H. R. 195 
One Hundred Fifteenth Congress 
of the 
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Wednesday, 
the third day of January, two thousand and eighteen 
An Act 
Making further continuing appropriations for the fiscal year ending September 
30, 2018, and for other purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
DIVISION A—FEDERAL REGISTER 
PRINTING SAVINGS ACT OF 2017 
SECTION 1. SHORT TITLE. 
This division may be cited as the ‘‘Federal Register Printing 
Savings Act of 2017’’. 
SEC. 2. RESTRICTIONS ON DISTRIBUTION OF FREE PRINTED COPIES 
OF FEDERAL REGISTER TO MEMBERS OF CONGRESS AND 
FEDERAL EMPLOYEES. 
(a) RESTRICTIONS.—Section 1506 of title 44, United States Code, 
is amended— 
(1) by striking ‘‘The Administrative Committee’’ and 
inserting ‘‘(a) COMPOSITION; DUTIES.—The Administrative Com-
mittee’’; 
(2) in subsection (a)(4), by striking ‘‘the number of copies’’ 
and inserting ‘‘subject to subsection (b), the number of copies’’; 
and 
(3) by adding at the end the following new subsection: 
‘‘(b) RESTRICTIONS ON DISTRIBUTION OF FREE PRINTED COPIES 
TO MEMBERS OF CONGRESS AND OFFICERS AND EMPLOYEES OF THE 
UNITED STATES.— 
‘‘(1) PROHIBITING SUBSCRIPTION TO PRINTED COPIES WITHOUT 
REQUEST.—Under the regulations prescribed to carry out sub-
section (a)(4), the Director of the Government Publishing Office 
may not provide a printed copy of the Federal Register without 
charge to any Member of Congress or any other office of the 
United States during a year unless— 
‘‘(A) the Member or office requests a printed copy of 
a specific issue of the Federal Register; or 
‘‘(B) during that year or during the previous year, 
the Member or office requested a subscription to printed 
copies of the Federal Register for that year, as described 
in paragraph (2). 
‘‘(2) ADMINISTRATION OF SUBSCRIPTIONS.—The regulations 
prescribed to carry out subsection (a)(4) shall include—
H. R. 195—2 
‘‘(A) provisions regarding notifications to offices of 
Members of Congress and other offices of the United States 
of the restrictions of paragraph (1); 
‘‘(B) provisions describing the process by which Mem-
bers and other offices may request a specific issue of the 
Federal Register for purposes of paragraph (1)(A); and 
‘‘(C) provisions describing the process by which Mem-
bers and other offices may request a subscription to the 
Federal Register for purposes of paragraph (1)(B), except 
that such regulations shall limit the period for such a 
subscription to not longer than 1 year.’’. 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall take effect January 1, 2018. 
DIVISION B—EXTENSION OF CONTINUING 
APPROPRIATIONS ACT, 2018 
SEC. 2001. The Continuing Appropriations Act, 2018 (division 
D of Public Law 115–56) is amended— 
(1) by striking the date specified in section 106(3) and 
inserting ‘‘February 8, 2018’’; and 
(2) by adding after section 147 the following: 
‘‘SEC. 148. Funds appropriated by the Department of Defense 
Missile Defeat and Defense Enhancements Appropriations Act, 2018 
(division B of Public Law 115–96) may be obligated and expended 
notwithstanding section 504(a)(1) of the National Security Act of 
1947 (50 U.S.C. 3094(a)(1)). 
‘‘SEC. 149. Amounts made available by section 101 for ‘Depart-
ment of Agriculture—Food and Nutrition Service—Child Nutrition 
Programs’ to carry out section 749(g) of the Agriculture Appropria-
tions Act of 2010 (Public Law 111–80) may be apportioned up 
to the rate for operations necessary to ensure that the program 
can be fully operational by May 2018. 
‘‘SEC. 150. Amounts made available by section 101 for ‘National 
Aeronautics and Space Administration—Exploration’ may be appor-
tioned up to the rate for operations necessary to maintain the 
planned launch capability schedules for the Space Launch System 
launch vehicle, Exploration Ground Systems, and Orion Multi-Pur-
pose Crew Vehicle programs. 
‘‘SEC. 151. Amounts made available by section 101 for ‘Depart-
ment of Energy—Energy Programs—Office of the Inspector General’ 
may be apportioned up to the rate for operations necessary to 
sustain staffing levels achieved on June 30, 2017. 
‘‘SEC. 152. Amounts made available by section 101 for ‘Small 
Business Administration—Business Loans Program Account’ may 
be apportioned up to the rate for operations necessary to accommo-
date increased demand for commitments for general business loans 
authorized under section 7(a) of the Small Business Act (15 U.S.C. 
636(a)). 
‘‘SEC. 153. For 2018, the Secretary of Housing and Urban 
Development may make temporary adjustments to the Section 8 
housing choice voucher annual renewal funding allocations and 
administrative fee eligibility determinations for public housing 
agencies in an area for which the President declared a disaster 
in 2017 or 2018 under title IV of the Robert T. Stafford Disaster 
Relief and Emergency Assistance Act (42 U.S.C. 5170 et seq.), 
to avoid significant adverse funding impacts that would otherwise
H. R. 195—3 
result from the disaster and that would otherwise prevent a public 
housing agency from leasing up to its authorized level of units 
under contract (but not to exceed such level), upon request by 
and in consultation with a public housing agency and supported 
by documentation as required by the Secretary that demonstrates 
the need for the adjustment. 
‘‘SEC. 154. (a) Employees furloughed as a result of any lapse 
in appropriations which begins on or about January 20, 2018, 
shall be compensated at their standard rate of compensation, for 
the period of such lapse in appropriations, as soon as practicable 
after such lapse in appropriations ends. 
‘‘(b) For purposes of this section, ‘employee’ means: 
‘‘(1) a federal employee; 
‘‘(2) an employee of the District of Columbia Courts; 
‘‘(3) an employee of the Public Defender Service for the 
District of Columbia; or 
‘‘(4) a District of Columbia Government employee. 
‘‘(c) All obligations incurred in anticipation of the appropriations 
made and authority granted by this division for the purposes of 
maintaining the essential level of activity to protect life and prop-
erty and bringing about orderly termination of Government func-
tions, and for purposes as otherwise authorized by law, are hereby 
ratified and approved if otherwise in accord with the provisions 
of this division. 
‘‘SEC. 155. (a) If a State (or another Federal grantee) used 
State funds (or the grantee’s non-Federal funds) to continue carrying 
out a Federal program or furloughed State employees (or the 
grantee’s 
employees) 
whose 
compensation 
is 
advanced 
or 
reimbursed in whole or in part by the Federal Government— 
‘‘(1) such furloughed employees shall be compensated at 
their standard rate of compensation for such period; 
‘‘(2) the State (or such other grantee) shall be reimbursed 
for expenses that would have been paid by the Federal Govern-
ment during such period had appropriations been available, 
including the cost of compensating such furloughed employees, 
together with interest thereon calculated under section 6503(d) 
of title 31, United States Code; and 
‘‘(3) the State (or such other grantee) may use funds avail-
able to the State (or the grantee) under such Federal program 
to reimburse such State (or the grantee), together with interest 
thereon calculated under section 6503(d) of title 31, United 
States Code. 
‘‘(b) For purposes of this section, the term ‘State’ and the 
term ‘grantee’ shall have the meaning as such term is defined 
under the applicable Federal program under subsection (a). In 
addition, ‘to continue carrying out a Federal program’ means the 
continued performance by a State or other Federal grantee, during 
the period of a lapse in appropriations, of a Federal program that 
the State or such other grantee had been carrying out prior to 
the period of the lapse in appropriations. 
‘‘(c) The authority under this section applies with respect to 
any period in fiscal year 2018 (not limited to periods beginning 
or ending after the date of the enactment of this division) during 
which there occurs a lapse in appropriations with respect to any 
department or agency of the Federal Government which, but for 
such lapse in appropriations, would have paid, or made reimburse-
ment relating to, any of the expenses referred to in this section
H. R. 195—4 
with respect to the program involved. Payments and reimburse-
ments under this authority shall be made only to the extent and 
in amounts provided in advance in appropriations Acts.’’. 
SEC. 2002. The Further Additional Continuing Appropriations 
Act, 2018 (division A of Public Law 115–96) is amended by striking 
section 1002. 
SEC. 2003. For the purposes of division D of Public Law 115– 
56, the time covered by such division shall be considered to include 
the period which began on or about January 20, 2018, during 
which there occurred a lapse in appropriations. 
This division may be cited as the ‘‘Extension of Continuing 
Appropriations Act, 2018’’. 
DIVISION C—HEALTHY KIDS ACT 
SEC. 3001. SHORT TITLE. 
This division may be cited as the ‘‘Helping Ensure Access 
for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance 
Delivery Stable Act’’ or the ‘‘HEALTHY KIDS Act’’. 
SEC. 3002. SIX-YEAR FUNDING EXTENSION OF THE CHILDREN’S 
HEALTH INSURANCE PROGRAM. 
(a) FUNDING.— 
(1) IN GENERAL.—Section 2104(a) of the Social Security 
Act (42 U.S.C. 1397dd(a)), as amended by section 3201(a) of 
the CHIP and Public Health Funding Extension Act (division 
C of Public Law 115–96), is amended— 
(A) in paragraph (20)(B), by striking ‘‘; and’’ and 
inserting a semicolon; 
(B) by striking paragraph (21) and inserting the fol-
lowing new paragraphs: 
‘‘(21) for fiscal year 2018, $21,500,000,000; 
‘‘(22) for fiscal year 2019, $22,600,000,000; 
‘‘(23) for fiscal year 2020, $23,700,000,000; 
‘‘(24) for fiscal year 2021, $24,800,000,000; 
‘‘(25) for fiscal year 2022, $25,900,000,000; and 
‘‘(26) for fiscal year 2023, for purposes of making two semi- 
annual allotments— 
‘‘(A) $2,850,000,000 for the period beginning on October 
1, 2022, and ending on March 31, 2023; and 
‘‘(B) $2,850,000,000 for the period beginning on April 
1, 2023, and ending on September 30, 2023.’’. 
(2) PREVENTION OF DUPLICATE APPROPRIATIONS FOR FISCAL 
YEAR 2018.—Notwithstanding any other provision of law, insofar 
as funds have been appropriated under subsection (a)(21) of 
section 2104 of the Social Security Act (42 U.S.C. 1397dd), 
as such subsection is in effect on the day before the date 
of the enactment of this Act, to provide allotments to States 
under the State Children’s Health Insurance Program estab-
lished under title XXI of the Social Security Act (42 U.S.C. 
1397aa et seq.) (whether implemented under title XIX, XXI, 
or both, of the Social Security Act) for fiscal year 2018— 
(A) any amounts that are so appropriated that are 
not so allotted and obligated before the date of the enact-
ment of this Act, are rescinded; and
H. R. 195—5 
(B) any amount provided for CHIP allotments to a 
State under this section (and the amendments made by 
this section) for such fiscal year shall be reduced by the 
amount of such appropriations so allotted and obligated 
before such date. 
(b) ALLOTMENTS.— 
(1) IN GENERAL.—Section 2104(m) of the Social Security 
Act (42 U.S.C. 1397dd(m)), as amended by section 3201(b) of 
the CHIP and Public Health Funding Extension Act (division 
C of Public Law 115–96), is amended— 
(A) in paragraph (2)(B)— 
(i) in the matter preceding clause (i), by striking 
‘‘(19)’’ and inserting ‘‘(25)’’; 
(ii) in clause (i), by striking ‘‘and 2017’’ and 
inserting ‘‘, 2017, and 2023’’; and 
(iii) in clause (ii)— 
(I) in the matter preceding subclause (I), by 
striking ‘‘and paragraph (10)’’; and 
(II) in subclause (I), by inserting ‘‘(or, in the 
case of fiscal year 2018, under paragraph (4))’’ 
after ‘‘clause (i)’’; 
(B) in paragraph (5), by striking ‘‘2018’’ and inserting 
‘‘2023’’; 
(C) in paragraph (7)— 
(i) in subparagraph (A), by striking ‘‘2017’’ and 
inserting ‘‘2023’’; 
(ii) in subparagraph (B), in the matter preceding 
clause (i), by inserting ‘‘(or, in the case of fiscal year 
2018, by not later than the date that is 60 days after 
the date of the enactment of the HEALTHY KIDS 
Act)’’ after ‘‘before the August 31 preceding the begin-
ning of the fiscal year’’; and 
(iii) in the matter following subparagraph (B), by 
striking ‘‘or fiscal year 2016’’ and inserting ‘‘fiscal year 
2016, fiscal year 2018, fiscal year 2020, or fiscal year 
2022’’; 
(D) in paragraph (9), by striking ‘‘2018’’ and inserting 
‘‘2023’’; and 
(E) by amending paragraph (10) to read as follows: 
‘‘(10) FOR FISCAL YEAR 2023.— 
‘‘(A) FIRST HALF.—Subject to paragraphs (5) and (7), 
from the amount made available under subparagraph (A) 
of paragraph (26) of subsection (a) for the semi-annual 
period described in such subparagraph, increased by the 
amount of the appropriation for such period under section 
3002(b)(2) of the HEALTHY KIDS Act, the Secretary shall 
compute a State allotment for each State (including the 
District of Columbia and each commonwealth and territory) 
for such semi-annual period in an amount equal to the 
first half ratio (described in subparagraph (D)) of the 
amount described in subparagraph (C). 
‘‘(B) SECOND HALF.—Subject to paragraphs (5) and (7), 
from the amount made available under subparagraph (B) 
of paragraph (26) of subsection (a) for the semi-annual 
period described in such subparagraph, the Secretary shall 
compute a State allotment for each State (including the 
District of Columbia and each commonwealth and territory)
H. R. 195—6 
for such semi-annual period in an amount equal to the 
amount made available under such subparagraph, multi-
plied by the ratio of— 
‘‘(i) the amount of the allotment to such State 
under subparagraph (A); to 
‘‘(ii) the total of the amount of all of the allotments 
made available under such subparagraph. 
‘‘(C) FULL YEAR AMOUNT BASED ON REBASED AMOUNT.— 
The amount described in this subparagraph for a State 
is equal to the Federal payments to the State that are 
attributable to (and countable towards) the total amount 
of allotments available under this section to the State 
in fiscal year 2022 (including payments made to the State 
under subsection (n) for fiscal year 2022 as well as amounts 
redistributed to the State in fiscal year 2022), multiplied 
by the allotment increase factor under paragraph (6) for 
fiscal year 2023. 
‘‘(D) FIRST HALF RATIO.—The first half ratio described 
in this subparagraph is the ratio of— 
‘‘(i) the sum of— 
‘‘(I) the amount made available under sub-
section (a)(26)(A); and 
‘‘(II) the amount of the appropriation for such 
period under section 3002(b)(2) of the HEALTHY 
KIDS Act; to 
‘‘(ii) the sum of— 
‘‘(I) the amount described in clause (i); and 
‘‘(II) the amount made available under sub-
section (a)(26)(B).’’. 
(2) ONE-TIME APPROPRIATION FOR FISCAL YEAR 2023.—There 
is appropriated to the Secretary of Health and Human Services, 
out of any money in the Treasury not otherwise appropriated, 
$20,200,000,000 to accompany the allotment made for the 
period beginning on October 1, 2022, and ending on March 
31, 2023, under paragraph (26)(A) of section 2104(a) of the 
Social Security Act (42 U.S.C. 1397dd(a)) (as added by sub-
section (a)), to remain available until expended. Such amount 
shall be used to provide allotments to States under paragraph 
(10) of section 2104(m) of such Act (as added by paragraph 
(1)) for the first 6 months of fiscal year 2023 in the same 
manner as allotments are provided under subsection (a)(26)(A) 
of such section 2104 and subject to the same terms and condi-
tions as apply to the allotments provided from such subsection 
(a)(26)(A). 
(c) EXTENSION
OF
THE
CHILD
ENROLLMENT
CONTINGENCY 
FUND.—Section 2104(n) of the Social Security Act (42 U.S.C. 
1397dd(n)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (A)(ii)— 
(i) by striking ‘‘2010, 2011, 2012, 2013, 2014, and 
2016’’ and inserting ‘‘2010 through 2014, 2016, and 
2018 through 2022’’; and 
(ii) by striking ‘‘fiscal year 2015 and fiscal year 
2017’’ and inserting ‘‘fiscal years 2015, 2017, and 2023’’; 
and 
(B) in subparagraph (B)—
H. R. 195—7 
(i) by striking ‘‘2010, 2011, 2012, 2013, 2014, and 
2016’’ and inserting ‘‘2010 through 2014, 2016, and 
2018 through 2022’’; and 
(ii) by striking ‘‘fiscal year 2015 and fiscal year 
2017’’ and inserting ‘‘fiscal years 2015, 2017, and 2023’’; 
and 
(2) in paragraph (3)(A), in the matter preceding clause 
(i), by striking ‘‘or a semi-annual allotment period for fiscal 
year 2015 or 2017’’ and inserting ‘‘or in any of fiscal years 
2018 through 2022 (or a semi-annual allotment period for fiscal 
year 2015, 2017, or 2023)’’. 
(d) EXTENSION OF QUALIFYING STATES OPTION.— 
(1) IN GENERAL.—Section 2105(g)(4) of the Social Security 
Act (42 U.S.C. 1397ee(g)(4)) is amended— 
(A) in the heading, by striking ‘‘THROUGH 2017’’ and 
inserting ‘‘THROUGH 2023’’; and 
(B) in subparagraph (A), by striking ‘‘2017’’ and 
inserting ‘‘2023’’. 
(2) TECHNICAL
AMENDMENTS.—Section 2104(f)(2)(B)(ii) of 
the Social Security Act (42 U.S.C. 1397dd(f)(2)(B)(ii)), as 
amended by section 3201(c) of the CHIP and Public Health 
Funding Extension Act (division C of Public Law 115–96), is 
amended— 
(A) in subclause (I), by striking ‘‘for the month (as 
defined in subclause (II))’’ and inserting ‘‘(as defined in 
subclause (II)) for the month’’; 
(B) in subclause (II), by inserting ‘‘, as in effect on 
the day before the date of the enactment of the HEALTHY 
KIDS Act,’’ after ‘‘section 2105(g)(4)(A)’’; and 
(C) in subclause (VI)— 
(i) by inserting ‘‘, as in effect on the day before 
the date of the enactment of the HEALTHY KIDS 
Act’’ after ‘‘, section 2105(g)(4)’’; and 
(ii) by inserting ‘‘, as so in effect’’ after ‘‘under 
section 2105(g)(4)’’. 
(e) EXTENSION OF EXPRESS LANE ELIGIBILITY OPTION.—Section 
1902(e)(13)(I) of the Social Security Act (42 U.S.C. 1396a(e)(13)(I)) 
is amended by striking ‘‘2017’’ and inserting ‘‘2023’’. 
(f) ASSURANCE OF AFFORDABILITY STANDARD FOR CHILDREN AND 
FAMILIES.— 
(1) IN GENERAL.—Section 2105(d)(3) of the Social Security 
Act (42 U.S.C. 1397ee(d)(3)) is amended— 
(A) in the paragraph heading, by striking ‘‘UNTIL 
OCTOBER 1, 2019’’ and inserting ‘‘THROUGH SEPTEMBER 30, 
2023’’; and 
(B) in subparagraph (A), in the matter preceding clause 
(i)— 
(i) by striking ‘‘2019’’ and inserting ‘‘2023’’; and 
(ii) by striking ‘‘The preceding sentence shall not 
be construed as preventing a State during such period’’ 
and inserting ‘‘During the period that begins on 
October 1, 2019, and ends on September 30, 2023, 
the preceding sentence shall only apply with respect 
to children in families whose income does not exceed 
300 percent of the poverty line (as defined in section 
2110(c)(5)) applicable to a family of the size involved.
H. R. 195—8 
The preceding sentences shall not be construed as pre-
venting a State during any such periods’’. 
(2) CONFORMING AMENDMENTS.—Section 1902(gg)(2) of the 
Social Security Act (42 U.S.C. 1396a(gg)(2)) is amended— 
(A) in the paragraph heading, by striking ‘‘UNTIL 
OCTOBER 1, 2019’’ and inserting ‘‘THROUGH SEPTEMBER 30, 
2023’’; and 
(B) by striking ‘‘September 30, 2019,’’ and inserting 
‘‘September 30, 2023 (but during the period that begins 
on October 1, 2019, and ends on September 30, 2023, 
only with respect to children in families whose income 
does not exceed 300 percent of the poverty line (as defined 
in section 2110(c)(5)) applicable to a family of the size 
involved)’’. 
(g) CHIP LOOK-ALIKE PLANS.— 
(1) BLENDING RISK POOLS.—Section 2107 of the Social Secu-
rity Act (42 U.S.C. 1397gg) is amended by adding at the end 
the following: 
‘‘(g) USE OF BLENDED RISK POOLS.— 
‘‘(1) IN GENERAL.—Nothing in this title (or any other provi-
sion of Federal law) shall be construed as preventing a State 
from considering children enrolled in a qualified CHIP look- 
alike program and children enrolled in a State child health 
plan under this title (or a waiver of such plan) as members 
of a single risk pool. 
‘‘(2) QUALIFIED CHIP LOOK-ALIKE PROGRAM.—In this sub-
section, the term ‘qualified CHIP look-alike program’ means 
a State program— 
‘‘(A) under which children who are under the age of 
19 and are not eligible to receive medical assistance under 
title XIX or child health assistance under this title may 
purchase coverage through the State that provides benefits 
that are at least identical to the benefits provided under 
the State child health plan under this title (or a waiver 
of such plan); and 
‘‘(B) that is funded exclusively through non-Federal 
funds, including funds received by the State in the form 
of premiums for the purchase of such coverage.’’. 
(2) COVERAGE RULE.— 
(A) IN GENERAL.—Section 5000A(f)(1) of the Internal 
Revenue Code of 1986 is amended in subparagraph (A)(iii), 
by inserting ‘‘or under a qualified CHIP look-alike program 
(as defined in section 2107(g) of the Social Security Act)’’ 
before the comma at the end. 
(B) EFFECTIVE
DATE.—The amendment made by 
subparagraph (A) shall apply with respect to taxable years 
beginning after December 31, 2017. 
(h) AVAILABILITY OF UNUSED FISCAL YEAR 2018 REDISTRIBUTION 
AMOUNTS.—Any amounts that have been redistributed to States 
under subsection (f) of section 2104 of the Social Security Act 
(42 U.S.C. 1397dd) for fiscal year 2018 that are not, or will not 
be, expended by the end of that fiscal year shall be— 
(1) adjusted by the Secretary before the end of fiscal year 
2018 to reflect an updated estimate of shortfalls under sub-
section (f)(2)(A) of such section; and 
(2) available for redistribution under subsection (f) of such 
section for subsequent fiscal years.
H. R. 195—9 
SEC. 3003. EXTENSION OF CERTAIN PROGRAMS AND DEMONSTRATION 
PROJECTS. 
(a) CHILDHOOD OBESITY DEMONSTRATION PROJECT.—Section 
1139A(e)(8) of the Social Security Act (42 U.S.C. 1320b–9a(e)(8)) 
is amended— 
(1) by striking ‘‘and $10,000,000’’ and inserting ‘‘, 
$10,000,000’’; and 
(2) by inserting after ‘‘2017’’ the following: ‘‘, and 
$30,000,000 for the period of fiscal years 2018 through 2023’’. 
(b) PEDIATRIC QUALITY MEASURES PROGRAM.—Section 1139A(i) 
of the Social Security Act (42 U.S.C. 1320b–9a(i)) is amended— 
(1) by striking ‘‘Out of any’’ and inserting the following: 
‘‘(1) IN GENERAL.—Out of any’’; 
(2) by striking ‘‘there is appropriated for each’’ and inserting 
‘‘there is appropriated— 
‘‘(A) for each’’; 
(3) by striking ‘‘, and there is appropriated for the period’’ 
and inserting ‘‘; 
‘‘(B) for the period’’; 
(4) by striking ‘‘. Funds appropriated under this subsection 
shall remain available until expended.’’ and inserting ‘‘; and’’; 
and 
(5) by adding at the end the following: 
‘‘(C) for the period of fiscal years 2018 through 2023, 
$90,000,000 for the purpose of carrying out this section 
(other than subsections (e), (f), and (g)). 
‘‘(2) AVAILABILITY.—Funds appropriated under this sub-
section shall remain available until expended.’’. 
SEC. 3004. EXTENSION OF OUTREACH AND ENROLLMENT PROGRAM. 
(a) IN GENERAL.—Section 2113 of the Social Security Act (42 
U.S.C. 1397mm) is amended— 
(1) in subsection (a)(1), by striking ‘‘2017’’ and inserting 
‘‘2023’’; and 
(2) in subsection (g)— 
(A) by striking ‘‘and $40,000,000’’ and inserting ‘‘, 
$40,000,000’’; and 
(B) by inserting after ‘‘2017’’ the following: ‘‘, and 
$120,000,000 for the period of fiscal years 2018 through 
2023’’. 
(b) MAKING
ORGANIZATIONS
THAT
USE
PARENT
MENTORS 
ELIGIBLE TO RECEIVE GRANTS.—Section 2113(f) of the Social Secu-
rity Act (42 U.S.C. 1397mm(f)) is amended— 
(1) in paragraph (1)(E), by striking ‘‘or community-based 
doula programs’’ and inserting ‘‘, community-based doula pro-
grams, or parent mentors’’; and 
(2) by adding at the end the following new paragraph: 
‘‘(5) PARENT
MENTOR.—The term ‘parent mentor’ means 
an individual who— 
‘‘(A) is a parent or guardian of at least one child 
who is an eligible child under this title or title XIX; and 
‘‘(B) is trained to assist families with children who 
have no health insurance coverage with respect to 
improving the social determinants of the health of such 
children, including by providing— 
‘‘(i) education about health insurance coverage, 
including, with respect to obtaining such coverage,
H. R. 195—10 
eligibility criteria and application and renewal proc-
esses; 
‘‘(ii) assistance with completing and submitting 
applications for health insurance coverage; 
‘‘(iii) a liaison between families and representatives 
of State plans under title XIX or State child health 
plans under this title; 
‘‘(iv) guidance on identifying medical and dental 
homes and community pharmacies for children; and 
‘‘(v) assistance and referrals to successfully address 
social determinants of children’s health, including pov-
erty, food insufficiency, and housing.’’. 
(c) EXCLUSION FROM MODIFIED ADJUSTED GROSS INCOME.— 
Section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) 
is amended— 
(1) in the first paragraph (14), relating to income deter-
mined using modified adjusted gross income, by adding at 
the end the following new subparagraph: 
‘‘(J) EXCLUSION
OF
PARENT
MENTOR
COMPENSATION 
FROM
INCOME
DETERMINATION.—Any nominal amount 
received by an individual as compensation, including a 
stipend, for participation as a parent mentor (as defined 
in paragraph (5) of section 2113(f)) in an activity or pro-
gram funded through a grant under such section shall 
be disregarded for purposes of determining the income 
eligibility of such individual for medical assistance under 
the State plan or any waiver of such plan.’’; and 
(2) by striking ‘‘(14) EXCLUSION’’ and inserting ‘‘(15) EXCLU-
SION’’. 
SEC. 3005. EXTENSION AND REDUCTION OF ADDITIONAL FEDERAL 
FINANCIAL PARTICIPATION FOR CHIP. 
Section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) 
is amended in the second sentence by inserting ‘‘and during the 
period that begins on October 1, 2019, and ends on September 
30, 2020, the enhanced FMAP determined for a State for a fiscal 
year (or for any portion of a fiscal year occurring during such 
period) shall be increased by 11.5 percentage points’’ after ‘‘23 
percentage points,’’. 
SEC. 3006. MEDICAID IMPROVEMENT FUND. 
Section 1941 of the Social Security Act (42 U.S.C. 1396w– 
1) is amended— 
(1) in subsection (a), in the first sentence, by inserting 
before the period at the end the following: ‘‘, and, in accordance 
with subsection (b)(3), for the purposes of subparagraph (B) 
of such subsection’’; and 
(2) in subsection (b)— 
(A) in paragraph (2)— 
(i) in the first sentence, by inserting ‘‘pursuant 
to paragraph (1)’’ after ‘‘in the Fund’’; 
(ii) by inserting after the first sentence the fol-
lowing sentence: ‘‘Amounts in the Fund pursuant to 
paragraph (3) shall be available in advance of appro-
priations but only if the total amount obligated from 
the Fund does not exceed the amount available to 
the Fund under such paragraph (3).’’; and
H. R. 195—11 
(iii) in the last sentence, by striking ‘‘sentence’’ 
and inserting ‘‘sentences’’; and 
(B) by adding at the end the following new paragraph: 
‘‘(3) ADDITIONAL FUNDING FOR STATE ACTIVITIES RELATING 
TO MECHANIZED CLAIMS SYSTEMS.— 
‘‘(A) IN GENERAL.—In addition to the amount made 
available under paragraph (1), there shall be available 
to the Fund, for expenditures from the Fund in accordance 
with subparagraph (B), for fiscal year 2023 and thereafter, 
$980,000,000, to remain available until expended. 
‘‘(B) PURPOSES.—The Secretary shall use amounts 
made available to the Fund under subparagraph (A) to 
pay to each State which has a plan approved under this 
title, for each quarter beginning during or after fiscal year 
2023 an amount equal to— 
‘‘(i) 100 percent minus the percent specified in 
clause (i) of section 1903(a)(3)(A) of so much of the 
sums expended by the State during such quarter as 
are attributable to the activities described in such 
clause; 
‘‘(ii) 100 percent minus the Federal medical assist-
ance percentage applied under clause (iii) of such sec-
tion of so much of the sums expended during such 
quarter (as found necessary by the Secretary under 
such clause) by the State as are attributable to the 
activities described in such clause; and 
‘‘(iii) 100 percent minus the percent specified in 
section 1903(a)(3)(B) of so much of the sums expended 
by the State during such quarter as are attributable 
to the activities described in such section.’’. 
DIVISION D—SUSPENSION OF CERTAIN 
HEALTH-RELATED TAXES 
SEC. 4001. EXTENSION OF MORATORIUM ON MEDICAL DEVICE EXCISE 
TAX. 
(a) IN GENERAL.—Section 4191(c) of the Internal Revenue Code 
of 1986 is amended by striking ‘‘December 31, 2017’’ and inserting 
‘‘December 31, 2019’’. 
(b) EFFECTIVE DATE.—The amendment made by this section 
shall apply to sales after December 31, 2017. 
SEC. 4002. DELAY IN IMPLEMENTATION OF EXCISE TAX ON HIGH COST 
EMPLOYER-SPONSORED HEALTH COVERAGE. 
Section 9001(c) of the Patient Protection and Affordable Care 
Act is amended by striking ‘‘December 31, 2019’’ and inserting 
‘‘December 31, 2021’’. 
SEC. 4003. SUSPENSION OF ANNUAL FEE ON HEALTH INSURANCE PRO-
VIDERS. 
(b) IN GENERAL.—Section 9010(j) of the Patient Protection and 
Affordable Care Act is amended— 
(1) by striking ‘‘and’’ at the end of paragraph (1), 
(2) by striking the period at the end of paragraph (2) 
and inserting ‘‘, and ending before January 1, 2019, and’’, 
and
H. R. 195—12 
(3) by adding at the end the following new paragraph: 
‘‘(3) beginning after December 31, 2019.’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall apply to calendar years beginning after December 31, 2018. 
DIVISION E—BUDGETARY EFFECTS 
SEC. 5001. BUDGETARY EFFECTS. 
(a) IN GENERAL.—The budgetary effects of division C and each 
succeeding division shall not be entered on either PAYGO scorecard 
maintained pursuant to section 4(d) of the Statutory Pay-As-You- 
Go Act of 2010. 
(b) SENATE PAYGO SCORECARDS.—The budgetary effects of divi-
sion C and each succeeding division shall not be entered on any 
PAYGO scorecard maintained for purposes of section 4106 of H. 
Con. Res. 71 (115th Congress). 
(c) CLASSIFICATION OF BUDGETARY EFFECTS.—Notwithstanding 
Rule 3 of the Budget Scorekeeping Guidelines set forth in the 
joint explanatory statement of the committee of conference accom-
panying Conference Report 105–217 and section 250(c)(8) of the 
Balanced Budget and Emergency Deficit Control Act of 1985, the 
budgetary effects of division C and each succeeding division shall 
not be estimated— 
(1) for purposes of section 251 of such Act; and 
(2) for purposes of paragraph (4)(C) of section 3 of the 
Statutory Pay-As-You-Go Act of 2010 as being included in an 
appropriation Act. 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.