I 
117TH CONGRESS 
1ST SESSION H. R. 1868 
To prevent across-the-board direct spending cuts, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 12, 2021 
Mr. YARMUTH (for himself, Mr. NEAL, Mr. PALLONE, and Mr. DAVID SCOTT 
of Georgia) introduced the following bill; which was referred to the Com-
mittee on the Budget, and in addition to the Committees on Energy and 
Commerce, and Ways and Means, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To prevent across-the-board direct spending cuts, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. PREVENTING PAYGO SEQUESTRATION. 
(a) STATUTORY PAYGO SCORECARDS.—The budg-
etary effects of this Act and the American Rescue Plan 
Act of 2021 (Public Law 117–2) shall not be counted on 
either PAYGO scorecard maintained pursuant to section 
4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 
U.S.C. 933(d)). 
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(b) SENATE PAYGO SCORECARDS.—The budgetary 
effects of this Act shall not be counted on any PAYGO 
scorecard maintained for purposes of section 4106 of H. 
Con. Res. 71 (115th Congress). 
SEC. 2. EXTENSION OF TEMPORARY SUSPENSION OF MEDI-
CARE SEQUESTRATION. 
(a) IN GENERAL.—Section 3709(a) of division A of 
the CARES Act (2 U.S.C. 901a note) is amended by strik-
ing ‘‘March 31, 2021’’ and inserting ‘‘December 31, 
2021’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect as if enacted as part of 
the CARES Act (Public Law 116–136). 
SEC. 3. TECHNICAL CORRECTIONS. 
(a) DISREGARD
OF CERTAIN ADDITIONAL COM-
PENSATION FOR PURPOSES OF MEDICAID AND CHIP.— 
Section 2104(h) of the CARES Act (15 U.S.C. 9023(h)) 
is amended by striking ‘‘Federal pandemic unemployment 
compensation’’ and inserting ‘‘Federal Pandemic Unem-
ployment Compensation or Mixed Earner Unemployment 
Compensation’’. 
(b) RURAL HEALTH CLINIC PAYMENTS.— 
(1) IN
GENERAL.—Section 1833(f)(3) of the 
Social Security Act (42 U.S.C. 1395l(f)(3)) is 
amended— 
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(A) in subparagraph (A)— 
(i) in clause (i), by striking subclauses 
(I) and (II) and inserting the following: 
‘‘(I) with respect to a rural health 
clinic that had a per visit payment amount 
established 
for 
services 
furnished 
in 
2020— 
‘‘(aa) the per visit payment 
amount applicable to such rural 
health clinic for rural health clinic 
services furnished in 2020, increased 
by the percentage increase in the MEI 
applicable to primary care services 
furnished as of the first day of 2021; 
or 
‘‘(bb) the limit described in para-
graph (2)(A); and 
‘‘(II) with respect to a rural health 
clinic that did not have a per visit payment 
amount established for services furnished 
in 2020— 
‘‘(aa) the per visit payment 
amount applicable to such rural 
health clinic for rural health clinic 
services furnished in 2021; or 
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‘‘(bb) the limit described in para-
graph (2)(A); and’’; and 
(ii) in clause (ii)(I), by striking 
‘‘under clause (i)(I)’’ and inserting ‘‘under 
subclause (I) or (II) of clause (i), as appli-
cable,’’; and 
(B) in subparagraph (B)— 
(i) in the matter preceding clause (i), 
by striking ‘‘2019, was’’ and inserting 
‘‘2020’’; 
(ii) in clause (i), by inserting ‘‘was’’ 
after ‘‘(i)’’; and 
(iii) by striking clause (ii) and insert-
ing the following: 
‘‘(ii)(I) was enrolled under section 1866(j) 
(including temporary enrollment during the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B) for such period); or 
‘‘(II) submitted an application for enroll-
ment under section 1866(j) (or requested such 
a temporary enrollment for such period) that 
was received not later than December 31, 
2020.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect as if included in 
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the enactment of the Consolidated Appropriations 
Act, 2021 (Public Law 116–260). 
(c) ELIGIBILITY FOR REEMPLOYMENT SERVICES.— 
Section 306(a) of the Social Security Act (42 U.S.C. 
506(a)) is amended— 
(1) by striking ‘‘individuals referred to reem-
ployment services as described in section 303(j)’’ 
and inserting ‘‘claimants for unemployment com-
pensation, including claimants referred to reemploy-
ment services as described in section 303(j),’’; and 
(2) by striking ‘‘such individuals’’ and inserting 
‘‘such claimants’’. 
(d) ADDITIONAL AMOUNT FOR CERTAIN HOSPITALS 
WITH HIGH DISPROPORATIONATE SHARE.—Effective as 
if included in the enactment of section 203(a) of title II 
of division CC of Public Law 116–260, subsection (g) of 
section 1923 of the Social Security Act (42 U.S.C. 1396r– 
4) amended by such section 203(a) is amended by adding 
at the end the following new paragraph: 
‘‘(3) ADDITIONAL AMOUNT FOR CERTAIN HOS-
PITALS WITH HIGH DISPROPORATIONATE SHARE.— 
‘‘(A) IN GENERAL.—In the case of a hos-
pital with high disproportionate share (as de-
fined in subparagraph (B)) located in a State 
referenced in subsection (e) of section 4721 of 
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