247 
which no more than $481,140,000,000 shall be for 
the nondefense category; 
‘‘(2) 
with 
respect 
to 
fiscal 
year 
2011, 
$1,096,439,000,000 in new budget authority of 
which no more than $476,329,000,000 shall be for 
the nondefense category; 
‘‘(3) 
with 
respect 
to 
fiscal 
year 
2012, 
$1,100,705,000 in new budget authority of which no 
more than $471,565,000,000 shall be for the non-
defense category; 
‘‘(4) 
with 
respect 
to 
fiscal 
year 
2013, 
$1,106,750,000,000 in new budget authority of 
which no more than $466,850,000,000 shall be for 
the nondefense category; 
‘‘(5) 
with 
respect 
to 
fiscal 
year 
2014, 
$1,116,011,000,000 in new budget authority of 
which no more than $462,181,000,000 shall be for 
the nondefense category; 
‘‘(6) 
with 
respect 
to 
fiscal 
year 
2015, 
$1,117,559,000,000 in new budget authority of 
which no more than $457,559,000,000 shall be for 
the nondefense category; 
‘‘(7) 
with 
respect 
to 
fiscal 
year 
2016, 
$1,117,984,000,000 in new budget authority of 
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which no more than $452,984,000,000 shall be for 
the nondefense category; 
‘‘(8) 
with 
respect 
to 
fiscal 
year 
2017, 
$1,118,454,000,000 in new budget authority of 
which no more than $448,454,000,000 shall be for 
the nondefense category; 
‘‘(9) 
with 
respect 
to 
fiscal 
year 
2018, 
$1,118,969,000,000 in new budget authority of 
which no more than 443,969,000,000 shall be for 
the nondefense category; and 
‘‘(10) with respect to fiscal year 2019, 
$1,127,530,000,000 in new budget authority of 
which no more than $439,530,000,000 shall be for 
the nondefense category.’’. 
(b) DISCRETIONARY SPENDING LIMIT POINT
OF 
ORDER.—Section 312 of the Congressional Budget Act of 
1974 (as amended by section 214(a)) is further amended 
by adding at the end the following new subsection: 
‘‘(h) DISCRETIONARY SPENDING LIMIT POINT OF 
ORDER.—It shall not be in order in the House of Rep-
resentatives or the Senate to consider any bill, joint resolu-
tion, amendment, or conference report that— 
‘‘(1) increases the discretionary spending limits 
for any ensuing fiscal year after the budget year; or 
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‘‘(2) would cause the discretionary spending 
limits for the budget year to be breached.’’. 
(c) ADVANCE APPROPRIATION POINT OF ORDER.— 
Section 312 of the Congressional Budget Act of 1974 (as 
amended by this section) is further amended by adding 
at the end the following new subsection: 
‘‘(i) ADVANCE APPROPRIATION POINT OF ORDER.— 
It shall not be in order in the House of Representatives 
or the Senate to consider any appropriation bill or joint 
resolution, or amendment thereto or conference report 
thereon, that provides advance discretionary new budget 
authority that first becomes available for any fiscal year 
after the budget year at an amount for any program, 
project, or activity above the amount of appropriations for 
fiscal year 2007 for such program, project, or activity.’’. 
Subtitle B—Repeal of Unused 
Stimulus Funds 
SEC. 1211. RESCISSION AND REPEAL IN ARRA. 
(a) RESCISSION.—Of the discretionary appropria-
tions made available in division A of the American Recov-
ery and Reinvestment Act of 2009 (Public Law 111–5), 
all unobligated balances are rescinded. 
(b) REPEAL.—Subtitles B and C of title II and titles 
III through VII of division B of the American Recovery 
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and Reinvestment Act of 2009 (Public Law 111–5) are 
repealed. 
Subtitle C—Savings From Health 
Care Efficiencies 
SEC. 1221. MEDICARE DSH REPORT AND PAYMENT ADJUST-
MENTS IN RESPONSE TO COVERAGE EXPAN-
SION. 
(a) DSH REPORT.— 
(1) IN GENERAL.—Not later than January 1, 
2014, the Secretary of Health and Human Services 
shall submit to Congress a report on Medicare DSH 
taking into account the impact of the health care re-
forms carried out under this Act in reducing the 
number of uninsured individuals. The report shall 
include recommendations relating to the following: 
(A) The appropriate amount, targeting, 
and distribution of Medicare DSH to com-
pensate for higher Medicare costs associated 
with serving low-income beneficiaries (taking 
into account variations in the empirical jus-
tification for Medicare DSH attributable to hos-
pital characteristics, including bed size), con-
sistent with the original intent of Medicare 
DSH. 
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(B) The appropriate amount, targeting, 
and distribution of Medicare DSH to hospitals 
given their continued uncompensated care costs, 
to the extent such costs remain. 
(2) COORDINATION WITH MEDICAID DSH RE-
PORT.—The Secretary shall coordinate the report 
under this subsection with the report on Medicaid 
DSH under section 1222(a). 
(b) PAYMENT ADJUSTMENTS IN RESPONSE TO COV-
ERAGE EXPANSION.— 
(1) IN GENERAL.—If there is a significant de-
crease in the national rate of uninsurance as a result 
of this Act (as determined under paragraph (2)(A)), 
then the Secretary of Health and Human Services 
shall, beginning in fiscal year 2015, implement the 
following adjustments to Medicare DSH: 
(A) In lieu of the amount of Medicare 
DSH payment that would otherwise be made 
under section 1886(d)(5)(F) of the Social Secu-
rity Act, the amount of Medicare DSH payment 
shall be an amount based on the recommenda-
tions of the report under subsection (a)(1)(A) 
and shall take into account variations in the 
empirical justification for Medicare DSH attrib-
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