I 
113TH CONGRESS 
2D SESSION 
H. R. 5098 
To amend the Internal Revenue Code of 1986 to temporarily exempt from 
the employer health insurance mandate certain Medicare and Medicaid 
providers. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 14, 2014 
Mr. DAINES introduced the following bill; which was referred to the 
Committee on Ways and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to temporarily 
exempt from the employer health insurance mandate cer-
tain Medicare and Medicaid providers. 
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 ‘‘Ensuring Medicaid and 
Medicare Access to Providers Act’’. 
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SEC. 2. CERTAIN MEDICARE AND MEDICAID PROVIDERS 
TEMPORARILY 
EXEMPT 
FROM 
EMPLOYER 
HEALTH INSURANCE MANDATE. 
(a) IN GENERAL.—Section 4980H(c)(2) of the Inter-
nal Revenue Code of 1986 is amended by adding at the 
end the following new subparagraph: 
‘‘(F) EXCEPTION FOR CERTAIN MEDICARE 
AND MEDICAID PROVIDERS.— 
‘‘(i) IN GENERAL.—In the case of any 
month beginning in 2014 or 2015, the 
term ‘applicable large employer’ shall not 
include any employer who is a specified 
Medicare and Medicaid provider with re-
spect to the calendar year in which such 
month begins. 
‘‘(ii) SPECIFIED MEDICARE AND MED-
ICAID
PROVIDER.—The term ‘specified 
Medicare and Medicaid provider’ means, 
with respect to any calendar year, any em-
ployer if the total specified Medicare and 
Medicaid payments received by such em-
ployer during the applicable period equals 
or exceeds 60 percent of the total gross re-
ceipts of such employer for such period. 
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items and services furnished to individuals 
enrolled in a health plan under a contract 
under title XVIII or XIX of the Social Se-
curity Act, payment for such items and 
services under such plan shall be treated 
as payment under such respective title. 
‘‘(v) APPLICABLE PERIOD.— 
‘‘(I) IN GENERAL.—For purposes 
of this subparagraph, the term ‘appli-
cable period’ means, with respect to 
any calendar year, the 3 taxable years 
ending before the beginning of such 
calendar year. 
‘‘(II) APPLICATION OF CERTAIN 
RULES.—Rules similar to the rules of 
subparagraphs (A), (C), and (D) of 
section 448(c)(3) shall apply for pur-
poses of this clause. 
‘‘(III) SPECIAL RULE FOR FIRST 
TAXABLE
YEAR
OF
EXISTENCE.—In 
the case of an employer no taxable 
year of which ends before the begin-
ning of the calendar year, the applica-
ble period for such calendar year shall 
be the period beginning on the date 
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that such employer came into exist-
ence and ending with the close of such 
calendar year.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to months beginning after Decem-
ber 31, 2013. 
Æ 
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