I 

111TH CONGRESS 

1ST SESSION H. R. 3608 

To amend the Internal Revenue Code of 1986 to codify the exclusion from 

gross income of medical care provided for Indians, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 21, 2009 

Mr. BECERRA (for himself, Mr. NUNES, Mr. RAHALL, Mr. BACA, Ms. BERKLEY, Mrs. BONO MACK, Mr. BOREN, Mr. COLE, Mr. HERGER, Mr. KILDEE, Mr. KLINE of Minnesota, Mr. LEWIS of California, Mr. LUJA ́N, Mr. 

MCCARTHY of California, Ms. MCCOLLUM, Mr. PALLONE, Mr. POMEROY, 

Mr. RADANOVICH, and Mr. SHULER) introduced the following bill; which 

was referred to the Committee on Ways and Means 

A BILL 

To amend the Internal Revenue Code of 1986 to codify 

the exclusion from gross income of medical care provided 

for Indians, and for other purposes. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Tribal Health Benefits 

5 Clarification Act of 2009’’. 


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1 SEC. 2. EXCLUSION FROM GROSS INCOME FOR MEDICAL 

2 CARE PROVIDED FOR INDIANS. 

3 (a) IN GENERAL.—Part III of subchapter B of chap4 ter 1 of the Internal Revenue Code of 1986 (relating to 

5 items specifically excluded from gross income) is amended 

6 by inserting after section 139C the following new section: 

7 ‘‘SEC. 139D. MEDICAL CARE PROVIDED FOR INDIANS. 

8 ‘‘(a) IN GENERAL.—Gross income does not include— 

9 ‘‘(1) health services or benefits provided or pur10 chased by the Indian Health Service, either directly 

11 or indirectly, through a grant to or a contract or 

12 compact with an Indian tribe or tribal organization 

13 or through programs of third parties funded by the 

14 Indian Health Service, 

15 ‘‘(2) medical care provided by an Indian tribe 

16 or tribal organization to a member of an Indian 

17 tribe (including for this purpose, to the member’s 

18 spouse or dependents) through any one of the fol19 lowing: provided or purchased medical care services; 

20 accident or health insurance (or an arrangement 

21 having the effect of accident or health insurance); or 

22 amounts paid, directly or indirectly, to reimburse the 

23 member for expenses incurred for medical care, 

24 ‘‘(3) the value of accident or health plan cov25 erage provided by an Indian tribe or tribal organiza26 tion for medical care to a member of an Indian tribe 


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1 (including for this purpose, coverage that extends to 

2 such member’s spouse or dependents) under an acci3 dent or health plan (or through an arrangement hav4 ing the effect of accident or health insurance), and 

5 ‘‘(4) any other medical care provided by an In6 dian tribe that supplements, replaces, or substitutes 

7 for the programs and services provided by the Fed8 eral Government to Indian tribes or Indians. 

9 ‘‘(b) DEFINITIONS.—For purposes of this section— 

10 ‘‘(1) IN GENERAL.—The terms ‘accident or 

11 health insurance’ and ‘accident or health plan’ have 

12 the same meaning as when used in sections 104 and 

13 106. 

14 ‘‘(2) MEDICAL CARE.—The term ‘medical care’ 

15 has the meaning given such term in section 213. 

16 ‘‘(3) DEPENDENT.—The term ‘dependent’ has 

17 the meaning given such term in section 152, deter18 mined without regard to subsections (b)(1), (b)(2) 

19 and (d)(1)(B). 

20 ‘‘(4) INDIAN TRIBE.—The term ‘Indian tribe’ 

21 means any Indian tribe, band, nation, pueblo, or 

22 other organized group or community, including any 

23 Alaska Native village, or regional or village corpora24 tion, as defined in, or established pursuant to, the 

25 Alaska Native Claims Settlement Act (43 U.S.C. 


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1 1601 et seq.), which is recognized as eligible for the 

2 special programs and services provided by the 

3 United States to Indians because of their status as 

4 Indians. 

5 ‘‘(5) TRIBAL ORGANIZATION.—The term ‘tribal 

6 organization’ has the meaning given such term in 

7 section 4(l) of the Indian Self-Determination and 

8 Education Assistance Act (25 U.S.C. 450b(l)).’’. 

9 (b) CLERICAL AMENDMENT.—The table of sections 

10 for such part III is amended by inserting after the item 

11 relating to section 139C the following new item: 

‘‘Sec. 139D. Medical care provided for Indians.’’. 

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

13 this section shall apply to health benefits and coverage 

14 provided after the date of enactment of this Act. 

15 (d) NO INFERENCE.—Nothing in the amendments 

16 made by this section shall be construed to create an infer17 ence with respect to the exclusion from gross income of— 

18 (1) benefits provided by Indian tribes that are 

19 not within the scope of this section, and 

20 (2) health benefits or coverage provided by In21 dian tribes prior to the effective date of this section. 

Æ 


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