I 
112TH CONGRESS 
1ST SESSION H. R. 1286 
To provide for fiscal accountability for new direct funding under the Patient 
Protection and Affordable Care Act by converting its direct funding 
into authorizations of appropriations and by rescinding unobligated direct 
funding. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 31, 2011 
Mrs. BACHMANN
(for herself, Mr. KINGSTON, Mr. GOHMERT, Mr. 
HENSARLING, Mr. BROUN of Georgia, Mr. REHBERG, Mr. NEUGEBAUER, 
Mr. FRANKS of Arizona, Mr. GRAVES of Missouri, Mr. TIPTON, Mr. 
SCALISE, Mr. STUTZMAN, Mr. RIBBLE, Mr. DESJARLAIS, Mr. MAN-
ZULLO, Mr. PEARCE, Mr. LAMBORN, Mr. FLEMING, Mr. BENISHEK, Mr. 
FLORES, Mr. FORTENBERRY, Mr. CANSECO, Mr. HUIZENGA of Michigan, 
Mr. WALBERG, Mr. PENCE, Mr. DUNCAN of South Carolina, Mr. 
SOUTHERLAND, Mr. HARRIS, Mrs. HARTZLER, and Mr. SCHWEIKERT) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committees on Ways and 
Means and Education and the Workforce, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To provide for fiscal accountability for new direct funding 
under the Patient Protection and Affordable Care Act 
by converting its direct funding into authorizations of 
appropriations and by rescinding unobligated direct fund-
ing. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Healthcare Fiscal Ac-
countability Act of 2011’’. 
SEC. 2. CONVERTING PPACA DIRECT FUNDING TO AUTHOR-
IZATIONS 
OF 
APPROPRIATIONS 
AND 
RE-
SCINDING 
UNOBLIGATED 
PPACA 
DIRECT 
FUNDING. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, for each provision described in column 1 in 
the table specified in subsection (b), the following rules 
shall apply: 
(1) DIRECT APPROPRIATIONS.— 
(A) CONVERSION TO AUTHORIZATIONS OF 
APPROPRIATIONS.—For each such provision 
that provides for a direct appropriation of funds 
for fiscal year 2012 or a subsequent fiscal year 
and for which special rule #1 or special rule 
#2 does not apply under column 3 of such 
table, such appropriation is deemed only to be 
an authorization of appropriations and amounts 
are available under such provision only pursu-
ant to appropriations made after the date of the 
enactment of this Act. 
(B) RESCISSION OF UNOBLIGATED APPRO-
PRIATIONS.—Of the funds available pursuant to 
a direct appropriation under such provision for 
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which special rule #1 or special rule #2 does 
not apply under column 3 of such table, the un-
obligated balance is rescinded. 
(2) FUND TRANSFERS.— 
(A) CONVERSION TO AUTHORIZATION OF 
TRANSFER SUBJECT TO APPROPRIATIONS.—For 
each such provision that provides for a transfer 
of funds for fiscal year 2012 or a subsequent 
fiscal year, such transfer is deemed only to be 
an authorization of such transfer in such 
amounts as are provided in advance in appro-
priations acts enacted after the date of the en-
actment of this Act. 
(B) 
RESTORATION
OF
TRANSFERRED 
FUNDS.—Amounts transferred under such pro-
vision which have not been obligated as of the 
date of the enactment of this Act shall be re-
stored to the Trust Fund or other fund from 
which they were transferred. 
(3) SPECIAL RULES.— 
(A) SPECIAL RULE #1 FOR CERTAIN EX-
TENSIONS
OF
APPROPRIATIONS
BEGINNING 
AFTER FISCAL YEAR 2011.—For each such pro-
vision for which column 3 of such table specifies 
that special rule #1 applies, the amendment (or 
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amendments) made by the section in column 2 
is repealed and such provision is restored as if 
PPACA had not been enacted. 
(B) SPECIAL RULE #2 FOR CERTAIN EX-
TENSIONS OF APPROPRIATIONS BEGINNING BE-
FORE FISCAL YEAR 2012.—For each such provi-
sion for which column 3 of such table specifies 
that special rule #2 applies— 
(i) the amendment (or amendments) 
made by the section in column 2 is re-
pealed and such provision is restored as if 
PPACA had not been enacted, except that 
such repeal shall not apply to fiscal year 
2010 or fiscal year 2011; and 
(ii) of the funds available pursuant to 
the operation of such amendment (or 
amendments) for fiscal year 2010 or fiscal 
year 2011, the unobligated balance is re-
scinded. 
(b) TABLE.—The table specified in this subsection is 
as follows (with provisions listed in the order in which 
they, or the section amending such provision, appear in 
PPACA, followed by provisions in HCERA): 
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Column 1: Provision 
containing direct appro-
priation or transfer 
Column 2: Amendatory 
section (if any) in 
PPACA or other law 
Column 3: Special rule 
(if any) that applies 
Section 1817(k)(8) of 
SSA 
as added by section 
1303(a) of HCERA 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘PPACA’’ means the Patient 
Protection and Affordable Care Act (Public Law 
111–148). 
(2) The term ‘‘HCERA’’ means the Health 
Care and Education Reconciliation Act of 2010 
(Public Law 111–152). 
(3) The term ‘‘SSA’’ means the Social Security 
Act. 
(4) The term ‘‘PHSA’’ means the Public 
Health Service Act. 
Æ 
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