To provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016.

Bill: 114-hr-3762
Sponsor: full_name: Rep. Price, Tom [R-GA-6]
Introduced: 2015-10-16
Policy area: Health
Subjects: Abortion

Appropriations

Drug trafficking and controlled substances

Drug, alcohol, tobacco use

Employee benefits and pensions

Employment taxes

Family planning and birth control

Government trust funds

Health care costs and insurance

Health care coverage and access

Health facilities and institutions

Health programs administration and funding

Health promotion and preventive care

Health technology, devices, supplies

Hospital care

Income tax credits

Income tax deductions

Medicaid

Medical education

Medicare

Mental health

Prescription drugs

Sales and excise taxes

Self-employed

Sex and reproductive health

Small business

Tax administration and collection, taxpayers

Tax-exempt organizations

Women's health
Latest action: action_date: 2016-02-02
text: On passage, the objections of the President to the contrary notwithstanding Failed by the Yeas and Nays: (2/3 required): 241 - 186 (Roll no. 53). (consideration: CR H482)

Summaries:
action_date: 2015-10-16
action_desc: Introduced in House
text: <p><b>Restoring Americans&rsquo; Healthcare Freedom Reconciliation Act of 2015</b></p> <p> This bill amends the Fair Labor Standards Act of 1938 to repeal the requirement that certain employers automatically enroll their employees in a health plan. <p>This bill amends the Patient Protection and Affordable Care Act (PPACA) to terminate the Prevention and Public Health Fund, which provides for investment in prevention and public health programs to improve health and help restrain the rate of growth in health care costs. Unobligated funds are rescinded.</p> <p>For one year, no federal funds may be made available to a state for payments to an entity (e.g., Planned Parenthood Federation of America) that:</p> <ul> <li>is a 501(c)(3) tax-exempt organization;</li> <li>is an essential community provider primarily engaged in family planning services and reproductive health;</li> <li>provides for elective abortions; and</li> <li>received a total of more than $350 million under Medicaid in FY2014, including payments to affiliates, subsidiaries, successors, or clinics.</li> </ul> <p>Funding for community health centers is increased.</p> <p>This bill amends the Internal Revenue Code to eliminate the requirement for individuals to maintain minimum essential health care coverage and the requirement for certain large employers to make shared responsibility payments, effective after December 31, 2014.</p> <p>The excise tax on medical devices is repealed.</p> <p>The excise tax on high cost employer-sponsored health coverage (popularly known as the &ldquo;Cadillac tax&rdquo;) is repealed after December 31, 2017. After 2014, W-2 forms no longer need to include the cost of employer-sponsored coverage.</p> The Independent Medicare Advisory Board is terminated, effective as of enactment of PPACA.

action_date: 2015-10-16
action_desc: Reported to House without amendment
text: <p><b>Restoring Americans&rsquo; Healthcare Freedom Reconciliation Act of 2015</b></p> <p>TITLE I--COMMITTEE ON EDUCATION AND THE WORKFORCE</p> <p>(Sec. 101) This bill amends the Fair Labor Standards Act of 1938 to repeal the requirement that certain employers automatically enroll their employees in a health plan.</p> <p>TITLE II--COMMITTEE ON ENERGY AND COMMERCE</p> <p>(Sec. 201) This bill amends the Patient Protection and Affordable Care Act (PPACA) to terminate the Prevention and Public Health Fund, which provides for investment in prevention and public health programs to improve health and help restrain the rate of growth in health care costs. Unobligated funds are rescinded.</p> <p>(Sec. 202) For one year, no federal funds may be made available to a state for payments to an entity (e.g., Planned Parenthood Federation of America) that:</p> <ul> <li>is a 501(c)(3) tax-exempt organization;</li> <li>is an essential community provider primarily engaged in family planning services and reproductive health;</li> <li>provides for elective abortions; and</li> <li>received a total of more than $350 million under Medicaid in FY2014, including payments to affiliates, subsidiaries, successors, or clinics.</li> </ul> <p>(Sec. 203) Funding for community health centers is increased.</p> <p>TITLE III--COMMITTEE ON WAYS AND MEANS</p> <p>Subtitle A--Revenue Provisions</p> <p>(Sec. 301) This bill amends the Internal Revenue Code to eliminate the requirement for individuals to maintain minimum essential health care coverage and the requirement for certain large employers to make shared responsibility payments, effective after December 31, 2014.</p> <p>(Sec. 303) The excise tax on medical devices is repealed.</p> <p>(Sec. 304) The excise tax on high cost employer-sponsored health coverage (popularly known as the &ldquo;Cadillac tax&rdquo;) is repealed after December 31, 2017. After 2014, W-2 forms no longer need to include the cost of employer-sponsored coverage.</p> <p>Subtitle B--Repeal of Independent Payment Advisory Board</p> (Sec. 311) The Independent Medicare Advisory Board is terminated, effective as of enactment of PPACA.

action_date: 2015-10-23
action_desc: Passed House amended
text: <p><b>Restoring Americans&rsquo; Healthcare Freedom Reconciliation Act of 2015</b></p> <p>TITLE I--COMMITTEE ON ENERGY AND COMMERCE</p> <p>(Sec. 101) This bill amends the Patient Protection and Affordable Care Act (PPACA) to terminate the Prevention and Public Health Fund, which provides for investment in prevention and public health programs to improve health and help restrain the rate of growth in health care costs. Unobligated funds are rescinded.</p> <p>(Sec. 102) For one year, no federal funds may be made available to a state for direct payments, or payments through a managed care organization, to an entity (e.g., Planned Parenthood Federation of America) that:</p> <ul> <li>is a 501(c)(3) tax-exempt organization;</li> <li>is an essential community provider primarily engaged in family planning services and reproductive health;</li> <li>provides for abortions other than abortions in cases of rape or incest, or where a physical condition endangers a woman's life unless an abortion is performed; and</li> <li>received a total of more than $350 million under Medicaid in FY2014, including payments to affiliates, subsidiaries, successors, or clinics.</li> </ul> <p>(Sec. 103) Funding for community health centers is increased.</p> <p>TITLE II--COMMITTEE ON WAYS AND MEANS</p> <p>(Sec. 201) This bill amends the Internal Revenue Code to eliminate the requirement for individuals to maintain minimum essential health care coverage and the requirement for certain large employers to make shared responsibility payments, effective after December 31, 2014.</p> <p>(Sec. 203) The excise tax on medical devices is repealed.</p> <p>(Sec. 204) The excise tax on high cost employer-sponsored health coverage (popularly known as the &ldquo;Cadillac tax&rdquo;) is repealed after December 31, 2017. After 2014, W-2 forms no longer need to include the cost of employer-sponsored coverage.</p>

action_date: 2015-12-03
action_desc: Passed Senate amended
text: <p>TITLE I--HEALTH, EDUCATION, LABOR, AND PENSIONS</p> <p>(Sec. 101) This bill amends the Patient Protection and Affordable Care Act (PPACA) to terminate the Prevention and Public Health Fund, which provides for investment in prevention and public health programs to improve health and restrain the rate of growth in health care costs. Unobligated funds are rescinded.</p> <p>(Sec. 102) Funding for community health centers is increased.</p> <p>(Sec. 103) Certain funding for U.S. territories that establish health insurance exchanges is no longer available after 2017. </p> <p>(Sec. 104) The Department of Health and Human Services (HHS) may not collect fees or make payments under the transitional reinsurance program.</p> <p>(Sec. 105) This bill makes appropriations for FY2016 and FY2017 for HHS to award grants to states to address substance abuse or to respond to urgent mental health needs.</p> <p>TITLE II--FINANCE</p> <p>(Sec. 201) This bill amends the Internal Revenue Code to require individuals to pay back the full amount of advance payments in excess of their premium assistance tax credit. (Currently, there is a limit on the amount of excess an individual must pay back.)</p> <p>(Sec. 202) Provisions relating to the premium assistance tax credit, reduced cost-sharing, and eligibility determinations for these subsidies are repealed on December 31, 2017.</p> <p>(Sec. 203) The small employer health insurance tax credit does not apply after 2017. (This credit is for certain employers who make contributions toward employee health coverage purchased through a health insurance exchange.) </p> <p>(Sec. 204) The penalty for individuals who do not maintain minimum essential health care coverage is eliminated.</p> <p>(Sec. 205) Large employers are no longer required to make shared responsibility payments.</p> <p>(Sec. 206) For one year, this bill restricts the availability of federal funding to a state for payments to an entity (e.g., Planned Parenthood Federation of America) that:</p> <ul> <li>is a 501(c)(3) tax-exempt organization;</li> <li>is an essential community provider primarily engaged in family planning services and reproductive health;</li> <li>provides for abortions other than abortions in cases of rape or incest, or where a physical condition endangers a woman's life unless an abortion is performed; and</li> <li>received a total of more than $350 million under Medicaid in FY2014, including payments to affiliates, subsidiaries, successors, or clinics.</li> </ul> <p>(Sec. 207) This bill amends part A (General Provisions) of title XI of the Social Security Act (SSAct) to require the additional payments to U.S. territories for Medicaid under the Health Care and Education Reconciliation Act of 2010 to be made by the end of FY2017 instead of the end of FY2019.</p> <p>This bill amends title XIX (Medicaid) of the SSAct to end the expansion of Medicaid under PPACA on December 31, 2017.</p> <p>After 2017, hospitals may no longer elect to provide Medicaid services to individuals during a presumptive eligibility period.</p> <p>States must maintain Medicaid eligibility standards for individuals under 19 years old through FY2017 instead of through FY2019.</p> <p>The federal medical assistance percentage (FMAP, the federal matching rate for Medicaid expenditures) for U.S. territories is 50% after 2017 (currently, the FMAP is 55%).</p> <p>The increased FMAP for childless adults and home and community-based attendant services under PPACA ends December 31, 2017.</p> <p>After 2017, states may no longer elect to provide certain individuals with a presumptive eligibility period for Medicaid.</p> <p>Medicaid benchmark plans are no longer required to provide minimum essential health benefits after 2017.</p> <p>After 2017, states are no longer required to operate a website for Medicaid enrollment that is linked to the state's health benefit exchange and Children's Health Insurance program (CHIP).</p> <p>(Sec. 208) Medicaid allotments for disproportionate share hospitals are increased.</p> <p>(Sec. 209) The excise tax on high cost employer-sponsored health coverage (popularly known as the &quot;Cadillac tax&quot;) does not apply after 2017.</p> <p>(Sec. 210) Health savings accounts (HSAs), Archer medical savings accounts (MSAs), health flexible spending arrangements (HFSAs), and health reimbursement arrangements may be used to pay for over-the-counter medications.</p> <p>(Sec. 211) This bill lowers the tax on distributions from HSAs and Archer MSAs that are not used for medical expenses.</p> <p>(Sec. 212) Salary reduction contributions to an HFSA under a cafeteria plan are no longer limited.</p> <p>(Sec. 213) The annual fee on manufacturers and importers of brand name prescription drugs is eliminated.</p> <p>(Sec. 214) The excise tax on medical devices is eliminated.</p> <p>(Sec. 215) The annual fee on health insurers is eliminated.</p> <p>(Sec. 216) Medical costs are allowed as a tax deduction regardless of whether the costs are taken into account when determining the amount of the subsidy for an employer-sponsored retiree prescription drug plan under Medicare part D (Voluntary Prescription Drug Benefit Program).</p> <p>(Sec. 217) A tax deduction is allowed for medical expenses in excess of 7.5% (currently, 10%) of adjusted gross income.</p> <p>(Sec. 218) The additional Medicare tax on income above a certain threshold is eliminated.</p> <p>(Sec. 219) The indoor tanning services tax is eliminated.</p> <p>(Sec. 220) The net investment income tax is eliminated.</p> <p>(Sec. 221) A health insurer is allowed a tax deduction for the full amount of an employee's compensation. (Currently, there is a limit on the amount of an employee's compensation that a health insurer may deduct.)</p> <p>(Sec. 222) Provisions relating to the economic substance doctrine are repealed. (The economic substance doctrine treats a transaction as having economic substance if it has a purpose other than reducing income taxes. Currently, there are penalties for claiming tax benefits for transactions without economic substance.)</p> <p>(Sec. 223) Funds are transferred from the Department of the Treasury to the Federal Hospital Insurance Trust Fund.</p>

tv_txt: IB 114th CONGRESS 1st Session H. R. 3762 IN THE HOUSE OF REPRESENTATIVES AN ACT To provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016.

1. Short title; table of contents (a) Short title This Act may be cited as the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015 . (b) Table of contents The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Title I—Committee on Energy and Commerce Sec. 101. Repeal of the Prevention and Public Health Fund. Sec. 102. Federal payment to States. Sec. 103. Funding for community health center program. Title II—Committee on Ways and Means Sec. 201. Repeal of individual mandate. Sec. 202. Repeal of employer mandate. Sec. 203. Repeal of medical device excise tax. Sec. 204. Repeal of the tax on employee health insurance premiums and health plan benefits and related reporting requirements. I Committee on Energy and Commerce 101. Repeal of the Prevention and Public Health Fund (a) In general Section 4002 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 300u–11 ) is repealed. (b) Rescission of unobligated funds Of the funds made available by such section 4002, the unobligated balance is rescinded. 102. Federal payment to States (a) In general Notwithstanding section 504(a), 1902(a)(23), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act ( 42 U.S.C. 704(a) , 1396b(a)(23), 1397a, 1397d(a)(4), 1397bb(a)(2), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act ( 42 U.S.C. 1315 , 1396n), for the 1-year period beginning on the date of the enactment of this Act no Federal funds may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State. (b) Definition of prohibited entity In this section, the term prohibited entity means an entity, including its affiliates, subsidiaries, successors, and clinics— (1) that, as of the date of enactment of this Act— (A) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; (B) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations, that is primarily engaged in family planning services, reproductive health, and related medical care; and (C) provides for abortions, other than an abortion— (i) if the pregnancy is the result of an act of rape or incest; or (ii) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and (2) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000. 103. Funding for community health center program Effective as if included in the enactment of the Medicare Access and CHIP Reauthorization Act of 2015 ( Public Law 114–10 , 129 Stat. 87), paragraph (1) of section 221(a) of such Act is amended by inserting after Section 10503(b)(1)(E) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 254b–2(b)(1)(E) ) is amended the following: by striking $3,600,000,000 and inserting $3,835,000,000 and . II Committee on Ways and Means 201. Repeal of individual mandate (a) In general Section 5000A of the Internal Revenue Code of 1986 is amended by adding at the end the following: (h) Termination This section shall not apply with respect to any month beginning after December 31, 2014. . (b) Conforming amendments (1) Section 5000A(c) of such Code is amended— (A) in paragraph (2)(B) by striking clauses (ii) and (iii), (B) in paragraph (3)(B) by striking 2014 and all that follows and inserting 2014. , and (C) in paragraph (3) by striking subparagraph (D). (2) Section 5000A(e)(1) of such Code is amended by striking subparagraph (D). (c) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 202. Repeal of employer mandate (a) In general Section 4980H of the Internal Revenue Code of 1986 is amended by adding at the end the following: (e) Termination This section shall not apply with respect to any month beginning after December 31, 2014. . (b) Conforming Amendment Section 4980H(c) of such Code is amended by striking paragraph (5). (c) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 203. Repeal of medical device excise tax (a) In general Chapter 32 of the Internal Revenue Code of 1986 is amended by striking subchapter E. (b) Conforming amendments (1) Subsection (a) of section 4221 of such Code is amended by striking the last sentence. (2) Paragraph (2) of section 6416(b) of such Code is amended by striking the last sentence. (c) Clerical amendment The table of subchapters for chapter 32 of such Code is amended by striking the item relating to subchapter E. (d) Effective date The amendments made by this section shall apply to sales in calendar quarters beginning after the date of the enactment of this Act. 204. Repeal of the tax on employee health insurance premiums and health plan benefits and related reporting requirements (a) Excise tax Chapter 43 of the Internal Revenue Code of 1986 is amended by striking section 4980I. (b) Reporting requirement Section 6051(a) of such Code is amended by inserting and at the end of paragraph (12), by striking , and at the end of paragraph (13) and inserting a period, and by striking paragraph (14). (c) Clerical amendment The table of sections for chapter 43 of such Code is amended by striking the item relating to section 4980I. (d) Effective dates (1) In general Except as provided by paragraph (2), the amendments made by this section shall apply to taxable years beginning after December 31, 2017. (2) Reporting requirement The amendment made by subsection (b) shall apply to calendar years beginning after December 31, 2014.

Passed the House of Representatives October 23, 2015. Karen L. Haas, Clerk.

tv_txt: IB Union Calendar No. 222 114th CONGRESS 1st Session H. R. 3762 [Report No. 114–293] IN THE HOUSE OF REPRESENTATIVES October 16, 2015 Mr. Price of Georgia reported the following bill; which was committed to the Committee of the Whole House on the State of the Union and ordered to be printed A BILL To provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016.

1. Short title; table of contents (a) Short title This Act may be cited as the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015 . (b) Table of contents The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Title I—Committee on Education and the Workforce Sec. 101. Repeal of automatic enrollment requirement. Title II—Committee on Energy and Commerce Sec. 201. Repeal of the Prevention and Public Health Fund. Sec. 202. Federal payment to States. Sec. 203. Funding for community health center program. Title III—Committee on Ways and Means Subtitle A—Revenue Provisions Sec. 301. Repeal of individual mandate. Sec. 302. Repeal of employer mandate. Sec. 303. Repeal of medical device excise tax. Sec. 304. Repeal of the tax on employee health insurance premiums and health plan benefits and related reporting requirements. Subtitle B—Repeal of Independent Payment Advisory Board Sec. 311. Repeal of Independent Payment Advisory Board. I Committee on Education and the Workforce 101. Repeal of automatic enrollment requirement The Fair Labor Standards Act of 1938 ( 29 U.S.C. 201 et seq. ) is amended by repealing section 18A (as added by section 1511 of the Patient Protection and Affordable Care Act ( Public Law 111–148 )). II Committee on Energy and Commerce 201. Repeal of the Prevention and Public Health Fund (a) In general Section 4002 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 300u–11 ) is repealed. (b) Rescission of unobligated funds Of the funds made available by such section 4002, the unobligated balance is rescinded. 202. Federal payment to States (a) In general Notwithstanding sections 504(a), 1902(a)(23), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act ( 42 U.S.C. 704(a) , 1396b(a)(23), 1397a, 1397d(a)(4), 1397bb(a)(2), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act ( 42 U.S.C. 1315 , 1396n), for the one-year period beginning on the date of the enactment of this Act no Federal funds may be made available to a State for payments to a prohibited entity. (b) Definition of prohibited entity In this section, the term prohibited entity means an entity, including its affiliates, subsidiaries, successors, and clinics— (1) that, as of the date of enactment of this Act— (A) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; (B) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations, that is primarily engaged in family planning services, reproductive health, and related medical care; and (C) provides for elective abortions; and (2) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000. 203. Funding for community health center program Effective as if included in the enactment of the Medicare Access and CHIP Reauthorization Act of 2015 ( Public Law 114–10 , 129 Stat. 87), paragraph (1) of section 221(a) of such Act is amended by inserting after Section 10503(b)(1)(E) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 254b-2(b)(1)(E) ) is amended the following: by striking $3,600,000,000 and inserting $3,835,000,000 and . III Committee on Ways and Means A Revenue Provisions 301. Repeal of individual mandate (a) In general Section 5000A of the Internal Revenue Code of 1986 is amended by adding at the end the following: (h) Termination This section shall not apply with respect to any month beginning after December 31, 2014. . (b) Conforming amendments (1) Section 5000A(c) of such Code is amended— (A) in paragraph (2)(B) by striking clauses (ii) and (iii), (B) in paragraph (3)(B) by striking 2014 and all that follows and inserting 2014. , and (C) in paragraph (3) by striking subparagraph (D). (2) Section 5000A(e)(1) of such Code is amended by striking subparagraph (D). (c) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 302. Repeal of employer mandate (a) In general Section 4980H of the Internal Revenue Code of 1986 is amended by adding at the end the following: (e) Termination This section shall not apply with respect to any month beginning after December 31, 2014. . (b) Conforming Amendment Section 4980H(c) of such Code is amended by striking paragraph (5). (c) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 303. Repeal of medical device excise tax (a) In general Chapter 32 of the Internal Revenue Code of 1986 is amended by striking subchapter E. (b) Conforming amendments (1) Subsection (a) of section 4221 of such Code is amended by striking the last sentence. (2) Paragraph (2) of section 6416(b) of such Code is amended by striking the last sentence. (c) Clerical amendment The table of subchapters for chapter 32 of such Code is amended by striking the item relating to subchapter E. (d) Effective date The amendments made by this section shall apply to sales in calendar quarters beginning after the date of the enactment of this Act. 304. Repeal of the tax on employee health insurance premiums and health plan benefits and related reporting requirements (a) Excise tax Chapter 43 of the Internal Revenue Code of 1986 is amended by striking section 4980I. (b) Reporting requirement Section 6051(a) of such Code is amended by inserting and at the end of paragraph (12), by striking , and at the end of paragraph (13) and inserting a period, and by striking paragraph (14). (c) Clerical amendment The table of sections for chapter 43 of such Code is amended by striking the item relating to section 4980I. (d) Effective dates (1) In general Except as provided by paragraph (2), the amendments made by this section shall apply to taxable years beginning after December 31, 2017. (2) Reporting requirement The amendment made by subsection (b) shall apply to calendar years beginning after December 31, 2014. B Repeal of Independent Payment Advisory Board 311. Repeal of Independent Payment Advisory Board Effective as of the enactment of the Patient Protection and Affordable Care Act ( Public Law 111–148 ), sections 3403 and 10320 of such Act (including the amendments made by such sections) are repealed, and any provision of law amended by such sections is hereby restored as if such sections had not been enacted into law.

October 16, 2015 Committed to the Committee of the Whole House on the State of the Union and ordered to be printed

tv_txt: II Calendar No. 299 114th CONGRESS 1st Session H. R. 3762 IN THE SENATE OF THE UNITED STATES November 18, 2015 Received; read the first time November 19, 2015 Read the second time and placed on the calendar AN ACT To provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016.

1. Short title; table of contents (a) Short title This Act may be cited as the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015 . (b) Table of contents The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Title I—Committee on Energy and Commerce Sec. 101. Repeal of the Prevention and Public Health Fund. Sec. 102. Federal payment to States. Sec. 103. Funding for community health center program. Title II—Committee on Ways and Means Sec. 201. Repeal of individual mandate. Sec. 202. Repeal of employer mandate. Sec. 203. Repeal of medical device excise tax. Sec. 204. Repeal of the tax on employee health insurance premiums and health plan benefits and related reporting requirements. I Committee on Energy and Commerce 101. Repeal of the Prevention and Public Health Fund (a) In general Section 4002 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 300u–11 ) is repealed. (b) Rescission of unobligated funds Of the funds made available by such section 4002, the unobligated balance is rescinded. 102. Federal payment to States (a) In general Notwithstanding section 504(a), 1902(a)(23), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act ( 42 U.S.C. 704(a) , 1396b(a)(23), 1397a, 1397d(a)(4), 1397bb(a)(2), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act ( 42 U.S.C. 1315 , 1396n), for the 1-year period beginning on the date of the enactment of this Act no Federal funds may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State. (b) Definition of prohibited entity In this section, the term prohibited entity means an entity, including its affiliates, subsidiaries, successors, and clinics— (1) that, as of the date of enactment of this Act— (A) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; (B) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations, that is primarily engaged in family planning services, reproductive health, and related medical care; and (C) provides for abortions, other than an abortion— (i) if the pregnancy is the result of an act of rape or incest; or (ii) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and (2) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000. 103. Funding for community health center program Effective as if included in the enactment of the Medicare Access and CHIP Reauthorization Act of 2015 ( Public Law 114–10 , 129 Stat. 87), paragraph (1) of section 221(a) of such Act is amended by inserting after Section 10503(b)(1)(E) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 254b–2(b)(1)(E) ) is amended the following: by striking $3,600,000,000 and inserting $3,835,000,000 and . II Committee on Ways and Means 201. Repeal of individual mandate (a) In general Section 5000A of the Internal Revenue Code of 1986 is amended by adding at the end the following: (h) Termination This section shall not apply with respect to any month beginning after December 31, 2014. . (b) Conforming amendments (1) Section 5000A(c) of such Code is amended— (A) in paragraph (2)(B) by striking clauses (ii) and (iii), (B) in paragraph (3)(B) by striking 2014 and all that follows and inserting 2014. , and (C) in paragraph (3) by striking subparagraph (D). (2) Section 5000A(e)(1) of such Code is amended by striking subparagraph (D). (c) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 202. Repeal of employer mandate (a) In general Section 4980H of the Internal Revenue Code of 1986 is amended by adding at the end the following: (e) Termination This section shall not apply with respect to any month beginning after December 31, 2014. . (b) Conforming Amendment Section 4980H(c) of such Code is amended by striking paragraph (5). (c) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 203. Repeal of medical device excise tax (a) In general Chapter 32 of the Internal Revenue Code of 1986 is amended by striking subchapter E. (b) Conforming amendments (1) Subsection (a) of section 4221 of such Code is amended by striking the last sentence. (2) Paragraph (2) of section 6416(b) of such Code is amended by striking the last sentence. (c) Clerical amendment The table of subchapters for chapter 32 of such Code is amended by striking the item relating to subchapter E. (d) Effective date The amendments made by this section shall apply to sales in calendar quarters beginning after the date of the enactment of this Act. 204. Repeal of the tax on employee health insurance premiums and health plan benefits and related reporting requirements (a) Excise tax Chapter 43 of the Internal Revenue Code of 1986 is amended by striking section 4980I. (b) Reporting requirement Section 6051(a) of such Code is amended by inserting and at the end of paragraph (12), by striking , and at the end of paragraph (13) and inserting a period, and by striking paragraph (14). (c) Clerical amendment The table of sections for chapter 43 of such Code is amended by striking the item relating to section 4980I. (d) Effective dates (1) In general Except as provided by paragraph (2), the amendments made by this section shall apply to taxable years beginning after December 31, 2017. (2) Reporting requirement The amendment made by subsection (b) shall apply to calendar years beginning after December 31, 2014.

Passed the House of Representatives October 23, 2015. Karen L. Haas, Clerk

November 19, 2015 Read the second time and placed on the calendar

tv_txt: 114th CONGRESS 1st Session H.R. 3762 In the Senate of the United States, December 3, 2015. Amendment:

That the bill from the House of Representatives (H.R. 3762) entitled An Act to provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016. , do pass with the following Strike all after the enacting clause and insert the following: I Health, Education, Labor, and Pensions 101. The prevention and public health fund (a) In general Subsection (b) of section 4002 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 300u–11 ) is amended— (1) in paragraph (2), by striking 2017 and inserting 2015 ; and (2) by striking paragraphs (3) through (5). (b) Rescission of unobligated funds Of the funds made available by such section 4002, the unobligated balance is rescinded. 102. Community health center program Effective as if included in the enactment of the Medicare Access and CHIP Reauthorization Act of 2015 ( Public Law 114–10 , 129 Stat. 87), paragraph (1) of section 221(a) of such Act is amended by inserting after Section 10503(b)(1)(E) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 254b–2(b)(1)(E) ) is amended the following: by striking $3,600,000,000 and inserting $3,835,000,000 and . 103. Territories Section 1323(c) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18043(c) ) is amended by adding at the end the following: (3) No force and effect Effective January 1, 2018, this subsection shall have no force or effect. . 104. Reinsurance, risk corridor, and risk adjustment programs (a) Transitional reinsurance program for individual market Section 1341 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18061 ) is amended by adding at the end the following: (e) No force and effect Effective January 1, 2016, the Secretary shall not collect fees and shall not make payments under this section. . 105. Support for State response to substance abuse public health crisis and urgent mental health needs (a) In general There are authorized to be appropriated, and are appropriated, out of monies in the Treasury not otherwise obligated, $750,000,000 for each of fiscal years 2016 and 2017, to the Secretary of Health and Human Services (referred to in this section as the Secretary ) to award grants to States to address the substance abuse public health crisis or to respond to urgent mental health needs within the State. In awarding grants under this section, the Secretary may give preference to States with an incidence or prevalence of substance use disorders that is substantial relative to other States or to States that identify mental health needs within their communities that are urgent relative to such needs of other States. Funds appropriated under this subsection shall remain available until expended. (b) Use of funds Grants awarded to a State under subsection (a) shall be used for one or more of the following public health-related activities: (1) Improving State prescription drug monitoring programs. (2) Implementing prevention activities, and evaluating such activities to identify effective strategies to prevent substance abuse. (3) Training for health care practitioners, such as best practices for prescribing opioids, pain management, recognizing potential cases of substance abuse, referral of patients to treatment programs, and overdose prevention. (4) Supporting access to health care services provided by federally certified opioid treatment programs or other appropriate health care providers to treat substance use disorders or mental health needs. (5) Other public health-related activities, as the State determines appropriate, related to addressing the substance abuse public health crisis or responding to urgent mental health needs within the State. II Finance 201. Recapture excess advance payments of premium tax credits Subparagraph (B) of section 36B(f)(2) of the Internal Revenue Code of 1986 is amended by adding at the end the following new clause: (iii) Nonapplicability of limitation This subparagraph shall not apply to taxable years ending after December 31, 2015, and before January 1, 2018. . 202. Premium tax credit and cost-sharing subsidies (a) Repeal of premium tax credit Subpart C of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by striking section 36B. (b) Repeal of cost-sharing subsidy Section 1402 of the Patient Protection and Affordable Care Act is repealed. (c) Repeal of eligibility determinations The following sections of the Patient Protection and Affordable Care Act are repealed: (1) Section 1411 (other than subsection (i), the last sentence of subsection (e)(4)(A)(ii), and such provisions of such section solely to the extent related to the application of the last sentence of subsection (e)(4)(A)(ii)). (2) Section 1412. (d) Protecting Americans by repeal of disclosure authority To carry out eligibility requirements for certain programs (1) In general Paragraph (21) of section 6103(l) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph: (D) Termination No disclosure may be made under this paragraph after December 31, 2017. . (e) Effective dates (1) Premium tax credit The amendment made by subsection (a) shall apply to taxable years beginning after December 31, 2017. (2) Cost sharing-subsidies and eligibility determinations The repeals in subsection (b) and (c) shall take effect on December 31, 2017. (3) Protecting Americans by rescinding disclosure authority The amendments made by subsection (d) shall take effect on December 31, 2017. 203. Small business tax credit (a) In general Section 45R of the Internal Revenue Code of 1986 is amended by adding at the end the following new subsection: (j) Shall not apply This section shall not apply with respect to amounts paid or incurred in taxable years beginning after December 31, 2017. . (b) Effective date The amendment made by this section shall apply to amounts paid or incurred in taxable years beginning after December 31, 2017. 204. Individual mandate (a) In general Section 5000A(c) of the Internal Revenue Code of 1986 is amended— (1) in paragraph (2)(B) by striking clauses (ii) and (iii) and inserting the following: (ii) Zero percent for taxable years beginning after 2014. , and (2) in paragraph (3)— (A) by striking $695 in subparagraph (A) and inserting $0 , (B) by striking and $325 for 2015 in subparagraph (B), and (C) by striking subparagraph (D). (b) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 205. Employer mandate (a) In general (1) Paragraph (1) of section 4980H(c) of the Internal Revenue Code of 1986 is amended by inserting ($0 in the case of months beginning after December 31, 2014) after $2,000 . (2) Paragraph (1) of section 4980H(b) of the Internal Revenue Code of 1986 is amended by inserting ($0 in the case of months beginning after December 31, 2014) after $3,000 . (b) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 206. Federal payments to States (a) In general Notwithstanding section 504(a), 1902(a)(23), 1903(a), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act ( 42 U.S.C. 704(a) , 1396a(a)(23), 1396b(a), 1397a, 1397d(a)(4), 1397bb(a)(7), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act ( 42 U.S.C. 1315 , 1396n), for the 1-year period beginning on the date of enactment of this Act, no Federal funds provided from a program referred to in this subsection that is considered direct spending for any year may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State. (b) Definitions In this section: (1) Prohibited entity The term prohibited entity means an entity, including its affiliates, subsidiaries, successors, and clinics— (A) that, as of the date of enactment of this Act— (i) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; (ii) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations (as in effect on the date of enactment of this Act), that is primarily engaged in family planning services, reproductive health, and related medical care; and (iii) provides for abortions, other than an abortion— (I) if the pregnancy is the result of an act of rape or incest; or (II) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and (B) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000. (2) Direct spending The term direct spending has the meaning given that term under section 250(c) of the Balanced Budget and Emergency Deficit Control Act of 1985 ( 2 U.S.C. 900(c) ). 207. Medicaid The Social Security Act ( 42 U.S.C. 301 et seq. ) is amended— (1) in section 1108(g)(5), by striking 2019 and inserting 2017 ; (2) in section 1902— (A) in subsection (a)(10)(A), in each of clauses (i)(VIII) and (ii)(XX), by inserting and ending December 31, 2017, after January 1, 2014, ; (B) in subsection (a)(47)(B), by inserting and provided that any such election shall cease to be effective on January 1, 2018, and no such election shall be made after that date before the semicolon at the end; and (C) in subsection (l)(2)(C), by inserting and ending December 31, 2017, after January 1, 2014, ; (3) in each of sections 1902(gg)(2) and 2105(d)(3)(A), by striking September 30, 2019 and inserting September 30, 2017 ; (4) in section 1905— (A) in the first sentence of subsection (b), by inserting (50 percent on or after January 1, 2018) after 55 percent ; (B) in subsection (y)(1), by striking the semicolon at the end of subparagraph (B) and all that follows through thereafter ; and (C) in subsection (z)(2)— (i) in subparagraph (A), by striking each year thereafter and inserting through 2017 ; and (ii) in subparagraph (B)(ii), by striking the semicolon at the end of subclause (IV) and all that follows through 100 percent ; (5) in section 1915(k)(2), by striking during the period described in paragraph (1) and inserting on or after the date referred to in paragraph (1) and before January 1, 2018 ; (6) in section 1920(e), by adding at the end the following: This subsection shall not apply after December 31, 2017. ; (7) in section 1937(b)(5), by adding at the end the following: This paragraph shall not apply after December 31, 2017. ; and (8) in section 1943(a), by inserting and before January 1, 2018, after January 1, 2014, . 208. Repeal of DSH allotment reductions Section 1923(f) of the Social Security Act ( 42 U.S.C. 1396r–4(f) ) is amended by striking paragraphs (7) and (8). 209. Repeal of the tax on employee health insurance premiums and health plan benefits (a) In general Chapter 43 of the Internal Revenue Code of 1986 is amended by striking section 4980I. (b) Effective date The amendment made by subsection (a) shall apply to taxable years beginning after December 31, 2017. 210. Repeal of tax on over-the-counter medications (a) HSAs Subparagraph (A) of section 223(d)(2) of the Internal Revenue Code of 1986 is amended by striking Such term and all that follows through the period. (b) Archer MSAs Subparagraph (A) of section 220(d)(2) of the Internal Revenue Code of 1986 is amended by striking Such term and all that follows through the period. (c) Health flexible spending arrangements and health reimbursement arrangements Section 106 of the Internal Revenue Code of 1986 is amended by striking subsection (f). (d) Effective dates (1) Distributions from savings accounts The amendments made by subsections (a) and (b) shall apply to amounts paid with respect to taxable years beginning after December 31, 2015. (2) Reimbursements The amendment made by subsection (c) shall apply to expenses incurred with respect to taxable years beginning after December 31, 2015. 211. Repeal of tax on health savings accounts (a) HSAs Section 223(f)(4)(A) of the Internal Revenue Code of 1986 is amended by striking 20 percent and inserting 10 percent . (b) Archer MSAs Section 220(f)(4)(A) of the Internal Revenue Code of 1986 is amended by striking 20 percent and inserting 15 percent . (c) Effective date The amendments made by this section shall apply to distributions made after December 31, 2015. 212. Repeal of limitations on contributions to flexible spending accounts (a) In general Section 125 of the Internal Revenue Code of 1986 is amended by striking subsection (i). (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 213. Repeal of tax on prescription medications Subsection (j) of section 9008 of the Patient Protection and Affordable Care Act is amended to read as follows: (j) Repeal This section shall apply to calendar years beginning after December 31, 2010, and ending before January 1, 2016. . 214. Repeal of medical device excise tax (a) In general Chapter 32 of the Internal Revenue Code of 1986 is amended by striking subchapter E. (b) Effective date The amendment made by this section shall apply to sales in calendar quarters beginning after December 31, 2015. 215. Repeal of health insurance tax Subsection (j) of section 9010 of the Patient Protection and Affordable Care Act is amended to read as follows: (j) Repeal This section shall apply to calendar years beginning after December 31, 2013, and ending before January 1, 2016. . 216. Repeal of elimination of deduction for expenses allocable to medicare part D subsidy (a) In general Section 139A of the Internal Revenue Code of 1986 is amended by adding at the end the following new sentence: This section shall not be taken into account for purposes of determining whether any deduction is allowable with respect to any cost taken into account in determining such payment. . (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 217. Repeal of chronic care tax (a) In general Subsection (a) of section 213 of the Internal Revenue Code of 1986 is amended by striking 10 percent and inserting 7.5 percent . (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 218. Repeal of Medicare tax increase (a) In general Subsection (b) of section 3101 of the Internal Revenue Code of 1986 is amended to read as follows: (b) Hospital insurance In addition to the tax imposed by the preceding subsection, there is hereby imposed on the income of every individual a tax equal to 1.45 percent of the wages (as defined in section 3121(a)) received by such individual with respect to employment (as defined in section 3121(b). . (b) SECA Subsection (b) of section 1401 of the Internal Revenue Code of 1986 is amended to read as follows: (b) Hospital insurance In addition to the tax imposed by the preceding subsection, there shall be imposed for each taxable year, on the self-employment income of every individual, a tax equal to 2.9 percent of the amount of the self-employment income for such taxable year. . (c) Effective date The amendments made by this section shall apply with respect to remuneration received after, and taxable years beginning after, December 31, 2015. 219. Repeal of tanning tax (a) In general The Internal Revenue Code of 1986 is amended by striking chapter 49. (b) Effective date The amendment made by this section shall apply to services performed on or after December 31, 2015. 220. Repeal of net investment tax (a) In general Subtitle A of the Internal Revenue Code of 1986 is amended by striking chapter 2A. (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 221. Remuneration Paragraph (6) of section 162(m) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph: (I) Termination This paragraph shall not apply to taxable years beginning after December 31, 2015. . 222. Economic substance doctrine (a) In general Subsection (o) of section 7701 of the Internal Revenue Code of 1986 is repealed. (b) Penalty for underpayments Paragraph (6) of section 6662(b) of the Internal Revenue Code of 1986 is repealed. (c) Increased penalty for nondisclosed transactions Subsection (i) of section 6662 of the Internal Revenue Code of 1986 is repealed. (d) Reasonable cause exception for underpayments Paragraph (2) of section 6664(c) of the Internal Revenue Code of 1986 is repealed. (e) Reasonable cause exception for nondisclosed transactions Paragraph (2) of section 6664(d) of the Internal Revenue Code of 1986 is repealed. (f) Erroneous claim for refund or credit Subsection (c) of section 6676 of the Internal Revenue Code of 1986 is repealed. (g) Effective date The repeals made by this section shall apply to transactions entered into, and to underpayments, understatements, or refunds and credits attributable to transactions entered into, after December 31, 2015. 223. Budgetary savings for extending medicare solvency As a result of policies contained in this Act, the Secretary of the Treasury shall transfer to the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act ( 42 U.S.C. 1395i ) $379,300,000,000 (which represents the full amount of on-budget savings during the period of fiscal years 2016 through 2025) for extending Medicare solvency, to remain available until expended.

Secretary

tv_txt: I One Hundred Fourteenth Congress of the United States of America At the Second Session Begun and held at the City of Washington on Monday, the fourth day of January, two thousand and sixteen H. R. 3762 AN ACT To provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016.

I Health, Education, Labor, and Pensions 101. The prevention and public health fund (a) In general Subsection (b) of section 4002 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 300u–11 ) is amended— (1) in paragraph (2), by striking 2017 and inserting 2015 ; and (2) by striking paragraphs (3) through (5). (b) Rescission of unobligated funds Of the funds made available by such section 4002, the unobligated balance is rescinded. 102. Community health center program Effective as if included in the enactment of the Medicare Access and CHIP Reauthorization Act of 2015 ( Public Law 114–10 , 129 Stat. 87), paragraph (1) of section 221(a) of such Act is amended by inserting after Section 10503(b)(1)(E) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 254b–2(b)(1)(E) ) is amended the following: by striking $3,600,000,000 and inserting $3,835,000,000 and . 103. Territories Section 1323(c) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18043(c) ) is amended by adding at the end the following: (3) No force and effect Effective January 1, 2018, this subsection shall have no force or effect. . 104. Reinsurance, risk corridor, and risk adjustment programs (a) Transitional reinsurance program for individual market Section 1341 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18061 ) is amended by adding at the end the following: (e) No force and effect Effective January 1, 2016, the Secretary shall not collect fees and shall not make payments under this section. . 105. Support for State response to substance abuse public health crisis and urgent mental health needs (a) In general There are authorized to be appropriated, and are appropriated, out of monies in the Treasury not otherwise obligated, $750,000,000 for each of fiscal years 2016 and 2017, to the Secretary of Health and Human Services (referred to in this section as the Secretary ) to award grants to States to address the substance abuse public health crisis or to respond to urgent mental health needs within the State. In awarding grants under this section, the Secretary may give preference to States with an incidence or prevalence of substance use disorders that is substantial relative to other States or to States that identify mental health needs within their communities that are urgent relative to such needs of other States. Funds appropriated under this subsection shall remain available until expended. (b) Use of funds Grants awarded to a State under subsection (a) shall be used for one or more of the following public health-related activities: (1) Improving State prescription drug monitoring programs. (2) Implementing prevention activities, and evaluating such activities to identify effective strategies to prevent substance abuse. (3) Training for health care practitioners, such as best practices for prescribing opioids, pain management, recognizing potential cases of substance abuse, referral of patients to treatment programs, and overdose prevention. (4) Supporting access to health care services provided by federally certified opioid treatment programs or other appropriate health care providers to treat substance use disorders or mental health needs. (5) Other public health-related activities, as the State determines appropriate, related to addressing the substance abuse public health crisis or responding to urgent mental health needs within the State. II Finance 201. Recapture excess advance payments of premium tax credits Subparagraph (B) of section 36B(f)(2) of the Internal Revenue Code of 1986 is amended by adding at the end the following new clause: (iii) Nonapplicability of limitation This subparagraph shall not apply to taxable years ending after December 31, 2015, and before January 1, 2018. . 202. Premium tax credit and cost-Sharing subsidies (a) Repeal of premium tax credit Subpart C of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by striking section 36B. (b) Repeal of cost-Sharing subsidy Section 1402 of the Patient Protection and Affordable Care Act is repealed. (c) Repeal of eligibility determinations The following sections of the Patient Protection and Affordable Care Act are repealed: (1) Section 1411 (other than subsection (i), the last sentence of subsection (e)(4)(A)(ii), and such provisions of such section solely to the extent related to the application of the last sentence of subsection (e)(4)(A)(ii)). (2) Section 1412. (d) Protecting Americans by repeal of disclosure authority To carry out eligibility requirements for certain programs (1) In general Paragraph (21) of section 6103(l) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph: (D) Termination No disclosure may be made under this paragraph after December 31, 2017. . (e) Effective dates (1) Premium tax credit The amendment made by subsection (a) shall apply to taxable years beginning after December 31, 2017. (2) Cost sharing-subsidies and eligibility determinations The repeals in subsection (b) and (c) shall take effect on December 31, 2017. (3) Protecting Americans by rescinding disclosure authority The amendments made by subsection (d) shall take effect on December 31, 2017. 203. Small business tax credit (a) In general Section 45R of the Internal Revenue Code of 1986 is amended by adding at the end the following new subsection: (j) Shall not apply This section shall not apply with respect to amounts paid or incurred in taxable years beginning after December 31, 2017. . (b) Effective date The amendment made by this section shall apply to amounts paid or incurred in taxable years beginning after December 31, 2017. 204. Individual mandate (a) In general Section 5000A(c) of the Internal Revenue Code of 1986 is amended— (1) in paragraph (2)(B) by striking clauses (ii) and (iii) and inserting the following: (ii) Zero percent for taxable years beginning after 2014. , and (2) in paragraph (3)— (A) by striking $695 in subparagraph (A) and inserting $0 , (B) by striking and $325 for 2015 in subparagraph (B), and (C) by striking subparagraph (D). (b) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 205. Employer mandate (a) In general (1) Paragraph (1) of section 4980H(c) of the Internal Revenue Code of 1986 is amended by inserting ($0 in the case of months beginning after December 31, 2014) after $2,000 . (2) Paragraph (1) of section 4980H(b) of the Internal Revenue Code of 1986 is amended by inserting ($0 in the case of months beginning after December 31, 2014) after $3,000 . (b) Effective date The amendments made by this section shall apply to months beginning after December 31, 2014. 206. Federal payments to States (a) In general Notwithstanding section 504(a), 1902(a)(23), 1903(a), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act ( 42 U.S.C. 704(a) , 1396a(a)(23), 1396b(a), 1397a, 1397d(a)(4), 1397bb(a)(7), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act ( 42 U.S.C. 1315 , 1396n), for the 1-year period beginning on the date of enactment of this Act, no Federal funds provided from a program referred to in this subsection that is considered direct spending for any year may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State. (b) Definitions In this section: (1) Prohibited entity The term prohibited entity means an entity, including its affiliates, subsidiaries, successors, and clinics— (A) that, as of the date of enactment of this Act— (i) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; (ii) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations (as in effect on the date of enactment of this Act), that is primarily engaged in family planning services, reproductive health, and related medical care; and (iii) provides for abortions, other than an abortion— (I) if the pregnancy is the result of an act of rape or incest; or (II) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and (B) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000. (2) Direct spending The term direct spending has the meaning given that term under section 250(c) of the Balanced Budget and Emergency Deficit Control Act of 1985 ( 2 U.S.C. 900(c) ). 207. Medicaid The Social Security Act ( 42 U.S.C. 301 et seq. ) is amended— (1) in section 1108(g)(5), by striking 2019 and inserting 2017 ; (2) in section 1902— (A) in subsection (a)(10)(A), in each of clauses (i)(VIII) and (ii)(XX), by inserting and ending December 31, 2017, after January 1, 2014, ; (B) in subsection (a)(47)(B), by inserting and provided that any such election shall cease to be effective on January 1, 2018, and no such election shall be made after that date before the semicolon at the end; and (C) in subsection (l)(2)(C), by inserting and ending December 31, 2017, after January 1, 2014, ; (3) in each of sections 1902(gg)(2) and 2105(d)(3)(A), by striking September 30, 2019 and inserting September 30, 2017 ; (4) in section 1905— (A) in the first sentence of subsection (b), by inserting (50 percent on or after January 1, 2018) after 55 percent ; (B) in subsection (y)(1), by striking the semicolon at the end of subparagraph (B) and all that follows through thereafter ; and (C) in subsection (z)(2)— (i) in subparagraph (A), by striking each year thereafter and inserting through 2017 ; and (ii) in subparagraph (B)(ii), by striking the semicolon at the end of subclause (IV) and all that follows through 100 percent ; (5) in section 1915(k)(2), by striking during the period described in paragraph (1) and inserting on or after the date referred to in paragraph (1) and before January 1, 2018 ; (6) in section 1920(e), by adding at the end the following: This subsection shall not apply after December 31, 2017. ; (7) in section 1937(b)(5), by adding at the end the following: This paragraph shall not apply after December 31, 2017. ; and (8) in section 1943(a), by inserting and before January 1, 2018, after January 1, 2014, . 208. Repeal of DSH allotment reductions Section 1923(f) of the Social Security Act ( 42 U.S.C. 1396r–4(f) ) is amended by striking paragraphs (7) and (8). 209. Repeal of the tax on employee health insurance premiums and health plan benefits (a) In general Chapter 43 of the Internal Revenue Code of 1986 is amended by striking section 4980I. (b) Effective date The amendment made by subsection (a) shall apply to taxable years beginning after December 31, 2017. 210. Repeal of tax on over-the-counter medications (a) HSAs Subparagraph (A) of section 223(d)(2) of the Internal Revenue Code of 1986 is amended by striking Such term and all that follows through the period. (b) Archer MSAs Subparagraph (A) of section 220(d)(2) of the Internal Revenue Code of 1986 is amended by striking Such term and all that follows through the period. (c) Health flexible spending arrangements and health reimbursement arrangements Section 106 of the Internal Revenue Code of 1986 is amended by striking subsection (f). (d) Effective dates (1) Distributions from savings accounts The amendments made by subsections (a) and (b) shall apply to amounts paid with respect to taxable years beginning after December 31, 2015. (2) Reimbursements The amendment made by subsection (c) shall apply to expenses incurred with respect to taxable years beginning after December 31, 2015. 211. Repeal of tax on health savings accounts (a) HSAs Section 223(f)(4)(A) of the Internal Revenue Code of 1986 is amended by striking 20 percent and inserting 10 percent . (b) Archer MSAs Section 220(f)(4)(A) of the Internal Revenue Code of 1986 is amended by striking 20 percent and inserting 15 percent . (c) Effective date The amendments made by this section shall apply to distributions made after December 31, 2015. 212. Repeal of limitations on contributions to flexible spending accounts (a) In general Section 125 of the Internal Revenue Code of 1986 is amended by striking subsection (i). (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 213. Repeal of tax on prescription medications Subsection (j) of section 9008 of the Patient Protection and Affordable Care Act is amended to read as follows: (j) Repeal This section shall apply to calendar years beginning after December 31, 2010, and ending before January 1, 2016. . 214. Repeal of medical device excise tax (a) In general Chapter 32 of the Internal Revenue Code of 1986 is amended by striking subchapter E. (b) Effective date The amendment made by this section shall apply to sales in calendar quarters beginning after December 31, 2015. 215. Repeal of health insurance tax Subsection (j) of section 9010 of the Patient Protection and Affordable Care Act is amended to read as follows: (j) Repeal This section shall apply to calendar years beginning after December 31, 2013, and ending before January 1, 2016. . 216. Repeal of elimination of deduction for expenses allocable to medicare part D subsidy (a) In general Section 139A of the Internal Revenue Code of 1986 is amended by adding at the end the following new sentence: This section shall not be taken into account for purposes of determining whether any deduction is allowable with respect to any cost taken into account in determining such payment. . (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 217. Repeal of chronic care tax (a) In general Subsection (a) of section 213 of the Internal Revenue Code of 1986 is amended by striking 10 percent and inserting 7.5 percent . (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 218. Repeal of Medicare tax increase (a) In general Subsection (b) of section 3101 of the Internal Revenue Code of 1986 is amended to read as follows: (b) Hospital insurance In addition to the tax imposed by the preceding subsection, there is hereby imposed on the income of every individual a tax equal to 1.45 percent of the wages (as defined in section 3121(a)) received by such individual with respect to employment (as defined in section 3121(b). . (b) SECA Subsection (b) of section 1401 of the Internal Revenue Code of 1986 is amended to read as follows: (b) Hospital insurance In addition to the tax imposed by the preceding subsection, there shall be imposed for each taxable year, on the self-employment income of every individual, a tax equal to 2.9 percent of the amount of the self-employment income for such taxable year. . (c) Effective date The amendments made by this section shall apply with respect to remuneration received after, and taxable years beginning after, December 31, 2015. 219. Repeal of tanning tax (a) In general The Internal Revenue Code of 1986 is amended by striking chapter 49. (b) Effective date The amendment made by this section shall apply to services performed on or after December 31, 2015. 220. Repeal of net investment tax (a) In general Subtitle A of the Internal Revenue Code of 1986 is amended by striking chapter 2A. (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2015. 221. Remuneration Paragraph (6) of section 162(m) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph: (I) Termination This paragraph shall not apply to taxable years beginning after December 31, 2015. . 222. Economic substance doctrine (a) In general Subsection (o) of section 7701 of the Internal Revenue Code of 1986 is repealed. (b) Penalty for underpayments Paragraph (6) of section 6662(b) of the Internal Revenue Code of 1986 is repealed. (c) Increased penalty for nondisclosed transactions Subsection (i) of section 6662 of the Internal Revenue Code of 1986 is repealed. (d) Reasonable cause exception for underpayments Paragraph (2) of section 6664(c) of the Internal Revenue Code of 1986 is repealed. (e) Reasonable cause exception for nondisclosed transactions Paragraph (2) of section 6664(d) of the Internal Revenue Code of 1986 is repealed. (f) Erroneous claim for refund or credit Subsection (c) of section 6676 of the Internal Revenue Code of 1986 is repealed. (g) Effective date The repeals made by this section shall apply to transactions entered into, and to underpayments, understatements, or refunds and credits attributable to transactions entered into, after December 31, 2015. 223. Budgetary savings for extending medicare solvency As a result of policies contained in this Act, the Secretary of the Treasury shall transfer to the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act ( 42 U.S.C. 1395i ) $379,300,000,000 (which represents the full amount of on-budget savings during the period of fiscal years 2016 through 2025) for extending Medicare solvency, to remain available until expended.

Speaker of the House of Representatives. Vice President of the United States and President of the Senate.