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‘‘(A) has not’’; 
(2) in subparagraph (A), as so inserted, by 
striking the period at the end and inserting ‘‘; and’’; 
and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(B) begins to expend amounts for all such 
individuals prior to January 1, 2026.’’. 
SEC. 44132. MORATORIUM ON NEW OR INCREASED PRO-
VIDER TAXES. 
Section 1903(w)(1)(A)(iii) of the Social Security Act 
(42 U.S.C. 1396b(w)(1)(A)(iii)) is amended— 
(1) by striking ‘‘or’’ at the end; 
(2) by striking ‘‘if there’’ and inserting ‘‘if— 
‘‘(I) there’’; and 
(3) by adding at the end the following new sub-
clauses: 
‘‘(II) the tax is first imposed by the State 
(or by a unit of local government in the State) 
on or after the date of the enactment of this 
subclause (other than such a tax for which the 
legislation or regulations providing for the im-
position of such tax were enacted or adopted 
prior to such date of enactment); or 
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‘‘(III) on or after the date of the enact-
ment of this subclause, the State (or unit of 
local government) increases the amount or rate 
of tax imposed with respect to a class of health 
care items or services (or with respect to a type 
of provider or activity within such a class), or 
increases the base of the tax such that the tax 
is imposed with respect to a class of items or 
services (or with respect to a type of provider 
or activity within such a class) to which the tax 
did not previously apply, but only to the extent 
that such revenues are attributable to such in-
crease and only if such increase was not pro-
vided for in legislation or regulations enacted or 
adopted prior to such date of enactment; or’’. 
SEC. 44133. REVISING PAYMENTS FOR CERTAIN STATE DI-
RECTED PAYMENTS. 
(a) IN GENERAL.—Subject to subsection (b), the Sec-
retary of Health and Human Services (in this section re-
ferred to as the Secretary) shall revise section 
438.6(c)(2)(iii) of title 42, Code of Federal Regulations 
such that, with respect to a payment described in such 
section made for a service furnished during a rating period 
beginning on or after the date of the enactment of this 
Act, the total payment rate for such service is limited to— 
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(1) in the case of a State that provides coverage 
to 
all 
individuals 
described 
in 
section 
1902(a)(10)(A)(i)(VIII) of the Social Security Act 
(42 U.S.C. 1396a(a)(10)(A)(i)(VIII)) that is equiva-
lent to minimum essential coverage (as described in 
section 5000A(f)(1)(A) of the Internal Revenue 
Code of 1986 and determined in accordance with 
standards prescribed by the Secretary in regula-
tions) under the State plan (or waiver of such plan) 
of such State under title XIX of such Act, 100 per-
cent of the specified total published Medicare pay-
ment rate (or, in the absence of a specified total 
published Medicare payment rate, an equivalent 
Medicare payment rate); or 
(2) in the case of a State other than a State 
described in paragraph (1), 110 percent of the speci-
fied total published Medicare payment rate (or, in 
the absence of a specified total published Medicare 
payment rate, an equivalent Medicare payment 
rate). 
(b) GRANDFATHERING CERTAIN PAYMENTS.—In the 
case of a payment described in section 438.6(c)(2)(iii) of 
title 42, Code of Federal Regulations for which written 
prior approval was made before the date of the enactment 
of this Act for the rating period occurring as of such date 
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HR 1 PCS
of enactment, or a payment so described for such rating 
period for which a preprint was submitted to the Secretary 
prior to such date of enactment, the revisions described 
in subsection (a) shall not apply to such payment for such 
rating period and for any subsequent rating period if the 
amount of such payment does not exceed the amount of 
such payment so approved. 
(c) TREATMENT OF EXPANSION STATES.—The revi-
sions described in subsection (a) shall provide that, with 
respect to a State that begins providing the coverage de-
scribed in paragraph (1) of such subsection on or after 
the date of the enactment of this Act, the limitation de-
scribed in such paragraph shall apply to such State with 
respect to a payment described in section 438.6(c)(2)(iii) 
of title 42, Code of Federal Regulations for a service fur-
nished during a rating period beginning on or after the 
date on which such State begins providing such coverage, 
including with respect to a payment so described for which 
written prior approval was made before such date. 
(d) DEFINITIONS.—In this section: 
(1) EQUIVALENT MEDICARE PAYMENT RATE.— 
The term ‘‘equivalent Medicare payment rate’’ 
means amounts calculated as payment for specific 
services comparable to the service furnished that 
have been developed under part A or part B of title 
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XVIII of the Social Security Act (42 U.S.C. 1396 et 
seq.). 
(2) RATING
PERIOD.—The term ‘‘rating pe-
riod’’ has the meaning given such term in section 
438.2 of title 42, Code of Federal Regulations. 
(3) TOTAL
PUBLISHED
MEDICARE
PAYMENT 
RATE.—The term ‘‘total published Medicare pay-
ment rate’’ means amounts calculated as payment 
for specific services including the service furnished 
that have been developed under part A or part B of 
title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.). 
(4) WRITTEN
PRIOR
APPROVAL.—The term 
‘‘written prior approval’’ has the meaning given such 
term in section 438.6(c)(2)(i) of title 42, Code of 
Federal Regulations. 
(e) FUNDING.—There are appropriated out of any 
monies in the Treasury not otherwise appropriated 
$7,000,000 for each of fiscal years 2026 through 2033 
for purposes of carrying out this section. 
SEC. 44134. REQUIREMENTS REGARDING WAIVER OF UNI-
FORM TAX REQUIREMENT FOR MEDICAID 
PROVIDER TAX. 
(a) IN GENERAL.—Section 1903(w) of the Social Se-
curity Act (42 U.S.C. 1396b(w)) is amended— 
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(1) in paragraph (3)(E), by inserting after 
clause (ii)(II) the following new clause: 
‘‘(iii) For purposes of clause (ii)(I), a tax is not con-
sidered to be generally redistributive if any of the following 
conditions apply: 
‘‘(I) Within a permissible class, the tax rate im-
posed on any taxpayer or tax rate group (as defined 
in paragraph (7)(J)) explicitly defined by its rel-
atively lower volume or percentage of Medicaid tax-
able units (as defined in paragraph (7)(H)) is lower 
than the tax rate imposed on any other taxpayer or 
tax rate group explicitly defined by its relatively 
higher volume or percentage of Medicaid taxable 
units. 
‘‘(II) Within a permissible class, the tax rate 
imposed on any taxpayer or tax rate group (as so 
defined) based upon its Medicaid taxable units (as 
so defined) is higher than the tax rate imposed on 
any taxpayer or tax rate group based upon its non- 
Medicaid taxable unit (as defined in paragraph 
(7)(I)). 
‘‘(III) The tax excludes or imposes a lower tax 
rate on a taxpayer or tax rate group (as so defined) 
based on or defined by any description that results 
in the same effect as described in subclause (I) or 
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(II) for a taxpayer or tax rate group. Characteristics 
that may indicate such type of exclusion include the 
use of terminology to establish a tax rate group— 
‘‘(aa) based on payments or expenditures 
made under the program under this title with-
out mentioning the term ‘Medicaid’ (or any 
similar term) to accomplish the same effect as 
described in subclause (I) or (II); or 
‘‘(bb) that closely approximates a taxpayer 
or tax rate group under the program under this 
title, to the same effect as described in sub-
clause (I) or (II).’’; and 
(2) in paragraph (7), by adding at the end the 
following new subparagraphs: 
‘‘(H) The term ‘Medicaid taxable unit’ means a 
unit that is being taxed within a health care related 
tax that is applicable to the program under this title. 
Such term includes a unit that is used as the basis 
for— 
‘‘(i) payment under the program under this 
title (such as Medicaid bed days); 
‘‘(ii) Medicaid revenue; 
‘‘(iii) costs associated with the program 
under this title (such as Medicaid charges, 
claims, or expenditures); and 
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HR 1 PCS
‘‘(iv) other units associated with the pro-
gram under this title, as determined by the Sec-
retary. 
‘‘(I) The term ‘non-Medicaid taxable unit’ 
means a unit that is being taxed within a health 
care related tax that is not applicable to the pro-
gram under this title. Such term includes a unit that 
is used as the basis for— 
‘‘(i) payment by non-Medicaid payers (such 
as non-Medicaid bed days); 
‘‘(ii) non-Medicaid revenue; 
‘‘(iii) costs that are not associated with the 
program under this title (such as non-Medicaid 
charges, non-Medicaid claims, or non-Medicaid 
expenditures); and 
‘‘(iv) other units not associated with the 
program under this title, as determined by the 
Secretary. 
‘‘(J) The term ‘tax rate group’ means a group 
of entities contained within a permissible class of a 
health care related tax that are taxed at the same 
rate.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall take effect upon the date of enactment 
of this Act, subject to any applicable transition period de-
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HR 1 PCS
termined appropriate by the Secretary of Health and 
Human Services, not to exceed 3 fiscal years. 
SEC. 44135. REQUIRING BUDGET NEUTRALITY FOR MED-
ICAID DEMONSTRATION PROJECTS UNDER 
SECTION 1115. 
Section 1115 of the Social Security Act (42 U.S.C. 
1315) is amended by adding at the end the following new 
subsection: 
‘‘(g) REQUIREMENT OF BUDGET NEUTRALITY FOR 
MEDICAID DEMONSTRATION PROJECTS.— 
‘‘(1) IN GENERAL.—Beginning on the date of 
the enactment of this subsection, the Secretary may 
not approve an application for (or renewal or 
amendment of) an experimental, pilot, or demonstra-
tion project undertaken under subsection (a) to pro-
mote the objectives of title XIX in a State (in this 
subsection referred to as a ‘Medicaid demonstration 
project’) unless the Secretary certifies that such 
project is not expected to result in an increase in the 
amount of expenditures compared to the amount 
that such expenditures would otherwise be in the ab-
sence of such project. 
‘‘(2) TREATMENT OF SAVINGS.—In the event 
that expenditures with respect to a State under a 
Medicaid demonstration project are, during an ap-
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HR 1 PCS
proval period for such project, less than the amount 
of such expenditures that would have otherwise been 
made in the absence of such project, the Secretary 
shall specify the methodology to be used with respect 
to any subsequent approval period for such project 
for purposes of taking the difference between such 
expenditures into account.’’. 
Subpart D—Increasing Personal Accountability 
SEC. 44141. REQUIREMENT FOR STATES TO ESTABLISH 
MEDICAID COMMUNITY ENGAGEMENT RE-
QUIREMENTS FOR CERTAIN INDIVIDUALS. 
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396a), as amended by sections 44103 
and 44104, is further amended by adding at the end the 
following new subsection: 
‘‘(xx) COMMUNITY ENGAGEMENT REQUIREMENT FOR 
APPLICABLE INDIVIDUALS.— 
‘‘(1) IN GENERAL.—Beginning not later than 
December 31, 2026, or, at the option of the State, 
such earlier date as the State may specify, subject 
to the succeeding provisions of this subsection, a 
State shall provide, as a condition of eligibility for 
medical assistance for an applicable individual, that 
such individual is required to demonstrate commu-
nity engagement under paragraph (2)— 
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‘‘(A) in the case of an applicable individual 
who has filed an application for medical assist-
ance under a State plan (or a waiver of such 
plan) under this title, for 1 or more (as speci-
fied by the State) consecutive months imme-
diately preceding the month during which such 
individual applies for such medical assistance; 
and 
‘‘(B) in the case of an applicable individual 
enrolled and receiving medical assistance under 
a State plan (or under a waiver of such plan) 
under this title, for 1 or more (as specified by 
the State) months, whether or not consecu-
tive— 
‘‘(i) during the period between such 
individual’s most recent determination (or 
redetermination, as applicable) of eligibility 
and such individual’s next regularly sched-
uled redetermination of eligibility (as 
verified by the State as part of such regu-
larly scheduled redetermination of eligi-
bility); or 
‘‘(ii) in the case of a State that has 
elected under paragraph (4) to conduct 
more frequent verifications of compliance 
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HR 1 PCS
with the requirement to demonstrate com-
munity engagement, during the period be-
tween the most recent and next such 
verification with respect to such individual. 
‘‘(2) COMMUNITY
ENGAGEMENT
COMPLIANCE 
DESCRIBED.—Subject to paragraph (3), an applica-
ble individual demonstrates community engagement 
under this paragraph for a month if such individual 
meets 1 or more of the following conditions with re-
spect to such month, as determined in accordance 
with criteria established by the Secretary through 
regulation: 
‘‘(A) The individual works not less than 80 
hours. 
‘‘(B) The individual completes not less 
than 80 hours of community service. 
‘‘(C) The individual participates in a work 
program for not less than 80 hours. 
‘‘(D) The individual is enrolled in an edu-
cational program at least half-time. 
‘‘(E) The individual engages in any com-
bination of the activities described in subpara-
graphs (A) through (D), for a total of not less 
than 80 hours. 
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HR 1 PCS
‘‘(F) The individual has a monthly income 
that is not less than the applicable minimum 
wage requirement under section 6 of the Fair 
Labor Standards Act of 1938, multiplied by 80 
hours. 
‘‘(3) EXCEPTIONS.— 
‘‘(A) MANDATORY
EXCEPTION
FOR
CER-
TAIN INDIVIDUALS.—The State shall deem an 
applicable individual to have demonstrated com-
munity engagement under paragraph (2) for a 
month if— 
‘‘(i) for part or all of such month, the 
individual— 
‘‘(I) was a specified excluded in-
dividual (as defined in paragraph 
(9)(A)(ii)); or 
‘‘(II) was— 
‘‘(aa) under the age of 19; 
‘‘(bb) pregnant or entitled to 
postpartum medical assistance 
under paragraph (5) or (16) of 
subsection (e); 
‘‘(cc) entitled to, or enrolled 
for, benefits under part A of title 
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HR 1 PCS
XVIII, or enrolled for benefits 
under part B of title XVIII; or 
‘‘(dd) described in any of 
subclauses (I) through (VII) of 
subsection (a)(10)(A)(i); or 
‘‘(ii) at any point during the 3-month 
period ending on the first day of such 
month, the individual was an inmate of a 
public institution. 
‘‘(B) OPTIONAL EXCEPTION FOR SHORT- 
TERM HARDSHIP EVENTS.— 
‘‘(i) IN GENERAL.—The State plan (or 
waiver of such plan) may provide, in the 
case of an applicable individual who experi-
ences a short-term hardship event during a 
month, that the State shall, upon the re-
quest of such individual under procedures 
established by the State (in accordance 
with standards specified by the Secretary), 
deem such individual to have demonstrated 
community engagement under paragraph 
(2) for such month. 
‘‘(ii) SHORT-TERM HARDSHIP EVENT 
DEFINED.—For purposes of this subpara-
graph, an applicable individual experiences 
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HR 1 PCS
a short-term hardship event during a 
month if, for part or all of such month— 
‘‘(I) such individual receives in-
patient hospital services, nursing facil-
ity services, services in an inter-
mediate care facility for individuals 
with intellectual disabilities, inpatient 
psychiatric hospital services, or such 
other services of similar acuity (in-
cluding outpatient care relating to 
other services specified in this sub-
clause) as the Secretary determines 
appropriate; or 
‘‘(II) such individual resides in a 
county (or equivalent unit of local 
government)— 
‘‘(aa) in which there exists 
an emergency or disaster de-
clared by the President pursuant 
to the National Emergencies Act 
or the Robert T. Stafford Dis-
aster Relief and Emergency As-
sistance Act; or 
‘‘(bb) that, subject to a re-
quest from the State to the Sec-
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HR 1 PCS
retary, made in such form, at 
such time, and containing such 
information as the Secretary may 
require, has an unemployment 
rate that is at or above the lesser 
of— 
‘‘(AA) 8 percent; or 
‘‘(BB) 1.5 times the 
national unemployment rate. 
‘‘(4) OPTION
TO
CONDUCT
MORE
FREQUENT 
COMPLIANCE
VERIFICATIONS.—With respect to an 
applicable individual enrolled and receiving medical 
assistance under a State plan (or a waiver of such 
plan) under this title, the State shall verify (in ac-
cordance with procedures specified by the Secretary) 
that each such individual has met the requirement 
to demonstrate community engagement under para-
graph (1) during each such individual’s regularly 
scheduled redetermination of eligibility, except that a 
State may provide for such verifications more fre-
quently. 
‘‘(5) EX PARTE VERIFICATIONS.—For purposes 
of verifying that an applicable individual has met the 
requirement to demonstrate community engagement 
under paragraph (1), the State shall, in accordance 
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HR 1 PCS
with standards established by the Secretary, estab-
lish processes and use reliable information available 
to the State (such as payroll data) without requir-
ing, where possible, the applicable individual to sub-
mit additional information. 
‘‘(6) PROCEDURE IN THE CASE OF NONCOMPLI-
ANCE.— 
‘‘(A) IN GENERAL.—If a State is unable to 
verify that an applicable individual has met the 
requirement to demonstrate community engage-
ment under paragraph (1) (including, if appli-
cable, by verifying that such individual was 
deemed to have demonstrated community en-
gagement under paragraph (3)) the State shall 
(in accordance with standards specified by the 
Secretary)— 
‘‘(i) provide such individual with the 
notice of noncompliance described in sub-
paragraph (B); 
‘‘(ii)(I) provide such individual with a 
period of 30 calendar days, beginning on 
the date on which such notice of non-
compliance is received by the individual, 
to— 
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HR 1 PCS
‘‘(aa) make a satisfactory show-
ing to the State of compliance with 
such requirement (including, if appli-
cable, by showing that such individual 
was deemed to have demonstrated 
community engagement under para-
graph (3)); or 
‘‘(bb) make a satisfactory show-
ing to the State that such require-
ment does not apply to such indi-
vidual on the basis that such indi-
vidual does not meet the definition of 
applicable individual under paragraph 
(9)(A); and 
‘‘(II) if such individual is enrolled 
under the State plan (or a waiver of such 
plan) under this title, continue to provide 
such individual with medical assistance 
during such 30-calendar-day period; and 
‘‘(iii) if no such satisfactory showing 
is made and the individual is not a speci-
fied excluded individual described in para-
graph (9)(A)(ii), deny such individual’s ap-
plication for medical assistance under the 
State plan (or waiver of such plan) or, as 
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HR 1 PCS
applicable, disenroll such individual from 
the plan (or waiver of such plan) not later 
than the end of the month following the 
month in which such 30-calendar-day pe-
riod ends, provided that— 
‘‘(I) the State first determines 
whether, with respect to the indi-
vidual, there is any other basis for eli-
gibility for medical assistance under 
the State plan (or waiver of such 
plan) or for another insurance afford-
ability program; and 
‘‘(II) the individual is provided 
written notice and granted an oppor-
tunity for a fair hearing in accordance 
with subsection (a)(3). 
‘‘(B) NOTICE.—The notice of noncompli-
ance provided to an applicable individual under 
subparagraph (A)(i) shall include information 
(in accordance with standards specified by the 
Secretary) on— 
‘‘(i) how such individual may make a 
satisfactory showing of compliance with 
such requirement (as described in subpara-
graph (A)(ii)) or make a satisfactory show-
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HR 1 PCS
ing that such requirement does not apply 
to such individual on the basis that such 
individual does not meet the definition of 
applicable 
individual 
under 
paragraph 
(9)(A); and 
‘‘(ii) how such individual may reapply 
for medical assistance under the State plan 
(or a waiver of such plan) under this title 
in the case that such individuals’ applica-
tion is denied or, as applicable, in the case 
that such individual is disenrolled from the 
plan (or waiver). 
‘‘(7) TREATMENT OF NONCOMPLIANT INDIVID-
UALS
IN
RELATION
TO
CERTAIN
OTHER
PROVI-
SIONS.— 
‘‘(A) CERTAIN FMAP INCREASES.—A State 
shall not be treated as not providing medical as-
sistance to all individuals described in section 
1902(a)(10)(A)(i)(VIII), or as not expending 
amounts for all such individuals under the 
State plan (or waiver of such plan), solely be-
cause such an individual is determined ineligible 
for medical assistance under the State plan (or 
waiver) on the basis of a failure to meet the re-
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quirement to demonstrate community engage-
ment under paragraph (1). 
‘‘(B) OTHER
PROVISIONS.—For purposes 
of section 36B(c)(2)(B) of the Internal Revenue 
Code of 1986, an individual shall be deemed to 
be eligible for minimum essential coverage de-
scribed in section 5000A(f)(1)(A)(ii) of such 
Code for a month if such individual would have 
been eligible for medical assistance under a 
State plan (or a waiver of such plan) under this 
title but for a failure to meet the requirement 
to demonstrate community engagement under 
paragraph (1). 
‘‘(8) OUTREACH.— 
‘‘(A) IN
GENERAL.—In accordance with 
standards specified by the Secretary, beginning 
not later than the date that precedes December 
31, 2026 (or, if the State elects under para-
graph (1) to specify an earlier date, such earlier 
date) by the number of months specified by the 
State under paragraph (1)(A) plus 3 months, 
and periodically thereafter, the State shall no-
tify applicable individuals enrolled under a 
State plan (or waiver) under this title of the re-
quirement to demonstrate community engage-
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ment under this subsection. Such notice shall 
include information on— 
‘‘(i) how to comply with such require-
ment, including an explanation of the ex-
ceptions to such requirement under para-
graph (3) and the definition of the term 
‘applicable individual’ under paragraph 
(9)(A); 
‘‘(ii) the consequences of noncompli-
ance with such requirement; and 
‘‘(iii) how to report to the State any 
change in the individual’s status that could 
result in— 
‘‘(I) the applicability of an excep-
tion under paragraph (3) (or the end 
of the applicability of such an excep-
tion); or 
‘‘(II) the individual qualifying as 
a specified excluded individual under 
paragraph (9)(A)(ii). 
‘‘(B) FORM OF OUTREACH NOTICE.—A no-
tice required under subparagraph (A) shall be 
delivered— 
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HR 1 PCS
‘‘(i) by regular mail (or, if elected by 
the individual, in an electronic format); 
and 
‘‘(ii) in 1 or more additional forms, 
which may include telephone, text message, 
an internet website, other commonly avail-
able electronic means, and such other 
forms as the Secretary determines appro-
priate. 
‘‘(9) DEFINITIONS.—In this subsection: 
‘‘(A) APPLICABLE INDIVIDUAL.— 
‘‘(i) IN GENERAL.—The term ‘applica-
ble individual’ means an individual (other 
than a specified excluded individual (as de-
fined in clause (ii)))— 
‘‘(I) who is eligible to enroll (or 
is enrolled) under the State plan 
under subsection (a)(10)(A)(i)(VIII); 
or 
‘‘(II) who— 
‘‘(aa) is otherwise eligible to 
enroll (or is enrolled) under a 
waiver of such plan that provides 
coverage that is equivalent to 
minimum essential coverage (as 
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HR 1 PCS
described 
in 
section 
5000A(f)(1)(A) of the Internal 
Revenue Code of 1986 and as de-
termined 
in 
accordance 
with 
standards prescribed by the Sec-
retary in regulations); and 
‘‘(bb) has attained the age 
of 19 and is under 65 years of 
age, is not pregnant, is not enti-
tled to, or enrolled for, benefits 
under part A of title XVIII, or 
enrolled for benefits under part 
B of title XVIII, and is not oth-
erwise eligible to enroll under 
such plan. 
‘‘(ii) SPECIFIED
EXCLUDED
INDI-
VIDUAL.—For purposes of clause (i), the 
term ‘specified excluded individual’ means 
an individual, as determined by the State 
(in accordance with standards specified by 
the Secretary)— 
‘‘(I) who is described in sub-
section (a)(10)(A)(i)(IX); 
‘‘(II) who— 
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HR 1 PCS
‘‘(aa) is an Indian or an 
Urban Indian (as such terms are 
defined in paragraphs (13) and 
(28) of section 4 of the Indian 
Health Care Improvement Act); 
‘‘(bb) is a California Indian 
described in section 809(a) of 
such Act; or 
‘‘(cc) has otherwise been de-
termined eligible as an Indian for 
the Indian Health Service under 
regulations promulgated by the 
Secretary; 
‘‘(III) who is the parent, guard-
ian, or caretaker relative of a disabled 
individual or a dependent child; 
‘‘(IV) who is a veteran with a 
disability rated as total under section 
1155 of title 38, United States Code; 
‘‘(V) who is medically frail or 
otherwise has special medical needs 
(as defined by the Secretary), includ-
ing an individual— 
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HR 1 PCS
‘‘(aa) who is blind or dis-
abled (as defined in section 
1614); 
‘‘(bb) with a substance use 
disorder; 
‘‘(cc) with a disabling men-
tal disorder; 
‘‘(dd) with a physical, intel-
lectual 
or 
developmental 
dis-
ability that significantly impairs 
their ability to perform 1 or more 
activities of daily living; or 
‘‘(ee) with a serious or com-
plex medical condition; 
‘‘(VI) who— 
‘‘(aa) is in compliance with 
any requirements imposed by the 
State pursuant to section 407; or 
‘‘(bb) is a member of a 
household that receives supple-
mental nutrition assistance pro-
gram benefits under the Food 
and Nutrition Act of 2008 and is 
not exempt from a work require-
ment under such Act; 
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HR 1 PCS
‘‘(VII) who is participating in a 
drug addiction or alcoholic treatment 
and rehabilitation program (as defined 
in section 3(h) of the Food and Nutri-
tion Act of 2008); or 
‘‘(VIII) who is an inmate of a 
public institution. 
‘‘(B) EDUCATIONAL PROGRAM.—The term 
‘educational program’ includes— 
‘‘(i) an institution of higher education 
(as defined in section 101 of the Higher 
Education Act of 1965); and 
‘‘(ii) a program of career and tech-
nical education (as defined in section 3 of 
the Carl D. Perkins Career and Technical 
Education Act of 2006). 
‘‘(C) STATE.—The term ‘State’ means 1 of 
the 50 States or the District of Columbia. 
‘‘(D) WORK
PROGRAM.—The term ‘work 
program’ has the meaning given such term in 
section 6(o)(1) of the Food and Nutrition Act 
of 2008. 
‘‘(10) PROHIBITING
WAIVER
OF
COMMUNITY 
ENGAGEMENT
REQUIREMENTS.—Notwithstanding 
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HR 1 PCS
section 1115(a), the provisions of this subsection 
may not be waived.’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1902(a)(10)(A)(i)(VIII) of the Social Security Act (42 
U.S.C. 1396a(a)(10)(A)(i)(VIII)) is amended by striking 
‘‘subject to subsection (k)’’ and inserting ‘‘subject to sub-
sections (k) and (xx)’’. 
(c) GUIDANCE.—Not later than December 31, 2025, 
the Secretary of Health and Human Services shall issue 
guidance relating to the initial implementation of the 
amendments made by this section. 
(d) DEVELOPMENT OF GOVERNMENT EFFICIENCY 
GRANTS TO STATES.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall, out of amounts appropriated 
under paragraph (3), award to each State a grant 
equal to the amount specified in paragraph (2) for 
such State for purposes of establishing systems nec-
essary to carry out the provisions of, and amend-
ments made by, this section. 
(2) AMOUNT
SPECIFIED.—For purposes of 
paragraph (2), the amount specified in this para-
graph is an amount that bears the same ratio to the 
amount appropriated under paragraph (3) as the 
number of applicable individuals (as defined in sec-
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HR 1 PCS
tion 1902(xx) of the Social Security Act, as added 
by subsection (a)) residing in such State bears to 
the total number of such individuals residing in all 
States. 
(3) FUNDING.—There are appropriated, out of 
any monies in the Treasury not otherwise appro-
priated, $100,000,000 for fiscal year 2026 for pur-
poses of awarding grants under paragraph (1). 
(4) DEFINITION.—In this subsection, the term 
‘‘State’’ means 1 of the 50 States and the District 
of Columbia. 
(e) IMPLEMENTATION FUNDING.—For the purposes 
of carrying out the provisions of, and the amendments 
made by, this section, there are appropriated, out of any 
monies in the Treasury not otherwise appropriated, to the 
Secretary of Health and Human Services, $50,000,000 for 
fiscal year 2026, to remain available until expended. 
SEC. 44142. MODIFYING COST SHARING REQUIREMENTS 
FOR 
CERTAIN 
EXPANSION 
INDIVIDUALS 
UNDER THE MEDICAID PROGRAM. 
(a) IN GENERAL.—Section 1916 of the Social Secu-
rity Act (42 U.S.C. 1396o) is amended— 
(1) in subsection (a), in the matter preceding 
paragraph (1), by inserting ‘‘(other than, beginning 
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HR 1 PCS
October 1, 2028, specified individuals (as defined in 
subsection (k)(3)))’’ after ‘‘individuals’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(k) SPECIAL RULES FOR CERTAIN EXPANSION IN-
DIVIDUALS.— 
‘‘(1) PREMIUMS.—Beginning October 1, 2028, 
the State plan shall provide that in the case of a 
specified individual (as defined in paragraph (3)) 
who is eligible under the plan, no enrollment fee, 
premium, or similar charge will be imposed under 
the plan. 
‘‘(2) REQUIRED
IMPOSITION
OF
COST
SHAR-
ING.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B) and subsection (j), in the case of a 
specified individual, the State plan shall, begin-
ning October 1, 2028, provide for the imposi-
tion of such deductions, cost sharing, or similar 
charges determined appropriate by the State (in 
an amount greater than $0) with respect to 
medical assistance furnished to such an indi-
vidual. 
‘‘(B) LIMITATIONS.— 
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‘‘(i) EXCLUSION
OF
CERTAIN
SERV-
ICES.—In no case may a deduction, cost 
sharing, or similar charge be imposed 
under the State plan with respect to serv-
ices described in any of subparagraphs (B) 
through (J) of subsection (a)(2), or any 
primary care services, mental health care 
services, or substance use disorder services, 
furnished to a specified individual. 
‘‘(ii) ITEM
AND
SERVICE
LIMITA-
TION.— 
‘‘(I) IN
GENERAL.—Except as 
provided in subclause (II), in no case 
may a deduction, cost sharing, or 
similar charge imposed under the 
State plan with respect to an item or 
service furnished to a specified indi-
vidual exceed $35. 
‘‘(II) SPECIAL RULES FOR PRE-
SCRIPTION DRUGS.—In no case may a 
deduction, cost sharing, or similar 
charge imposed under the State plan 
with respect to a prescription drug 
furnished to a specified individual ex-
ceed the limit that would be applicable 
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HR 1 PCS
under paragraph (2)(A)(i) or (2)(B) 
of section 1916A(c) with respect to 
such drug and individual if such drug 
so furnished were subject to cost shar-
ing under such section. 
‘‘(iii) MAXIMUM LIMIT ON COST SHAR-
ING.—The total aggregate amount of de-
ductions, cost sharing, or similar charges 
imposed under the State plan for all indi-
viduals in the family may not exceed 5 per-
cent of the family income of the family in-
volved, as applied on a quarterly or month-
ly basis (as specified by the State). 
‘‘(C) CASES OF NONPAYMENT.—Notwith-
standing subsection (e), a State may permit a 
provider participating under the State plan to 
require, as a condition for the provision of care, 
items, or services to a specified individual enti-
tled to medical assistance under this title for 
such care, items, or services, the payment of 
any deductions, cost sharing, or similar charges 
authorized to be imposed with respect to such 
care, items, or services. Nothing in this sub-
paragraph shall be construed as preventing a 
provider from reducing or waiving the applica-
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HR 1 PCS
tion of such deductions, cost sharing, or similar 
charges on a case-by-case basis. 
‘‘(3) SPECIFIED
INDIVIDUAL
DEFINED.—For 
purposes of this subsection, the term ‘specified indi-
vidual’ means an individual who has a family income 
(as 
determined 
in 
accordance 
with 
section 
1902(e)(14)) that exceeds the poverty line (as de-
fined in section 2110(c)(5)) applicable to a family of 
the size involved and— 
‘‘(A) 
is 
enrolled 
under 
section 
1902(a)(10)(A)(i)(VIII); or 
‘‘(B) is described in such subsection and 
otherwise enrolled under a waiver of such plan 
that provides coverage that is equivalent to 
minimum essential coverage (as described in 
section 5000A(f)(1)(A) of the Internal Revenue 
Code of 1986 and determined in accordance 
with standards prescribed by the Secretary in 
regulations) to all individuals described in sec-
tion 1902(a)(10)(A)(i)(VIII).’’. 
(b) CONFORMING AMENDMENTS.— 
(1) 
REQUIRED
APPLICATION.—Section 
1902(a)(14) of the Social Security Act (42 U.S.C. 
1396a(a)(14)) is amended by inserting ‘‘and provide 
for imposition of such deductions, cost sharing, or 
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HR 1 PCS
similar charges for medical assistance furnished to 
specified individuals (as defined in paragraph (3) of 
section 1916(k)) in accordance with paragraph (2) 
of such section’’ after ‘‘section 1916’’. 
(2) NONAPPLICABILITY OF ALTERNATIVE COST 
SHARING.—Section 1916A(a)(1) of the Social Secu-
rity Act (42 U.S.C. 1396o–1(a)(1)) is amended, in 
the second sentence, by striking ‘‘or (j)’’ and insert-
ing ‘‘(j), or (k)’’. 
PART 2—AFFORDABLE CARE ACT 
SEC. 44201. ADDRESSING WASTE, FRAUD, AND ABUSE IN 
THE ACA EXCHANGES. 
(a) CHANGES TO ENROLLMENT PERIODS FOR EN-
ROLLING IN EXCHANGES.—Section 1311 of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18031) is 
amended— 
(1) in subsection (c)(6)— 
(A) by striking subparagraph (A); 
(B) by striking ‘‘The Secretary’’ and in-
serting the following: 
‘‘(A) IN GENERAL.—The Secretary’’; 
(C) by redesignating subparagraphs (B) 
through (D) as clauses (i) through (iii), respec-
tively, and adjusting the margins accordingly; 
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HR 1 PCS
(D) in clause (i), as so redesignated, by 
striking ‘‘periods, as determined by the Sec-
retary for calendar years after the initial enroll-
ment period;’’ and inserting the following: ‘‘pe-
riods for plans offered in the individual mar-
ket— 
‘‘(I) for enrollment for plan years 
beginning before January 1, 2026, as 
determined by the Secretary; and 
‘‘(II) for enrollment for plan 
years beginning on or after January 
1, 2026, beginning on November 1 
and ending on December 15 of the 
preceding calendar year;’’; 
(E) in clause (ii), as so redesignated, by 
inserting ‘‘subject to subparagraph (B),’’ before 
‘‘special enrollment periods specified’’; and 
(F) by adding at the end the following new 
subparagraph: 
‘‘(B) PROHIBITED SPECIAL ENROLLMENT 
PERIOD.—With respect to plan years beginning 
on or after January 1, 2026, the Secretary may 
not require an Exchange to provide for a spe-
cial enrollment period for an individual on the 
basis of the relationship of the income of such 
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HR 1 PCS
individual to the poverty line, other than a spe-
cial enrollment period based on a change in cir-
cumstances or the occurrence of a specific 
event.’’; and 
(2) in subsection (d), by adding at the end the 
following new paragraphs: 
‘‘(8) PROHIBITED ENROLLMENT PERIODS.—An 
Exchange may not provide for, with respect to en-
rollment for plan years beginning on or after Janu-
ary 1, 2026— 
‘‘(A) an annual open enrollment period 
other than the period described in subpara-
graph (A)(i) of subsection (c)(6); or 
‘‘(B) a special enrollment period described 
in subparagraph (B) of such subsection. 
‘‘(9) VERIFICATION OF ELIGIBILITY FOR SPE-
CIAL ENROLLMENT PERIODS.— 
‘‘(A) IN GENERAL.—With respect to enroll-
ment for plan years beginning on or after Janu-
ary 1, 2026, an Exchange shall verify that each 
individual seeking to enroll in a qualified health 
plan offered by the Exchange during a special 
enrollment period selected under subparagraph 
(B) is eligible to enroll during such special en-
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HR 1 PCS
rollment period prior to enrolling such indi-
vidual in such plan. 
‘‘(B) SELECTED
SPECIAL
ENROLLMENT 
PERIODS.—For purposes of subparagraph (A), 
an Exchange shall select one or more special 
enrollment periods for a plan year with respect 
to which such Exchange shall conduct the 
verification required under subparagraph (A) 
such 
that 
the 
Exchange 
conducts 
such 
verification for not less than 75 percent of all 
individuals enrolling in a qualified health plan 
offered by the Exchange during any special en-
rollment period with respect to such plan 
year.’’. 
(b) VERIFYING INCOME FOR INDIVIDUALS ENROLL-
ING IN A QUALIFIED HEALTH PLAN THROUGH AN EX-
CHANGE.— 
(1) IN
GENERAL.—Section 1411(e)(4) of the 
Patient Protection and Affordable Care Act (42 
U.S.C. 18081(e)(4)) is amended— 
(A) by redesignating subparagraph (C) as 
subparagraph (E); and 
(B) by inserting after subparagraph (B) 
the following new subparagraphs: 
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HR 1 PCS
‘‘(C) REQUIRING
VERIFICATION
OF
IN-
COME AND FAMILY SIZE WHEN TAX DATA IS 
UNAVAILABLE.—For plan years beginning on or 
after January 1, 2026, for purposes of subpara-
graph (A), in the case that the Exchange re-
quests data from the Secretary of the Treasury 
regarding an individual’s household income and 
the Secretary of the Treasury does not return 
such data, such information may not be verified 
solely on the basis of the attestation of such in-
dividual with respect to such household income, 
and the Exchange shall take the actions de-
scribed in subparagraph (A). 
‘‘(D) REQUIRING
VERIFICATION
OF
IN-
COME IN THE CASE OF CERTAIN INCOME DIS-
CREPANCIES.— 
‘‘(i) IN GENERAL.—Subject to clause 
(iii), for plan years beginning on or after 
January 1, 2026, for purposes of subpara-
graph (A), in the case that a specified in-
come discrepancy described in clause (ii) of 
this subparagraph exists with respect to 
the information provided by an applicant 
under subsection (b)(3), the household in-
come of such individual shall be treated as 
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HR 1 PCS
inconsistent 
with 
information 
in 
the 
records maintained by persons under sub-
section (c), or as not verified under sub-
section (d), and the Exchange shall take 
the actions described in such subparagraph 
(A). 
‘‘(ii) SPECIFIED
INCOME
DISCREP-
ANCY.—For purposes of clause (i), a speci-
fied income discrepancy exists with respect 
to the information provided by an appli-
cant under subsection (b)(3) if— 
‘‘(I) the applicant attests to a 
projected annual household income 
that would qualify such applicant to 
be an applicable taxpayer under sec-
tion 36B(c)(1)(A) of the Internal Rev-
enue Code of 1986 with respect to the 
taxable year involved; 
‘‘(II) the Exchange receives data 
from the Secretary of the Treasury or 
other reliable, third party data, that 
indicates that the household income of 
such applicant is less than the house-
hold income that would qualify such 
applicant to be an applicable taxpayer 
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HR 1 PCS
under such section 36B(c)(1)(A) with 
respect to the taxable year involved; 
‘‘(III) such attested projected an-
nual household income exceeds the in-
come reflected in the data described in 
subclause (II) by a reasonable thresh-
old established by the Exchange and 
approved by the Secretary (which 
shall be not less than 10 percent, and 
may also be a dollar amount); and 
‘‘(IV) the Exchange has not as-
sessed or determined based on the 
data described in subclause (II) that 
the household income of the applicant 
meets the applicable income-based eli-
gibility standard for the Medicaid pro-
gram under title XIX of the Social 
Security Act or the State children’s 
health insurance program under title 
XXI of such Act. 
‘‘(iii) EXCLUSION OF CERTAIN INDI-
VIDUALS
INELIGIBLE
FOR
MEDICAID.— 
This subparagraph shall not apply in the 
case of an applicant who is an alien law-
fully present in the United States, who is 
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not eligible for the Medicaid program 
under title XIX of the Social Security Act 
by reason of such alien status.’’. 
(2) REQUIRING
INDIVIDUALS
ON
WHOSE
BE-
HALF ADVANCE PAYMENTS OF THE PREMIUM TAX 
CREDITS ARE MADE TO FILE AND RECONCILE ON AN 
ANNUAL
BASIS.—Section 1412(b) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 
18082(b)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(3) ANNUAL REQUIREMENT TO FILE AND REC-
ONCILE.— 
‘‘(A) IN GENERAL.—For plan years begin-
ning on or after January 1, 2026, in the case 
of an individual with respect to whom any ad-
vance payment of the premium tax credit allow-
able under section 36B of the Internal Revenue 
Code of 1986 was made under this section to 
the issuer of a qualified health plan for the rel-
evant prior tax year, an advance determination 
of eligibility for such premium tax credit may 
not be made under this subsection with respect 
to such individual and such plan year if the Ex-
change determines, based on information pro-
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HR 1 PCS
vided by the Secretary of the Treasury, that 
such individual— 
‘‘(i) has not filed an income tax re-
turn, as required under sections 6011 and 
6012 of such Code (and implementing reg-
ulations), for the relevant prior tax year; 
or 
‘‘(ii) as necessary, has not reconciled 
(in accordance with subsection (f) of such 
section 36B) the advance payment of the 
premium tax credit made with respect to 
such individual for such relevant prior tax 
year. 
‘‘(B) RELEVANT
PRIOR
TAX
YEAR.—For 
purposes of subparagraph (A), the term ‘rel-
evant prior tax year’ means, with respect to the 
advance determination of eligibility made under 
this subsection with respect to an individual, 
the taxable year for which tax return data 
would be used for purposes of verifying the 
household income and family size of such indi-
vidual (as described in section 1411(b)(3)(A)). 
‘‘(C) PRELIMINARY ATTESTATION.—If an 
individual subject to subparagraph (A) attests 
that such individual has fulfilled the require-
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ments to file an income tax return for the rel-
evant prior tax year and, as necessary, to rec-
oncile the advance payment of the premium tax 
credit made with respect to such individual for 
such relevant prior tax year (as described in 
clauses (i) and (ii) of such subparagraph), the 
Secretary may make an initial advance deter-
mination of eligibility with respect to such indi-
vidual and may delay for a reasonable period 
(as determined by the Secretary) any deter-
mination based on information provided by the 
Secretary of the Treasury that such individual 
has not fulfilled such requirements. 
‘‘(D) NOTICE.—If the Secretary deter-
mines that an individual did not meet the re-
quirements described in subparagraph (A) with 
respect to the relevant prior tax year and noti-
fies the Exchange of such determination, the 
Exchange shall comply with the notification re-
quirement described in section 155.305(f)(4)(i) 
of title 45, Code of Federal Regulations (as in 
effect with respect to plan year 2025).’’. 
(3) REMOVING AUTOMATIC EXTENSION OF PE-
RIOD TO RESOLVE INCOME INCONSISTENCIES.—The 
Secretary of Health and Human Services shall revise 
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HR 1 PCS
section 155.315(f) of title 45, Code of Federal Regu-
lations, to remove paragraph (7) of such section 
such that, with respect to enrollment for plan years 
beginning on or after January 1, 2026, in the case 
that an Exchange established under subtitle D of 
title I of the Patient Protection and Affordable Care 
Act (42 U.S.C. 18021 et seq.) provides an individual 
applying for enrollment in a qualified health plan 
with a 90-day period to resolve an inconsistency in 
the application of such individual pursuant to sec-
tion 1411(e)(4)(A)(ii)(II) of such Act, the Exchange 
may not provide for an automatic extension to such 
90-day period on the basis that such individual is re-
quired to present satisfactory documentary evidence 
to verify household income. 
(c) REVISING RULES ON ALLOWABLE VARIATION IN 
ACTUARIAL VALUE OF HEALTH PLANS.—The Secretary 
of Health and Human Services shall— 
(1) revise section 156.140(c) of title 45, Code 
of Federal Regulations, to provide that, for plan 
years beginning on or after January 1, 2026, the al-
lowable variation in the actuarial value of a health 
plan applicable under such section shall be the allow-
able variation for such plan applicable under such 
section for plan year 2022; 
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HR 1 PCS
(2) revise section 156.200(b)(3) of title 45, 
Code of Federal Regulations, to provide that, for 
plan years beginning on or after January 1, 2026, 
the requirement for a qualified health plan issuer de-
scribed in such section is that the issuer ensures 
that each qualified health plan complies with benefit 
design standards, as defined in section 156.20 of 
such title; and 
(3) revise section 156.400 of title 45, Code of 
Federal Regulations, to provide that, for plan years 
beginning on or after January 1, 2026, the term ‘‘de 
minimis variation for a silver plan variation’’ means 
a minus 1 percentage point and plus 1 percentage 
point allowable actuarial value variation. 
(d) UPDATING PREMIUM ADJUSTMENT PERCENTAGE 
METHODOLOGY.—Section 1302(c)(4) of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 18022(c)(4)) 
is amended— 
(1) by striking ‘‘For purposes’’ and inserting: 
‘‘(A) IN GENERAL.—For purposes’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(B) UPDATE
TO
METHODOLOGY.—For 
calendar years beginning with 2026, the pre-
mium adjustment percentage under this para-
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HR 1 PCS
graph for such calendar year shall be deter-
mined consistent with the methodology pub-
lished in the Federal Register on April 25, 
2019 (84 Fed. Reg. 17537 through 17541).’’. 
(e) ELIMINATING THE FIXED-DOLLAR AND GROSS- 
PERCENTAGE THRESHOLDS APPLICABLE TO EXCHANGE 
ENROLLMENTS.—The Secretary of Health and Human 
Services shall revise section 155.400(g) of title 45, Code 
of Federal Regulations to eliminate, for plan years begin-
ning on or after January 1, 2026, the gross premium per-
centage-based premium payment threshold policy de-
scribed in paragraph (2) of such section and the fixed- 
dollar premium payment threshold policy described in 
paragraph (3) of such section. 
(f) PROHIBITING AUTOMATIC REENROLLMENT FROM 
BRONZE TO SILVER LEVEL QUALIFIED HEALTH PLANS 
OFFERED BY EXCHANGES.—The Secretary of Health and 
Human Services shall revise section 155.335(j) of title 45, 
Code of Federal Regulations to remove paragraph (4) of 
such section such that, with respect to reenrollments for 
plan years beginning on or after January 1, 2026, an Ex-
change established under subtitle D of title I of the Pa-
tient Protection and Affordable Care Act (42 U.S.C. 
18021 et seq.) may not reenroll an individual who was 
enrolled in a bronze level qualified health plan in a silver 
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HR 1 PCS
level qualified health plan (as such terms are defined in 
section 1301(a) and described in 1302(d) of such Act) un-
less otherwise permitted under section 155.335(j) of title 
45, Code of Federal Regulations, as in effect on the day 
before the date of the enactment of this section. 
(g) REDUCING ADVANCE PAYMENTS OF PREMIUM 
TAX CREDITS FOR CERTAIN INDIVIDUALS REENROLLED 
IN EXCHANGES.—Section 1412 of the Patient Protection 
and Affordable Care Act (42 U.S.C. 18082) is amended— 
(1) in subsection (a)(3), by inserting ‘‘, subject 
to subsection (c)(2)(C),’’ after ‘‘qualified health 
plans’’; and 
(2) in subsection (c)(2)— 
(A) in subparagraph (A), by striking 
‘‘The’’ and inserting ‘‘Subject to subparagraph 
(C), the’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(C) REDUCTION
IN
ADVANCE
PAYMENT 
FOR SPECIFIED REENROLLED INDIVIDUALS.— 
‘‘(i) IN GENERAL.—The amount of an 
advance payment made under subpara-
graph (A) to reduce the premium payable 
for a qualified health plan that provides 
coverage to a specified reenrolled individual 
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HR 1 PCS
for an applicable month shall be an 
amount equal to the amount that would 
otherwise be made under such subpara-
graph reduced by $5 (or such higher 
amount as the Secretary determines appro-
priate). 
‘‘(ii) DEFINITIONS.—In this subpara-
graph: 
‘‘(I) APPLICABLE
MONTH.—The 
term ‘applicable month’ means, with 
respect to a specified reenrolled indi-
vidual, any month during a plan year 
beginning on or after January 1, 
2027 (or, in the case of an individual 
reenrolled in a qualified health plan 
by an Exchange established pursuant 
to section 1321(c), January 1, 2026) 
if, prior to the first day of such 
month, such individual has failed to 
confirm or update such information as 
is necessary to redetermine the eligi-
bility of such individual for such plan 
year pursuant to section 1411(f). 
‘‘(II) SPECIFIED
REENROLLED 
INDIVIDUAL.—The term ‘specified re-
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HR 1 PCS
enrolled individual’ means an indi-
vidual who is reenrolled in a qualified 
health plan and with respect to whom 
the advance payment made under sub-
paragraph (A) would, without applica-
tion of any reduction under this sub-
paragraph, reduce the premium pay-
able for a qualified health plan that 
provides coverage to such an indi-
vidual to $0.’’. 
(h) PROHIBITING COVERAGE OF GENDER TRANSI-
TION PROCEDURES AS AN ESSENTIAL HEALTH BENEFIT 
UNDER PLANS OFFERED BY EXCHANGES.— 
(1) IN GENERAL.—Section 1302(b)(2) of the 
Patient Protection and Affordable Care Act (42 
U.S.C. 18022(b)(2)) is amended by adding at the 
end the following new subparagraph: 
‘‘(C) 
GENDER
TRANSITION
PROCE-
DURES.—For plan years beginning on or after 
January 1, 2027, the essential health benefits 
defined pursuant to paragraph (1) may not in-
clude items and services furnished for a gender 
transition procedure.’’. 
(2) GENDER
TRANSITION
PROCEDURE
DE-
FINED.—Section 1304 of the Patient Protection and 
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HR 1 PCS
Affordable Care Act (42 U.S.C. 18024) is amended 
by adding at the end the following new subsection: 
‘‘(f) GENDER TRANSITION PROCEDURE.— 
‘‘(1) IN GENERAL.—In this title, except as pro-
vided in paragraph (2), the term ‘gender transition 
procedure’ means, with respect to an individual, any 
of the following when performed for the purpose of 
intentionally changing the body of such individual 
(including by disrupting the body’s development, in-
hibiting its natural functions, or modifying its ap-
pearance) to no longer correspond to the individual’s 
sex: 
‘‘(A) Performing any surgery, including— 
‘‘(i) castration; 
‘‘(ii) sterilization; 
‘‘(iii) orchiectomy; 
‘‘(iv) scrotoplasty; 
‘‘(v) vasectomy; 
‘‘(vi) tubal ligation; 
‘‘(vii) hysterectomy; 
‘‘(viii) oophorectomy; 
‘‘(ix) ovariectomy; 
‘‘(x) metoidioplasty; 
‘‘(xi) clitoroplasty; 
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HR 1 PCS
‘‘(xii) reconstruction of the fixed part 
of 
the 
urethra 
with 
or 
without 
a 
metoidioplasty or a phalloplasty; 
‘‘(xiii) penectomy; 
‘‘(xiv) phalloplasty; 
‘‘(xv) vaginoplasty; 
‘‘(xvi) vaginectomy; 
‘‘(xvii) vulvoplasty; 
‘‘(xviii) reduction thyrochondroplasty; 
‘‘(xix) chondrolaryngoplasty; 
‘‘(xx) mastectomy; and 
‘‘(xxi) any plastic, cosmetic, or aes-
thetic 
surgery 
that 
feminizes 
or 
masculinizes the facial or other body fea-
tures of an individual. 
‘‘(B) Any placement of chest implants to 
create feminine breasts or any placement of 
erection or testicular prosetheses. 
‘‘(C) Any placement of fat or artificial im-
plants in the gluteal region. 
‘‘(D) Administering, prescribing, or dis-
pensing to an individual medications, includ-
ing— 
‘‘(i) gonadotropin-releasing hormone 
(GnRH) analogues or other puberty-block-
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HR 1 PCS
ing drugs to stop or delay normal puberty; 
and 
‘‘(ii) testosterone, estrogen, or other 
androgens to an individual at doses that 
are supraphysiologic than would normally 
be produced endogenously in a healthy in-
dividual of the same age and sex. 
‘‘(2) EXCEPTION.—Paragraph (1) shall not 
apply to the following: 
‘‘(A) Puberty suppression or blocking pre-
scription drugs for the purpose of normalizing 
puberty for an individual experiencing pre-
cocious puberty. 
‘‘(B) Medically necessary procedures or 
treatments to correct for— 
‘‘(i) a medically verifiable disorder of 
sex development, including— 
‘‘(I) 46,XX chromosomes with 
virilization; 
‘‘(II) 46,XY chromosomes with 
undervirilization; and 
‘‘(III) both ovarian and testicular 
tissue; 
‘‘(ii) sex chromosome structure, sex 
steroid hormone production, or sex hor-
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HR 1 PCS
mone action, if determined to be abnormal 
by a physician through genetic or bio-
chemical testing; 
‘‘(iii) infection, disease, injury, or dis-
order caused or exacerbated by a previous 
procedure described in paragraph (1), or a 
physical disorder, physical injury, or phys-
ical illness that would, as certified by a 
physician, place the individual in imminent 
danger of death or impairment of a major 
bodily function unless the procedure is per-
formed, not including procedures per-
formed for the alleviation of mental dis-
tress; or 
‘‘(iv) procedures to restore or recon-
struct the body of the individual in order 
to correspond to the individual’s sex after 
one or more previous procedures described 
in paragraph (1), which may include the 
removal of a pseudo phallus or breast aug-
mentation. 
‘‘(3) SEX.—For purposes of this subsection, the 
term ‘sex’ means either male or female, as bio-
logically determined and defined by subparagraph 
(A) and subparagraph (B). 
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‘‘(A) FEMALE.—The term ‘female’ means 
an individual who naturally has, had, will have, 
or would have, but for a developmental or ge-
netic anomaly or historical accident, the repro-
ductive system that at some point produces, 
transports, and utilizes eggs for fertilization. 
‘‘(B) MALE.—The term ‘male’ means an 
individual who naturally has, had, will have, or 
would have, but for a developmental or genetic 
anomaly or historical accident, the reproductive 
system that at some point produces, transports, 
and utilizes sperm for fertilization.’’. 
(i) CLARIFYING LAWFUL PRESENCE FOR PURPOSES 
OF THE EXCHANGES.— 
(1) IN GENERAL.—Section 1312(f) of the Pa-
tient Protection and Affordable Care Act (42 U.S.C. 
18032(f)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(4) CLARIFICATION OF LAWFUL PRESENCE.— 
In this title, the term ‘alien lawfully present in the 
United States’ does not include an alien granted de-
ferred action under the Deferred Action for Child-
hood Arrivals process pursuant to the memorandum 
of the Department of Homeland Security entitled 
‘Exercising Prosecutorial Discretion with Respect to 
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HR 1 PCS
Individuals Who Came to the United States as Chil-
dren’ issued on June 15, 2012.’’. 
(2) 
COST-SHARING
REDUCTIONS.—Section 
1402(e)(2) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18071(e)(2)) is amended by 
adding at the end the following new sentence: ‘‘For 
purposes of this section, an individual shall not be 
treated as lawfully present if the individual is an 
alien granted deferred action under the Deferred Ac-
tion for Childhood Arrivals process pursuant to the 
memorandum of the Department of Homeland Secu-
rity entitled ‘Exercising Prosecutorial Discretion 
with Respect to Individuals Who Came to the United 
States as Children’ issued on June 15, 2012.’’. 
(3) PAYMENT PROHIBITION.—Section 1412(d) 
of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18082(d)) is amended by adding at the 
end the following new sentence: ‘‘For purposes of 
the previous sentence, an individual shall not be 
treated as lawfully present if the individual is an 
alien granted deferred action under the Deferred Ac-
tion for Childhood Arrivals process pursuant to the 
memorandum of the Department of Homeland Secu-
rity entitled ‘Exercising Prosecutorial Discretion 
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with Respect to Individuals Who Came to the United 
States as Children’ issued on June 15, 2012.’’. 
(4) EFFECTIVE DATE.—The amendments made 
by this section shall apply with respect to plan years 
beginning on or after January 1, 2026. 
(j) ENSURING APPROPRIATE APPLICATION OF GUAR-
ANTEED
ISSUE
REQUIREMENTS
IN
CASE
OF
NON-
PAYMENT OF PAST PREMIUMS.— 
(1) IN GENERAL.—Section 2702 of the Public 
Health Service Act (42 U.S.C. 300gg–1) is amended 
by adding at the end the following new subsection: 
‘‘(e) NONPAYMENT OF PAST PREMIUMS.— 
‘‘(1) IN GENERAL.—A health insurance issuer 
offering individual health insurance coverage may, to 
the extent allowed under State law, deny such cov-
erage in the case of an individual who owes any 
amount for premiums for individual health insurance 
coverage offered by such issuer (or by a health in-
surance issuer in the same controlled group (as de-
fined in paragraph (3)) as such issuer) in which 
such individual was previously enrolled. 
‘‘(2) ATTRIBUTION OF INITIAL PREMIUM PAY-
MENT
TO
OWED
AMOUNT.—A health insurance 
issuer offering individual health insurance coverage 
may, in the case of an individual described in para-
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HR 1 PCS
graph (1) and to the extent allowed under State law, 
attribute the initial premium payment for such cov-
erage applicable to such individual to the amount 
owed by such individual for premiums for individual 
health insurance coverage offered by such issuer (or 
by a health insurance issuer in the same controlled 
group as such issuer) in which such individual was 
previously enrolled. 
‘‘(3) CONTROLLED GROUP DEFINED.—For pur-
poses of this subsection, the term ‘controlled group’ 
means a group of of two or more persons that is 
treated as a single employer under section 52(a), 
52(b), 414(m), or 414(o) of the Internal Revenue 
Code of 1986.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply with respect to plan 
years beginning on or after January 1, 2026. 
SEC. 44202. FUNDING COST SHARING REDUCTION PAY-
MENTS. 
Section 1402 of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18071) is amended by adding 
at the end the following new subsection: 
‘‘(h) FUNDING.— 
‘‘(1) IN GENERAL.—There are appropriated out 
of any monies in the Treasury not otherwise appro-
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HR 1 PCS
priated such sums as may be necessary for purposes 
of making payments under this section for plan 
years beginning on or after January 1, 2026. 
‘‘(2) LIMITATION.— 
‘‘(A) IN GENERAL.—The amounts appro-
priated under paragraph (1) may not be used 
for purposes of making payments under this 
section for a qualified health plan that provides 
health benefit coverage that includes coverage 
of abortion. 
‘‘(B) 
EXCEPTION.—Subparagraph 
(A) 
shall not apply to payments for a qualified 
health plan that provides coverage of abortion 
only if necessary to save the life of the mother 
or if the pregnancy is a result of an act of rape 
or incest.’’. 
PART 3—IMPROVING AMERICANS’ ACCESS TO 
CARE 
SEC. 44301. EXPANDING AND CLARIFYING THE EXCLUSION 
FOR ORPHAN DRUGS UNDER THE DRUG 
PRICE NEGOTIATION PROGRAM. 
(a) IN GENERAL.—Section 1192(e) of the Social Se-
curity Act (42 U.S.C. 1320f–1(e)) is amended— 
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HR 1 PCS
(1) in paragraph (1), in the matter preceding 
subparagraph (A), by striking ‘‘and (3)’’ and insert-
ing ‘‘through (4)’’; 
(2) in paragraph (3)(A)— 
(A) by striking ‘‘only one rare disease or 
condition’’ and inserting ‘‘one or more rare dis-
eases or conditions’’; and 
(B) by striking ‘‘such disease or condition’’ 
and inserting ‘‘one or more rare diseases or 
conditions (as such term is defined in section 
526(a)(2) of the Federal Food, Drug, and Cos-
metic Act)’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(4) 
TREATMENT
OF
FORMER
ORPHAN 
DRUGS.—In the case of a drug or biological product 
that, as of the date of the approval or licensure of 
such drug or biological product, is a drug or biologi-
cal product described in paragraph (3)(A), para-
graph (1)(A)(ii) or (1)(B)(ii) (as applicable) shall 
apply as if the reference to ‘the date of such ap-
proval’ or ‘the date of such licensure’, respectively, 
were instead a reference to ‘the first day after the 
date of such approval for which such drug is not a 
drug described in paragraph (3)(A)’ or ‘the first day 
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HR 1 PCS
after the date of such licensure for which such bio-
logical product is not a biological product described 
in paragraph (3)(A)’, respectively.’’. 
(b) APPLICATION.—The amendments made by sub-
section (a) shall apply with respect to initial price applica-
bility years (as defined in section 1191(b) of the Social 
Security Act (42 U.S.C. 1320f(b))) beginning on or after 
January 1, 2028. 
SEC. 44302. STREAMLINED ENROLLMENT PROCESS FOR EL-
IGIBLE OUT-OF-STATE PROVIDERS UNDER 
MEDICAID AND CHIP. 
(a) IN GENERAL.—Section 1902(kk) of the Social Se-
curity Act (42 U.S.C. 1396a(kk)) is amended by adding 
at the end the following new paragraph: 
‘‘(10) STREAMLINED
ENROLLMENT
PROCESS 
FOR ELIGIBLE OUT-OF-STATE PROVIDERS.— 
‘‘(A) IN GENERAL.—The State— 
‘‘(i) adopts and implements a process 
to allow an eligible out-of-State provider to 
enroll under the State plan (or a waiver of 
such plan) to furnish items and services to, 
or order, prescribe, refer, or certify eligi-
bility for items and services for, qualifying 
individuals without the imposition of 
screening or enrollment requirements by 
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HR 1 PCS
such State that exceed the minimum nec-
essary for such State to provide payment 
to an eligible out-of-State provider under 
such State plan (or a waiver of such plan), 
such as the provider’s name and National 
Provider Identifier (and such other infor-
mation specified by the Secretary); and 
‘‘(ii) provides that an eligible out-of- 
State provider that enrolls as a partici-
pating provider in the State plan (or a 
waiver of such plan) through such process 
shall be so enrolled for a 5-year period, un-
less the provider is terminated or excluded 
from participation during such period. 
‘‘(B) DEFINITIONS.—In this paragraph: 
‘‘(i) ELIGIBLE
OUT-OF-STATE
PRO-
VIDER.—The term ‘eligible out-of-State 
provider’ means, with respect to a State, a 
provider— 
‘‘(I) that is located in any other 
State; 
‘‘(II) that— 
‘‘(aa) was determined by the 
Secretary to have a limited risk 
of fraud, waste, and abuse for 
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HR 1 PCS
purposes of determining the level 
of screening to be conducted 
under section 1866(j)(2), has 
been so screened under such sec-
tion 1866(j)(2), and is enrolled in 
the Medicare program under title 
XVIII; or 
‘‘(bb) was determined by the 
State agency administering or su-
pervising the administration of 
the State plan (or a waiver of 
such plan) of such other State to 
have a limited risk of fraud, 
waste, and abuse for purposes of 
determining the level of screening 
to be conducted under paragraph 
(1) of this subsection, has been 
so screened under such para-
graph (1), and is enrolled under 
such State plan (or a waiver of 
such plan); and 
‘‘(III) that has not been— 
‘‘(aa) excluded from partici-
pation in any Federal health care 
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HR 1 PCS
program 
pursuant 
to 
section 
1128 or 1128A; 
‘‘(bb) excluded from partici-
pation in the State plan (or a 
waiver of such plan) pursuant to 
part 1002 of title 42, Code of 
Federal Regulations, or State 
law; or 
‘‘(cc) terminated from par-
ticipating in a Federal health 
care program or the State plan 
(or a waiver of such plan) for a 
reason described in paragraph 
(8)(A). 
‘‘(ii) QUALIFYING
INDIVIDUAL.—The 
term ‘qualifying individual’ means an indi-
vidual under 21 years of age who is en-
rolled under the State plan (or waiver of 
such plan). 
‘‘(iii) 
STATE.—The 
term 
‘State’ 
means 1 of the 50 States or the District 
of Columbia.’’. 
(b) CONFORMING AMENDMENTS.— 
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HR 1 PCS
(1) Section 1902(a)(77) of the Social Security 
Act (42 U.S.C. 1396a(a)(77)) is amended by insert-
ing ‘‘enrollment,’’ after ‘‘screening,’’. 
(2) 
The 
subsection 
heading 
for 
section 
1902(kk) of such Act (42 U.S.C. 1396a(kk)) is 
amended 
by 
inserting 
‘‘ENROLLMENT,’’ 
after 
‘‘SCREENING,’’. 
(3) Section 2107(e)(1)(G) of such Act (42 
U.S.C. 1397gg(e)(1)(G)) is amended by inserting 
‘‘enrollment,’’ after ‘‘screening,’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply beginning on the date that is 4 
years after the date of enactment of this Act. 
SEC. 44303. DELAYING DSH REDUCTIONS. 
(a) IN GENERAL.—Section 1923(f) of the Social Se-
curity Act (42 U.S.C. 1396r–4(f)) is amended— 
(1) in paragraph (7)(A)— 
(A) in clause (i)— 
(i) in the matter preceding subclause 
(I), by striking ‘‘2026 through 2028’’ and 
inserting ‘‘2029 through 2031’’; and 
(ii) in subclause (II), by striking ‘‘or 
period’’; and 
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HR 1 PCS
(B) in clause (ii), by striking ‘‘2026 
through 2028’’ and inserting ‘‘2029 through 
2031’’; and 
(2) in paragraph (8), by striking ‘‘2027’’ and 
inserting ‘‘2031’’. 
(b) 
TENNESSEE
DSH 
ALLOTMENT.—Section 
1923(f)(6)(A)(vi) of the Social Security Act (42 U.S.C. 
1396r–4(f)(6)(A)(vi)) is amended— 
(1) in the header, by striking ‘‘2025’’ and insert-
ing ‘‘2028’’; and 
(2) by striking ‘‘fiscal year 2025’’ and inserting 
‘‘fiscal year 2028’’. 
SEC. 44304. MODIFYING UPDATE TO THE CONVERSION FAC-
TOR UNDER THE PHYSICIAN FEE SCHEDULE 
UNDER THE MEDICARE PROGRAM. 
Section 1848(d) of the Social Security Act (42 U.S.C. 
1395w–4(d)) is amended— 
(1) in paragraph (1)— 
(A) in subparagraph (A)— 
(i) in the first sentence, by striking 
‘‘and ending with 2025’’; and 
(ii) by striking the second sentence; 
and 
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HR 1 PCS
(B) in subparagraph (D), by striking ‘‘(or, 
beginning with 2026, applicable conversion fac-
tor)’’; and 
(2) by amending paragraph (20) to read as fol-
lows: 
‘‘(20) UPDATE
FOR
2026
AND
SUBSEQUENT 
YEARS.—The update to the single conversion factor 
established in paragraph (1)(A)— 
‘‘(A) for 2026 is 75 percent of the Sec-
retary’s estimate of the percentage increase in 
the MEI (as defined in section 1842(i)(3)) for 
the year; and 
‘‘(B) for 2027 and each subsequent year is 
10 percent of the Secretary’s estimate of the 
percentage increase in the MEI for the year.’’. 
SEC. 44305. MODERNIZING AND ENSURING PBM ACCOUNT-
ABILITY. 
(a) IN GENERAL.— 
(1) 
PRESCRIPTION
DRUG
PLANS.—Section 
1860D–12 of the Social Security Act (42 U.S.C. 
1395w–112) is amended by adding at the end the 
following new subsection: 
‘‘(h) REQUIREMENTS RELATING TO PHARMACY BEN-
EFIT MANAGERS.—For plan years beginning on or after 
January 1, 2028: 
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HR 1 PCS
‘‘(1) AGREEMENTS WITH PHARMACY BENEFIT 
MANAGERS.—Each contract entered into with a 
PDP sponsor under this part with respect to a pre-
scription drug plan offered by such sponsor shall 
provide that any pharmacy benefit manager acting 
on behalf of such sponsor has a written agreement 
with the PDP sponsor under which the pharmacy 
benefit manager, and any affiliates of such phar-
macy benefit manager, as applicable, agree to meet 
the following requirements: 
‘‘(A) NO INCOME OTHER THAN BONA FIDE 
SERVICE FEES.— 
‘‘(i) IN
GENERAL.—The pharmacy 
benefit manager and any affiliate of such 
pharmacy benefit manager shall not derive 
any remuneration with respect to any serv-
ices provided on behalf of any entity or in-
dividual, in connection with the utilization 
of covered part D drugs, from any such en-
tity or individual other than bona fide serv-
ice fees, subject to clauses (ii) and (iii). 
‘‘(ii) INCENTIVE PAYMENTS.—For the 
purposes of this subsection, an incentive 
payment (as determined by the Secretary) 
paid by a PDP sponsor to a pharmacy 
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HR 1 PCS
benefit manager (or an affiliate of such 
pharmacy benefit manager) that is per-
forming services on behalf of such sponsor 
shall be deemed a ‘bona fide service fee’ 
(even if such payment does not otherwise 
meet the definition of such term under 
paragraph (7)(B)) if such payment is a 
flat dollar amount, is consistent with fair 
market value (as specified by the Sec-
retary), is related to services actually per-
formed by the pharmacy benefit manager 
or affiliate of such pharmacy benefit man-
ager, on behalf of the PDP sponsor mak-
ing such payment, in connection with the 
utilization of covered part D drugs, and 
meets additional requirements, if any, as 
determined appropriate by the Secretary. 
‘‘(iii) CLARIFICATION
ON
REBATES 
AND DISCOUNTS USED TO LOWER COSTS 
FOR COVERED PART D DRUGS.—Rebates, 
discounts, and other price concessions re-
ceived by a pharmacy benefit manager or 
an affiliate of a pharmacy benefit manager 
from manufacturers, even if such price 
concessions are calculated as a percentage 
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HR 1 PCS
of a drug’s price, shall not be considered a 
violation of the requirements of clause (i) 
if they are fully passed through to a PDP 
sponsor and are compliant with all regu-
latory and subregulatory requirements re-
lated to direct and indirect remuneration 
for manufacturer rebates under this part, 
including in cases where a PDP sponsor is 
acting as a pharmacy benefit manager on 
behalf of a prescription drug plan offered 
by such PDP sponsor. 
‘‘(iv) EVALUATION OF REMUNERATION 
ARRANGEMENTS.—Components of subsets 
of remuneration arrangements (such as 
fees or other forms of compensation paid 
to or retained by the pharmacy benefit 
manager or affiliate of such pharmacy ben-
efit manager), as determined appropriate 
by the Secretary, between pharmacy ben-
efit managers or affiliates of such phar-
macy benefit managers, as applicable, and 
other entities involved in the dispensing or 
utilization of covered part D drugs (includ-
ing PDP sponsors, manufacturers, and 
pharmacies) shall be subject to review by 
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HR 1 PCS
the Secretary, in consultation with the Of-
fice of the Inspector General of the De-
partment of Health and Human Services, 
as determined appropriate by the Sec-
retary. The Secretary, in consultation with 
the Office of the Inspector General, shall 
review whether remuneration under such 
arrangements is consistent with fair mar-
ket value (as specified by the Secretary) 
through reviews and assessments of such 
remuneration, as determined appropriate. 
‘‘(v) DISGORGEMENT.—The pharmacy 
benefit manager shall disgorge any remu-
neration paid to such pharmacy benefit 
manager or an affiliate of such pharmacy 
benefit manager in violation of this sub-
paragraph to the PDP sponsor. 
‘‘(vi) ADDITIONAL REQUIREMENTS.— 
The pharmacy benefit manager shall— 
‘‘(I) enter into a written agree-
ment with any affiliate of such phar-
macy benefit manager, under which 
the affiliate shall identify and disgorge 
any remuneration described in clause 
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HR 1 PCS
(v) to the pharmacy benefit manager; 
and 
‘‘(II) attest, subject to any re-
quirements determined appropriate by 
the Secretary, that the pharmacy ben-
efit manager has entered into a writ-
ten agreement described in subclause 
(I) with any relevant affiliate of the 
pharmacy benefit manager. 
‘‘(B) TRANSPARENCY REGARDING GUARAN-
TEES
AND
COST
PERFORMANCE
EVALUA-
TIONS.—The pharmacy benefit manager shall— 
‘‘(i) define, interpret, and apply, in a 
fully transparent and consistent manner 
for purposes of calculating or otherwise 
evaluating pharmacy benefit manager per-
formance against pricing guarantees or 
similar cost performance measurements re-
lated to rebates, discounts, price conces-
sions, or net costs, terms such as— 
‘‘(I) ‘generic drug’, in a manner 
consistent with the definition of the 
term under section 423.4 of title 42, 
Code of Federal Regulations; 
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HR 1 PCS
‘‘(II) ‘brand name drug’, in a 
manner consistent with the definition 
of the term under section 423.4 of 
title 42, Code of Federal Regulations; 
‘‘(III) ‘specialty drug’; 
‘‘(IV) ‘rebate’; and 
‘‘(V) ‘discount’; 
‘‘(ii) identify any drugs, claims, or 
price concessions excluded from any pric-
ing guarantee or other cost performance 
measure in a clear and consistent manner; 
and 
‘‘(iii) where a pricing guarantee or 
other cost performance measure is based 
on a pricing benchmark other than the 
wholesale acquisition cost (as defined in 
section 1847A(c)(6)(B)) of a drug, cal-
culate and provide a wholesale acquisition 
cost-based equivalent to the pricing guar-
antee or other cost performance measure. 
‘‘(C) PROVISION OF INFORMATION.— 
‘‘(i) IN
GENERAL.—Not later than 
July 1 of each year, beginning in 2028, the 
pharmacy benefit manager shall submit to 
the PDP sponsor, and to the Secretary, a 
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HR 1 PCS
report, in accordance with this subpara-
graph, and shall make such report avail-
able to such sponsor at no cost to such 
sponsor in a format specified by the Sec-
retary under paragraph (5). Each such re-
port shall include, with respect to such 
PDP sponsor and each plan offered by 
such sponsor, the following information 
with respect to the previous plan year: 
‘‘(I) A list of all drugs covered by 
the plan that were dispensed includ-
ing, with respect to each such drug— 
‘‘(aa) the brand name, ge-
neric or non-proprietary name, 
and National Drug Code; 
‘‘(bb) the number of plan 
enrollees for whom the drug was 
dispensed, the total number of 
prescription claims for the drug 
(including original prescriptions 
and refills, counted as separate 
claims), and the total number of 
dosage units of the drug dis-
pensed; 
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HR 1 PCS
‘‘(cc) the number of pre-
scription claims described in item 
(bb) by each type of dispensing 
channel through which the drug 
was dispensed, including retail, 
mail order, specialty pharmacy, 
long term care pharmacy, home 
infusion pharmacy, or other types 
of pharmacies or providers; 
‘‘(dd) the average wholesale 
acquisition cost, listed as cost per 
day’s supply, cost per dosage 
unit, and cost per typical course 
of treatment (as applicable); 
‘‘(ee) the average wholesale 
price for the drug, listed as price 
per day’s supply, price per dos-
age unit, and price per typical 
course of treatment (as applica-
ble); 
‘‘(ff) the total out-of-pocket 
spending by plan enrollees on 
such drug after application of 
any benefits under the plan, in-
cluding plan enrollee spending 
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HR 1 PCS
through copayments, coinsurance, 
and deductibles; 
‘‘(gg) total rebates paid by 
the manufacturer on the drug as 
reported under the Detailed DIR 
Report (or any successor report) 
submitted by such sponsor to the 
Centers for Medicare & Medicaid 
Services; 
‘‘(hh) all other direct or in-
direct remuneration on the drug 
as reported under the Detailed 
DIR Report (or any successor re-
port) submitted by such sponsor 
to the Centers for Medicare & 
Medicaid Services; 
‘‘(ii) the average pharmacy 
reimbursement amount paid by 
the plan for the drug in the ag-
gregate and disaggregated by dis-
pensing channel identified in item 
(cc); 
‘‘(jj) the average National 
Average Drug Acquisition Cost 
(NADAC); and 
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HR 1 PCS
‘‘(kk) total manufacturer-de-
rived revenue, inclusive of bona 
fide service fees, attributable to 
the drug and retained by the 
pharmacy benefit manager and 
any affiliate of such pharmacy 
benefit manager. 
‘‘(II) In the case of a pharmacy 
benefit manager that has an affiliate 
that is a retail, mail order, or spe-
cialty pharmacy, with respect to drugs 
covered by such plan that were dis-
pensed, the following information: 
‘‘(aa) The percentage of 
total prescriptions that were dis-
pensed by pharmacies that are an 
affiliate of the pharmacy benefit 
manager for each drug. 
‘‘(bb) 
The 
interquartile 
range of the total combined costs 
paid by the plan and plan enroll-
ees, per dosage unit, per course 
of treatment, per 30-day supply, 
and per 90-day supply for each 
drug dispensed by pharmacies 
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HR 1 PCS
that are not an affiliate of the 
pharmacy benefit manager and 
that are included in the phar-
macy network of such plan. 
‘‘(cc) 
The 
interquartile 
range of the total combined costs 
paid by the plan and plan enroll-
ees, per dosage unit, per course 
of treatment, per 30-day supply, 
and per 90-day supply for each 
drug dispensed by pharmacies 
that are an affiliate of the phar-
macy benefit manager and that 
are included in the pharmacy 
network of such plan. 
‘‘(dd) The lowest total com-
bined cost paid by the plan and 
plan enrollees, per dosage unit, 
per course of treatment, per 30- 
day supply, and per 90-day sup-
ply, for each drug that is avail-
able from any pharmacy included 
in the pharmacy network of such 
plan. 
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HR 1 PCS
‘‘(ee) The difference between 
the average acquisition cost of 
the affiliate, such as a pharmacy 
or other entity that acquires pre-
scription drugs, that initially ac-
quires the drug and the amount 
reported under subclause (I)(jj) 
for each drug. 
‘‘(ff) A list inclusive of the 
brand name, generic or non-pro-
prietary 
name, 
and 
National 
Drug Code of covered part D 
drugs subject to an agreement 
with a covered entity under sec-
tion 340B of the Public Health 
Service Act for which the phar-
macy benefit manager or an affil-
iate of the pharmacy benefit 
manager had a contract or other 
arrangement with such a covered 
entity in the service area of such 
plan. 
‘‘(III) Where a drug approved 
under section 505(c) of the Federal 
Food, Drug, and Cosmetic Act (re-
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HR 1 PCS
ferred to in this subclause as the ‘list-
ed drug’) is covered by the plan, the 
following information: 
‘‘(aa) A list of currently 
marketed generic drugs approved 
under section 505(j) of the Fed-
eral Food, Drug, and Cosmetic 
Act pursuant to an application 
that references such listed drug 
that are not covered by the plan, 
are covered on the same for-
mulary tier or a formulary tier 
typically associated with higher 
cost-sharing than the listed drug, 
or are subject to utilization man-
agement that the listed drug is 
not subject to. 
‘‘(bb) The estimated average 
beneficiary 
cost-sharing 
under 
the plan for a 30-day supply of 
the listed drug. 
‘‘(cc) Where a generic drug 
listed under item (aa) is on a for-
mulary tier typically associated 
with higher cost-sharing than the 
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HR 1 PCS
listed drug, the estimated aver-
age cost-sharing that a bene-
ficiary would have paid for a 30- 
day supply of each of the generic 
drugs described in item (aa), had 
the plan provided coverage for 
such drugs on the same for-
mulary tier as the listed drug. 
‘‘(dd) A written justification 
for providing more favorable cov-
erage of the listed drug than the 
generic drugs described in item 
(aa). 
‘‘(ee) The number of cur-
rently marketed generic drugs 
approved under section 505(j) of 
the Federal Food, Drug, and 
Cosmetic Act pursuant to an ap-
plication that references such 
listed drug. 
‘‘(IV) Where a reference product 
(as defined in section 351(i) of the 
Public Health Service Act) is covered 
by the plan, the following information: 
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HR 1 PCS
‘‘(aa) A list of currently 
marketed 
biosimilar 
biological 
products licensed under section 
351(k) of the Public Health 
Service Act pursuant to an appli-
cation that refers to such ref-
erence product that are not cov-
ered by the plan, are covered on 
the same formulary tier or a for-
mulary tier typically associated 
with higher cost-sharing than the 
reference product, or are subject 
to utilization management that 
the reference product is not sub-
ject to. 
‘‘(bb) The estimated average 
beneficiary 
cost-sharing 
under 
the plan for a 30-day supply of 
the reference product. 
‘‘(cc) Where a biosimilar bi-
ological product listed under item 
(aa) is on a formulary tier typi-
cally associated with higher cost- 
sharing than the reference prod-
uct, the estimated average cost- 
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HR 1 PCS
sharing that a beneficiary would 
have paid for a 30-day supply of 
each of the biosimilar biological 
products described in item (aa), 
had the plan provided coverage 
for such products on the same 
formulary tier as the reference 
product. 
‘‘(dd) A written justification 
for providing more favorable cov-
erage of the reference product 
than the biosimilar biological 
product described in item (aa). 
‘‘(ee) The number of cur-
rently marketed biosimilar bio-
logical products licensed under 
section 351(k) of the Public 
Health Service Act, pursuant to 
an application that refers to such 
reference product. 
‘‘(V) Total gross spending on 
covered part D drugs by the plan, not 
net of rebates, fees, discounts, or 
other direct or indirect remuneration. 
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HR 1 PCS
‘‘(VI) The total amount retained 
by the pharmacy benefit manager or 
an affiliate of such pharmacy benefit 
manager in revenue related to utiliza-
tion of covered part D drugs under 
that plan, inclusive of bona fide serv-
ice fees. 
‘‘(VII) The total spending on cov-
ered part D drugs net of rebates, fees, 
discounts, or other direct and indirect 
remuneration by the plan. 
‘‘(VIII) An explanation of any 
benefit design parameters under such 
plan that encourage plan enrollees to 
fill prescriptions at pharmacies that 
are an affiliate of such pharmacy ben-
efit manager, such as mail and spe-
cialty home delivery programs, and re-
tail and mail auto-refill programs. 
‘‘(IX) The following information: 
‘‘(aa) A list of all brokers, 
consultants, advisors, and audi-
tors that receive compensation 
from the pharmacy benefit man-
ager or an affiliate of such phar-
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HR 1 PCS
macy benefit manager for refer-
rals, 
consulting, 
auditing, 
or 
other services offered to PDP 
sponsors related to pharmacy 
benefit management services. 
‘‘(bb) The amount of com-
pensation provided by such phar-
macy benefit manager or affiliate 
to each such broker, consultant, 
advisor, and auditor. 
‘‘(cc) The methodology for 
calculating the amount of com-
pensation provided by such phar-
macy benefit manager or affil-
iate, for each such broker, con-
sultant, advisor, and auditor. 
‘‘(X) A list of all affiliates of the 
pharmacy benefit manager. 
‘‘(XI) A summary document sub-
mitted in a standardized template de-
veloped by the Secretary that includes 
such information described in sub-
clauses (I) through (X). 
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HR 1 PCS
‘‘(ii) WRITTEN EXPLANATION OF CON-
TRACTS
OR
AGREEMENTS
WITH
DRUG 
MANUFACTURERS.— 
‘‘(I) IN
GENERAL.—The phar-
macy benefit manager shall, not later 
than 30 days after the finalization of 
any contract or agreement between 
such pharmacy benefit manager or an 
affiliate of such pharmacy benefit 
manager and a drug manufacturer (or 
subsidiary, agent, or entity affiliated 
with such drug manufacturer) that 
makes rebates, discounts, payments, 
or other financial incentives related to 
one or more covered part D drugs or 
other prescription drugs, as applica-
ble, of the manufacturer directly or 
indirectly contingent upon coverage, 
formulary placement, or utilization 
management conditions on any other 
covered part D drugs or other pre-
scription drugs, as applicable, submit 
to the PDP sponsor a written expla-
nation of such contract or agreement. 
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‘‘(II) REQUIREMENTS.—A writ-
ten explanation under subclause (I) 
shall— 
‘‘(aa) include the manufac-
turer subject to the contract or 
agreement, all covered part D 
drugs 
and 
other 
prescription 
drugs, as applicable, subject to 
the contract or agreement and 
the manufacturers of such drugs, 
and a high-level description of 
the terms of such contract or 
agreement and how such terms 
apply to such drugs; and 
‘‘(bb) be certified by the 
Chief Executive Officer, Chief Fi-
nancial Officer, or General Coun-
sel of such pharmacy benefit 
manager, or affiliate of such 
pharmacy benefit manager, as 
applicable, or an individual dele-
gated with the authority to sign 
on behalf of one of these officers, 
who reports directly to the offi-
cer. 
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‘‘(III) DEFINITION
OF
OTHER 
PRESCRIPTION DRUGS.—For purposes 
of this clause, the term ‘other pre-
scription drugs’ means prescription 
drugs covered as supplemental bene-
fits under this part or prescription 
drugs paid outside of this part. 
‘‘(D) AUDIT RIGHTS.— 
‘‘(i) IN GENERAL.—Not less than once 
a year, at the request of the PDP sponsor, 
the pharmacy benefit manager shall allow 
for an audit of the pharmacy benefit man-
ager to ensure compliance with all terms 
and conditions under the written agree-
ment described in this paragraph and the 
accuracy of information reported under 
subparagraph (C). 
‘‘(ii) AUDITOR.—The PDP sponsor 
shall have the right to select an auditor. 
The pharmacy benefit manager shall not 
impose any limitations on the selection of 
such auditor. 
‘‘(iii) PROVISION OF INFORMATION.— 
The pharmacy benefit manager shall make 
available to such auditor all records, data, 
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contracts, and other information necessary 
to confirm the accuracy of information 
provided under subparagraph (C), subject 
to reasonable restrictions on how such in-
formation must be reported to prevent re-
disclosure of such information. 
‘‘(iv) TIMING.—The pharmacy benefit 
manager must provide information under 
clause (iii) and other information, data, 
and records relevant to the audit to such 
auditor within 6 months of the initiation of 
the audit and respond to requests for addi-
tional information from such auditor with-
in 30 days after the request for additional 
information. 
‘‘(v) INFORMATION
FROM
AFFILI-
ATES.—The pharmacy benefit manager 
shall be responsible for providing to such 
auditor information required to be reported 
under subparagraph (C) or under clause 
(iii) of this subparagraph that is owned or 
held by an affiliate of such pharmacy ben-
efit manager. 
‘‘(2) ENFORCEMENT.— 
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‘‘(A) IN
GENERAL.—Each PDP sponsor 
shall— 
‘‘(i) disgorge to the Secretary any 
amounts disgorged to the PDP sponsor by 
a pharmacy benefit manager under para-
graph (1)(A)(v); 
‘‘(ii) require, in a written agreement 
with any pharmacy benefit manager acting 
on behalf of such sponsor or affiliate of 
such pharmacy benefit manager, that such 
pharmacy benefit manager or affiliate re-
imburse the PDP sponsor for any civil 
money penalty imposed on the PDP spon-
sor as a result of the failure of the phar-
macy benefit manager or affiliate to meet 
the requirements of paragraph (1) that are 
applicable to the pharmacy benefit man-
ager or affiliate under the agreement; and 
‘‘(iii) require, in a written agreement 
with any such pharmacy benefit manager 
acting on behalf of such sponsor or affil-
iate of such pharmacy benefit manager, 
that such pharmacy benefit manager or af-
filiate be subject to punitive remedies for 
breach of contract for failure to comply 
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HR 1 PCS
with the requirements applicable under 
paragraph (1). 
‘‘(B) REPORTING
OF
ALLEGED
VIOLA-
TIONS.—The Secretary shall make available and 
maintain a mechanism for manufacturers, PDP 
sponsors, pharmacies, and other entities that 
have contractual relationships with pharmacy 
benefit managers or affiliates of such pharmacy 
benefit managers to report, on a confidential 
basis, alleged violations of paragraph (1)(A) or 
subparagraph (C). 
‘‘(C) ANTI-RETALIATION AND ANTI-COER-
CION.—Consistent with applicable Federal or 
State law, a PDP sponsor shall not— 
‘‘(i) retaliate against an individual or 
entity for reporting an alleged violation 
under subparagraph (B); or 
‘‘(ii) coerce, intimidate, threaten, or 
interfere with the ability of an individual 
or entity to report any such alleged viola-
tions. 
‘‘(3) CERTIFICATION OF COMPLIANCE.— 
‘‘(A) IN
GENERAL.—Each PDP sponsor 
shall furnish to the Secretary (at a time and in 
a manner specified by the Secretary) an annual 
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HR 1 PCS
certification of compliance with this subsection, 
as well as such information as the Secretary de-
termines necessary to carry out this subsection. 
‘‘(B) IMPLEMENTATION.—The Secretary 
may implement this paragraph by program in-
struction or otherwise. 
‘‘(4) RULE
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed as— 
‘‘(A) prohibiting flat dispensing fees or re-
imbursement or payment for ingredient costs 
(including customary, industry-standard dis-
counts directly related to drug acquisition that 
are retained by pharmacies or wholesalers) to 
entities that acquire or dispense prescription 
drugs; or 
‘‘(B) modifying regulatory requirements or 
sub-regulatory program instruction or guidance 
related to pharmacy payment, reimbursement, 
or dispensing fees. 
‘‘(5) STANDARD FORMATS.— 
‘‘(A) IN GENERAL.—Not later than June 
1, 2027, the Secretary shall specify standard, 
machine-readable formats for pharmacy benefit 
managers to submit annual reports required 
under paragraph (1)(C)(i). 
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‘‘(B) IMPLEMENTATION.—The Secretary 
may implement this paragraph by program in-
struction or otherwise. 
‘‘(6) CONFIDENTIALITY.— 
‘‘(A) IN GENERAL.—Information disclosed 
by a pharmacy benefit manager, an affiliate of 
a pharmacy benefit manager, a PDP sponsor, 
or a pharmacy under this subsection that is not 
otherwise publicly available or available for pur-
chase shall not be disclosed by the Secretary or 
a PDP sponsor receiving the information, ex-
cept that the Secretary may disclose the infor-
mation for the following purposes: 
‘‘(i) As the Secretary determines nec-
essary to carry out this part. 
‘‘(ii) To permit the Comptroller Gen-
eral to review the information provided. 
‘‘(iii) To permit the Executive Direc-
tor of the Medicare Payment Advisory 
Commission to review the information pro-
vided. 
‘‘(iv) To the Attorney General for the 
purposes of conducting oversight and en-
forcement under this title. 
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‘‘(v) To the Inspector General of the 
Department of Health and Human Serv-
ices in accordance with its authorities 
under the Inspector General Act of 1978 
(section 406 of title 5, United States 
Code), and other applicable statutes. 
‘‘(B) RESTRICTION ON USE OF INFORMA-
TION.—The Secretary, the Comptroller General, 
and the Executive Director of the Medicare 
Payment Advisory Commission shall not report 
on or disclose information disclosed pursuant to 
subparagraph (A) to the public in a manner 
that would identify— 
‘‘(i) a specific pharmacy benefit man-
ager, affiliate, pharmacy, manufacturer, 
wholesaler, PDP sponsor, or plan; or 
‘‘(ii) contract prices, rebates, dis-
counts, or other remuneration for specific 
drugs in a manner that may allow the 
identification of specific contracting parties 
or of such specific drugs. 
‘‘(7) DEFINITIONS.—For purposes of this sub-
section: 
‘‘(A) AFFILIATE.—The term ‘affiliate’ 
means, with respect to any pharmacy benefit 
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HR 1 PCS
manager or PDP sponsor, any entity that, di-
rectly or indirectly— 
‘‘(i) owns or is owned by, controls or 
is controlled by, or is otherwise related in 
any ownership structure to such pharmacy 
benefit manager or PDP sponsor; or 
‘‘(ii) acts as a contractor, principal, or 
agent to such pharmacy benefit manager 
or PDP sponsor, insofar as such con-
tractor, principal, or agent performs any of 
the functions described under subpara-
graph (C). 
‘‘(B) BONA FIDE SERVICE FEE.—The term 
‘bona fide service fee’ means a fee that is reflec-
tive of the fair market value (as specified by the 
Secretary, through notice and comment rule-
making) for a bona fide, itemized service actu-
ally performed on behalf of an entity, that the 
entity would otherwise perform (or contract for) 
in the absence of the service arrangement and 
that is not passed on in whole or in part to a 
client or customer, whether or not the entity 
takes title to the drug. Such fee must be a flat 
dollar amount and shall not be directly or indi-
rectly based on, or contingent upon— 
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HR 1 PCS
‘‘(i) drug price, such as wholesale ac-
quisition cost or drug benchmark price 
(such as average wholesale price); 
‘‘(ii) the amount of discounts, rebates, 
fees, or other direct or indirect remunera-
tion with respect to covered part D drugs 
dispensed to enrollees in a prescription 
drug plan, except as permitted pursuant to 
paragraph (1)(A)(ii); 
‘‘(iii) coverage or formulary placement 
decisions or the volume or value of any re-
ferrals or business generated between the 
parties to the arrangement; or 
‘‘(iv) any other amounts or meth-
odologies prohibited by the Secretary. 
‘‘(C) PHARMACY BENEFIT MANAGER.—The 
term ‘pharmacy benefit manager’ means any 
person or entity that, either directly or through 
an intermediary, acts as a price negotiator or 
group purchaser on behalf of a PDP sponsor or 
prescription drug plan, or manages the pre-
scription drug benefits provided by such spon-
sor or plan, including the processing and pay-
ment of claims for prescription drugs, the per-
formance of drug utilization review, the proc-
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HR 1 PCS
essing of drug prior authorization requests, the 
adjudication of appeals or grievances related to 
the prescription drug benefit, contracting with 
network pharmacies, controlling the cost of cov-
ered part D drugs, or the provision of related 
services. Such term includes any person or enti-
ty that carries out one or more of the activities 
described in the preceding sentence, irrespective 
of whether such person or entity calls itself a 
‘pharmacy benefit manager’.’’. 
(2) MA–PD PLANS.—Section 1857(f)(3) of the 
Social Security Act (42 U.S.C. 1395w–27(f)(3)) is 
amended by adding at the end the following new 
subparagraph: 
‘‘(F) REQUIREMENTS RELATING TO PHAR-
MACY BENEFIT MANAGERS.—For plan years be-
ginning on or after January 1, 2028, section 
1860D–12(h).’’. 
(3) NONAPPLICATION OF PAPERWORK REDUC-
TION ACT.—Chapter 35 of title 44, United States 
Code, shall not apply to the implementation of this 
subsection. 
(4) FUNDING.— 
(A) SECRETARY.—In addition to amounts 
otherwise available, there is appropriated to the 
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Centers for Medicare & Medicaid Services Pro-
gram Management Account, out of any money 
in the Treasury not otherwise appropriated, 
$113,000,000 for fiscal year 2025, to remain 
available until expended, to carry out this sub-
section. 
(B) OIG.—In addition to amounts other-
wise available, there is appropriated to the In-
spector General of the Department of Health 
and Human Services, out of any money in the 
Treasury 
not 
otherwise 
appropriated, 
$20,000,000 for fiscal year 2025, to remain 
available until expended, to carry out this sub-
section. 
(b) MEDPAC REPORTS
ON AGREEMENTS WITH 
PHARMACY BENEFIT MANAGERS WITH RESPECT TO PRE-
SCRIPTION DRUG PLANS AND MA-PD PLANS.— 
(1) IN GENERAL.—The Medicare Payment Ad-
visory Commission shall submit to Congress the fol-
lowing reports: 
(A) INITIAL REPORT.—Not later than the 
first March 15 occurring after the date that is 
2 years after the date on which the Secretary 
makes the data available to the Commission, a 
report regarding agreements with pharmacy 
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benefit managers with respect to prescription 
drug plans and MA–PD plans. Such report 
shall include, to the extent practicable— 
(i) a description of trends and pat-
terns, including relevant averages, totals, 
and other figures for the types of informa-
tion submitted; 
(ii) an analysis of any differences in 
agreements and their effects on plan en-
rollee out-of-pocket spending and average 
pharmacy reimbursement, and other im-
pacts; and 
(iii) any recommendations the Com-
mission determines appropriate. 
(B) FINAL
REPORT.—Not later than 2 
years after the date on which the Commission 
submits the initial report under subparagraph 
(A), a report describing any changes with re-
spect to the information described in subpara-
graph (A) over time, together with any rec-
ommendations the Commission determines ap-
propriate. 
(2) FUNDING.—In addition to amounts other-
wise available, there is appropriated to the Medicare 
Payment Advisory Commission, out of any money in 
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the 
Treasury 
not 
otherwise 
appropriated, 
$1,000,000 for fiscal year 2026, to remain available 
until expended, to carry out this subsection. 
TITLE V—COMMITTEE ON 
FINANCIAL SERVICES 
SEC. 50001. GREEN AND RESILIENT RETROFIT PROGRAM 
FOR MULTIFAMILY FAMILY HOUSING. 
The unobligated balance of amounts made available 
under section 30002(a) of Public Law 117-169 (commonly 
referred to as the ‘‘Inflation Reduction Act’’; 136 Stat. 
2027) are rescinded. 
SEC. 50002. PUBLIC COMPANY ACCOUNTING OVERSIGHT 
BOARD. 
(a) During the period beginning on the date of enact-
ment of this Act and ending on the transfer date— 
(1) all intellectual property retained by the 
Public 
Company 
Accounting 
Oversight 
Board 
(‘‘Board’’) in support of its programs for registra-
tion, standard-setting, and inspection shall be shared 
with the Securities and Exchange Commission 
(‘‘Commission’’); and 
(2) pending enforcement and disciplinary ac-
tions of the Board shall be referred to the Commis-
sion or another Federal functional regulator (as de-
fined in section 509 of the Gramm-Leach-Bliley Act 
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(15 U.S.C. 6809)) in accordance with section 105 of 
the Sarbanes-Oxley Act of 2002 (15 U.S.C. 7215). 
(b) Effective on the transfer date— 
(1) all unobligated fees collected under section 
109(d) of the Sarbanes-Oxley Act of 2002 shall be 
transferred to the general fund of the Treasury, and 
the Commission may not collect fees under such sec-
tion 109(d); 
(2) the duties and powers of the Board in effect 
as of the day before the transfer date, other than 
those described in section 107 of the Sarbanes-Oxley 
Act of 2002 (15 U.S.C. 7217), shall be transferred 
to the Commission; 
(3) the Commission may not use funds to carry 
out section 107 of the Sarbanes-Oxley Act of 2002 
(15 U.S.C. 7217) for activities related to overseeing 
the Board; 
(4) the Board shall transfer all intellectual 
property described in subsection (a)(1) to the Com-
mission; 
(5) existing processes and regulations of the 
Board, including existing Board auditing standards, 
shall continue in effect unless modified through rule 
making by the Commission; and 
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(6) in connection with the duties and powers 
transferred under paragraph (2), any reference to 
the Board in any law implemented by a Federal 
functional regulator (as defined in section 509 of the 
Gramm-Leach-Bliley Act (15 U.S.C. 6809)), in any 
rule or guidance issued by a Federal functional reg-
ulator (as defined in section 509 of the Gramm- 
Leach-Bliley Act (15 U.S.C. 6809)), or in any 
records or other documents in the possession of a 
Federal functional regulator (as defined in section 
509 of the Gramm-Leach-Bliley Act (15 U.S.C. 
6809)), shall be deemed a reference to the Commis-
sion. 
(c) Any employee of the Board as of the date of en-
actment of this Act may— 
(1) be offered equivalent positions on the Com-
mission staff, as determined by the Commission, and 
submit to the Commission’s standard employment 
policies; and 
(2) receive pay that is not higher than the high-
est paid employee of similarly situated employees of 
the Commission. 
(d) In this section, the term ‘‘transfer date’’ means 
the date established by the Commission for purposes of 
this section, except that such date may not be later than 
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the date that is 1 year after the date of enactment of this 
Act. 
SEC. 50003. BUREAU OF CONSUMER FINANCIAL PROTEC-
TION. 
Section 1017(a)(2) of the Consumer Financial Pro-
tection Act of 2010 (12 U.S.C. 5497(a)(2)) is amended— 
(1) in subparagraph (A)(iii)— 
(A) by striking ‘‘12 percent’’ and inserting 
‘‘5 percent’’; and 
(B) by striking ‘‘2013’’ and inserting 
‘‘2025’’; and 
(2) by striking subparagraph (C) and inserting 
the following: 
‘‘(C) LIMITATION ON UNOBLIGATED BAL-
ANCES.—With respect to a fiscal year, the 
amount of unobligated balances of the Bureau 
may not exceed 5 percent of the dollar amount 
referred to in subparagraph (A)(iii), as adjusted 
under subparagraph (B). The Director shall 
transfer any excess amount of such unobligated 
balances to the general fund of the Treasury.’’. 
SEC. 50004. CONSUMER FINANCIAL CIVIL PENALTY FUND. 
Section 1017(d) of the Consumer Financial Protec-
tion Act of 2010 (12 U.S.C. 5497(d)) is amended— 
(1) in paragraph (2)— 
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(A) in the first sentence, by inserting ‘‘di-
rect’’ before ‘‘victims’’; and 
(B) by striking the second sentence; and 
(2) by adding at the end the following: 
‘‘(3) TREATMENT OF EXCESS AMOUNTS.—With 
respect to a civil penalty described under paragraph 
(1), if the Bureau makes payments to all of the di-
rect victims of activities for which that civil penalty 
was imposed, the Bureau shall transfer all amounts 
that remain in the Civil Penalty Fund with respect 
to that civil penalty to the general fund of the 
Treasury.’’. 
SEC. 50005. FINANCIAL RESEARCH FUND. 
Section 155 of the Financial Stability Act of 2010 
(12 U.S.C. 5345) is amended by adding at the end the 
following: 
‘‘(e) LIMITATION ON ASSESSMENTS AND THE FINAN-
CIAL RESEARCH FUND.— 
‘‘(1) LIMITATION
ON
ASSESSMENTS.—Assess-
ments may not be collected under subsection (d) if 
the assessments would result in— 
‘‘(A) the Financial Research Fund exceed-
ing the average annual budget amount; or 
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‘‘(B) the total assessments collected during 
a single fiscal year exceeding the average an-
nual budget amount. 
‘‘(2) TRANSFER
OF
EXCESS
FUNDS.—Any 
amounts in the Financial Research Fund exceeding 
the average annual budget amount shall be deposited 
into the general fund of the Treasury. 
‘‘(3) AVERAGE ANNUAL BUDGET AMOUNT DE-
FINED.—In this subsection the term ‘average annual 
budget amount’ means the annual average, over the 
3 most recently completed fiscal years, of the ex-
penses of the Council in carrying out the duties and 
responsibilities of the Council that were paid by the 
Office using amounts obtained through assessments 
under subsection (d).’’. 
TITLE VI—COMMITTEE ON 
HOMELAND SECURITY 
SEC. 60001. BORDER BARRIER SYSTEM CONSTRUCTION, 
INVASIVE SPECIES, AND BORDER SECURITY 
FACILITIES IMPROVEMENTS. 
In addition to amounts otherwise available, there is 
appropriated to the Commissioner of U.S. Customs and 
Border Protection for fiscal year 2025, out of any money 
in the Treasury not otherwise appropriated, to remain 
available until September 30, 2029, the following: 
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(1) $46,500,000,000 for necessary expenses re-
lating to the following: 
(A) Construction, installation, or improve-
ment of primary, waterborne, and secondary 
barriers. 
(B) Access roads. 
(C) Barrier system attributes, including 
cameras, lights, sensors, roads, and other detec-
tion technology. 
(2) $50,000,000 for necessary expenses relating 
to eradication and removal of the carrizo cane plant, 
salt cedar, or any other invasive plant species that 
impedes border security operations along the Rio 
Grande River. 
(3) $5,000,000,000 for necessary expenses re-
lating to lease, acquisition, construction, or improve-
ment of U.S. Customs and Border Protection facili-
ties and checkpoints in the vicinity of the southwest, 
northern, and maritime borders. 
SEC. 60002. U.S. CUSTOMS AND BORDER PROTECTION PER-
SONNEL AND FLEET VEHICLES. 
(a) CBP PERSONNEL.—In addition to amounts oth-
erwise available, there is appropriated to the Commis-
sioner of U.S. Customs and Border Protection for fiscal 
year 2025, out of any money in the Treasury not otherwise 
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appropriated, $4,100,000,000, to remain available until 
September 30, 2029, to hire and train additional Border 
Patrol agents, Office of Field Operations Officers, Air and 
Marine agents, rehired annuitants, and U.S. Customs and 
Border Protection support personnel. 
(b) RESTRICTIONS.—None of the funds made avail-
able by subsection (a) may be used to recruit, hire, or train 
personnel for the duties of processing coordinators. 
(c) CBP RETENTION AND HIRING BONUSES.—In ad-
dition to amounts otherwise available, there is appro-
priated to the Commissioner of U.S. Customs and Border 
Protection for fiscal year 2025, out of any money in the 
Treasury not otherwise appropriated, $2,052,630,000, to 
remain available until September 30, 2029, to provide an-
nual retention bonuses or signing bonuses to eligible Bor-
der Patrol agents, Office of Field Operations Officers, and 
Air and Marine agents. 
(d) CBP VEHICLES.—In addition to amounts other-
wise available, there is appropriated to the Commissioner 
of U.S. Customs and Border Protection for fiscal year 
2025, out of any money in the Treasury not otherwise ap-
propriated, $813,000,000, to remain available until Sep-
tember 30, 2029, for the lease or acquisition of additional 
marked patrol units. 
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(e) FLETC.—In addition to amounts otherwise avail-
able, there is appropriated to the Director of the Federal 
Law Enforcement Training Center for fiscal year 2025, 
out of any money in the Treasury not otherwise appro-
priated— 
(1) $285,000,000, to remain available until 
September 30, 2029, to support the training of 
newly hired Federal law enforcement personnel em-
ployed by the Department of Homeland Security; 
and 
(2) $465,000,000, to remain available until 
September 30, 2029, for procurement and construc-
tion, improvements, and related expenses of the Fed-
eral Law Enforcement Training Centers facilities. 
(f) BORDER SECURITY WORKFORCE RECRUITMENT 
AND APPLICANT SOURCING.—In addition to amounts oth-
erwise available, there is appropriated to the Commis-
sioner of U.S. Customs and Border Protection for fiscal 
year 2025, out of any money in the Treasury not otherwise 
appropriated, $600,000,000, to remain available until 
September 30, 2029, for marketing, recruiting, applicant 
sourcing and vetting, and operational mobility programs 
for border security personnel. 
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SEC. 60003. U.S. CUSTOMS AND BORDER PROTECTION 
TECHNOLOGY, 
VETTING 
ACTIVITIES, 
AND 
OTHER EFFORTS TO ENHANCE BORDER SE-
CURITY. 
(a) CBP TECHNOLOGY.—In addition to amounts oth-
erwise available, there is appropriated to the Commis-
sioner of U.S. Customs and Border Protection for fiscal 
year 2025, out of any money in the Treasury not otherwise 
appropriated, to remain available until September 30, 
2029, the following: 
(1) $1,076,317,000 for necessary expenses re-
lating to procurement and integration of new non-in-
trusive inspection equipment and associated civil 
works, artificial intelligence, integration, and ma-
chine learning, as well as other mission support, to 
combat the entry of illicit narcotics along the south-
west, northern, and maritime borders. 
(2) $2,766,000,000 for necessary expenses re-
lating to upgrades and procurement of border sur-
veillance technologies along the southwest, northern, 
and maritime borders. 
(3) $673,000,000 for necessary expenses, in-
cluding the deployment of technology, relating to the 
biometric entry and exit system under section 7208 
of the Intelligence Reform and Terrorism Prevention 
Act of 2004 (8 U.S.C. 1365b). 
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(b) RESTRICTIONS.—None of the funds made avail-
able pursuant to subsection (a)(2) may be used for the 
procurement or deployment of surveillance towers that 
have not been— 
(1) tested, and 
(2) accepted, 
by the Federal Government to deliver autonomous capa-
bilities. 
(c) AIR AND MARINE OPERATIONS.—In addition to 
amounts otherwise available, there is appropriated to the 
Commissioner of U.S. Customs and Border Protection for 
fiscal year 2025, out of any money in the Treasury not 
otherwise appropriated, $1,234,000,000, to remain avail-
able until September 30, 2029, for Air and Marine Oper-
ations’ upgrading and procurement of new platforms for 
rapid air and marine response capabilities. 
(d) CBP VETTING
ACTIVITIES.—In addition to 
amounts otherwise available, there is appropriated to the 
Commissioner of U.S. Customs and Border Protection for 
fiscal year 2025, out of any money in the Treasury not 
otherwise appropriated, $16,000,000, to remain available 
until September 30, 2029, for necessary expenses to sup-
port screening, vetting activities, and expansion of U.S. 
Customs and Border Protection’s criminal history data-
bases. 
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(e) OTHER EFFORTS
TO COMBAT DRUG TRAF-
FICKING TO ENHANCE BORDER SECURITY.—In addition 
to amounts otherwise available, there is appropriated to 
the Secretary of Homeland Security for fiscal year 2025, 
out of any money in the Treasury not otherwise appro-
priated, $500,000,000, to remain available until Sep-
tember 30, 2029, for enhancing border security and com-
batting trafficking, including fentanyl and its precursor 
chemicals, at the southwest, northern, and maritime bor-
ders. 
(f) COMMEMORATIONS.—In addition to amounts oth-
erwise available, there is appropriated to the Secretary of 
Homeland Security for fiscal year 2025, out of any money 
in the Treasury not otherwise appropriated, $1,000,000, 
to remain available until September 30, 2029, for com-
memorating efforts and events related to border security. 
(g) DEFINITION.—In this section, the term ‘‘autono-
mous’’ means integrated software and hardware systems 
that utilize sensors, onboard computing, and artificial in-
telligence to identify items of interest that would otherwise 
be manually identified by U.S. Customs and Border Pro-
tection personnel. 
SEC. 60004. STATE BORDER SECURITY REIMBURSEMENT. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary of Home-
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land Security, for fiscal year 2025, out of any money in 
the 
Treasury 
not 
otherwise 
appropriated, 
$12,000,000,000, to remain available until September 30, 
2029, to carry out this section. 
(b) USE OF FUNDS.—The Secretary of Homeland Se-
curity shall use amounts made available under subsection 
(a) to make grants to States for costs associated with ac-
tions taken on or after January 21, 2021, to assist the 
Federal border security missions to enforce the immigra-
tion laws, including through detention and removal, and 
to combat the unlawful entry of persons and contraband. 
(c) APPLICATION.—The Secretary of Homeland Se-
curity shall develop a process for States to submit a grant 
application, together with satisfactory evidence of costs in-
curred, to seek reimbursement for any expenses described 
in subsection (b). 
(d) PROHIBITION.—The Secretary of Homeland Se-
curity may not make a grant for reimbursement under this 
section to a State if such State has received such reim-
bursement under any other grant program of the Depart-
ment of Homeland Security. 
SEC. 60005. STATE AND LOCAL LAW ENFORCEMENT PRESI-
DENTIAL RESIDENCE PROTECTION. 
(a) PRESIDENTIAL RESIDENCE PROTECTION.—In 
addition to amounts otherwise available, there is appro-
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priated to the Administrator of the Federal Emergency 
Management Agency, for fiscal year 2025, out of any 
money in the Treasury not otherwise appropriated, 
$300,000,000, to remain available until September 30, 
2029, for the reimbursement of extraordinary law enforce-
ment personnel costs for protection activities directly and 
demonstrably associated with any residence of the Presi-
dent that is designated pursuant to section 3 of the Presi-
dential Protection Assistance Act of 1976 (Public Law 
94–524) to be secured by the United States Secret Serv-
ice. 
(b) AVAILABILITY.—Funds under subsection (a) shall 
be available only for costs that a State or local agency— 
(1) incurred or incurs on or after July 1, 2024; 
(2) can demonstrate to the Administrator of the 
Federal Emergency Management Agency as being— 
(A) in excess of the costs of normal and 
typical law enforcement operations; 
(B) directly attributable to the provision of 
protection described in such subsection; and 
(C) associated with a non-governmental 
property designated pursuant to section 3 of 
the Presidential Protection Assistance Act of 
1976 (Public Law 94–524) to be secured by the 
United States Secret Service; and 
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(3) certifies to the Administrator as being for 
protection activities requested by the Director of the 
United States Secret Service. 
SEC. 60006. STATE HOMELAND SECURITY GRANT PRO-
GRAM. 
In addition to amounts otherwise available, there is 
appropriated to the Administrator of the Federal Emer-
gency Management Agency, for fiscal year 2025, out of 
any money in the Treasury, not otherwise appropriated, 
to be administered under the State Homeland Security 
Grant Program authorized under section 2004 of the 
Homeland Security Act of 2002 (6 U.S.C. 605), to en-
hance State, local, and Tribal security through grants, 
contracts, cooperative agreements, and other activities, of 
which— 
(1) $500,000,000, to remain available until 
September 30, 2029, for State and local capabilities 
to detect, identify, track, or monitor threats from 
unmanned aircraft systems (as such term is defined 
in section 44801 of title 49, United States Code); 
(2) $625,000,000, to remain available until 
September 30, 2029, for security, planning, and 
other costs related to the 2026 FIFA World Cup; 
(3) $1,000,000,000, to remain available until 
September 30, 2029, for security, planning, and 
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other costs related to the 2028 Olympic Games and 
2028 Paralympic Games; and 
(4) $450,000,000, to remain available until 
September 30, 2029, for the Operation Stonegarden 
Grant Program. 
TITLE VII—COMMITTEE ON THE 
JUDICIARY 
Subtitle A—Immigration Matters 
PART 1—IMMIGRATION FEES 
SEC. 70001. APPLICABILITY OF THE IMMIGRATION LAWS. 
(a) APPLICABILITY.—Notwithstanding any provision 
of the immigration laws (as defined under section 101 of 
the Immigration and Nationality Act), the fees under this 
subtitle shall apply. 
(b) TERMS.—The terms used under this subtitle shall 
have the meanings given such terms in section 101 of the 
Immigration and Nationality Act. 
(c) REFERENCES
TO IMMIGRATION
AND NATION-
ALITY ACT.—Except as otherwise expressly provided, 
whenever this subtitle references a section or other provi-
sion, the reference shall be considered to be to a section 
or other provision of the Immigration and Nationality Act. 
SEC. 70002. ASYLUM FEE. 
(a) IN GENERAL.—In addition to any other fee au-
thorized by law, the Secretary of Homeland Security or 
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the Attorney General, as applicable, shall impose a fee in 
the amount specified in this section for a fiscal year on 
each alien who files an application for asylum under sec-
tion 208 of the Immigration and Nationality Act at the 
time such application is filed. 
(b) INITIAL AMOUNT.—The amount specified in this 
section for fiscal year 2025 shall be such amount as the 
Secretary or Attorney General, as applicable, may by rule 
provide, but in any event not less than $1,000. 
(c) SUBSEQUENT ADJUSTMENT.—Beginning in fiscal 
year 2026 and each fiscal year thereafter, the amount 
specified in this section for a fiscal year shall be equal 
to the sum of— 
(1) the amount imposed under this section for 
the prior fiscal year; and 
(2) rounded to the next lowest multiple of $10, 
the amount referred to in paragraph (1), multiplied 
by the percentage (if any) by which the Consumer 
Price Index for All Urban Consumers for the month 
of July preceding the date on which such adjustment 
takes effect exceeds the Consumer Price Index for 
All Urban Consumers for the same month of the 
preceding calendar year. 
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(d) CREDITING CERTAIN FUNDS.—During any fiscal 
year, the total amount of fees received under this section 
shall be subject to the following: 
(1) 50 percent of fees received from applica-
tions filed with the Attorney General shall be cred-
ited to the Executive Office for Immigration Review 
to retain and spend without further appropriation. 
(2) 50 percent of fees received from applica-
tions filed with the Secretary of Homeland Security 
shall be credited to U.S. Citizenship and Immigra-
tion Services and deposited into the Immigration 
Examinations Fee Account established under section 
286(m) of the Immigration and Nationality Act (8 
U.S.C. 1356(m)) to retain and spend without fur-
ther appropriation. 
(3) Any amounts not credited to the Executive 
Office for Immigration Review or U.S. Citizenship 
and Immigration Services shall be deposited into the 
general fund of the Treasury. 
(e) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
SEC. 70003. EMPLOYMENT AUTHORIZATION DOCUMENT 
FEES. 
(a) ASYLUM APPLICANTS.— 
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(1) IN GENERAL.—In addition to any other fee 
authorized by law, the Secretary of Homeland Secu-
rity shall impose on any alien who files an initial ap-
plication for employment authorization under section 
208(d)(2) of the Immigration and Nationality Act a 
fee in the amount specified in this subsection at the 
time such initial employment authorization applica-
tion is filed. Each initial employment authorization 
shall be valid for a period of not more than six 
months. 
(2) INITIAL AMOUNT.— For purposes of this 
subsection, the amount specified in this subsection 
for fiscal year 2025 shall be such amount as the 
Secretary may by rule provide, but in any event not 
less than $550. 
(3) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount for a fiscal year shall be equal to the sum 
of— 
(A) the amount imposed under this section 
for the prior fiscal year; and 
(B) rounded to the next lowest multiple of 
$10, the amount referred to in subparagraph 
(A), multiplied by the percentage (if any) by 
which the Consumer Price Index for All Urban 
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Consumers for the month of July preceding the 
date on which such adjustment takes effect ex-
ceeds the Consumer Price Index for All Urban 
Consumers for the same month of the preceding 
calendar year. 
(4) CREDITING OF FUNDS.—25 percent of fees 
received under this section shall be credited to U.S. 
Citizenship and Immigration Services and deposited 
into the Immigration Examinations Fee Account es-
tablished under section 286(m) of the Immigration 
and Nationality Act (8 U.S.C. 1356(m)) to retain 
and spend without further appropriation, of which 
50 percent shall be used by U.S. Citizenship and Im-
migration Services to detect and prevent immigra-
tion benefit fraud. Any amounts not credited to U.S. 
Citizenship and Immigration Services under this sec-
tion shall be deposited into the general fund of the 
Treasury. 
(5) NO
WAIVER.—A fee imposed under this 
subsection shall not be waived or reduced. 
(b) PAROLE.— 
(1) IN GENERAL.—In addition to any other fee 
authorized by law, the Secretary of Homeland Secu-
rity shall impose on any alien paroled into the 
United States a fee for any initial application for 
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employment authorization in an amount specified in 
this subsection at the time such initial application is 
filed. Each initial employment authorization shall be 
valid for a period of not more than six months. 
(2) INITIAL
AMOUNT.—For purposes of this 
subsection, the amount specified in this subsection 
for fiscal year 2025 shall be such amount as the 
Secretary may by rule provide, but in any event not 
less than $550. 
(3) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
(A) the amount imposed under this sub-
section for the prior fiscal year; and 
(B) rounded to the next lowest multiple of 
$10, the amount referred to in subparagraph 
(A), multiplied by the percentage (if any) by 
which the Consumer Price Index for All Urban 
Consumers for the month of July preceding the 
date on which such adjustment takes effect ex-
ceeds the Consumer Price Index for All Urban 
Consumers for the same month of the preceding 
calendar year. 
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(4) CREDITING OF FUNDS.—The fees received 
under this section shall be deposited into the general 
fund of the Treasury. 
(5) NO
WAIVER.—A fee imposed under this 
subsection shall not be waived or reduced. 
(c) TEMPORARY PROTECTED STATUS.— 
(1) IN GENERAL.—In addition to any other fee 
authorized by law, for any alien who files an initial 
application for employment authorization under sec-
tion 244(a)(1)(B) of the Immigration and Nation-
ality Act, the Secretary of Homeland Security shall 
impose a fee in an amount specified in this sub-
section at the time such initial application is filed. 
Each initial employment authorization shall be valid 
for a period of not more than six months. 
(2) INITIAL
AMOUNT.—For purposes of this 
subsection, the amount specified in this subsection 
for fiscal year 2025 shall be such amount as the 
Secretary may by rule provide, but in any event not 
less than $550. 
(3) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
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(A) the amount imposed under this sub-
section for the prior fiscal year; and 
(B) rounded to the next lowest multiple of 
$10, the amount referred to in subparagraph 
(A), multiplied by the percentage (if any) by 
which the Consumer Price Index for All Urban 
Consumers for the month of July preceding the 
date on which such adjustment takes effect ex-
ceeds the Consumer Price Index for All Urban 
Consumers for the same month of the preceding 
calendar year. 
(4) CREDITING OF CERTAIN FUNDS.—The fees 
received under this section shall be deposited into 
the general fund of the Treasury. 
(5) NO
WAIVER.—A fee imposed under this 
subsection shall not be waived or reduced. 
SEC. 70004. PAROLE FEE. 
(a) IN GENERAL.—In addition to any other fee au-
thorized by law, the Secretary of Homeland Security shall 
impose a fee in an amount specified in this section on each 
alien who is paroled into the United States, except if, as 
established by the alien, the alien is paroled because— 
(1) the alien has a medical emergency, and— 
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(A) the alien cannot obtain necessary 
treatment in the foreign state in which the alien 
is residing; or 
(B) the medical emergency is life-threat-
ening and there is insufficient time for the alien 
to be admitted to the United States through the 
normal visa process; 
(2) the alien is the parent or legal guardian of 
an alien described in paragraph (1) and the alien de-
scribed in paragraph (1) is a minor; 
(3) the alien is needed in the United States to 
donate an organ or other tissue for transplant and 
there is insufficient time for the alien to be admitted 
to the United States through the normal visa proc-
ess; 
(4) the alien has a close family member in the 
United States whose death is imminent and the alien 
could not arrive in the United States in time to see 
such family member alive if the alien were to be ad-
mitted to the United States through the normal visa 
process; 
(5) the alien is seeking to attend the funeral of 
a close family member and the alien could not arrive 
in the United States in time to attend such funeral 
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if the alien were to be admitted to the United States 
through the normal visa process; 
(6) the alien is an adopted child with an urgent 
medical condition who is in the legal custody of the 
petitioner for a final adoption-related visa and whose 
medical treatment is required before the expected 
award of a final adoption-related visa; 
(7) the alien is a lawful applicant for adjust-
ment of status under section 245 of the Immigration 
and Nationality Act and is returning to the United 
States after temporary travel abroad; 
(8) the alien is returned to a contiguous coun-
try under section 235(b)(2)(C) of the Immigration 
and Nationality Act and paroled into the United 
States to allow the alien to attend the alien’s immi-
gration hearing; 
(9) the alien— 
(A) is a national of the Republic of Cuba 
and is living in the Republic of Cuba; 
(B) is the beneficiary of an approved peti-
tion under section 203(a) of the Immigration 
and Nationality Act; 
(C) is an alien for whom an immigrant 
visa is not immediately available; 
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(D) meets all eligibility requirements for 
an immigrant visa; 
(E) is not otherwise inadmissible; and 
(F) is receiving a grant of parole in fur-
therance of the commitment of the United 
States to the minimum level of annual legal mi-
gration of Cuban nationals to the United States 
specified in the U.S.-Cuba Joint Communique´ 
on Migration, done at New York September 9, 
1994, and reaffirmed in the Cuba-United 
States: Joint Statement on Normalization of 
Migration, Building on the Agreement of Sep-
tember 9, 1994, done at New York May 2, 
1995; or 
(10) the Secretary of Homeland Security deter-
mines that a significant public benefit has resulted 
or will result from the parole of an alien only if— 
(A) the alien has assisted or will assist the 
United States Government in a law enforcement 
matter; 
(B) the alien’s presence is required by the 
Government in furtherance of such law enforce-
ment matter; and 
(C) the alien is inadmissible, does not sat-
isfy the eligibility requirements for admission as 
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a nonimmigrant, or there is insufficient time for 
the alien to be admitted to the United States 
through the normal visa process. 
(b) INITIAL AMOUNT.—For purposes of this section, 
the amount specified in this subsection for fiscal year 
2025 shall be such amount as the Secretary may by rule 
provide, but in any event not less than $1,000. 
(c) SUBSEQUENT ADJUSTMENT.—Beginning in fiscal 
year 2026 and each fiscal year thereafter, the amount 
specified in this section for a fiscal year shall be equal 
to the sum of— 
(1) the amount imposed under this section for 
the prior fiscal year; and 
(2) rounded to the next lowest multiple of $10, 
the amount referred to in paragraph (1), multiplied 
by the percentage (if any) by which the Consumer 
Price Index for All Urban Consumers for the month 
of July preceding the date on which such adjustment 
takes effect exceeds the Consumer Price Index for 
All Urban Consumers for the same month of the 
preceding calendar year. 
(d) CREDITING OF FUNDS.—Fees received under this 
section shall be deposited in the general fund of the Treas-
ury. 
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(e) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
SEC. 70005. SPECIAL IMMIGRANT JUVENILE FEE. 
(a) IN GENERAL.—In addition to any other fee au-
thorized by law, the Secretary of Homeland Security shall 
impose a fee in an amount specified in this section on any 
alien applying for special immigrant juvenile status under 
section 101(a)(27)(J) of the Immigration and Nationality 
Act if reunification with 1 parent or legal guardian is via-
ble, notwithstanding abuse, neglect, abandonment, or a 
similar basis found under State law making reunification 
with the other parent or legal guardian not viable. 
(b) INITIAL AMOUNT.—For purposes of this sub-
section, the amount specified in this section for fiscal year 
2025 shall be such amount as the Secretary may by rule 
provide, but in any event not less than $500. 
(c) SUBSEQUENT ADJUSTMENT.—Beginning in fiscal 
year 2026 and each fiscal year thereafter, the amount 
specified in this section for a fiscal year shall be equal 
to the sum of— 
(1) the amount imposed under this section for 
the prior fiscal year; and 
(2) rounded to the next lowest multiple of $10, 
the amount referred to in paragraph (1), multiplied 
by the percentage (if any) by which the Consumer 
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Price Index for All Urban Consumers for the month 
of July preceding the date on which such adjustment 
takes effect exceeds the Consumer Price Index for 
All Urban Consumers for the same month of the 
preceding calendar year. 
(d) CREDITING OF FUNDS.—Fees received under this 
section shall be deposited in the general fund of the Treas-
ury. 
(e) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
SEC. 70006. TEMPORARY PROTECTED STATUS FEE. 
(a) IN GENERAL.—In addition to any other fee au-
thorized by law, the Secretary of Homeland Security shall 
impose a fee in an amount specified in this section for 
the consideration of an application for temporary pro-
tected status under section 244 of the Immigration and 
Nationality Act on any alien who— 
(1) has not been admitted into the United 
States; or 
(2) has been admitted to the United States as 
a nonimmigrant but at the time of application for 
temporary protected status has failed— 
(A) to maintain or extend the non-
immigrant status in which the alien was admit-
ted or to which the status was changed under 
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section 248 of the Immigration and Nationality 
Act, including complying with the period of stay 
authorized by the Secretary of Homeland Secu-
rity in connection with such status; or 
(B) to comply with the conditions of such 
nonimmigrant status. 
(b) INITIAL AMOUNT.—For purposes of this sub-
section, the amount specified in this section for fiscal year 
2025 shall be such amount as the Secretary may by rule 
provide, but in any event not less than $500. 
(c) SUBSEQUENT ADJUSTMENT.—Beginning in fiscal 
year 2026 and each fiscal year thereafter, the amount 
specified in this section for a fiscal year shall be equal 
to the sum of— 
(1) the amount imposed under this section for 
the prior fiscal year; and 
(2) rounded to the next lowest multiple of $10, 
the amount referred to in paragraph (1), multiplied 
by the percentage (if any) by which the Consumer 
Price Index for All Urban Consumers for the month 
of July preceding the date on which such adjustment 
takes effect exceeds the Consumer Price Index for 
All Urban Consumers for the same month of the 
preceding calendar year. 
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(d) CREDITING OF FUNDS.—Fees received under this 
section shall be deposited in the general fund of the Treas-
ury. 
(e) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
SEC. 70007. UNACCOMPANIED ALIEN CHILD SPONSOR FEE. 
(a) IN GENERAL.—In addition to any other fee au-
thorized by law, before placing the child with an individual 
under section 235(c) of the William Wilberforce Traf-
ficking Victims Protection Reauthorization Act of 2008, 
the Secretary of Health and Human Services shall collect 
from that individual a fee in an amount specified in this 
section as partial reimbursement to the Federal Govern-
ment for the period during which the child was in the cus-
tody of the Government, for processing, housing, feeding, 
educating, transporting, and otherwise providing for the 
care of the child. 
(b) INITIAL AMOUNT.—For purposes of this sub-
section, the amount specified in this section for fiscal year 
2025 shall be such amount as the Secretary may by rule 
provide, but in any event not less than $3,500. 
(c) SUBSEQUENT ADJUSTMENT.—Beginning in fiscal 
year 2026 and each fiscal year thereafter, the amount 
specified in this section for a fiscal year shall be equal 
to the sum of— 
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(1) the amount imposed under this section for 
the prior fiscal year; and 
(2) rounded to the next lowest multiple of $10, 
the amount referred to in paragraph (1), multiplied 
by the percentage (if any) by which the Consumer 
Price Index for All Urban Consumers for the month 
of July preceding the date on which such adjustment 
takes effect exceeds the Consumer Price Index for 
All Urban Consumers for the same month of the 
preceding calendar year. 
(d) CREDITING OF FUNDS.—During any fiscal year, 
the total amount of fees received under this section shall 
be subject to the following: 
(1) 25 percent of fees received under this sec-
tion shall be credited to the Department of Health 
and Human Services to retain and spend without 
further appropriation and shall be used for the pur-
pose of conducting background checks of potential 
sponsors of unaccompanied alien children and of 
adults residing in potential sponsors’ households, 
which shall include, at a minimum— 
(A) the name of the individual and all 
adult residents of the individual’s household; 
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(B) the social security number of the indi-
vidual and all adult residents of the individual’s 
household; 
(C) the date of birth of the individual and 
all adult residents of the individual’s household; 
(D) the validated location of the individ-
ual’s residence where the child will be placed; 
(E) the immigration status of the indi-
vidual and all adult residents of the individual’s 
household; 
(F) contact information for the individual 
and all adult residents of the individual’s house-
hold; and 
(G) the results of all background and 
criminal records checks for the individual and 
all adult residents of the individual’s household, 
which shall include at a minimum an investiga-
tion of the public records sex offender registry, 
a public records background check, and a na-
tional criminal history check based on finger-
prints. 
(2) Any amounts not credited to the Depart-
ment of Health and Human Services shall be depos-
ited into the general fund of the Treasury. 
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(e) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
SEC. 70008. VISA INTEGRITY FEE. 
(a) VISA INTEGRITY FEE.— 
(1) IN GENERAL.—In addition to any other fee 
authorized by law, the Secretary of Homeland Secu-
rity shall impose a fee in an amount specified in this 
subsection on each alien issued a nonimmigrant visa 
upon the issuance of such alien’s nonimmigrant visa. 
(2) INITIAL
AMOUNT.—For purposes of this 
subsection, the amount specified in this subsection 
for fiscal year 2025 shall be such amount as the 
Secretary may by rule provide, but in any event not 
less than $250. 
(3) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
(A) the amount imposed under this section 
for the prior fiscal year; and 
(B) rounded to the next lowest multiple of 
$1, the amount referred to in subparagraph 
(A), multiplied by the percentage (if any) by 
which the Consumer Price Index for All Urban 
Consumers for the month of July preceding the 
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date on which such adjustment takes effect ex-
ceeds the Consumer Price Index for All Urban 
Consumers for the same month of the preceding 
calendar year. 
(4) CREDITING OF FUNDS.—The fees received 
under this subsection that are not reimbursed in ac-
cordance with subsection (b) shall be deposited in 
the general fund of the Treasury. 
(5) NO
WAIVER.—A fee imposed under this 
subsection shall not be waived or reduced. 
(b) FEE REIMBURSEMENT.—The Secretary of Home-
land Security may reimburse to an alien a fee imposed 
under this section on that alien for the issuance of a non-
immigrant visa after the expiration of such nonimmigrant 
visa’s period of validity if the alien demonstrates that— 
(1) the alien has not sought admission during 
such period of validity; 
(2) the alien, after admission to the United 
States pursuant to such nonimmigrant visa, com-
plied with all conditions of such nonimmigrant visa, 
including the condition that an alien shall not accept 
unauthorized employment, and that the alien de-
parted the United States not later than 5 days after 
the date on which the alien was authorized to re-
main in the United States; or 
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(3) the alien filed to extend, change, or adjust 
such status within the nonimmigrant visa’s period of 
validity. 
SEC. 70009. FORM I–94 FEE. 
(a) FEE AUTHORIZED.—In addition to any other fee 
authorized by law, the Secretary of Homeland Security 
shall impose a fee in an amount specified in subsection 
(b) on any alien upon the alien’s application for a Form 
I–94 Arrival/Departure Record. 
(b) FEE SPECIFIED.— 
(1) INITIAL AMOUNT.—The amount specified in 
this subsection for fiscal year 2025 shall be such 
amount as the Secretary may by rule provide, but in 
any event not less than $24. 
(2) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
(A) the amount imposed under this section 
for the prior fiscal year; and 
(B) the amount referred to in subpara-
graph (A), multiplied by the percentage (if any) 
by which the Consumer Price Index for All 
Urban Consumers for the month of July pre-
ceding the date on which such adjustment takes 
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effect exceeds the Consumer Price Index for All 
Urban Consumers for the same month of the 
preceding calendar year. 
(c) CREDITING OF FUNDS.—During any fiscal year, 
the total amount of fees received under this section shall 
be subject to the following: 
(1) 20 percent of the fee collected under this 
section for each application shall be deposited pursu-
ant to section 286(q)(2) of the Immigration and Na-
tionality Act (8 U.S.C. 1356(q)(2)) and made avail-
able to U.S. Customs and Border Protection to re-
tain and spend without further appropriation for the 
purpose of processing Form I–94. 
(2) Any amounts not credited to U.S. Customs 
and Border Protection shall be deposited in the gen-
eral fund of the Treasury. 
(d) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
SEC. 70010. YEARLY ASYLUM FEE. 
(a) FEE AUTHORIZED.—In addition to any other fee 
authorized by law, for each calendar year that an alien’s 
application for asylum remains pending, the Secretary of 
Homeland Security or the Attorney General, as applicable, 
shall impose a fee in an amount specified in subsection 
(b) on that alien. 
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(b) FEE SPECIFIED.— 
(1) INITIAL AMOUNT.—The amount specified in 
this subsection for fiscal year 2025 shall be such 
amount as the Secretary and the Attorney General 
may by rule provide, but in any event not less than 
$100. 
(2) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
(A) the amount imposed under this section 
for the prior fiscal year; and 
(B) the amount referred to in subpara-
graph (A), multiplied by the percentage (if any) 
by which the Consumer Price Index for All 
Urban Consumers for the month of July pre-
ceding the date on which such adjustment takes 
effect exceeds the Consumer Price Index for All 
Urban Consumers for the same month of the 
preceding calendar year. 
(c) CREDITING OF FUNDS.—The fees received under 
this section shall be deposited in the general fund of the 
Treasury. 
(d) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
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SEC. 70011. FEE FOR CONTINUANCES GRANTED IN IMMI-
GRATION COURT PROCEEDINGS. 
(a) IN GENERAL.—In addition to any other fee au-
thorized by law, the Attorney General shall impose a fee 
in an amount specified in subsection (b) on any alien who 
requests and is granted a continuance by an immigration 
judge for each such continuance. 
(b) FEE SPECIFIED.— 
(1) INITIAL AMOUNT.—The amount specified in 
this subsection for fiscal year 2025 shall be such 
amount as the Attorney General may by rule pro-
vide, but in any event not less than $100. 
(2) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
(A) the amount imposed under this section 
for the prior fiscal year; and 
(B) the amount referred to in subpara-
graph (A), multiplied by the percentage (if any) 
by which the Consumer Price Index for All 
Urban Consumers for the month of July pre-
ceding the date on which such adjustment takes 
effect exceeds the Consumer Price Index for All 
Urban Consumers for the same month of the 
preceding calendar year. 
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(c) CREDITING OF CERTAIN FUNDS.—Amounts re-
ceived as fees under this section shall be deposited in the 
general fund of the Treasury. 
(d) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced, except no fee shall be im-
posed on any alien whose request for a continuance is 
granted based on exceptional circumstances (as such term 
is defined in section 240 of the Immigration and Nation-
ality Act). 
SEC. 70012. FEE RELATING TO RENEWAL AND EXTENSION 
OF EMPLOYMENT AUTHORIZATION FOR PA-
ROLEES. 
(a) FEE IMPOSED.—In addition to any other fee au-
thorized by law, for a parolee who seeks a renewal or ex-
tension of employment authorization based on a grant of 
parole, the Secretary of Homeland Security shall impose 
a fee in an amount specified in subsection (b). 
(b) FEE SPECIFIED.— 
(1) INITIAL AMOUNT.—The amount specified in 
this subsection for fiscal year 2025 shall be such 
amount as the Secretary may by rule provide, but in 
any event not less than $550. 
(2) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
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amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
(A) the amount imposed under this sub-
section for the prior fiscal year; and 
(B) rounded to the next lowest multiple of 
$10, the amount referred to in subparagraph 
(A), multiplied by the percentage (if any) by 
which the Consumer Price Index for All Urban 
Consumers for the month of July preceding the 
date on which such adjustment takes effect ex-
ceeds the Consumer Price Index for All Urban 
Consumers for the same month of the preceding 
calendar year. 
(c) IN GENERAL.—The employment authorization for 
any alien paroled into the United States, or any renewal 
or extension thereof, shall be valid for a period of not more 
than six months. 
(d) CREDITING OF FUNDS.—The fees received under 
this section shall be deposited into the general fund of the 
Treasury. 
(e) NO WAIVER.—A fee imposed under this sub-
section shall not be waived or reduced. 
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SEC. 70013. FEE RELATING TO TERMINATION, RENEWAL, 
AND EXTENSION OF EMPLOYMENT AUTHOR-
IZATION FOR ASYLUM APPLICANTS. 
(a) FEE IMPOSED.—In addition to any other fee au-
thorized by law, for any alien who applies for asylum and 
who seeks a renewal or extension of employment author-
ization based on such application, the Secretary of Home-
land Security shall impose a fee of not less than $550 for 
each such renewal or extension, in accordance with sub-
section (b). 
(b) EMPLOYMENT AUTHORIZATION.—The Secretary 
of Homeland Security may provide employment authoriza-
tion to an applicant for asylum for a period of not more 
than six months. Each renewal or extension thereof shall 
also be valid for a period of not more than six months. 
(c) TERMINATION.—Each initial employment author-
ization, or renewal or extension of such authorization, 
shall terminate as follows: 
(1) Immediately following the denial of an asy-
lum application by an asylum officer, unless the case 
is referred to an immigration judge. 
(2) On the date that is 30 days after the date 
on which an immigration judge denies an asylum ap-
plication, unless the alien makes a timely appeal to 
the Board of Immigration Appeals. 
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(3) Immediately following the denial by the 
Board of Immigration Appeals of an appeal of a de-
nial of an asylum application. 
(d) PROHIBITION.—The Secretary of Homeland Se-
curity shall not grant, renew, or extend employment au-
thorization to an alien if the alien was previously granted 
employment authorization as an applicant for asylum and 
the employment authorization was terminated pursuant to 
a circumstance described in subsection (c), unless a Fed-
eral Court of Appeals remands the alien’s case to the 
Board of Immigration Appeals. 
(e) CREDITING OF FUNDS.—The total amount of fees 
received under this section shall be deposited in the gen-
eral fund of the Treasury. 
(f) NO WAIVER.—A fee imposed under this sub-
section shall not be waived or reduced. 
SEC. 70014. FEE RELATING TO RENEWAL AND EXTENSION 
OF 
EMPLOYMENT 
AUTHORIZATION 
FOR 
ALIENS GRANTED TEMPORARY PROTECTED 
STATUS. 
(a) FEE IMPOSED.—In addition to any other fee au-
thorized by law, for any alien who seeks a renewal or ex-
tension of employment authorization based on a grant of 
temporary protected status, the Secretary of Homeland 
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Security shall impose a fee in an amount specified in sub-
section (b) at the time of each such renewal or extension. 
(b) FEE SPECIFIED.— 
(1) INITIAL AMOUNT.—The amount specified in 
this subsection for fiscal year 2025 shall be such 
amount as the Secretary may by rule provide, but in 
any event not less than $550. 
(2) SUBSEQUENT ADJUSTMENT.—Beginning in 
fiscal year 2026 and each fiscal year thereafter, the 
amount specified in this subsection for a fiscal year 
shall be equal to the sum of— 
(A) the amount imposed under this sub-
section for the prior fiscal year; and 
(B) rounded to the next lowest multiple of 
$10, the amount referred to in subparagraph 
(A), multiplied by the percentage (if any) by 
which the Consumer Price Index for All Urban 
Consumers for the month of July preceding the 
date on which such adjustment takes effect ex-
ceeds the Consumer Price Index for All Urban 
Consumers for the same month of the preceding 
calendar year. 
(c) EMPLOYMENT AUTHORIZATION.—Any employ-
ment authorization for an alien granted temporary pro-
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tected status, or any renewal or extension thereof, shall 
be valid for a period of not more than six months. 
(d) CREDITING OF FUNDS.—The fees received under 
this section shall be deposited into the general fund of the 
Treasury. 
(e) NO WAIVER.—A fee imposed under this sub-
section shall not be waived or reduced. 
SEC. 70015. DIVERSITY IMMIGRANT VISA FEES. 
(a) FEE FOR FILING A DIVERSITY IMMIGRANT VISA 
APPLICATION.— 
(1) IN GENERAL.—In addition to any other fee 
authorized by law, the Secretary of Homeland Secu-
rity shall impose a fee on any alien who files an ap-
plication for a diversity immigrant visa as described 
in section 203(c) of the Immigration and Nationality 
Act (8 U.S.C. 1153(c)), in the amount specified in 
this subsection at the time such application is filed. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Secretary may by rule 
provide, but in any event not less than $400. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
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section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(b) FEE FOR ALIENS WHO REGISTER FOR THE DI-
VERSITY IMMIGRANT VISA PROGRAM.— 
(1) IN GENERAL.—In addition to any other fee 
authorized by law, the Secretary of Homeland Secu-
rity shall impose a fee on any alien who registers for 
the diversity immigrant visa program, as described 
in section 203(c) of the Immigration and Nationality 
Act (8 U.S.C. 1153(c)), in the amount specified in 
this subsection at the time of registration. 
(2) FEE SPECIFIED.— 
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(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Secretary may by rule 
provide, but in any event not less than $250. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) the amount referred to in clause 
(i), multiplied by the percentage (if any) by 
which the Consumer Price Index for All 
Urban Consumers for the month of July 
preceding the date on which such adjust-
ment takes effect exceeds the Consumer 
Price Index for All Urban Consumers for 
the same month of the preceding calendar 
year. 
(c) FUNDS.—During any fiscal year, the total 
amount of fees received under this section shall be subject 
to the following: 
(1) 10 percent of fees received shall be used to 
detect and prevent fraud in the diversity immigrant 
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visa program and to offset costs associated with 
such program. 
(2) 10 percent of fees received shall be credited 
to U.S. Immigration and Customs Enforcement to 
retain and spend without further appropriation for 
the purpose of detention and immigration enforce-
ment and removal operations. 
(3) Any amounts not used or credited under 
this subsection shall be deposited into the general 
fund of the Treasury. 
(d) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
SEC. 70016. EOIR FEES. 
(a) FEE FOR FILING AN APPLICATION TO ADJUST 
STATUS
TO THAT
OF
A LAWFUL PERMANENT RESI-
DENT.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files with an immigration court an 
application to adjust the alien’s status to that of a 
lawful permanent resident, or whose application to 
adjust status to that of a lawful permanent resident 
is adjudicated in immigration court, a fee in the 
amount specified in this subsection at the time such 
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application is filed, or, as applicable, prior to the ad-
judication of such application in immigration court. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$1,500. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
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(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 50 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(b) FEE FOR FILING AN APPLICATION FOR WAIVER 
OF GROUNDS OF INADMISSIBILITY.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files with an immigration court an 
application for waiver of grounds of inadmissibility, 
or whose application for waiver of grounds of inad-
missibility is adjudicated in immigration court, a fee 
in the amount specified in this subsection at the 
time such application is filed, or, as applicable, prior 
to the adjudication of such application in immigra-
tion court. 
(2) FEE SPECIFIED.— 
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HR 1 PCS
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$1,050. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
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490 
HR 1 PCS
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(c) FEE FOR FILING AN APPLICATION FOR TEM-
PORARY PROTECTED STATUS.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files with an immigration court an 
application for temporary protected status, or whose 
application for temporary protected status is adju-
dicated in immigration court, a fee in the amount 
specified in this subsection at the time such applica-
tion is filed or, as applicable, prior to the adjudica-
tion of such application in immigration court. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$500. 
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HR 1 PCS
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
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492 
HR 1 PCS
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(d) FEE FOR FILING AN APPEAL FROM A DECISION 
OF AN IMMIGRATION JUDGE.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files any appeal from a decision of 
an immigration judge a fee in the amount specified 
in this subsection at the time such appeal is filed. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$900. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
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493 
HR 1 PCS
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) EXCEPTION.—The fee described in this sec-
tion shall not apply to the appeal of a bond decision. 
(4) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(e) FEE FOR FILING AN APPEAL FROM A DECISION 
OF AN OFFICER OF THE DEPARTMENT OF HOMELAND 
SECURITY.— 
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HR 1 PCS
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files an appeal from a decision of 
an officer of the Department of Homeland Security 
a fee in the amount specified in this subsection at 
the time such appeal is filed. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$900. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
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495 
HR 1 PCS
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of Immigra-
tion and Nationality and credited to the Executive 
Office for Immigration Review to retain and spend 
without further appropriation. Any amounts not 
credited under the previous sentence shall be depos-
ited into the general fund of the Treasury. 
(f) FEE FOR FILING AN APPEAL FROM A DECISION 
OF AN ADJUDICATING OFFICIAL IN A PRACTITIONER DIS-
CIPLINARY CASE.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any practitioner who files an appeal from a deci-
sion of an adjudicating official in a practitioner dis-
ciplinary case a fee in the amount specified in this 
subsection at the time such appeal is filed. 
(2) FEE SPECIFIED.— 
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496 
HR 1 PCS
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$1,325. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
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497 
HR 1 PCS
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(g) FEE FOR FILING A MOTION TO REOPEN OR A 
MOTION TO RECONSIDER.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files a motion to reopen or motion 
to reconsider a decision of an immigration judge or 
the Board of Immigration Appeals a fee in the 
amount specified in this subsection at the time such 
motion is filed. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$900. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
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498 
HR 1 PCS
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) EXCEPTIONS.—The fee described in this 
section shall not apply to any motion that is: 
(A) a motion to reopen a removal order en-
tered in absentia if the motion is filed under 
section 240(b)(5)(C)(ii) of the Immigration and 
Nationality Act; or 
(B) a motion to reopen a deportation order 
entered in absentia if the motion is filed under 
section 242B(c)(3)(B) of the Immigration and 
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499 
HR 1 PCS
Nationality Act, as the section existed prior to 
April 1, 1997. 
(4) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(h) FEE FOR FILING AN APPLICATION FOR SUSPEN-
SION OF DEPORTATION.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files with an immigration court an 
application for suspension of deportation a fee in the 
amount specified in this subsection at the time such 
application is filed. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
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500 
HR 1 PCS
by rule provide, but in any event not less than 
$600. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
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501 
HR 1 PCS
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(i) FEE FOR FILING AN APPLICATION FOR CAN-
CELLATION
OF REMOVAL
FOR CERTAIN PERMANENT 
RESIDENTS.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files with an immigration court an 
application for cancellation of removal for certain 
permanent residents a fee in the amount specified in 
this subsection at the time such application is filed. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$600. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
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HR 1 PCS
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
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503 
HR 1 PCS
(j) FEE FOR FILING AN APPLICATION FOR CAN-
CELLATION OF REMOVAL AND ADJUSTMENT OF STATUS 
FOR CERTAIN NONPERMANENT RESIDENTS.— 
(1) IN GENERAL.—In addition to any other fees 
authorized by law, the Attorney General shall impose 
on any alien who files with an immigration court an 
application for cancellation of removal and adjust-
ment of status for certain nonpermanent residents a 
fee in the amount specified in this subsection at the 
time such application is filed. 
(2) FEE SPECIFIED.— 
(A) INITIAL AMOUNT.—The amount speci-
fied in this subsection for fiscal year 2025 shall 
be such amount as the Attorney General may 
by rule provide, but in any event not less than 
$1,500. 
(B) SUBSEQUENT
ADJUSTMENT.—Begin-
ning in fiscal year 2026 and each fiscal year 
thereafter, the amount specified in this sub-
section for a fiscal year shall be equal to the 
sum of— 
(i) the amount imposed under this 
subsection for the prior fiscal year; and 
(ii) rounded to the next lowest mul-
tiple of $10, the amount referred to in 
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504 
HR 1 PCS
clause (i), multiplied by the percentage (if 
any) by which the Consumer Price Index 
for All Urban Consumers for the month of 
July preceding the date on which such ad-
justment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
sumers for the same month of the pre-
ceding calendar year. 
(3) CREDITING CERTAIN FUNDS.—During any 
fiscal year, not more than 25 percent of the total 
amount of fees received under this section shall be 
derived by transfer from the Immigration Examina-
tions Fee Account under section 286(n) of the Im-
migration and Nationality Act and credited to the 
Executive Office for Immigration Review to retain 
and spend without further appropriation. Any 
amounts not credited under the previous sentence 
shall be deposited into the general fund of the 
Treasury. 
(k) NO WAIVER.—Any fee imposed under this section 
shall not be waived or reduced. 
(l) CONDITION ON FUNDS.—No fees received under 
this section shall be used to fund the Legal Orientation 
Program or any successor program. 
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505 
HR 1 PCS
SEC. 70017. ESTA FEE. 
Section 217(h)(3)(B) of the Immigration and Nation-
ality Act (8 U.S.C. 1187(h)(3)(B)) is amended— 
(1) in clause (i)— 
(A) in subclause (I), by striking ‘‘and’’ at 
the end; 
(B) in subclause (II)— 
(i) by inserting after ‘‘an amount’’ the 
following ‘‘of not less than $10’’; and 
(ii) by striking the period at the end 
and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(III) not less than $13.’’; 
(2) in clause (ii)— 
(A) by striking ‘‘Amounts collected under 
clause (i)(I)’’ and inserting the following: 
‘‘(I) 
IN
GENERAL.—Of 
the 
amounts collected under clause (i)(I) 
during a fiscal year, not more than 
$20,000,000’’; 
(B) by inserting before the period at the 
end of the first sentence the following: ‘‘, and 
the remainder of the amounts collected under 
clause (i)(I) shall be deposited in the general 
fund of the Treasury’’; and 
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HR 1 PCS
(C) by inserting after ‘‘to pay the costs in-
curred to administer the System.’’ the fol-
lowing: ‘‘Amounts collected under clause (i)(III) 
shall be deposited in the general fund of the 
Treasury.’’; 
(3) in clause (iii), by striking ‘‘2028’’ and in-
serting ‘‘2034’’; and 
(4) by adding at the end the following: 
‘‘(iv) SUBSEQUENT
ADJUSTMENT.— 
Beginning in fiscal year 2026 and each fis-
cal year thereafter, the amount specified in 
clause (i)(II) for a fiscal year shall be 
equal to the sum of— 
‘‘(I) the amount imposed under 
this subsection for the prior fiscal 
year; and 
‘‘(II) the amount referred to in 
subclause (I), multiplied by the per-
centage (if any) by which the Con-
sumer Price Index for All Urban Con-
sumers for the month of July pre-
ceding the date on which such adjust-
ment takes effect exceeds the Con-
sumer Price Index for All Urban Con-
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HR 1 PCS
sumers for the same month of the 
preceding calendar year.’’. 
SEC. 70018. IMMIGRATION USER FEES. 
Section 286 of the Immigration and Nationality Act 
(8 U.S.C. 1356) is amended— 
(1) in subsection (d)— 
(A) by striking ‘‘In addition to any other 
fee’’ and inserting the following: 
‘‘(1) IN GENERAL.—In addition to any other 
fee’’; 
(B) by inserting ‘‘and except as provided 
in subsection (e),’’ before ‘‘the Attorney General 
shall charge and collect’’; 
(C) by striking ‘‘$7’’ and inserting ‘‘a fee 
in an amount specified in paragraph (2)’’; and 
(D) by adding at the end the following: 
‘‘(2) INITIAL AMOUNT.—For purposes of this 
section, the amount specified in this section for fis-
cal year 2025 shall be not less than $10. 
‘‘(3) SUBSEQUENT
ADJUSTMENT.—Beginning 
in fiscal year 2026 and each fiscal year thereafter, 
the amount specified in this subsection for a fiscal 
year shall be equal to the sum of— 
‘‘(A) the amount imposed under this sub-
section for the prior fiscal year; and 
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HR 1 PCS
‘‘(B) rounded to the next lowest multiple 
of $0.25, the amount referred to in subpara-
graph (A), multiplied by the percentage (if any) 
by which the Consumer Price Index for All 
Urban Consumers for the month of July pre-
ceding the date on which such adjustment takes 
effect exceeds the Consumer Price Index for All 
Urban Consumers for the same month of the 
preceding calendar year. 
‘‘(4) CREDITING
OF
AMOUNTS.—Of amounts 
collected under this subsection $1 per individual for 
immigration inspection or preinspection as described 
in this subsection shall be deposited in the general 
fund of the Treasury. 
‘‘(5) NO WAIVER.—A fee imposed under this 
subsection shall not be waived or reduced.’’; and 
(2) in subsection (e)— 
(A) by striking paragraph (1); 
(B) by redesignating paragraphs (2) and 
(3) as paragraphs (1) and (2); and 
(C) in paragraph (2) (as redesignated by 
subparagraph (B) above), by striking ‘‘The At-
torney General shall charge’’ and all that fol-
lows through ‘‘this requirement shall not apply 
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HR 1 PCS
to’’ and inserting the following: ‘‘No fee shall be 
charged under subsection (d) for’’. 
SEC. 70019. EVUS FEE. 
(a) IN GENERAL.— In addition to any other fee au-
thorized by law, the Secretary of Homeland Security shall 
impose on any alien subject to the Electronic Visa Update 
System a fee in the amount specified in this section at 
the time of such alien’s enrollment in the Electronic Visa 
Update System. 
(b) AMOUNT.—For purposes of this section, the 
amount specified in this section for fiscal year 2025 shall 
be such amount as the Secretary may by rule provide, but 
in any event not less than $30. 
(c) SUBSEQUENT ADJUSTMENT.—Beginning in fiscal 
year 2026 and each fiscal year thereafter, the amount 
specified in this section for a fiscal year shall be equal 
to the sum of— 
(1) the amount imposed under this section for 
the prior fiscal year; and 
(2) rounded to the next lowest multiple of 
$0.25, the amount referred to in paragraph (1), 
multiplied by the percentage (if any) by which the 
Consumer Price Index for All Urban Consumers for 
the month of July preceding the date on which such 
adjustment takes effect exceeds the Consumer Price 
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Index for All Urban Consumers for the same month 
of the preceding calendar year. 
(d) CREDITING OF FUNDS.— 
(1) IN GENERAL.—The fees received under this 
section shall be deposited into the CBP Electronic 
Visa Update System Account, less $5 per enrollment 
which shall be deposited into the general fund of the 
Treasury. 
(2) ESTABLISHMENT.—There is hereby estab-
lished in the Treasury of the United States a sepa-
rate account which shall be known as the ‘‘CBP 
Electronic Visa Update System Account’’. 
(3) APPROPRIATION.— Amounts deposited in 
the CBP Electronic Visa Update System Account 
are hereby appropriated to make payments and off-
set program costs as specified in this section without 
further appropriation necessary and shall remain 
available until expended for any U.S. Customs and 
Border Protection costs associated with admin-
istering the Electronic Visa Update System. 
(e) NO WAIVER.—A fee imposed under this section 
shall not be waived or reduced. 
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