I 

117TH CONGRESS 

1ST SESSION H. R. 2713 

To provide for equitable treatment for Puerto Rico, the Virgin Islands, Guam, 

the Northern Mariana Islands, and American Samoa. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 20, 2021 

Ms. VELA ́ZQUEZ (for herself, Ms. OCASIO-CORTEZ, Mr. GRIJALVA, and Mr. 

TORRES of New York) introduced the following bill; which was referred 

to the Committee on Ways and Means, and in addition to the Committees 

on Energy and Commerce, Agriculture, Education and Labor, and Natural Resources, 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 equitable treatment for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and 

American Samoa. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Territorial Equity Act of 2021’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows: 


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Sec. 1. Short title; table of contents. 

TITLE I—HEALTH EQUITY FOR THE TERRITORIES 

Subtitle A—Medicaid 

Sec. 101. Elimination of general Medicaid funding limitations (‘‘cap’’) for territories. 

Sec. 102. Elimination of specific Federal medical assistance percentage 

(FMAP) limitation for territories; temporary increase in 

FMAP for Puerto Rico and the Virgin Islands to 100 percent. 

Sec. 103. Application of Medicaid waiver authority to all of the territories. 

Sec. 104. Permitting Medicaid DSH allotments for territories. 

Subtitle B—Medicare Part A 

Sec. 111. Calculation of Medicare DSH payments for IPPS hospitals in Puerto 

Rico. 

Sec. 112. Rebasing target amount for hospitals in territories. 

Sec. 113. Medicare DSH target adjustment for hospitals in territories. 

Subtitle C—Medicare Part B 

Sec. 121. Application of part B deemed enrollment process to residents of 

Puerto Rico; special enrollment period and limit on late enrollment penalties. 

Subtitle D—Medicare Advantage (Part C) 

Sec. 131. Adjustment in benchmark for low-base payment counties in Puerto 

Rico. 

Subtitle E—Medicare Part D 

Sec. 141. Improved use of allocated prescription drug funds by territories. 

Sec. 142. Report on treatment of territories under Medicare part D. 

Subtitle F—Miscellaneous 

Sec. 151. Medicaid and CHIP territory transparency and information. 

Sec. 152. Report on exclusion of territories from Exchanges. 

Sec. 153. Access to coverage for individuals in certain areas without any available Exchange plans. 

TITLE II—INCLUSION OF THE TERRITORIES IN THE 

SUPPLEMENTAL NUTRITIONAL ASSISTANCE PROGRAM 

Sec. 201. Participation and transition of Puerto Rico, American Samoa, and 

the Northern Mariana Islands in supplemental nutrition assistance program. 

TITLE III—EQUITABLE TREATMENT FOR PUERTO RICO AND THE 

VIRGIN ISLANDS WITH RESPECT TO TAX CREDITS 

Sec. 301. Equitable treatment for residents of Puerto Rico and the Virgin Islands with respect to the earned income tax credit and the 

child tax credit. 

TITLE IV—LABOR EQUITY FOR PUERTO RICO 


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Sec. 401. Minimum wage for young employees in Puerto Rico. 

Sec. 402. Overtime hours protections for workers in Puerto Rico. 

TITLE V—EXTENSION OF SUPPLEMENTAL SECURITY INCOME 

(SSI) PROGRAM TO ALL TERRITORIES 

Sec. 501. Extension of SSI program to all territories. 

1 TITLE I—HEALTH EQUITY FOR 

2 THE TERRITORIES 

3 Subtitle A—Medicaid 

4 SEC. 101. ELIMINATION OF GENERAL MEDICAID FUNDING 

5 LIMITATIONS (‘‘CAP’’) FOR TERRITORIES. 

6 (a) IN GENERAL.—Section 1108 of the Social Secu7 rity Act (42 U.S.C. 1308) is amended— 

8 (1) in subsection (f), in the matter preceding 

9 paragraph (1), by striking ‘‘and (h)’’ and inserting 

10 ‘‘(h), and (i)’’; 

11 (2) in subsection (g)(2), in the matter pre12 ceding subparagraph (A), by inserting ‘‘subsection 

13 (i),’’ after ‘‘subject to’’; and 

14 (3) by adding at the end the following new sub15 section: 

16 ‘‘(i) SUNSET OF MEDICAID FUNDING LIMITATIONS

17 FOR PUERTO RICO, THE VIRGIN ISLANDS, GUAM, THE

18 NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA.— 

19 Subsections (f) and (g) shall not apply to Puerto Rico, 

20 the Virgin Islands, Guam, the Northern Mariana Islands, 

21 and American Samoa beginning with fiscal year 2022.’’. 

22 (b) CONFORMING AMENDMENTS.— 


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1 (1) Section 1902(j) of the Social Security Act 

2 (42 U.S.C. 1396a(j)) is amended by striking ‘‘, the 

3 limitation in section 1108(f),’’. 

4 (2) Section 1903(u) of the Social Security Act 

5 (42 U.S.C. 1396b(u)) is amended by striking para6 graph (4). 

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

8 this section shall apply beginning with fiscal year 2022. 

9 SEC. 102. ELIMINATION OF SPECIFIC FEDERAL MEDICAL 

10 ASSISTANCE PERCENTAGE (FMAP) LIMITA11 TION FOR TERRITORIES; TEMPORARY IN12 CREASE IN FMAP FOR PUERTO RICO AND 

13 THE VIRGIN ISLANDS TO 100 PERCENT. 

14 Section 1905(b) of the Social Security Act (42 U.S.C. 

15 1396d(b)) is amended— 

16 (1) in clause (2), by inserting ‘‘for fiscal years 

17 before fiscal year 2022’’ after ‘‘American Samoa’’; 

18 and 

19 (2) by adding at the end the following new sen20 tence: ‘‘Notwithstanding the first sentence of this 

21 subsection, for each of fiscal years 2022 and 2023, 

22 the Federal medical assistance percentage for Puerto 

23 Rico and the Virgin Islands shall be 100 percent.’’. 


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1 SEC. 103. APPLICATION OF MEDICAID WAIVER AUTHORITY 

2 TO ALL OF THE TERRITORIES. 

3 (a) IN GENERAL.—Section 1902(j) of the Social Se4 curity Act (42 U.S.C. 1396a(j)) is amended— 

5 (1) by striking ‘‘American Samoa and the 

6 Northern Mariana Islands’’ and inserting ‘‘Puerto 

7 Rico, the Virgin Islands, Guam, the Northern Mar8 iana Islands, and American Samoa’’; 

9 (2) by striking ‘‘American Samoa or the North10 ern Mariana Islands’’ and inserting ‘‘Puerto Rico, 

11 the Virgin Islands, Guam, the Northern Mariana Is12 lands, or American Samoa’’; 

13 (3) by inserting ‘‘(1)’’ before ‘‘Notwith14 standing’’; 

15 (4) by inserting ‘‘except as otherwise provided 

16 in this subsection,’’ after ‘‘Notwithstanding any 

17 other requirement of this title’’; and 

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

19 ‘‘(2) The Secretary may not waive under this sub20 section— 

21 ‘‘(A) the requirement of subsection 

22 (a)(10)(A)(i)(IX) (relating to coverage of adults for23 merly under foster care) with respect to any terri24 tory; 

25 ‘‘(B) the requirement to provide medical assist26 ance for early and periodic screening, diagnostic, 


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1 and treatment services (as defined in section 

2 1905(r)) for individuals who are eligible for assist3 ance under the program and who are under the age 

4 of 21; or 

5 ‘‘(C) the requirement to provide for payment 

6 for services described in section 1905(a)(2)(C) fur7 nished by a Federally-qualified health center and 

8 services described in section 1905(a)(2)(B) furnished 

9 by a rural health clinic in accordance with the provi10 sions of subsection (bb).’’. 

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

12 this section shall apply beginning October 1, 2021. 

13 SEC. 104. PERMITTING MEDICAID DSH ALLOTMENTS FOR 

14 TERRITORIES. 

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

16 1396r–4(f)) is amended— 

17 (1) in paragraph (6), by adding at the end the 

18 following new subparagraph: 

19 ‘‘(C) TERRITORIES.— 

20 ‘‘(i) FISCAL YEAR 2021.—For fiscal 

21 year 2022, the DSH allotment for Puerto 

22 Rico, the Virgin Islands, Guam, the North23 ern Mariana Islands, and American Samoa 

24 shall bear the same ratio to $300,000,000 

25 as the ratio of the number of individuals 


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1 who are low-income or uninsured and re2 siding in such respective territory (as esti3 mated from time to time by the Secretary) 

4 bears to the sums of the number of such 

5 individuals residing in all of the territories. 

6 ‘‘(ii) SUBSEQUENT FISCAL YEAR.— 

7 For each subsequent fiscal year, the DSH 

8 allotment for each such territory is subject 

9 to an increase in accordance with para10 graph (3).’’; and 

11 (2) in paragraph (9), by inserting before the pe12 riod at the end the following: ‘‘, and includes, begin13 ning with fiscal year 2022, Puerto Rico, the Virgin 

14 Islands, Guam, the Northern Mariana Islands, and 

15 American Samoa’’. 

16 Subtitle B—Medicare Part A 

17 SEC. 111. CALCULATION OF MEDICARE DSH PAYMENTS FOR 

18 IPPS HOSPITALS IN PUERTO RICO. 

19 Section 1886(d)(9)(D)(iii) of the Social Security Act 

20 (42 U.S.C. 1395ww(d)(9)(D)(iii)) is amended to read as 

21 follows: 

22 ‘‘(iii) Subparagraph (F) (relating to dispropor23 tionate share payments), including application of 

24 subsection (r), except that for this purpose— 


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1 ‘‘(I) the sum described in clause (ii) of this 

2 subparagraph shall be substituted for the sum 

3 referred to in paragraph (5)(F)(ii)(I); and 

4 ‘‘(II) for discharges occurring on or after 

5 October 1, 2021, subclause (I) of paragraph 

6 (5)(F)(vi) shall be applied by substituting for 

7 the numerator described in such subclause the 

8 number of subsection (d) Puerto Rico hospital’s 

9 patient days for the cost reporting period in10 volved which were made up of patients who (for 

11 such days) were entitled to benefits under part 

12 A of this title and were— 

13 ‘‘(aa) entitled to supplementary secu14 rity income benefits (excluding any State 

15 supplementation) under title XVI of this 

16 Act; 

17 ‘‘(bb) eligible for medical assistance 

18 under a State plan under title XIX; or 

19 ‘‘(cc) receiving aid or assistance under 

20 any plan of the State approved under title 

21 I, X, XIV, or XVI.’’. 


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1 SEC. 112. REBASING TARGET AMOUNT FOR HOSPITALS IN 

2 TERRITORIES. 

3 Section 1886(b)(3) of the Social Security Act (42 

4 U.S.C. 1395ww(b)(3)) is amended by adding at the end 

5 the following new subparagraph: 

6 ‘‘(M)(i) For each cost reporting period beginning on 

7 or after October 1, 2021, in the case of a hospital located 

8 in a territory of the United States, there shall be sub9 stituted for the target amount otherwise determined under 

10 subparagraph (A) the rebased target amount (as defined 

11 in clause (ii)), if such substitution results in an amount 

12 of payment under this section to the hospital for such pe13 riod that is greater than the amount of payment that 

14 would be made under this section to the hospital for such 

15 period if this subparagraph were not to apply. 

16 ‘‘(ii) For purposes of this subparagraph, the term 

17 ‘rebased target amount’ has the meaning given the term 

18 ‘target amount’ in subparagraph (A), except that— 

19 ‘‘(I) there shall be substituted for the preceding 

20 12-month cost reporting period the 12-month cost 

21 reporting period beginning during fiscal year 2017 

22 (or, at the option of the hospital, beginning during 

23 fiscal year 2019); 

24 ‘‘(II) any reference in subparagraph (A)(i) to 

25 the ‘first such cost reporting period’ is deemed a ref26 erence to the first cost reporting period following the 


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1 12-month cost reporting period beginning during fis2 cal year 2017 (or, at the option of the hospital, be3 ginning during fiscal year 2019); and 

4 ‘‘(III) the applicable percentage increase shall 

5 only be applied under subparagraph (B)(ii) for cost 

6 reporting periods beginning on or after October 1, 

7 2021. 

8 ‘‘(iii) Nothing in this subparagraph shall affect any 

9 pending request by a hospital for a new target amount 

10 for any cost reporting period beginning during a fiscal 

11 year before fiscal year 2022.’’. 

12 SEC. 113. MEDICARE DSH TARGET ADJUSTMENT FOR HOS13 PITALS IN TERRITORIES. 

14 Section 1886(b)(3) of the Social Security Act (42 

15 U.S.C. 1395ww(b)(3)), as amended by section 112, is fur16 ther amended by adding at the end the following new sub17 paragraph: 

18 ‘‘(N)(i) For each cost reporting period beginning on 

19 or after October 1, 2020, in the case of a hospital that 

20 is located in a territory of the United States other than 

21 Puerto Rico and that would be a subsection (d) hospital 

22 if it were located in one of the 50 States, the target 

23 amount shall be increased by— 

24 ‘‘(I) in the case that such hospital has a dis25 proportionate patient percentage of not less than 15 


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1 percent and not greater than 40 percent, 10 percent; 

2 and 

3 ‘‘(II) in the case that such hospital has a dis4 proportionate patient percentage of greater than 40 

5 percent, 10 percent plus 60 percent of the number 

6 of percentage points by which such hospital’s dis7 proportionate patient percentage exceeds 40 percent. 

8 ‘‘(ii) For purposes of this subparagraph, the term 

9 ‘disproportionate patient percentage’ has the meaning 

10 given such term in subsection (d)(5)(F)(vi), except that 

11 in applying such meaning any reference under such sub12 section to individuals entitled to supplementary security 

13 income under title XVI shall be deemed for purposes of 

14 this subparagraph to include individuals— 

15 ‘‘(I) eligible for medical assistance under a 

16 State plan under title XIX; or 

17 ‘‘(II) receiving aid or assistance under any plan 

18 of the territory approved under title I, X, XIV, or 

19 XVI.’’. 


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1 Subtitle C—Medicare Part B 

2 SEC. 121. APPLICATION OF PART B DEEMED ENROLLMENT 

3 PROCESS TO RESIDENTS OF PUERTO RICO; 

4 SPECIAL ENROLLMENT PERIOD AND LIMIT 

5 ON LATE ENROLLMENT PENALTIES. 

6 (a) APPLICATION OF PART B DEEMED ENROLLMENT

7 PROCESS TO RESIDENTS OF PUERTO RICO.—Section 

8 1837(f)(3) of the Social Security Act (42 U.S.C. 

9 1395p(f)(3)) is amended by striking ‘‘, exclusive of Puerto 

10 Rico’’. 

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

12 subsection (a) shall apply to individuals whose initial en13 rollment period under section 1837(d) of the Social Secu14 rity Act begins on or after the first day of the effective 

15 month, specified by the Secretary of Health and Human 

16 Services under section 1839(k)(1)(C) of such Act, as 

17 added by subsection (c)(2). 

18 (c) TRANSITION PROVIDING SPECIAL ENROLLMENT

19 PERIOD AND LIMIT ON LATE ENROLLMENT PENALTIES

20 FOR CERTAIN MEDICARE BENEFICIARIES.—Section 1839 

21 of the Social Security Act (42 U.S.C. 1395r) is amend22 ed— 

23 (1) in the first sentence of subsection (b), by in24 serting ‘‘subject to subsection (k)(2) of this section,’’ 


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1 after ‘‘subsection (i)(4), (l), or (l) of section 1837,’’; 

2 and 

3 (2) by adding at the end the following new sub4 section: 

5 ‘‘(k) SPECIAL RULES FOR CERTAIN RESIDENTS OF

6 PUERTO RICO.— 

7 ‘‘(1) SPECIAL ENROLLMENT PERIOD, COVERAGE

8 PERIOD FOR RESIDENTS WHO ARE ELIGIBLE BUT

9 NOT ENROLLED.— 

10 ‘‘(A) IN GENERAL.—In the case of a tran11 sition individual (as defined in paragraph (3)) 

12 who is not enrolled under this part as of the 

13 day before the first day of the effective month 

14 (as defined in subparagraph (C)), the Secretary 

15 shall provide for a special enrollment period 

16 under section 1837 of 7 months beginning with 

17 such effective month during which the indi18 vidual may be enrolled under this part. 

19 ‘‘(B) COVERAGE PERIOD.—In the case of 

20 such an individual who enrolls during such spe21 cial enrollment period, the coverage period 

22 under section 1838 shall begin on the first day 

23 of the second month after the month in which 

24 the individual enrolls. 


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1 ‘‘(C) EFFECTIVE MONTH DEFINED.—In 

2 this section, the term ‘effective month’ means a 

3 month, not earlier than October 2022 and not 

4 later than January 2023, specified by the Sec5 retary. 

6 ‘‘(2) REDUCTION IN LATE ENROLLMENT PEN7 ALTIES FOR CURRENT ENROLLEES AND INDIVID8 UALS ENROLLING DURING TRANSITION.— 

9 ‘‘(A) IN GENERAL.—In the case of a tran10 sition individual who is enrolled under this part 

11 as of the day before the first day of the effec12 tive month or who enrolls under this part on or 

13 after the date of the enactment of this sub14 section but before the end of the special enroll15 ment period under paragraph (1)(A), the 

16 amount of the late enrollment penalty imposed 

17 under section 1839(b) shall be recalculated by 

18 reducing the penalty to 15 percent of the pen19 alty otherwise established. 

20 ‘‘(B) APPLICATION.—Subparagraph (A) 

21 shall be applied in the case of a transition indi22 vidual who— 

23 ‘‘(i) is enrolled under this part as of 

24 the month before the effective month, for 


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1 premiums for months beginning with such 

2 effective month; or 

3 ‘‘(ii) enrolls under this part on or 

4 after the date of the enactment of this Act 

5 and before the end of the special enroll6 ment period under paragraph (1)(A), for 

7 premiums for months during the coverage 

8 period under this part which occur during 

9 or after the effective month. 

10 ‘‘(C) LOSS OF REDUCTION IF INDIVIDUAL

11 TERMINATES ENROLLMENT.—Subparagraph 

12 (A) shall not apply to a transition individual if 

13 the individual terminates enrollment under this 

14 part after the end of the special enrollment pe15 riod under paragraph (1). 

16 ‘‘(3) TRANSITION INDIVIDUAL DEFINED.—In 

17 this section, the term ‘transition individual’ means 

18 an individual who resides in Puerto Rico and who 

19 would have been deemed enrolled under this part 

20 pursuant to section 1837(f) before the first day of 

21 the effective month but for the fact that the indi22 vidual was a resident of Puerto Rico, regardless of 

23 whether the individual is enrolled under this part as 

24 of such first day.’’. 


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1 Subtitle D—Medicare Advantage 

2 (Part C) 

3 SEC. 131. ADJUSTMENT IN BENCHMARK FOR LOW-BASE 

4 PAYMENT COUNTIES IN PUERTO RICO. 

5 Section 1853(n) of the Social Security Act (42 U.S.C. 

6 1395w–23(n)) is amended— 

7 (1) in paragraph (1), by striking ‘‘and (5)’’ and 

8 inserting ‘‘(5), and (6)’’; 

9 (2) in paragraph (4), by striking ‘‘In no case’’ 

10 and inserting ‘‘Subject to paragraph (6), in no 

11 case’’; and 

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

13 paragraph: 

14 ‘‘(6) SPECIAL RULES FOR BLENDED BENCH15 MARK AMOUNT FOR TERRITORIES.— 

16 ‘‘(A) IN GENERAL.—Subject to subpara17 graph (B), the blended benchmark amount for 

18 an area in a territory for a year (beginning with 

19 2022) shall not be less than 80 percent of the 

20 national average of the base payment amounts 

21 specified in subparagraph (2)(E) for such year 

22 for areas within the 50 States and the District 

23 of Columbia. 

24 ‘‘(B) LIMITATION.—In no case shall the 

25 blended benchmark amount for an area in a 


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1 territory for a year under subparagraph (A) ex2 ceed the lowest blended benchmark amount for 

3 any area within the 50 States and the District 

4 of Columbia for such year.’’. 

5 Subtitle E—Medicare Part D 

6 SEC. 141. IMPROVED USE OF ALLOCATED PRESCRIPTION 

7 DRUG FUNDS BY TERRITORIES. 

8 Section 1935(e) of the Social Security Act (42 U.S.C. 

9 1396u–5(e)) is amended— 

10 (1) by redesignating paragraph (5) as para11 graph (6); and 

12 (2) by inserting after paragraph (4) the fol13 lowing new paragraph: 

14 ‘‘(5) IMPROVED USE OF FUNDS FOR LOW-IN15 COME PART D ELIGIBLE INDIVIDUALS.—This sub16 section shall be applied beginning with fiscal year 

17 2022 as follows, notwithstanding any other provision 

18 of this title: 

19 ‘‘(A) CLARIFYING STATE FLEXIBILITY TO

20 COVER NON-DUAL-ELIGIBLE INDIVIDUALS.—In 

21 this title, the term ‘medical assistance’ includes 

22 financial assistance furnished by a State under 

23 this subsection to part D eligible individuals 

24 who, if they were residing in one of the 50 

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1 ify as subsidy eligible individuals under section 

2 1860D–14(a)(3), and without regard to wheth3 er such individuals otherwise qualify for medical 

4 assistance under this title. 

5 ‘‘(B) 100 PERCENT FMAP TO REFLECT NO

6 STATE MATCHING REQUIRED FOR PART D LOW

7 INCOME SUBSIDIES.—The Federal medical as8 sistance percentage applicable to the assistance 

9 furnished under this subsection is 100 percent. 

10 ‘‘(C) LIMITED FUNDING FOR SPECIAL

11 RULES.—Subparagraphs (A) and (B), and the 

12 provision of medical assistance for covered part 

13 D drugs to low-income part D eligible individ14 uals for a State and period under this sub15 section, is limited to the amount specified in 

16 paragraph (3) for such State and period.’’. 

17 SEC. 142. REPORT ON TREATMENT OF TERRITORIES 

18 UNDER MEDICARE PART D. 

19 Paragraph (6) of section 1935(e) of the Social Secu20 rity Act (42 U.S.C. 1396u–5(e)), as redesignated by sec21 tion 141, is amended to read as follows: 

22 ‘‘(6) REPORT ON APPLICATION OF SUB23 SECTION.— 

24 ‘‘(A) IN GENERAL.—Not later than Feb25 ruary 1, 2023, the Secretary shall submit to 


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1 Congress a report on the application of this 

2 subsection during the period beginning fiscal 

3 year 2006 and ending fiscal year 2022. 

4 ‘‘(B) INFORMATION TO BE INCLUDED IN

5 REPORT.—Such report shall include— 

6 ‘‘(i) program guidance issued by the 

7 Secretary to implement this subsection; 

8 ‘‘(ii) for each territory, information on 

9 the increased amount under paragraph (3) 

10 and how the territory has applied such 

11 amount, including the territory’s program 

12 design, expenditures, and number of indi13 viduals (and dual-eligible individuals) as14 sisted; and 

15 ‘‘(iii) differences between how such 

16 territories are treated under part D of title 

17 XVIII and under this title compared with 

18 the treatment of the 50 States and the 

19 District of Columbia under such part and 

20 this title for different fiscal years within 

21 the period covered under the report. 

22 ‘‘(C) RECOMMENDATIONS.—Such report 

23 shall include recommendations for improving 

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1 ommendations regarding each of the following 

2 alternative approaches: 

3 ‘‘(i) Adjusting the aggregate amount 

4 specified in paragraph (3)(B). 

5 ‘‘(ii) Allowing residents of the terri6 tories to be subsidy eligible individuals 

7 under section 1860D–14, notwithstanding 

8 subsection (a)(3)(F) of such section, or 

9 providing substantially equivalent low-in10 come prescription drug subsidies to such 

11 residents.’’. 

12 Subtitle F—Miscellaneous 

13 SEC. 151. MEDICAID AND CHIP TERRITORY TRANSPARENCY 

14 AND INFORMATION. 

15 (a) PUBLICATION OF INFORMATION ON FEDERAL

16 EXPENDITURES UNDER MEDICAID AND CHIP IN THE

17 TERRITORIES.—Not later than 180 days after the date 

18 of the enactment of this Act, the Secretary of Health and 

19 Human Services shall publish, and periodically update, on 

20 the Internet site of the Centers for Medicare & Medicaid 

21 Services information on Medicaid and CHIP carried out 

22 in the territories of the United States. Such information 

23 shall include, with respect to each such territory— 

24 (1) the income levels established by the terri25 tory for purposes of eligibility of an individual to reVerDate Sep 11 2014 23:20 Jun 10, 2021 Jkt 019200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H2713.IH H2713

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1 ceive medical assistance under Medicaid or child 

2 health assistance under CHIP; 

3 (2) the number of individuals enrolled in Med4 icaid and CHIP in such territory; 

5 (3) any State plan amendments in effect to 

6 carry out Medicaid or CHIP in such territory; 

7 (4) any waiver of the requirements of title XIX 

8 or title XXI issued by the Secretary to carry out 

9 Medicaid or CHIP in the territory, including a waiv10 er under section 1115 of the Social Security Act (42 

11 U.S.C. 1315), any application for such a waiver, and 

12 any documentation related to such application (in13 cluding correspondence); 

14 (5) the amount of the Federal and non-Federal 

15 share of expenditures under Medicaid and CHIP in 

16 such territory; 

17 (6) the systems in place for the furnishing of 

18 health care items and services under Medicaid and 

19 CHIP in such territory; 

20 (7) the design of CHIP in such territory; and 

21 (8) other information regarding the carrying 

22 out of Medicaid and CHIP in the territory that is 

23 published on such Internet site with respect to car24 rying out Medicaid and CHIP in each State and the 

25 District of Columbia. 


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1 (b) DEFINITIONS.—In this section: 

2 (1) CHIP.—The term ‘‘CHIP’’ means the 

3 State Children’s Health Insurance Program under 

4 title XXI of the Social Security Act. 

5 (2) MEDICAID.—The term ‘‘Medicaid’’ means 

6 the Medicaid program under title XIX of the Social 

7 Security Act. 

8 (3) TERRITORY.—The term ‘‘territory of the 

9 United States’’ includes Puerto Rico, the Virgin Is10 lands of the United States, Guam, the Northern 

11 Mariana Islands, and American Samoa. 

12 SEC. 152. REPORT ON EXCLUSION OF TERRITORIES FROM 

13 EXCHANGES. 

14 (a) IN GENERAL.—Not later than 180 days after the 

15 date of enactment of this Act, the Secretary of Health and 

16 Human Services shall submit to Congress a report that 

17 details the adverse impacts in each territory from the 

18 practical exclusion of the territories from the provisions 

19 of part II or III of subtitle D of title I of the Patient 

20 Protection and Affordable Care Act insofar as such provi21 sions provide for the establishment of an American Health 

22 Benefit Exchange or the administration of a federally fa23 cilitated Exchange in each State and in the District of 

24 Columbia for the purpose of making health insurance 


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1 more affordable and accessible for individuals and small 

2 businesses. 

3 (b) INFORMATION IN REPORT.—The report shall in4 clude information on the following: 

5 (1) An estimate of the total number of individ6 uals residing in each territory with health insurance 

7 coverage, and the total number of individuals in each 

8 territory without health insurance coverage. 

9 (2) The number of health insurance issuers in 

10 each territory and the health insurance coverage 

11 each such issuer offers. 

12 (3) An estimate of the number of individuals re13 siding in each territory who are denied premium and 

14 cost-sharing assistance that would otherwise be 

15 available to them for obtaining health insurance cov16 erage through an Exchange if they resided in one of 

17 the 50 States or in the District of Columbia. 

18 (4) An estimate of the amount of Federal as19 sistance described in paragraph (3) that is not being 

20 made available to residents of each territory. 

21 (5) An estimate of the number of small employ22 ers in each territory that would be eligible to pur23 chase health insurance coverage through a Small 

24 Business Health Options Program (SHOP) Market25 place that would operate as part of an Exchange if 


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1 the employers were in one of the 50 States or in the 

2 District of Columbia. 

3 SEC. 153. ACCESS TO COVERAGE FOR INDIVIDUALS IN CER4 TAIN AREAS WITHOUT ANY AVAILABLE EX5 CHANGE PLANS. 

6 Part 2 of subtitle D of title I of the Patient Protec7 tion and Affordable Care Act (42 U.S.C. 18031 et seq.) 

8 is amended by adding at the end the following: 

9 ‘‘SEC. 1314. ACCESS TO COVERAGE FOR INDIVIDUALS IN 

10 CERTAIN AREAS WITHOUT ANY AVAILABLE 

11 EXCHANGE PLANS. 

12 ‘‘(a) IN GENERAL.— 

13 ‘‘(1) COVERAGE THROUGH DC EXCHANGE.— 

14 Not later than 3 months after the date of enactment 

15 of this section, the Secretary, in consultation with 

16 the Secretary of the Treasury and the Director of 

17 the Office of Personnel Management, shall establish 

18 a mechanism to ensure that, for any plan year be19 ginning on or after the date described in subsection 

20 (c), any individual described in paragraph (2) has 

21 access to health insurance coverage which is at least 

22 as broad as the coverage available to Members of 

23 Congress and congressional staff (as defined in sec24 tion 1312(d)(3)(D)) through the Exchange operating 

25 in the District of Columbia. Such individuals shall 


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1 be eligible for any premium tax credit under section 

2 36B of the Internal Revenue Code of 1986, reduced 

3 cost sharing under section 1402, and advance deter4 mination and payment of such credits or such reduc5 tions under section 1412 to be administered by the 

6 Secretary, in consultation with the Secretary of the 

7 Treasury and the Director of the Office of Personnel 

8 Management. The District of Columbia, its resi9 dents, and small businesses shall be held harmless 

10 from any increased costs resulting from the enact11 ment of this section. 

12 ‘‘(2) INDIVIDUAL DESCRIBED.—An individual 

13 described in this paragraph is any individual who— 

14 ‘‘(A) is not eligible to enroll in an em15 ployer-sponsored health plan (excluding such a 

16 plan that would not be considered minimum es17 sential coverage due to the application of sub18 paragraph (C) of section 36B(c)(2) of the In19 ternal Revenue Code of 1986 if such subpara20 graph applied to such plan); and 

21 ‘‘(B) is a bona fide resident of any posses22 sion of the United States (as determined under 

23 section 937(a) of such Code) in which the Sec24 retary certifies that no qualified health plan is 


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1 offered through an Exchange established under 

2 this title. 

3 ‘‘(3) POSSESSION OF THE UNITED STATES.— 

4 For purposes of this section, the term ‘possession of 

5 the United States’ shall include such possessions as 

6 are specified in section 937(a)(1) of the Internal 

7 Revenue Code of 1986. 

8 ‘‘(b) TREATMENT OF POSSESSIONS.— 

9 ‘‘(1) PAYMENTS TO POSSESSIONS.— 

10 ‘‘(A) MIRROR CODE POSSESSION.—The 

11 Secretary of the Treasury shall periodically (but 

12 not less frequently than annually) pay to each 

13 possession of the United States with a mirror 

14 code tax system amounts equal to the loss to 

15 that possession by reason of the application of 

16 this section (determined without regard to para17 graph (2)) with respect to taxable years begin18 ning after the date described in subsection (c). 

19 Such amounts shall be determined by the Sec20 retary of the Treasury based on information 

21 provided by the government of the respective 

22 possession. 

23 ‘‘(B) OTHER POSSESSIONS.—The Sec24 retary of the Treasury shall periodically (but 

25 not less frequently than annually) pay to each 


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1 possession of the United States which does not 

2 have a mirror code tax system amounts esti3 mated by the Secretary of the Treasury as 

4 being equal to the aggregate benefits that would 

5 have been provided to residents of such posses6 sion by reason of the application of this section 

7 for any taxable years beginning after the date 

8 described in subsection (c) if a mirror code tax 

9 system had been in effect in such possession. 

10 The preceding sentence shall not apply with re11 spect to any possession of the United States un12 less such possession has a plan, which has been 

13 approved by the Secretary of the Treasury, 

14 under which such possession will promptly dis15 tribute such payments to the residents of such 

16 possession. 

17 ‘‘(2) COORDINATION WITH CREDIT ALLOWED

18 AGAINST UNITED STATES INCOME TAXES.—No cred19 it shall be allowed against United States income 

20 taxes for any taxable year under section 36B of the 

21 Internal Revenue Code of 1986 to any person— 

22 ‘‘(A) to whom a credit is allowed against 

23 taxes imposed by the possession by reason of 

24 this section (determined without regard to this 

25 paragraph) for such taxable year, or 


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1 ‘‘(B) who is eligible for a payment under 

2 a plan described in paragraph (1)(B) with re3 spect to such taxable year. 

4 ‘‘(3) MIRROR CODE TAX SYSTEM.—For pur5 poses of this subsection, the term ‘mirror code tax 

6 system’ means, with respect to any possession of the 

7 United States, the income tax system of such posses8 sion if the income tax liability of the residents of 

9 such possession under such system is determined by 

10 reference to the income tax laws of the United 

11 States as if such possession were the United States. 

12 ‘‘(4) TREATMENT OF PAYMENTS.—For pur13 poses of section 1324(b)(2) of title 31, United 

14 States Code, or any similar rule of law, the pay15 ments under this subsection shall be treated in the 

16 same manner as a refund due from the credit al17 lowed under section 36B of the Internal Revenue 

18 Code of 1986. 

19 ‘‘(c) DATE DESCRIBED.—The date described in this 

20 subsection is the date on which the Secretary establishes 

21 the mechanism described in subsection (a)(1).’’. 


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1 TITLE II—INCLUSION OF THE 

2 TERRITORIES IN THE SUP3 PLEMENTAL NUTRITIONAL 

4 ASSISTANCE PROGRAM 

5 SEC. 201. PARTICIPATION AND TRANSITION OF PUERTO 

6 RICO, AMERICAN SAMOA, AND THE NORTH7 ERN MARIANA ISLANDS IN SUPPLEMENTAL 

8 NUTRITION ASSISTANCE PROGRAM. 

9 (a) DEFINITIONS.—Section 3 of the Food and Nutri10 tion Act of 2008 (7 U.S.C. 2012) is amended— 

11 (1) in subsection (r), by inserting ‘‘the Com12 monwealth of Puerto Rico, American Samoa, the 

13 Commonwealth of the Northern Mariana Islands,’’ 

14 after ‘‘Guam,’’; and 

15 (2) in subsection (u)(3), by inserting ‘‘the Com16 monwealth of Puerto Rico, American Samoa, the 

17 Commonwealth of the Northern Mariana Islands,’’ 

18 after ‘‘Guam,’’. 

19 (b) ELIGIBLE HOUSEHOLDS.—Section 5 of the Food 

20 and Nutrition Act of 2008 (7 U.S.C. 2014) is amended— 

21 (1) in subsection (b), in the first sentence, by 

22 inserting ‘‘the Commonwealth of Puerto Rico, Amer23 ican Samoa, the Commonwealth of the Northern 

24 Mariana Islands,’’ after ‘‘Guam,’’; 


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1 (2) in subsection (c)(1), by striking ‘‘and 

2 Guam,’’ and inserting ‘‘Guam, the Commonwealth of 

3 Puerto Rico, American Samoa, and the Common4 wealth of the Northern Mariana Islands,’’; and 

5 (3) in subsection (e)— 

6 (A) in paragraph (1)(A), by inserting ‘‘the 

7 Commonwealth of Puerto Rico, American 

8 Samoa, the Commonwealth of the Northern 

9 Mariana Islands,’’ after ‘‘Hawaii,’’ each place it 

10 appears; and 

11 (B) in paragraph (6)(B), in the matter 

12 preceding clause (i), by inserting ‘‘the Common13 wealth of Puerto Rico, American Samoa, the 

14 Commonwealth of the Northern Mariana Is15 lands,’’ after ‘‘Guam,’’. 

16 (c) EFFECTIVE DATE.— 

17 (1) IN GENERAL.—The amendments made by 

18 subsections (a) and (b) shall be effective with re19 spect to the Commonwealth of Puerto Rico, Amer20 ican Samoa, and the Commonwealth of the Northern 

21 Mariana Islands, as applicable, on the date described 

22 in paragraph (2) if the Secretary of Agriculture sub23 mits to Congress a certification under subsection 

24 (f)(2)(B) of section 19 of the Food and Nutrition 

25 Act of 2008 (7 U.S.C. 2028). 


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1 (2) DATE DESCRIBED.—The date referred to in 

2 paragraph (1) is, with respect to the Commonwealth 

3 of Puerto Rico, American Samoa, and the Common4 wealth of the Northern Mariana Islands, the date es5 tablished by the Commonwealth of Puerto Rico, 

6 American Samoa, or the Commonwealth of the 

7 Northern Mariana Islands, respectively, in the appli8 cable plan of operation submitted to the Secretary of 

9 Agriculture under subsection (f)(1) of section 19 of 

10 the Food and Nutrition Act of 2008 (7 U.S.C. 

11 2028). 

12 (d) TRANSITION OF PUERTO RICO, AMERICAN

13 SAMOA, AND THE NORTHERN MARIANA ISLANDS TO SUP14 PLEMENTAL NUTRITION ASSISTANCE PROGRAM.—Section 

15 19 of the Food and Nutrition Act of 2008 (7 U.S.C. 2028) 

16 is amended— 

17 (1) in subsection (a)(1)— 

18 (A) in subparagraph (A), by striking 

19 ‘‘and’’ at the end; 

20 (B) in subparagraph (B), by striking the 

21 period at the end and inserting ‘‘; and’’; and 

22 (C) by adding at the end the following: 

23 ‘‘(C) the Commonwealth of the Northern 

24 Mariana Islands.’’; and 

25 (2) by adding at the end the following: 


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1 ‘‘(f) TRANSITION OF PUERTO RICO, AMERICAN

2 SAMOA, AND THE NORTHERN MARIANA ISLANDS TO SUP3 PLEMENTAL NUTRITION ASSISTANCE PROGRAM.— 

4 ‘‘(1) DEFINITION OF GOVERNMENTAL ENTI5 TY.—In this subsection, the term ‘governmental en6 tity’ means— 

7 ‘‘(A) the Commonwealth of Puerto Rico; 

8 ‘‘(B) American Samoa; and 

9 ‘‘(C) the Commonwealth of the Northern 

10 Mariana Islands. 

11 ‘‘(2) REQUEST FOR PARTICIPATION.—A govern12 mental entity may submit to the Secretary a request 

13 to participate in the supplemental nutrition assist14 ance program, which shall include a plan of oper15 ation described in section 11(d), which shall include 

16 the date on which the governmental entity intends to 

17 begin participation in the program. 

18 ‘‘(3) CERTIFICATION BY SECRETARY.— 

19 ‘‘(A) IN GENERAL.—The Secretary shall 

20 certify a governmental entity that submits a re21 quest under paragraph (2) as qualified to par22 ticipate in the supplemental nutrition assistance 

23 program if the Secretary— 


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1 ‘‘(i) approves the plan of operation 

2 submitted with the request, in accordance 

3 with this subsection; and 

4 ‘‘(ii) approves the applications de5 scribed in paragraph (5) in accordance 

6 with that paragraph. 

7 ‘‘(B) SUBMISSION OF CERTIFICATION TO

8 CONGRESS.—The Secretary shall submit each 

9 certification under subparagraph (A) to Con10 gress. 

11 ‘‘(C) CERTIFICATION DECISION.—The Sec12 retary shall certify or not certify a govern13 mental entity that submits a request under 

14 paragraph (2) not later than 90 days after the 

15 date on which the Secretary receives the re16 quest. 

17 ‘‘(4) DETERMINATION OF PLAN OF OPER18 ATION.— 

19 ‘‘(A) APPROVAL.—The Secretary shall ap20 prove a plan of operation submitted with a re21 quest under paragraph (2) if the plan satisfies 

22 the requirements under this Act. 

23 ‘‘(B) DISAPPROVAL.—If the Secretary does 

24 not approve a plan of operation submitted with 

25 a request under paragraph (2), the Secretary 


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1 shall provide to the governmental entity a state2 ment that describes each requirement under 

3 this Act that is not satisfied by the plan. 

4 ‘‘(5) RETAIL FOOD STORES.—If the Secretary 

5 approves a plan of operation under paragraph (4)(A) 

6 for a governmental entity, the Secretary shall accept 

7 applications from retail food stores located in that 

8 governmental entity to be authorized under section 

9 9 to participate in the supplemental nutrition assist10 ance program. 

11 ‘‘(6) PUERTO RICO.—In the case of a request 

12 under paragraph (2) by the Commonwealth of Puer13 to Rico, notwithstanding subsection (g), the Sec14 retary shall allow the Commonwealth of Puerto Rico 

15 to continue to carry out under the supplemental nu16 trition assistance program the Family Market Pro17 gram established pursuant to this section. 

18 ‘‘(7) TEMPORARY FUNDING.—Any govern19 mental entity that has a request under paragraph 

20 (2) pending before the Secretary (including a plan of 

21 operation pending under paragraph (4)) shall receive 

22 block grants under this section, in amounts deter23 mined by the Secretary, until the date on which the 

24 Secretary certifies the governmental entity. 


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1 ‘‘(8) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to the Sec3 retary such sums as are necessary to carry out this 

4 subsection for fiscal year 2021, to remain available 

5 until expended. 

6 ‘‘(g) TECHNICAL INFRASTRUCTURE IMPLEMENTA7 TION.— 

8 ‘‘(1) IN GENERAL.—A governmental entity (as 

9 defined in subsection (f)) may request from the Sec10 retary a 1-time grant to pay for the cost of the tech11 nology infrastructure necessary to implement the 

12 supplemental nutrition assistance program, including 

13 the cost of information technology, information tech14 nology personnel, and training relating to program 

15 implementation. 

16 ‘‘(2) APPLICATION.—A governmental entity 

17 making a request under paragraph (1) for a grant 

18 shall submit to the Secretary an application at such 

19 time, in such manner, and containing such informa20 tion as the Secretary may require, including— 

21 ‘‘(A) a description of the costs to be paid 

22 for by the grant; and 

23 ‘‘(B) a plan for implementing the tech24 nology infrastructure described in paragraph 

25 (1)— 


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1 ‘‘(i) within 1 year of receiving the 

2 grant; and 

3 ‘‘(ii) that is reasonably cost efficient, 

4 as determined by the Secretary. 

5 ‘‘(3) DETERMINATION.— 

6 ‘‘(A) TIME LIMIT.—The Secretary shall 

7 approve or deny an application submitted under 

8 paragraph (2) not later than 90 days after the 

9 date on which the application is submitted. 

10 ‘‘(B) DENIAL.—If the Secretary denies an 

11 application submitted under paragraph (2), the 

12 governmental entity may amend the plan de13 scribed in subparagraph (B) of that paragraph, 

14 in coordination with the Secretary, to resubmit 

15 to the Secretary for approval. 

16 ‘‘(4) FUNDING.— 

17 ‘‘(A) IN GENERAL.—There is appropriated 

18 to the Secretary, out of funds in the Treasury 

19 not otherwise appropriated, $5,000,000 to carry 

20 out this subsection, to remain available until 3 

21 years after the date of enactment of this sub22 section. 

23 ‘‘(B) REVERSION OF FUNDS.—Any funds 

24 appropriated to the Secretary under subpara25 graph (A) that remain available by the date deVerDate Sep 11 2014 23:20 Jun 10, 2021 Jkt 019200 PO 00000 Frm 00036 Fmt 6652 Sfmt 6201 E:\BILLS\H2713.IH H2713

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1 scribed in that subparagraph shall revert to the 

2 Treasury. 

3 ‘‘(h) TERMINATION OF EFFECTIVENESS.— 

4 ‘‘(1) IN GENERAL.—Subsections (a) through (e) 

5 shall cease to be effective with respect to the Com6 monwealth of Puerto Rico, American Samoa, and 

7 the Commonwealth of the Northern Mariana Is8 lands, as applicable, on the date described in para9 graph (2) if the Secretary submits to Congress a 

10 certification under subsection (f)(3)(B) for that gov11 ernmental entity. 

12 ‘‘(2) DATE DESCRIBED.—The date referred to 

13 in paragraph (1) is, with respect to the Common14 wealth of Puerto Rico, American Samoa, and the 

15 Commonwealth of the Northern Mariana Islands, 

16 the date established by the Commonwealth of Puerto 

17 Rico, American Samoa, or the Commonwealth of the 

18 Northern Mariana Islands, respectively, in the appli19 cable plan of operation submitted to the Secretary 

20 under subsection (f)(2).’’. 


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1 TITLE III—EQUITABLE TREAT2 MENT FOR PUERTO RICO AND 

3 THE VIRGIN ISLANDS WITH 

4 RESPECT TO TAX CREDITS 

5 SEC. 301. EQUITABLE TREATMENT FOR RESIDENTS OF 

6 PUERTO RICO AND THE VIRGIN ISLANDS 

7 WITH RESPECT TO THE EARNED INCOME TAX 

8 CREDIT AND THE CHILD TAX CREDIT. 

9 (a) PUERTO RICO RESIDENTS ELIGIBLE FOR

10 EARNED INCOME TAX CREDIT.— 

11 (1) IN GENERAL.—Section 32 of the Internal 

12 Revenue Code of 1986, as amended by section 

13 9621(a) of the American Rescue Plan Act of 2021 

14 (Public Law 117–2), is amended by adding at the 

15 end the following new subsection: 

16 ‘‘(o) RESIDENTS OF PUERTO RICO.— 

17 ‘‘(1) IN GENERAL.—In the case of residents of 

18 Puerto Rico— 

19 ‘‘(A) the United States shall be treated as 

20 including Puerto Rico for purposes of sub21 sections (c)(1)(A)(ii)(I) and (c)(3)(C), 

22 ‘‘(B) subsection (c)(1)(D) shall not apply 

23 to nonresident alien individuals who are resi24 dents of Puerto Rico, and 


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1 ‘‘(C) adjusted gross income and gross in2 come shall be computed without regard to sec3 tion 933 for purposes of subsections (a)(2)(B) 

4 and (c)(2)(A)(i). 

5 ‘‘(2) LIMITATION.—The credit allowed under 

6 this section by reason of this subsection for any tax7 able year shall not exceed the amount, determined 

8 under regulations or other guidance promulgated by 

9 the Secretary, that a similarly situated taxpayer 

10 would receive if residing in a State.’’. 

11 (2) CHILD TAX CREDIT NOT REDUCED.—Sub12 clause (II) of section 24(d)(1)(B)(ii) of such Code is 

13 amended by inserting before the period ‘‘(determined 

14 without regard to section 32(n) in the case of resi15 dents of Puerto Rico)’’. 

16 (3) EFFECTIVE DATE.—The amendments made 

17 this subsection shall apply to taxable years begin18 ning after December 31, 2020. 

19 (b) EQUITABLE TREATMENT FOR RESIDENTS OF

20 PUERTO RICO WITH RESPECT TO THE REFUNDABLE

21 PORTION OF THE CHILD TAX CREDIT.— 

22 (1) IN GENERAL.—Section 24(d)(1) of the In23 ternal Revenue Code of 1986 is amended by insert24 ing ‘‘or section 933’’ after ‘‘section 112’’. 


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1 (2) EFFECTIVE DATE.—The amendment made 

2 by paragraph (1) shall apply to taxable years begin3 ning after December 31, 2020. 

4 (c) TREATMENT OF RESIDENTS OF THE VIRGIN IS5 LANDS.— 

6 (1) IN GENERAL.—The Secretary of the Treas7 ury shall pay to the government of the Virgin Is8 lands amounts equal to the loss to that possession 

9 by reason of the application of— 

10 (A) section 32 of the Internal Revenue 

11 Code of 1986 (determined as if subsection (o) 

12 of such section, as added by subsection (a), ap13 plied to bona fide residents of that possession), 

14 and 

15 (B) section 24(d) of such Code (deter16 mined as if the amendment made by subsection 

17 (b) applied to bona fide residents of that pos18 session), 

19 with respect to taxable years beginning after Decem20 ber 31, 2020. Such amounts shall be determined by 

21 the Secretary of the Treasury based on information 

22 provided by the government of the Virgin Islands. 

23 (2) TREATMENT OF PAYMENTS.—For purposes 

24 of section 1324(b)(2) of title 31, United States 

25 Code, the payments under this subsection shall be 


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1 treated in the same manner as a refund due from 

2 the credit allowed under section 32 or 24 (by reason 

3 of subsection (d) thereof), whichever is applicable, of 

4 the Internal Revenue Code of 1986. 

5 TITLE IV—LABOR EQUITY FOR 

6 PUERTO RICO 

7 SEC. 401. MINIMUM WAGE FOR YOUNG EMPLOYEES IN 

8 PUERTO RICO. 

9 Section 6(g) of the Fair Labor Standards Act of 

10 1938 (29 U.S.C. 206(g)) is amended— 

11 (1) by striking paragraph (2) and redesignating 

12 paragraphs (3) through (5) as paragraphs (2) 

13 through (4), respectively; 

14 (2) in paragraph (2), as so redesignated, by 

15 striking ‘‘or (2)’’; and 

16 (3) in paragraph (4), as so redesignated, by 

17 striking ‘‘20 years, except’’ and all that follows 

18 through the period and inserting ‘‘20 years.’’. 

19 SEC. 402. OVERTIME HOURS PROTECTIONS FOR WORKERS 

20 IN PUERTO RICO. 

21 Section 404 of the Puerto Rico Oversight, Manage22 ment, and Economic Stability Act (48 U.S.C. 2193) is re23 pealed. 


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1 TITLE V—EXTENSION OF SUP2 PLEMENTAL SECURITY IN3 COME (SSI) PROGRAM TO ALL 

4 TERRITORIES 

5 SEC. 501. EXTENSION OF SSI PROGRAM TO ALL TERRI6 TORIES. 

7 (a) APPLICATION OF SOCIAL SECURITY AMEND8 MENTS OF 1972 AMENDMENTS AND REPEALS TO TERRI9 TORIES.— 

10 (1) IN GENERAL.—Effective January 1, 2022, 

11 the amendments made by sections 301 and 302 of 

12 the Social Security Amendments of 1972 (Public 

13 Law 92–603) and the repeals made by section 

14 303(a) of the Social Security Amendments of 1972 

15 shall be applicable in the case of Puerto Rico, Guam, 

16 the Virgin Islands, and American Samoa. 

17 (2) CONFORMING AMENDMENT.—Effective Jan18 uary 1, 2022, section 303 of the Social Security 

19 Amendments of 1972 (Public Law 92–603) is 

20 amended by striking subsection (b). 

21 (b) CONFORMING AMENDMENTS.— 

22 (1) DEFINITION OF STATE.—Section 1101(1) of 

23 the Social Security Act (42 U.S.C. 1301(1)) is 

24 amended by striking the fifth sentence and inserting 

25 the following: ‘‘In the case of supplemental security 


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1 income under title XVI, such term also includes the 

2 Virgin Islands, Guam, the Northern Mariana Is3 lands, and American Samoa.’’. 

4 (2) DEFINITION OF UNITED STATES.—Section 

5 1614(e) of the Social Security Act (42 U.S.C. 

6 1382c(e)) is amended by striking ‘‘and the District 

7 of Columbia’’ and inserting ‘‘, the District of Colum8 bia, Puerto Rico, the Virgin Islands, Guam, the 

9 Northern Mariana Islands, and American Samoa’’. 

10 (3) EFFECTIVE DATE.—The amendments made 

11 by this subsection shall take effect on January 1, 

12 2022. 

Æ 


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