I 
111TH CONGRESS 
1ST SESSION H. R. 3608 
To amend the Internal Revenue Code of 1986 to codify the exclusion from 
gross income of medical care provided for Indians, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 21, 2009 
Mr. BECERRA (for himself, Mr. NUNES, Mr. RAHALL, Mr. BACA, Ms. BERK-
LEY, Mrs. BONO MACK, Mr. BOREN, Mr. COLE, Mr. HERGER, Mr. KIL-
DEE, Mr. KLINE of Minnesota, Mr. LEWIS of California, Mr. LUJA´N, Mr. 
MCCARTHY of California, Ms. MCCOLLUM, Mr. PALLONE, Mr. POMEROY, 
Mr. RADANOVICH, and Mr. SHULER) introduced the following bill; which 
was referred to the Committee on Ways and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to codify 
the exclusion from gross income of medical care provided 
for Indians, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Tribal Health Benefits 
Clarification Act of 2009’’. 
VerDate Nov 24 2008 
21:17 Sep 21, 2009
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H3608.IH
H3608
hsrobinson on DSK69SOYB1PROD with BILLS
SEC. 2. EXCLUSION FROM GROSS INCOME FOR MEDICAL 
CARE PROVIDED FOR INDIANS. 
(a) IN GENERAL.—Part III of subchapter B of chap-
ter 1 of the Internal Revenue Code of 1986 (relating to 
items specifically excluded from gross income) is amended 
by inserting after section 139C the following new section: 
‘‘SEC. 139D. MEDICAL CARE PROVIDED FOR INDIANS. 
‘‘(a) IN GENERAL.—Gross income does not include— 
‘‘(1) health services or benefits provided or pur-
chased by the Indian Health Service, either directly 
or indirectly, through a grant to or a contract or 
compact with an Indian tribe or tribal organization 
or through programs of third parties funded by the 
Indian Health Service, 
‘‘(2) medical care provided by an Indian tribe 
or tribal organization to a member of an Indian 
tribe (including for this purpose, to the member’s 
spouse or dependents) through any one of the fol-
lowing: provided or purchased medical care services; 
accident or health insurance (or an arrangement 
having the effect of accident or health insurance); or 
amounts paid, directly or indirectly, to reimburse the 
member for expenses incurred for medical care, 
‘‘(3) the value of accident or health plan cov-
erage provided by an Indian tribe or tribal organiza-
tion for medical care to a member of an Indian tribe 
VerDate Nov 24 2008 
21:17 Sep 21, 2009
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H3608.IH
H3608
hsrobinson on DSK69SOYB1PROD with BILLS
(including for this purpose, coverage that extends to 
such member’s spouse or dependents) under an acci-
dent or health plan (or through an arrangement hav-
ing the effect of accident or health insurance), and 
‘‘(4) any other medical care provided by an In-
dian tribe that supplements, replaces, or substitutes 
for the programs and services provided by the Fed-
eral Government to Indian tribes or Indians. 
‘‘(b) DEFINITIONS.—For purposes of this section— 
‘‘(1) IN
GENERAL.—The terms ‘accident or 
health insurance’ and ‘accident or health plan’ have 
the same meaning as when used in sections 104 and 
106. 
‘‘(2) MEDICAL CARE.—The term ‘medical care’ 
has the meaning given such term in section 213. 
‘‘(3) DEPENDENT.—The term ‘dependent’ has 
the meaning given such term in section 152, deter-
mined without regard to subsections (b)(1), (b)(2) 
and (d)(1)(B). 
‘‘(4) INDIAN TRIBE.—The term ‘Indian tribe’ 
means any Indian tribe, band, nation, pueblo, or 
other organized group or community, including any 
Alaska Native village, or regional or village corpora-
tion, as defined in, or established pursuant to, the 
Alaska Native Claims Settlement Act (43 U.S.C. 
VerDate Nov 24 2008 
21:17 Sep 21, 2009
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H3608.IH
H3608
hsrobinson on DSK69SOYB1PROD with BILLS