multiplied by the allotment increase factor 
under paragraph (5) for such even-num-
bered fiscal year.’’; 
(C) in paragraph (3)— 
(i) in the heading, by striking ‘‘2015’’ 
and inserting ‘‘2019’’; 
(ii) in subparagraph (A), by striking 
‘‘paragraph (18)’’ and inserting ‘‘para-
graph (22)’’; 
(iii) in subparagraph (B), by striking 
‘‘paragraph (18)’’ and inserting ‘‘para-
graph (22)’’; 
(iv) in subparagraph (C)— 
(I) by striking ‘‘2014’’ each place 
it appears and inserting ‘‘2018’’; and 
(II) by striking ‘‘2015’’ and in-
serting ‘‘2019’’; and 
(v) in subparagraph (D)— 
(I) in clause (i)— 
(aa) in subclause (I), by 
striking ‘‘subsection (a)(18)(A)’’ 
and 
inserting 
‘‘subsection 
(a)(22)(A)’’; and 
(bb) in subclause (II), by 
striking ‘‘section 108 of the Chil-
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smartinez on DSK4TPTVN1PROD with BILLS
dren’s Health Insurance Program 
Reauthorization Act of 2009’’ 
and inserting ‘‘section 101(b)(2) 
of the CHIP Extension and Im-
provement Act of 2014’’; and 
(II) in clause (ii)(II), by striking 
‘‘subsection (a)(18)(B)’’ and inserting 
‘‘subsection (a)(22)(B)’’; 
(D) in paragraph (4), by striking ‘‘2015’’ 
and inserting ‘‘2019’’; 
(E) in paragraph (6)— 
(i) in subparagraph (A), by striking 
‘‘2015’’ and inserting ‘‘2019’’; and 
(ii) in the second sentence, by striking 
‘‘or fiscal year 2014’’ and inserting ‘‘fiscal 
year 2014, fiscal year 2016, or fiscal year 
2018’’; and 
(F) in paragraph (8)— 
(i) in the paragraph heading, by strik-
ing ‘‘2015’’ and inserting ‘‘2019’’; and 
(ii) by striking ‘‘for a period in fiscal 
year 2015’’ and inserting ‘‘for a period in 
fiscal year 2019’’. 
(2) SUPPLEMENTAL APPROPRIATION FOR FIS-
CAL YEAR 2019.—There is appropriated to the Sec-
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retary, out of any money in the Treasury not other-
wise appropriated, $16,700,000,000 to accompany 
the allotment made for the period beginning on Oc-
tober 1, 2018, and ending on March 31, 2019, 
under section 2104(a)(22)(A) of the Social Security 
Act (42 U.S.C. 1397dd(a)(22)(A)) (as added by sub-
section (a)), to remain available until expended. 
Such amount shall be used to provide allotments to 
States under paragraph (3) of section 2104(m) of 
such Act (42 U.S.C. 1397dd(m)) (as amended by 
paragraph (1)(C)) for the first 6 months of fiscal 
year 2019 in the same manner as allotments are 
provided under subsection (a)(22)(A) of such section 
2104 and subject to the same terms and conditions 
as apply to the allotments provided from such sub-
section (a)(22)(A). 
(c) 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 paragraph heading, by striking 
‘‘2015’’ and inserting ‘‘2019’’; and 
(2) in subparagraph (A), by striking ‘‘2015’’ 
and inserting ‘‘2019’’. 
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SEC. 102. PERFORMANCE INCENTIVE PROGRAM IMPROVE-
MENTS. 
(a) EXTENSION THROUGH FISCAL YEAR 2019.—Sec-
tion 2105(a)(3) of the Social Security Act (42 U.S.C. 
1397ee(a)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘2013’’ 
and inserting ‘‘2019’’; 
(2) in subparagraph (E)— 
(A) in clause (ii)— 
(i) in the matter preceding subclause 
(I), by inserting ‘‘after the application of 
section 2104(n)(3)(D)(ii) with respect to 
such amounts,’’ after ‘‘limitation,’’; 
(ii) by striking subclause (I) and in-
serting the following new subclause: 
‘‘(I) 
UNOBLIGATED
NATIONAL 
ALLOTMENT FOR FISCAL YEARS 2009 
THROUGH 2015.—As of December 31 
of fiscal year 2009, and as of Decem-
ber 31 of each succeeding fiscal year 
through fiscal year 2015, the portion, 
if any, of the amount appropriated 
under section 2104(a) for such fiscal 
year that is unobligated for allotment 
to a State under section 2104(m) for 
such fiscal year or set aside under 
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subsection (a)(3) or (b)(2) of section 
2111 for such fiscal year.’’; 
(iii) in subclause (II), by striking 
‘‘2013’’ and inserting ‘‘2015’’; and 
(iv) in subclause (III), by striking 
‘‘2013’’ and inserting ‘‘2015’’; 
(B) by redesignating clause (iii) as clause 
(iv); and 
(C) by inserting after clause (ii), the fol-
lowing new clause: 
‘‘(iii) APPROPRIATION
FOR
FISCAL 
YEARS 2016 THROUGH 2019.—Out of any 
money in the Treasury not otherwise ap-
propriated, 
there 
are 
appropriated 
$500,000,000 for each of fiscal years 2016 
through 2019 for making payments under 
this paragraph. Amounts appropriated for 
a fiscal year under this clause shall remain 
available for making payments under this 
paragraph until January 1 of the following 
fiscal year. Any amounts of such appro-
priations that remain unexpended or unob-
ligated as of such date shall be transferred 
and made available for making payments 
under section 2104(n).’’; and 
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(3) in subparagraph (F)(iii), by striking 
‘‘2013’’ and inserting ‘‘2019’’. 
(b) UPDATED PERFORMANCE INCENTIVE CRITERIA 
FOR FISCAL YEARS 2015 THROUGH 2019.—Section 
2105(a) of the Social Security Act (42 U.S.C. 1397ee(a)) 
is amended— 
(1) in paragraph (3)(A), by inserting ‘‘or (5)’’ 
after ‘‘paragraph (4)’’; 
(2) in paragraph (4)— 
(A) in the heading, by inserting ‘‘FISCAL 
YEARS 2009 THROUGH 2014’’ after ‘‘FOR CHIL-
DREN’’; and 
(B) in the matter preceding subparagraph 
(A), by striking ‘‘for a fiscal year if’’ and in-
serting ‘‘for fiscal years 2009 through 2014 if’’; 
and 
(3) by adding at the end the following new 
paragraph: 
‘‘(5) ENROLLMENT
AND
RETENTION
PROVI-
SIONS FOR CHILDREN FOR FISCAL YEAR 2015 AND 
SUCCEEDING FISCAL YEARS.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (3)(A), a State meets the condition of 
this paragraph for fiscal year 2015 and any 
succeeding fiscal year if it is implementing at 
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