(3) by inserting after subparagraph (C) the fol-
lowing: 
‘‘(D) $37,500,000 for the period of the first 
and second quarters of fiscal year 2018, to re-
main available until expended.’’. 
(b) SPECIAL DIABETES PROGRAM FOR INDIANS.—Sub-
paragraph (D) of section 330C(c)(2) of the Public Health 
Service Act (42 U.S.C. 254c–3(c)(2)) is amended by insert-
ing ‘‘and $37,500,000 for the second quarter of fiscal year 
2018’’ before the period at the end. 
SEC. 3103. PREVENTION AND PUBLIC HEALTH FUND. 
Section 4002(b) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 300u–11(b)) is amended— 
(1) in paragraph (3), by striking ‘‘each of fiscal 
years 2018 and 2019’’ and inserting ‘‘fiscal year 
2018’’; 
(2) by redesignating paragraphs (4) through (8) 
as paragraphs (5) through (9); 
(3) by inserting after paragraph (3) the fol-
lowing new paragraph: 
‘‘(4) for fiscal year 2019, $800,000,000;’’; 
(4) in paragraph (5), as so redesignated, by 
striking 
‘‘$1,000,000,000’’ 
and 
inserting 
‘‘$800,000,000’’; and
(5) in paragraph (6), as so redesignated, by 
striking 
‘‘$1,500,000,000’’ 
and 
inserting 
‘‘$1,250,000,000’’. 
TITLE II—CHILDREN’S HEALTH 
INSURANCE PROGRAM (CHIP) 
SEC. 3201. FUNDING EXTENSION OF THE CHILDREN’S 
HEALTH INSURANCE PROGRAM. 
(a) APPROPRIATION; TOTAL
ALLOTMENT.—Section 
2104(a) of the Social Security Act (42 U.S.C. 1397dd(a)) 
is amended— 
(1) in paragraph (19), by striking ‘‘and’’; 
(2) in paragraph (20), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new para-
graph: 
‘‘(21) for fiscal year 2018, for purposes of mak-
ing 1 semi-annual allotment— 
‘‘(A) $2,850,000,000 for the period begin-
ning on October 1, 2017, and ending on March 
31, 2018.’’. 
(b) ALLOTMENTS.— 
(1) IN GENERAL.—Section 2104(m) of the Social 
Security Act (42 U.S.C. 1397dd(m)) is amended—
(A) in paragraph (2)(B)(ii), in the matter 
preceding subclause (I), by inserting ‘‘and para-
graph (10)’’ after ‘‘clauses (iii) and (iv)’’; 
(B) in paragraph (5)— 
(i) by striking ‘‘or (4)’’ and inserting 
‘‘(4), or (10)’’; and 
(ii) by striking ‘‘or 2017’’ and insert-
ing ‘‘, 2017, or 2018’’; 
(C) in paragraph (9)— 
(i) in the heading, by striking ‘‘FISCAL 
YEARS 2015 AND 2017’’ and inserting ‘‘CER-
TAIN FISCAL YEARS’’; 
(ii) by striking ‘‘or (4)’’ and inserting 
‘‘, (4), or (10)’’; and 
(iii) by striking ‘‘or fiscal year 2017’’ 
and inserting ‘‘, 2017, or 2018’’; and 
(D) by adding at the end the following new 
paragraph: 
‘‘(10) FOR FISCAL YEAR 2018.— 
‘‘(A) FIRST HALF.— 
‘‘(i) IN
GENERAL.—Subject to para-
graphs (5) and (7), from the amount made 
available under subparagraph (A) of para-
graph (21) of subsection (a) for the semi-an-
nual period described in such subpara-
graph, the Secretary shall compute a State 
allotment for each State (including the Dis-
trict of Columbia and each commonwealth 
and territory) for such semi-annual period 
in an amount equal to 1⁄2 of the amount de-
scribed in clause (ii) for the State. 
‘‘(ii) FULL YEAR AMOUNT BASED ON 
GROWTH FACTOR UPDATED AMOUNT.—The 
amount described in this clause for a State 
is equal to the sum of— 
‘‘(I) the sum of the 2 semi-annual 
allotments made to the State under 
paragraph (4) for fiscal year 2017; 
and 
‘‘(II) the amount of any payments 
made to the State under subsection (n) 
for fiscal year 2017, 
multiplied by the allotment increase factor 
under paragraph (6) for fiscal year 2018.’’. 
(2) 
CONFORMING
AMENDMENTS.—Section 
2104(m)(2) of such Act (42 U.S.C. 1397dd(m)(2)) is 
amended— 
(A) in the paragraph heading, by striking 
‘‘2010 THROUGH 2016’’ and inserting ‘‘BEGINNING 
WITH FISCAL YEAR 2010’’; and
(B) by striking ‘‘the allotment increase fac-
tor under paragraph (5)’’ each place it appears 
and inserting ‘‘the allotment increase factor 
under paragraph (6)’’. 
(3) APPLICATION
OF
REGULAR
EXPENDITURE 
RULES.—Amounts allotted to a State under section 
2104(m)(10)(A) of the Social Security Act (42 U.S.C. 
1397dd(m)(10)(A)) (as added by paragraph (1)) shall 
be subject to the same requirements of title XXI of 
such Act and applicable regulations of the Secretary 
of Health and Human Services as apply to other al-
lotments made to States for a fiscal year under sec-
tion 2104 of such Act. 
(c) EXTENSION OF CHIP ALLOCATION REDISTRIBU-
TION SPECIAL RULE FOR CERTAIN SHORTFALL STATES.— 
(1) IN
GENERAL.—Section 2104(f)(2)(B)(ii) of 
the Social Security Act (42 U.S.C. 1397dd(f)(2)(B)), 
as amended by section 201 of Public Law 115–90, is 
amended— 
(A) in the clause heading, by striking 
‘‘FIRST QUARTER’’ and inserting ‘‘FIRST HALF’’; 
(B) by redesignating subclause (III) as sub-
clause (VI); and 
(C) by striking subclauses (I) and (II) and 
inserting the following:
‘‘(I) 
IN
GENERAL.—For 
each 
month beginning during the period be-
ginning on October 1, 2017, and end-
ing March 31, 2018, subject to the suc-
ceeding subclauses of this clause, the 
Secretary 
shall 
redistribute 
any 
amounts available for redistribution 
under paragraph (1) for fiscal year 
2018, to each State that is an emer-
gency shortfall State for the month (as 
defined in subclause (II)) such amount 
as the Secretary determines will elimi-
nate the estimated shortfall described 
in subclause (II) for such State for the 
month (as may be adjusted under sub-
paragraph (C)) before the Secretary 
may redistribute such amounts to any 
shortfall State that is not an emer-
gency shortfall State. In the case of 
any amounts redistributed under this 
subclause to a State that is not an 
emergency 
shortfall 
State, 
such 
amounts shall be determined in accord-
ance with clause (i).
‘‘(II) 
EMERGENCY
SHORTFALL 
STATE DEFINED.—For purposes of this 
clause, the term ‘emergency shortfall 
State’ means, with respect to a month 
beginning during the period beginning 
October 1, 2017, and ending March 31, 
2018, a shortfall State for which the 
Secretary estimates, in accordance 
with subparagraph (A) (unless other-
wise specified in this subclause) and on 
a monthly basis using the most recent 
data available to the Secretary as of 
such month, that the projected expendi-
tures under the State child health plan 
and under section 2105(g) (calculated 
as if the reference under section 
2105(g)(4)(A) to ‘2017’ were a ref-
erence to ‘2018’ and insofar as the al-
lotments are available to the State 
under this subsection or subsection (e) 
or (m)) for such month will exceed the 
sum of the amounts described in 
clauses (i) through (iii) of subpara-
graph (A) for such month, including 
after application of any amount redis-
tributed under paragraph (1) for a 
previous month for fiscal year 2018 in 
accordance with this clause, to such 
State. A shortfall State may be an 
emergency shortfall State under the 
previous sentence without regard to 
whether any amounts were redistrib-
uted to such State under paragraph (1) 
for a previous month in fiscal year 
2018. 
‘‘(III) FUNDS REDISTRIBUTED IN 
THE ORDER IN WHICH STATES REAL-
IZE FUNDING SHORTFALLS.—The Sec-
retary shall redistribute the amounts 
available 
for 
redistribution 
under 
paragraph (1) to emergency shortfall 
States described in subclause (II) in 
the order in which such States realize 
monthly funding shortfalls under this 
title for fiscal year 2018. The Secretary 
shall only make redistributions under 
this clause to the extent that such 
amounts are available for such redis-
tributions.
‘‘(IV) PRORATION
RULE.—If the 
amounts available for redistribution 
under paragraph (1) for a month dur-
ing the period described in subclause 
(I) are less than the total amounts of 
the estimated shortfalls determined for 
the month for emergency shortfall 
States described in subclause (II), the 
amount computed under subclause (I) 
for each emergency shortfall State shall 
be reduced proportionally. 
‘‘(V) UNOBLIGATED
REDISTRIB-
UTED
FUNDS.—The Secretary shall 
withhold any funds redistributed under 
paragraph (1) for fiscal year 2018 be-
fore January 1, 2018, but which have 
not been obligated for amounts ex-
pended by a State as of that date, and 
shall redistribute such funds in accord-
ance with the preceding subclauses of 
this clause.’’. 
(2) RULE OF CONSTRUCTION.—Nothing in the 
amendments made by paragraph (1) shall be con-
strued as authorizing the Secretary of Health and 
Human Services to de-obligate any funds redistrib-
uted under clause (ii) of section 2104(f)(2)(B) of the 
Social Security Act (42 U.S.C. 1397dd(f)(2)(B)) that 
have been obligated for amounts expended by an 
emergency shortfall State described in such clause as 
of January 1, 2018. 
This division may be cited as the ‘‘CHIP and Public 
Health Funding Extension Act’’. 
DIVISION D—OTHER MATTERS 
SEC. 4001. VA CHOICE. 
There is appropriated, out of any funds in the Treas-
ury not otherwise appropriated, $2,100,000,000, to remain 
available until expended, to be deposited in the Veterans 
Choice Fund under section 802 of the Veterans Access, 
Choice, and Accountability Act of 2014 (Public Law 113– 
146; 38 U.S.C. 1701 note). 
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