‘‘(C) LIMITATION ON AMOUNT OF BONDS 
DESIGNATED.—The maximum aggregate face 
amount of bonds which may be designated by 
any Indian tribal government under subpara-
graph (A) shall not exceed the amount of na-
tional tribal economic development bond limita-
tion allocated to such government under para-
graph (1).’’. 
(b) STUDY.—The Secretary of the Treasury, or the 
Secretary’s delegate, shall conduct a study of the effects 
of the amendment made by subsection (a). Not later than 
1 year after the date of the enactment of this Act, the 
Secretary of the Treasury, or the Secretary’s delegate, 
shall report to Congress on the results of the studies con-
ducted under this paragraph, including the Secretary’s 
recommendations regarding such amendment. 
(c) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to obligations issued after the 
date of the enactment of this Act. 
PART V—REPEAL OF WITHHOLDING TAX ON 
GOVERNMENT CONTRACTORS 
SEC. 1541. REPEAL OF WITHHOLDING TAX ON GOVERN-
MENT CONTRACTORS. 
Section 3402 is amended by striking subsection (t). 
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Subtitle G—Energy Incentives 
PART I—RENEWABLE ENERGY INCENTIVES 
SEC. 1601. EXTENSION OF CREDIT FOR ELECTRICITY PRO-
DUCED 
FROM 
CERTAIN 
RENEWABLE 
RE-
SOURCES. 
(a) IN GENERAL.—Subsection (d) of section 45 is 
amended— 
(1) by striking ‘‘2010’’ in paragraph (1) and in-
serting ‘‘2013’’, 
(2) by striking ‘‘2011’’ each place it appears in 
paragraphs (2), (3), (4), (6), (7), and (9) and insert-
ing ‘‘2014’’, and 
(3) by striking ‘‘2012’’ in paragraph (11)(B) 
and inserting ‘‘2014’’. 
(b) TECHNICAL AMENDMENT.—Paragraph (5) of 
section 45(d) is amended by striking ‘‘and before’’ and 
all that follows and inserting ‘‘and before October 3, 
2008.’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—The amendments made by 
subsection (a) shall apply to property placed in serv-
ice after the date of the enactment of this Act. 
(2) TECHNICAL AMENDMENT.—The amendment 
made by subsection (b) shall take effect as if in-
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cluded in section 102 of the Energy Improvement 
and Extension Act of 2008. 
SEC. 1602. ELECTION OF INVESTMENT CREDIT IN LIEU OF 
PRODUCTION CREDIT. 
(a) IN GENERAL.—Subsection (a) of section 48 is 
amended by adding at the end the following new para-
graph: 
‘‘(5) ELECTION TO TREAT QUALIFIED FACILI-
TIES AS ENERGY PROPERTY.— 
‘‘(A) IN
GENERAL.—In the case of any 
qualified investment credit facility placed in 
service in 2009 or 2010— 
‘‘(i) such facility shall be treated as 
energy property for purposes of this sec-
tion, and 
‘‘(ii) the energy percentage with re-
spect to such property shall be 30 percent. 
‘‘(B) DENIAL OF PRODUCTION CREDIT.— 
No credit shall be allowed under section 45 for 
any taxable year with respect to any qualified 
investment credit facility. 
‘‘(C) QUALIFIED INVESTMENT CREDIT FA-
CILITY.—For purposes of this paragraph, the 
term ‘qualified investment credit facility’ means 
any facility described in paragraph (1), (2), (3), 
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(4), (6), (7), (9), or (11) of section 45(d) if no 
credit has been allowed under section 45 with 
respect to such facility and the taxpayer makes 
an irrevocable election to have this paragraph 
apply to such facility.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to facilities placed in service after 
December 31, 2008. 
SEC. 1603. REPEAL OF CERTAIN LIMITATIONS ON CREDIT 
FOR RENEWABLE ENERGY PROPERTY. 
(a) REPEAL OF LIMITATION ON CREDIT FOR QUALI-
FIED SMALL WIND ENERGY PROPERTY.—Paragraph (4) 
of section 48(c) is amended by striking subparagraph (B) 
and by redesignating subparagraphs (C) and (D) as sub-
paragraphs (B) and (C). 
(b) REPEAL
OF LIMITATION
ON PROPERTY FI-
NANCED BY SUBSIDIZED ENERGY FINANCING.— 
(1) IN GENERAL.—Subsection (a) of section 48 
is amended by striking paragraph (4). 
(2) CONFORMING AMENDMENTS.— 
(A) Section 25C(e)(1) is amended by strik-
ing ‘‘(8), and (9)’’ and inserting ‘‘and (8)’’. 
(B) Section 25D(e) is amended by striking 
paragraph (9). 
(c) EFFECTIVE DATE.— 
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(1) IN GENERAL.—Except as provided in para-
graph (2),the amendment made by this section shall 
apply to periods after December 31, 2008, under 
rules similar to the rules of section 48(m) of the In-
ternal Revenue Code of 1986 (as in effect on the day 
before the date of the enactment of the Revenue 
Reconciliation Act of 1990). 
(2) CONFORMING AMENDMENTS.—The amend-
ments made by subsection (b)(2) shall apply to tax-
able years beginning after December 31, 2008. 
SEC. 1604. COORDINATION WITH RENEWABLE ENERGY 
GRANTS. 
Section 48 is amended by adding at the end the fol-
lowing new subsection: 
‘‘(d) COORDINATION WITH DEPARTMENT OF EN-
ERGY GRANTS.—In the case of any property with respect 
to which the Secretary of Energy makes a grant under 
section 1721 of the American Recovery and Reinvestment 
Tax Act of 2009— 
‘‘(1) DENIAL
OF
PRODUCTION
AND
INVEST-
MENT
CREDITS.—No credit shall be determined 
under this section or section 45 with respect to such 
property for the taxable year in which such grant is 
made or any subsequent taxable year. 
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‘‘(2) RECAPTURE OF CREDITS FOR PROGRESS 
EXPENDITURES MADE BEFORE GRANT.—If a credit 
was determined under this section with respect to 
such property for any taxable year ending before 
such grant is made— 
‘‘(A) the tax imposed under subtitle A on 
the taxpayer for the taxable year in which such 
grant is made shall be increased by so much of 
such credit as was allowed under section 38, 
‘‘(B) the general business carryforwards 
under section 39 shall be adjusted so as to re-
capture the portion of such credit which was 
not so allowed, and 
‘‘(C) the amount of such grant shall be de-
termined without regard to any reduction in the 
basis of such property by reason of such credit. 
‘‘(3) TREATMENT OF GRANTS.—Any such grant 
shall— 
‘‘(A) not be includible in the gross income 
of the taxpayer, but 
‘‘(B) shall be taken into account in deter-
mining the basis of the property to which such 
grant relates, except that the basis of such 
property shall be reduced under section 50(c) in 
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PART III—ENERGY CONSERVATION INCENTIVES 
SEC. 1621. EXTENSION AND MODIFICATION OF CREDIT FOR 
NONBUSINESS ENERGY PROPERTY. 
(a) IN GENERAL.—Section 25C is amended by strik-
ing subsections (a) and (b) and inserting the following new 
subsections: 
‘‘(a) ALLOWANCE OF CREDIT.—In the case of an in-
dividual, there shall be allowed as a credit against the tax 
imposed by this chapter for the taxable year an amount 
equal to 30 percent of the sum of— 
‘‘(1) the amount paid or incurred by the tax-
payer during such taxable year for qualified energy 
efficiency improvements, and 
‘‘(2) the amount of the residential energy prop-
erty expenditures paid or incurred by the taxpayer 
during such taxable year. 
‘‘(b) LIMITATION.—The aggregate amount of the 
credits allowed under this section for taxable years begin-
ning in 2009 and 2010 with respect to any taxpayer shall 
not exceed $1,500.’’. 
(b) EXTENSION.—Section 25C(g)(2) is amended by 
striking ‘‘December 31, 2009’’ and inserting ‘‘December 
31, 2010’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2008. 
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SEC. 1622. MODIFICATION OF CREDIT FOR RESIDENTIAL 
ENERGY EFFICIENT PROPERTY. 
(a) REMOVAL OF CREDIT LIMITATION FOR PROP-
ERTY PLACED IN SERVICE.— 
(1) IN
GENERAL.—Paragraph (1) of section 
25D(b) is amended to read as follows: 
‘‘(1) MAXIMUM CREDIT FOR FUEL CELLS.—In 
the case of any qualified fuel cell property expendi-
ture, the credit allowed under subsection (a) (deter-
mined without regard to subsection (c)) for any tax-
able year shall not exceed $500 with respect to each 
half kilowatt of capacity of the qualified fuel cell 
property (as defined in section 48(c)(1)) to which 
such expenditure relates.’’. 
(2) CONFORMING AMENDMENT.—Paragraph (4) 
of section 25D(e) is amended— 
(A) by striking all that precedes subpara-
graph (B) and inserting the following: 
‘‘(4) FUEL
CELL
EXPENDITURE
LIMITATIONS 
IN CASE OF JOINT OCCUPANCY.—In the case of any 
dwelling unit with respect to which qualified fuel cell 
property expenditures are made and which is jointly 
occupied and used during any calendar year as a 
residence by two or more individuals the following 
rules shall apply: 
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‘‘(A) MAXIMUM EXPENDITURES FOR FUEL 
CELLS.—The maximum amount of such ex-
penditures which may be taken into account 
under subsection (a) by all such individuals 
with respect to such dwelling unit during such 
calendar year shall be $1,667 in the case of 
each half kilowatt of capacity of qualified fuel 
cell property (as defined in section 48(c)(1)) 
with respect to which such expenditures re-
late.’’, and 
(B) by striking subparagraph (C). 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2008. 
SEC. 1623. TEMPORARY INCREASE IN CREDIT FOR ALTER-
NATIVE FUEL VEHICLE REFUELING PROP-
ERTY. 
(a) IN GENERAL.—Section 30C(e) is amended by 
adding at the end the following new paragraph: 
‘‘(6) SPECIAL RULE FOR PROPERTY PLACED IN 
SERVICE
DURING
2009
AND
2010.—In the case of 
property placed in service in taxable years beginning 
after December 31, 2008, and before January 1, 
2011— 
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‘‘(A) in the case of any such property 
which does not relate to hydrogen— 
‘‘(i) subsection (a) shall be applied by 
substituting ‘50 percent’ for ‘30 percent’, 
‘‘(ii) subsection (b)(1) shall be applied 
by substituting ‘$50,000’ for ‘$30,000’, 
and 
‘‘(iii) subsection (b)(2) shall be ap-
plied by substituting ‘$2,000’ for ‘$1,000’, 
and 
‘‘(B) in the case of any such property 
which relates to hydrogen, subsection (b) shall 
be applied by substituting ‘$200,000’ for 
‘$30,000’.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2008. 
PART IV—ENERGY RESEARCH INCENTIVES 
SEC. 1631. INCREASED RESEARCH CREDIT FOR ENERGY RE-
SEARCH. 
(a) IN GENERAL.—Section 41 is amended by redesig-
nating subsection (h) as subsection (i) and by inserting 
after subsection (g) the following new subsection: 
‘‘(h) ENERGY RESEARCH CREDIT.—In the case of 
any taxable year beginning in 2009 or 2010— 
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‘‘(1) IN
GENERAL.—The credit determined 
under subsection (a)(1) shall be increased by 20 per-
cent of the qualified energy research expenses for 
the taxable year. 
‘‘(2) 
QUALIFIED
ENERGY
RESEARCH
EX-
PENSES.—For purposes of this subsection, the term 
‘qualified energy research expenses’ means so much 
of the taxpayer’s qualified research expenses as are 
related to the fields of fuel cells and battery tech-
nology, renewable energy, energy conservation tech-
nology, efficient transmission and distribution of 
electricity, and carbon capture and sequestration. 
‘‘(3) COORDINATION
WITH
OTHER
RESEARCH 
CREDITS.— 
‘‘(A) INCREMENTAL CREDIT.—The amount 
of qualified energy research expenses taken into 
account under subsection (a)(1)(A) shall not ex-
ceed the base amount. 
‘‘(B) ALTERNATIVE SIMPLIFIED CREDIT.— 
For purposes of subsection (c)(5), the amount 
of qualified energy research expenses taken into 
account for the taxable year for which the cred-
it is being determined shall not exceed— 
‘‘(i) 
in 
the 
case 
of 
subsection 
(c)(5)(A), 50 percent of the average quali-
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fied research expenses for the 3 taxable 
years preceding the taxable year for which 
the credit is being determined, and 
‘‘(ii) 
in 
the 
case 
of 
subsection 
(c)(5)(B)(ii), zero. 
‘‘(C) BASIC RESEARCH AND ENERGY RE-
SEARCH CONSORTIUM PAYMENTS.—Any amount 
taken into account under paragraph (1) shall 
not be taken into account under paragraph (2) 
or (3) of subsection (a).’’. 
(b) CONFORMING AMENDMENT.—Subparagraph (B) 
of section 41(i)(1)(B), as redesignated by subsection (a), 
is amended by inserting ‘‘(in the case of the increase in 
the credit determined under subsection (h), December 31, 
2010)’’ after ‘‘December 31, 2009’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2008. 
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Subtitle H—Other Provisions 
PART 
I—APPLICATION 
OF 
CERTAIN 
LABOR 
STANDARDS TO PROJECTS FINANCED WITH 
CERTAIN TAX-FAVORED BONDS 
SEC. 1701. APPLICATION OF CERTAIN LABOR STANDARDS 
TO PROJECTS FINANCED WITH CERTAIN TAX- 
FAVORED BONDS. 
Subchapter IV of chapter 31 of the title 40, United 
States Code, shall apply to projects financed with the pro-
ceeds of— 
(1) any qualified clean renewable energy bond 
(as defined in section 54C of the Internal Revenue 
Code of 1986) issued after the date of the enact-
ment of this Act, 
(2) any qualified energy conservation bond (as 
defined in section 54D of the Internal Revenue Code 
of 1986) issued after the date of the enactment of 
this Act, 
(3) any qualified zone academy bond (as de-
fined in section 54E of the Internal Revenue Code 
of 1986) issued after the date of the enactment of 
this Act, 
(4) any qualified school construction bond (as 
defined in section 54F of the Internal Revenue Code 
of 1986), and 
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(5) any recovery zone economic development 
bond (as defined in section 1400U–2 of the Internal 
Revenue Code of 1986). 
PART II—GRANTS TO PROVIDE FINANCING FOR 
LOW-INCOME HOUSING 
SEC. 1711. GRANTS TO STATES FOR LOW-INCOME HOUSING 
PROJECTS IN LIEU OF LOW-INCOME HOUS-
ING CREDIT ALLOCATIONS FOR 2009. 
(a) IN GENERAL.—The Secretary of the Treasury 
shall make a grant to the housing credit agency of each 
State in an amount equal to such State’s low-income hous-
ing grant election amount. 
(b) LOW-INCOME
HOUSING
GRANT
ELECTION 
AMOUNT.—For purposes of this section, the term ‘‘low- 
income housing grant election amount’’ means, with re-
spect to any State, such amount as the State may elect 
which does not exceed 85 percent of the product of— 
(1) the sum of— 
(A) 100 percent of the State housing credit 
ceiling for 2009 which is attributable to 
amounts described in clauses (i) and (iii) of sec-
tion 42(h)(3)(C) of the Internal Revenue Code 
of 1986, and 
(B) 40 percent of the State housing credit 
ceiling for 2009 which is attributable to 
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amounts described in clauses (ii) and (iv) of 
such section, multiplied by 
(2) 10. 
(c) SUBAWARDS FOR LOW-INCOME BUILDINGS.— 
(1) IN GENERAL.—A State housing credit agen-
cy receiving a grant under this section shall use such 
grant to make subawards to finance the construction 
or acquisition and rehabilitation of qualified low-in-
come buildings. A subaward under this section may 
be made to finance a qualified low-income building 
with or without an allocation under section 42 of the 
Internal Revenue Code of 1986, except that a State 
housing credit agency may make subawards to fi-
nance qualified low-income buildings without an allo-
cation only if it makes a determination that such use 
will increase the total funds available to the State to 
build and rehabilitate affordable housing. In com-
plying with such determination requirement, a State 
housing credit agency shall establish a process in 
which applicants that are allocated credits are re-
quired to demonstrate good faith efforts to obtain 
investment commitments for such credits before the 
agency makes such subawards. 
(2) SUBAWARDS SUBJECT TO SAME REQUIRE-
MENTS AS LOW-INCOME HOUSING CREDIT ALLOCA-
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TIONS.—Any such subaward with respect to any 
qualified low-income building shall be made in the 
same manner and shall be subject to the same limi-
tations (including rent, income, and use restrictions 
on such building) as an allocation of housing credit 
dollar amount allocated by such State housing credit 
agency under section 42 of the Internal Revenue 
Code of 1986, except that such subawards shall not 
be limited by, or otherwise affect (except as provided 
in subsection (h)(3)(J) of such section), the State 
housing credit ceiling applicable to such agency. 
(3) COMPLIANCE AND ASSET MANAGEMENT.— 
The State housing credit agency shall perform asset 
management functions to ensure compliance with 
section 42 of the Internal Revenue Code of 1986 
and the long-term viability of buildings funded by 
any subaward under this section. The State housing 
credit agency may collect reasonable fees from a 
subaward recipient to cover expenses associated with 
the performance of its duties under this paragraph. 
The State housing credit agency may retain an 
agent or other private contractor to satisfy the re-
quirements of this paragraph. 
(4) RECAPTURE.—The State housing credit 
agency shall impose conditions or restrictions, in-
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cluding a requirement providing for recapture, on 
any subaward under this section so as to assure that 
the building with respect to which such subaward is 
made remains a qualified low-income building during 
the compliance period. Any such recapture shall be 
payable to the Secretary of the Treasury for deposit 
in the general fund of the Treasury and may be en-
forced by means of liens or such other methods as 
the Secretary of the Treasury determines appro-
priate. 
(d) RETURN OF UNUSED GRANT FUNDS.—Any grant 
funds not used to make subawards under this section be-
fore January 1, 2011, shall be returned to the Secretary 
of the Treasury on such date. Any subawards returned 
to the State housing credit agency on or after such date 
shall be promptly returned to the Secretary of the Treas-
ury. Any amounts returned to the Secretary of the Treas-
ury under this subsection shall be deposited in the general 
fund of the Treasury. 
(e) DEFINITIONS.—Any term used in this section 
which is also used in section 42 of the Internal Revenue 
Code of 1986 shall have the same meaning for purposes 
of this section as when used in such section 42. Any ref-
erence in this section to the Secretary of the Treasury 
shall be treated as including the Secretary’s delegate. 
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(f) APPROPRIATIONS.—There is hereby appropriated 
to the Secretary of the Treasury such sums as may be 
necessary to carry out this section. 
PART III—GRANTS FOR SPECIFIED ENERGY 
PROPERTY IN LIEU OF TAX CREDITS 
SEC. 1721. GRANTS FOR SPECIFIED ENERGY PROPERTY IN 
LIEU OF TAX CREDITS. 
(a) IN GENERAL.—Upon application, the Secretary 
of Energy shall, within 60 days of the application and sub-
ject to the requirements of this section, provide a grant 
to each person who places in service specified energy prop-
erty during 2009 or 2010 to reimburse such person for 
a portion of the expense of such facility as provided in 
subsection (b). 
(b) GRANT AMOUNT.— 
(1) IN GENERAL.—The amount of the grant 
under subsection (a) with respect to any specified 
energy property shall be the applicable percentage of 
the basis of such facility. 
(2) APPLICABLE PERCENTAGE.—For purposes 
of paragraph (1), the term ‘‘applicable percentage’’ 
means— 
(A) 30 percent in the case of any property 
described in paragraphs (1) through (4) of sub-
section (c), and 
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(B) 10 percent in the case of any other 
property. 
(3) DOLLAR
LIMITATIONS.—In the case of 
property described in paragraph (2), (6), or (7) of 
subsection (c), the amount of any grant under this 
section with respect to such property shall not ex-
ceed the limitation described in section 48(c)(1)(B), 
48(c)(2)(B), or 48(c)(3)(B) of the Internal Revenue 
Code of 1986, respectively, with respect to such 
property. 
(c) SPECIFIED ENERGY PROPERTY.—For purposes 
of this section, the term ‘‘specified energy property’’ 
means any of the following: 
(1) QUALIFIED
FACILITIES.—Any facility de-
scribed in paragraph (1), (2), (3), (4), (6), (7), (9), 
or (11) of section 45(d) of the Internal Revenue 
Code of 1986. 
(2) QUALIFIED
FUEL
CELL
PROPERTY.—Any 
qualified fuel cell property (as defined in section 
48(c)(1) of such Code). 
(3) SOLAR PROPERTY.—Any property described 
in clause (i) or (ii) of section 48(a)(3)(A) of such 
Code. 
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(4) QUALIFIED
SMALL
WIND
ENERGY
PROP-
ERTY.—Any qualified small wind energy property 
(as defined in section 48(c)(4) of such Code). 
(5) GEOTHERMAL
PROPERTY.—Any property 
described in clause (iii) of section 48(a)(3)(A) of 
such Code. 
(6) QUALIFIED
MICROTURBINE
PROPERTY.— 
Any qualified microturbine property (as defined in 
section 48(c)(2) of such Code). 
(7) COMBINED
HEAT
AND
POWER
SYSTEM 
PROPERTY.—Any combined heat and power system 
property (as defined in section 48(c)(3) of such 
Code). 
(8) GEOTHERMAL HEATPUMP PROPERTY.—Any 
property described in clause (vii) of section 
48(a)(3)(A) of such Code. 
(d) APPLICATION OF CERTAIN RULES.—In making 
grants under this section, the Secretary of Energy shall 
apply rules similar to the rules of section 50 of the Inter-
nal Revenue Code of 1986. In applying such rules, if the 
facility is disposed of, or otherwise ceases to be a qualified 
renewable energy facility, the Secretary of Energy shall 
provide for the recapture of the appropriate percentage of 
the grant amount in such manner as the Secretary of En-
ergy determines appropriate. 
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(e) EXCEPTION FOR CERTAIN NON-TAXPAYERS.— 
The Secretary of Energy shall not make any grant under 
this section to any Federal, State, or local government (or 
any political subdivision, agency, or instrumentality there-
of) or any organization described in section 501(c) of the 
Internal Revenue Code of 1986 and exempt from tax 
under section 501(a) of such Code. 
(f) DEFINITIONS.—Terms used in this section which 
are also used in section 45 or 48 of the Internal Revenue 
Code of 1986 shall have the same meaning for purposes 
of this section as when used in such section 45 or 48. 
Any reference in this section to the Secretary of the Treas-
ury shall be treated as including the Secretary’s delegate. 
(g) COORDINATION BETWEEN DEPARTMENTS
OF 
TREASURY AND ENERGY.—The Secretary of the Treasury 
shall provide the Secretary of Energy with such technical 
assistance as the Secretary of Energy may require in car-
rying out this section. The Secretary of Energy shall pro-
vide the Secretary of the Treasury with such information 
as the Secretary of the Treasury may require in carrying 
out the amendment made by section 1604. 
(h) APPROPRIATIONS.—There is hereby appropriated 
to the Secretary of Energy such sums as may be necessary 
to carry out this section. 
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(i) TERMINATION.—The Secretary of Energy shall 
not make any grant to any person under this section un-
less the application of such person for such grant is re-
ceived before October 1, 2011. 
TITLE II—ASSISTANCE FOR UN-
EMPLOYED 
WORKERS 
AND 
STRUGGLING FAMILIES 
SEC. 2000. SHORT TITLE, ETC. 
(a) SHORT TITLE.—This title may be cited as the 
‘‘Assistance for Unemployed Workers and Struggling 
Families Act’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this title is as follows: 
Sec. 2000. Short title, etc. 
Subtitle A—Unemployment Insurance 
Sec. 2001. Extension of emergency unemployment compensation program. 
Sec. 2002. Increase in unemployment compensation benefits. 
Sec. 2003. Special transfers for unemployment compensation modernization. 
Subtitle B—Assistance for Vulnerable Individuals 
Sec. 2101. Emergency fund for TANF program. 
Sec. 2102. One-time emergency SSI payment. 
Sec. 2103. Temporary resumption of prior child support law. 
Subtitle A—Unemployment 
Insurance 
SEC. 2001. EXTENSION OF EMERGENCY UNEMPLOYMENT 
COMPENSATION PROGRAM. 
(a) IN GENERAL.—Section 4007 of the Supplemental 
Appropriations Act, 2008 (Public Law 110–252; 26 
U.S.C. 3304 note), as amended by section 4 of the Unem-
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ployment Compensation Extension Act of 2008 (Public 
Law 110–449; 122 Stat. 5015), is amended— 
(1) by striking ‘‘March 31, 2009’’ each place it 
appears and inserting ‘‘December 31, 2009’’; 
(2) in the heading for subsection (b)(2), by 
striking ‘‘MARCH 31, 2009’’ and inserting ‘‘DECEM-
BER 31, 2009’’; and 
(3) in subsection (b)(3), by striking ‘‘August 
27, 2009’’ and inserting ‘‘May 31, 2010’’. 
(b) FINANCING PROVISIONS.—Section 4004 of such 
Act is amended by adding at the end the following: 
‘‘(e) TRANSFER OF FUNDS.—Notwithstanding any 
other provision of law, the Secretary of the Treasury shall 
transfer from the general fund of the Treasury (from 
funds not otherwise appropriated)— 
‘‘(1) to the extended unemployment compensa-
tion account (as established by section 905 of the 
Social Security Act) such sums as the Secretary of 
Labor estimates to be necessary to make payments 
to States under this title by reason of the amend-
ments made by section 2001(a) of the Assistance for 
Unemployed Workers and Struggling Families Act; 
and 
‘‘(2) to the employment security administration 
account (as established by section 901 of the Social 
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Security Act) such sums as the Secretary of Labor 
estimates to be necessary for purposes of assisting 
States in meeting administrative costs by reason of 
the amendments referred to in paragraph (1). 
There are appropriated from the general fund of the 
Treasury, without fiscal year limitation, the sums referred 
to in the preceding sentence and such sums shall not be 
required to be repaid.’’. 
SEC. 2002. INCREASE IN UNEMPLOYMENT COMPENSATION 
BENEFITS. 
(a) FEDERAL-STATE
AGREEMENTS.—Any State 
which desires to do so may enter into and participate in 
an agreement under this section with the Secretary of 
Labor (hereinafter in this section referred to as the ‘‘Sec-
retary’’). Any State which is a party to an agreement 
under this section may, upon providing 30 days’ written 
notice to the Secretary, terminate such agreement. 
(b) PROVISIONS OF AGREEMENT.— 
(1) ADDITIONAL COMPENSATION.—Any agree-
ment under this section shall provide that the State 
agency of the State will make payments of regular 
compensation to individuals in amounts and to the 
extent that they would be determined if the State 
law of the State were applied, with respect to any 
week for which the individual is (disregarding this 
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section) otherwise entitled under the State law to re-
ceive regular compensation, as if such State law had 
been modified in a manner such that the amount of 
regular compensation (including dependents’ allow-
ances) payable for any week shall be equal to the 
amount determined under the State law (before the 
application of this paragraph) plus an additional 
$25. 
(2) ALLOWABLE METHODS OF PAYMENT.—Any 
additional compensation provided for in accordance 
with paragraph (1) shall be payable either— 
(A) as an amount which is paid at the 
same time and in the same manner as any reg-
ular compensation otherwise payable for the 
week involved; or 
(B) at the option of the State, by pay-
ments which are made separately from, but on 
the same weekly basis as, any regular com-
pensation otherwise payable. 
(c) NONREDUCTION RULE.—An agreement under 
this section shall not apply (or shall cease to apply) with 
respect to a State upon a determination by the Secretary 
that the method governing the computation of regular 
compensation under the State law of that State has been 
modified in a manner such that— 
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(1) the average weekly benefit amount of reg-
ular compensation which will be payable during the 
period of the agreement (determined disregarding 
any additional amounts attributable to the modifica-
tion described in subsection (b)(1)) will be less than 
(2) the average weekly benefit amount of reg-
ular compensation which would otherwise have been 
payable during such period under the State law, as 
in effect on December 31, 2008. 
(d) PAYMENTS TO STATES.— 
(1) IN GENERAL.— 
(A) FULL REIMBURSEMENT.—There shall 
be paid to each State which has entered into an 
agreement under this section an amount equal 
to 100 percent of— 
(i) the total amount of additional 
compensation (as described in subsection 
(b)(1)) paid to individuals by the State 
pursuant to such agreement; and 
(ii) any additional administrative ex-
penses incurred by the State by reason of 
such agreement (as determined by the Sec-
retary). 
(B) TERMS OF PAYMENTS.—Sums payable 
to any State by reason of such State’s having 
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an agreement under this section shall be pay-
able, either in advance or by way of reimburse-
ment (as determined by the Secretary), in such 
amounts as the Secretary estimates the State 
will be entitled to receive under this section for 
each calendar month, reduced or increased, as 
the case may be, by any amount by which the 
Secretary finds that his estimates for any prior 
calendar month were greater or less than the 
amounts which should have been paid to the 
State. Such estimates may be made on the 
basis of such statistical, sampling, or other 
method as may be agreed upon by the Secretary 
and the State agency of the State involved. 
(2) 
CERTIFICATIONS.—The 
Secretary 
shall 
from time to time certify to the Secretary of the 
Treasury for payment to each State the sums pay-
able to such State under this section. 
(3) APPROPRIATION.—There are appropriated 
from the general fund of the Treasury, without fiscal 
year limitation, such sums as may be necessary for 
purposes of this subsection. 
(e) APPLICABILITY.— 
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(1) IN GENERAL.—An agreement entered into 
under this section shall apply to weeks of unemploy-
ment— 
(A) beginning after the date on which such 
agreement is entered into; and 
(B) ending before January 1, 2010. 
(2) TRANSITION RULE FOR INDIVIDUALS RE-
MAINING ENTITLED TO REGULAR COMPENSATION AS 
OF JANUARY 1, 2010.—In the case of any individual 
who, as of the date specified in paragraph (1)(B), 
has not yet exhausted all rights to regular com-
pensation under the State law of a State with re-
spect to a benefit year that began before such date, 
additional compensation (as described in subsection 
(b)(1)) shall continue to be payable to such indi-
vidual for any week beginning on or after such date 
for which the individual is otherwise eligible for reg-
ular compensation with respect to such benefit year. 
(3) TERMINATION.—Notwithstanding any other 
provision of this subsection, no additional compensa-
tion (as described in subsection (b)(1)) shall be pay-
able for any week beginning after June 30, 2010. 
(f) FRAUD AND OVERPAYMENTS.—The provisions of 
section 4005 of the Supplemental Appropriations Act, 
2008 (Public Law 110–252; 122 Stat. 2356) shall apply 
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with respect to additional compensation (as described in 
subsection (b)(1)) to the same extent and in the same 
manner as in the case of emergency unemployment com-
pensation. 
(g) APPLICATION TO OTHER UNEMPLOYMENT BENE-
FITS.— 
(1) IN GENERAL.—Each agreement under this 
section shall include provisions to provide that the 
purposes of the preceding provisions of this section 
shall be applied with respect to unemployment bene-
fits described in subsection (h)(3) to the same extent 
and in the same manner as if those benefits were 
regular compensation. 
(2) ELIGIBILITY AND TERMINATION RULES.— 
Additional compensation (as described in subsection 
(b)(1))— 
(A) shall not be payable, pursuant to this 
subsection, with respect to any unemployment 
benefits described in subsection (h)(3) for any 
week beginning on or after the date specified in 
subsection (e)(1)(B), except in the case of an 
individual who was eligible to receive additional 
compensation (as so described) in connection 
with any regular compensation or any unem-
ployment benefits described in subsection (h)(3) 
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for any period of unemployment ending before 
such date; and 
(B) shall in no event be payable for any 
week beginning after the date specified in sub-
section (e)(3). 
(h) DEFINITIONS.—For purposes of this section— 
(1) the terms ‘‘compensation’’, ‘‘regular com-
pensation’’, ‘‘benefit year’’, ‘‘State’’, ‘‘State agency’’, 
‘‘State law’’, and ‘‘week’’ have the respective mean-
ings given such terms under section 205 of the Fed-
eral-State Extended Unemployment Compensation 
Act of 1970 (26 U.S.C. 3304 note); 
(2) the term ‘‘emergency unemployment com-
pensation’’ means emergency unemployment com-
pensation under title IV of the Supplemental Appro-
priations Act, 2008 (Public Law 110–252; 122 Stat. 
2353); and 
(3) any reference to unemployment benefits de-
scribed in this paragraph shall be considered to refer 
to— 
(A) extended compensation (as defined by 
section 205 of the Federal-State Extended Un-
employment Compensation Act of 1970); and 
(B) unemployment compensation (as de-
fined by section 85(b) of the Internal Revenue 
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Code of 1986) provided under any program ad-
ministered by a State under an agreement with 
the Secretary. 
SEC. 2003. SPECIAL TRANSFERS FOR UNEMPLOYMENT 
COMPENSATION MODERNIZATION. 
(a) IN GENERAL.—Section 903 of the Social Security 
Act (42 U.S.C. 1103) is amended by adding at the end 
the following: 
‘‘Special Transfers in Fiscal Years 2009, 2010, and 2011 
for Modernization 
‘‘(f)(1)(A) In addition to any other amounts, the Sec-
retary of Labor shall provide for the making of unemploy-
ment compensation modernization incentive payments 
(hereinafter ‘incentive payments’) to the accounts of the 
States in the Unemployment Trust Fund, by transfer from 
amounts reserved for that purpose in the Federal unem-
ployment account, in accordance with succeeding provi-
sions of this subsection. 
‘‘(B) The maximum incentive payment allowable 
under this subsection with respect to any State shall, as 
determined by the Secretary of Labor, be equal to the 
amount obtained by multiplying $7,000,000,000 by the 
same ratio as would apply under subsection (a)(2)(B) for 
purposes of determining such State’s share of any excess 
amount (as described in subsection (a)(1)) that would 
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have been subject to transfer to State accounts, as of Oc-
tober 1, 2008, under the provisions of subsection (a). 
‘‘(C) Of the maximum incentive payment determined 
under subparagraph (B) with respect to a State— 
‘‘(i) one-third shall be transferred to the ac-
count of such State upon a certification under para-
graph (4)(B) that the State law of such State meets 
the requirements of paragraph (2); and 
‘‘(ii) the remainder shall be transferred to the 
account of such State upon a certification under 
paragraph (4)(B) that the State law of such State 
meets the requirements of paragraph (3). 
‘‘(2) The State law of a State meets the requirements 
of this paragraph if such State law— 
‘‘(A) uses a base period that includes the most 
recently completed calendar quarter before the start 
of the benefit year for purposes of determining eligi-
bility for unemployment compensation; or 
‘‘(B) provides that, in the case of an individual 
who would not otherwise be eligible for unemploy-
ment compensation under the State law because of 
the use of a base period that does not include the 
most recently completed calendar quarter before the 
start of the benefit year, eligibility shall be deter-
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mined using a base period that includes such cal-
endar quarter. 
‘‘(3) The State law of a State meets the requirements 
of this paragraph if such State law includes provisions to 
carry out at least 2 of the following subparagraphs: 
‘‘(A) An individual shall not be denied regular 
unemployment compensation under any State law 
provisions relating to availability for work, active 
search for work, or refusal to accept work, solely be-
cause such individual is seeking only part-time (and 
not full-time) work, except that the State law provi-
sions carrying out this subparagraph may exclude an 
individual if a majority of the weeks of work in such 
individual’s base period do not include part-time 
work. 
‘‘(B) An individual shall not be disqualified 
from regular unemployment compensation for sepa-
rating from employment if that separation is for any 
compelling family reason. For purposes of this sub-
paragraph, the term ‘compelling family reason’ 
means the following: 
‘‘(i) Domestic violence, verified by such 
reasonable and confidential documentation as 
the State law may require, which causes the in-
dividual reasonably to believe that such individ-
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ual’s continued employment would jeopardize 
the safety of the individual or of any member 
of the individual’s immediate family (as defined 
by the Secretary of Labor). 
‘‘(ii) The illness or disability of a member 
of the individual’s immediate family (as defined 
by the Secretary of Labor). 
‘‘(iii) The need for the individual to accom-
pany such individual’s spouse— 
‘‘(I) to a place from which it is im-
practical for such individual to commute; 
and 
‘‘(II) due to a change in location of 
the spouse’s employment. 
‘‘(C) Weekly unemployment compensation is 
payable under this subparagraph to any individual 
who is unemployed (as determined under the State 
unemployment compensation law), has exhausted all 
rights to regular unemployment compensation under 
the State law, and is enrolled and making satisfac-
tory progress in a State-approved training program 
or in a job training program authorized under the 
Workforce Investment Act of 1998. Such programs 
shall prepare individuals who have been separated 
from a declining occupation, or who have been invol-
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untarily and indefinitely separated from employment 
as a result of a permanent reduction of operations 
at the individual’s place of employment, for entry 
into a high-demand occupation. The amount of un-
employment compensation payable under this sub-
paragraph to an individual for a week of unemploy-
ment shall be equal to the individual’s average week-
ly benefit amount (including dependents’ allowances) 
for the most recent benefit year, and the total 
amount of unemployment compensation payable 
under this subparagraph to any individual shall be 
equal to at least 26 times the individual’s average 
weekly benefit amount (including dependents’ allow-
ances) for the most recent benefit year. 
‘‘(D) Dependents’ allowances are provided, in 
the case of any individual who is entitled to receive 
regular unemployment compensation and who has 
any dependents (as defined by State law), in an 
amount equal to at least $15 per dependent per 
week, subject to any aggregate limitation on such al-
lowances which the State law may establish (but 
which aggregate limitation on the total allowance for 
dependents paid to an individual may not be less 
than $50 for each week of unemployment or 50 per-
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cent of the individual’s weekly benefit amount for 
the benefit year, whichever is less). 
‘‘(4)(A) Any State seeking an incentive payment 
under this subsection shall submit an application therefor 
at such time, in such manner, and complete with such in-
formation as the Secretary of Labor may within 60 days 
after the date of the enactment of this subsection prescribe 
(whether by regulation or otherwise), including informa-
tion relating to compliance with the requirements of para-
graph (2) or (3), as well as how the State intends to use 
the incentive payment to improve or strengthen the State’s 
unemployment compensation program. The Secretary of 
Labor shall, within 30 days after receiving a complete ap-
plication, notify the State agency of the State of the Sec-
retary’s findings with respect to the requirements of para-
graph (2) or (3) (or both). 
‘‘(B)(i) If the Secretary of Labor finds that the State 
law provisions (disregarding any State law provisions 
which are not then currently in effect as permanent law 
or which are subject to discontinuation) meet the require-
ments of paragraph (2) or (3), as the case may be, the 
Secretary of Labor shall thereupon make a certification 
to that effect to the Secretary of the Treasury, together 
with a certification as to the amount of the incentive pay-
ment to be transferred to the State account pursuant to 
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that finding. The Secretary of the Treasury shall make 
the appropriate transfer within 7 days after receiving such 
certification. 
‘‘(ii) For purposes of clause (i), State law provisions 
which are to take effect within 12 months after the date 
of their certification under this subparagraph shall be con-
sidered to be in effect as of the date of such certification. 
‘‘(C)(i) No certification of compliance with the re-
quirements of paragraph (2) or (3) may be made with re-
spect to any State whose State law is not otherwise eligible 
for certification under section 303 or approvable under 
section 3304 of the Federal Unemployment Tax Act. 
‘‘(ii) No certification of compliance with the require-
ments of paragraph (3) may be made with respect to any 
State whose State law is not in compliance with the re-
quirements of paragraph (2). 
‘‘(iii) No application under subparagraph (A) may be 
considered if submitted before the date of the enactment 
of this subsection or after the latest date necessary (as 
specified by the Secretary of Labor) to ensure that all in-
centive payments under this subsection are made before 
October 1, 2011. 
‘‘(5)(A) Except as provided in subparagraph (B), any 
amount transferred to the account of a State under this 
subsection may be used by such State only in the payment 
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of cash benefits to individuals with respect to their unem-
ployment (including for dependents’ allowances and for 
unemployment compensation under paragraph (3)(C)), ex-
clusive of expenses of administration. 
‘‘(B) A State may, subject to the same conditions as 
set forth in subsection (c)(2) (excluding subparagraph (B) 
thereof, and deeming the reference to ‘subsections (a) and 
(b)’ in subparagraph (D) thereof to include this sub-
section), use any amount transferred to the account of 
such State under this subsection for the administration 
of its unemployment compensation law and public employ-
ment offices. 
‘‘(6) Out of any money in the Federal unemployment 
account not otherwise appropriated, the Secretary of the 
Treasury shall reserve $7,000,000,000 for incentive pay-
ments under this subsection. Any amount so reserved shall 
not be taken into account for purposes of any determina-
tion under section 902, 910, or 1203 of the amount in 
the Federal unemployment account as of any given time. 
Any amount so reserved for which the Secretary of the 
Treasury has not received a certification under paragraph 
(4)(B) by the deadline described in paragraph (4)(C)(iii) 
shall, upon the close of fiscal year 2011, become unre-
stricted as to use as part of the Federal unemployment 
account. 
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‘‘(7) For purposes of this subsection, the terms ‘ben-
efit year’, ‘base period’, and ‘week’ have the respective 
meanings given such terms under section 205 of the Fed-
eral-State Extended Unemployment Compensation Act of 
1970 (26 U.S.C. 3304 note). 
‘‘Special Transfer in Fiscal Year 2009 for Administration 
‘‘(g)(1) In addition to any other amounts, the Sec-
retary of the Treasury shall transfer from the employment 
security administration account to the account of each 
State in the Unemployment Trust Fund, within 30 days 
after the date of the enactment of this subsection, the 
amount determined with respect to such State under para-
graph (2). 
‘‘(2) The amount to be transferred under this sub-
section to a State account shall (as determined by the Sec-
retary of Labor and certified by such Secretary to the Sec-
retary of the Treasury) be equal to the amount obtained 
by multiplying $500,000,000 by the same ratio as deter-
mined under subsection (f)(1)(B) with respect to such 
State. 
‘‘(3) Any amount transferred to the account of a 
State as a result of the enactment of this subsection may 
be used by the State agency of such State only in the pay-
ment of expenses incurred by it for— 
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‘‘(A) the administration of the provisions of its 
State law carrying out the purposes of subsection 
(f)(2) or any subparagraph of subsection (f)(3); 
‘‘(B) improved outreach to individuals who 
might be eligible for regular unemployment com-
pensation by virtue of any provisions of the State 
law which are described in subparagraph (A); 
‘‘(C) the improvement of unemployment benefit 
and unemployment tax operations, including re-
sponding to increased demand for unemployment 
compensation; and 
‘‘(D) staff-assisted reemployment services for 
unemployment compensation claimants.’’. 
(b) REGULATIONS.—The Secretary of Labor may 
prescribe any regulations, operating instructions, or other 
guidance necessary to carry out the amendment made by 
subsection (a). 
Subtitle B—Assistance for 
Vulnerable Individuals 
SEC. 2101. EMERGENCY FUND FOR TANF PROGRAM. 
(a) IN GENERAL.—Section 403 of the Social Security 
Act (42 U.S.C. 603) is amended by adding at the end the 
following: 
‘‘(c) EMERGENCY FUND.— 
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‘‘(1) ESTABLISHMENT.—There is established in 
the Treasury of the United States a fund which 
shall be known as the ‘Emergency Contingency 
Fund for State Temporary Assistance for Needy 
Families Programs’ (in this subsection referred to as 
the ‘Emergency Fund’). 
‘‘(2) DEPOSITS INTO FUND.—Out of any money 
in the Treasury of the United States not otherwise 
appropriated, there are appropriated such sums as 
are necessary for payment to the Emergency Fund. 
‘‘(3) GRANTS.— 
‘‘(A) GRANT RELATED TO CASELOAD IN-
CREASES.— 
‘‘(i) IN GENERAL.—For each calendar 
quarter in fiscal year 2009 or 2010, the 
Secretary shall make a grant from the 
Emergency Fund to each State that— 
‘‘(I) requests a grant under this 
subparagraph for the quarter; and 
‘‘(II) meets the requirement of 
clause (ii) for the quarter. 
‘‘(ii) CASELOAD INCREASE REQUIRE-
MENT.—A State meets the requirement of 
this clause for a quarter if the average 
monthly assistance caseload of the State 
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100 
for the quarter exceeds the average month-
ly assistance caseload of the State for the 
corresponding quarter in the emergency 
fund base year of the State. 
‘‘(iii) AMOUNT OF GRANT.—Subject to 
paragraph (5), the amount of the grant to 
be made to a State under this subpara-
graph for a quarter shall be 80 percent of 
the amount (if any) by which the total ex-
penditures of the State for basic assistance 
(as defined by the Secretary) in the quar-
ter, whether under the State program 
funded under this part or as qualified 
State expenditures, exceeds the total ex-
penditures of the State for such assistance 
for the corresponding quarter in the emer-
gency fund base year of the State. 
‘‘(B) GRANT RELATED TO INCREASED EX-
PENDITURES
FOR
NON-RECURRENT
SHORT- 
TERM BENEFITS.— 
‘‘(i) IN GENERAL.—For each calendar 
quarter in fiscal year 2009 or 2010, the 
Secretary shall make a grant from the 
Emergency Fund to each State that— 
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101 
‘‘(I) requests a grant under this 
subparagraph for the quarter; and 
‘‘(II) meets the requirement of 
clause (ii) for the quarter. 
‘‘(ii) NON-RECURRENT
SHORT-TERM 
EXPENDITURE
REQUIREMENT.—A State 
meets the requirement of this clause for a 
quarter if the total expenditures of the 
State for non-recurrent short-term benefits 
in the quarter, whether under the State 
program funded under this part or as 
qualified State expenditures, exceeds the 
total such expenditures of the State for 
non-recurrent short-term benefits in the 
corresponding quarter in the emergency 
fund base year of the State. 
‘‘(iii) AMOUNT OF GRANT.—Subject to 
paragraph (5), the amount of the grant to 
be made to a State under this subpara-
graph for a quarter shall be an amount 
equal to 80 percent of the excess described 
in clause (ii). 
‘‘(C) GRANT RELATED TO INCREASED EX-
PENDITURES FOR SUBSIDIZED EMPLOYMENT.— 
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‘‘(i) IN GENERAL.—For each calendar 
quarter in fiscal year 2009 or 2010, the 
Secretary shall make a grant from the 
Emergency Fund to each State that— 
‘‘(I) requests a grant under this 
subparagraph for the quarter; and 
‘‘(II) meets the requirement of 
clause (ii) for the quarter. 
‘‘(ii) SUBSIDIZED
EMPLOYMENT
EX-
PENDITURE
REQUIREMENT.—A 
State 
meets the requirement of this clause for a 
quarter if the total expenditures of the 
State for subsidized employment in the 
quarter, whether under the State program 
funded under this part or as qualified 
State expenditures, exceeds the total of 
such expenditures of the State in the cor-
responding quarter in the emergency fund 
base year of the State. 
‘‘(iii) AMOUNT OF GRANT.—Subject to 
paragraph (5), the amount of the grant to 
be made to a State under this subpara-
graph for a quarter shall be an amount 
equal to 80 percent of the excess described 
in clause (ii). 
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103 
‘‘(4) AUTHORITY TO MAKE NECESSARY ADJUST-
MENTS TO DATA AND COLLECT NEEDED DATA.—In 
determining the size of the caseload of a State and 
the expenditures of a State for basic assistance, non- 
recurrent short-term benefits, and subsidized em-
ployment, during any period for which the State re-
quests funds under this subsection, and during the 
emergency fund base year of the State, the Sec-
retary may make appropriate adjustments to the 
data to ensure that the data reflect expenditures 
under the State program funded under this part and 
qualified State expenditures. The Secretary may de-
velop a mechanism for collecting expenditure data, 
including procedures which allow States to make 
reasonable estimates, and may set deadlines for 
making revisions to the data. 
‘‘(5) LIMITATION.—The total amount payable 
to a single State under subsection (b) and this sub-
section for a fiscal year shall not exceed 25 percent 
of the State family assistance grant. 
‘‘(6) LIMITATIONS ON USE OF FUNDS.—A State 
to which an amount is paid under this subsection 
may use the amount only as authorized by section 
404. 
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‘‘(7) TIMING OF IMPLEMENTATION.—The Sec-
retary shall implement this subsection as quickly as 
reasonably possible, pursuant to appropriate guid-
ance to States. 
‘‘(8) DEFINITIONS.—In this subsection: 
‘‘(A) 
AVERAGE
MONTHLY
ASSISTANCE 
CASELOAD.—The term ‘average monthly assist-
ance caseload’ means, with respect to a State 
and a quarter, the number of families receiving 
assistance during the quarter under the State 
program funded under this part or as qualified 
State expenditures, subject to adjustment under 
paragraph (4). 
‘‘(B) EMERGENCY FUND BASE YEAR.— 
‘‘(i) IN GENERAL.—The term ‘emer-
gency fund base year’ means, with respect 
to a State and a category described in 
clause (ii), whichever of fiscal year 2007 or 
2008 is the fiscal year in which the 
amount described by the category with re-
spect to the State is the lesser. 
‘‘(ii) CATEGORIES
DESCRIBED.—The 
categories described in this clause are the 
following: 
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‘‘(I) The average monthly assist-
ance caseload of the State. 
‘‘(II) The total expenditures of 
the State for non-recurrent short-term 
benefits, whether under the State pro-
gram funded under this part or as 
qualified State expenditures. 
‘‘(III) The total expenditures of 
the State for subsidized employment, 
whether under the State program 
funded under this part or as qualified 
State expenditures. 
‘‘(C) QUALIFIED STATE EXPENDITURES.— 
The term ‘qualified State expenditures’ has the 
meaning given the term in section 409(a)(7).’’. 
(b) TEMPORARY MODIFICATION OF CASELOAD RE-
DUCTION CREDIT.—Section 407(b)(3)(A)(i) of such Act 
(42 U.S.C. 607(b)(3)(A)(i)) is amended by inserting ‘‘(or 
if the immediately preceding fiscal year is fiscal year 2009 
or 2010, then, at State option, during the emergency fund 
base year of the State with respect to the average monthly 
assistance caseload of the State (within the meaning of 
section 403(c)(8)(B)))’’ before ‘‘under the State’’. 
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(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of the enactment 
of this Act. 
SEC. 2102. ONE-TIME EMERGENCY SSI PAYMENT. 
(a) PAYMENT AUTHORITY.— 
(1) IN GENERAL.—At the earliest practicable 
date in calendar year 2009 but not later than 90 
days after the date of the enactment of this section, 
the Commissioner of Social Security shall make a 
one-time payment, subject to subsection (b)(2) of 
this section, to each individual who is determined by 
the Commissioner in calendar year 2009 to be an in-
dividual who— 
(A) is entitled to a cash benefit under the 
supplemental security income program under 
title XVI of the Social Security Act (other than 
pursuant to section 1611(e)(1)(B) of such Act) 
for at least 1 day in the calendar month in 
which the first payment under this section is to 
be made; or 
(B)(i) was entitled to such a cash benefit 
(other than pursuant to section 1611(e)(1)(B) 
of such Act) for at least 1 day in the 2-month 
period preceding that calendar month; and 
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(ii) whose entitlement to that benefit 
ceased in that 2-month period solely because 
the income of the individual (and the income of 
the spouse, if any, of the individual) exceeded 
the applicable income limit described in para-
graph (1)(A) or (2)(A) of section 1611(a) of 
such Act. 
(2) AMOUNT
OF
PAYMENT.—Subject to sub-
section (b)(1) of this section, the amount of the pay-
ment shall be— 
(A) in the case of an individual eligible for 
a payment under this section who does not have 
a spouse eligible for such a payment, an 
amount equal to the average of the cash bene-
fits payable in the aggregate under section 
1611 or 1619(a) of the Social Security Act to 
eligible individuals who do not have an eligible 
spouse, for the most recent month for which 
data on payment of the benefits are available, 
as determined by the Commissioner of Social 
Security; or 
(B) in the case of an individual eligible for 
a payment under this section who has a spouse 
eligible for such a payment, an amount equal to 
the average of the cash benefits payable in the 
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aggregate under section 1611 or 1619(a) of the 
Social Security Act to eligible individuals who 
have an eligible spouse, for the most recent 
month for which data on payment of the bene-
fits are available, as so determined. 
(b) ADMINISTRATIVE PROVISIONS.— 
(1) AUTHORITY
TO
WITHHOLD
PAYMENT
TO 
RECOVER PRIOR OVERPAYMENT OF SSI BENEFITS.— 
The Commissioner of Social Security may withhold 
part or all of a payment otherwise required to be 
made under subsection (a) of this section to an indi-
vidual, in order to recover a prior overpayment of 
benefits to the individual under the supplemental se-
curity income program under title XVI of the Social 
Security Act, subject to the limitations of section 
1631(b) of such Act. 
(2) AUTHORITY TO MAKE PAYMENTS OVER THE 
COURSE OF 2 MONTHS.—The Commissioner of So-
cial Security may provide for payments under this 
section to be made over the course of 2 calendar 
months as may be necessary for the effective and ef-
ficient administration of this section. 
(3) PAYMENT TO BE DISREGARDED IN DETER-
MINING
UNDERPAYMENTS
UNDER
THE
SSI
PRO-
GRAM.—A payment under subsection (a) shall be 
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109 
disregarded in determining whether there has been 
an underpayment of benefits under the supplemental 
security income program under title XVI of the So-
cial Security Act. 
(4) NONASSIGNMENT.—The provisions of sec-
tion 207 of the Social Security Act shall apply with 
respect to payments under this section to the same 
extent as they apply in the case of title II of such 
Act. 
(c) PAYMENTS TO BE DISREGARDED FOR PURPOSES 
OF ALL FEDERAL
AND FEDERALLY ASSISTED PRO-
GRAMS.—A payment under subsection (a) shall not be re-
garded as income to the recipient, and shall not be re-
garded as a resource of the recipient for the month of re-
ceipt and the following 6 months, for purposes of deter-
mining the eligibility of any individual for benefits or as-
sistance, or the amount or extent of benefits or assistance, 
under any Federal program or under any State or local 
program financed in whole or in part with Federal funds. 
(d) APPROPRIATION.—Out of any sums in the Treas-
ury of the United States not otherwise appropriated, there 
are appropriated such sums as may be necessary to carry 
out this section. 
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110 
SEC. 2103. TEMPORARY RESUMPTION OF PRIOR CHILD 
SUPPORT LAW. 
During the period that begins with October 1, 2008, 
and ends with September 30, 2010, section 455(a)(1) of 
the Social Security Act shall be applied and administered 
as if the phrase ‘‘from amounts paid to the State under 
section 458 or’’ did not appear in such section. 
TITLE III—HEALTH INSURANCE 
ASSISTANCE FOR THE UNEM-
PLOYED 
SEC. 3001. SHORT TITLE AND TABLE OF CONTENTS OF 
TITLE. 
(a) SHORT TITLE OF TITLE.—This title may be cited 
as the ‘‘Health Insurance Assistance for the Unemployed 
Act of 2009’’. 
(b) TABLE OF CONTENTS OF TITLE.—The table of 
contents of this title is as follows: 
Sec. 3001. Short title and table of contents of title. 
Sec. 3002. Premium assistance for COBRA benefits and extension of COBRA 
benefits for older or long-term employees. 
Sec. 3003. Temporary optional Medicaid coverage for the unemployed. 
SEC. 3002. PREMIUM ASSISTANCE FOR COBRA BENEFITS 
AND EXTENSION OF COBRA BENEFITS FOR 
OLDER OR LONG-TERM EMPLOYEES. 
(a) PREMIUM ASSISTANCE FOR COBRA CONTINU-
ATION COVERAGE FOR INDIVIDUALS AND THEIR FAMI-
LIES.— 
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(1) PROVISION OF PREMIUM ASSISTANCE.— 
(A) 
REDUCTION
OF
PREMIUMS
PAY-
ABLE.—In the case of any premium for a pe-
riod of coverage beginning on or after the date 
of the enactment of this Act for COBRA con-
tinuation coverage with respect to any assist-
ance eligible individual, such individual shall be 
treated for purposes of any COBRA continu-
ation provision as having paid the amount of 
such premium if such individual pays 35 per-
cent of the amount of such premium (as deter-
mined without regard to this subsection). 
(B) PREMIUM REIMBURSEMENT.—For pro-
visions providing the balance of such premium, 
see section 6431 of the Internal Revenue Code 
of 1986, as added by paragraph (12). 
(2) LIMITATION OF PERIOD OF PREMIUM AS-
SISTANCE.— 
(A) IN GENERAL.—Paragraph (1)(A) shall 
not apply with respect to any assistance eligible 
individual for months of coverage beginning on 
or after the earlier of— 
(i) the first date that such individual 
is eligible for coverage under any other 
group health plan (other than coverage 
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112 
consisting of only dental, vision, coun-
seling, or referral services (or a combina-
tion thereof), coverage under a health re-
imbursement arrangement or a health 
flexible spending arrangement, or coverage 
of treatment that is furnished in an on-site 
medical facility maintained by the em-
ployer and that consists primarily of first- 
aid services, prevention and wellness care, 
or similar care (or a combination thereof)) 
or is eligible for benefits under title XVIII 
of the Social Security Act. 
(ii) the earliest of— 
(I) the date which is 12 months 
after the first day of first month that 
paragraph (1)(A) applies with respect 
to such individual, 
(II) the date following the expira-
tion of the maximum period of con-
tinuation coverage required under the 
applicable COBRA continuation cov-
erage provision, or 
(III) the date following the expi-
ration of the period of continuation 
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113 
coverage allowed under paragraph 
(4)(B)(ii). 
(B) TIMING
OF
ELIGIBILITY
FOR
ADDI-
TIONAL COVERAGE.—For purposes of subpara-
graph (A)(i), an individual shall not be treated 
as eligible for coverage under a group health 
plan before the first date on which such indi-
vidual could be covered under such plan. 
(C) 
NOTIFICATION
REQUIREMENT.—An 
assistance eligible individual shall notify in writ-
ing the group health plan with respect to which 
paragraph (1)(A) applies if such paragraph 
ceases to apply by reason of subparagraph 
(A)(i). Such notice shall be provided to the 
group health plan in such time and manner as 
may be specified by the Secretary of Labor. 
(3) ASSISTANCE
ELIGIBLE
INDIVIDUAL.—For 
purposes of this section, the term ‘‘assistance eligible 
individual’’ means any qualified beneficiary if— 
(A) at any time during the period that be-
gins with September 1, 2008, and ends with 
December 31, 2009, such qualified beneficiary 
is eligible for COBRA continuation coverage, 
(B) such qualified beneficiary elects such 
coverage, and 
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114 
(C) the qualifying event with respect to the 
COBRA continuation coverage consists of the 
involuntary termination of the covered employ-
ee’s employment and occurred during such pe-
riod. 
(4) EXTENSION OF ELECTION PERIOD AND EF-
FECT ON COVERAGE.— 
(A) IN
GENERAL.—Notwithstanding sec-
tion 605(a) of the Employee Retirement Income 
Security Act of 1974, section 4980B(f)(5)(A) of 
the Internal Revenue Code of 1986, section 
2205(a) of the Public Health Service Act, and 
section 8905a(c)(2) of title 5, United States 
Code, in the case of an individual who is a 
qualified beneficiary described in paragraph 
(3)(A) as of the date of the enactment of this 
Act and has not made the election referred to 
in paragraph (3)(B) as of such date, such indi-
vidual may elect the COBRA continuation cov-
erage under the COBRA continuation coverage 
provisions containing such sections during the 
60-day period commencing with the date on 
which the notification required under paragraph 
(7)(C) is provided to such individual. 
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115 
(B) COMMENCEMENT
OF
COVERAGE; NO 
REACH-BACK.—Any COBRA continuation cov-
erage elected by a qualified beneficiary during 
an extended election period under subparagraph 
(A)— 
(i) shall commence on the date of the 
enactment of this Act, and 
(ii) shall not extend beyond the period 
of COBRA continuation coverage that 
would have been required under the appli-
cable COBRA continuation coverage provi-
sion if the coverage had been elected as re-
quired under such provision. 
(C) PREEXISTING CONDITIONS.—With re-
spect to a qualified beneficiary who elects 
COBRA continuation coverage pursuant to sub-
paragraph (A), the period— 
(i) beginning on the date of the quali-
fying event, and 
(ii) ending with the day before the 
date of the enactment of this Act, 
shall be disregarded for purposes of deter-
mining the 63-day periods referred to in section 
701)(2) of the Employee Retirement Income 
Security Act of 1974, section 9801(c)(2) of the 
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Internal Revenue Code of 1986, and section 
2701(c)(2) of the Public Health Service Act. 
(5) EXPEDITED REVIEW OF DENIALS OF PRE-
MIUM ASSISTANCE.—In any case in which an indi-
vidual requests treatment as an assistance eligible 
individual and is denied such treatment by the group 
health plan by reason of such individual’s ineligi-
bility for COBRA continuation coverage, the Sec-
retary of Labor (or the Secretary of Health and 
Human services in connection with COBRA continu-
ation coverage which is provided other than pursu-
ant to part 6 of subtitle B of title I of the Employee 
Retirement Income Security Act of 1974), in con-
sultation with the Secretary of the Treasury, shall 
provide for expedited review of such denial. An indi-
vidual shall be entitled to such review upon applica-
tion to such Secretary in such form and manner as 
shall be provided by such Secretary. Such Secretary 
shall make a determination regarding such individ-
ual’s eligibility within 10 business days after receipt 
of such individual’s application for review under this 
paragraph. 
(6) DISREGARD OF SUBSIDIES FOR PURPOSES 
OF
FEDERAL
AND
STATE
PROGRAMS.—Notwith-
standing any other provision of law, any premium 
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reduction with respect to an assistance eligible indi-
vidual under this subsection shall not be considered 
income or resources in determining eligibility for, or 
the amount of assistance or benefits provided under, 
any other public benefit provided under Federal law 
or the law of any State or political subdivision there-
of. 
(7) NOTICES TO INDIVIDUALS.— 
(A) GENERAL NOTICE.— 
(i) IN GENERAL.—In the case of no-
tices provided under section 606(4) of the 
Employee Retirement Income Security Act 
of 1974 (29 U.S.C. 1166(4)), section 
4980B(f)(6)(D) of the Internal Revenue 
Code of 1986, section 2206(4) of the Pub-
lic Health Service Act (42 U.S.C. 300bb– 
6(4)), or section 8905a(f)(2)(A) of title 5, 
United States Code, with respect to indi-
viduals who, during the period described in 
paragraph (3)(A), become entitled to elect 
COBRA continuation coverage, such no-
tices shall include an additional notifica-
tion to the recipient of the availability of 
premium reduction with respect to such 
coverage under this subsection. 
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118 
(ii) ALTERNATIVE
NOTICE.—In the 
case of COBRA continuation coverage to 
which the notice provision under such sec-
tions does not apply, the Secretary of 
Labor, in consultation with the Secretary 
of the Treasury and the Secretary of 
Health and Human Services, shall, in co-
ordination with administrators of the 
group health plans (or other entities) that 
provide or administer the COBRA continu-
ation coverage involved, provide rules re-
quiring the provision of such notice. 
(iii) FORM.—The requirement of the 
additional notification under this subpara-
graph may be met by amendment of exist-
ing notice forms or by inclusion of a sepa-
rate document with the notice otherwise 
required. 
(B) SPECIFIC REQUIREMENTS.—Each ad-
ditional notification under subparagraph (A) 
shall include— 
(i) the forms necessary for estab-
lishing eligibility for premium reduction 
under this subsection, 
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119 
(ii) the name, address, and telephone 
number necessary to contact the plan ad-
ministrator and any other person main-
taining relevant information in connection 
with such premium reduction, 
(iii) a description of the extended elec-
tion period provided for in paragraph 
(4)(A), 
(iv) a description of the obligation of 
the qualified beneficiary under paragraph 
(2)(C) to notify the plan providing continu-
ation coverage of eligibility for subsequent 
coverage under another group health plan 
or eligibility for benefits under title XVIII 
of the Social Security Act and the penalty 
provided for failure to so notify the plan, 
and 
(v) a description, displayed in a 
prominent manner, of the qualified bene-
ficiary’s right to a reduced premium and 
any conditions on entitlement to the re-
duced premium. 
(C) NOTICE
RELATING
TO
RETROACTIVE 
COVERAGE.—In the case of an individual de-
scribed in paragraph (3)(A) who has elected 
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120 
COBRA continuation coverage as of the date of 
enactment of this Act or an individual described 
in paragraph (4)(A), the administrator of the 
group health plan (or other entity) involved 
shall provide (within 60 days after the date of 
enactment of this Act) for the additional notifi-
cation required to be provided under subpara-
graph (A). 
(D) MODEL NOTICES.—Not later than 30 
days after the date of enactment of this Act, 
the Secretary of the Labor, in consultation with 
the Secretary of the Treasury and the Secretary 
of Health and Human Services, shall prescribe 
models for the additional notification required 
under this paragraph. 
(8) SAFEGUARDS.—The Secretary of the Treas-
ury shall provide such rules, procedures, regulations, 
and other guidance as may be necessary and appro-
priate to prevent fraud and abuse under this sub-
section. 
(9) OUTREACH.—The Secretary of Labor, in 
consultation with the Secretary of the Treasury and 
the Secretary of Health and Human Services, shall 
provide outreach consisting of public education and 
enrollment assistance relating to premium reduction 
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provided under this subsection. Such outreach shall 
target employers, group health plan administrators, 
public assistance programs, States, insurers, and 
other entities as determined appropriate by such 
Secretaries. Such outreach shall include an initial 
focus on those individuals electing continuation cov-
erage who are referred to in paragraph (7)(C). In-
formation on such premium reduction, including en-
rollment, shall also be made available on website of 
the Departments of Labor, Treasury, and Health 
and Human Services. 
(10) DEFINITIONS.—For purposes of this sub-
section— 
(A) ADMINISTRATOR.—The term ‘‘admin-
istrator’’ has the meaning given such term in 
section 3(16) of the Employee Retirement In-
come Security Act of 1974. 
(B) COBRA CONTINUATION COVERAGE.— 
The term ‘‘COBRA continuation coverage’’ 
means continuation coverage provided pursuant 
to part 6 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974 
(other than under section 609), title XXII of 
the Public Health Service Act, section 4980B of 
the Internal Revenue Code of 1986 (other than 
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subsection (f)(1) of such section insofar as it 
relates to pediatric vaccines), or section 8905a 
of title 5, United States Code, or under a State 
program that provides continuation coverage 
comparable to such continuation coverage. Such 
term does not include coverage under a health 
flexible spending arrangement. 
(C) COBRA CONTINUATION PROVISION.— 
The term ‘‘COBRA continuation provision’’ 
means the provisions of law described in sub-
paragraph (B). 
(D) 
COVERED
EMPLOYEE.—The 
term 
‘‘covered employee’’ has the meaning given such 
term in section 607(2) of the Employee Retire-
ment Income Security Act of 1974. 
(E) QUALIFIED BENEFICIARY.—The term 
‘‘qualified beneficiary’’ has the meaning given 
such term in section 607(3) of the Employee 
Retirement Income Security Act of 1974. 
(F) GROUP
HEALTH
PLAN.—The term 
‘‘group health plan’’ has the meaning given 
such term in section 607(1) of the Employee 
Retirement Income Security Act of 1974. 
(G) STATE.—The term ‘‘State’’ includes 
the District of Columbia, the Commonwealth of 
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123 
Puerto Rico, the Virgin Islands, Guam, Amer-
ican Samoa, and the Commonwealth of the 
Northern Mariana Islands. 
(11) REPORTS.— 
(A) INTERIM REPORT.—The Secretary of 
the Treasury shall submit an interim report to 
the Committee on Education and Labor, the 
Committee on Ways and Means, and the Com-
mittee on Energy and Commerce of the House 
of Representatives and the Committee on 
Health, Education, Labor, and Pensions and 
the Committee on Finance of the Senate re-
garding the premium reduction provided under 
this subsection that includes— 
(i) the number of individuals provided 
such assistance as of the date of the re-
port; and 
(ii) the total amount of expenditures 
incurred (with administrative expenditures 
noted separately) in connection with such 
assistance as of the date of the report. 
(B) FINAL
REPORT.—As soon as prac-
ticable after the last period of COBRA continu-
ation coverage for which premium reduction is 
provided under this section, the Secretary of the 
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124 
Treasury shall submit a final report to each 
Committee referred to in subparagraph (A) that 
includes— 
(i) the number of individuals provided 
premium reduction under this section; 
(ii) 
the 
average 
dollar 
amount 
(monthly and annually) of premium reduc-
tions provided to such individuals; and 
(iii) the total amount of expenditures 
incurred (with administrative expenditures 
noted separately) in connection with pre-
mium reduction under this section. 
(12) COBRA PREMIUM ASSISTANCE.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 65 of the Internal Revenue Code of 1986 is 
amended by adding at the end the following 
new section: 
‘‘SEC. 6431. COBRA PREMIUM ASSISTANCE. 
‘‘(a) IN GENERAL.—The entity to whom premiums 
are payable under COBRA continuation coverage shall be 
reimbursed for the amount of premiums not paid by plan 
beneficiaries by reason of section 3002(a) of the Health 
Insurance Assistance for the Unemployed Act of 2009. 
Such amount shall be treated as a credit against the re-
quirement of such entity to make deposits of payroll taxes. 
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125 
To the extent that such amount exceeds the amount of 
such taxes, the Secretary shall pay to such entity the 
amount of such excess. No payment may be made under 
this subsection to an entity with respect to any assistance 
eligible individual until after such entity has received the 
reduced premium from such individual required under sec-
tion 3002(a)(1)(A) of such Act. 
‘‘(b) PAYROLL TAXES.—For purposes of this section, 
the term ‘payroll taxes’ means— 
‘‘(1) amounts required to be deducted and with-
held for the payroll period under section 3401 (relat-
ing to wage withholding), 
‘‘(2) amounts required to be deducted for the 
payroll period under section 3102 (relating to FICA 
employee taxes), and 
‘‘(3) amounts of the taxes imposed for the pay-
roll period under section 3111 (relating to FICA em-
ployer taxes). 
‘‘(c) TREATMENT OF CREDIT.—Except as otherwise 
provided by the Secretary, the credit described in sub-
section (a) shall be applied as though the employer had 
paid to the Secretary, on the day that the qualified bene-
ficiary’s premium payment is received, an amount equal 
to such credit. 
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126 
‘‘(d) TREATMENT OF PAYMENT.—For purposes of 
section 1324(b)(2) of title 31, United States Code, any 
payment under this subsection shall be treated in the same 
manner as a refund of the credit under section 35. 
‘‘(e) REPORTING.— 
‘‘(1) IN GENERAL.—Each entity entitled to re-
imbursement under subsection (a) for any period 
shall submit such reports as the Secretary may re-
quire, including— 
‘‘(A) an attestation of involuntary termi-
nation of employment for each covered em-
ployee on the basis of whose termination entitle-
ment to reimbursement is claimed under sub-
section (a), and 
‘‘(B) a report of the amount of payroll 
taxes offset under subsection (a) for the report-
ing period and the estimated offsets of such 
taxes for the subsequent reporting period in 
connection with reimbursements under sub-
section (a). 
‘‘(2) TIMING
OF
REPORTS
RELATING
TO 
AMOUNT
OF
PAYROLL
TAXES.—Reports required 
under paragraph (1)(B) shall be submitted at the 
same time as deposits of taxes imposed by chapters 
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127 
21, 22, and 24 or at such time as is specified by the 
Secretary. 
‘‘(f) REGULATIONS.—The Secretary may issue such 
regulations or other guidance as may be necessary or ap-
propriate to carry out this section, including the require-
ment to report information or the establishment of other 
methods for verifying the correct amounts of payments 
and credits under this section.’’. 
(B) SOCIAL SECURITY TRUST FUNDS HELD 
HARMLESS.—In determining any amount trans-
ferred or appropriated to any fund under the 
Social Security Act, section 6431 of the Inter-
nal Revenue Code of 1986 shall not be taken 
into account. 
(C) CLERICAL AMENDMENT.—The table of 
sections for subchapter B of chapter 65 of the 
Internal Revenue Code of 1986 is amended by 
adding at the end the following new item: 
‘‘Sec. 6431. COBRA premium assistance.’’. 
(D) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to pre-
miums to which subsection (a)(1)(A) applies. 
(13) PENALTY
FOR
FAILURE
TO
NOTIFY 
HEALTH PLAN OF CESSATION OF ELIGIBILITY FOR 
PREMIUM ASSISTANCE.— 
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128 
(A) IN GENERAL.—Part I of subchapter B 
of chapter 68 of the Internal Revenue Code of 
1986 is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 6720C. PENALTY FOR FAILURE TO NOTIFY HEALTH 
PLAN OF CESSATION OF ELIGIBILITY FOR 
COBRA PREMIUM ASSISTANCE. 
‘‘(a) IN GENERAL.—Any person required to notify a 
group health plan under section 3002(a)(2)(C)) of the 
Health Insurance Assistance for the Unemployed Act of 
2009 who fails to make such a notification at such time 
and in such manner as the Secretary of Labor may require 
shall pay a penalty of 110 percent of the premium reduc-
tion provided under such section after termination of eligi-
bility under such subsection. 
‘‘(b) REASONABLE CAUSE EXCEPTION.—No penalty 
shall be imposed under subsection (a) with respect to any 
failure if it is shown that such failure is due to reasonable 
cause and not to willful neglect.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections of part I of subchapter B of chapter 68 
of such Code is amended by adding at the end 
the following new item: 
‘‘Sec. 6720C. Penalty for failure to notify health plan of cessation of eligibility 
for COBRA premium assistance.’’. 
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129 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to failures 
occurring after the date of the enactment of 
this Act. 
(14) COORDINATION WITH HCTC.— 
(A) IN GENERAL.—Subsection (g) of sec-
tion 35 of the Internal Revenue Code of 1986 
is amended by redesignating paragraph (9) as 
paragraph (10) and inserting after paragraph 
(8) the following new paragraph: 
‘‘(9) COBRA PREMIUM
ASSISTANCE.—In the 
case of an assistance eligible individual who receives 
premium reduction for COBRA continuation cov-
erage under section 3002(a) of the Health Insurance 
Assistance for the Unemployed Act of 2009 for any 
month during the taxable year, such individual shall 
not be treated as an eligible individual, a certified 
individual, or a qualifying family member for pur-
poses of this section or section 7527 with respect to 
such month.’’. 
(B) EFFECTIVE
DATE.—The amendment 
made by subparagraph (A) shall apply to tax-
able years ending after the date of the enact-
ment of this Act. 
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130 
(15) EXCLUSION OF COBRA PREMIUM ASSIST-
ANCE FROM GROSS INCOME.— 
(A) IN GENERAL.—Part III of subchapter 
B of chapter 1 of the Internal Revenue Code of 
1986 is amended by inserting after section 
139B the following new section: 
‘‘SEC. 139C. COBRA PREMIUM ASSISTANCE. 
‘‘In the case of an assistance eligible individual (as 
defined in section 3002 of the Health Insurance Assist-
ance for the Unemployed Act of 2009), gross income does 
not include any premium reduction provided under sub-
section (a) of such section.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for part III of subchapter B of chapter 
1 of such Code is amended by inserting after 
the item relating to section 139B the following 
new item: 
‘‘Sec. 139C. COBRA premium assistance.’’. 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to taxable 
years ending after the date of the enactment of 
this Act. 
(b) EXTENSION OF COBRA BENEFITS FOR OLDER 
OR LONG-TERM EMPLOYEES.— 
(1) ERISA AMENDMENT.—Section 602(2)(A) 
of the Employee Retirement Income Security Act of 
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131 
1974 is amended by adding at the end the following 
new clauses: 
‘‘(x) SPECIAL RULE FOR OLDER OR 
LONG-TERM EMPLOYEES GENERALLY.—In 
the case of a qualifying event described in 
section 603(2) with respect to a covered 
employee who (as of such qualifying event) 
has attained age 55 or has completed 10 
or more years of service with the entity 
that is the employer at the time of the 
qualifying event, clauses (i) and (ii) shall 
not apply. 
‘‘(xi) YEAR
OF
SERVICE.—For pur-
poses of this subparagraph, the term ‘year 
of service’ shall have the meaning provided 
in section 202(a)(3).’’. 
(2) IRC AMENDMENT.—Clause (i) of section 
4980B(f)(2)(B) of the Internal Revenue Code of 
1986 is amended by adding at the end the following 
new subclauses: 
‘‘(X) SPECIAL RULE FOR OLDER 
OR
LONG-TERM
EMPLOYEES
GEN-
ERALLY.—In the case of a qualifying 
event described in paragraph (3)(B) 
with respect to a covered employee 
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132 
who (as of such qualifying event) has 
attained age 55 or has completed 10 
or more years of service with the enti-
ty that is the employer at the time of 
the qualifying event, subclauses (I) 
and (II) shall not apply. 
‘‘(XI) YEAR
OF
SERVICE.—For 
purposes of this clause, the term ‘year 
of service’ shall have the meaning pro-
vided in section 202(a)(3) of the Em-
ployee Retirement Income Security 
Act of 1974.’’. 
(3) PHSA AMENDMENT.—Section 2202(2)(A) 
of the Public Health Service Act is amended by add-
ing at the end the following new clauses: 
‘‘(viii) SPECIAL RULE FOR OLDER OR 
LONG-TERM EMPLOYEES GENERALLY.—In 
the case of a qualifying event described in 
section 2203(2) with respect to a covered 
employee who (as of such qualifying event) 
has attained age 55 or has completed 10 
or more years of service with the entity 
that is the employer at the time of the 
qualifying event, clauses (i) and (ii) shall 
not apply. 
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133 
‘‘(ix) YEAR
OF
SERVICE.—For pur-
poses of this subparagraph, the term ‘year 
of service’ shall have the meaning provided 
in section 202(a)(3) of the Employee Re-
tirement Income Security Act of 1974.’’. 
(4) EFFECTIVE DATE OF AMENDMENTS.—The 
amendments made by this subsection shall apply to 
periods of coverage which would (without regard to 
the amendments made by this section) end on or 
after the date of the enactment of this Act. 
SEC. 3003. TEMPORARY OPTIONAL MEDICAID COVERAGE 
FOR THE UNEMPLOYED. 
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396b) is amended— 
(1) in subsection (a)(10)(A)(ii)— 
(A) by striking ‘‘or’’ at the end of sub-
clause (XVIII); 
(B) by adding ‘‘or’’ at the end of subclause 
(XIX); and 
(C) by adding at the end the following new 
subclause 
‘‘(XX) who are described in sub-
section (dd)(1) (relating to certain un-
employed individuals and their fami-
lies);’’; and 
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134 
(2) by adding at the end the following new sub-
section: 
‘‘(dd)(1) Individuals described in this paragraph 
are— 
‘‘(A) individuals who— 
‘‘(i) are within one or more of the cat-
egories described in paragraph (2), as elected 
under the State plan; and 
‘‘(ii) meet the applicable requirements of 
paragraph (3); and 
‘‘(B) individuals who— 
‘‘(i) are the spouse, or dependent child 
under 19 years of age, of an individual de-
scribed in subparagraph (A); and 
‘‘(ii) meet the requirement of paragraph 
(3)(B). 
‘‘(2) The categories of individuals described in this 
paragraph are each of the following: 
‘‘(A) Individuals who are receiving unemploy-
ment compensation benefits. 
‘‘(B) Individuals who were receiving, but have 
exhausted, unemployment compensation benefits on 
or after July 1, 2008. 
‘‘(C) Individuals who are involuntarily unem-
ployed and were involuntarily separated from em-
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135 
ployment on or after September 1, 2008, and before 
January 1, 2011, whose family gross income does 
not exceed a percentage specified by the State (not 
to exceed 200 percent) of the income official poverty 
line (as defined by the Office of Management and 
Budget, and revised annually in accordance with sec-
tion 673(2) of the Omnibus Budget Reconciliation 
Act of 1981) applicable to a family of the size in-
volved, 
and 
who, 
but 
for 
subsection 
(a)(10)(A)(ii)(XX), are not eligible for medical as-
sistance under this title or health assistance under 
title XXI. 
‘‘(D) Individuals who are involuntarily unem-
ployed and were involuntarily separated from em-
ployment on or after September 1, 2008, and before 
January 1, 2011, who are members of households 
participating in the supplemental nutrition assist-
ance program established under the Food and Nutri-
tion Act of 2008 (7 U.S.C. 2011 et seq), and who, 
but for subsection (a)(10)(A)(ii)(XX), are not eligi-
ble for medical assistance under this title or health 
assistance under title XXI. 
A State plan may elect one or more of the categories de-
scribed in this paragraph but may not elect the category 
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136 
described in subparagraph (B) unless the State plan also 
elects the category described in subparagraph (A). 
‘‘(3) The requirements of this paragraph with respect 
to an individual are the following: 
‘‘(A) In the case of individuals within a cat-
egory described in subparagraph (A) or (B) of para-
graph (2), the individual was involuntarily separated 
from employment on or after September 1, 2008, 
and before January 1, 2011, or meets such com-
parable requirement as the Secretary specifies 
through rule, guidance, or otherwise in the case of 
an individual who was an independent contractor. 
‘‘(B) The individual is not otherwise covered 
under creditable coverage, as defined in section 
2701(c) of the Public Health Service Act (42 U.S.C. 
300gg(c)), but applied without regard to paragraph 
(1)(F) of such section and without regard to cov-
erage provided by reason of the application of sub-
section (a)(10)(A)(ii)(XX). 
‘‘(4)(A) No income or resources test shall be applied 
with respect to any category of individuals described in 
subparagraph (A), (B), or (D) of paragraph (2) who are 
eligible for medical assistance only by reason of the appli-
cation of subsection (a)(10)(A)(ii)(XX). 
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137 
‘‘(B) Nothing in this subsection shall be construed 
to prevent a State from imposing a resource test for the 
category of individuals described in paragraph (2)(C)). 
‘‘(C) In the case of individuals provided medical as-
sistance by reason of the application of subsection 
(a)(10)(A)(ii)(XX), the requirements of subsections 
(i)(22) and (x) shall not apply.’’. 
(b) 100 PERCENT FEDERAL MATCHING RATE.— 
(1) FMAP FOR
TIME-LIMITED
PERIOD.—The 
third sentence of section 1905(b) of such Act (42 
U.S.C. 1396d(b)) is amended by inserting before the 
period at the end the following: ‘‘and for items and 
services furnished on or after the date of enactment 
of this Act and before January 1, 2011, to individ-
uals who are eligible for medical assistance only by 
reason 
of 
the 
application 
of 
section 
1902(a)(10)(A)(ii)(XX)’’. 
(2) CERTAIN ENROLLMENT-RELATED ADMINIS-
TRATIVE COSTS.—Notwithstanding any other provi-
sion of law, for purposes of applying section 1903(a) 
of the Social Security Act (42 U.S.C. 1396b(a)), 
with respect to expenditures incurred on or after the 
date of the enactment of this Act and before Janu-
ary 1, 2011, for costs of administration (including 
outreach and the modification and operation of eligi-
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138 
bility information systems) attributable to eligibility 
determination and enrollment of individuals who are 
eligible for medical assistance only by reason of the 
application of section 1902(a)(10)(A)(ii)(XX) of 
such Act, as added by subsection (a)(1), the Federal 
matching percentage shall be 100 percent instead of 
the matching percentage otherwise applicable. 
(c) 
CONFORMING
AMENDMENTS.—(1) 
Section 
1903(f)(4) of such Act (42 U.S.C. 1396c(f)(4)) is amend-
ed by inserting ‘‘1902(a)(10)(A)(ii)(XX), or’’ after 
‘‘1902(a)(10)(A)(ii)(XIX),’’. 
(2) Section 1905(a) of such Act (42 U.S.C. 
1396d(a)) is amended, in the matter preceding paragraph 
(1)— 
(A) by striking ‘‘or’’ at the end of clause (xii); 
(B) by adding ‘‘or’’ at the end of clause (xiii); 
and 
(C) by inserting after clause (xiii) the following 
new clause: 
‘‘(xiv) individuals described in section 
1902(dd)(1),’’. 
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139 
TITLE IV—HEALTH 
INFORMATION TECHNOLOGY 
SEC. 4001. SHORT TITLE; TABLE OF CONTENTS OF TITLE. 
(a) SHORT TITLE.—This title may be cited as the 
‘‘Health Information Technology for Economic and Clin-
ical Health Act’’ or the ‘‘HITECH Act’’. 
(b) TABLE OF CONTENTS OF TITLE.—The table of 
contents of this title is as follows: 
Sec. 4001. Short title; table of contents of title. 
Subtitle A—Promotion of Health Information Technology 
PART I—IMPROVING HEALTH CARE QUALITY, SAFETY, AND EFFICIENCY 
Sec. 4101. ONCHIT; standards development and adoption. 
‘‘TITLE XXX—HEALTH INFORMATION TECHNOLOGY AND 
QUALITY 
‘‘Sec. 3000. Definitions. 
‘‘Subtitle A—Promotion of Health Information Technology 
‘‘Sec. 3001. Office of the National Coordinator for Health Information 
Technology. 
‘‘Sec. 3002. HIT Policy Committee. 
‘‘Sec. 3003. HIT Standards Committee. 
‘‘Sec. 3004. Process for adoption of endorsed recommendations; adoption 
of initial set of standards, implementation specifications, 
and certification criteria. 
‘‘Sec. 3005. Application and use of adopted standards and implementation 
specifications by Federal agencies. 
‘‘Sec. 3006. Voluntary application and use of adopted standards and im-
plementation specifications by private entities. 
‘‘Sec. 3007. Federal health information technology. 
‘‘Sec. 3008. Transitions. 
‘‘Sec. 3009. Relation to HIPAA privacy and security law. 
‘‘Sec. 3010. Authorization for appropriations. 
Sec. 4102. Technical amendment. 
PART II—APPLICATION AND USE OF ADOPTED HEALTH INFORMATION 
TECHNOLOGY STANDARDS; REPORTS 
Sec. 4111. Coordination of Federal activities with adopted standards and imple-
mentation specifications. 
Sec. 4112. Application to private entities. 
Sec. 4113. Study and reports. 
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140 
Subtitle B—Testing of Health Information Technology 
Sec. 4201. National Institute for Standards and Technology testing. 
Sec. 4202. Research and development programs. 
Subtitle C—Incentives for the Use of Health Information Technology 
PART I—GRANTS AND LOANS FUNDING 
Sec. 4301. Grant, loan, and demonstration programs. 
‘‘Subtitle B—Incentives for the Use of Health Information Technology 
‘‘Sec. 3011. Immediate funding to strengthen the health information tech-
nology infrastructure. 
‘‘Sec. 3012. Health information technology implementation assistance. 
‘‘Sec. 3013. State grants to promote health information technology. 
‘‘Sec. 3014. Competitive grants to States and Indian tribes for the devel-
opment of loan programs to facilitate the widespread 
adoption of certified EHR technology. 
‘‘Sec. 3015. Demonstration program to integrate information technology 
into clinical education. 
‘‘Sec. 3016. Information technology professionals on health care. 
‘‘Sec. 3017. General grant and loan provisions. 
‘‘Sec. 3018. Authorization for appropriations. 
PART II—MEDICARE PROGRAM 
Sec. 4311. Incentives for eligible professionals. 
Sec. 4312. Incentives for hospitals. 
Sec. 4313. Treatment of payments and savings; implementation funding. 
Sec. 4314. Study on application of HIT payment incentives for providers not 
receiving other incentive payments. 
PART III—MEDICAID FUNDING 
Sec. 4321. Medicaid provider HIT adoption and operation payments; implemen-
tation funding. 
Subtitle D—Privacy 
Sec. 4400. Definitions. 
PART I—IMPROVED PRIVACY PROVISIONS AND SECURITY PROVISIONS 
Sec. 4401. Application of security provisions and penalties to business associ-
ates of covered entities; annual guidance on security provisions. 
Sec. 4402. Notification in the case of breach. 
Sec. 4403. Education on Health Information Privacy. 
Sec. 4404. Application of privacy provisions and penalties to business associates 
of covered entities. 
Sec. 4405. Restrictions on certain disclosures and sales of health information; 
accounting of certain protected health information disclosures; 
access to certain information in electronic format. 
Sec. 4406. Conditions on certain contacts as part of health care operations. 
Sec. 4407. Temporary breach notification requirement for vendors of personal 
health records and other non-HIPAA covered entities. 
Sec. 4408. Business associate contracts required for certain entities. 
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141 
Sec. 4409. Clarification of application of wrongful disclosures criminal pen-
alties. 
Sec. 4410. Improved enforcement. 
Sec. 4411. Audits. 
PART II—RELATIONSHIP TO OTHER LAWS; REGULATORY REFERENCES; 
EFFECTIVE DATE; REPORTS 
Sec. 4421. Relationship to other laws. 
Sec. 4422. Regulatory references. 
Sec. 4423. Effective date. 
Sec. 4424. Studies, reports, guidance. 
Subtitle E—Miscellaneous Medicare Provisions 
Sec. 4501. Moratoria on certain Medicare regulations. 
Sec. 4502. Long-term care hospital technical corrections. 
Subtitle A—Promotion of Health 
Information Technology 
PART I—IMPROVING HEALTH CARE QUALITY, 
SAFETY, AND EFFICIENCY 
SEC. 4101. ONCHIT; STANDARDS DEVELOPMENT AND ADOP-
TION. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended by adding at the end the following: 
‘‘TITLE XXX—HEALTH INFORMA-
TION 
TECHNOLOGY 
AND 
QUALITY 
‘‘SEC. 3000. DEFINITIONS. 
‘‘In this title: 
‘‘(1) CERTIFIED EHR TECHNOLOGY.—The term 
‘certified EHR technology’ means a qualified elec-
tronic health record that is certified pursuant to sec-
tion 3001(c)(5) as meeting standards adopted under 
section 3004 that are applicable to the type of 
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142 
record involved (as determined by the Secretary, 
such as an ambulatory electronic health record for 
office-based physicians or an inpatient hospital elec-
tronic health record for hospitals). 
‘‘(2) ENTERPRISE
INTEGRATION.—The term 
‘enterprise integration’ means the electronic linkage 
of health care providers, health plans, the govern-
ment, and other interested parties, to enable the 
electronic exchange and use of health information 
among all the components in the health care infra-
structure in accordance with applicable law, and 
such term includes related application protocols and 
other related standards. 
‘‘(3) HEALTH
CARE
PROVIDER.—The term 
‘health care provider’ means a hospital, skilled nurs-
ing facility, nursing facility, home health entity or 
other long-term care facility, health care clinic, Fed-
erally qualified health center, group practice (as de-
fined in section 1877(h)(4) of the Social Security 
Act), a pharmacist, a pharmacy, a laboratory, a phy-
sician (as defined in section 1861(r) of the Social 
Security Act), a practitioner (as described in section 
1842(b)(18)(C) of the Social Security Act), a pro-
vider operated by, or under contract with, the Indian 
Health Service or by an Indian tribe (as defined in 
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the Indian Self-Determination and Education Assist-
ance Act), tribal organization, or urban Indian orga-
nization (as defined in section 4 of the Indian 
Health Care Improvement Act), a rural health clinic, 
a covered entity under section 340B, and any other 
category of facility or clinician determined appro-
priate by the Secretary. 
‘‘(4) HEALTH INFORMATION.—The term ‘health 
information’ has the meaning given such term in 
section 1171(4) of the Social Security Act. 
‘‘(5) HEALTH
INFORMATION
TECHNOLOGY.— 
The term ‘health information technology’ means 
hardware, software, integrated technologies and re-
lated licenses, intellectual property, upgrades, and 
packaged solutions sold as services that are specifi-
cally designed for use by health care entities for the 
electronic creation, maintenance, or exchange of 
health information. 
‘‘(6) HEALTH PLAN.—The term ‘health plan’ 
has the meaning given such term in section 1171(5) 
of the Social Security Act. 
‘‘(7) HIT POLICY COMMITTEE.—The term ‘HIT 
Policy Committee’ means such Committee estab-
lished under section 3002(a). 
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‘‘(8) HIT STANDARDS COMMITTEE.—The term 
‘HIT Standards Committee’ means such Committee 
established under section 3003(a). 
‘‘(9) INDIVIDUALLY IDENTIFIABLE HEALTH IN-
FORMATION.—The term ‘individually identifiable 
health information’ has the meaning given such term 
in section 1171(6) of the Social Security Act. 
‘‘(10) LABORATORY.—The term ‘laboratory’ 
has the meaning given such term in section 353(a). 
‘‘(11) NATIONAL
COORDINATOR.—The term 
‘National Coordinator’ means the head of the Office 
of the National Coordinator for Health Information 
Technology established under section 3001(a). 
‘‘(12) PHARMACIST.—The term ‘pharmacist’ 
has the meaning given such term in section 804(2) 
of the Federal Food, Drug, and Cosmetic Act. 
‘‘(13) 
QUALIFIED
ELECTRONIC
HEALTH 
RECORD.—The term ‘qualified electronic health 
record’ means an electronic record of health-related 
information on an individual that— 
‘‘(A) includes patient demographic and 
clinical health information, such as medical his-
tory and problem lists; and 
‘‘(B) has the capacity— 
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‘‘(i) to provide clinical decision sup-
port; 
‘‘(ii) to support physician order entry; 
‘‘(iii) to capture and query informa-
tion relevant to health care quality; and 
‘‘(iv) to exchange electronic health in-
formation with, and integrate such infor-
mation from other sources. 
‘‘(14) STATE.—The term ‘State’ means each of 
the several States, the District of Columbia, Puerto 
Rico, the Virgin Islands, Guam, American Samoa, 
and the Northern Mariana Islands. 
‘‘Subtitle A—Promotion of Health 
Information Technology 
‘‘SEC. 3001. OFFICE OF THE NATIONAL COORDINATOR FOR 
HEALTH INFORMATION TECHNOLOGY. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Department of Health and Human Services an Office 
of the National Coordinator for Health Information Tech-
nology (referred to in this section as the ‘Office’). The Of-
fice shall be headed by a National Coordinator who shall 
be appointed by the Secretary and shall report directly to 
the Secretary. 
‘‘(b) PURPOSE.—The National Coordinator shall per-
form the duties under subsection (c) in a manner con-
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sistent with the development of a nationwide health infor-
mation technology infrastructure that allows for the elec-
tronic use and exchange of information and that— 
‘‘(1) ensures that each patient’s health informa-
tion is secure and protected, in accordance with ap-
plicable law; 
‘‘(2) improves health care quality, reduces med-
ical errors, and advances the delivery of patient-cen-
tered medical care; 
‘‘(3) reduces health care costs resulting from 
inefficiency, medical errors, inappropriate care, du-
plicative care, and incomplete information; 
‘‘(4) provides appropriate information to help 
guide medical decisions at the time and place of 
care; 
‘‘(5) ensures the inclusion of meaningful public 
input in such development of such infrastructure; 
‘‘(6) improves the coordination of care and in-
formation among hospitals, laboratories, physician 
offices, and other entities through an effective infra-
structure for the secure and authorized exchange of 
health care information; 
‘‘(7) improves public health activities and facili-
tates the early identification and rapid response to 
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public health threats and emergencies, including bio-
terror events and infectious disease outbreaks; 
‘‘(8) facilitates health and clinical research and 
health care quality; 
‘‘(9) promotes prevention of chronic diseases; 
‘‘(10) promotes a more effective marketplace, 
greater competition, greater systems analysis, in-
creased consumer choice, and improved outcomes in 
health care services; and 
‘‘(11) improves efforts to reduce health dispari-
ties. 
‘‘(c) DUTIES OF THE NATIONAL COORDINATOR.— 
‘‘(1) STANDARDS.—The National Coordinator 
shall review and determine whether to endorse each 
standard, implementation specification, and certifi-
cation criterion for the electronic exchange and use 
of health information that is recommended by the 
HIT Standards Committee under section 3003 for 
purposes of adoption under section 3004. The Coor-
dinator shall make such determination, and report to 
the Secretary such determination, not later than 45 
days after the date the recommendation is received 
by the Coordinator. 
‘‘(2) HIT POLICY COORDINATION.— 
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‘‘(A) IN GENERAL.—The National Coordi-
nator shall coordinate health information tech-
nology policy and programs of the Department 
with those of other relevant executive branch 
agencies with a goal of avoiding duplication of 
efforts and of helping to ensure that each agen-
cy undertakes health information technology ac-
tivities primarily within the areas of its greatest 
expertise and technical capability and in a man-
ner towards a coordinated national goal. 
‘‘(B) HIT POLICY AND STANDARDS COM-
MITTEES.—The National Coordinator shall be a 
leading member in the establishment and oper-
ations of the HIT Policy Committee and the 
HIT Standards Committee and shall serve as a 
liaison among those two Committees and the 
Federal Government. 
‘‘(3) STRATEGIC PLAN.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator shall, in consultation with other appro-
priate Federal agencies (including the National 
Institute of Standards and Technology), update 
the Federal Health IT Strategic Plan (devel-
oped as of June 3, 2008) to include specific ob-
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jectives, milestones, and metrics with respect to 
the following: 
‘‘(i) The electronic exchange and use 
of health information and the enterprise 
integration of such information. 
‘‘(ii) The utilization of an electronic 
health record for each person in the United 
States by 2014. 
‘‘(iii) The incorporation of privacy and 
security protections for the electronic ex-
change of an individual’s individually iden-
tifiable health information. 
‘‘(iv) Ensuring security methods to 
ensure appropriate authorization and elec-
tronic authentication of health information 
and specifying technologies or methodolo-
gies for rendering health information unus-
able, unreadable, or indecipherable. 
‘‘(v) Specifying a framework for co-
ordination and flow of recommendations 
and policies under this subtitle among the 
Secretary, the National Coordinator, the 
HIT Policy Committee, the HIT Standards 
Committee, and other health information 
exchanges and other relevant entities. 
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‘‘(vi) Methods to foster the public un-
derstanding of health information tech-
nology. 
‘‘(vii) Strategies to enhance the use of 
health information technology in improving 
the quality of health care, reducing medical 
errors, reducing health disparities, improv-
ing public health, and improving the con-
tinuity of care among health care settings. 
‘‘(B) 
COLLABORATION.—The 
strategic 
plan shall be updated through collaboration of 
public and private entities. 
‘‘(C) MEASURABLE
OUTCOME
GOALS.— 
The strategic plan update shall include measur-
able outcome goals. 
‘‘(D) PUBLICATION.—The National Coor-
dinator shall republish the strategic plan, in-
cluding all updates. 
‘‘(4) WEBSITE.—The National Coordinator 
shall maintain and frequently update an Internet 
website on which there is posted information on the 
work, schedules, reports, recommendations, and 
other information to ensure transparency in pro-
motion of a nationwide health information tech-
nology infrastructure. 
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‘‘(5) CERTIFICATION.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator, in consultation with the Director of the 
National Institute of Standards and Tech-
nology, shall develop a program (either directly 
or by contract) for the voluntary certification of 
health information technology as being in com-
pliance with applicable certification criteria 
adopted under this subtitle. Such program shall 
include testing of the technology in accordance 
with section 4201(b) of the HITECH Act. 
‘‘(B) 
CERTIFICATION
CRITERIA
DE-
SCRIBED.—In this title, the term ‘certification 
criteria’ means, with respect to standards and 
implementation specifications for health infor-
mation technology, criteria to establish that the 
technology meets such standards and implemen-
tation specifications. 
‘‘(6) REPORTS AND PUBLICATIONS.— 
‘‘(A) REPORT
ON
ADDITIONAL
FUNDING 
OR AUTHORITY NEEDED.—Not later than 12 
months after the date of the enactment of this 
title, the National Coordinator shall submit to 
the appropriate committees of jurisdiction of 
the House of Representatives and the Senate a 
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report on any additional funding or authority 
the Coordinator or the HIT Policy Committee 
or HIT Standards Committee requires to evalu-
ate and develop standards, implementation 
specifications, and certification criteria, or to 
achieve full participation of stakeholders in the 
adoption of a nationwide health information 
technology infrastructure that allows for the 
electronic use and exchange of health informa-
tion. 
‘‘(B) 
IMPLEMENTATION
REPORT.—The 
National Coordinator shall prepare a report 
that identifies lessons learned from major pub-
lic and private health care systems in their im-
plementation of health information technology, 
including information on whether the tech-
nologies and practices developed by such sys-
tems may be applicable to and usable in whole 
or in part by other health care providers. 
‘‘(C) ASSESSMENT OF IMPACT OF HIT ON 
COMMUNITIES WITH HEALTH DISPARITIES AND 
UNINSURED, UNDERINSURED, AND MEDICALLY 
UNDERSERVED AREAS.—The National Coordi-
nator shall assess and publish the impact of 
health information technology in communities 
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with health disparities and in areas with a high 
proportion of individuals who are uninsured, 
underinsured, and medically underserved indi-
viduals (including urban and rural areas) and 
identify practices to increase the adoption of 
such technology by health care providers in 
such communities. 
‘‘(D) EVALUATION
OF
BENEFITS
AND 
COSTS
OF
THE
ELECTRONIC
USE
AND
EX-
CHANGE OF HEALTH INFORMATION.—The Na-
tional Coordinator shall evaluate and publish 
evidence on the benefits and costs of the elec-
tronic use and exchange of health information 
and assess to whom these benefits and costs ac-
crue. 
‘‘(E) 
RESOURCE
REQUIREMENTS.—The 
National Coordinator shall estimate and publish 
resources required annually to reach the goal of 
utilization of an electronic health record for 
each person in the United States by 2014, in-
cluding the required level of Federal funding, 
expectations for regional, State, and private in-
vestment, and the expected contributions by vol-
unteers to activities for the utilization of such 
records. 
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‘‘(7) ASSISTANCE.—The National Coordinator 
may provide financial assistance to consumer advo-
cacy groups and not-for-profit entities that work in 
the public interest for purposes of defraying the cost 
to such groups and entities to participate under, 
whether in whole or in part, the National Tech-
nology Transfer Act of 1995 (15 U.S.C. 272 note). 
‘‘(8) GOVERNANCE FOR NATIONWIDE HEALTH 
INFORMATION
NETWORK.—The National Coordi-
nator shall establish a governance mechanism for the 
nationwide health information network. 
‘‘(d) DETAIL OF FEDERAL EMPLOYEES.— 
‘‘(1) IN GENERAL.—Upon the request of the 
National Coordinator, the head of any Federal agen-
cy is authorized to detail, with or without reimburse-
ment from the Office, any of the personnel of such 
agency to the Office to assist it in carrying out its 
duties under this section. 
‘‘(2) EFFECT OF DETAIL.—Any detail of per-
sonnel under paragraph (1) shall— 
‘‘(A) not interrupt or otherwise affect the 
civil service status or privileges of the Federal 
employee; and 
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‘‘(B) be in addition to any other staff of 
the Department employed by the National Co-
ordinator. 
‘‘(3) ACCEPTANCE
OF
DETAILEES.—Notwith-
standing any other provision of law, the Office may 
accept detailed personnel from other Federal agen-
cies without regard to whether the agency described 
under paragraph (1) is reimbursed. 
‘‘(e) CHIEF PRIVACY OFFICER OF THE OFFICE OF 
THE
NATIONAL
COORDINATOR.—Not later than 12 
months after the date of the enactment of this title, the 
Secretary shall appoint a Chief Privacy Officer of the Of-
fice of the National Coordinator, whose duty it shall be 
to advise the National Coordinator on privacy, security, 
and data stewardship of electronic health information and 
to coordinate with other Federal agencies (and similar pri-
vacy officers in such agencies), with State and regional 
efforts, and with foreign countries with regard to the pri-
vacy, security, and data stewardship of electronic individ-
ually identifiable health information. 
‘‘SEC. 3002. HIT POLICY COMMITTEE. 
‘‘(a) ESTABLISHMENT.—There is established a HIT 
Policy Committee to make policy recommendations to the 
National Coordinator relating to the implementation of a 
nationwide health information technology infrastructure, 
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including implementation of the strategic plan described 
in section 3001(c)(3). 
‘‘(b) DUTIES.— 
‘‘(1) RECOMMENDATIONS ON HEALTH INFOR-
MATION TECHNOLOGY INFRASTRUCTURE.—The HIT 
Policy Committee shall recommend a policy frame-
work for the development and adoption of a nation-
wide health information technology infrastructure 
that permits the electronic exchange and use of 
health information as is consistent with the strategic 
plan under section 3001(c)(3) and that includes the 
recommendations under paragraph (2). The Com-
mittee shall update such recommendations and make 
new recommendations as appropriate. 
‘‘(2) SPECIFIC AREAS OF STANDARD DEVELOP-
MENT.— 
‘‘(A) IN GENERAL.—The HIT Policy Com-
mittee shall recommend the areas in which 
standards, implementation specifications, and 
certification criteria are needed for the elec-
tronic exchange and use of health information 
for purposes of adoption under section 3004 
and shall recommend an order of priority for 
the development, harmonization, and recogni-
tion of such standards, specifications, and cer-
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tification criteria among the areas so rec-
ommended. Such standards and implementation 
specifications shall include named standards, 
architectures, and software schemes for the au-
thentication and security of individually identifi-
able health information and other information 
as needed to ensure the reproducible develop-
ment of common solutions across disparate en-
tities. 
‘‘(B) AREAS
REQUIRED
FOR
CONSIDER-
ATION.—For purposes of subparagraph (A), the 
HIT Policy Committee shall make recommenda-
tions for at least the following areas: 
‘‘(i) Technologies that protect the pri-
vacy of health information and promote se-
curity in a qualified electronic health 
record, including for the segmentation and 
protection from disclosure of specific and 
sensitive individually identifiable health in-
formation with the goal of minimizing the 
reluctance of patients to seek care (or dis-
close information about a condition) be-
cause of privacy concerns, in accordance 
with applicable law, and for the use and 
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disclosure of limited data sets of such in-
formation. 
‘‘(ii) A nationwide health information 
technology infrastructure that allows for 
the electronic use and accurate exchange of 
health information. 
‘‘(iii) The utilization of a certified 
electronic health record for each person in 
the United States by 2014. 
‘‘(iv) Technologies that as a part of a 
qualified electronic health record allow for 
an accounting of disclosures made by a 
covered entity (as defined for purposes of 
regulations promulgated under section 
264(c) of the Health Insurance Portability 
and Accountability Act of 1996) for pur-
poses of treatment, payment, and health 
care operations (as such terms are defined 
for purposes of such regulations). 
‘‘(v) The use of certified electronic 
health records to improve the quality of 
health care, such as by promoting the co-
ordination of health care and improving 
continuity of health care among health 
care providers, by reducing medical errors, 
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by improving population health, and by ad-
vancing research and education. 
‘‘(C) 
OTHER
AREAS
FOR
CONSIDER-
ATION.—In making recommendations under 
subparagraph (A), the HIT Policy Committee 
may consider the following additional areas: 
‘‘(i) The appropriate uses of a nation-
wide health information infrastructure, in-
cluding for purposes of— 
‘‘(I) the collection of quality data 
and public reporting; 
‘‘(II) biosurveillance and public 
health; 
‘‘(III) medical and clinical re-
search; and 
‘‘(IV) drug safety. 
‘‘(ii) Self-service technologies that fa-
cilitate the use and exchange of patient in-
formation and reduce wait times. 
‘‘(iii) Telemedicine technologies, in 
order to reduce travel requirements for pa-
tients in remote areas. 
‘‘(iv) Technologies that facilitate home 
health care and the monitoring of patients 
recuperating at home. 
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‘‘(v) Technologies that help reduce 
medical errors. 
‘‘(vi) Technologies that facilitate the 
continuity of care among health settings. 
‘‘(vii) Technologies that meet the 
needs of diverse populations. 
‘‘(viii) Any other technology that the 
HIT Policy Committee finds to be among 
the technologies with the greatest potential 
to improve the quality and efficiency of 
health care. 
‘‘(3) FORUM.—The HIT Policy Committee shall 
serve as a forum for broad stakeholder input with 
specific expertise in policies relating to the matters 
described in paragraphs (1) and (2). 
‘‘(c) MEMBERSHIP AND OPERATIONS.— 
‘‘(1) IN GENERAL.—The National Coordinator 
shall provide leadership in the establishment and op-
erations of the HIT Policy Committee. 
‘‘(2) MEMBERSHIP.—The membership of the 
HIT Policy Committee shall at least reflect pro-
viders, ancillary healthcare workers, consumers, pur-
chasers, health plans, technology vendors, research-
ers, relevant Federal agencies, and individuals with 
technical expertise on health care quality, privacy 
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and security, and on the electronic exchange and use 
of health information. 
‘‘(3) CONSIDERATION.—The National Coordi-
nator shall ensure that the relevant recommenda-
tions and comments from the National Committee 
on Vital and Health Statistics are considered in the 
development of policies. 
‘‘(d) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.), other than section 14 of 
such Act, shall apply to the HIT Policy Committee. 
‘‘(e) PUBLICATION.—The Secretary shall provide for 
publication in the Federal Register and the posting on the 
Internet website of the Office of the National Coordinator 
for Health Information Technology of all policy rec-
ommendations made by the HIT Policy Committee under 
this section. 
‘‘SEC. 3003. HIT STANDARDS COMMITTEE. 
‘‘(a) ESTABLISHMENT.—There is established a com-
mittee to be known as the HIT Standards Committee to 
recommend to the National Coordinator standards, imple-
mentation specifications, and certification criteria for the 
electronic exchange and use of health information for pur-
poses of adoption under section 3004, consistent with the 
implementation of the strategic plan described in section 
3001(c)(3) and beginning with the areas listed in section 
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3002(b)(2)(B) in accordance with policies developed by 
the HIT Policy Committee. 
‘‘(b) DUTIES.— 
‘‘(1) STANDARD DEVELOPMENT.— 
‘‘(A) IN GENERAL.—The HIT Standards 
Committee shall recommend to the National 
Coordinator standards, implementation speci-
fications, and certification criteria described in 
subsection (a) that have been developed, har-
monized, or recognized by the HIT Standards 
Committee. The HIT Standards Committee 
shall update such recommendations and make 
new recommendations as appropriate, including 
in response to a notification sent under section 
3004(b)(2). Such recommendations shall be 
consistent with the latest recommendations 
made by the HIT Policy Committee. 
‘‘(B) PILOT TESTING OF STANDARDS AND 
IMPLEMENTATION SPECIFICATIONS.—In the de-
velopment, harmonization, or recognition of 
standards and implementation specifications, 
the HIT Standards Committee shall, as appro-
priate, provide for the testing of such standards 
and specifications by the National Institute for 
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Standards and Technology under section 4201 
of the HITECH Act. 
‘‘(C) CONSISTENCY.—The standards, im-
plementation specifications, and certification 
criteria recommended under this subsection 
shall be consistent with the standards for infor-
mation transactions and data elements adopted 
pursuant to section 1173 of the Social Security 
Act. 
‘‘(2) FORUM.—The HIT Standards Committee 
shall serve as a forum for the participation of a 
broad range of stakeholders to provide input on the 
development, harmonization, and recognition of 
standards, implementation specifications, and certifi-
cation criteria necessary for the development and 
adoption of a nationwide health information tech-
nology infrastructure that allows for the electronic 
use and exchange of health information. 
‘‘(3) SCHEDULE.—Not later than 90 days after 
the date of the enactment of this title, the HIT 
Standards Committee shall develop a schedule for 
the assessment of policy recommendations developed 
by the HIT Policy Committee under section 3002. 
The HIT Standards Committee shall update such 
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schedule annually. The Secretary shall publish such 
schedule in the Federal Register. 
‘‘(4) PUBLIC
INPUT.—The HIT Standards 
Committee shall conduct open public meetings and 
develop a process to allow for public comment on the 
schedule described in paragraph (3) and rec-
ommendations described in this subsection. Under 
such process comments shall be submitted in a time-
ly manner after the date of publication of a rec-
ommendation under this subsection. 
‘‘(c) MEMBERSHIP AND OPERATIONS.— 
‘‘(1) IN GENERAL.—The National Coordinator 
shall provide leadership in the establishment and op-
erations of the HIT Standards Committee. 
‘‘(2) MEMBERSHIP.—The membership of the 
HIT Standards Committee shall at least reflect pro-
viders, ancillary healthcare workers, consumers, pur-
chasers, health plans, technology vendors, research-
ers, relevant Federal agencies, and individuals with 
technical expertise on health care quality, privacy 
and security, and on the electronic exchange and use 
of health information. 
‘‘(3) CONSIDERATION.—The National Coordi-
nator shall ensure that the relevant recommenda-
tions and comments from the National Committee 
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on Vital and Health Statistics are considered in the 
development of standards. 
‘‘(4) ASSISTANCE.—For the purposes of car-
rying out this section, the Secretary may provide or 
ensure that financial assistance is provided by the 
HIT Standards Committee to defray in whole or in 
part any membership fees or dues charged by such 
Committee to those consumer advocacy groups and 
not for profit entities that work in the public inter-
est as a part of their mission. 
‘‘(d) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.), other than section 14, 
shall apply to the HIT Standards Committee. 
‘‘(e) PUBLICATION.—The Secretary shall provide for 
publication in the Federal Register and the posting on the 
Internet website of the Office of the National Coordinator 
for Health Information Technology of all recommenda-
tions made by the HIT Standards Committee under this 
section. 
‘‘SEC. 3004. PROCESS FOR ADOPTION OF ENDORSED REC-
OMMENDATIONS; ADOPTION OF INITIAL SET 
OF STANDARDS, IMPLEMENTATION SPECI-
FICATIONS, AND CERTIFICATION CRITERIA. 
‘‘(a) PROCESS FOR ADOPTION OF ENDORSED REC-
OMMENDATIONS.— 
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‘‘(1) REVIEW OF ENDORSED STANDARDS, IM-
PLEMENTATION
SPECIFICATIONS, 
AND
CERTIFI-
CATION CRITERIA.—Not later than 90 days after the 
date of receipt of standards, implementation speci-
fications, or certification criteria endorsed under sec-
tion 3001(c), the Secretary, in consultation with rep-
resentatives of other relevant Federal agencies, shall 
jointly review such standards, implementation speci-
fications, or certification criteria and shall determine 
whether or not to propose adoption of such stand-
ards, implementation specifications, or certification 
criteria. 
‘‘(2) DETERMINATION TO ADOPT STANDARDS, 
IMPLEMENTATION
SPECIFICATIONS, AND
CERTIFI-
CATION CRITERIA.—If the Secretary determines— 
‘‘(A) to propose adoption of any grouping 
of such standards, implementation specifica-
tions, or certification criteria, the Secretary 
shall, by regulation, determine whether or not 
to adopt such grouping of standards, implemen-
tation specifications, or certification criteria; or 
‘‘(B) not to propose adoption of any group-
ing of standards, implementation specifications, 
or certification criteria, the Secretary shall no-
tify the National Coordinator and the HIT 
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203 
used to exchange health information in a man-
ner that, in accordance with law and standards 
(as adopted under section 3005) applicable to 
the exchange of information, improves the qual-
ity of health care, such as promoting care co-
ordination; and 
‘‘(C) comply with such other requirements 
as the entity or the Secretary may require; 
‘‘(D) include a plan on how health care 
providers involved intend to maintain and sup-
port the certified EHR technology over time; 
‘‘(E) include a plan on how the health care 
providers involved intend to maintain and sup-
port the certified EHR technology that would 
be purchased with such loan, including the type 
of resources expected to be involved and any 
such other information as the State or Indian 
tribe, respectively, may require; and 
‘‘(5) agrees to provide matching funds in ac-
cordance with subsection (i). 
‘‘(c) ESTABLISHMENT OF FUND.—For purposes of 
subsection (b)(3), an eligible entity shall establish a cer-
tified EHR technology loan fund (referred to in this sub-
section as a ‘Loan Fund’) and comply with the other re-
quirements contained in this section. A grant to an eligible 
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entity under this section shall be deposited in the Loan 
Fund established by the eligible entity. No funds author-
ized by other provisions of this title to be used for other 
purposes specified in this title shall be deposited in any 
Loan Fund. 
‘‘(d) STRATEGIC PLAN.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(b)(2), a strategic plan of an eligible entity under 
this subsection shall identify the intended uses of 
amounts available to the Loan Fund of such entity. 
‘‘(2) CONTENTS.—A strategic plan under para-
graph (1), with respect to a Loan Fund of an eligi-
ble entity, shall include for a year the following: 
‘‘(A) A list of the projects to be assisted 
through the Loan Fund during such year. 
‘‘(B) A description of the criteria and 
methods established for the distribution of 
funds from the Loan Fund during the year. 
‘‘(C) A description of the financial status 
of the Loan Fund as of the date of submission 
of the plan. 
‘‘(D) The short-term and long-term goals 
of the Loan Fund. 
‘‘(e) USE OF FUNDS.—Amounts deposited in a Loan 
Fund, including loan repayments and interest earned on 
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‘‘(ii) the Medicare physician expendi-
ture proportion specified in subparagraph 
(C) for the year. 
‘‘(C) MEDICARE PHYSICIAN EXPENDITURE 
PROPORTION.—The Medicare physician expend-
iture proportion under this subparagraph for a 
year is the Secretary’s estimate of the propor-
tion, of the expenditures under parts A and B 
that are not attributable to this part, that are 
attributable to expenditures for physicians’ 
services. 
‘‘(D) APPLICATION OF PAYMENT ADJUST-
MENT.—In the case that a qualifying MA orga-
nization attests that not all eligible profes-
sionals are meaningful EHR users with respect 
to a year, the Secretary shall apply the payment 
adjustment under this paragraph based on the 
proportion of such eligible professionals that are 
not meaningful EHR users for such year. 
‘‘(5) 
QUALIFYING
MA
ORGANIZATION
DE-
FINED.—In this subsection and subsection (m), the 
term ‘qualifying MA organization’ means a Medicare 
Advantage organization that is organized as a health 
maintenance organization (as defined in section 
2791(b)(3) of the Public Health Service Act). 
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