In the House of Representatives, U. S., 
January 18, 2018. 
Resolved, That the House agree to the amendment of the 
Senate to the bill (H.R. 195) entitled ‘‘An Act to amend title 
44, United States Code, to restrict the distribution of free 
printed copies of the Federal Register to Members of Con-
gress and other officers and employees of the United States, 
and for other purposes.’’, with the following 
HOUSE AMENDMENT TO SENATE AMENDMENT: 
In lieu of the matter proposed to be inserted by the 
amendment of the Senate, insert the following: 
DIVISION B—EXTENSION OF CONTINUING 
APPROPRIATIONS ACT, 2018 
SEC. 2001. The Continuing Appropriations Act, 2018 
(division D of Public Law 115–56) is amended— 
(1) by striking the date specified in section 
106(3) and inserting ‘‘February 16, 2018’’; and 
(2) by adding after section 147 the following: 
‘‘SEC. 148. Funds appropriated by the Department of 
Defense Missile Defeat and Defense Enhancements Appro-
priations Act, 2018 (division B of Public Law 115–96) may 
be 
obligated 
and 
expended 
notwithstanding 
section 
504(a)(1) of the National Security Act of 1947 (50 U.S.C. 
3094(a)(1)).
‘‘SEC. 149. Amounts made available by section 101 for 
‘Department of Agriculture—Food and Nutrition Service— 
Child Nutrition Programs’ to carry out section 749(g) of 
the Agriculture Appropriations Act of 2010 (Public Law 
111–80) may be apportioned up to the rate for operations 
necessary to ensure that the program can be fully oper-
ational by May 2018. 
‘‘SEC. 150. Amounts made available by section 101 for 
‘National Aeronautics and Space Administration—Explo-
ration’ may be apportioned up to the rate for operations 
necessary to maintain the planned launch capability sched-
ules for the Space Launch System launch vehicle, Explo-
ration Ground Systems, and Orion Multi-Purpose Crew Ve-
hicle programs. 
‘‘SEC. 151. Amounts made available by section 101 for 
‘Department of Energy—Energy Programs—Office of the 
Inspector General’ may be apportioned up to the rate for 
operations necessary to sustain staffing levels achieved on 
June 30, 2017. 
‘‘SEC. 152. Amounts made available by section 101 for 
‘Small Business Administration—Business Loans Program 
Account’ may be apportioned up to the rate for operations 
necessary to accommodate increased demand for commit-
ments for general business loans authorized under section 
7(a) of the Small Business Act (15 U.S.C. 636(a)).
‘‘SEC. 153. For 2018, the Secretary of Housing and 
Urban Development may make temporary adjustments to 
the Section 8 housing choice voucher annual renewal fund-
ing allocations and administrative fee eligibility deter-
minations for public housing agencies in an area for which 
the President declared a disaster in 2017 or 2018 under 
title IV of the Robert T. Stafford Disaster Relief and Emer-
gency Assistance Act (42 U.S.C. 5170 et seq.), to avoid sig-
nificant adverse funding impacts that would otherwise re-
sult from the disaster and that would otherwise prevent a 
public housing agency from leasing up to its authorized 
level of units under contract (but not to exceed such level), 
upon request by and in consultation with a public housing 
agency and supported by documentation as required by the 
Secretary that demonstrates the need for the adjustment.’’. 
SEC. 2002. The Further Additional Continuing Appro-
priations Act, 2018 (division A of Public Law 115–96) is 
amended by striking section 1002. 
This division may be cited as the ‘‘Extension of Con-
tinuing Appropriations Act, 2018’’. 
DIVISION C—HEALTHY KIDS ACT 
SEC. 3001. SHORT TITLE. 
This division may be cited as the ‘‘Helping Ensure 
Access for Little Ones, Toddlers, and Hopeful Youth by
‘‘(B) $2,850,000,000 for the period begin-
ning on April 1, 2023, and ending on September 
30, 2023.’’. 
(2) PREVENTION OF DUPLICATE APPROPRIATIONS 
FOR FISCAL YEAR 2018.—Notwithstanding any other 
provision of law, insofar as funds have been appro-
priated under subsection (a)(21) of section 2104 of the 
Social Security Act (42 U.S.C. 1397dd), as such sub-
section is in effect on the day before the date of the 
enactment of this Act, to provide allotments to States 
under the State Children’s Health Insurance Program 
established under title XXI of the Social Security Act 
(42 U.S.C. 1397aa et seq.) (whether implemented 
under title XIX, XXI, or both, of the Social Security 
Act) for fiscal year 2018— 
(A) any amounts that are so appropriated 
that are not so allotted and obligated before the 
date of the enactment of this Act, are rescinded; 
and 
(B) any amount provided for CHIP allot-
ments to a State under this section (and the 
amendments made by this section) for such fiscal 
year shall be reduced by the amount of such ap-
propriations so allotted and obligated before such 
date.
(b) ALLOTMENTS.— 
(1) IN GENERAL.—Section 2104(m) of the Social 
Security Act (42 U.S.C. 1397dd(m)), as amended by 
section 3201(b) of the CHIP and Public Health Fund-
ing Extension Act (division C of Public Law 115–96), 
is amended— 
(A) in paragraph (2)(B)— 
(i) in the matter preceding clause (i), 
by striking ‘‘(19)’’ and inserting ‘‘(25)’’; 
(ii) in clause (i), by striking ‘‘and 
2017’’ and inserting ‘‘, 2017, and 2023’’; 
and 
(iii) in clause (ii)— 
(I) in the matter preceding sub-
clause (I), by striking ‘‘and paragraph 
(10)’’; and 
(II) in subclause (I), by inserting 
‘‘(or, in the case of fiscal year 2018, 
under paragraph (4))’’ after ‘‘clause 
(i)’’; 
(B) in paragraph (5), by striking ‘‘2018’’ 
and inserting ‘‘2023’’; 
(C) in paragraph (7)— 
(i) in subparagraph (A), by striking 
‘‘2017’’ and inserting ‘‘2023’’;
(ii) in subparagraph (B), in the mat-
ter preceding clause (i), by inserting ‘‘(or, 
in the case of fiscal year 2018, by not later 
than the date that is 60 days after the date 
of the enactment of the HEALTHY KIDS 
Act)’’ after ‘‘before the August 31 preceding 
the beginning of the fiscal year’’; and 
(iii) in the matter following subpara-
graph (B), by striking ‘‘or fiscal year 2016’’ 
and inserting ‘‘fiscal year 2016, fiscal year 
2018, fiscal year 2020, or fiscal year 2022’’; 
(D) in paragraph (9), by striking ‘‘2018’’ 
and inserting ‘‘2023’’; and 
(E) by amending paragraph (10) to read as 
follows: 
‘‘(10) FOR FISCAL YEAR 2023.— 
‘‘(A) FIRST HALF.—Subject to paragraphs 
(5) and (7), from the amount made available 
under subparagraph (A) of paragraph (26) of 
subsection (a) for the semi-annual period de-
scribed in such subparagraph, increased by the 
amount of the appropriation for such period 
under section 3002(b)(2) of the HEALTHY 
KIDS Act, the Secretary shall compute a State 
allotment for each State (including the District
of Columbia and each commonwealth and terri-
tory) for such semi-annual period in an amount 
equal to the first half ratio (described in sub-
paragraph (D)) of the amount described in sub-
paragraph (C). 
‘‘(B) SECOND
HALF.—Subject to para-
graphs (5) and (7), from the amount made 
available under subparagraph (B) of paragraph 
(26) of subsection (a) for the semi-annual period 
described in such subparagraph, the Secretary 
shall compute a State allotment for each State 
(including the District of Columbia and each 
commonwealth and territory) for such semi-an-
nual period in an amount equal to the amount 
made available under such subparagraph, multi-
plied by the ratio of— 
‘‘(i) the amount of the allotment to 
such State under subparagraph (A); to 
‘‘(ii) the total of the amount of all of 
the allotments made available under such 
subparagraph. 
‘‘(C) FULL
YEAR
AMOUNT
BASED
ON 
REBASED
AMOUNT.—The amount described in 
this subparagraph for a State is equal to the 
Federal payments to the State that are attrib-
utable to (and countable towards) the total 
amount of allotments available under this section 
to the State in fiscal year 2022 (including pay-
ments made to the State under subsection (n) for 
fiscal year 2022 as well as amounts redistributed 
to the State in fiscal year 2022), multiplied by 
the allotment increase factor under paragraph 
(6) for fiscal year 2023. 
‘‘(D) FIRST
HALF
RATIO.—The first half 
ratio described in this subparagraph is the ratio 
of— 
‘‘(i) the sum of— 
‘‘(I) the amount made available 
under subsection (a)(26)(A); and 
‘‘(II) the amount of the appro-
priation for such period under section 
3002(b)(2) of the HEALTHY KIDS 
Act; to 
‘‘(ii) the sum of— 
‘‘(I) the amount described in 
clause (i); and 
‘‘(II) the amount made available 
under subsection (a)(26)(B).’’. 
(2) ONE-TIME APPROPRIATION FOR FISCAL YEAR 
2023.—There is appropriated to the Secretary of
Health and Human Services, out of any money in the 
Treasury not otherwise appropriated, $20,200,000,000 
to accompany the allotment made for the period be-
ginning on October 1, 2022, and ending on March 31, 
2023, under paragraph (26)(A) of section 2104(a) of 
the Social Security Act (42 U.S.C. 1397dd(a)) (as 
added by subsection (a)), to remain available until 
expended. Such amount shall be used to provide allot-
ments to States under paragraph (10) of section 
2104(m) of such Act (as added by paragraph (1)) for 
the first 6 months of fiscal year 2023 in the same 
manner as allotments are provided under subsection 
(a)(26)(A) of such section 2104 and subject to the 
same terms and conditions as apply to the allotments 
provided from such subsection (a)(26)(A). 
(c) EXTENSION OF THE CHILD ENROLLMENT CONTIN-
GENCY FUND.—Section 2104(n) of the Social Security Act 
(42 U.S.C. 1397dd(n)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (A)(ii)— 
(i) by striking ‘‘2010, 2011, 2012, 
2013, 2014, and 2016’’ and inserting ‘‘2010 
through 2014, 2016, and 2018 through 
2022’’; and
(ii) by striking ‘‘fiscal year 2015 and 
fiscal year 2017’’ and inserting ‘‘fiscal 
years 2015, 2017, and 2023’’; and 
(B) in subparagraph (B)— 
(i) by striking ‘‘2010, 2011, 2012, 
2013, 2014, and 2016’’ and inserting ‘‘2010 
through 2014, 2016, and 2018 through 
2022’’; and 
(ii) by striking ‘‘fiscal year 2015 and 
fiscal year 2017’’ and inserting ‘‘fiscal 
years 2015, 2017, and 2023’’; and 
(2) in paragraph (3)(A), in the matter preceding 
clause (i), by striking ‘‘or a semi-annual allotment 
period for fiscal year 2015 or 2017’’ and inserting 
‘‘or in any of fiscal years 2018 through 2022 (or a 
semi-annual allotment period for fiscal year 2015, 
2017, or 2023)’’. 
(d) EXTENSION OF QUALIFYING STATES OPTION.— 
(1) IN GENERAL.—Section 2105(g)(4) of the So-
cial Security Act (42 U.S.C. 1397ee(g)(4)) is amend-
ed— 
(A) in the heading, by striking ‘‘THROUGH 
2017’’ and inserting ‘‘THROUGH 2023’’; and 
(B) in subparagraph (A), by striking 
‘‘2017’’ and inserting ‘‘2023’’.
(2) 
TECHNICAL
AMENDMENTS.—Section 
2104(f)(2)(B)(ii) of the Social Security Act (42 
U.S.C. 1397dd(f)(2)(B)(ii)), as amended by section 
3201(c) of the CHIP and Public Health Funding Ex-
tension Act (division C of Public Law 115–96), is 
amended— 
(A) in subclause (I), by striking ‘‘for the 
month (as defined in subclause (II))’’ and insert-
ing ‘‘(as defined in subclause (II)) for the 
month’’; 
(B) in subclause (II), by inserting ‘‘, as in 
effect on the day before the date of the enactment 
of the HEALTHY KIDS Act,’’ after ‘‘section 
2105(g)(4)(A)’’; and 
(C) in subclause (VI)— 
(i) by inserting ‘‘, as in effect on the 
day before the date of the enactment of the 
HEALTHY KIDS Act’’ after ‘‘, section 
2105(g)(4)’’; and 
(ii) by inserting ‘‘, as so in effect’’ 
after ‘‘under section 2105(g)(4)’’. 
(e) EXTENSION OF EXPRESS LANE ELIGIBILITY OP-
TION.—Section 1902(e)(13)(I) of the Social Security Act 
(42 U.S.C. 1396a(e)(13)(I)) is amended by striking ‘‘2017’’ 
and inserting ‘‘2023’’.
(f) ASSURANCE OF AFFORDABILITY STANDARD FOR 
CHILDREN AND FAMILIES.— 
(1) IN GENERAL.—Section 2105(d)(3) of the So-
cial Security Act (42 U.S.C. 1397ee(d)(3)) is amend-
ed— 
(A) in the paragraph heading, by striking 
‘‘UNTIL
OCTOBER
1, 2019’’ and inserting 
‘‘THROUGH SEPTEMBER 30, 2023’’; and 
(B) in subparagraph (A), in the matter pre-
ceding clause (i)— 
(i) by striking ‘‘2019’’ and inserting 
‘‘2023’’; and 
(ii) by striking ‘‘The preceding sen-
tence shall not be construed as preventing a 
State during such period’’ and inserting 
‘‘During the period that begins on October 
1, 2019, and ends on September 30, 2023, 
the preceding sentence shall only apply with 
respect to children in families whose income 
does not exceed 300 percent of the poverty 
line (as defined in section 2110(c)(5)) ap-
plicable to a family of the size involved. The 
preceding sentences shall not be construed as 
preventing a State during any such peri-
ods’’.
(2) 
CONFORMING
AMENDMENTS.—Section 
1902(gg)(2) of the Social Security Act (42 U.S.C. 
1396a(gg)(2)) is amended— 
(A) in the paragraph heading, by striking 
‘‘UNTIL
OCTOBER
1, 2019’’ and inserting 
‘‘THROUGH SEPTEMBER 30, 2023’’; and 
(B) by striking ‘‘September 30, 2019,’’ and 
inserting ‘‘September 30, 2023 (but during the 
period that begins on October 1, 2019, and ends 
on September 30, 2023, only with respect to chil-
dren in families whose income does not exceed 
300 percent of the poverty line (as defined in sec-
tion 2110(c)(5)) applicable to a family of the 
size involved)’’. 
(g) CHIP LOOK-ALIKE PLANS.— 
(1) BLENDING RISK POOLS.—Section 2107 of the 
Social Security Act (42 U.S.C. 1397gg) is amended 
by adding at the end the following: 
‘‘(g) USE OF BLENDED RISK POOLS.— 
‘‘(1) IN GENERAL.—Nothing in this title (or any 
other provision of Federal law) shall be construed as 
preventing a State from considering children enrolled 
in a qualified CHIP look-alike program and children 
enrolled in a State child health plan under this title
(or a waiver of such plan) as members of a single risk 
pool. 
‘‘(2) QUALIFIED CHIP LOOK-ALIKE PROGRAM.— 
In this subsection, the term ‘qualified CHIP look-alike 
program’ means a State program— 
‘‘(A) under which children who are under 
the age of 19 and are not eligible to receive med-
ical assistance under title XIX or child health 
assistance under this title may purchase coverage 
through the State that provides benefits that are 
at least identical to the benefits provided under 
the State child health plan under this title (or a 
waiver of such plan); and 
‘‘(B) that is funded exclusively through non- 
Federal funds, including funds received by the 
State in the form of premiums for the purchase 
of such coverage.’’. 
(2) COVERAGE RULE.— 
(A) IN GENERAL.—Section 5000A(f)(1) of 
the Internal Revenue Code of 1986 is amended in 
subparagraph (A)(iii), by inserting ‘‘or under a 
qualified CHIP look-alike program (as defined 
in section 2107(g) of the Social Security Act)’’ 
before the comma at the end.
(B) EFFECTIVE
DATE.—The amendment 
made by subparagraph (A) shall apply with re-
spect to taxable years beginning after December 
31, 2017. 
(h) AVAILABILITY OF UNUSED FISCAL YEAR 2018 RE-
DISTRIBUTION AMOUNTS.—Any amounts that have been re-
distributed to States under subsection (f) of section 2104 
of the Social Security Act (42 U.S.C. 1397dd) for fiscal year 
2018 that are not, or will not be, expended by the end of 
that fiscal year shall be— 
(1) adjusted by the Secretary before the end of 
fiscal year 2018 to reflect an updated estimate of 
shortfalls under subsection (f)(2)(A) of such section; 
and 
(2) available for redistribution under subsection 
(f) of such section for subsequent fiscal years. 
SEC. 3003. EXTENSION OF CERTAIN PROGRAMS AND DEM-
ONSTRATION PROJECTS. 
(a) 
CHILDHOOD
OBESITY
DEMONSTRATION 
PROJECT.—Section 1139A(e)(8) of the Social Security Act 
(42 U.S.C. 1320b–9a(e)(8)) is amended— 
(1) by striking ‘‘and $10,000,000’’ and inserting 
‘‘, $10,000,000’’; and
(2) by inserting after ‘‘2017’’ the following: ‘‘, 
and $30,000,000 for the period of fiscal years 2018 
through 2023’’. 
(b) PEDIATRIC QUALITY MEASURES PROGRAM.—Sec-
tion 1139A(i) of the Social Security Act (42 U.S.C. 1320b– 
9a(i)) is amended— 
(1) by striking ‘‘Out of any’’ and inserting the 
following: 
‘‘(1) IN GENERAL.—Out of any’’; 
(2) by striking ‘‘there is appropriated for each’’ 
and inserting ‘‘there is appropriated— 
‘‘(A) for each’’; 
(3) by striking ‘‘, and there is appropriated for 
the period’’ and inserting ‘‘; 
‘‘(B) for the period’’; 
(4) by striking ‘‘. Funds appropriated under this 
subsection shall remain available until expended.’’ 
and inserting ‘‘; and’’; and 
(5) by adding at the end the following: 
‘‘(C) for the period of fiscal years 2018 
through 2023, $90,000,000 for the purpose of 
carrying out this section (other than subsections 
(e), (f), and (g)).
‘‘(2) AVAILABILITY.—Funds appropriated under 
this subsection shall remain available until ex-
pended.’’. 
SEC. 3004. EXTENSION OF OUTREACH AND ENROLLMENT 
PROGRAM. 
(a) IN GENERAL.—Section 2113 of the Social Security 
Act (42 U.S.C. 1397mm) is amended— 
(1) in subsection (a)(1), by striking ‘‘2017’’ and 
inserting ‘‘2023’’; and 
(2) in subsection (g)— 
(A) by striking ‘‘and $40,000,000’’ and in-
serting ‘‘, $40,000,000’’; and 
(B) by inserting after ‘‘2017’’ the following: 
‘‘, and $120,000,000 for the period of fiscal years 
2018 through 2023’’. 
(b) MAKING ORGANIZATIONS THAT USE PARENT MEN-
TORS ELIGIBLE TO RECEIVE GRANTS.—Section 2113(f) of 
the Social Security Act (42 U.S.C. 1397mm(f)) is amend-
ed— 
(1) in paragraph (1)(E), by striking ‘‘or commu-
nity-based doula programs’’ and inserting ‘‘, commu-
nity-based doula programs, or parent mentors’’; and 
(2) by adding at the end the following new para-
graph:
‘‘(5) PARENT MENTOR.—The term ‘parent men-
tor’ means an individual who— 
‘‘(A) is a parent or guardian of at least one 
child who is an eligible child under this title or 
title XIX; and 
‘‘(B) is trained to assist families with chil-
dren who have no health insurance coverage with 
respect to improving the social determinants of 
the health of such children, including by pro-
viding— 
‘‘(i) education about health insurance 
coverage, including, with respect to obtain-
ing such coverage, eligibility criteria and 
application and renewal processes; 
‘‘(ii) assistance with completing and 
submitting applications for health insur-
ance coverage; 
‘‘(iii) a liaison between families and 
representatives of State plans under title 
XIX or State child health plans under this 
title; 
‘‘(iv) guidance on identifying medical 
and dental homes and community phar-
macies for children; and
‘‘(v) assistance and referrals to success-
fully address social determinants of chil-
dren’s health, including poverty, food insuf-
ficiency, and housing.’’. 
(c) EXCLUSION FROM MODIFIED ADJUSTED GROSS 
INCOME.—Section 1902(e) of the Social Security Act (42 
U.S.C. 1396a(e)) is amended— 
(1) in the first paragraph (14), relating to in-
come determined using modified adjusted gross in-
come, by adding at the end the following new sub-
paragraph: 
‘‘(J) EXCLUSION OF PARENT MENTOR COM-
PENSATION
FROM
INCOME
DETERMINATION.— 
Any nominal amount received by an individual 
as compensation, including a stipend, for par-
ticipation as a parent mentor (as defined in 
paragraph (5) of section 2113(f)) in an activity 
or program funded through a grant under such 
section shall be disregarded for purposes of deter-
mining the income eligibility of such individual 
for medical assistance under the State plan or 
any waiver of such plan.’’; and 
(2) by striking ‘‘(14) EXCLUSION’’ and inserting 
‘‘(15) EXCLUSION’’.
SEC. 3005. EXTENSION AND REDUCTION OF ADDITIONAL 
FEDERAL FINANCIAL PARTICIPATION FOR 
CHIP. 
Section 2105(b) of the Social Security Act (42 U.S.C. 
1397ee(b)) is amended in the second sentence by inserting 
‘‘and during the period that begins on October 1, 2019, and 
ends on September 30, 2020, the enhanced FMAP deter-
mined for a State for a fiscal year (or for any portion of 
a fiscal year occurring during such period) shall be in-
creased by 11.5 percentage points’’ after ‘‘23 percentage 
points,’’. 
SEC. 3006. MEDICAID IMPROVEMENT FUND. 
Section 1941 of the Social Security Act (42 U.S.C. 
1396w–1) is amended— 
(1) in subsection (a), in the first sentence, by in-
serting before the period at the end the following: ‘‘, 
and, in accordance with subsection (b)(3), for the pur-
poses of subparagraph (B) of such subsection’’; and 
(2) in subsection (b)— 
(A) in paragraph (2)— 
(i) in the first sentence, by inserting 
‘‘pursuant to paragraph (1)’’ after ‘‘in the 
Fund’’; 
(ii) by inserting after the first sentence 
the following sentence: ‘‘Amounts in the 
Fund pursuant to paragraph (3) shall be
available in advance of appropriations but 
only if the total amount obligated from the 
Fund does not exceed the amount available 
to the Fund under such paragraph (3).’’; 
and 
(iii) in the last sentence, by striking 
‘‘sentence’’ and inserting ‘‘sentences’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(3) ADDITIONAL FUNDING FOR STATE ACTIVI-
TIES RELATING TO MECHANIZED CLAIMS SYSTEMS.— 
‘‘(A) IN
GENERAL.—In addition to the 
amount made available under paragraph (1), 
there shall be available to the Fund, for expendi-
tures from the Fund in accordance with sub-
paragraph (B), for fiscal year 2023 and there-
after, $980,000,000, to remain available until ex-
pended. 
‘‘(B) PURPOSES.—The Secretary shall use 
amounts made available to the Fund under sub-
paragraph (A) to pay to each State which has 
a plan approved under this title, for each quar-
ter beginning during or after fiscal year 2023 an 
amount equal to—
‘‘(i) 100 percent minus the percent 
specified 
in 
clause 
(i) 
of 
section 
1903(a)(3)(A) of so much of the sums ex-
pended by the State during such quarter as 
are attributable to the activities described in 
such clause; 
‘‘(ii) 100 percent minus the Federal 
medical assistance percentage applied under 
clause (iii) of such section of so much of the 
sums expended during such quarter (as 
found necessary by the Secretary under such 
clause) by the State as are attributable to 
the activities described in such clause; and 
‘‘(iii) 100 percent minus the percent 
specified in section 1903(a)(3)(B) of so 
much of the sums expended by the State 
during such quarter as are attributable to 
the activities described in such section.’’.
DIVISION 
D—SUSPENSION 
OF 
CERTAIN 
HEALTH-RELATED 
TAXES 
SEC. 4001. EXTENSION OF MORATORIUM ON MEDICAL DE-
VICE EXCISE TAX. 
(a) IN GENERAL.—Section 4191(c) of the Internal 
Revenue Code of 1986 is amended by striking ‘‘December 
31, 2017’’ and inserting ‘‘December 31, 2019’’. 
(b) EFFECTIVE DATE.—The amendment made by this 
section shall apply to sales after December 31, 2017. 
SEC. 4002. DELAY IN IMPLEMENTATION OF EXCISE TAX ON 
HIGH COST EMPLOYER-SPONSORED HEALTH 
COVERAGE. 
Section 9001(c) of the Patient Protection and Afford-
able Care Act is amended by striking ‘‘December 31, 2019’’ 
and inserting ‘‘December 31, 2021’’. 
SEC. 4003. SUSPENSION OF ANNUAL FEE ON HEALTH IN-
SURANCE PROVIDERS. 
(b) IN GENERAL.—Section 9010(j) of the Patient Pro-
tection and Affordable Care Act is amended— 
(1) by striking ‘‘and’’ at the end of paragraph 
(1), 
(2) by striking the period at the end of para-
graph (2) and inserting ‘‘, and ending before January 
1, 2019, and’’, and
(3) by adding at the end the following new para-
graph: 
‘‘(3) beginning after December 31, 2019.’’. 
(c) EFFECTIVE DATE.—The amendments made by this 
section shall apply to calendar years beginning after De-
cember 31, 2018. 
DIVISION E—BUDGETARY 
EFFECTS 
SEC. 5001. BUDGETARY EFFECTS. 
(a) IN GENERAL.—The budgetary effects of division C 
and each succeeding division shall not be entered on either 
PAYGO scorecard maintained pursuant to section 4(d) of 
the Statutory Pay-As-You-Go Act of 2010. 
(b) SENATE PAYGO SCORECARDS.—The budgetary ef-
fects of division C and each succeeding division shall not 
be entered on any PAYGO scorecard maintained for pur-
poses of section 4106 of H. Con. Res. 71 (115th Congress). 
(c) CLASSIFICATION OF BUDGETARY EFFECTS.—Not-
withstanding Rule 3 of the Budget Scorekeeping Guidelines 
set forth in the joint explanatory statement of the committee 
of conference accompanying Conference Report 105–217 
and section 250(c)(8) of the Balanced Budget and Emer-
gency Deficit Control Act of 1985, the budgetary effects of 
division C and each succeeding division shall not be esti-
mated—
(1) for purposes of section 251 of such Act; and 
(2) for purposes of paragraph (4)(C) of section 
3 of the Statutory Pay-As-You-Go Act of 2010 as 
being included in an appropriation Act. 
Attest: 
Clerk.
115TH CONGRESS 
2D SESSION 
H.R. 195 
HOUSE AMENDMENT TO 
SENATE AMENDMENT