IB 
Union Calendar No. 262 
115TH CONGRESS 
1ST SESSION H. R. 3922 
[Report No. 115–359, Part I] 
To extend funding for certain public health programs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 3, 2017 
Mr. WALDEN introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
OCTOBER 19, 2017 
Reported from the Committee on Energy and Commerce with an amendment 
[Strike out all after the enacting clause and insert the part printed in italic] 
OCTOBER 19, 2017 
The Committee on Ways and Means discharged; committed to the Committee 
of the Whole House on the State of the Union and ordered to be printed 
[For text of introduced bill, see copy of bill as introduced on October 3, 2017] 
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A BILL 
To extend funding for certain public health programs, and 
for other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Community Health And 
Medical Professionals Improve Our Nation Act of 2017’’ or 
the ‘‘CHAMPION Act’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—EXTENSION OF PUBLIC HEALTH PROGRAMS 
Sec. 101. Extension for community health centers and the National Health Serv-
ice Corps. 
Sec. 102. Extension for special diabetes programs. 
Sec. 103. Reauthorization of program of payments to teaching health centers that 
operate graduate medical education programs. 
Sec. 104. Extension for family-to-family health information centers. 
Sec. 105. Youth empowerment program; personal responsibility education. 
TITLE II—OFFSETS 
Sec. 201. Providing for qualified health plan grace period requirements for issuer 
receipt of advance payments of cost-sharing reductions and pre-
mium tax credits that are more consistent with State law grace 
period requirements. 
Sec. 202. Prevention and Public Health Fund. 
TITLE I—EXTENSION OF PUBLIC 
HEALTH PROGRAMS 
SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS 
AND THE NATIONAL HEALTH SERVICE CORPS. 
(a) COMMUNITY HEALTH CENTERS FUNDING.—Sec-
tion 10503(b)(1)(E) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 254b–2(b)(1)(E)) is amended by 
striking ‘‘2017’’ and inserting ‘‘2019’’. 
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(b) OTHER COMMUNITY HEALTH CENTERS PROVI-
SIONS.—Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (b)(1)(A)(ii), by striking 
‘‘abuse’’ and inserting ‘‘use disorder’’; 
(2) in subsection (b)(2)(A), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(3) in subsection (c)— 
(A) in paragraph (1), by striking subpara-
graphs (B) through (D); 
(B) by striking ‘‘(1) IN GENERAL’’ and all 
that follows through ‘‘The Secretary’’ and insert-
ing the following: 
‘‘(1) CENTERS.—The Secretary’’; and 
(C) in paragraph (1), as amended, by redes-
ignating clauses (i) through (v) as subpara-
graphs (A) through (E) and moving the margin 
of each of such redesignated subparagraph 2 ems 
to the left; 
(4) by striking subsection (d) and inserting the 
following: 
‘‘(d) IMPROVING QUALITY OF CARE.— 
‘‘(1) SUPPLEMENTAL
AWARDS.—The Secretary 
may award supplemental grant funds to health cen-
ters funded under this section to implement evidence- 
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based models for increasing access to high-quality pri-
mary care services, which may include models related 
to— 
‘‘(A) improving the delivery of care for in-
dividuals with multiple chronic conditions; 
‘‘(B) workforce configuration; 
‘‘(C) reducing the cost of care; 
‘‘(D) enhancing care coordination; 
‘‘(E) expanding the use of telehealth and 
technology-enabled collaborative learning and ca-
pacity building models; 
‘‘(F) care integration, including integration 
of behavioral health, mental health, or substance 
use disorder services; and 
‘‘(G) addressing emerging public health or 
substance use disorder issues to meet the health 
needs of the population served by the health cen-
ter. 
‘‘(2) SUSTAINABILITY.—In making supplemental 
awards under this subsection, the Secretary may con-
sider whether the health center involved has submitted 
a plan for continuing the activities funded under this 
subsection after supplemental funding is expended. 
‘‘(3) SPECIAL
CONSIDERATION.—The Secretary 
may give special consideration to applications for 
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supplemental funding under this subsection that seek 
to address significant barriers to access to care in 
areas with a greater shortage of health care providers 
and health services relative to the national average.’’; 
(5) in subsection (e)(1)— 
(A) in subparagraph (B)— 
(i) by striking ‘‘2 years’’ and inserting 
‘‘1 year’’; and 
(ii) by adding at the end the following: 
‘‘The Secretary shall not make a grant 
under this paragraph unless the applicant 
provides assurances to the Secretary that 
within 120 days of receiving grant funding 
for the operation of the health center, the 
applicant will submit, for approval by the 
Secretary, an implementation plan to meet 
the requirements of subsection (l)(3). The 
Secretary may extend such 120-day period 
for achieving compliance upon a demonstra-
tion of good cause by the health center.’’; 
and 
(B) in subparagraph (C)— 
(i) in the subparagraph heading, by 
striking ‘‘AND PLANS’’; 
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(ii) by striking ‘‘or plan (as described 
in subparagraphs (B) and (C) of subsection 
(c)(1))’’; 
(iii) by striking ‘‘or plan, including 
the purchase’’ and inserting the following: 
‘‘including— 
‘‘(i) the purchase’’; 
(iv) by inserting ‘‘, which may include 
data and information systems’’ after ‘‘of 
equipment’’; 
(v) by striking the period at the end 
and inserting a semicolon; and 
(vi) by adding at the end the following: 
‘‘(ii) the provision of training and 
technical assistance; and 
‘‘(iii) other activities that— 
‘‘(I) reduce costs associated with 
the provision of health services; 
‘‘(II) improve access to, and 
availability of, health services provided 
to individuals served by the centers; 
‘‘(III) enhance the quality and co-
ordination of health services; or 
‘‘(IV) improve the health status of 
communities.’’; 
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(6) in subsection (e)(5)(B)— 
(A) in the heading of subparagraph (B), by 
striking ‘‘AND PLANS’’; and 
(B) by striking ‘‘and subparagraphs (B) 
and (C) of subsection (c)(1) to a health center or 
to a network or plan’’ and inserting ‘‘to a health 
center or to a network’’; 
(7) by striking subsection (s); 
(8) by redesignating subsections (g) through (r) 
as subsections (h) through (s), respectively; 
(9) by inserting after subsection (f), the fol-
lowing: 
‘‘(g) NEW ACCESS POINTS
AND EXPANDED SERV-
ICES.— 
‘‘(1) APPROVAL OF NEW ACCESS POINTS.— 
‘‘(A) IN GENERAL.—The Secretary may ap-
prove applications for grants under subpara-
graph (A) or (B) of subsection (e)(1) to establish 
new delivery sites. 
‘‘(B) SPECIAL
CONSIDERATION.—In car-
rying out subparagraph (A), the Secretary may 
give special consideration to applicants that 
have demonstrated the new delivery site will be 
located within a sparsely populated area, or an 
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area which has a level of unmet need that is 
higher relative to other applicants. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying out subparagraph (A), the Secretary 
shall approve applications for grants under sub-
paragraphs (A) and (B) of subsection (e)(1) in 
such a manner that the ratio of the medically 
underserved populations in rural areas which 
may be expected to use the services provided by 
the applicants involved to the medically under-
served populations in urban areas which may be 
expected to use the services provided by the ap-
plicants is not less than two to three or greater 
than three to two. 
‘‘(D) SERVICE AREA OVERLAP.—If in car-
rying out subparagraph (A) the applicant pro-
poses to serve an area that is currently served by 
another health center funded under this section, 
the Secretary may consider whether the award of 
funding to an additional health center in the 
area can be justified based on the unmet need for 
additional services within the catchment area. 
‘‘(2) APPROVAL OF EXPANDED SERVICE APPLICA-
TIONS.— 
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‘‘(A) IN GENERAL.—The Secretary may ap-
prove applications for grants under subpara-
graph (A) or (B) of subsection (e)(1) to expand 
the capacity of the applicant to provide required 
primary health services described in subsection 
(b)(1) or additional health services described in 
subsection (b)(2). 
‘‘(B) PRIORITY EXPANSION PROJECTS.—In 
carrying out subparagraph (A), the Secretary 
may give special consideration to expanded serv-
ice applications that seek to address emerging 
public health or behavioral health, mental health, 
or substance abuse issues through increasing the 
availability of additional health services de-
scribed in subsection (b)(2) in an area in which 
there are significant barriers to accessing care. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying out subparagraph (A), the Secretary 
shall approve applications for applicants in such 
a manner that the ratio of the medically under-
served populations in rural areas which may be 
expected to use the services provided by the ap-
plicants involved to the medically underserved 
populations in urban areas which may be ex-
pected to use the services provided by such appli-
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cants is not less than two to three or greater 
than three to two.’’; 
(10) in subsection (i) (as so redesignated)— 
(A) in paragraph (1), by striking ‘‘and 
children and youth at risk of homelessness’’ and 
inserting ‘‘, children and youth at risk of home-
lessness, homeless veterans, and veterans at risk 
of homelessness’’; and 
(B) in paragraph (5)— 
(i) by striking subparagraph (B); 
(ii) by redesignating subparagraph (C) 
as subparagraph (B); and 
(iii) in subparagraph (B) (as so redes-
ignated)— 
(I) in the subparagraph heading, 
by striking ‘‘ABUSE’’ and inserting 
‘‘USE DISORDER’’; and 
(II) by striking ‘‘abuse’’ and in-
serting ‘‘use disorder’’; 
(11) in subsection (l) (as so redesignated)— 
(A) in paragraph (2)— 
(i) in the paragraph heading, by in-
serting ‘‘UNMET’’ before ‘‘NEED’’; 
(ii) in the matter preceding subpara-
graph (A), by inserting ‘‘and an applica-
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tion for a grant under subsection (g)’’ after 
‘‘subsection (e)(1)’’; 
(iii) in subparagraph (A), by inserting 
‘‘unmet’’ before ‘‘need for health services’’; 
(iv) in subparagraph (B), by striking 
‘‘and’’ at the end; 
(v) in subparagraph (C), by striking 
the period at the end and inserting ‘‘; and’’; 
and 
(vi) by adding after subparagraph (C) 
the following: 
‘‘(D) in the case of an application for a 
grant pursuant to subsection (g)(1), a dem-
onstration that the applicant has consulted with 
appropriate State and local government agen-
cies, and health care providers regarding the 
need for the health services to be provided at the 
proposed delivery site.’’; 
(B) in paragraph (3)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘or subsection (g)’’ 
after ‘‘subsection (e)(1)(B)’’; 
(ii) in subparagraph (B), by striking 
‘‘in the catchment area of the center’’ and 
inserting ‘‘, including other health care pro-
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viders 
that 
provide 
care 
within 
the 
catchment area, local hospitals, and spe-
cialty providers in the catchment area of 
the center, to provide access to services not 
available through the health center and to 
reduce the non-urgent use of hospital emer-
gency departments’’; 
(iii) in subparagraph (H)(ii), by in-
serting ‘‘who shall be directly employed by 
the center’’ after ‘‘approves the selection of 
a director for the center’’; 
(iv) in subparagraph (L), by striking 
‘‘and’’ at the end; 
(v) in subparagraph (M), by striking 
the period and inserting ‘‘; and’’; and 
(vi) by inserting after subparagraph 
(M), the following: 
‘‘(N) the center has written policies and 
procedures in place to ensure the appropriate use 
of Federal funds in compliance with applicable 
Federal statutes, regulations, and the terms and 
conditions of the Federal award.’’; and 
(C) by striking paragraph (4); 
(12) in subsection (m) (as so redesignated), by 
adding at the end the following: ‘‘Funds expended to 
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carry out activities under this subsection and oper-
ational support activities under subsection (n) shall 
not exceed 3 percent of the amount appropriated for 
this section for the fiscal year involved.’’; 
(13) in subsection (q) (as so redesignated), by 
striking ‘‘grants for new health centers under sub-
sections (c) and (e)’’ and inserting ‘‘operating grants 
under subsection (e), applications for new access 
points and expanded service pursuant to subsection 
(g)’’; 
(14) in subsection (r)(4) (as so redesignated), by 
adding at the end the following: ‘‘A waiver provided 
by the Secretary under this paragraph may not re-
main in effect for more than 1 year and may not be 
extended after such period. An entity may not receive 
more than one waiver under this paragraph in con-
secutive years.’’; 
(15) in subsection (s)(3) (as so redesignated)— 
(A) by striking ‘‘appropriate committees of 
Congress a report concerning the distribution of 
funds under this section’’ and inserting the fol-
lowing: ‘‘Committee on Health, Education, 
Labor, and Pensions of the Senate, and the Com-
mittee on Energy and Commerce of the House of 
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‘‘(H) the number and reason for any grants 
awarded pursuant to subsection (e)(1)(B); and 
‘‘(I) the number and reason for any waivers 
provided pursuant to subsection (r)(4).’’; and 
(16) in subsection (s) (as so redesignated) by 
adding at the end the following new paragraph: 
‘‘(5) FUNDING FOR PARTICIPATION OF HEALTH 
CENTERS IN ALL OF US RESEARCH PROGRAM.—In ad-
dition to any amounts made available pursuant to 
subsection (d) of this section, paragraph (1) of this 
subsection, section 402A of this Act, or section 10503 
of the Patient Protection and Affordable Care Act, 
there is authorized to be appropriated, and there is 
appropriated, out of any monies in the Treasury not 
otherwise appropriated, to the Secretary $25,000,000 
for fiscal year 2018 to support the participation of 
health centers in the All of Us Research Program 
under the Precision Medicine Initiative under section 
498E of this Act.’’. 
(c) NATIONAL HEALTH SERVICE CORPS.—Section 
10503(b)(2)(E) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 254b–2(b)(2)(E)) is amended by strik-
ing ‘‘2017’’ and inserting ‘‘2019’’. 
(d) APPLICATION.—Amounts appropriated pursuant 
to this section for fiscal year 2018 or 2019 are subject to 
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the requirements contained in Public Law 115–31 for funds 
for programs authorized under sections 330 through 340 of 
the Public Health Service Act (42 U.S.C. 254b–256). 
(e) CONFORMING AMENDMENTS.—Section 3014(h) of 
title 18, United States Code, is amended— 
(1) in paragraph (1), by striking ‘‘, as amended 
by section 221 of the Medicare Access and CHIP Re-
authorization Act of 2015,’’; and 
(2) in paragraph (4), by inserting ‘‘and section 
101(d) of the Community Health And Medical Profes-
sionals Improve Our Nation Act of 2017’’ after ‘‘sec-
tion 221(c) of the Medicare Access and CHIP Reau-
thorization Act of 2015’’. 
SEC. 102. EXTENSION FOR SPECIAL DIABETES PROGRAMS. 
(a) SPECIAL DIABETES PROGRAM FOR TYPE I DIABE-
TES.—Section 330B(b)(2)(C) of the Public Health Service 
Act (42 U.S.C. 254c–2(b)(2)(C)) is amended by striking 
‘‘2017’’ and inserting ‘‘2019’’. 
(b) SPECIAL DIABETES PROGRAM FOR INDIANS.—Sec-
tion 330C(c)(2) of the Public Health Service Act (42 U.S.C. 
254c–3(c)(2)) is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (D), by striking the period 
at the end and inserting ‘‘and $112,500,000 for the 
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period consisting of the second, third, and fourth 
quarters of fiscal year 2018; and’’; and 
(3) by adding at the end the following: 
‘‘(E) $150,000,000 for fiscal year 2019.’’. 
SEC. 103. REAUTHORIZATION OF PROGRAM OF PAYMENTS 
TO TEACHING HEALTH CENTERS THAT OPER-
ATE GRADUATE MEDICAL EDUCATION PRO-
GRAMS. 
(a) PAYMENTS.—Subsection (a) of section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended to 
read as follows: 
‘‘(a) PAYMENTS.— 
‘‘(1) IN GENERAL.—Subject to subsection (h)(2), 
the Secretary shall make payments under this section 
for direct expenses and indirect expenses to qualified 
teaching health centers that are listed as sponsoring 
institutions by the relevant accrediting body for— 
‘‘(A) maintenance of existing approved 
graduate medical residency training programs; 
‘‘(B) expansion of existing approved grad-
uate medical residency training programs; and 
‘‘(C) establishment of new approved grad-
uate medical residency training programs, as 
appropriate. 
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‘‘(2) PRIORITY.—In making payments pursuant 
to paragraph (1)(C), the Secretary shall give priority 
to qualified teaching health centers that— 
‘‘(A) serve a health professional shortage 
area with a designation in effect under section 
332 or a medically underserved community (as 
defined in section 799B); or 
‘‘(B) are located in a rural area (as defined 
in section 1886(d)(2)(D) of the Social Security 
Act).’’. 
(b) FUNDING.—Subsection (g) of section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended— 
(1) by striking ‘‘To carry out’’ and inserting the 
following: 
‘‘(1) IN GENERAL.—To carry out’’; 
(2) by striking ‘‘and $15,000,000 for the first 
quarter of fiscal year 2018’’ and inserting ‘‘, 
$15,000,000 for the first quarter of fiscal year 2018, 
$111,500,000 for the period consisting of the second, 
third, and fourth quarters of fiscal year 2018, and 
$126,500,000 for fiscal year 2019, to remain available 
until expended’’; and 
(3) by adding at the end the following: 
‘‘(2) 
ADMINISTRATIVE
EXPENSES.—Of 
the 
amount made available to carry out this section for 
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any fiscal year, the Secretary may not use more than 
5 percent of such amount for the expenses of admin-
istering this section.’’. 
(c) ANNUAL REPORTING.—Subsection (h)(1) of section 
340H of the Public Health Service Act (42 U.S.C. 256h) 
is amended— 
(1) by redesignating subparagraph (D) as sub-
paragraph (H); and 
(2) by inserting after subparagraph (C) the fol-
lowing: 
‘‘(D) The number of patients treated by 
residents described in paragraph (4). 
‘‘(E) The number of visits by patients treat-
ed by residents described in paragraph (4). 
‘‘(F) Of the number of residents described in 
paragraph (4) who completed their residency 
training at the end of such residency academic 
year, the number and percentage of such resi-
dents entering primary care practice (meaning 
any of the areas of practice listed in the defini-
tion of a primary care residency program in sec-
tion 749A). 
‘‘(G) Of the number of residents described in 
paragraph (4) who completed their residency 
training at the end of such residency academic 
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year, the number and percentage of such resi-
dents who entered practice at a health care facil-
ity— 
‘‘(i) primarily serving a health profes-
sional shortage area with a designation in 
effect under section 332 or a medically un-
derserved community (as defined in section 
799B); or 
‘‘(ii) located in a rural area (as de-
fined in section 1886(d)(2)(D) of the Social 
Security Act).’’. 
(d) REPORT ON TRAINING COSTS.—Not later than 
March 31, 2019, the Secretary of Health and Human Serv-
ices shall submit to the Congress a report on the direct grad-
uate expenses of approved graduate medical residency 
training programs, and the indirect expenses associated 
with the additional costs of teaching residents, of qualified 
teaching health centers (as such terms are used or defined 
in section 340H of the Public Health Service Act (42 U.S.C. 
256h)). 
(e) DEFINITION.—Subsection (j) of section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended— 
(1) by redesignating paragraphs (2) and (3) as 
paragraphs (3) and (4), respectively; and 
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(2) by inserting after paragraph (1) the fol-
lowing: 
‘‘(2) NEW APPROVED GRADUATE MEDICAL RESI-
DENCY TRAINING PROGRAM.—The term ‘new approved 
graduate medical residency training program’ means 
an approved graduate medical residency training 
program for which the sponsoring qualified teaching 
health center has not received a payment under this 
section for a previous fiscal year (other than pursuant 
to subsection (a)(1)(C)).’’. 
(f) TECHNICAL CORRECTION.—Subsection (f) of section 
340H (42 U.S.C. 256h) is amended by striking ‘‘hospital’’ 
each place it appears and inserting ‘‘teaching health cen-
ter’’. 
(g) PAYMENTS FOR PREVIOUS FISCAL YEARS.—The 
provisions of section 340H of the Public Health Service Act 
(42 U.S.C. 256h), as in effect on the day before the date 
of enactment of this Act, shall continue to apply with re-
spect to payments under such section for fiscal years before 
fiscal year 2018. 
SEC. 104. EXTENSION FOR FAMILY-TO-FAMILY HEALTH IN-
FORMATION CENTERS. 
Section 501(c) of the Social Security Act (42 U.S.C. 
701(c)) is amended— 
(1) in paragraph (1)(A)— 
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(A) in clause (v), by striking ‘‘and’’ at the 
end; 
(B) in clause (vi), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(vii) $6,000,000 for each of fiscal years 2018 
and 2019.’’; 
(2) in paragraph (3)(C), by inserting before the 
period the following: ‘‘, and with respect to fiscal 
years 2018 and 2019, such centers shall also be devel-
oped in all territories and at least one such center 
shall be developed for Indian tribes’’; and 
(3) by amending paragraph (5) to read as fol-
lows: 
‘‘(5) For purposes of this subsection— 
‘‘(A) the term ‘Indian tribe’ has the meaning 
given such term in section 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603); 
‘‘(B) the term ‘State’ means each of the 50 States 
and the District of Columbia; and 
‘‘(C) the term ‘territory’ means Puerto Rico, 
Guam, American Samoa, the Virgin Islands, and the 
Northern Mariana Islands.’’. 
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SEC. 105. YOUTH EMPOWERMENT PROGRAM; PERSONAL RE-
SPONSIBILITY EDUCATION. 
(a) YOUTH EMPOWERMENT PROGRAM.— 
(1) IN GENERAL.—Section 510 of the Social Se-
curity Act (42 U.S.C. 710) is amended to read as fol-
lows: 
‘‘SEC. 510. YOUTH EMPOWERMENT PROGRAM. 
‘‘(a) IN GENERAL.— 
‘‘(1) ALLOTMENTS TO STATES.—For the purpose 
described in subsection (b), the Secretary shall, for 
each of fiscal years 2018 and 2019, allot to each State 
which has transmitted an application for the fiscal 
year under section 505(a) an amount equal to the 
product of— 
‘‘(A) the amount appropriated pursuant to 
subsection (e)(1) for the fiscal year, minus the 
amount reserved under subsection (e)(2) for the 
fiscal year; and 
‘‘(B) the proportion that the number of low- 
income children in the State bears to the total of 
such numbers of children for all the States. 
‘‘(2) OTHER ALLOTMENTS.— 
‘‘(A) OTHER
ENTITIES.—For the purpose 
described in subsection (b), the Secretary shall, 
for each of fiscal years 2018 and 2019, for any 
State which has not transmitted an application 
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for the fiscal year under section 505(a), allot to 
one or more entities in the State the amount that 
would have been allotted to the State under 
paragraph (1) if the State had submitted such 
an application. 
‘‘(B) PROCESS.—The Secretary shall select 
the recipients of allotments under subparagraph 
(A) by means of a competitive grant process 
under which— 
‘‘(i) not later than 30 days after the 
deadline for the State involved to submit an 
application for the fiscal year under section 
505(a), the Secretary publishes a notice so-
liciting grant applications; and 
‘‘(ii) not later than 120 days after such 
deadline, all such applications must be sub-
mitted. 
‘‘(b) PURPOSE.— 
‘‘(1) IN GENERAL.—Except for research under 
paragraph (5) and information collection and report-
ing under paragraph (6), the purpose of an allotment 
under subsection (a) to a State (or to another entity 
in the State pursuant to subsection (a)(2)) is to en-
able the State or other entity to implement education 
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exclusively on sexual risk avoidance (meaning volun-
tarily refraining from sexual activity). 
‘‘(2) REQUIRED
COMPONENTS.—Education on 
sexual risk avoidance pursuant to an allotment under 
this section shall— 
‘‘(A) ensure that the unambiguous and pri-
mary emphasis and context for each topic de-
scribed in paragraph (3) is a message to youth 
that normalizes the optimal health behavior of 
avoiding nonmarital sexual activity; 
‘‘(B) be medically accurate and complete; 
‘‘(C) be age-appropriate; and 
‘‘(D) be based on adolescent learning and 
developmental theories for the age group receiv-
ing the education. 
‘‘(3) TOPICS.—Education on sexual risk avoid-
ance pursuant to an allotment under this section 
shall address each of the following topics: 
‘‘(A) The holistic individual and societal 
benefits associated with personal responsibility, 
self-regulation, goal setting, healthy decision-
making, and a focus on the future. 
‘‘(B) The advantage of refraining from non-
marital sexual activity in order to improve the 
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future prospects and physical and emotional 
health of youth. 
‘‘(C) The increased likelihood of avoiding 
poverty when youth attain self-sufficiency and 
emotional maturity before engaging in sexual ac-
tivity. 
‘‘(D) 
The 
foundational 
components 
of 
healthy relationships and their impact on the 
formation of healthy marriages and safe and sta-
ble families. 
‘‘(E) How other youth risk behaviors, such 
as drug and alcohol usage, increase the risk for 
teen sex. 
‘‘(F) How to resist and avoid, and receive 
help regarding, sexual coercion and dating vio-
lence, recognizing that even with consent teen sex 
remains a youth risk behavior. 
‘‘(4) CONTRACEPTION.—Education on sexual risk 
avoidance pursuant to an allotment under this section 
shall ensure that— 
‘‘(A) any information provided on contra-
ception is medically accurate and ensures that 
students understand that contraception offers 
physical risk reduction, but not risk elimination; 
and 
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‘‘(B) the education does not include dem-
onstrations, simulations, or distribution of con-
traceptive devices. 
‘‘(5) RESEARCH.— 
‘‘(A) IN GENERAL.—A State or other entity 
receiving an allotment pursuant to subsection (a) 
may use up to 20 percent of such allotment to 
build the evidence base for sexual risk avoidance 
education by conducting or supporting research. 
‘‘(B) REQUIREMENTS.—Any research con-
ducted or supported pursuant to subparagraph 
(A) shall be— 
‘‘(i) rigorous; 
‘‘(ii) evidence-based; and 
‘‘(iii) designed and conducted by inde-
pendent researchers who have experience in 
conducting and publishing research in peer- 
reviewed outlets. 
‘‘(6) INFORMATION
COLLECTION
AND
REPORT-
ING.—A State or other entity receiving an allotment 
pursuant to subsection (a) shall, as specified by the 
Secretary— 
‘‘(A) collect information on the programs 
and activities funded through the allotment; and 
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‘‘(B) submit reports to the Secretary on the 
data from such programs and activities. 
‘‘(c) NATIONAL EVALUATION.— 
‘‘(1) IN GENERAL.—The Secretary shall— 
‘‘(A) in consultation with appropriate State 
and local agencies, conduct one or more rigorous 
evaluations of the education funded through this 
section and associated data; and 
‘‘(B) submit a report to the Congress on the 
results of such evaluations, together with a sum-
mary of the information collected pursuant to 
subsection (b)(6). 
‘‘(2) CONSULTATION.—In conducting the evalua-
tions required by paragraph (1), including the estab-
lishment of evaluation methodologies, the Secretary 
shall consult with relevant stakeholders. 
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.— 
‘‘(1) Sections 503, 507, and 508 apply to allot-
ments under subsection (a) to the same extent and in 
the same manner as such sections apply to allotments 
under section 502(c). 
‘‘(2) Sections 505 and 506 apply to allotments 
under subsection (a) to the extent determined by the 
Secretary to be appropriate. 
‘‘(e) FUNDING.— 
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‘‘(1) IN GENERAL.—To carry out this section, 
there is appropriated, out of any money in the Treas-
ury not otherwise appropriated, $75,000,000 for each 
of fiscal years 2018 and 2019. 
‘‘(2) RESERVATION.—The Secretary shall reserve, 
for each of fiscal years 2018 and 2019, not more than 
20 percent of the amount appropriated pursuant to 
paragraph (1) for administering the program under 
this section, including the conducting of national 
evaluations and the provision of technical assistance 
to the recipients of allotments.’’. 
(2) EFFECTIVE DATE.—The amendment made by 
this section takes effect on October 1, 2017. 
(b) PERSONAL RESPONSIBILITY EDUCATION.— 
(1) IN GENERAL.—Section 513 of the Social Se-
curity Act (42 U.S.C. 713) is amended— 
(A) in subsection (a)(1)(A), by striking 
‘‘2017’’ and inserting ‘‘2019’’; and 
(B) in subsection (a)(4)— 
(i) in subparagraph (A), by striking 
‘‘2017’’ each place it appears and inserting 
‘‘2019’’; and 
(ii) in subparagraph (B)— 
(I) in the subparagraph heading, 
by striking ‘‘3-YEAR GRANTS’’ and in-
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serting ‘‘COMPETITIVE PREP GRANTS’’; 
and 
(II) in clause (i), by striking ‘‘so-
licit applications to award 3-year 
grants in each of fiscal years 2012 
through 2017’’ and inserting ‘‘continue 
through fiscal year 2019 grants award-
ed for any of fiscal years 2015 through 
2017’’; 
(C) in subsection (c)(1), by inserting after 
‘‘youth with HIV/AIDS,’’ the following: ‘‘victims 
of human trafficking,’’; and 
(D) in subsection (f), by striking ‘‘2017’’ 
and inserting ‘‘2019’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection take effect on October 1, 2017. 
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TITLE II—OFFSETS 
SEC. 201. PROVIDING FOR QUALIFIED HEALTH PLAN GRACE 
PERIOD REQUIREMENTS FOR ISSUER RE-
CEIPT OF ADVANCE PAYMENTS OF COST- 
SHARING REDUCTIONS AND PREMIUM TAX 
CREDITS THAT ARE MORE CONSISTENT WITH 
STATE LAW GRACE PERIOD REQUIREMENTS. 
(a) IN GENERAL.—Section 1412(c) of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 18082(c)) is 
amended— 
(1) in paragraph (2)— 
(A) in subparagraph (B)(iv)(II), by strik-
ing ‘‘a 3-month grace period’’ and inserting ‘‘a 
grace period specified in subparagraph (C)’’; and 
(B) by adding at the end the following new 
subparagraphs: 
‘‘(C) GRACE PERIOD SPECIFIED.—For pur-
poses of subparagraph (B)(iv)(II), the grace pe-
riod specified in this subparagraph is— 
‘‘(i) for plan years beginning before 
January 1, 2018, a 3-month grace period; 
and 
‘‘(ii) for plan years beginning on or 
after January 1, 2018— 
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‘‘(I) in the case of an Exchange 
operating in a State that has a State 
law grace period in place, such State 
law grace period; and 
‘‘(II) in the case of an Exchange 
operating in a State that does not have 
a State law grace period in place, a 1- 
month grace period. 
‘‘(D) STATE LAW GRACE PERIOD.—For pur-
poses of subparagraph (C), the term ‘State law 
grace period’ means, with respect to a State, a 
grace period for nonpayment of premiums before 
discontinuing coverage that is applicable under 
the State law to health insurance coverage offered 
in the individual market of the State.’’; and 
(2) in paragraph (3), by adding at the end the 
following new sentence: ‘‘The requirements of para-
graph (2)(B)(iv) apply to an issuer of a qualified 
health plan receiving an advanced payment under 
this paragraph in the same manner and to the same 
extent that such requirements apply to an issuer of a 
qualified health plan receiving an advanced payment 
under paragraph (2)(A).’’. 
(b) REPORT ON ALIGNING GRACE PERIODS FOR MED-
ICAID, MEDICARE, AND EXCHANGE PLANS.—Not later than 
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two years after the date of full implementation of subsection 
(a), the Comptroller General of the United States shall sub-
mit to Congress a report on— 
(1) the effects on consumers of aligning grace pe-
riods applied under the Medicaid program under title 
XIX of the Social Security Act, under the Medicare 
program under parts C and D of title XVIII of such 
Act, and under qualified health plans offered on an 
Exchange established under title I of the Patient Pro-
tection and Affordable Care Act, including the extent 
to which such an alignment of grace periods may help 
to avoid enrollment status confusion for individuals 
under such Medicaid program, Medicare program, 
and qualified health plans; and 
(2) the extent to which such an alignment of 
grace periods may reduce fraud, waste, and abuse 
under the Medicaid program. 
SEC. 202. PREVENTION AND PUBLIC HEALTH FUND. 
Section 4002(b) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 300u–11(b)) is amended by strik-
ing paragraphs (3) through (8) and inserting the following 
new paragraphs: 
‘‘(3) for fiscal year 2018, $900,000,000; 
‘‘(4) for fiscal year 2019, $500,000,000; 
‘‘(5) for fiscal year 2020, $500,000,000; 
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‘‘(6) for fiscal year 2021, $500,000,000; 
‘‘(7) for fiscal year 2022, $500,000,000; 
‘‘(8) for fiscal year 2023, $500,000,000; 
‘‘(9) for fiscal year 2024, $500,000,000; 
‘‘(10) for fiscal year 2025, $750,000,000; 
‘‘(11) for fiscal year 2026, $1,000,000,000; and 
‘‘(12) for fiscal year 2027 and each fiscal year 
thereafter, $2,000,000,000.’’. 
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Union Calendar No. 262 
115TH CONGRESS 
1ST SESSION 
H. R. 3922 
[Report No. 115–359, Part I] 
A BILL 
To extend funding for certain public health 
programs, and for other purposes. 
OCTOBER 19, 2017 
Reported from the Committee on Energy and Commerce 
with an amendment 
OCTOBER 19, 2017 
The Committee on Ways and Means discharged; com-
mitted to the Committee of the Whole House on the 
State of the Union and ordered to be printed 
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