442 
to fees on health insurance and self-insured 
plans) for such fiscal year; and 
‘‘(B) subject to subsection (c)(2), amounts 
determined by the Secretary of Health and 
Human Services to be equivalent to the fair 
share per capita amount computed under sub-
section (c)(1) for the fiscal year multiplied by 
the average number of individuals entitled to 
benefits under part A, or enrolled under part B, 
of title XVIII of the Social Security Act during 
such fiscal year. 
The amounts appropriated under paragraphs (1), (2), (3), 
and (4)(B) shall be transferred from the Federal Hospital 
Insurance Trust Fund and from the Federal Supple-
mentary Medical Insurance Trust Fund (established under 
section 1841 of such Act), and from the Medicare Prescrip-
tion Drug Account within such Trust Fund, in proportion 
(as estimated by the Secretary) to the total expenditures 
during such fiscal year that are made under title XVIII 
of such Act from the respective trust fund or account. 
‘‘(c) FAIR SHARE PER CAPITA AMOUNT.— 
‘‘(1) COMPUTATION.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the fair share per capita amount 
under this paragraph for a fiscal year (begin-
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ning with fiscal year 2011) is an amount com-
puted by the Secretary of Health and Human 
Services for such fiscal year that, when applied 
under this section and subchapter B of chapter 
34 of the Internal Revenue Code of 1986, will re-
sult in revenues to the CERTF of $375,000,000 
for the fiscal year. 
‘‘(B) ALTERNATIVE COMPUTATION.— 
‘‘(i) IN GENERAL.—If the Secretary is 
unable to compute the fair share per capita 
amount under subparagraph (A) for a fiscal 
year, the fair share per capita amount 
under this paragraph for the fiscal year 
shall be the default amount determined 
under clause (ii) for the fiscal year. 
‘‘(ii) DEFAULT AMOUNT.—The default 
amount under this clause for— 
‘‘(I) fiscal year 2011 is equal to 
$2; or 
‘‘(II) a subsequent year is equal to 
the default amount under this clause 
for the preceeding fiscal year increased 
by the annual percentage increase in 
the medical care component of the con-
sumer price index (United States city 
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average) for the 12-month period end-
ing with April of the preceding fiscal 
year. 
Any amount determined under subclause 
(II) shall be rounded to the nearest penny. 
‘‘(2) LIMITATION ON MEDICARE FUNDING.—In no 
case shall the amount transferred under subsection 
(b)(4)(B) for any fiscal year exceed $90,000,000. 
‘‘(d) EXPENDITURES FROM FUND.— 
‘‘(1) IN
GENERAL.—Subject to paragraph (2), 
amounts in the CERTF are available to the Secretary 
of Health and Human Services for carrying out sec-
tion 1822 of the Social Security Act. 
‘‘(2) ALLOCATION
FOR
COMMISSION.—Not less 
than the following amounts in the CERTF for a fiscal 
year shall be available to carry out the activities of 
the Comparative Effectiveness Research Commission 
established under section 1822(b) of the Social Secu-
rity Act for such fiscal year: 
‘‘(A) For fiscal year 2008, $7,000,000. 
‘‘(B) For fiscal year 2009, $9,000,000. 
‘‘(C) For each fiscal year beginning with 
2010, $10,000,000. 
Nothing in this paragraph shall be construed as pre-
venting additional amounts in the CERTF from 
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being made available to the Comparative Effectiveness 
Research Commission for such activities. 
‘‘(e) NET REVENUES.—For purposes of this section, the 
term ‘net revenues’ means the amount estimated by the Sec-
retary based on the excess of— 
‘‘(1) the fees received in the Treasury under sub-
chapter B of chapter 34, over 
‘‘(2) the decrease in the tax imposed by chapter 
1 resulting from the fees imposed by such sub-
chapter.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for such subchapter A is amended by 
adding at the end thereof the following new item: 
‘‘Sec. 9511. Health Care Comparative Effectiveness Research Trust Fund.’’. 
(2) FINANCING FOR FUND FROM FEES ON IN-
SURED AND SELF-INSURED HEALTH PLANS.— 
(A) GENERAL RULE.—Chapter 34 of the In-
ternal Revenue Code of 1986 is amended by add-
ing at the end the following new subchapter: 
‘‘Subchapter B—Insured and Self-Insured 
Health Plans 
‘‘Sec. 4375. Health insurance. 
‘‘Sec. 4376. Self-insured health plans 
‘‘Sec. 4377. Definitions and special rules 
‘‘SEC. 4375. HEALTH INSURANCE. 
‘‘(a) IMPOSITION OF FEE.—There is hereby imposed 
on each specified health insurance policy for each policy 
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year a fee equal to the fair share per capita amount deter-
mined under section 9511(c)(1) multiplied by the average 
number of lives covered under the policy. 
‘‘(b) LIABILITY FOR FEE.—The fee imposed by sub-
section (a) shall be paid by the issuer of the policy. 
‘‘(c) SPECIFIED HEALTH INSURANCE POLICY.—For 
purposes of this section— 
‘‘(1) IN GENERAL.—Except as otherwise provided 
in this section, the term ‘specified health insurance 
policy’ means any accident or health insurance policy 
issued with respect to individuals residing in the 
United States. 
‘‘(2) EXEMPTION
OF
CERTAIN
POLICIES.—The 
term ‘specified health insurance policy’ does not in-
clude any insurance policy if substantially all of the 
coverage provided under such policy relates to— 
‘‘(A) liabilities incurred under workers’ 
compensation laws, 
‘‘(B) tort liabilities, 
‘‘(C) liabilities relating to ownership or use 
of property, 
‘‘(D) credit insurance, 
‘‘(E) medicare supplemental coverage, or 
‘‘(F) such other similar liabilities as the 
Secretary may specify by regulations. 
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