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and population 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 
flexibility to tailor a Medicaid program that fits 
the needs of its unique population. Moreover, 
this budget assumes the repeal of the Medicaid 
expansions in the President’s health care law, 
relieving State governments of its crippling one- 
size-fits-all enrollment mandates. 
(C) For the Supplemental Nutrition As-
sistance Program, this budget assumes the con-
version of the program into a flexible State al-
lotment tailored to meet each State’s needs. 
The allotment would increase based on the De-
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 
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during the 10-year period preceding fiscal year 2015 
is 5.7 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 2015 is 5.4 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-
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-
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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. 
TITLE V—BUDGET 
ENFORCEMENT 
SEC. 501. LIMITATION ON ADVANCE APPROPRIATIONS. 
(a) IN GENERAL.—In the House, except as provided 
for in subsection (b), 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. 
(b) EXCEPTIONS.—An advance appropriation may be 
provided for programs, projects, activities, or accounts re-
ferred to in subsection (c)(1) or identified in the report 
to accompany this concurrent resolution or the joint ex-
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planatory statement of managers to accompany this con-
current resolution under the heading ‘‘Accounts Identified 
for Advance Appropriations’’. 
(c) LIMITATIONS.—For fiscal year 2016, the aggre-
gate level of advance appropriations shall not exceed— 
(1) $58,662,202,000 for the following programs 
in the Department of Veterans Affairs— 
(A) Medical Services; 
(B) Medical Support and Compliance; and 
(C) Medical Facilities accounts of the Vet-
erans Health Administration; and 
(2) $28,781,000,000 in new budget authority 
for all programs identified pursuant to subsection 
(b). 
(d) DEFINITION.—In this section, the term ‘‘advance 
appropriation’’ means any new discretionary budget au-
thority provided in a bill or joint resolution, or amendment 
thereto or conference report thereon, making general ap-
propriations or any new discretionary budget authority 
provided in a bill or joint resolution making continuing 
appropriations for fiscal year 2016. 
SEC. 502. CONCEPTS AND DEFINITIONS. 
Upon the enactment of any bill or joint resolution 
providing for a change in budgetary concepts or defini-
tions, the chair of the Committee on the Budget may ad-
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just any allocations, aggregates, and other appropriate lev-
els in this concurrent resolution accordingly. 
SEC. 503. ADJUSTMENTS OF AGGREGATES, ALLOCATIONS, 
AND APPROPRIATE BUDGETARY LEVELS. 
(a) ADJUSTMENTS OF DISCRETIONARY AND DIRECT 
SPENDING LEVELS.—If a committee (other than the Com-
mittee on Appropriations) reports a bill or joint resolution, 
or amendment thereto or conference report thereon, pro-
viding for a decrease in direct spending (budget authority 
and outlays flowing therefrom) for any fiscal year and also 
provides for an authorization of appropriations for the 
same purpose, upon the enactment of such measure, the 
chair of the Committee on the Budget may decrease the 
allocation to such committee and increase the allocation 
of discretionary spending (budget authority and outlays 
flowing therefrom) to the Committee on Appropriations 
for fiscal year 2015 by an amount equal to the new budget 
authority (and outlays flowing therefrom) provided for in 
a bill or joint resolution making appropriations for the 
same purpose. 
(b) ADJUSTMENTS
TO FUND OVERSEAS CONTIN-
GENCY OPERATIONS/GLOBAL WAR ON TERRORISM.—In 
order to take into account any new information included 
in the budget submission by the President for fiscal year 
2015, the chair of the Committee on the Budget may ad-
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