1985, the budgetary effects of 

24 division C and each succeeding division shall not be esti25 mated— 
26 

•HR 195 EAH 

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

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

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

4 being included in an appropriation Act. 

Attest: 

Clerk. 

115TH CONGRESS 

2D SESSION H.R. 195 

HOUSE AMENDMENT TO 

SENATE AMENDMENT