(C) Paragraph (2) of section 7213(a) of 
such Code is amended by striking ‘‘or (20)’’ 
and inserting ‘‘(20), or (21)’’. 
(f) DISCLOSURE OF TAXPAYER RETURN INFORMA-
TION TO CARRY OUT PREMIUM SUBSIDIES.—Section 
6103(k) of the Internal Revenue Code of 1986 is amended 
by adding at the end the following new paragraph: 
‘‘(10) DISCLOSURE OF INFORMATION TO AD-
MINISTER PREMIUM SUBSIDY UNDER SECTION 36.— 
To the extent that Secretary determines that disclo-
sure is necessary to permit the effective administra-
tion of section 36, the Secretary may disclose the 
modified adjusted gross income (as defined in sec-
tion 36) of any individual whose modified adjusted 
gross income is taken into account in determining 
the amount of any credit under such section.’’. 
(g) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
shall take effect on January 1, 2011. 
(2) SUBSECTIONS (a) AND (b).—The amend-
ments made by subsections (a) and (b) shall apply 
to months beginning after December 31, 2010, in 
taxable years ending after such date. 
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(3) SUBSECTION (d).—The amendments made 
by subsection (d) shall apply to taxable years begin-
ning after December 31, 2010. 
SEC. 4. AMENDMENTS TO THE MEDICAID PROGRAM AND 
SCHIP. 
(a) MAINTENANCE OF EFFORT IN MEDICAID PAY-
MENTS.—Section 1902 of the Social Security Act (42 
U.S.C. 1396b) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(dd)(1) For each State fiscal year that begins on 
or after January 1 of the first calendar year in which cov-
erage is provided under title XXII, each State shall submit 
a report to the Secretary on the amount of State expendi-
tures for health services, as defined by the Secretary. 
‘‘(2) Subject to paragraph (4), if the amount so re-
ported for a State fiscal year is less than the amount spec-
ified in paragraph (3) for that State fiscal year, the State 
shall provide for payment to the Secretary of the amount 
of such difference. The provisions of subparagraphs (B) 
and (C) of section 1935(c)(1) shall apply to payment 
under the previous sentence in the same manner as they 
apply to payment under subparagraph (A) of such section, 
except that such payments shall be deposited into the 
American Health Benefits Program Trust Fund estab-
lished under section 2204(c). 
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‘‘(3) The amount specified in this paragraph for a 
State for— 
‘‘(A) the first State fiscal year described in 
paragraph (1), is the total amount of the State 
share of expenditures for health services (as defined 
in paragraph (1)) under all public health programs 
operated in the State that are funded in whole or in 
part with State expenditures, including expenditures 
under this title and title XXI, for the previous State 
fiscal year; and 
‘‘(B) a subsequent State fiscal year, is the 
amount specified in this paragraph for the previous 
State fiscal year increased by the percentage change, 
if any, in the consumer price index for all urban con-
sumers for the most recent completed Federal fiscal 
year. 
‘‘(4) The Secretary may waive payment of all or a 
portion of the amount otherwise payable under paragraph 
(2) based on criteria specified by the Secretary’’. 
(b) SUNSET OF SCHIP FUNDING.—Section 2105 of 
such Act (42 U.S.C. 1397ee) is amended by adding at the 
end the following new subsection: 
‘‘(h) SUNSET OF PROGRAM UPON INITIATION OF 
AMERICAN HEALTH BENEFITS PROGRAM.—No payment 
shall be made under this title to a State for items and 
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services furnished after the effective date of the American 
Health Benefits Program under title XXII.’’. 
(c) REDUCTION IN MEDICAID DSH PAYMENTS.— 
Section 1923(f) of such Act (42 U.S.C. 1396r–4(f)) is 
amended— 
(1) by redesignating paragraph (7) as para-
graph (8); and 
(2) by inserting after paragraph (6) the fol-
lowing new paragraph: 
‘‘(7) 
REDUCTION
IN
CONNECTION
WITH 
AHBP.—Notwithstanding the previous provisions in 
this paragraph, the Secretary shall provide for a 
phased-down reduction over a 5-fiscal-year-period 
beginning with fiscal year 2011 of the amount of the 
DSH allotment for each State so that, by the end 
of such period, such amount is equal to 10 percent 
of the amount of such allotment for such State for 
fiscal year 2010.’’. 
SEC. 5. PROMOTION OF USE OF HEALTH INFORMATION 
TECHNOLOGIES. 
The Commissioner of Health Benefits (appointed 
under section 2206(d)(1) of the Social Security Act, as 
added by section 2(a)), in consultation with the Secretary 
of Health and Human Services, shall establish new guide-
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lines that promote the proper use and understanding of 
health information technologies. 
SEC. 6. NON-PREEMPTION OF EXISTING COLLECTIVE BAR-
GAINING AGREEMENTS. 
Nothing in this Act shall be construed as preempting 
any collective bargaining agreement that is in effect as of 
the date of the enactment of this Act, during the period 
in which such agreement is in effect (without regard to 
any extension of such agreement effected as such date of 
enactment). 
SEC. 7. HEALTH BENEFITS COMMISSION. 
(a) ESTABLISHMENT.—There is established an inde-
pendent commission to be known as the Health Benefits 
Commission (in this section referred to as the ‘‘Commis-
sion’’). 
(b) DUTIES OF THE COMMISSION.— 
(1) GENERAL DUTIES.—The Commission shall 
examine and make recommendations regarding the 
major issues and cost drivers affecting the delivery 
of healthcare services as it pertains to the American 
Health Benefits Program under title XXII of the 
Social Security Act (in this section referred to as 
‘‘AHBP’’). 
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