196
(d) EFFECTIVE DATE.—The amendments made by
subsections (b) and (c) shall take effect January 1, 1997,
and shall apply to premiums beginning with such January.
SEC. 508. CHANGES IN PARTICIPATION AGREEMENTS.
(a) PROVIDERS OF SERVICES.—Section 1866(a)(1)
of the Social Security Act (42 U.S.C. 1395cc(a)(1)) is
amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (P),
(2) by striking the period at the end of sub-
paragraph (Q) and inserting ‘‘, and’’, and
(3) by inserting after subparagraph (Q) the fol-
lowing new subparagraph:
‘‘(R) effective January 1, 1994, to have
entered into a participation agreement under
title XXII of this Act and to report to the Fed-
eral Health Care Cost Containment Commission
information, described in section 302(d)(2) of
the Health Insurance Coverage and Cost Con-
tainment Act of 1993, in accordance with uni-
form standards developed under such section.’’.
(b) PHYSICIANS.—Section 1842(h)(1) of such Act
(42 U.S.C. 1395u(h)(1)) is amended by adding at the end
the following: ‘‘No such agreement with a physician shall
be entered into and continued in effect on or after January
197
1, 1994, unless the physician has entered into a com-
parable agreement for purposes of title XXII and agrees
to report to the Federal Health Care Cost Containment
Commission information, described in section 302(d)(2) of
the Health Insurance Coverage and Cost Containment Act
of 1993, in accordance with uniform standards developed
under such section.’’
SEC. 509. ASSURING COORDINATION OF ENROLLMENT
WITH QUALIFIED HEALTH PLANS.
(a) NOTICES.—Section 1837 of the Social Security
Act (42 U.S.C. 1395p) is amended by adding at the end
the following new subsection:
‘‘(j) The Secretary shall provide for notices of cov-
erage under this part (and part A) in the same manner
as qualified health plans are required to provide notices
of coverage under section 2157(b).’’.
(b) TREATMENT
OF
SECONDARY
PAYMENT
IN
CASE
OF
PART-TIME
EMPLOYMENT.—Section
1862(b)(1)(A)(i)(I) 
of 
such 
Act 
(42 
U.S.C.
1395y(b)(1)(A)(i)(I)) is amended by inserting ‘‘other than
on a part-time described in section 2181(b)(2)’’ after ‘‘in-
dividual’s spouse)’’.
(c) EFFECTIVE DATES.—(1) The amendment made
by subsection (a) shall take effect on the date specified
in section 2157(b)(2) of the Social Security Act.
198
(2) The amendment made by subsection (b) shall
apply to employment occurring on or after January 1,
1994.
TITLE VI—FINANCING
PROVISIONS
Subtitle A—General Provisions
SEC. 601. INCREASE IN WAGE BASE FOR HOSPITAL INSUR-
ANCE TAX.
(a) GENERAL RULE.—Paragraph (2) of section
3121(x) of the Internal Revenue Code of 1986 (defining
applicable contribution base for hospital insurance tax) is
amended—
(1) in subparagraph (A), by striking ‘‘and’’ at
the end,
(2) in subparagraph (B), by striking ‘‘for any
calendar year after 1991’’ and inserting ‘‘for cal-
endar years 1992 and 1993’’ and by striking the pe-
riod at the end and inserting ‘‘, and’’, and
(3) by adding at the end the following new sub-
paragraph:
‘‘(C) for any calendar year after 1993, an
amount without any limit.’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) shall apply to calendar year 1994 and fol-
lowing calendar years.
199
Subtitle B—Deductibility of
Certain Health Insurance Costs
SEC. 611. INDEFINITE EXTENSION OF DEDUCTION FOR
HEALTH INSURANCE COSTS OF SELF-EM-
PLOYED INDIVIDUALS.
(a) IN GENERAL.—Subsection (l) of section 162 of
the Internal Revenue Code of 1986 (relating to special
rules for health insurance costs of self-employed individ-
uals) is amended by striking paragraph (6).
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall apply to taxable years beginning after
December 31, 1993.
SEC. 612. INCREASE IN AMOUNT OF DEDUCTION FOR SELF-
EMPLOYED INDIVIDUALS.
(a) GENERAL RULE.—Paragraph (1) of section
162(l) of the Internal Revenue Code of 1986 is amended
by striking ‘‘25 percent of’’.
(b) EFFECTIVE DATE.—
(1) IN
GENERAL.—Except as otherwise pro-
vided in this subsection, the amendment made by
subsection (a) shall apply to taxable years beginning
after December 31, 1993.
(2) SPECIAL RULES FOR SELF-EMPLOYED INDI-
VIDUALS
AND
PERSONAL
CORPORATIONS
BEFORE
‘‘PAY-OR-PLAY PROVISIONS’’ TAKE EFFECT.—
200
(A) IN GENERAL.—If the requirements of
subparagraph (B) are not met by any taxpayer
to whom this paragraph applies during any pe-
riod before the ‘‘pay-or-play’’ provisions take ef-
fect with respect to such taxpayer—
(i) in the case of a taxpayer described
in subparagraph (C)(i), the amount allow-
able as a deduction to such taxpayer under
section 162(l) of the Internal Revenue
Code of 1986 for amounts attributable to
such period shall be determined without re-
gard to the amendment made by sub-
section (a), and
(ii) in the case of a taxpayer described
in subparagraph (C)(ii), the amount allow-
able as a deduction under such Code for
amounts which are attributable to such pe-
riod and which are paid or incurred for
coverage provided to any employee-owner
under an accident or health plan of such
taxpayer shall be 25 percent of the amount
which but for this clause would have been
so allowable.
For purposes of clause (ii), the term ‘‘owner-
employee’’ has the meaning given such term by
201
section 269A(b)(2) of such Code with the modi-
fications provided in section 441(i)(2) of such
Code.
(B) REQUIREMENTS.—The requirements
of this subparagraph are met by any taxpayer
for any period if such taxpayer makes available
on the same terms and conditions health cov-
erage under a plan which would qualify as a
qualified employer health plan under title XXI
of the Social Security Act to all employees of
such taxpayer who normally work for 171⁄2
hours or more per week.
(C) TAXPAYERS TO WHOM PARAGRAPH AP-
PLIES.—This paragraph shall apply to—
(i) any individual who is an employee
within the meaning of section 401(c)(1) of
such Code, and
(ii) any personal service corporation
(as defined in section 441(i)(2) of such
Code).
(D) WHEN
‘‘PAY-OR-PLAY’’ PROVISIONS
TAKE
EFFECT.—For purposes of this para-
graph, the ‘‘pay-or-play’’ provisions take effect
on January 1, 1997, or, if earlier, the date on
which the requirements of part A of title XXI