cent shall be available for the costs of administering the 
grant program established under this section, for each of 
the fiscal years 2018 through 2022. 
SEC. 303. EXTENSION AND IMPROVEMENT OF NEW MAR-
KETS TAX CREDIT. 
(a) EXTENSION.—Section 45D(f)(1) of the Internal 
Revenue Code of 1986 is amended by adding ‘‘, and’’ at 
the end of subparagraph (F), by striking the period at 
the end of subparagraph (G) and inserting ‘‘, and’’, and 
by adding at the end the following new subparagraph: 
‘‘(H) $10,000,000,000 for each of calendar 
years 2020 through 2029.’’. 
(b) DEGREE OF DISTRESS OF TARGETED COMMU-
NITY TAKEN INTO ACCOUNT IN MAKING ALLOCATIONS.— 
(1) IN GENERAL.—Section 45D(f)(2) of such 
Code is amended by inserting the following after the 
first sentence: ‘‘In making allocations under this 
paragraph, the Secretary shall take into account the 
entity’s business strategy, community impact, man-
agement capacity, and capitalization strategy, and 
the degree of distress of the communities served by 
the entity.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
45D(f)(2) of such Code is amended by striking 
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‘‘under the preceding sentence’’ and inserting 
‘‘under this paragraph’’. 
(c) INCREASED CREDIT FOR INVESTMENTS IN COM-
MUNITY DEVELOPMENT ENTITIES SERVING DISTRESSED 
COMMUNITIES.—Section 45D of such Code is amended by 
redesignating subsections (h) and (i) as subsections (i) 
and (j), respectively, and by inserting after subsection (g) 
the following new subsection: 
‘‘(h) INCREASED CREDIT FOR INVESTMENTS IN COM-
MUNITY DEVELOPMENT ENTITIES SERVING DISTRESSED 
COMMUNITIES.— 
‘‘(1) IN GENERAL.—In the case of a qualified 
equity investment in a qualified distressed commu-
nity development entity, subsection (a)(2) shall be 
applied— 
‘‘(A) by substituting ‘6 percent’ for ‘5 per-
cent’ in subparagraph (A), and 
‘‘(B) by substituting ‘7 percent’ for ‘6 per-
cent’ in subparagraph (B). 
‘‘(2) QUALIFIED DISTRESSED COMMUNITY DE-
VELOPMENT
ENTITY.—For purposes of this sub-
section— 
‘‘(A) IN
GENERAL.—The term ‘qualified 
distressed 
community 
development 
entity’ 
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means any qualified community development 
entity if— 
‘‘(i) a substantial portion of the serv-
ices and investment capital provided by 
such entity is provided with respect to dis-
tressed communities, and 
‘‘(ii) such entity is certified by the 
Secretary for purposes of this section as 
being a qualified distressed community de-
velopment entity. 
‘‘(B) DISTRESSED COMMUNITY.—The term 
‘distressed community’ means any population 
census tract (or equivalent county division with-
in the meaning of subsection (e)(3)) which 
would be a low-income community if— 
‘‘(i) subsection (e)(1)(A) were applied 
by substituting ‘30 percent’ for ‘20 per-
cent’, and 
‘‘(ii) subsection (e)(1)(B) were applied 
by substituting ‘60 percent’ for ‘80 per-
cent’ each place it appears.’’. 
(d) EFFECTIVE DATES.— 
(1) EXTENSION.—The amendments made by 
subsection (a) shall apply to calendar years after 
2019. 
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(2) DEGREE OF DISTRESS OF TARGETED COM-
MUNITY TAKEN INTO ACCOUNT IN MAKING ALLOCA-
TIONS.—The amendments made by subsection (b) 
shall apply to allocations made by the Secretary 
after the date of the enactment of this Act. 
(3) INCREASED CREDIT FOR INVESTMENTS IN 
COMMUNITY DEVELOPMENT ENTITIES SERVING DIS-
TRESSED COMMUNITIES.—The amendments made by 
subsection (c) shall apply to qualified equity invest-
ments acquired at original issue after the date of the 
enactment of this Act. 
SEC. 304. RACE TO THE SHOP. 
(a) PROGRAM AUTHORIZED.—From the amounts ap-
propriated under subsection (e), the Secretary of Labor 
shall award grants, on a competitive basis, to eligible enti-
ties to increase and improve skills training for current and 
prospective workers in highly-skilled industries. 
(b) APPLICATION.—To receive a grant under this sec-
tion, an eligible entity shall submit to the Secretary an 
application at such time, in such manner, and containing 
such information as the Secretary may require, which shall 
include the following: 
(1) A bold economic plan for the eligible entity 
that builds on the special assets and strengths of the 
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entity in highly-skilled industries, as such assets and 
strengths are determined by the entity. 
(2) An identification and prioritization of key 
weaknesses or barriers (such as lack of strong voca-
tional education or skills training system, or absence 
of customized training for industrial firms and sec-
tors), as determined by the eligible entity, to suc-
cessfully implementing such plan. 
(3) A description of strategies that will carry 
out the plan through projects and investments, with 
deep and sustainable involvement of highly-skilled 
industries. 
(4) A description of how other Federal and 
non-Federal funds will be leverage in support of 
such strategies. 
(5) A description of how the eligible entity will 
reform the entity’s policies or governance in support 
of such strategies. 
(c) USE OF FUNDS.—An eligible entity that receives 
a grant under this section shall use such grant to carry 
out the entity’s bold economic plan described in subsection 
(b)(1). 
(d) LIMITATION.—An eligible entity may not receive 
assistance from more than 1 grant awarded under this 
section for a fiscal year. 
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(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated $25,000,000 for each 
of fiscal years 2018 through 2022. 
(f) DEFINITIONS.—In this Act: 
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a State or unit of general local govern-
ment. 
(2) HIGHLY-SKILLED
INDUSTRY.—The term 
‘‘highly-skilled industry’’ includes the manufacturing 
industry. 
(3) WIOA TERMS.—The terms ‘‘State’’ and 
‘‘unit of general local government’’ have the mean-
ings given the terms in section 3 of the Workforce 
Investment and Opportunity Act (29 U.S.C. 3102). 
TITLE IV—EXPANDED ACCESS 
TO CARE 
SEC. 401. STUDY ON THE UNINSURED. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall— 
(1) conduct a study, in accordance with the 
standards under section 3101 of the Public Health 
Service Act (42 U.S.C. 300kk), on the demographic 
characteristics of the population of individuals who 
do not have health insurance coverage; 
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(2) include in such study an analysis of the 
usage by such population of emergency room and ur-
gent care facilities; and 
(3) predict, based on such study, the demo-
graphic characteristics of the population of individ-
uals who would remain without health insurance cov-
erage after the end of open enrollment or any special 
enrollment period. 
(b) REPORTING REQUIREMENTS.— 
(1) IN GENERAL.—Not later than 12 months 
after the date of the enactment of this Act, the Sec-
retary shall submit to the Congress the results of 
the study under subsection (a) and the prediction 
made under subsection (a)(3). 
(2) REPORTING OF DEMOGRAPHIC CHARACTER-
ISTICS.—The Secretary shall report the demographic 
characteristics under paragraphs (1), (2), and (3) of 
subsection (a) on the basis of racial and ethnic 
group, and shall stratify the reporting on each racial 
and ethnic group by other demographic characteris-
tics that can impact access to health insurance cov-
erage, such as sexual orientation, gender identity, 
primary language, disability status, sex, socio-
economic status, age group, and citizenship and im-
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migration status, in a manner consistent with title 
I of this Act. 
SEC. 402. VOLUNTEER DENTAL PROJECTS AND ACTION FOR 
DENTAL HEALTH PROGRAM. 
Part B of title III of the Public Health Service Act 
is revised by amending section 317M (42 U.S.C. 247b– 
14) as follows: 
(1) by redesignating subsections (e) and (f) as 
(g) and (h), respectively; 
(2) by inserting after subsection (d), the fol-
lowing: 
‘‘(e) GRANTS TO SUPPORT VOLUNTEER DENTAL 
PROJECTS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, may award grants to or 
enter into contracts with eligible entities to obtain 
portable or mobile dental equipment, and pay for ap-
propriate operational costs, for the provision of free 
dental services to underserved populations that are 
delivered in a manner consistent with State licensing 
laws. 
‘‘(2) ELIGIBLE ENTITY.—In this subsection, the 
term ‘eligible entity’ includes a State or local dental 
association, a State oral health program, a dental 
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education, dental hygiene education, or postdoctoral 
dental education program accredited by the Commis-
sion on Dental Accreditation, and a community- 
based organization that partners with an academic 
institution, that— 
‘‘(A) is exempt from tax under section 
501(c) of the Internal Revenue Code of 1986; 
and 
‘‘(B) offers a free dental services program 
for underserved populations. 
‘‘(f) ACTION FOR DENTAL HEALTH PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, may award grants to or 
enter into contracts with eligible entities to collabo-
rate with State, county, or local public officials and 
other stakeholders to develop and implement initia-
tives to accomplish any of the following goals: 
‘‘(A) To improve oral health education and 
dental disease prevention, including community- 
wide prevention programs, use of dental 
sealants and fluoride varnish, and increasing 
oral health literacy. 
‘‘(B) To make the health care delivery sys-
tem providing dental services more accessible 
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and efficient through the development and ex-
pansion of outreach programs that will facili-
tate the establishment of dental homes for chil-
dren and adults, including the aged, blind, and 
disabled populations. 
‘‘(C) To reduce geographic, language, cul-
tural, and similar barriers in the provision of 
dental services. 
‘‘(D) To help reduce the use of emergency 
departments by those who seek dental services 
more appropriately delivered in a dental pri-
mary care setting. 
‘‘(E) To facilitate the provision of dental 
care to nursing home residents who are dis-
proportionately affected by lack of care. 
‘‘(2) ELIGIBLE ENTITY.—In this subsection, the 
term ‘eligible entity’ includes a State or local dental 
association, a State oral health program, or a dental 
education, dental hygiene, or postdoctoral dental 
education program accredited by the Commission on 
Dental Accreditation, and a community-based orga-
nization that partners with an academic institution, 
that— 
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‘‘(A) is exempt from tax under section 
501(c) of the Internal Revenue Code of 1986; 
and 
‘‘(B) partners with public and private 
stakeholders to facilitate the provision of dental 
services for underserved populations.’’; and 
(3) in subsection (h), as redesignated by para-
graph (1), by striking ‘‘fiscal years 2001 through 
2005’’ and inserting ‘‘fiscal years 2016 through 
2020’’. 
SEC. 403. CRITICAL ACCESS HOSPITAL IMPROVEMENTS. 
(a) ELIMINATION OF ISOLATION TEST FOR COST- 
BASED AMBULANCE REIMBURSEMENT.— 
(1) IN
GENERAL.—Section 1834(l)(8) of the 
Social Security Act (42 U.S.C. 1395m(l)(8)) is 
amended— 
(A) in subparagraph (B)— 
(i) by striking ‘‘owned and’’; and 
(ii) by inserting ‘‘(including when 
such services are provided by the entity 
under an arrangement with the hospital)’’ 
after ‘‘hospital’’; and 
(B) by striking the comma at the end of 
subparagraph (B) and all that follows and in-
serting a period. 
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