I 
115TH CONGRESS 
1ST SESSION H. R. 3927 
To amend title XXI to allow for the blending of risk pools of children’s 
health insurance buy-in programs with the risk pools of State child 
health plans under such title, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 3, 2017 
Mr. BILIRAKIS introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Ways and Means, 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 amend title XXI to allow for the blending of risk pools 
of children’s health insurance buy-in programs with the 
risk pools of State child health plans under such title, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. ENSURING STATE FLEXIBILITY IN OFFERING 
CHILDREN’S 
HEALTH 
INSURANCE 
BUY-IN 
PROGRAMS. 
(a) 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 con-
strued as preventing a State from considering chil-
dren enrolled in a qualified children’s health insur-
ance buy-in 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 CHILDREN’S HEALTH INSUR-
ANCE
BUY-IN
PROGRAM.—In this subsection, the 
term ‘qualified children’s health insurance buy-in 
program’ means a State program— 
‘‘(A) under which children who are under 
the age of 18 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 bene-
fits that are at least identical to the benefits 
provided under the State child health plan 
under this title (or a waiver of such plan); or 
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‘‘(B) that is funded exclusively through 
non-Federal funds, including funds received by 
the State in the form of premiums for the pur-
chase of such coverage.’’. 
(b) MINIMUM ESSENTIAL COVERAGE.— 
(1) IN
GENERAL.—Section 5000A(f)(1)(A) of 
the Internal Revenue Code of 1986 is amended— 
(A) in clause (vi), by striking ‘‘or’’ at the 
end; 
(B) in clause (vii), by striking the period 
at the end and inserting ‘‘; or’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(viii) a qualified children’s health in-
surance buy-in program (as defined in sec-
tion 2107(g) of the Social Security Act).’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply with respect to taxable 
years beginning after December 31, 2017. 
Æ 
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