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appropriate levels in this concurrent resolution for the 
budgetary effects of any bill or joint resolution reported 
by the Committee on Ways and Means, or amendment 
thereto or conference report thereon, that decreases rev-
enue, but only if such measure would not increase the def-
icit for the period of fiscal years 2014 through 2023. 
SEC. 408. DEFICIT-NEUTRAL RESERVE FUND FOR RURAL 
COUNTIES AND SCHOOLS. 
In the House, the chair of the Committee on the 
Budget may revise the allocations, aggregates, and other 
appropriate levels and limits in this resolution for the 
budgetary effects of any bill or joint resolution, or amend-
ment thereto or conference report thereon, that makes 
changes to or provides for the reauthorization of the Se-
cure Rural Schools and Community Self Determination 
Act of 2000 (Public Law 106–393) by the amounts pro-
vided by that legislation for those purposes, if such legisla-
tion requires sustained yield timber harvests obviating the 
need for funding under P.L. 106–393 in the future and 
would not increase the deficit or direct spending for fiscal 
year 2014, the period of fiscal years 2014 through 2018, 
or the period of fiscal years 2014 through 2023.
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SEC. 409. IMPLEMENTATION OF A DEFICIT AND LONG- 
TERM DEBT REDUCTION AGREEMENT. 
In the House, the chair of the Committee on the 
Budget may revise the allocations, aggregates, and other 
appropriate levels in this concurrent resolution to accom-
modate the enactment of a deficit and long-term debt re-
duction agreement if it includes permanent spending re-
ductions and reforms to direct spending programs. 
TITLE V—ESTIMATES OF DIRECT 
SPENDING 
SEC. 501. DIRECT SPENDING. 
(a) MEANS-TESTED DIRECT SPENDING.— 
(1) For means-tested direct spending, the aver-
age rate of growth in the total level of outlays dur-
ing the 10-year period preceding fiscal year 2014 is 
6.7 percent. 
(2) For means-tested direct spending, the esti-
mated average rate of growth in the total level of 
outlays during the 10-year period beginning with fis-
cal year 2014 is 6.2 percent under current law. 
(3) The following reforms are proposed in this 
concurrent resolution for means-tested direct spend-
ing: 
(A) In 1996, a Republican Congress and a 
Democratic president reformed welfare by lim-
iting the duration of benefits, giving States
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more control over the program, and helping re-
cipients find work. In the five years following 
passage, child-poverty rates fell, welfare case-
loads fell, and workers’ wages increased. This 
budget applies the lessons of welfare reform to 
both the Supplemental Nutrition Assistance 
Program and Medicaid. 
(B) For Medicaid, this budget converts the 
Federal share of Medicaid spending into a flexi-
ble State allotment tailored to meet each 
State’s needs, indexed for inflation and popu-
lation growth. Such a reform would end the 
misguided one-size-fits-all approach that has 
tied the hands of State governments. Instead, 
each State would have the freedom and flexi-
bility to tailor a Medicaid program that fits the 
needs of its unique population. Moreover, this 
budget repeals the Medicaid expansions in the 
President’s health care law, relieving State gov-
ernments of its crippling one-size-fits-all enroll-
ment mandates. 
(C) For the Supplemental Nutrition As-
sistance Program, this budget converts the pro-
gram into a flexible State allotment tailored to 
meet each State’s needs, increases in the De-
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partment of Agriculture Thrifty Food Plan 
index and beneficiary growth. Such a reform 
would provide incentives for States to ensure 
dollars will go towards those who need them 
most. Additionally, it requires that more strin-
gent work requirements and time limits apply 
under the program. 
(b) NONMEANS-TESTED DIRECT SPENDING.— 
(1) For nonmeans-tested direct spending, the 
average rate of growth in the total level of outlays 
during the 10-year period preceding fiscal year 2014 
is 5.9 percent. 
(2) For nonmeans-tested direct spending, the 
estimated average rate of growth in the total level of 
outlays during the 10-year period beginning with fis-
cal year 2014 is 5.3 percent under current law. 
(3) The following reforms are proposed in this 
concurrent resolution for nonmeans-tested direct 
spending: 
(A) For Medicare, this budget advances 
policies to put seniors, not the Federal Govern-
ment, in control of their health care decisions. 
Those in or near retirement will see no changes, 
while future retirees would be given a choice of 
private plans competing alongside the tradi-
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tional fee-for-service Medicare program. Medi-
care would provide a premium-support payment 
either to pay for or offset the premium of the 
plan chosen by the senior, depending on the 
plan’s cost. The Medicare premium-support 
payment would be adjusted so that the sick 
would receive higher payments if their condi-
tions worsened; lower-income seniors would re-
ceive additional assistance to help cover out-of- 
pocket costs; and wealthier seniors would as-
sume responsibility for a greater share of their 
premiums. Putting seniors in charge of how 
their health care dollars are spent will force 
providers to compete against each other on 
price and quality. This market competition will 
act as a real check on widespread waste and 
skyrocketing health care costs. 
(B) In keeping with a recommendation 
from the National Commission on Fiscal Re-
sponsibility and Reform, this budget calls for 
Federal employees—including Members of Con-
gress and congressional staff—to make greater 
contributions toward their own retirement.
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TITLE VI—BUDGET 
ENFORCEMENT 
SEC. 601. LIMITATION ON ADVANCE APPROPRIATIONS. 
(a) FINDINGS.—The House finds the following: 
(1) The Veterans Health Care Budget and Re-
form Transparency Act of 2009 provides advance 
appropriations for the following veteran medical care 
accounts: Medical Services, Medical Support and 
Compliance, and Medical Facilities. 
(2) The President has yet to submit a budget 
request as required under section 1105(a) of title 
31, United States Code, including the request for 
the Department of Veterans Affairs, for fiscal year 
2014, hence the request for veteran medical care ad-
vance appropriations for fiscal year 2015 is unavail-
able as of the writing of this concurrent resolution. 
(3) This concurrent resolution reflects the most 
up-to-date estimate on veterans’ health care needs 
included in the President’s fiscal year 2013 request 
for fiscal year 2015. 
(b) IN GENERAL.—In the House, except as provided 
for in subsection (c), any bill or joint resolution, or amend-
ment thereto or conference report thereon, making a gen-
eral appropriation or continuing appropriation may not 
provide for advance appropriations.