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SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ambulatory Surgical Center Medicare 
Payment Modernization Act of 2005''.

SEC. 2. MEDICARE PAYMENT FOR AMBULATORY SURGICAL CENTER SERVICES.

    (a) In General.--Section 1833(i) of the Social Security Act (42 
U.S.C. 1395l(i)) is amended to read as follows:
    ``(i)(1) Payment shall be made under this part in the amount 
specified under paragraph (2) for facility services furnished to an 
individual in an ambulatory surgical center in connection with any 
outpatient surgical procedure covered under this part as a hospital 
outpatient department service, except for those procedures that the 
Secretary designates, in consultation with appropriate trade and 
professional organizations (including those having direct experience 
with ambulatory surgical centers) as posing a significant safety risk 
or requiring an overnight stay when performed in ambulatory surgical 
centers. Not less frequently than once every two years the Secretary 
shall review and, may, after public comment, make appropriate 
adjustments to this list of procedures excluded from coverage when 
performed in ambulatory surgical centers as the Secretary deems 
necessary.
    ``(2)(A) Subject to subparagraphs (B) and (C), the amount of 
payment to be made under this subsection for facility services 
furnished to an individual in an ambulatory surgical center in 
accordance with paragraph (1) shall be equal to 75 percent of the fee 
schedule amount determined under paragraph (3)(A) of subsection (t) for 
payment of the same service furnished in hospital outpatient 
departments, as adjusted under paragraphs (4)(A), (6), and (15) of such 
subsection, less a 20 percent beneficiary copayment.
    ``(B) For covered ambulatory surgical center services furnished on 
or after January 1, 2008, and before January 1, 2012, for which the 
ambulatory surgical center payment amount payable under this subsection 
in 2007 (in this subsection referred to as the `2007 ASC payment 
amount') is less than 75 percent of the hospital OPD fee schedule 
amount under subsection (t) in 2007 for the same services, the amount 
of payment under this subsection shall be calculated as follows:
            ``(i) For services furnished during 2008, the amount shall 
        be equal to the sum of--
                    ``(I) 80 percent of the 2007 ASC payment amount, as 
                increased by the percentage increase in the consumer 
                price index for all urban consumers (United States city 
                average) as estimated by the Secretary for the 12-month 
                period ending with December 31, 2006; and
                    ``(II) 20 percent of the payment amount under 
                paragraph (2)(A) for 2008.
            ``(ii) For services furnished during 2009, the amount shall 
        be equal to the sum of--
                    ``(I) 60 percent of the 2007 ASC payment amount as 
                increased under clause (i)(I) and as further increased 
                by the percentage increase in the consumer price index 
                for all urban consumers (United States city average) as 
                estimated by the Secretary for the 12-month period 
                ending with December 31, 2007; and
                    ``(II) 40 percent of the payment amount under 
                paragraph (2)(A) for 2009.
            ``(iii) For services furnished during 2010, the amount 
        shall be equal to the sum of--
                    ``(I) 40 percent of the 2007 ASC payment amount as 
                increased under clauses (i)(I) and (ii)(I) and as 
                further increased by the percentage increase in the 
                consumer price index for all urban consumers (United 
                States city average) as estimated by the Secretary for 
                the 12-month period ending with December 31, 2008; and
                    ``(II) 60 percent of the payment amount under 
                paragraph (2)(A) for 2010.
            ``(iv) For services furnished during 2011, the amount shall 
        be equal to the sum of--
                    ``(I) 20 percent of the 2007 ASC payment amount as 
                increased under clauses (i)(I), (ii)(I), and (iii)(I) 
                and as further increased by the percentage increase in 
                the consumer price index for all urban consumers 
                (United States city average) as estimated by the 
                Secretary for the 12-month period ending with December 
                31, 2009; and
                    ``(II) 80 percent of the payment amount under 
                paragraph (2)(A) for 2011.
    ``(C) For covered ambulatory surgical center services for which the 
2007 ASC payment amount is--
            ``(i) greater than 75 percent, but less than 100 percent, 
        of the hospital OPD fee schedule amount under subsection (t) in 
        2007 for the same services, the amount of payment under this 
        subsection shall be the greater of the 2007 ASC payment amount 
        or--
                    ``(I) for services furnished in 2008, the payment 
                amount under subparagraph (B)(i);
                    ``(II) for services furnished in 2009, the payment 
                amount under subparagraph (B)(ii);
                    ``(III) for services furnished in 2010, the payment 
                amount under subparagraph (B)(iii);
                    ``(IV) for services furnished in 2011, the payment 
                amount under subparagraph (B)(iv); or
                    ``(V) in 2012 and subsequent years, the payment 
                amount under subparagraph (A),
        but in no case in excess of the then applicable hospital OPD 
        fee schedule amount; or
            ``(ii) greater than the hospital OPD fee schedule amount 
        under subsection (t) in 2007 for the same services, the amount 
        of payment under this subsection--
                    ``(I) for services furnished during 2008, is equal 
                to the midpoint between the 2007 ASC payment amount and 
                100 percent of such 2007 hospital OPD fee schedule 
                amount; or
                    ``(II) for services furnished in a subsequent year 
                is equal to the greater of the 2007 hospital OPD fee 
                schedule amount or the payment amount specified under 
                subclause (I) through (V) of clause (i) for the year 
                involved, but but in no case in excess of the then 
                applicable hospital OPD fee schedule amount.''.
    (b) Conforming Amendments.--
            (1) Section 1832(a)(2)(F)(i) of such Act (42 U.S.C. 
        1395k(a)(2)(F)(i)) is amended--
                    (A) by striking ``section 1833(i)(1)(A)'' and 
                inserting ``section 1833(i)(1)'';
                    (B) by striking ``the standard overhead amount as 
                determined under section 1833(i)(2)(A)'' and inserting 
                ``the amount determined under section 1833(i)(2)''; and
                    (C) by striking all that follows ``as full payment 
                for such services'' and inserting ``, or''.
            (2) Section 1833(a)(1)(G) of such Act (42 U.S.C. 
        1395l(a)(1)(G)) is amended--
                    (A) by striking ``subsection (i)(1)(A)'' and 
                inserting ``subsection (i)(1)'';
                    (B) by striking ``for services furnished 
                beginning'' and all that follows through ``subsection 
                (i)(2)(D)''; and
                    (C) by striking ``such revised payment system'' and 
                inserting ``under subsection (i)(2)''.
            (3) Section 1833(a)(4) of such Act (42 U.S.C. 1395l(a)(4)) 
        is amended--
                    (A) by striking ``section 1833(i)(1)(A)'' and 
                inserting ``subsection (i)(1)''; and
                    (B) by striking ``paragraph (2) or (3) of 
                subsection (i)'' and inserting ``subsection (i)(1)''.
    (c) Effective Date.--The amendments made by this section shall 
apply to ambulatory surgical center services furnished on or after 
January 1, 2008.
Ambulatory Surgical Center Medicare Payment Modernization Act of 2005 - Amends title XVIII (Medicare) of the Social Security Act to revise the requirements and the formula for payments for services furnished to individuals in ambulatory surgical centers.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Equity and Access under the 
Law for Immigrant Women and Families Act of 2014'' or as the ``HEAL 
Immigrant Women and Families Act of 2014''.

SEC. 2. FINDINGS.

    Congress finds as follows:
            (1) Insurance coverage reduces harmful health disparities 
        by alleviating cost barriers to and increasing utilization of 
        basic preventive health services, especially among low-income 
        and underserved populations, and especially among women.
            (2) Based solely on their immigration status, many 
        immigrants and their families face legal restrictions on their 
        ability to obtain health insurance coverage through Medicaid, 
        CHIP, and Health Insurance Exchanges.
            (3) Lack of health insurance contributes to persistent 
        disparities in the prevention, diagnosis, and treatment of 
        negative health outcomes borne by immigrants and their 
        families.
            (4) Immigrant women are disproportionately of reproductive 
        age, low-income, and lacking health insurance coverage. Legal 
        barriers to affordable health insurance coverage therefore 
        particularly exacerbate their risk of negative sexual, 
        reproductive, and maternal health outcomes, with lasting health 
        and economic consequences for immigrant women, their families, 
        and society as a whole.
            (5) Denying coverage or imposing waiting periods for 
        coverage unfairly hinders the ability of immigrants to take 
        responsibility for their own health and economic well-being and 
        that of their families. To fully and productively participate 
        in society, access to health care is fundamental, which for 
        women includes access to the services necessary to plan whether 
        and when to have a child.
            (6) The population of immigrant families in the United 
        States is expected to continue to grow. Indeed one in five 
        children in the United States is part of an immigrant family. 
        It is therefore in the nation's shared public health and 
        economic interest to remove legal barriers to affordable health 
        insurance coverage based on immigration status.

SEC. 3. REMOVING BARRIERS TO HEALTH COVERAGE FOR LAWFULLY PRESENT 
              INDIVIDUALS.

    (a) Medicaid.--Section 1903(v)(4) of the Social Security Act (42 
U.S.C. 1396b(v)(4)) is amended--
            (1) by amending subparagraph (A) to read as follows:
    ``(A) Notwithstanding sections 401(a), 402(b), 403, and 421 of the 
Personal Responsibility and Work Opportunity Reconciliation Act of 
1996, payment shall be made under this section for care and services 
that are furnished to aliens, including those described in paragraph 
(1), if they otherwise meet the eligibility requirements for medical 
assistance under the State plan approved under this title (other than 
the requirement of the receipt of aid or assistance under title IV, 
supplemental security income benefits under title XVI, or a State 
supplementary payment), and are lawfully present in the United 
States.'';
            (2) in subparagraph (B)--
                    (A) by striking ``a State that has elected to 
                provide medical assistance to a category of aliens 
                under subparagraph (A)'' and inserting ``aliens 
                provided medical assistance pursuant to subparagraph 
                (A)''; and
                    (B) by striking ``to such category'' and inserting 
                ``to such alien''; and
            (3) in subparagraph (C)--
                    (A) by striking ``an election by the State under 
                subparagraph (A)'' and inserting ``the application of 
                subparagraph (A)'';
                    (B) by inserting ``or be lawfully present'' after 
                ``lawfully reside''; and
                    (C) by inserting ``or present'' after ``lawfully 
                residing'' each place it appears.
    (b) CHIP.--Subparagraph (J) of section 2107(e)(1) of the Social 
Security Act (42 U.S.C. 1397gg(e)(1)) is amended to read as follows:
                    ``(J) Paragraph (4) of section 1903(v) (relating to 
                lawfully present individuals).''.
    (c) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by this section shall take effect on the date 
        of the enactment of this Act and shall apply to services 
        furnished on or after the date that is 90 days after such date 
        of the enactment.
            (2) Exception if state legislation required.--In the case 
        of a State plan for medical assistance under title XIX, or a 
        State child health plan under title XXI, of the Social Security 
        Act which the Secretary of Health and Human Services determines 
        requires State legislation (other than legislation 
        appropriating funds) in order for the plan to meet the 
        additional requirements imposed by the amendments made by this 
        section, the respective State plan shall not be regarded as 
        failing to comply with the requirements of such title solely on 
        the basis of its failure to meet these additional requirements 
        before the first day of the first calendar quarter beginning 
        after the close of the first regular session of the State 
        legislature that begins after the date of the enactment of this 
        Act. For purposes of the previous sentence, in the case of a 
        State that has a 2-year legislative session, each year of such 
        session shall be deemed to be a separate regular session of the 
        State legislature.

SEC. 4. REMOVING BARRIERS TO HEALTH COVERAGE FOR INDIVIDUALS GRANTED 
              DEFERRED ACTION FOR CHILDHOOD ARRIVALS.

    (a) In General.--For the purposes of eligibility under any of the 
provisions referred to in subsection (b), individuals granted deferred 
action under the Deferred Action for Childhood Arrivals process of the 
Department of Homeland Security, as described in the memorandum of the 
Secretary of Homeland Security on June 15, 2012, shall be considered 
lawfully present in the United States.
    (b) Provisions Described.--The provisions described in this 
subsection are the following:
            (1) Exchange eligibility.--Section 1311 of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18031).
            (2) Reduced cost-sharing eligibility.--Section 1402 of the 
        Patient Protection and Affordable Care Act (42 U.S.C. 18071).
            (3) Premium subsidy eligibility.--Section 36B of the 
        Internal Revenue Code of 1986.
            (4) Medicaid and chip eligibility.--Titles XIX and XXI of 
        the Social Security Act, including under section 1903(v) of 
        such Act (42 U.S.C. 1396b(v)).
    (c) Effective Date.--
            (1) In general.--Subsection (a) shall take effect on the 
        date of the enactment of this Act.
            (2) Transition through special enrollment period.--In the 
        case of an individual described in subsection (a) who, before 
        the first day of the first annual open enrollment period under 
        subparagraph (B) of section 1311(c)(6) of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)) 
        beginning after the date of the enactment of this Act, is 
        granted deferred action described in subsection (a) and who, as 
        a result of such subsection, qualifies for a subsidy described 
        in paragraph (2) or (3) of such subsection, the Secretary of 
        Health and Human Services shall establish a special enrollment 
        period under section 1311(c)(6)(C) of such Act during which 
        such individual may enroll in qualified health plans through 
        Exchanges under title I of such Act and qualify for such a 
        subsidy. For such an individual who has been granted deferred 
        action as of the date of the enactment of this Act, such 
        special enrollment period shall begin not later than 90 days 
        after such date of enactment. Nothing in this paragraph shall 
        be construed as affecting the authority of the Secretary to 
        establish additional special enrollment periods under section 
        1311(c)(6)(C) of the Patient Protection and Affordable Care Act 
        (42 U.S.C. 18031(c)(6)(C)).
Health Equity and Access under the Law for Immigrant Women and Families Act of 2014 or the HEAL Immigrant Women and Families Act of 2014 - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act to extend Medicaid and CHIP coverage to aliens lawfully present in the United States.  Makes individuals granted deferred action under the Deferred Action for Childhood Arrivals process eligible for: (1) health care exchanges and reduced cost sharing under the Patient Protection and Affordable Care Act, (2) premium subsidies under the Internal Revenue Code, and (3) Medicaid and CHIP.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Railroad Shipper Protection Act of 
1997''.

SEC. 2. FINDINGS.

    The Congress finds that--
            (1) the railroad industry has consolidated dramatically 
        since passage of the Staggers Rail Act of 1980 (94 Stat. 1895 
        et seq.), leaving the railroad industry with only a few major 
        carriers and providing shippers with limited competitive 
        options;
            (2) the financial health of the railroad industry has 
        improved substantially since the passage of the Staggers Rail 
        Act of 1980;
            (3) due partly to the continued consolidation of the 
        railroad industry, captive rail shippers--
                    (A) continue to exist; and
                    (B) are increasing in number; and
            (4) rail shippers, including captive rail shippers, will 
        benefit from increased competition among railroads and a 
        streamlined process under which the Surface Transportation 
        Board determines the reasonableness of captive rail shipper 
        rates.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Secretary.--The term ``Secretary'' means the Secretary 
        of Transportation.
            (2) Surface transportation board.--The term ``Surface 
        Transportation Board'' or ``Board'' means the Surface 
        Transportation Board established under section 701 of title 49, 
        United States Code.

SEC. 4. PURPOSES.

    The purposes of this Act are--
            (1) to clarify the rail transportation policy of the United 
        States;
            (2) to ensure rail competition for shippers in geographic 
        areas in which rail competition is physically available;
            (3) to ensure reasonable rates for captive rail shippers; 
        and
            (4) to remove unnecessary regulatory burdens from the rate 
        reasonableness process of the Surface Transportation Board.

SEC. 5. CLARIFICATION OF RAIL TRANSPORTATION POLICY.

    Section 10101 of title 49, United States Code, is amended--
            (1) by inserting ``(a) In General.--'' before ``In 
        regulating''; and
            (2) by adding at the end the following:
    ``(b) Primary Objectives.--The primary objectives of the rail 
transportation policy of the United States shall be--
            ``(1) to ensure effective competition among rail carriers 
        at origin and destination; and
            ``(2) to maintain reasonable rates in the absence of 
        effective competition.''.

SEC. 6. REQUIREMENT OF RAILROADS TO ESTABLISH RATES TO FACILITATE RAIL 
              TO RAIL COMPETITION.

    (a) Establishment of Rate.--Section 11101(a) of title 49, United 
States Code, is amended by inserting after the first sentence the 
following: ``Upon the request of a shipper, a rail carrier shall 
establish a rate for transportation requested by the shipper between 
any 2 points on the system of that rail carrier where traffic 
originates, terminates, or may be interchanged. A rate established 
under the preceding sentence shall apply to the shipper that makes the 
request for the rate without regard to whether the rate established is 
for part of a through transportation route between an origin and a 
destination or whether the shipper has made arrangements for 
transportation over any other part of that through route.''.
    (b) Review of Reasonableness of Rate.--Section 10701(d) of title 
49, United States Code, is amended--
            (1) by redesignating paragraph (3) as paragraph (4); and
            (2) by inserting after paragraph (2) the following:
    ``(3) If a rail carrier establishes a rate for transportation 
between any 2 points on the system of that rail carrier where rail 
traffic originates, terminates, or may be interchanged, the shipper may 
challenge the reasonableness of--
            ``(A) that rate; or
            ``(B) the aggregate rate between origin and destination (if 
        the rate established is for part of a through route).''.

SEC. 7. SIMPLIFIED STANDARD FOR MARKET DOMINANCE.

    Section 10707(d) of title 49, United States Code, is amended--
            (1) by striking paragraph (2);
            (2) by striking ``(1)(A)'' and inserting ``(3)'';
            (3) by striking ``(B) For purposes'' and inserting ``(4) 
        For purposes''; and
            (4) by inserting before paragraph (3), as redesignated, the 
        following:
    ``(1) In making a determination under this section, the Board shall 
find that the rail carrier establishing the challenged rate referred to 
in subsection (b) has market dominance over the transportation to which 
the rate applies if that rail carrier--
            ``(A) is the only rail carrier serving the origin, 
        destination, or intermediate portion of the route involved; and
            ``(B) does not prove to the Board that the rate charged 
        results in a revenue-variable cost percentage for that 
        transportation that is less than 180 percent.
    ``(2) In making a market dominance determination under this section 
in any case in which 2 or more rail carriers provide service at an 
origin or destination, the Board shall consider only transportation 
competition at that origin or destination.''.

SEC. 8. REVENUE ADEQUACY DETERMINATIONS.

    (a) Rail Transportation Policy.--Section 10101(3) of title 49, 
United States Code, is amended by striking ``, as determined by the 
Board;''.
    (b) Authority for Revenue Adequacy Determination.--Section 10704(a) 
of title 49, United States Code, is amended--
            (1) by striking ``(a)(1)'' and inserting ``(a)''; and
            (2) by striking paragraphs (2) and (3).

SEC. 9. REDUCTION OF PROCEDURAL BARRIERS FACED BY SMALL SHIPPERS.

    (a) Administrative Relief.--Not later than 180 days after the date 
of enactment of this Act, the Surface Transportation Board shall--
            (1) review the rules and procedures applicable to rate 
        complaints and other complaints filed with the Board by small 
        shippers;
            (2) identify any such rules or procedures that are unduly 
        burdensome to small shippers; and
            (3) take such action, including rulemaking, as is 
        appropriate to reduce or eliminate the aspects of the rules and 
        procedures that the Board determines under paragraph (2) to be 
        unduly burdensome to small shippers.
    (b) Legislative Relief.--The Board shall notify the Committee on 
Commerce, Science, and Transportation of the Senate and the Committee 
on Transportation and Infrastructure of the House of Representatives if 
the Board determines that additional changes in the rules and 
procedures described in subsection (a) are appropriate and require 
commensurate changes in statutory law. In making that notification, the 
Board shall make recommendations concerning those changes.

Railroad Shipper Protection Act of 1997 - Amends Federal transportation law to declare as primary objectives for U.S. rail transportation policy:  (1) ensuring effective competition among rail carriers at origin and destination; and (2) maintaining reasonable rates in the absence of such competition. 
Requires a rail carrier, upon request from a shipper, to establish a rail transportation rate between any two points on the carrier's system where traffic originates, terminates, or may be interchanged. Authorizes such shipper to then challenge the reasonableness of the rate established or the aggregate rate between origin and destination (if the rate established is for part of a through rate). 
Requires the Surface Transportation Board to find that the rail carrier establishing a challenged rail rate has market dominance over the transportation to which the rate applies if such carrier:  (1) is the only carrier serving the origin, destination, or intermediate portion of the route involved; or (2) does not prove to the Board that the rate charged results in a revenue-variable cost percentage for that transportation that is less than 180 percent. 
Terminates Board authority to determine the revenue adequacy of rail carriers. 
Directs the Board to:  (1) review and take appropriate action with respect to the rules and procedures applicable to rate complaints and other complaints filed with the Board by small shippers; and (2) notify specified congressional committees if it determines that additional (legislative) changes in such rules and procedures are appropriate.