143 
‘‘(7) ADDITIONAL PAYMENTS.— 
‘‘(A) PROVISION
OF
ASSISTANCE.—The 
Secretary shall provide payments to loan 
servicers for retaining jobs at locations in the 
United States where such servicers were oper-
ating under part B on January 1, 2010. 
‘‘(B) FUNDS.—There are authorized to be 
appropriated, and there are appropriated, to 
carry out this paragraph (in addition to any 
other amounts appropriated to carry out this 
paragraph and out of any money in the Treas-
ury not otherwise appropriated), $25,000,000 
for each of the fiscal years 2010 and 2011.’’. 
(2) CONFORMING
AMENDMENT.—Section 458 
(20 U.S.C. 1087h) is further amended by striking 
‘‘subsection (a)(3)’’ in subsection (b) and inserting 
‘‘subsection (a)(4)’’. 
SEC. 2213. INCOME-BASED REPAYMENT. 
Section 493C (20 U.S.C. 1098e) is amended by add-
ing at the end the following new subsection: 
‘‘(e) SPECIAL TERMS FOR NEW BORROWERS ON AND 
AFTER JULY 1, 2014.—With respect to any loan made 
to a new borrower on or after July 1, 2014— 
‘‘(1) subsection (a)(3)(B) shall be applied by 
substituting ‘10 percent’ for ‘15 percent’; and
144 
‘‘(2) subsection (b)(7)(B) shall be applied by 
substituting ‘20 years’ for ‘25 years’.’’. 
Subtitle B—Health 
SEC. 2301. INSURANCE REFORMS. 
(a) EXTENDING CERTAIN INSURANCE REFORMS TO 
GRANDFATHERED PLANS.—Section 1251(a) of the Pa-
tient Protection and Affordable Care Act, as added by sec-
tion 10103(d) of such Act, is amended by adding at the 
end the following: 
‘‘(4) APPLICATION OF CERTAIN PROVISIONS.— 
‘‘(A) IN GENERAL.—The following provi-
sions of the Public Health Service Act (as 
added by this title) shall apply to grandfathered 
health plans for plan years beginning with the 
first plan year to which such provisions would 
otherwise apply: 
‘‘(i) Section 2708 (relating to exces-
sive waiting periods). 
‘‘(ii) Those provisions of section 2711 
relating to lifetime limits. 
‘‘(iii) Section 2712 (relating to rescis-
sions). 
‘‘(iv) Section 2714 (relating to exten-
sion of dependent coverage).
145 
‘‘(B) PROVISIONS
APPLICABLE
ONLY
TO 
GROUP HEALTH PLANS.— 
‘‘(i) PROVISIONS DESCRIBED.—Those 
provisions of section 2711 relating to an-
nual limits and the provisions of section 
2704 (relating to pre-existing condition ex-
clusions) of the Public Health Service Act 
(as added by this subtitle) shall apply to 
grandfathered health plans that are group 
health plans for plan years beginning with 
the first plan year to which such provisions 
otherwise apply. 
‘‘(ii) ADULT CHILD COVERAGE.—For 
plan years beginning before January 1, 
2014, the provisions of section 2714 of the 
Public Health Service Act (as added by 
this subtitle) shall apply in the case of an 
adult child with respect to a grandfathered 
health plan that is a group health plan 
only if such adult child is not eligible to 
enroll in an eligible employer-sponsored 
health 
plan 
(as 
defined 
in 
section 
5000A(f)(2) of the Internal Revenue Code 
of 1986) other than such grandfathered 
health plan.’’.
146 
(b) CLARIFICATION REGARDING DEPENDENT COV-
ERAGE.—Section 2714(a) of the Public Health Service 
Act, as added by section 1001(5) of the Patient Protection 
and Affordable Care Act, is amended by striking ‘‘(who 
is not married)’’. 
SEC. 2302. DRUGS PURCHASED BY COVERED ENTITIES. 
Section 340B of the Public Health Service Act (42 
U.S.C. 256b), as amended by sections 7101 and 7102 of 
the Patient Protection and Affordable Care Act, is amend-
ed— 
(1) in subsection (a)— 
(A) in paragraphs (1), (2), (5), (7), and 
(9), by striking the terms ‘‘covered drug’’ and 
‘‘covered drugs’’ each place either term appears 
and inserting ‘‘covered outpatient drug’’ or 
‘‘covered outpatient drugs’’, respectively; 
(B) in paragraph (4)(L)— 
(i) in clause (i), by striking ‘‘and’’ at 
the end; 
(ii) in clause (ii), by striking the pe-
riod and inserting ‘‘; and’’; and 
(iii) by inserting after clause (ii), the 
following: 
‘‘(iii) does not obtain covered out-
patient drugs through a group purchasing
147 
organization or other group purchasing ar-
rangement.’’; and 
(C) in paragraph (5)— 
(i) by striking subparagraph (C); 
(ii) by redesignating subparagraphs 
(D) and (E) as subparagraphs (C) and 
(D), respectively; and 
(iii) in subparagraph (D), as so redes-
ignated, by striking ‘‘subparagraph (D)’’ 
and inserting ‘‘subparagraph (C)’’; 
(2) by striking subsection (c); 
(3) in subsection (d)— 
(A) by striking ‘‘covered drugs’’ each place 
it appears and inserting ‘‘covered outpatient 
drugs’’; 
(B) by striking ‘‘(a)(5)(D)’’ each place it 
appears and inserting ‘‘(a)(5)(C)’’; and 
(C) by striking ‘‘(a)(5)(E)’’ each place it 
appears and inserting ‘‘(a)(5)(D)’’; and 
(4) by inserting after subsection (d) the fol-
lowing: 
‘‘(e) EXCLUSION OF ORPHAN DRUGS FOR CERTAIN 
COVERED ENTITIES.—For covered entities described in 
subparagraph (M), (N), or (O) of subsection (a)(4), the 
term ‘covered outpatient drug’ shall not include a drug
148 
designated by the Secretary under section 526 of the Fed-
eral Food, Drug, and Cosmetic Act for a rare disease or 
condition.’’. 
SEC. 2303. COMMUNITY HEALTH CENTERS. 
Section 10503(b)(1) of the Patient Protection and 
Affordable Care Act is amended— 
(1) 
in 
subparagraph 
(A), 
by 
striking 
‘‘700,000,000’’ and inserting ‘‘1,000,000,000’’; 
(2) 
in 
subparagraph 
(B), 
by 
striking 
‘‘800,000,000’’ and inserting ‘‘1,200,000,000’’; 
(3) 
in 
subparagraph 
(C), 
by 
striking 
‘‘1,000,000,000’’ and inserting ‘‘1,500,000,000’’; 
(4) 
in 
subparagraph 
(D), 
by 
striking 
‘‘1,600,000,000’’ and inserting ‘‘2,200,000,000’’; 
and 
(5) 
in 
subparagraph 
(E), 
by 
striking 
‘‘2,900,000,000’’ and inserting ‘‘3,600,000,000’’. 
Passed the House of Representatives March 21, 
2010. 
Attest: 
Clerk.
111TH CONGRESS 
2D SESSION 
H. R. 4872 
AN ACT 
To provide for reconciliation pursuant to Title II of 
the concurrent resolution on the budget for fiscal 
year 2010 (S. Con. Res. 13).