Title: Making an extension of continuing appropriations for fiscal year 2018, and for other purposes.
Policy area: Economics and Public Finance

Summary:
This joint resolution amends the Continuing Appropriations Act, 2018 to extend the expiration date of the FY2018 Continuing Resolution (CR) from January 19, 2018, to February 16, 2018. The joint resolution provides continuing appropriations for federal agencies through the earlier of February 16, 2018, or the enactment of the applicable appropriations legislation. It prevents a government shutdown that would otherwise occur when the existing CR expires.
The joint resolution amends title XXI (Children's Health insurance Program) (CHIP) of the Social Security Act to extend funding through FY2023 for CHIP. In addition, the joint resolution: (1) extends through FY2023 funding for the Child Enrollment Contingency Fund, the Childhood Obesity Demonstration Project, the Pediatric Quality Measures Program, and specified outreach and enrollment grants; and (2) reauthorizes through FY2023 the qualifying-states option and the express-lane eligibility option.
Current law provides states with an enhanced Federal Matching Assistance Percentage (FMAP) for child-health assistance through FY2019. The joint resolution maintains the enhanced FMAP in FY2020, but halves the percentage-point increase.
The Centers for Medicare & Medicaid Services shall make additional funding available to states for specified activities related to mechanized claims systems.
The joint resolution amends the Internal Revenue Code and the Patient Protection and Affordable Care Act to suspend specified health-related taxes and fees.
Specified budgetary effects of the joint resolution shall be exempt from Pay-As-You-Go (PAYGO) rules and certain budget scorekeeping guidelines.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.J. Res. 125 Introduced in House (IH)]

<DOC>






115th CONGRESS
  2d Session
H. J. RES. 125

Making an extension of continuing appropriations for fiscal year 2018, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 16, 2018

 Mr. Frelinghuysen submitted the following joint resolution; which was 
  referred to the Committee on Appropriations, and in addition to the 
   Committees on Ways and Means, and the Budget, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                            JOINT RESOLUTION


 
Making an extension of continuing appropriations for fiscal year 2018, 
                        and for other purposes.

    Resolved by the Senate and House of Representatives of the United 
States of America in Congress assembled,

      DIVISION B--EXTENSION OF CONTINUING APPROPRIATIONS ACT, 2018

    Sec. 2001.  The Continuing Appropriations Act, 2018 (division D of 
Public Law 115-56) is amended--
            (1) by striking the date specified in section 106(3) and 
        inserting ``February 16, 2018''; and
            (2) by adding after section 147 the following:
    ``Sec. 148.  Funds appropriated by the Department of Defense 
Missile Defeat and Defense Enhancements Appropriations Act, 2018 
(division B of Public Law 115-96) may be obligated and expended 
notwithstanding section 504(a)(1) of the National Security Act of 1947 
(50 U.S.C. 3094(a)(1)).
    ``Sec. 149.  Amounts made available by section 101 for `Department 
of Agriculture--Food and Nutrition Service--Child Nutrition Programs' 
to carry out section 749(g) of the Agriculture Appropriations Act of 
2010 (Public Law 111-80) may be apportioned up to the rate for 
operations necessary to ensure that the program can be fully 
operational by May 2018.
    ``Sec. 150.  Amounts made available by section 101 for `National 
Aeronautics and Space Administration--Exploration' may be apportioned 
up to the rate for operations necessary to maintain the planned launch 
capability schedules for the Space Launch System launch vehicle, 
Exploration Ground Systems, and Orion Multi-Purpose Crew Vehicle 
programs.
    ``Sec. 151.  Amounts made available by section 101 for `Department 
of Energy--Energy Programs--Office of the Inspector General' may be 
apportioned up to the rate for operations necessary to sustain staffing 
levels achieved on June 30, 2017.
    ``Sec. 152.  Amounts made available by section 101 for `Small 
Business Administration--Business Loans Program Account' may be 
apportioned up to the rate for operations necessary to accommodate 
increased demand for commitments for general business loans authorized 
under section 7(a) of the Small Business Act (15 U.S.C. 636(a)).
    ``Sec. 153.  For 2018, the Secretary of Housing and Urban 
Development may make temporary adjustments to the Section 8 housing 
choice voucher annual renewal funding allocations and administrative 
fee eligibility determinations for public housing agencies in an area 
for which the President declared a disaster in 2017 or 2018 under title 
IV of the Robert T. Stafford Disaster Relief and Emergency Assistance 
Act (42 U.S.C. 5170 et seq.), to avoid significant adverse funding 
impacts that would otherwise result from the disaster and that would 
otherwise prevent a public housing agency from leasing up to its 
authorized level of units under contract (but not to exceed such 
level), upon request by and in consultation with a public housing 
agency and supported by documentation as required by the Secretary that 
demonstrates the need for the adjustment.''.
    Sec. 2002.  The Further Additional Continuing Appropriations Act, 
2018 (division A of Public Law 115-96) is amended by striking section 
1002.
     This division may be cited as the ``Extension of Continuing 
Appropriations Act, 2018''.

                      DIVISION C--HEALTHY KIDS ACT

SEC. 3001. 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'' or the ``HEALTHY KIDS Act''.

SEC. 3002. SIX-YEAR FUNDING EXTENSION OF THE CHILDREN'S HEALTH 
              INSURANCE PROGRAM.

    (a) Funding.--
            (1) In general.--Section 2104(a) of the Social Security Act 
        (42 U.S.C. 1397dd(a)), as amended by section 3201(a) of the 
        CHIP and Public Health Funding Extension Act (division C of 
        Public Law 115-96), is amended--
                    (A) in paragraph (20)(B), by striking ``; and'' and 
                inserting a semicolon; and
                    (B) by striking paragraph (21) and inserting 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;
            ``(25) for fiscal year 2022, $25,900,000,000; and
            ``(26) for fiscal year 2023, for purposes of making two 
        semi-annual allotments--
                    ``(A) $2,850,000,000 for the period beginning on 
                October 1, 2022, and ending on March 31, 2023; and
                    ``(B) $2,850,000,000 for the period beginning on 
                April 1, 2023, and ending on September 30, 2023.''.
            (2) Prevention of duplicate appropriations for fiscal year 
        2018.--Notwithstanding any other provision of law, insofar as 
        funds have been appropriated under subsection (a)(21) of 
        section 2104 of the Social Security Act (42 U.S.C. 1397dd), as 
        such subsection is in effect on the day before the date of the 
        enactment of this Act, to provide allotments to States under 
        the State Children's Health Insurance Program established under 
        title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) 
        (whether implemented under title XIX, XXI, or both, of the 
        Social Security Act) for fiscal year 2018--
                    (A) any amounts that are so appropriated that are 
                not so allotted and obligated before the date of the 
                enactment of this Act, are rescinded; and
                    (B) any amount provided for CHIP allotments to a 
                State under this section (and the amendments made by 
                this section) for such fiscal year shall be reduced by 
                the amount of such appropriations so allotted and 
                obligated before such date.
    (b) Allotments.--
            (1) In general.--Section 2104(m) of the Social Security Act 
        (42 U.S.C. 1397dd(m)), as amended by section 3201(b) of the 
        CHIP and Public Health Funding Extension Act (division C of 
        Public Law 115-96), is amended--
                    (A) in paragraph (2)(B)--
                            (i) in the matter preceding clause (i), by 
                        striking ``(19)'' and inserting ``(25)'';
                            (ii) in clause (i), by striking ``and 
                        2017'' and inserting ``, 2017, and 2023''; and
                            (iii) in clause (ii)--
                                    (I) in the matter preceding 
                                subclause (I), by striking ``and 
                                paragraph (10)''; and
                                    (II) in subclause (I), by inserting 
                                ``(or, in the case of fiscal year 2018, 
                                under paragraph (4))'' after ``clause 
                                (i)'';
                    (B) in paragraph (5), by striking ``2018'' and 
                inserting ``2023'';
                    (C) in paragraph (7)--
                            (i) in subparagraph (A), by striking 
                        ``2017'' and inserting ``2023'';
                            (ii) in subparagraph (B), in the matter 
                        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 subparagraph 
                        (B), by striking ``or fiscal year 2016'' and 
                        inserting ``fiscal year 2016, fiscal year 2018, 
                        fiscal year 2020, or fiscal year 2022'';
                    (D) in paragraph (9), by striking ``2018'' and 
                inserting ``2023''; and
                    (E) by amending paragraph (10) to read as follows:
            ``(10) For fiscal year 2023.--
                    ``(A) First half.--Subject to paragraphs (5) and 
                (7), from the amount made available under subparagraph 
                (A) of paragraph (26) of subsection (a) for the semi-
                annual period described in such subparagraph, increased 
                by the amount of the appropriation for such period 
                under section 3002(b)(2) of the HEALTHY KIDS Act, the 
                Secretary 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 first half ratio (described 
                in subparagraph (D)) of the amount described in 
                subparagraph (C).
                    ``(B) Second half.--Subject to paragraphs (5) and 
                (7), from the amount made available under subparagraph 
                (B) of paragraph (26) of subsection (a) for the semi-
                annual period described in such subparagraph, the 
                Secretary 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 subparagraph, 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 rebased amount.--
                The amount described in this subparagraph for a State 
                is equal to the Federal payments to the State that are 
                attributable to (and countable towards) the total 
                amount of allotments available under this section to 
                the State in fiscal year 2022 (including payments made 
                to the State under subsection (n) for fiscal year 2022 
                as well as amounts redistributed to the State in fiscal 
                year 2022), multiplied by the allotment increase factor 
                under paragraph (6) for fiscal year 2023.
                    ``(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)(26)(A); and
                                    ``(II) the amount of the 
                                appropriation for such period under 
                                section 3002(b)(2) 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)(26)(B).''.
            (2) One-time appropriation for fiscal year 2023.--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, 2022, and ending on March 31, 2023, 
        under paragraph (26)(A) of section 2104(a) of the Social 
        Security Act (42 U.S.C. 1397dd(a)) (as added by subsection 
        (a)), 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 paragraph (1)) for the 
        first 6 months of fiscal year 2023 in the same manner as 
        allotments are provided under subsection (a)(26)(A) of such 
        section 2104 and subject to the same terms and conditions as 
        apply to the allotments provided from such subsection 
        (a)(26)(A).
    (c) Extension of the Child Enrollment Contingency 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 2022''; and
                            (ii) by striking ``fiscal year 2015 and 
                        fiscal year 2017'' and inserting ``fiscal years 
                        2015, 2017, and 2023''; and
                    (B) in subparagraph (B)--
                            (i) by striking ``2010, 2011, 2012, 2013, 
                        2014, and 2016'' and inserting ``2010 through 
                        2014, 2016, and 2018 through 2022''; and
                            (ii) by striking ``fiscal year 2015 and 
                        fiscal year 2017'' and inserting ``fiscal years 
                        2015, 2017, and 2023''; and
            (2) in paragraph (3)(A), in the matter preceding clause 
        (i), by striking ``or a semi-annual allotment period for fiscal 
        year 2015 or 2017'' and inserting ``or in any of fiscal years 
        2018 through 2022 (or a semi-annual allotment period for fiscal 
        year 2015, 2017, or 2023)''.
    (d) Extension of Qualifying States Option.--
            (1) In general.--Section 2105(g)(4) of the Social Security 
        Act (42 U.S.C. 1397ee(g)(4)) is amended--
                    (A) in the heading, by striking ``through 2017'' 
                and inserting ``through 2023''; and
                    (B) in subparagraph (A), by striking ``2017'' and 
                inserting ``2023''.
            (2) Technical amendments.--Section 2104(f)(2)(B)(ii) of the 
        Social Security Act (42 U.S.C. 1397dd(f)(2)(B)(ii)), as amended 
        by section 3201(c) of the CHIP and Public Health Funding 
        Extension Act (division C of Public Law 115-96), is amended--
                    (A) in subclause (I), by striking ``for the month 
                (as defined in subclause (II))'' and inserting ``(as 
                defined in subclause (II)) for the month'';
                    (B) in subclause (II), by inserting ``, as in 
                effect on the day before the date of the enactment of 
                the HEALTHY KIDS Act,'' after ``section 
                2105(g)(4)(A)''; and
                    (C) in subclause (VI)--
                            (i) by inserting ``, as in effect on the 
                        day before the date of the enactment of the 
                        HEALTHY KIDS Act'' after ``, section 
                        2105(g)(4)''; and
                            (ii) by inserting ``, as so in effect'' 
                        after ``under section 2105(g)(4)''.
    (e) Extension of Express Lane Eligibility Option.--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 ``2023''.
    (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, 
                2023''; and
                    (B) in subparagraph (A), in the matter preceding 
                clause (i)--
                            (i) by striking ``2019'' and inserting 
                        ``2023''; and
                            (ii) by striking ``The preceding sentence 
                        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, 2023, 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, 
                2023''; and
                    (B) by striking ``September 30, 2019,'' and 
                inserting ``September 30, 2023 (but during the period 
                that begins on October 1, 2019, and ends on September 
                30, 2023, only 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)''.
    (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 construed as preventing a 
        State from considering children enrolled in a qualified CHIP 
        look-alike program 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 benefits that are at least identical to the 
                benefits provided under the State child health plan 
                under this title (or a waiver of such plan); and
                    ``(B) that is funded exclusively through non-
                Federal funds, including funds received by the State in 
                the form of premiums for the purchase of such 
                coverage.''.
            (2) Coverage rule.--
                    (A) In general.--Section 5000A(f)(1) of the 
                Internal Revenue Code of 1986 is amended in 
                subparagraph (A)(iii), by inserting ``or under a 
                qualified CHIP look-alike program (as defined in 
                section 2107(g) of the Social Security Act)'' before 
                the comma at the end.
                    (B) Effective date.--The amendment made by 
                subparagraph (A) shall apply with respect to taxable 
                years beginning after December 31, 2017.
    (h) Availability of Unused Fiscal Year 2018 Redistribution 
Amounts.--Any amounts that have been redistributed to States under 
subsection (f) of section 2104 of the Social Security Act (42 U.S.C. 
1397dd) for fiscal year 2018 that are not, or will not be, expended by 
the end of that fiscal year shall be--
            (1) adjusted by the Secretary before the end of fiscal year 
        2018 to reflect an updated estimate of shortfalls under 
        subsection (f)(2)(A) of such section; and
            (2) available for redistribution under subsection (f) of 
        such section for subsequent fiscal years.

SEC. 3003. EXTENSION OF CERTAIN PROGRAMS AND DEMONSTRATION PROJECTS.

    (a) Childhood Obesity Demonstration Project.--Section 1139A(e)(8) 
of the Social Security Act (42 U.S.C. 1320b-9a(e)(8)) is amended--
            (1) by striking ``and $10,000,000'' and inserting ``, 
        $10,000,000''; and
            (2) by inserting after ``2017'' the following: ``, and 
        $30,000,000 for the period of fiscal years 2018 through 2023''.
    (b) Pediatric Quality Measures Program.--Section 1139A(i) of the 
Social Security Act (42 U.S.C. 1320b-9a(i)) is amended--
            (1) by striking ``Out of any'' and inserting the following:
            ``(1) In general.--Out of any'';
            (2) by striking ``there is appropriated for each'' and 
        inserting ``there is appropriated--
                    ``(A) for each'';
            (3) by striking ``, and there is appropriated for the 
        period'' and inserting ``;
                    ``(B) for the period'';
            (4) by striking ``. Funds appropriated under this 
        subsection shall remain available until expended.'' and 
        inserting ``; and''; and
            (5) by adding at the end the following:
                    ``(C) for the period of fiscal years 2018 through 
                2023, $90,000,000 for the purpose of carrying out this 
                section (other than subsections (e), (f), and (g)).
            ``(2) Availability.--Funds appropriated under this 
        subsection shall remain available until expended.''.

SEC. 3004. EXTENSION OF OUTREACH AND ENROLLMENT PROGRAM.

    (a) In General.--Section 2113 of the Social Security Act (42 U.S.C. 
1397mm) is amended--
            (1) in subsection (a)(1), by striking ``2017'' and 
        inserting ``2023''; and
            (2) in subsection (g)--
                    (A) by striking ``and $40,000,000'' and inserting 
                ``, $40,000,000''; and
                    (B) by inserting after ``2017'' the following: ``, 
                and $120,000,000 for the period of fiscal years 2018 
                through 2023''.
    (b) Making Organizations That Use Parent Mentors Eligible To 
Receive Grants.--Section 2113(f) of the Social Security Act (42 U.S.C. 
1397mm(f)) is amended--
            (1) in paragraph (1)(E), by striking ``or community-based 
        doula programs'' and inserting ``, community-based doula 
        programs, or parent mentors''; and
            (2) by adding at the end the following new paragraph:
            ``(5) Parent mentor.--The term `parent mentor' means an 
        individual who--
                    ``(A) is a parent or guardian of at least one child 
                who is an eligible child under this title or title XIX; 
                and
                    ``(B) is trained to assist families with children 
                who have no health insurance coverage with respect to 
                improving the social determinants of the health of such 
                children, including by providing--
                            ``(i) education about health insurance 
                        coverage, including, with respect to obtaining 
                        such coverage, eligibility criteria and 
                        application and renewal processes;
                            ``(ii) assistance with completing and 
                        submitting applications for health insurance 
                        coverage;
                            ``(iii) a liaison between families and 
                        representatives of State plans under title XIX 
                        or State child health plans under this title;
                            ``(iv) guidance on identifying medical and 
                        dental homes and community pharmacies for 
                        children; and
                            ``(v) assistance and referrals to 
                        successfully address social determinants of 
                        children's health, including poverty, food 
                        insufficiency, and housing.''.
    (c) Exclusion From Modified Adjusted Gross Income.--Section 1902(e) 
of the Social Security Act (42 U.S.C. 1396a(e)) is amended--
            (1) in the first paragraph (14), relating to income 
        determined using modified adjusted gross income, by adding at 
        the end the following new subparagraph:
                    ``(J) Exclusion of parent mentor compensation from 
                income determination.--Any nominal amount received by 
                an individual as compensation, including a stipend, for 
                participation as a parent mentor (as defined in 
                paragraph (5) of section 2113(f)) in an activity or 
                program funded through a grant under such section shall 
                be disregarded for purposes of determining the income 
                eligibility of such individual for medical assistance 
                under the State plan or any waiver of such plan.''; and
            (2) by striking ``(14) Exclusion'' and inserting ``(15) 
        Exclusion''.

SEC. 3005. EXTENSION AND REDUCTION OF ADDITIONAL FEDERAL FINANCIAL 
              PARTICIPATION FOR CHIP.

    Section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) is 
amended in the second sentence by inserting ``and during the period 
that begins on October 1, 2019, and ends on September 30, 2020, the 
enhanced FMAP determined for a State for a fiscal year (or for any 
portion of a fiscal year occurring during such period) shall be 
increased by 11.5 percentage points'' after ``23 percentage points,''.

SEC. 3006. MEDICAID IMPROVEMENT FUND.

    Section 1941 of the Social Security Act (42 U.S.C. 1396w-1) is 
amended--
            (1) in subsection (a), in the first sentence, by inserting 
        before the period at the end the following: ``, and, in 
        accordance with subsection (b)(3), for the purposes of 
        subparagraph (B) of such subsection''; and
            (2) in subsection (b)--
                    (A) in paragraph (2)--
                            (i) in the first sentence, by inserting 
                        ``pursuant to paragraph (1)'' after ``in the 
                        Fund'';
                            (ii) by inserting after the first sentence 
                        the following sentence: ``Amounts in the Fund 
                        pursuant to paragraph (3) shall be available in 
                        advance of appropriations but only if the total 
                        amount obligated from the Fund does not exceed 
                        the amount available to the Fund under such 
                        paragraph (3).''; and
                            (iii) in the last sentence, by striking 
                        ``sentence'' and inserting ``sentences''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(3) Additional funding for state activities relating to 
        mechanized claims systems.--
                    ``(A) In general.--In addition to the amount made 
                available under paragraph (1), there shall be available 
                to the Fund, for expenditures from the Fund in 
                accordance with subparagraph (B), for fiscal year 2023 
                and thereafter, $980,000,000, to remain available until 
                expended.
                    ``(B) Purposes.--The Secretary shall use amounts 
                made available to the Fund under subparagraph (A) to 
                pay to each State which has a plan approved under this 
                title, for each quarter beginning during or after 
                fiscal year 2023 an amount equal to--
                            ``(i) 100 percent minus the percent 
                        specified in clause (i) of section 
                        1903(a)(3)(A) of so much of the sums expended 
                        by the State during such quarter as are 
                        attributable to the activities described in 
                        such clause;
                            ``(ii) 100 percent minus the Federal 
                        medical assistance percentage applied under 
                        clause (iii) of such section of so much of the 
                        sums expended during such quarter (as found 
                        necessary by the Secretary under such clause) 
                        by the State as are attributable to the 
                        activities described in such clause; and
                            ``(iii) 100 percent minus the percent 
                        specified in section 1903(a)(3)(B) of so much 
                        of the sums expended by the State during such 
                        quarter as are attributable to the activities 
                        described in such section.''.

         DIVISION D--SUSPENSION OF CERTAIN HEALTH-RELATED TAXES

SEC. 4001. EXTENSION OF MORATORIUM ON MEDICAL DEVICE EXCISE TAX.

    (a) In General.--Section 4191(c) of the Internal Revenue Code of 
1986 is amended by striking ``December 31, 2017'' and inserting 
``December 31, 2019''.
    (b) Effective Date.--The amendment made by this section shall apply 
to sales after December 31, 2017.

SEC. 4002. DELAY IN IMPLEMENTATION OF EXCISE TAX ON HIGH COST EMPLOYER-
              SPONSORED HEALTH COVERAGE.

    Section 9001(c) of the Patient Protection and Affordable Care Act 
is amended by striking ``December 31, 2019'' and inserting ``December 
31, 2021''.

SEC. 4003. SUSPENSION OF ANNUAL FEE ON HEALTH INSURANCE PROVIDERS.

    (b) In General.--Section 9010(j) of the Patient Protection and 
Affordable Care Act is amended--
            (1) by striking ``and'' at the end of paragraph (1);
            (2) by striking the period at the end of paragraph (2) and 
        inserting ``, and ending before January 1, 2019, and''; and
            (3) by adding at the end the following new paragraph:
            ``(3) beginning after December 31, 2019.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to calendar years beginning after December 31, 2018.

                     DIVISION E--BUDGETARY EFFECTS

SEC. 5001. BUDGETARY EFFECTS.

    (a) In General.--The budgetary effects of division C and each 
succeeding division shall not be entered on either PAYGO scorecard 
maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act 
of 2010.
    (b) Senate PAYGO Scorecards.--The budgetary effects of division C 
and each succeeding division shall not be entered on any PAYGO 
scorecard maintained for purposes of section 4106 of H. Con. Res. 71 
(115th Congress).
    (c) Classification of Budgetary Effects.--Notwithstanding Rule 3 of 
the Budget Scorekeeping Guidelines set forth in the joint explanatory 
statement of the committee of conference accompanying Conference Report 
105-217 and section 250(c)(8) of the Balanced Budget and Emergency 
Deficit Control Act of 1985, the budgetary effects of division C and 
each succeeding division shall not be estimated--
            (1) for purposes of section 251 of such Act; and
            (2) for purposes of paragraph (4)(C) of section 3 of the 
        Statutory Pay-As-You-Go Act of 2010 as being included in an 
        appropriation Act.
                                 <all>