100 
rules for health insurance costs of self-employed individ-
uals) is amended by striking paragraph (4) and by redes-
ignating paragraph (5) as paragraph (4). 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2008. 
SEC. 302. DEDUCTION FOR QUALIFIED HEALTH INSURANCE 
COSTS OF INDIVIDUALS. 
(a) IN GENERAL.—Part VII of subchapter B of chap-
ter 1 of the Internal Revenue Code of 1986 (relating to 
additional itemized deductions for individuals) is amended 
by redesignating section 224 as section 225 and by insert-
ing after section 223 the following new section: 
‘‘SEC. 224. COSTS OF QUALIFIED HEALTH INSURANCE. 
‘‘(a) IN GENERAL.—In the case of an individual, 
there shall be allowed as a deduction an amount equal to 
the amount paid during the taxable year for coverage for 
the taxpayer, his spouse, and dependents under qualified 
health insurance. 
‘‘(b) QUALIFIED HEALTH INSURANCE.—For pur-
poses of this section, the term ‘qualified health insurance’ 
means insurance which constitutes medical care, other 
than insurance substantially all of the coverage of which 
is of excepted benefits described in section 9832(c). 
‘‘(c) SPECIAL RULES.— 
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101 
‘‘(1) COORDINATION
WITH
MEDICAL
DEDUC-
TION, ETC.—Any amount paid by a taxpayer for in-
surance to which subsection (a) applies shall not be 
taken into account in computing the amount allow-
able to the taxpayer as a deduction under section 
162(l) or 213(a). Any amount taken into account in 
determining the credit allowed under section 35 shall 
not be taken into account for purposes of this sec-
tion. 
‘‘(2) DEDUCTION NOT ALLOWED FOR SELF-EM-
PLOYMENT
TAX
PURPOSES.—The deduction allow-
able by reason of this section shall not be taken into 
account in determining an individual’s net earnings 
from self-employment (within the meaning of section 
1402(a)) for purposes of chapter 2.’’. 
(b) DEDUCTION
ALLOWED
IN
COMPUTING
AD-
JUSTED GROSS INCOME.—Subsection (a) of section 62 of 
such Code is amended by inserting before the last sentence 
the following new paragraph: 
‘‘(22) COSTS
OF
QUALIFIED
HEALTH
INSUR-
ANCE.—The deduction allowed by section 224.’’. 
(c) CLERICAL AMENDMENT.—The table of sections 
for part VII of subchapter B of chapter 1 of such Code 
is amended by redesignating the item relating to section 
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102 
224 as an item relating to section 225 and inserting before 
such item the following new item: 
‘‘Sec. 224. Costs of qualified health insurance.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2008. 
TITLE IV—INCREASING ACCESS 
TO VA HEALTH CARE 
SEC. 401. REQUIREMENT FOR PAYMENTS TO FACILITIES 
OTHER THAN THE DEPARTMENT OF VET-
ERANS 
AFFAIRS 
FOR 
COVERED 
HEALTH 
SERVICES. 
(a) REQUIREMENT TO AUTHORIZE RECEIPT OF COV-
ERED HEALTH SERVICES AT NON-DEPARTMENT FACILI-
TIES PURSUANT
TO CONTRACTS WITH SUCH FACILI-
TIES.—Subsection (a) of section 1703 of title 38, United 
States Code, is amended to read as follows: 
‘‘(a) An enrolled veteran may elect to receive covered 
health services through a non-Department facility. Such 
an election shall be made by submission to the Secretary 
of an application in accordance with such regulations as 
the Secretary prescribes. The Secretary shall authorize 
such services to be furnished to such veteran pursuant to 
contracting with such a facility to furnish such services 
to such a veteran, as authorized in section 1710 of this 
title.’’. 
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103 
(b) DESCRIPTIONS OF COVERED HEALTH SERVICES 
AND ENROLLED VETERANS.—Such section is further 
amended by adding at the end the following new sub-
section: 
‘‘(e) For purposes of subsection (a)— 
‘‘(1) a covered health service is any hospital 
care, medical service, rehabilitative service, or pre-
ventative health service for which the veteran de-
scribed in such subsection is eligible under this title; 
and 
‘‘(2) an enrolled veteran is a veteran who is en-
rolled in the system of patient enrollment established 
under section 1705(a) of this title.’’. 
(c) EFFECTIVE DATE.—The Secretary of Veterans 
Affairs shall implement the amendments made by sub-
sections (a) and (b) in order for enrolled veterans de-
scribed in section 1703(e)(2) of title 38, United States 
Code, as added by subsection (b), to receive covered health 
services in accordance with section 1703(a) of such title, 
as amended by subsection (a), not later than 180 days 
after the date of the enactment of this Act. 
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104 
SEC. 402. AUTHORITY OF DEPARTMENT OF VETERANS AF-
FAIRS PHARMACIES TO DISPENSE MEDICA-
TIONS TO VETERANS ON PRESCRIPTIONS 
WRITTEN BY PRIVATE PRACTITIONERS. 
Section 1712 of title 38, United States Code, is 
amended by adding at the end the following new sub-
section: 
‘‘(f) Subject to section 1722A of this title, the Sec-
retary shall furnish to a veteran, through a Department 
health-care facility, such drugs and medicines as may be 
ordered on prescription of a duly licensed physician in the 
treatment of any illness or injury of the veteran provided 
pursuant to the authority to contract with a non-Depart-
ment facility for such treatment under section 1703 of this 
title.’’. 
TITLE V—NURSING SHORTAGE 
SEC. 501. CHILD CARE ASSISTANCE FOR INDIVIDUALS PUR-
SUING ADVANCED NURSING DEGREES. 
Part E of title VIII of the Public Health Service Act 
(42 U.S.C. 297a et seq.) is amended— 
(1) by redesignating section 810 (relating to a 
prohibition against discrimination by schools) as sec-
tion 846B; and 
(2) by adding at the end the following: 
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