SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Continuing Community 
Health And Medical Professional Programs to Improve 
Our Nation, Increase National Gains, and Help Ensure 
Access for Little Ones, Toddlers, and Hopeful Youth by 
Keeping Insurance Delivery Stable Act of 2017’’ or the 
‘‘CHAMPIONING HEALTHY KIDS Act’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
DIVISION A—CHAMPION ACT 
Sec. 100. Short title. 
TITLE I—EXTENSION OF PUBLIC HEALTH PROGRAMS 
Sec. 101. Extension for community health centers, the National Health Service 
Corps, and teaching health centers that operate GME pro-
grams. 
Sec. 102. Extension for special diabetes programs. 
Sec. 103. Extension for family-to-family health information centers. 
Sec. 104. Youth empowerment program; personal responsibility education. 
TITLE II—OFFSETS 
Sec. 201. Providing for qualified health plan grace period requirements for 
issuer receipt of advance payments of cost-sharing reductions 
and premium tax credits that are more consistent with State 
law grace period requirements. 
Sec. 202. Prevention and Public Health Fund. 
DIVISION B—HEALTHY KIDS ACT 
Sec. 300. Short title. 
TITLE I—CHIP EXTENSION AND OTHER MEDICAID AND CHIP 
PROVISIONS 
Sec. 301. Five-year funding extension of the Children’s Health Insurance Pro-
gram. 
Sec. 302. Extension of certain programs and demonstration projects. 
Sec. 303. Extension of outreach and enrollment program. 
Sec. 304. Extension and reduction of additional Federal financial participation 
for CHIP. 
Sec. 305. Modifying reductions in Medicaid DSH allotments.
Sec. 306. Puerto Rico and the Virgin Islands Medicaid payments. 
TITLE II—OFFSETS 
Sec. 401. Medicaid third party liability provisions. 
Sec. 402. Treatment of lottery winnings and other lump-sum income for pur-
poses of income eligibility under Medicaid. 
Sec. 403. Adjustments to Medicare part B and part D premium subsidies for 
higher income individuals. 
DIVISION A—CHAMPION ACT 
SEC. 100. SHORT TITLE. 
This division may be cited as the ‘‘Community Health 
And Medical Professionals Improve Our Nation Act of 
2017’’ or the ‘‘CHAMPION Act’’. 
TITLE I—EXTENSION OF PUBLIC 
HEALTH PROGRAMS 
SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS, 
THE NATIONAL HEALTH SERVICE CORPS, 
AND TEACHING HEALTH CENTERS THAT OP-
ERATE GME PROGRAMS. 
(a) COMMUNITY HEALTH CENTERS FUNDING.—Sec-
tion 10503(b)(1)(E) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 254b–2(b)(1)(E)) is amended 
by striking ‘‘2017’’ and inserting ‘‘2019’’. 
(b) OTHER COMMUNITY HEALTH CENTERS PROVI-
SIONS.—Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (b)(1)(A)(ii), by striking 
‘‘abuse’’ and inserting ‘‘use disorder’’;
(2) in subsection (b)(2)(A), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(3) in subsection (c)— 
(A) in paragraph (1), by striking subpara-
graphs (B) through (D); 
(B) by striking ‘‘(1) IN GENERAL’’ and all 
that follows through ‘‘The Secretary’’ and in-
serting the following: 
‘‘(1) CENTERS.—The Secretary’’; and 
(C) in paragraph (1), as amended, by re-
designating clauses (i) through (v) as subpara-
graphs (A) through (E) and moving the margin 
of each of such redesignated subparagraph 2 
ems to the left; 
(4) by striking subsection (d) and inserting the 
following: 
‘‘(d) IMPROVING QUALITY OF CARE.— 
‘‘(1) SUPPLEMENTAL AWARDS.—The Secretary 
may award supplemental grant funds to health cen-
ters funded under this section to implement evi-
dence-based models for increasing access to high- 
quality primary care services, which may include 
models related to— 
‘‘(A) improving the delivery of care for in-
dividuals with multiple chronic conditions;
‘‘(B) workforce configuration; 
‘‘(C) reducing the cost of care; 
‘‘(D) enhancing care coordination; 
‘‘(E) expanding the use of telehealth and 
technology-enabled collaborative learning and 
capacity building models; 
‘‘(F) care integration, including integration 
of behavioral health, mental health, or sub-
stance use disorder services; and 
‘‘(G) addressing emerging public health or 
substance use disorder issues to meet the health 
needs of the population served by the health 
center. 
‘‘(2) 
SUSTAINABILITY.—In 
making 
supple-
mental awards under this subsection, the Secretary 
may consider whether the health center involved has 
submitted a plan for continuing the activities funded 
under this subsection after supplemental funding is 
expended. 
‘‘(3) SPECIAL CONSIDERATION.—The Secretary 
may give special consideration to applications for 
supplemental funding under this subsection that 
seek to address significant barriers to access to care 
in areas with a greater shortage of health care pro-
viders and health services relative to the national av-
erage.’’; 
(5) in subsection (e)(1)— 
(A) in subparagraph (B)— 
(i) by striking ‘‘2 years’’ and inserting 
‘‘1 year’’; and 
(ii) by adding at the end the fol-
lowing: ‘‘The Secretary shall not make a 
grant under this paragraph unless the ap-
plicant provides assurances to the Sec-
retary that within 120 days of receiving 
grant funding for the operation of the 
health center, the applicant will submit, for 
approval by the Secretary, an implementa-
tion plan to meet the requirements of sub-
section (k)(3). The Secretary may extend 
such 120-day period for achieving compli-
ance upon a demonstration of good cause 
by the health center.’’; and 
(B) in subparagraph (C)— 
(i) in the subparagraph heading, by 
striking ‘‘AND PLANS’’; 
(ii) by striking ‘‘or plan (as described 
in subparagraphs (B) and (C) of sub-
section (c)(1))’’;
(iii) by striking ‘‘or plan, including 
the purchase’’ and inserting the following: 
‘‘including— 
‘‘(i) the purchase’’; 
(iv) by inserting ‘‘, which may include 
data and information systems’’ after ‘‘of 
equipment’’; 
(v) by striking the period at the end 
and inserting a semicolon; and 
(vi) by adding at the end the fol-
lowing: 
‘‘(ii) the provision of training and 
technical assistance; and 
‘‘(iii) other activities that— 
‘‘(I) reduce costs associated with 
the provision of health services; 
‘‘(II) improve access to, and 
availability of, health services provided 
to individuals served by the centers; 
‘‘(III) enhance the quality and 
coordination of health services; or 
‘‘(IV) improve the health status 
of communities.’’; 
(6) in subsection (e)(5)(B)—
(A) in the heading of subparagraph (B), by 
striking ‘‘AND PLANS’’; and 
(B) by striking ‘‘and subparagraphs (B) 
and (C) of subsection (c)(1) to a health center 
or to a network or plan’’ and inserting ‘‘to a 
health center or to a network’’; 
(7) in subsection (e), by adding at the end the 
following: 
‘‘(6) NEW
ACCESS
POINTS
AND
EXPANDED 
SERVICES.— 
‘‘(A) 
APPROVAL
OF
NEW
ACCESS 
POINTS.— 
‘‘(i) IN
GENERAL.—The Secretary 
may approve applications for grants under 
subparagraph (A) or (B) of paragraph (1) 
to establish new delivery sites. 
‘‘(ii) SPECIAL
CONSIDERATION.—In 
carrying out clause (i), the Secretary may 
give special consideration to applicants 
that have demonstrated the new delivery 
site will be located within a sparsely popu-
lated area, or an area which has a level of 
unmet need that is higher relative to other 
applicants.
‘‘(iii) CONSIDERATION
OF
APPLICA-
TIONS.—In carrying out clause (i), the 
Secretary shall approve applications for 
grants in such a manner that the ratio of 
the medically underserved populations in 
rural areas which may be expected to use 
the services provided by the applicants in-
volved to the medically underserved popu-
lations in urban areas which may be ex-
pected to use the services provided by the 
applicants is not less than two to three or 
greater than three to two. 
‘‘(iv) SERVICE AREA OVERLAP.—If in 
carrying out clause (i) the applicant pro-
poses to serve an area that is currently 
served by another health center funded 
under this section, the Secretary may con-
sider whether the award of funding to an 
additional health center in the area can be 
justified based on the unmet need for addi-
tional services within the catchment area. 
‘‘(B) APPROVAL
OF
EXPANDED
SERVICE 
APPLICATIONS.— 
‘‘(i) IN
GENERAL.—The Secretary 
may approve applications for grants under
subparagraph (A) or (B) of paragraph (1) 
to expand the capacity of the applicant to 
provide required primary health services 
described in subsection (b)(1) or additional 
health services described in subsection 
(b)(2). 
‘‘(ii) 
PRIORITY
EXPANSION 
PROJECTS.—In carrying out clause (i), the 
Secretary may give special consideration to 
expanded service applications that seek to 
address emerging public health or behav-
ioral health, mental health, or substance 
abuse issues through increasing the avail-
ability of additional health services de-
scribed in subsection (b)(2) in an area in 
which there are significant barriers to ac-
cessing care. 
‘‘(iii) CONSIDERATION
OF
APPLICA-
TIONS.—In carrying out clause (i), the 
Secretary shall approve applications for 
grants in such a manner that the ratio of 
the medically underserved populations in 
rural areas which may be expected to use 
the services provided by the applicants in-
volved to the medically underserved popu-
lations in urban areas which may be ex-
pected to use the services provided by such 
applicants is not less than two to three or 
greater than three to two.’’; 
(8) in subsection (h)— 
(A) in paragraph (1), by striking ‘‘and 
children and youth at risk of homelessness’’ and 
inserting ‘‘, children and youth at risk of home-
lessness, homeless veterans, and veterans at 
risk of homelessness’’; and 
(B) in paragraph (5)— 
(i) by striking subparagraph (B); 
(ii) by redesignating subparagraph 
(C) as subparagraph (B); and 
(iii) in subparagraph (B) (as so redes-
ignated)— 
(I) in the subparagraph heading, 
by striking ‘‘ABUSE’’ and inserting 
‘‘USE DISORDER’’; and 
(II) by striking ‘‘abuse’’ and in-
serting ‘‘use disorder’’; 
(9) in subsection (k)— 
(A) in paragraph (2)— 
(i) in the paragraph heading, by in-
serting ‘‘UNMET’’ before ‘‘NEED’’;
(ii) in the matter preceding subpara-
graph (A), by inserting ‘‘or subsection 
(e)(6)’’ after ‘‘subsection (e)(1)’’; 
(iii) in subparagraph (A), by inserting 
‘‘unmet’’ before ‘‘need for health services’’; 
(iv) in subparagraph (B), by striking 
‘‘and’’ at the end; 
(v) in subparagraph (C), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
(vi) by adding after subparagraph (C) 
the following: 
‘‘(D) in the case of an application for a 
grant pursuant to subsection (e)(6), a dem-
onstration that the applicant has consulted with 
appropriate State and local government agen-
cies, and health care providers regarding the 
need for the health services to be provided at 
the proposed delivery site.’’; 
(B) in paragraph (3)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘or subsection 
(e)(6)’’ after ‘‘subsection (e)(1)(B)’’; 
(ii) in subparagraph (B), by striking 
‘‘in the catchment area of the center’’ and
inserting ‘‘, including other health care 
providers that provide care within the 
catchment area, local hospitals, and spe-
cialty providers in the catchment area of 
the center, to provide access to services not 
available through the health center and to 
reduce the non-urgent use of hospital 
emergency departments’’; 
(iii) in subparagraph (H)(ii), by in-
serting ‘‘who shall be directly employed by 
the center’’ after ‘‘approves the selection of 
a director for the center’’; 
(iv) in subparagraph (L), by striking 
‘‘and’’ at the end; 
(v) in subparagraph (M), by striking 
the period and inserting ‘‘; and’’; and 
(vi) by inserting after subparagraph 
(M), the following: 
‘‘(N) the center has written policies and 
procedures in place to ensure the appropriate 
use of Federal funds in compliance with appli-
cable Federal statutes, regulations, and the 
terms and conditions of the Federal award.’’; 
and 
(C) by striking paragraph (4);
(10) in subsection (l), by adding at the end the 
following: ‘‘Funds expended to carry out activities 
under this subsection and operational support activi-
ties under subsection (m) shall not exceed 3 percent 
of the amount appropriated for this section for the 
fiscal year involved.’’; 
(11) in subsection (q)(4), by adding at the end 
the following: ‘‘A waiver provided by the Secretary 
under this paragraph may not remain in effect for 
more than 1 year and may not be extended after 
such period. An entity may not receive more than 
one waiver under this paragraph in consecutive 
years.’’; 
(12) in subsection (r)(3)— 
(A) by striking ‘‘appropriate committees of 
Congress a report concerning the distribution of 
funds under this section’’ and inserting the fol-
lowing: ‘‘Committee on Health, Education, 
Labor, and Pensions of the Senate, and the 
Committee on Energy and Commerce of the 
House of Representatives, a report including, at 
a minimum— 
‘‘(A) the distribution of funds for carrying 
out this section’’;
(B) by striking ‘‘populations. Such report 
shall include an assessment’’ and inserting the 
following: ‘‘populations; 
‘‘(B) an assessment’’; 
(C) by striking ‘‘and the rationale for any 
substantial changes in the distribution of 
funds.’’ and inserting a semicolon; and 
(D) by adding at the end the following: 
‘‘(C) the distribution of awards and fund-
ing for new or expanded services in each of 
rural areas and urban areas; 
‘‘(D) the distribution of awards and fund-
ing for establishing new access points, and the 
number of new access points created; 
‘‘(E) the amount of unexpended funding 
for loan guarantees and loan guarantee author-
ity under title XVI; 
‘‘(F) the rationale for any substantial 
changes in the distribution of funds; 
‘‘(G) the rate of closures for health centers 
and access points; 
‘‘(H) the number and reason for any 
grants 
awarded 
pursuant 
to 
subsection 
(e)(1)(B); and
‘‘(I) the number and reason for any waiv-
ers provided pursuant to subsection (q)(4).’’; 
(13) in subsection (r), by adding at the end the 
following new paragraph: 
‘‘(5) FUNDING FOR PARTICIPATION OF HEALTH 
CENTERS IN ALL OF US RESEARCH PROGRAM.—In 
addition to any amounts made available pursuant to 
paragraph (1) of this subsection, section 402A of 
this Act, or section 10503 of the Patient Protection 
and Affordable Care Act, there is authorized to be 
appropriated, and there is appropriated, out of any 
monies in the Treasury not otherwise appropriated, 
to the Secretary $25,000,000 for fiscal year 2018 to 
support the participation of health centers in the All 
of Us Research Program under the Precision Medi-
cine Initiative under section 498E of this Act.’’; and 
(14) by striking subsection (s). 
(c) NATIONAL HEALTH SERVICE CORPS.—Section 
10503(b)(2)(E) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 254b–2(b)(2)(E)) is amended by 
striking ‘‘2017’’ and inserting ‘‘2019’’. 
(d) TEACHING HEALTH CENTERS THAT OPERATE 
GRADUATE MEDICAL EDUCATION PROGRAMS.—
(1) PAYMENTS.—Subsection (a) of section 
340H of the Public Health Service Act (42 U.S.C. 
256h) is amended to read as follows: 
‘‘(a) PAYMENTS.— 
‘‘(1) IN
GENERAL.—Subject to subsection 
(h)(2), the Secretary shall make payments under 
this section for direct expenses and indirect expenses 
to qualified teaching health centers that are listed as 
sponsoring institutions by the relevant accrediting 
body for, as appropriate— 
‘‘(A) maintenance of existing approved 
graduate medical residency training programs; 
‘‘(B) expansion of existing approved grad-
uate medical residency training programs; and 
‘‘(C) establishment of new approved grad-
uate medical residency training programs. 
‘‘(2) PRIORITY.—In making payments pursuant 
to paragraph (1)(C), the Secretary shall give priority 
to qualified teaching health centers that— 
‘‘(A) serve a health professional shortage 
area with a designation in effect under section 
332 or a medically underserved community (as 
defined in section 799B); or
‘‘(B) are located in a rural area (as de-
fined in section 1886(d)(2)(D) of the Social Se-
curity Act).’’. 
(2) FUNDING.—Subsection (g) of section 340H 
of the Public Health Service Act (42 U.S.C. 256h) 
is amended— 
(A) by striking ‘‘To carry out’’ and insert-
ing the following: 
‘‘(1) IN GENERAL.—To carry out’’; 
(B) by striking ‘‘and $15,000,000 for the 
first quarter of fiscal year 2018’’ and inserting 
‘‘and $126,500,000 for each of fiscal years 
2018 and 2019, to remain available until ex-
pended’’; and 
(C) by adding at the end the following: 
‘‘(2) 
ADMINISTRATIVE
EXPENSES.—Of 
the 
amount made available to carry out this section for 
any fiscal year, the Secretary may not use more 
than 5 percent of such amount for the expenses of 
administering this section.’’. 
(3) ANNUAL REPORTING.—Subsection (h)(1) of 
section 340H of the Public Health Service Act (42 
U.S.C. 256h) is amended— 
(A) by redesignating subparagraph (D) as 
subparagraph (H); and
(B) by inserting after subparagraph (C) 
the following: 
‘‘(D) The number of patients treated by 
residents described in paragraph (4). 
‘‘(E) The number of visits by patients 
treated by residents described in paragraph (4). 
‘‘(F) Of the number of residents described 
in paragraph (4) who completed their residency 
training at the end of such residency academic 
year, the number and percentage of such resi-
dents entering primary care practice (meaning 
any of the areas of practice listed in the defini-
tion of a primary care residency program in 
section 749A). 
‘‘(G) Of the number of residents described 
in paragraph (4) who completed their residency 
training at the end of such residency academic 
year, the number and percentage of such resi-
dents who entered practice at a health care fa-
cility— 
‘‘(i) primarily serving a health profes-
sional shortage area with a designation in 
effect under section 332 or a medically un-
derserved community (as defined in section 
799B); or
‘‘(ii) located in a rural area (as de-
fined in section 1886(d)(2)(D) of the So-
cial Security Act).’’. 
(4) REPORT ON TRAINING COSTS.—Not later 
than March 31, 2019, the Secretary of Health and 
Human Services shall submit to the Congress a re-
port on the direct graduate expenses of approved 
graduate medical residency training programs, and 
the indirect expenses associated with the additional 
costs of teaching residents, of qualified teaching 
health centers (as such terms are used or defined in 
section 340H of the Public Health Service Act (42 
U.S.C. 256h)). 
(5) DEFINITION.—Subsection (j) of section 
340H of the Public Health Service Act (42 U.S.C. 
256h) is amended— 
(A) by redesignating paragraphs (2) and 
(3) as paragraphs (3) and (4), respectively; and 
(B) by inserting after paragraph (1) the 
following: 
‘‘(2) NEW
APPROVED
GRADUATE
MEDICAL 
RESIDENCY
TRAINING
PROGRAM.—The term ‘new 
approved graduate medical residency training pro-
gram’ means an approved graduate medical resi-
dency training program for which the sponsoring
qualified teaching health center has not received a 
payment under this section for a previous fiscal year 
(other than pursuant to subsection (a)(1)(C)).’’. 
(6) TECHNICAL
CORRECTION.—Subsection (f) 
of section 340H (42 U.S.C. 256h) is amended by 
striking ‘‘hospital’’ each place it appears and insert-
ing ‘‘teaching health center’’. 
(7) PAYMENTS FOR PREVIOUS FISCAL YEARS.— 
The provisions of section 340H of the Public Health 
Service Act (42 U.S.C. 256h), as in effect on the 
day before the date of enactment of this Act, shall 
continue to apply with respect to payments under 
such section for fiscal years before fiscal year 2018. 
(e) APPLICATION.—Amounts appropriated pursuant 
to this section for fiscal year 2018 or 2019 are subject 
to the requirements contained in Public Law 115–31 for 
funds for programs authorized under sections 330 through 
340 of the Public Health Service Act (42 U.S.C. 254b– 
256). 
(f) CONFORMING AMENDMENTS.—Section 3014(h) of 
title 18, United States Code, is amended— 
(1) in paragraph (1), by striking ‘‘, as amended 
by section 221 of the Medicare Access and CHIP 
Reauthorization Act of 2015,’’; and
(2) in paragraph (4), by inserting ‘‘and section 
101(e) of the Community Health And Medical Pro-
fessionals Improve Our Nation Act of 2017’’ after 
‘‘section 221(c) of the Medicare Access and CHIP 
Reauthorization Act of 2015’’. 
SEC. 102. EXTENSION FOR SPECIAL DIABETES PROGRAMS. 
(a) SPECIAL DIABETES PROGRAM FOR TYPE I DIA-
BETES.—Section 330B(b)(2)(C) of the Public Health 
Service Act (42 U.S.C. 254c–2(b)(2)(C)) is amended by 
striking ‘‘2017’’ and inserting ‘‘2019’’. 
(b) SPECIAL DIABETES PROGRAM FOR INDIANS.— 
Subparagraph (D) of section 330C(c)(2) of the Public 
Health Service Act (42 U.S.C. 254c–3(c)(2)) is amended 
to read as follows: 
‘‘(D) $150,000,000 for each of fiscal years 
2018 and 2019.’’. 
SEC. 103. EXTENSION FOR FAMILY-TO-FAMILY HEALTH IN-
FORMATION CENTERS. 
Section 501(c) of the Social Security Act (42 U.S.C. 
701(c)) is amended— 
(1) in paragraph (1)(A)— 
(A) in clause (v), by striking ‘‘and’’ at the 
end; 
(B) in clause (vi), by striking the period at 
the end and inserting ‘‘; and’’; and
(C) by adding at the end the following new 
clause: 
‘‘(vii) $6,000,000 for each of fiscal years 2018 
and 2019.’’; 
(2) in paragraph (3)(C), by inserting before the 
period the following: ‘‘, and with respect to fiscal 
years 2018 and 2019, such centers shall also be de-
veloped in all territories and at least one such center 
shall be developed for Indian tribes’’; and 
(3) by amending paragraph (5) to read as fol-
lows: 
‘‘(5) For purposes of this subsection— 
‘‘(A) the term ‘Indian tribe’ has the meaning 
given such term in section 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603); 
‘‘(B) the term ‘State’ means each of the 50 
States and the District of Columbia; and 
‘‘(C) the term ‘territory’ means Puerto Rico, 
Guam, American Samoa, the Virgin Islands, and the 
Northern Mariana Islands.’’. 
SEC. 104. YOUTH EMPOWERMENT PROGRAM; PERSONAL 
RESPONSIBILITY EDUCATION. 
(a) YOUTH EMPOWERMENT PROGRAM.—
(1) IN GENERAL.—Section 510 of the Social 
Security Act (42 U.S.C. 710) is amended to read as 
follows: 
‘‘SEC. 510. YOUTH EMPOWERMENT PROGRAM. 
‘‘(a) IN GENERAL.— 
‘‘(1) ALLOTMENTS TO STATES.—For the pur-
pose described in subsection (b), the Secretary shall, 
for each of fiscal years 2018 and 2019, allot to each 
State which has transmitted an application for the 
fiscal year under section 505(a) an amount equal to 
the product of— 
‘‘(A) the amount appropriated pursuant to 
subsection (e)(1) for the fiscal year, minus the 
amount reserved under subsection (e)(2) for the 
fiscal year; and 
‘‘(B) the proportion that the number of 
low-income children in the State bears to the 
total of such numbers of children for all the 
States. 
‘‘(2) OTHER ALLOTMENTS.— 
‘‘(A) OTHER ENTITIES.—For the purpose 
described in subsection (b), the Secretary shall, 
for each of fiscal years 2018 and 2019, for any 
State which has not transmitted an application 
for the fiscal year under section 505(a), allot to
one or more entities in the State the amount 
that would have been allotted to the State 
under paragraph (1) if the State had submitted 
such an application. 
‘‘(B) PROCESS.—The Secretary shall select 
the recipients of allotments under subparagraph 
(A) by means of a competitive grant process 
under which— 
‘‘(i) not later than 30 days after the 
deadline for the State involved to submit 
an application for the fiscal year under 
section 505(a), the Secretary publishes a 
notice soliciting grant applications; and 
‘‘(ii) not later than 120 days after 
such deadline, all such applications must 
be submitted. 
‘‘(b) PURPOSE.— 
‘‘(1) IN GENERAL.—Except for research under 
paragraph (5) and information collection and report-
ing under paragraph (6), the purpose of an allot-
ment under subsection (a) to a State (or to another 
entity in the State pursuant to subsection (a)(2)) is 
to enable the State or other entity to implement edu-
cation exclusively on sexual risk avoidance (meaning 
voluntarily refraining from sexual activity).
‘‘(2) REQUIRED COMPONENTS.—Education on 
sexual risk avoidance pursuant to an allotment 
under this section shall— 
‘‘(A) ensure that the unambiguous and pri-
mary emphasis and context for each topic de-
scribed in paragraph (3) is a message to youth 
that normalizes the optimal health behavior of 
avoiding nonmarital sexual activity; 
‘‘(B) be medically accurate and complete; 
‘‘(C) be age-appropriate; and 
‘‘(D) be based on adolescent learning and 
developmental theories for the age group receiv-
ing the education. 
‘‘(3) TOPICS.—Education on sexual risk avoid-
ance pursuant to an allotment under this section 
shall address each of the following topics: 
‘‘(A) The holistic individual and societal 
benefits associated with personal responsibility, 
self-regulation, goal setting, healthy decision-
making, and a focus on the future. 
‘‘(B) The advantage of refraining from 
nonmarital sexual activity in order to improve 
the future prospects and physical and emotional 
health of youth.
‘‘(C) The increased likelihood of avoiding 
poverty when youth attain self-sufficiency and 
emotional maturity before engaging in sexual 
activity. 
‘‘(D) The foundational components of 
healthy relationships and their impact on the 
formation of healthy marriages and safe and 
stable families. 
‘‘(E) How other youth risk behaviors, such 
as drug and alcohol usage, increase the risk for 
teen sex. 
‘‘(F) How to resist and avoid, and receive 
help regarding, sexual coercion and dating vio-
lence, recognizing that even with consent teen 
sex remains a youth risk behavior. 
‘‘(4) CONTRACEPTION.—Education on sexual 
risk avoidance pursuant to an allotment under this 
section shall ensure that— 
‘‘(A) any information provided on contra-
ception is medically accurate and ensures that 
students understand that contraception offers 
physical risk reduction, but not risk elimination; 
and
‘‘(B) the education does not include dem-
onstrations, simulations, or distribution of con-
traceptive devices. 
‘‘(5) RESEARCH.— 
‘‘(A) IN GENERAL.—A State or other enti-
ty receiving an allotment pursuant to subsection 
(a) may use up to 20 percent of such allotment 
to build the evidence base for sexual risk avoid-
ance education by conducting or supporting re-
search. 
‘‘(B) REQUIREMENTS.—Any research con-
ducted or supported pursuant to subparagraph 
(A) shall be— 
‘‘(i) rigorous; 
‘‘(ii) evidence-based; and 
‘‘(iii) designed and conducted by inde-
pendent researchers who have experience 
in conducting and publishing research in 
peer-reviewed outlets. 
‘‘(6) INFORMATION COLLECTION AND REPORT-
ING.—A State or other entity receiving an allotment 
pursuant to subsection (a) shall, as specified by the 
Secretary—
‘‘(A) collect information on the programs 
and activities funded through the allotment; 
and 
‘‘(B) submit reports to the Secretary on 
the data from such programs and activities. 
‘‘(c) NATIONAL EVALUATION.— 
‘‘(1) IN GENERAL.—The Secretary shall— 
‘‘(A) in consultation with appropriate State 
and local agencies, conduct one or more rig-
orous evaluations of the education funded 
through this section and associated data; and 
‘‘(B) submit a report to the Congress on 
the results of such evaluations, together with a 
summary of the information collected pursuant 
to subsection (b)(6). 
‘‘(2) CONSULTATION.—In conducting the eval-
uations required by paragraph (1), including the es-
tablishment of evaluation methodologies, the Sec-
retary shall consult with relevant stakeholders. 
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.— 
‘‘(1) Sections 503, 507, and 508 apply to allot-
ments under subsection (a) to the same extent and 
in the same manner as such sections apply to allot-
ments under section 502(c).
‘‘(2) Sections 505 and 506 apply to allotments 
under subsection (a) to the extent determined by the 
Secretary to be appropriate. 
‘‘(e) FUNDING.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there is appropriated, out of any money in the 
Treasury not otherwise appropriated, $75,000,000 
for each of fiscal years 2018 and 2019. 
‘‘(2) RESERVATION.—The Secretary shall re-
serve, for each of fiscal years 2018 and 2019, not 
more than 20 percent of the amount appropriated 
pursuant to paragraph (1) for administering the 
program under this section, including the conducting 
of national evaluations and the provision of technical 
assistance to the recipients of allotments.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by this subsection takes effect on October 1, 2017. 
(b) PERSONAL RESPONSIBILITY EDUCATION.— 
(1) IN GENERAL.—Section 513 of the Social 
Security Act (42 U.S.C. 713) is amended— 
(A) in subsection (a)(1)(A), by striking 
‘‘2017’’ and inserting ‘‘2019’’; and 
(B) in subsection (a)(4)—
(i) in subparagraph (A), by striking 
‘‘2017’’ each place it appears and inserting 
‘‘2019’’; and 
(ii) in subparagraph (B)— 
(I) in the subparagraph heading, 
by striking ‘‘3-YEAR GRANTS’’ and in-
serting 
‘‘COMPETITIVE
PREP 
GRANTS’’; and 
(II) in clause (i), by striking ‘‘so-
licit applications to award 3-year 
grants in each of fiscal years 2012 
through 2017’’ and inserting ‘‘con-
tinue through fiscal year 2019 grants 
awarded for any of fiscal years 2015 
through 2017’’; 
(C) in subsection (c)(1), by inserting after 
‘‘youth with HIV/AIDS,’’ the following: ‘‘vic-
tims of human trafficking,’’; and 
(D) in subsection (f), by striking ‘‘2017’’ 
and inserting ‘‘2019’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection take effect on October 1, 2017.
TITLE II—OFFSETS 
SEC. 201. PROVIDING FOR QUALIFIED HEALTH PLAN 
GRACE PERIOD REQUIREMENTS FOR ISSUER 
RECEIPT OF ADVANCE PAYMENTS OF COST- 
SHARING REDUCTIONS AND PREMIUM TAX 
CREDITS THAT ARE MORE CONSISTENT WITH 
STATE LAW GRACE PERIOD REQUIREMENTS. 
(a) IN GENERAL.—Section 1412(c) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18082(c)) 
is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (B)(iv)(II), by strik-
ing ‘‘a 3-month grace period’’ and inserting ‘‘a 
grace period specified in subparagraph (C)’’; 
and 
(B) by adding at the end the following new 
subparagraphs: 
‘‘(C) GRACE PERIOD SPECIFIED.—For pur-
poses of subparagraph (B)(iv)(II), the grace pe-
riod specified in this subparagraph is— 
‘‘(i) for plan years beginning before 
January 1, 2018, a 3-month grace period; 
and 
‘‘(ii) for plan years beginning on or 
after January 1, 2018—
‘‘(I) in the case of an Exchange 
operating in a State that has a State 
law grace period in place, such State 
law grace period; and 
‘‘(II) in the case of an Exchange 
operating in a State that does not 
have a State law grace period in 
place, a 1-month grace period. 
‘‘(D) STATE
LAW
GRACE
PERIOD.—For 
purposes of subparagraph (C), the term ‘State 
law grace period’ means, with respect to a 
State, a grace period for nonpayment of pre-
miums before discontinuing coverage that is ap-
plicable under the State law to health insurance 
coverage offered in the individual market of the 
State.’’; and 
(2) in paragraph (3), by adding at the end the 
following new sentence: ‘‘The requirements of para-
graph (2)(B)(iv) apply to an issuer of a qualified 
health plan receiving an advanced payment under 
this paragraph in the same manner and to the same 
extent that such requirements apply to an issuer of 
a qualified health plan receiving an advanced pay-
ment under paragraph (2)(A).’’.
(b) REPORT
ON ALIGNING GRACE PERIODS
FOR 
MEDICAID, MEDICARE, AND EXCHANGE PLANS.—Not 
later than 2 years after the date of full implementation 
of subsection (a), the Comptroller General of the United 
States shall submit to Congress a report on— 
(1) the effects on consumers of aligning grace 
periods applied under the Medicaid program under 
title XIX of the Social Security Act, under the Medi-
care program under parts C and D of title XVIII of 
such Act, and under qualified health plans offered 
on an Exchange established under title I of the Pa-
tient Protection and Affordable Care Act, including 
the extent to which such an alignment of grace peri-
ods may help to avoid enrollment status confusion 
for individuals under such Medicaid program, Medi-
care program, and qualified health plans; and 
(2) the extent to which such an alignment of 
grace periods may reduce fraud, waste, and abuse 
under the Medicaid program. 
SEC. 202. PREVENTION AND PUBLIC HEALTH FUND. 
Section 4002(b) of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 300u–11(b)) is amended by 
striking paragraphs (3) through (8) and inserting the fol-
lowing new paragraphs: 
‘‘(3) for fiscal year 2018, $900,000,000;
‘‘(4) for fiscal year 2019, $500,000,000; 
‘‘(5) for fiscal year 2020, $500,000,000; 
‘‘(6) for fiscal year 2021, $500,000,000; 
‘‘(7) for fiscal year 2022, $500,000,000; 
‘‘(8) for fiscal year 2023, $500,000,000; 
‘‘(9) for fiscal year 2024, $500,000,000; 
‘‘(10) for fiscal year 2025, $750,000,000; 
‘‘(11) for fiscal year 2026, $1,000,000,000; and 
‘‘(12) for fiscal year 2027 and each fiscal year 
thereafter, $2,000,000,000.’’. 
DIVISION B—HEALTHY KIDS ACT 
SEC. 300. SHORT TITLE. 
This division may be cited as the ‘‘Helping Ensure 
Access for Little Ones, Toddlers, and Hopeful Youth by 
Keeping Insurance Delivery Stable Act of 2017’’ or the 
‘‘HEALTHY KIDS Act’’. 
TITLE I—CHIP EXTENSION AND 
OTHER MEDICAID AND CHIP 
PROVISIONS 
SEC. 301. FIVE-YEAR FUNDING EXTENSION OF THE CHIL-
DREN’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 a semicolon; and 
(3) by adding at the end the following new 
paragraphs: 
‘‘(21) for fiscal year 2018, $21,500,000,000; 
‘‘(22) for fiscal year 2019, $22,600,000,000; 
‘‘(23) for fiscal year 2020, $23,700,000,000; 
‘‘(24) for fiscal year 2021, $24,800,000,000; 
and 
‘‘(25) for fiscal year 2022, for purposes of mak-
ing two semi-annual allotments— 
‘‘(A) $2,850,000,000 for the period begin-
ning on October 1, 2021, and ending on March 
31, 2022; and 
‘‘(B) $2,850,000,000 for the period begin-
ning on April 1, 2022, and ending on Sep-
tember 30, 2022.’’. 
(b) ALLOTMENTS.— 
(1) IN GENERAL.—Section 2104(m) of the So-
cial Security Act (42 U.S.C. 1397dd(m)) is amend-
ed— 
(A) in paragraph (2)— 
(i) 
in 
the 
heading, 
by 
striking 
‘‘THROUGH
2016’’ 
and 
inserting 
‘‘THROUGH 2022’’; and
(ii) in subparagraph (B)— 
(I) in the matter preceding clause 
(i), by striking ‘‘(19)’’ and inserting 
‘‘(24)’’; 
(II) in clause (ii), in the matter 
preceding subclause (I), by inserting 
‘‘(other than fiscal year 2022)’’ after 
‘‘even-numbered fiscal year’’; and 
(III) in clause (ii)(I), by inserting 
‘‘(or, in the case of fiscal year 2018, 
under paragraph (4))’’ after ‘‘clause 
(i)’’; 
(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 2022’’; 
(C) in paragraph (7)— 
(i) in subparagraph (A), by striking 
‘‘2017’’ and inserting ‘‘2022’’; 
(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, fis-
cal year 2018, fiscal year 2020, or fiscal 
year 2022’’; 
(D) in paragraph (9)— 
(i) in the heading, by striking ‘‘FISCAL 
YEARS 2015 AND 2017’’ and inserting 
‘‘CERTAIN FISCAL YEARS’’; 
(ii) by striking ‘‘or (4)’’ and inserting 
‘‘, (4), or (10)’’; and 
(iii) by striking ‘‘or fiscal year 2017’’ 
and inserting ‘‘, 2017, or 2022’’; and 
(E) by adding at the end the following new 
paragraph: 
‘‘(10) FOR FISCAL YEAR 2022.— 
‘‘(A) FIRST HALF.—Subject to paragraphs 
(5) and (7), from the amount made available 
under subparagraph (A) of paragraph (25) 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 301(b)(3) 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 
(25) of subsection (a) for the semi-annual pe-
riod described in such subparagraph, the Sec-
retary shall compute a State allotment for each 
State (including the District of Columbia and 
each commonwealth and territory) for such 
semi-annual period in an amount equal to the 
amount made available under such subpara-
graph, multiplied 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 
GROWTH
FACTOR
UPDATED
AMOUNT.—The 
amount described in this subparagraph for a 
State is equal to the sum of— 
‘‘(i) the amount of the State allotment 
for fiscal year 2021 determined under 
paragraph (2)(B)(i); and 
‘‘(ii) the amount of any payments 
made to the State under subsection (n) for 
fiscal year 2021, 
multiplied by the allotment increase factor 
under paragraph (6) for fiscal year 2022. 
‘‘(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)(25)(A); and 
‘‘(II) the amount of the appro-
priation for such period under section 
301(b)(3) 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)(25)(B).’’. 
(2) 
TECHNICAL
AMENDMENT.—Section 
2104(m)(2)(A) 
of 
such 
Act 
(42 
U.S.C. 
1397dd(m)(2)(A)) is amended by striking ‘‘the allot-
ment increase factor under paragraph (5)’’ each 
place it appears and inserting ‘‘the allotment in-
crease factor under paragraph (6)’’. 
(3) ONE-TIME
APPROPRIATION
FOR
FISCAL 
YEAR 2022.—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 beginning on October 1, 2021, and 
ending on March 31, 2022, under paragraph 
(25)(A) of section 2104(a) of the Social Security Act 
(42 U.S.C. 1397dd(a)) (as added by subsection 
(a)(3)), to remain available until expended. Such 
amount shall be used to provide allotments to States 
under paragraph (10) of section 2104(m) of such 
Act (as added by subsection (b)(1)(E)) for the first 
6 months of fiscal year 2022 in the same manner as 
allotments are provided under subsection (a)(25)(A) 
of such section 2104 and subject to the same terms
and conditions as apply to the allotments provided 
from such subsection (a)(25)(A). 
(c) EXTENSION OF THE CHILD ENROLLMENT CON-
TINGENCY 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 2021’’; and 
(ii) by striking ‘‘fiscal year 2015 and 
fiscal year 2017’’ and inserting ‘‘fiscal 
years 2015, 2017, and 2022’’; and 
(B) in subparagraph (B)— 
(i) by striking ‘‘2010, 2011, 2012, 
2013, 2014, and 2016’’ and inserting 
‘‘2010 through 2014, 2016, and 2018 
through 2021’’; and 
(ii) by striking ‘‘fiscal year 2015 and 
fiscal year 2017’’ and inserting ‘‘fiscal 
years 2015, 2017, and 2022’’; and 
(2) in paragraph (3)(A), in the matter pre-
ceding clause (i), by striking ‘‘or a semi-annual allot-
ment period for fiscal year 2015 or 2017’’ and in-
serting ‘‘or in any of fiscal years 2018 through 2021 
(or a semi-annual allotment period for fiscal year 
2015, 2017, or 2022)’’. 
(d) EXTENSION OF QUALIFYING STATES OPTION.— 
Section 2105(g)(4) of the Social Security Act (42 U.S.C. 
1397ee(g)(4)) is amended— 
(1) in the heading, by striking ‘‘THROUGH 
2017’’ and inserting ‘‘THROUGH 2022’’; and 
(2) in subparagraph (A), by striking ‘‘2017’’ 
and inserting ‘‘2022’’. 
(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 ‘‘2022’’. 
(f) ASSURANCE OF AFFORDABILITY STANDARD FOR 
CHILDREN AND FAMILIES.— 
(1) IN GENERAL.—Section 2105(d)(3) of the 
Social Security Act (42 U.S.C. 1397ee(d)(3)) is 
amended— 
(A) in the paragraph heading, by striking 
‘‘UNTIL
OCTOBER
1, 2019’’ and inserting 
‘‘THROUGH SEPTEMBER 30, 2022’’; and 
(B) in subparagraph (A), in the matter 
preceding clause (i)—
(i) by striking ‘‘2019’’ and inserting 
‘‘2022’’; 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, 2022, 
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)) applicable to a family of the 
size involved. The preceding sentences shall 
not be construed as preventing a State 
during any such periods’’. 
(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, 2022’’; and 
(B) by striking ‘‘September 30, 2019,’’ 
and inserting ‘‘September 30, 2022 (but during 
the period that begins on October 1, 2019, and 
ends on September 30, 2022, only with respect
to children in families whose income does not 
exceed 300 percent of the poverty line (as de-
fined in section 2110(c)(5)) applicable to a fam-
ily 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 con-
strued as preventing a State from considering chil-
dren enrolled in a qualified CHIP look-alike pro-
gram 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 
medical assistance under title XIX or child 
health assistance under this title may purchase 
coverage through the State that provides bene-
fits that are at least identical to the benefits
SEC. 306. PUERTO RICO AND THE VIRGIN ISLANDS MED-
ICAID PAYMENTS. 
(a) INCREASED CAP.—Section 1108(g) of the Social 
Security Act (42 U.S.C. 1308(g)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (A), by inserting ‘‘(or, 
with respect to fiscal years 2018 and 2019, in-
creased by such percentage increase plus one 
percentage point)’’ after ‘‘beginning of the fis-
cal year’’; and 
(B) in subparagraph (B), by inserting 
‘‘(or, with respect to fiscal years 2018 and 
2019, increased by such percentage increase 
plus one percentage point)’’ after ‘‘percentage 
increase referred to in subparagraph (A)’’; 
(2) in paragraph (5)— 
(A) in subparagraph (A), by striking ‘‘sub-
paragraph (B)’’ and inserting ‘‘subparagraphs 
(B), (C), (D), (E), and (F)’’; and 
(B) by adding at the end the following new 
subparagraphs: 
‘‘(C) The amount of the increase otherwise pro-
vided under subparagraph (A) for Puerto Rico shall 
be further increased by $880,000,000. 
‘‘(D)(i) For the period beginning October 1, 
2017, and ending December 31, 2019, the amount