[House Report 114-293]
[From the U.S. Government Publishing Office]
114th Congress } { Report
1st Session } HOUSE OF REPRESENTATIVES { 114-293
_______________________________________________________________________
RESTORING AMERICANS' HEALTHCARE FREEDOM RECONCILIATION ACT OF 2015
__________
R E P O R T
of the
COMMITTEE ON THE BUDGET
HOUSE OF REPRESENTATIVES
to accompany
H.R. 3762
A BILL TO PROVIDE FOR RECONCILIATION PURSUANT TO SECTION 2002 OF THE
CONCURRENT RESOLUTION ON THE BUDGET FOR FISCAL YEAR 2016
together with
ADDITIONAL AND MINORITY VIEWS
October 16, 2015.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______________
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COMMITTEE ON THE BUDGET
TOM PRICE, M.D., Georgia,Chairman
TODD ROKITA, Indiana,Vice Chairman CHRIS VAN HOLLEN, Maryland,
SCOTT GARRETT, New Jersey Ranking Minority Member
MARIO DIAZ-BALART, Florida JOHN A. YARMUTH, Kentucky
TOM COLE, Oklahoma BILL PASCRELL, Jr., New Jersey
TOM McCLINTOCK, California TIM RYAN, Ohio
DIANE BLACK, Tennessee GWEN MOORE, Wisconsin
ROB WOODALL, Georgia KATHY CASTOR, Florida
MARSHA BLACKBURN, Tennessee JIM McDERMOTT, Washington
VICKY HARTZLER, Missouri BARBARA LEE, California
TOM RICE, South Carolina MARK POCAN, Wisconsin
MARLIN A. STUTZMAN, Indiana MICHELLE LUJAN GRISHAM, New Mexico
MARK SANFORD, South Carolina DEBBIE DINGELL, Michigan
VERN BUCHANAN, Florida TED LIEU, California
STEVE WOMACK, Arkansas DONALD NORCROSS, New Jersey
DAVE BRAT, Virginia SETH MOULTON, Massachusetts
ROD BLUM, Iowa
ALEXANDER X. MOONEY, West Virginia
GLENN GROTHMAN, Wisconsin
GARY J. PALMER, Alabama
JOHN R. MOOLENAAR, Michigan
BRUCE WESTERMAN, Arkansas
Professional Staff
Richard E. May,Staff Director
Thomas S. Kahn,Minority Staff Director
C O N T E N T S
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Page
Introduction by the Committee on the Budget...................... 3
Reconciliation and the Budget Resolution......................... 9
Title I--Committee on Education and the Workforce................ 14
Title II--Committee on Energy and Commerce....................... 67
Title III--Committee on Ways and Means........................... 69
Subtitle A--Revenue Provisions............................... 73
Subtitle B--Repeal of the Independent Payment Advisory Board. 141
Committee on the Budget:
Votes of the Committee on the Budget......................... 189
Other House Report Requirements.............................. 193
Views of Committee Members................................... 199
H.R. 3762, Restoring Americans' Healthcare Freedom Reconciliation
Act of 2015.................................................... 205
114th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 114-293
======================================================================
RESTORING AMERICANS' HEALTHCARE FREEDOM RECONCILIATION ACT OF 2015
_______
PROVIDING FOR RECONCILIATION PURSUANT TO SECTION 2002 OF THE CONCURRENT
RESOLUTION ON THE BUDGET FOR FISCAL YEAR 2016
_______
October 16, 2015.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Tom Price of Georgia, from the Committee on the Budget, submitted
the following
R E P O R T
together with
ADDITIONAL AND MINORITY VIEWS
[To accompany H.R. 3762]
The Committee on the Budget, to whom reconciliation
recommendations were submitted pursuant to section 2002 of S.
Con. Res. 11, the concurrent resolution on the budget for
fiscal year 2016, having considered the same, reports favorably
thereon without amendment and recommends that the bill do pass.
INTRODUCTION BY THE
COMMITTEE ON THE BUDGET
----------
Clearing the Way for Real Health Care Reform
The essential failing of Obamacare runs deeper than its
distortions of health care delivery and financing, its clumsy
rollout, or the President's numerous unilateral changes in the
lawafter its enactment. Beneath all these, the fundamental flaw
of Obamacare is the conceit that Washington could somehow
centrally manage a vast and complex medical sector serving
nearly 320 million diverse individuals. That notion has proved
a failure. It requires suffocating mandates and regulations. It
stifles health care delivery, making it less responsive and
more costly. Above all, it necessarily imposes government
dictates on highly personal medical decisions, effectively
placing a government agent in every examining room and
alongside every hospital bed.
That is why Obamacare must be dismantled. The aim is not
only to reject this illegitimately conceived government
expansion, which still--more than 5 years after its enactment--
lacks the support of even a simple majority of the American
public. It is not just to replace one national health program
with another. The point is to discard the entire pretense of
nationalized medicine, and recognize that health care works
best when it promotes the most important and basic relationship
in medicine--the one between the patient and the doctor.
Everything else in the $3 trillion health care network--
hospitals, nurses, technicians, medical device makers,
pharmaceutical companies, researchers, health insurers, and
many more--revolves around that fundamental partnership.
Obamacare must be repealed to clear the way for genuine,
compassionate, patient-centered health care reform. That is the
broader aim of this legislation: the Restoring Americans'
Healthcare Freedom Reconciliation Act of 2015.
Like so much of Washington's health care policy, this
massive program--formally called the Affordable Care Act\1\--
was designed to satisfy the ivory tower aspirations of
academics and protect the fortresses of government
bureaucracies. Instead of responding to the medical needs of
real people in the real world, it adds layers of rules and
directives to further systematize health care as a government-
run service. It seeks to control costs from the top down--which
can only lead to rationing health services--rather than
trusting prices to emerge naturally from the free choices of
millions of individuals.
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\1\Because the House and Senate could not agree on a single plan,
they had to pass two bills, one modifying the other, to create the
Affordable Care Act. The two measures were the Patient Protection and
Affordable Care Act (H.R. 3590, Public Law 111-148) and the Health Care
and Education Reconciliation Act of 2010 (H.R. 4872, Public Law 111-
152).
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True health care reform can only arise from a different way
of thinking about it. There is no one strategy for making
health care more effective and efficient; there is no unified
approach, especially not by government. True reform can only
emerge from the flexibility and innovation of all the
participants, always seeking creative ways to advance better
and less costly health care. As spelled out in the fiscal year
2016 budget resolution, which led to this legislation,
policymakers should apply the guiding principles below to
develop real health care reform.\2\
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\2\See section 6205 of the Conference Report accompanying the
Concurrent Resolution on the Budget for Fiscal Year 2016 (S. Con. Res.
11).
Affordability. Real reform should ensure that all
Americans, no matter their age, income, or health status, can
afford health coverage. The health care delivery structure
should be improved, and individuals should not be priced out of
the insurance market due to pre-existing conditions.
Nationalized health care not only fails to accomplish these
aims, but in fact undermines them. Individuals should be
allowed to join together voluntarily to pool risk through
mechanisms such as Individual Membership Associations and Small
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Employer Membership Associations.
Accessibility. Instead of Washington dictating to Americans
how they may or may not use their health insurance, reforms
should make health coverage more portable. Individuals should
be able to own their insurance and have it follow them in and
out of jobs throughout their careers. Small business owners
should be permitted to band together across State lines through
their membership in bona fide trade or professional
associations to purchase health coverage for their families and
employees at a low cost. This will increase small businesses'
bargaining power, volume discounts, and administrative
efficiencies while giving them freedom from State-mandated
benefit packages. Also, insurers licensed to sell policies in
one State should be permitted to offer them to residents in any
other State; consumers should be permitted to shop for health
insurance across State lines, as they are with other insurance
products online, by mail, by telephone, or in consultation with
an insurance agent.
Quality. Incentives for providers to deliver high-quality,
responsive, and coordinated care will promote better patient
outcomes and drive down health care costs. Likewise, reforms
should work to restore the patient-physician relationship by
reducing administrative burdens and allowing physicians to do
what they do best: care for patients.
Choices. Genuine reform should free individuals and
families to secure the health coverage that best meets their
needs, rather than instituting one-size-fits-all directives
from Federal bureaucracies such as the Internal Revenue
Service, the Department of Health and Human Services, and the
Independent Payment Advisory Board.
Innovation. Instead of stifling innovation in health care
technologies, treatments, medications, and therapies with
Federal mandates, taxes, and price controls, a reformed health
care system should encourage research, development, and
innovation.
Responsiveness. Reform should vigorously apply the spirit
of federalism, returning authority to States wherever possible,
to make health care more responsive to patients and their
needs. Instead of tying States' hands with Federal requirements
for their Medicaid programs, the Federal Government should
return control of this program to the States. The current
Medicaid Program only drives up Federal debt and threatens to
bankrupt State budgets. States are better positioned to provide
quality, affordable care to those eligible for the program and
to track down and weed out waste, fraud, and abuse. Beneficiary
choices in the State Children's Health Insurance Program
[SCHIP] and Medicaid should be improved. States should make
available the purchase of private insurance as an option to
their Medicaid and SCHIP populations (though they should not
require enrollment).
Legal Reforms. Policymakers should develop reforms that
prevent lawsuit abuse and curb the practice of defensive
medicine, which are significant drivers increasing health care
costs. The burden of proof in medical malpractice cases should
be based on compliance with best practice guidelines and States
should be free to implement those policies to best suit their
needs.
The Role of the Committee on the Budget
As required by the conference agreement accompanying the
Concurrent Resolution on the Budget for Fiscal Year 2016 (S.
Con. Res. 11), this reconciliation legislation comprises
provisions from three committees of the House of
Representatives with jurisdiction related to the Affordable
Care Act: the Committee on Education and the Workforce, the
Committee on Energy and Commerce, and the Committee on Ways and
Means. Each committee met its instruction to achieve at least
$1 billion in deficit reduction over 10 years, submitting
targeted provisions aimed at deconstructing the foundation of
the Affordable Care Act.
At this stage of the process, the role of the Committee on
the Budget is to determine whether the bill complies with the
deficit reduction targets in the budget resolution. It then
binds together the submissions of the three committees into a
single bill. The Committee on the Budget subsequently reports
the combined bill to the House with the recommendation that it
be passed by the entire House. The Congressional Budget Act of
1974 precludes the Committee on the Budget from making any
substantive change in the bill during the course of its markup.
If a change in the reported bill is necessary, section
310(d)(5) of the Act prescribes the following procedure: ``The
Committee on Rules of the House of Representatives may make in
order amendments to achieve changes specified by reconciliation
directives contained in a concurrent resolution on the budget
if a committee or committees of the House fail to submit
recommended changes to its Committee on the Budget pursuant to
its instruction.''
During markup, the Committee on the Budget adopted a motion
granting the Chairman, at his discretion, the authority to
request the Committee on Rules to report a rule for
consideration of this measure that would make in order an
amendment to the bill.
It is not unusual for amendments to budget reconciliation
legislation to be made in order at the Rules Committee for
reasons other than one or more committees failing to meet
reconciliation instructions. Amendments often are needed to
make technical and conforming changes in complex legislation.
At other times, changes are needed to address any of the many
House and Senate budget rules. On occasion, amendments are
needed to resolve the inevitable interactions among multiple
committees' submissions or to address unresolved policy issues.
The Committees' Submissions
The submissions from the three reporting committees detail
and explain their specific provisions and outline how they
fulfill their instructions and provide the required amount of
deficit reduction over the next 10 years. A summary of the
provisions is as follows:
TITLE I: COMMITTEE ON EDUCATION AND THE WORKFORCE
Section 101: Repeal of Automatic Enrollment Requirement.
Repeals Section 18A of the Fair Labor Standards Act (29 U.S.C.
218a), as added by section 1511 of the Affordable Care Act.
Section 1511 requires employers with more than 200 employees to
automatically enroll new full-time equivalents into a
qualifying health plan if offered by that employer, and to
automatically continue enrollment of current employees.
Net Change in Deficit, 2016-2025: -$7.9 billion.
TITLE II: COMMITTEE ON ENERGY AND COMMERCE
Section 201: Repeal Prevention and Public Health Fund.
Repeals the Prevention and Public Health Fund [PPHF] and
rescinds unobligated balances. The PPHF allows the Secretary of
Health and Human Services to transfer amounts from the fund to
Department of Health and Human Services accounts to increase
funding for Public Health Service Act-authorized prevention,
wellness, and public health activities, including prevention
research and health screenings.
Section 202: Federal Payment to States. Prohibits Medicaid
reimbursement for 1 year for a defined entity, which includes
its affiliates, subsidiaries, successors, and clinics.
Section 203: Funding for Community Health Center Program.
Increases funding to the Community Health Center Fund by $235
million in each of fiscal years 2016 and 2017, as extended by
the Medicare Access and CHIP Reauthorization Act (H.R. 2).
Net Change in Deficit, 2016-2025: -$12.4 billion.
TITLE III: COMMITTEE ON WAYS AND MEANS
Subtitle A--Revenue Provisions
Section 301: Repeal Individual Mandate Tax. Repeals the
penalty on individuals who do not obtain qualified health
insurance, effective after 1 December 2014.
Section 302. Repeal of Employer Mandate. Repeals the
penalty on employers who do not offer their employees qualified
health insurance, effective after 1 December 2014.
Section 303: Repeal Medical Device Tax. Repeals the 2.3-
percent excise tax, effective 31 December 2012, on the sale of
any taxable medical device by a manufacturer, producer, or
importer of such device.
Section 304: Repeal of the Excise Tax on Employee Health
Insurance Premiums and Health Benefits and Related Reporting
Requirements (i.e. the Cadillac Tax). Repeals the 40-percent
excise tax on high-value health plans.
Subtitle B--Repeal of the Independent Payment Advisory Board
Section 311: Repeal Medicare Independent Payment Advisory
Board [IPAB]. Repeals IPAB, which would have been required
under certain circumstances to modify the Medicare Program to
achieve specified savings in the Medicare Program. See also
H.R. 1190, which passed the House on 23 June 2015.
Net Change in Deficit, 2016-2025: -$37.1 billion.
Due to interactions between the provisions submitted by the
House committees, an additional net change in the deficit of
-$19.4 billion for fiscal years 2016-2025 was determined by the
Congressional Budget Office. The reconciliation bill's total
net change in the deficit for all reported provisions is -$78.9
billion for fiscal years 2016-2025.
RECONCILIATION AND THE
BUDGET RESOLUTION
----------
Budget resolutions and reconciliation bills have a special
relationship in the congressional budget process. The adoption
of a budget resolution--formally designated a concurrent
resolution on the budget--establishes the reconciliation
process for a fiscal year in addition to providing rules that
assist in guiding a reconciliation bill through the
congressional legislative procedure. Conversely, a
reconciliation bill may be essential to fulfilling the aims of
a given budget resolution.
The Reconciliation Process
The term ``reconciliation'' refers to both a form of
legislation and a specific legislative procedure. Only by
adopting a concurrent resolution on the budget that includes
reconciliation instructions can Congress initiate the
reconciliation process,\3\ ideally culminating in the enactment
of reconciliation legislation. Such a measure is termed a
``reconciliation bill'' because it is designed to amend
existing law to reflect the assumptions underlying the budget
resolution from which it has commenced; that is, it reconciles
current law to the budget resolution framework.
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\3\Section 310 of the Congressional Budget Act of 1974 (2 U.S.C.
Sec. 641).
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S. Con. Res. 11, the conference report accompanying the
Concurrent Resolution on the Budget for Fiscal Year 2016,\4\
agreed to on May 5, 2015, included reconciliation instructions
requiring three House committees and two Senate committees to
amend laws in their jurisdictions such that each committee
reduces the deficit by $1 billion over 10 years.\5\ Under the
procedure, these legislative amendments were then to be
submitted to the Committees on the Budget of the House and
Senate by July 24, 2015.
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\4\H. Rept. 114-096.
\5\Sections 2001(a) and 2002(a) of S. Con. Res. 11 (114th
Congress).
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In the House, the Committee on the Budget accepted
submissions from the three reconciled committees--the
Committees on Education and the Workforce, Energy and Commerce,
and Ways and Means--on October 2, 2015. The submissions
included legislative text, short summaries, Congressional
Budget Office estimates, and other material to assist the
Committee on the Budget in preparing this explanatory report.
The basic elements of a reconciliation bill are set forth
in the Congressional Budget Act of 1974 [Budget Act].
Additional guidelines over content and procedures governing
consideration may be included in budget resolutions.
Reconciliation in the House of Representatives
Reconciliation is defined as a privileged measure in the
House and hence takes precedence over certain other matters
that may be considered on the floor. When a bill is reported by
the Committee on the Budget, comprising the submissions
transmitted to it, under House Rules such a bill is
``originated'' rather than ``introduced''. Only certain
measures become legislation in this fashion: resolutions
providing for consideration of bills on the floor,
appropriation bills, and budget resolutions are examples.
Therefore, a reconciliation bill neither receives an ``H.R.''
number nor is considered a legislative matter until the
Committee on the Budget votes to report the bill and formally
files it with the Clerk of the House.
Budget Resolution Adjustment and House Rules. Under normal
circumstances, all points of order and other procedural budget-
related requirements apply to House reconciliation bills. For
the measure reported by the Committee on the Budget on October
9, 2015, this is not the case. S. Con. Res. 11 specifically
provided for the consideration of this bill and took into
account its budgetary effects. Therefore, Budget Act points of
order, the Cut-As-You-Go point of order,\6\ and the long-term
direct spending point of order contained in the fiscal year
2016 budget resolution\7\ do not apply to this House
reconciliation bill.
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\6\Clause 10 of rule XXI of the Rules of the House of
Representatives.
\7\Section 3101(b)(2) of S. Con. Res. 11 (114th Congress).
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The budget resolution also affirmed and clarified the
authority of the Chairman of the Committee on the Budget to
determine the cost estimates of legislative measures.\8\ In
particular, if the Congressional Budget Office makes
adjustments to its baseline subsequent to its official
publication, the Chairman is authorized to make decisions as to
how to treat those updates. The intent of the provision is to
affirm the Chairman's ability to take into account
unforeseeable events that may occur and diverge from the
assumptions underlying the budget resolution. This has
important implications in how the budgetary effects of
reconciliation bills are determined.
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\8\Section 2002(b)(1)(A) of S. Con. Res. 11 (114th Congress).
Reconciliation and Health Care Legislation. An additional
House component of the budget resolution entails providing
guidance to the committees receiving reconciliation
instructions. They are asked to ``note the policies discussed
in the fiscal year 2016 budget resolution that repeal the
Affordable Care Act and the health care related provisions of
the Health Care and Education Reconciliation Act of 2010''.
Reconciliation in the Senate
The two committees in the Senate that received
reconciliation instructions are the Committee on Finance and
the Committee on Health, Education, Labor, and Pensions. These
Senate committees generally have commensurate jurisdiction as
those in the House, and each was required to reduce the deficit
by $1 billion over the same 10-year period.
Reconciliation and the Deficit Point of Order. The budget
resolution amended Senate legislative procedures by repealing
the point of order against a reconciliation bill increasing the
deficit over 5 or 10 fiscal years.\9\ This prohibition was
originally adopted in the 110th Congress and was intended to
prevent such bills from reducing taxes. The reconciliation bill
considered and reported by the Committee on the Budget of the
House does not increase the deficit in either of the periods
set forth in the Senate point of order repealed by the budget
resolution.
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\9\Section 3204 of S. Con. Res. 11 (114th Congress).
Debt Limit Prohibition. Under the Congressional Budget Act
of 1974, reconciliation bills are specifically allowed to
include changes in the public debt limit.\10\ Section
2001(b)(1) of S. Con. Res. 11, though, overturns that authority
and instead establishes a point of order against including a
debt limit increase. The Senate may not consider a
reconciliation bill, joint resolution, conference report, or an
amendment, if it would increase the public debt limit in any
year during the period of fiscal years 2016 through 2025.\11\
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\10\Section 310(a)(3) of the Congressional Budget Act of 1974
authorizes a reconciliation measure to ``specify the amounts by which
the statutory limit on the public debt is to be changed and direct the
committee having jurisdiction to recommend such change.''
\11\The statutory debt limit is set in 31 U.S.C. Sec. 3101.
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This point of order may be waived, but only if two-thirds
of the Senate (67 Senators) votes to do so. This supermajority
is atypical in that most budget-related points of order may be
waived by a three-fifths vote (60 Senators).
Conclusion
The relationship between the concurrent resolution on the
budget for a fiscal year, and a reconciliation bill that may
result from the adoption of such a measure, is a significant
element of the congressional budget process. Budget resolutions
not only initiate the reconciliation procedure, but can set key
parameters and guidelines by which a reconciliation bill
ultimately navigates the sometimes complex legislative process
of the U.S. Congress. Conversely, the provisions of a
reconciliation bill may be necessary for achieving the budget
resolution's goals. Thus, this reconciliation measure
represents an important step toward fulfilling the aims of S.
Con. Res. 11, the Concurrent Resolution on the Budget for
Fiscal Year 2016.
[COMMITTEE PRINT]
[Budget Reconciliation Legislative Recommendations Relating to Repeal of
Automatic Enrollment Requirement]
TITLE I--COMMITTEE ON EDUCATION AND THE WORKFORCE
SEC._01. 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 (P.L. 111-
148)).
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets and
existing law in which no change is proposed is shown in roman):
SECTION 18A OF THE FAIR LABOR STANDARDS ACT OF 1938
[SEC. 18A. AUTOMATIC ENROLLMENT FOR EMPLOYEES OF LARGE EMPLOYERS.
[In accordance with regulations promulgated by the Secretary,
an employer to which this Act applies that has more than 200
full-time employees and that offers employees enrollment in 1
or more health benefits plans shall automatically enroll new
full-time employees in one of the plans offered (subject to any
waiting period authorized by law) and to continue the
enrollment of current employees in a health benefits plan
offered through the employer. Any automatic enrollment program
shall include adequate notice and the opportunity for an
employee to opt out of any coverage the individual or employee
were automatically enrolled in. Nothing in this section shall
be construed to supersede any State law which establishes,
implements, or continues in effect any standard or requirement
relating to employers in connection with payroll except to the
extent that such standard or requirement prevents an employer
from instituting the automatic enrollment program under this
section.]
Amendment in the nature of a substitute to the committee
recommendations for the Committee on the Budget
Offered by Ms. Stefanik of New York
Strike all after the instruction and insert the following:
TITLE I--COMMITTEE ON EDUCATION AND THE WORKFORCE
SEC._01. REPEAL OF AUTOMATIC ENROLLMENT REQUIREMENT.
The Fair Labor Standards Act (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 (P.L. 111-148)).
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets and
existing law in which no change is proposed is shown in roman):
PATIENT PROTECTION AND AFFORDABLE CARE ACT
* * * * * * *
TITLE IV--PREVENTION OF CHRONIC DISEASE AND IMPROVING PUBLIC HEALTH
Subtitle A--Modernizing Disease Prevention and Public Health Systems
* * * * * * *
[SEC. 4002. PREVENTION AND PUBLIC HEALTH FUND.
[(a)Purpose.--It is the purpose of this section to establish
a Prevention and Public Health Fund (referred to in this
section as the ``Fund''), to be administered through the
Department of Health and Human Services, Office of the
Secretary, to provide for expanded and sustained national
investment in prevention and public health programs to improve
health and help restrain the rate of growth in private and
public sector health care costs.
[(b)Funding.--There are hereby authorized to be appropriated,
and appropriated, to the Fund, out of any monies in the
Treasury not otherwise appropriated--
[(1) for fiscal year 2010, $500,000,000;
[(2) for each of fiscal years 2012 through 2017,
$1,000,000,000;
[(3) for each of fiscal years 2018 and 2019,
$1,250,000,000;
[(4) for each of fiscal years 2020 and 2021,
$1,500,000,000; and
[(5) for fiscal year 2022, and each fiscal year
thereafter, $2,000,000,000.
[(c)Use of Fund.--The Secretary shall transfer amounts in the
Fund to accounts within the Department of Health and Human
Services to increase funding, over the fiscal year 2008 level,
for programs authorized by the Public Health Service Act, for
prevention, wellness, and public health activities including
prevention research, health screenings, and initiatives, such
as the Community Transformation grant program, the Education
and Outreach Campaign Regarding Preventive Benefits, and
immunization programs.
[(d)Transfer Authority.--The Committee on Appropriations of
the Senate and the Committee on Appropriations of the House of
Representatives may provide for the transfer of funds in the
Fund to eligible activities under this section, subject to
subsection (c).]
* * * * * * *
----------
MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT OF 2015
* * * * * * *
TITLE II--MEDICARE AND OTHER HEALTH EXTENDERS
* * * * * * *
Subtitle B--Other Health Extenders
* * * * * * *
SEC. 221. EXTENSION OF FUNDING FOR COMMUNITY HEALTH CENTERS, THE
NATIONAL HEALTH SERVICE CORPS, AND TEACHING HEALTH
CENTERS.
(a)Funding for Community Health Centers and the National
Health Service Corps.--
(1)Community health centers.--Section 10503(b)(1)(E)
of the Patient Protection and Affordable Care Act (42
U.S.C. 254b-2(b)(1)(E)) is amendedby striking
``$3,600,000,000'' and inserting ``$3,835,000,000'' and
by striking ``for fiscal year 2015'' and inserting
``for each of fiscal years 2015 through 2017''.
(2)National health service corps.--Section
10503(b)(2)(E) of the Patient Protection and Affordable
Care Act (42 U.S.C. 254b-2(b)(2)(E)) is amended by
striking ``for fiscal year 2015'' and inserting ``for
each of fiscal years 2015 through 2017''.
(b)Extension of Teaching Health Centers Program.--Section
340H(g) of the Public Health Service Act (42 U.S.C. 256h(g)) is
amended by inserting ``and $60,000,000 for each of fiscal years
2016 and 2017'' before the period at the end.
(c)Application.--Amounts appropriated pursuant to this
section for fiscal year 2016 and fiscal year 2017 are subject
to the requirements contained in Public Law 113-235 for funds
for programs authorized under sections 330 through 340 of the
Public Health Service Act (42 U.S.C. 254b-256).
* * * * * * *
Recommendations Approved By the Committee on Energy and Commerce for
Transmittal to the Committee on Budget Pursuant to Section 2002(a)(2)
of the Concurrent Resolution on the Budget for Fiscal Year 2016 (S.
Con. Res. 11)
TITLE II--COMMITTEE ON ENERGY AND COMMERCE
SEC. 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.
SEC. 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.
SEC. 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''.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italics and existing law in which no change is
proposed is shown in roman):
INTERNAL REVENUE CODE OF 1986
* * * * * * *
Subtitle D--Miscellaneous Excise Taxes
* * * * * * *
CHAPTER 32--MANUFACTURERS EXCISE TAXES
* * * * * * *
[SUBCHAPTER E--Medical Devices]
* * * * * * *
[Subchapter E--Medical Devices
[SEC. 4191. MEDICAL DEVICES.
[(a) In General.--There is hereby imposed on the sale of any
taxable medical device by the manufacturer, producer, or
importer a tax equal to 2.3 percent of the price for which so
sold.
[(b) Taxable Medical Device.--For purposes of this section--
[(1) In general.--The term ``taxable medical device''
means any device (as defined in section 201(h) of the
Federal Food, Drug, and Cosmetic Act) intended for
humans.
[(2) Exemptions.--Such term shall not include--
[(A) eyeglasses,
[(B) contact lenses,
[(C) hearing aids, and
[(D) any other medical device determined by
the Secretary to be of a type which is
generally purchased by the general public at
retail for individual use.]
* * * * * * *
Subchapter G--Exemptions, Registration, Etc
SEC. 4221. CERTAIN TAX-FREE SALES.
(a) General Rule.--Under regulations prescribed by the
Secretary, no tax shall be imposed under this chapter (other
than under section 4121 or 4081) on the sale by the
manufacturer (or under subchapter C of chapter 31 on the first
retail sale) of an article--
(1) for use by the purchaser for further manufacture,
or for resale by the purchaser to a second purchaser
for use by such second purchaser in further
manufacture,
(2) for export, or for resale by the purchaser to a
second purchaser for export,
(3) for use by the purchaser as supplies for vessels
or aircraft,
(4) to a State or local government for the exclusive
use of a State or local government,
(5) to a nonprofit educational organization for its
exclusive use, or
(6) to a qualified blood collector organization (as
defined in section 7701(a)(49)) for such organization's
exclusive use in the collection, storage, or
transportation of blood,
but only if such exportation or use is to occur before any
other use. Paragraphs (4), (5), and (6) shall not apply to the
tax imposed by section 4064. In the case of taxes imposed by
section 4051, or 4071, paragraphs (4) and (5) shall not apply
on and after October 1, 2016. In the case of the tax imposed by
section 4131, paragraphs (3), (4), and (5) shall not apply and
paragraph (2) shall apply only if the use of the exported
vaccine meets such requirements as the Secretary may by
regulations prescribe. In the case of taxes imposed by
subchapter C or D, paragraph (6) shall not apply. [In the case
of the tax imposed by section 4191, paragraphs (3), (4), (5),
and (6) shall not apply.]
(b) Proof of Resale for Further Manufacture; Proof of
Export.--Where an article has been sold free of tax under
subsection (a)--
(1) for resale by the purchaser to a second purchaser
for use by such second purchaser in further
manufacture, or
(2) for export, or for resale by the purchaser to a
second purchaser for export,
subsection (a) shall cease to apply in respect of such sale of
such article unless, within the 6-month period which begins on
the date of the sale by the manufacturer (or, if earlier, on
the date of shipment by the manufacturer), the manufacturer
receives proof that the article has been exported or resold for
use in further manufacture.
(c) Manufacturer Relieved from Liability in Certain Cases.--
In the case of any article sold free of tax under this section
(other than a sale to which subsection (b) applies), and in the
case of any article sold free of tax under section 4053(6), if
the manufacturer in good faith accepts a certification by the
purchaser that the article will be used in accordance with the
applicable provisions of law, no tax shall thereafter be
imposed under this chapter in respect of such sale by such
manufacturer.
(d) Definitions.--For purposes of this section--
(1) Manufacturer.--The term ``manufacturer'' includes
a producer or importer of an article, and, in the case
of taxes imposed by subchapter C of chapter 31,
includes the retailer with respect to the first retail
sale.
(2) Export.--The term ``export'' includes shipment to
a possession of the United States; and the term
``exported'' includes shipped to a possession of the
United States.
(3) Supplies for vessels or aircraft.--The term
``supplies for vessels or aircraft'' means fuel
supplies, ships' stores, sea stores, or legitimate
equipment on vessels of war of the United States or of
any foreign nation, vessels employed in the fisheries
or in the whaling business, or vessels actually engaged
in foreign trade or trade between the Atlantic and
Pacific ports of the United States or between the
United States and any of its possessions. For purposes
of the preceding sentence, the term ``vessels''
includes civil aircraft employed in foreign trade or
trade between the United States and any of its
possessions, and the term ``vessels of war of the
United States or of any foreign nation'' includes
aircraft owned by the United States or by any foreign
nation and constituting a part of the armed forces
thereof.
(4) State or local government.--The term ``State or
local government'' means any State, any political
subdivision thereof, or the District of Columbia.
(5) Nonprofit educational organization.--The term
``nonprofit educational organization'' means an
educational organization described in section
170(b)(1)(A)(ii) which is exempt from income tax under
section 501(a). The term also includes a school
operated as an activity of an organization described in
section 501(c)(3) which is exempt from income tax under
section 501(a), if such school normally maintains a
regular faculty and curriculum and normally has a
regularly enrolled body of pupils or students in
attendance at the place where its educational
activities are regularly carried on.
(6) Use in further manufacture.--An article shall be
treated as sold for use in further manufacture if--
(A) such article is sold for use by the
purchaser as material in the manufacture or
production of, or as a component part of,
another article taxable under this chapter to
be manufactured or produced by him; or
(B) in the case of gasoline taxable under
section 4081, such gasoline is sold for use by
the purchaser, for nonfuel purposes, as a
material in the manufacture or production of
another article to be manufactured or produced
by him.
(7) Qualified bus.--
(A) In general.--The term ``qualified bus''
means--
(i) an intercity or local bus, and
(ii) a school bus.
(B) Intercity or local bus.--The term
``intercity or local bus'' means any automobile
bus which is used predominantly in furnishing
(for compensation) passenger land
transportation available to the general public
if--
(i) such transportation is scheduled
and along regular routes, or
(ii) the seating capacity of such bus
is at least 20 adults (not including
the driver).
(C) School bus.--The term ``school bus''
means any automobile bus substantially all the
use of which is in transporting students and
employees of schools. For purposes of the
preceding sentence, the term ``school'' means
an educational organization which normally
maintains a regular faculty and curriculum and
normally has a regularly enrolled body of
pupils or students in attendance at the place
where its educational activities are carried
on.
(e) Special Rules.--
(1) Reciprocity required in case of civil aircraft.--
In the case of articles sold for use as supplies for
aircraft, the privileges granted under subsection
(a)(3) in respect of civil aircraft employed in foreign
trade or trade between the United States and any of its
possessions, in respect of aircraft registered in a
foreign country, shall be allowed only if the Secretary
of the Treasury has been advised by the Secretary of
Commerce that he has found that such foreign country
allows, or will allow, substantially reciprocal
privileges in respect of aircraft registered in the
United States. If the Secretary of the Treasury is
advised by the Secretary of Commerce that he has found
that a foreign country has discontinued or will
discontinue the allowance of such privileges, the
privileges granted under subsection (a)(3) shall not
apply thereafter in respect of civil aircraft
registered in that foreign country and employed in
foreign trade or trade between the United States and
any of its possessions.
(2) Tires.--
(A) Tax-free sales.--Under regulations
prescribed by the Secretary, no tax shall be
imposed under section 4071 on the sale by the
manufacturer of a tire if--
(i) such tire is sold for use by the
purchaser for sale on or in connection
with the sale of another article
manufactured or produced by such
purchaser; and
(ii) such other article is to be sold
by such purchaser in a sale which
either will satisfy the requirements of
paragraph (2), (3), (4), or (5) of
subsection (a) for a tax-free sale, or
would satisfy such requirements but for
the fact that such other article is not
subject to tax under this chapter.
(B) Proof.--Where a tire has been sold free
of tax under this paragraph, this paragraph
shall cease to apply unless, within the 6-moth
period which begins on the date of the sale by
him (or, if earlier on the date of the shipment
by him), the manufacturer of such tire receives
proof that the other article referred to in
clause (ii) of subparagraph (A) has been sold
in a manner which satisfies the requirements of
such clause (ii) (including in the case of a
sale for export, proof of export of such other
article).
(C) Subsection(a)(1) does not apply.--
Paragraph (1) of subsection (a) shall not apply
with respect to the tax imposed under section
4071 on the sale of a tire.
(3) Tires used on intercity, local, and school
buses.--Under regulations prescribed by the Secretary,
the tax imposed by section 4071 shall not apply in the
case of tires sold for use by the purchaser on or in
connection with a qualified bus.
* * * * * * *
CHAPTER 43--QUALIFIED PENSION, ETC., PLANS
* * * * * * *
[Sec. 4980I. Excise tax on high cost employer-sponsored health
coverage.]
* * * * * * *
SEC. 4980H. SHARED RESPONSIBILITY FOR EMPLOYERS REGARDING HEALTH
COVERAGE.
(a) Large Employers Not Offering Health Coverage.--If--
(1) any applicable large employer fails to offer to
its full-time employees (and their dependents) the
opportunity to enroll in minimum essential coverage
under an eligible employer-sponsored plan (as defined
in section 5000A(f)(2)) for any month, and
(2) at least one full-time employee of the applicable
large employer has been certified to the employer under
section 1411 of the Patient Protection and Affordable
Care Act as having enrolled for such month in a
qualified health plan with respect to which an
applicable premium tax credit or cost-sharing reduction
is allowed or paid with respect to the employee,
then there is hereby imposed on the employer an assessable
payment equal to the product of the applicable payment amount
and the number of individuals employed by the employer as full-
time employees during such month.
(b) Large Employers Offering Coverage With Employees Who
Qualify for Premium Tax Credits or Cost-Sharing Reductions.--
(1) In general.--If--
(A) an applicable large employer offers to
its full-time employees (and their dependents)
the opportunity to enroll in minimum essential
coverage under an eligible employer-sponsored
plan (as defined in section 5000A(f)(2)) for
any month, and
(B) 1 or more full-time employees of the
applicable large employer has been certified to
the employer under section 1411 of the Patient
Protection and Affordable Care Act as having
enrolled for such month in a qualified health
plan with respect to which an applicable
premium tax credit or cost-sharing reduction is
allowed or paid with respect to the employee,
then there is hereby imposed on the employer an
assessable payment equal to the product of the number
of full-time employees of the applicable large employer
described in subparagraph (B) for such month and an
amount equal to \1/12\ of $3,000.
(2) Overall limitation.--The aggregate amount of tax
determined under paragraph (1) with respect to all
employees of an applicable large employer for any month
shall not exceed the product of the applicable payment
amount and the number of individuals employed by the
employer as full-time employees during such month.
(c) Definitions and Special Rules.--For purposes of this
section--
(1) Applicable payment amount.--The term ``applicable
payment amount'' means, with respect to any month, \1/
12\ of $2,000.
(2) Applicable large employer.--
(A) In general.--The term ``applicable large
employer'' means, with respect to a calendar
year, an employer who employed an average of at
least 50 full-time employees on business days
during the preceding calendar year.
(B) Exemption for certain employers.--
(i) In general.--An employer shall
not be considered to employ more than
50 full-time employees if--
(I) the employer's workforce
exceeds 50 full-time employees
for 120 days or fewer during
the calendar year, and
(II) the employees in excess
of 50 employed during such 120-
day period were seasonal
workers.
(ii) Definition of seasonal
workers.--The term ``seasonal worker''
means a worker who performs labor or
services on a seasonal basis as defined
by the Secretary of Labor, including
workers covered by section 500.20(s)(1)
of title 29, Code of Federal
Regulations and retail workers employed
exclusively during holiday seasons.
(C) Rules for determining employer size.--For
purposes of this paragraph--
(i) Application of aggregation rule
for employers.--All persons treated as
a single employer under subsection (b),
(c), (m), or (o) of section 414 of the
Internal Revenue Code of 1986 shall be
treated as 1 employer.
(ii) Employers not in existence in
preceding year.--In the case of an
employer which was not in existence
throughout the preceding calendar year,
the determination of whether such
employer is an applicable large
employer shall be based on the average
number of employees that it is
reasonably expected such employer will
employ on business days in the current
calendar year.
(iii) Predecessors.--Any reference in
this subsection to an employer shall
include a reference to any predecessor
of such employer.
(D) Application of employer size to
assessable penalties.--
(i) In general.--The number of
individuals employed by an applicable
large employer as full-time employees
during any month shall be reduced by 30
solely for purposes of calculating--
(I) the assessable payment
under subsection (a), or
(II) the overall limitation
under subsection (b)(2).
(ii) Aggregation.--In the case of
persons treated as 1 employer under
subparagraph (C)(i), only 1 reduction
under subclause (I) or (II) shall be
allowed with respect to such persons
and such reduction shall be allocated
among such persons ratably on the basis
of the number of full-time employees
employed by each such person.
(E) Full-time equivalents treated as full-
time employees.--Solely for purposes of
determining whether an employer is an
applicable large employer under this paragraph,
an employer shall, in addition to the number of
full-time employees for any month otherwise
determined, include for such month a number of
full-time employees determined by dividing the
aggregate number of hours of service of
employees who are not full-time employees for
the month by 120.
(F) Exemption for health coverage under
TRICARE or the Veterans Administration.--Solely
for purposes of determining whether an employer
is an applicable large employer under this
paragraph for any month, an individual shall
not be taken into account as an employee for
such month if such individual has medical
coverage for such month under--
(i) chapter 55 of title 10, United
States Code, including coverage under
the TRICARE program, or
(ii) under a health care program
under chapter 17 or 18 of title 38,
United States Code, as determined by
the Secretary of Veterans Affairs, in
coordination with the Secretary of
Health and Human Services and the
Secretary.
(3) Applicable premium tax credit and cost-sharing
reduction.--The term ``applicable premium tax credit
and cost-sharing reduction'' means--
(A) any premium tax credit allowed under
section 36B,
(B) any cost-sharing reduction under section
1402 of the Patient Protection and Affordable
Care Act, and
(C) any advance payment of such credit or
reduction under section 1412 of such Act.
(4) Full-time employee.--
(A) In general.--The term ``full-time
employee'' means, with respect to any month, an
employee who is employed on average at least 30
hours of service per week.
(B) Hours of service.--The Secretary, in
consultation with the Secretary of Labor, shall
prescribe such regulations, rules, and guidance
as may be necessary to determine the hours of
service of an employee, including rules for the
application of this paragraph to employees who
are not compensated on an hourly basis.
[(5) Inflation adjustment.--
[(A) In general.--In the case of any calendar
year after 2014, each of the dollar amounts in
subsection (b) and paragraph (1) shall be
increased by an amount equal to the product
of--
[(i) such dollar amount, and
[(ii) the premium adjustment
percentage (as defined in section
1302(c)(4) of the Patient Protection
and Affordable Care Act) for the
calendar year.
[(B) Rounding.--If the amount of any increase
under subparagraph (A) is not a multiple of
$10, such increase shall be rounded to the next
lowest multiple of $10.]
(6) Other definitions.--Any term used in this section
which is also used in the Patient Protection and
Affordable Care Act shall have the same meaning as when
used in such Act.
(7) Tax nondeductible.--For denial of deduction for
the tax imposed by this section, see section 275(a)(6).
(d) Administration and Procedure.--
(1) In general.--Any assessable payment provided by
this section shall be paid upon notice and demand by
the Secretary, and shall be assessed and collected in
the same manner as an assessable penalty under
subchapter B of chapter 68.
(2) Time for payment.--The Secretary may provide for
the payment of any assessable payment provided by this
section on an annual, monthly, or other periodic basis
as the Secretary may prescribe.
(3) Coordination with credits, etc..--The Secretary
shall prescribe rules, regulations, or guidance for the
repayment of any assessable payment (including
interest) if such payment is based on the allowance or
payment of an applicable premium tax credit or cost-
sharing reduction with respect to an employee, such
allowance or payment is subsequently disallowed, and
the assessable payment would not have been required to
be made but for such allowance or payment.
(e) Termination.--This section shall not apply with respect
to any month beginning after December 31, 2014.
[SEC. 4980I. EXCISE TAX ON HIGH COST EMPLOYER-SPONSORED HEALTH
COVERAGE.
[(a) Imposition of Tax.--If--
[(1) an employee is covered under any applicable
employer-sponsored coverage of an employer at any time
during a taxable period, and
[(2) there is any excess benefit with respect to the
coverage, there is hereby imposed a tax equal to 40
percent of the excess benefit.
[(b) Excess Benefit.--For purposes of this section--
[(1) In general.--The term ``excess benefit'' means,
with respect to any applicable employer-sponsored
coverage made available by an employer to an employee
during any taxable period, the sum of the excess
amounts determined under paragraph (2) for months
during the taxable period.
[(2) Monthly excess amount.--The excess amount
determined under this paragraph for any month is the
excess (if any) of--
[(A) the aggregate cost of the applicable
employer- sponsored coverage of the employee
for the month, over
[(B) an amount equal to \1/12\ of the annual
limitation under paragraph (3) for the calendar
year in which the month occurs.
[(3) Annual limitation.--For purposes of this
subsection--
[(A) In general.--The annual limitation under
this paragraph for any calendar year is the
dollar limit determined under subparagraph (C)
for the calendar year.
[(B) Applicable annual limitation.--
[(i) In general.--Except as provided
in clause (ii), the annual limitation
which applies for any month shall be
determined on the basis of the type of
coverage (as determined under
subsection (f)(1)) provided to the
employee by the employer as of the
beginning of the month.
[(ii) Multiemployer plan coverage.--
Any coverage provided under a
multiemployer plan (as defined in
section 414(f)) shall be treated as
coverage other than self-only coverage.
[(C) Applicable dollar limit.--
[(i) 2018.--In the case of 2018, the
dollar limit under this subparagraph
is--
[(I) in the case of an
employee with self-only
coverage, $10,200 multiplied by
the health cost adjustment
percentage (determined by only
taking into account self-only
coverage), and
[(II) in the case of an
employee with coverage other
than self-only coverage,
$27,500 multiplied by the
health cost adjustment
percentage (determined by only
taking into account coverage
other than self-only coverage).
[(ii)Health cost adjustment
percentage.--For purposes of clause
(i), the health cost adjustment
percentage is equal to 100 percent plus
the excess (if any) of--
[(I) the percentage by which
the per employee cost for
providing coverage under the
Blue Cross/Blue Shield standard
benefit option under the
Federal Employees Health
Benefits Plan for plan year
2018 (determined by using the
benefit package for such
coverage in 2010) exceeds such
cost for plan year 2010, over
[(II) 55 percent.
[(iii) Age and gender adjustment.--
[(I) In general.--The amount
determined under subclause (I)
or (II) of clause (i),
whichever is applicable, for
any taxable period shall be
increased by the amount
determined under subclause
(II).
[(II) Amount determined.--The
amount determined under this
subclause is an amount equal to
the excess (if any) of--
[(aa) the premium
cost of the Blue Cross/
Blue Shield standard
benefit option under
the Federal Employees
Health Benefits Plan
for the type of
coverage provided such
individual in such
taxable period if
priced for the age and
gender characteristics
of all employees of the
individual's employer,
over
[(bb) that premium
cost for the provision
of such coverage under
such option in such
taxable period if
priced for the age and
gender characteristics
of the national
workforce.
[(iv) Exception for certain
individuals.--In the case of an
individual who is a qualified retiree
or who participates in a plan sponsored
by an employer the majority of whose
employees covered by the plan are
engaged in a high-risk profession or
employed to repair or install
electrical or telecommunications
lines--
[(I) the dollar amount in
clause (i)(I) shall be
increased by $1,650, and
[(II) the dollar amount in
clause (i)(II) shall be
increased by $3,450,
[(v) Subsequent years.--In the case
of any calendar year after 2018, each
of the dollar amounts under clauses (i)
(after the application of clause (ii))
and (iv) shall be increased to the
amount equal to such amount as in
effect for the calendar year preceding
such year, increased by an amount equal
to the product of--
[(I) such amount as so in
effect, multiplied by
[(II) the cost-of-living
adjustment determined under
section 1(f)(3) for such year
(determined by substituting the
calendar year that is 2 years
before such year for ``1992''
in subparagraph (B) thereof),
increased by 1 percentage point
in the case of determinations
for calendar years beginning
before 2020.
If any amount determined under this
clause is not a multiple of $50, such
amount shall be rounded to the nearest
multiple of $50.
[(c) Liability to Pay Tax.--
[(1) In general.--Each coverage provider shall pay
the tax imposed by subsection (a) on its applicable
share of the excess benefit with respect to an employee
for any taxable period.
[(2) Coverage provider.--For purposes of this
subsection, the term ``coverage provider'' means each
of the following:
[(A) Health insurance coverage.--If the
applicable employer-sponsored coverage consists
of coverage under a group health plan which
provides health insurance coverage, the health
insurance issuer.
[(B) HSA and MSA contributions.--If the
applicable employer-sponsored coverage consists
of coverage under an arrangement under which
the employer makes contributions described in
subsection (b) or (d) of section 106, the
employer.
[(C) Other coverage.--In the case of any
other applicable employer-sponsored coverage,
the person that administers the plan benefits.
[(3) Applicable share.--For purposes of this
subsection, a coverage provider's applicable share of
an excess benefit for any taxable period is the amount
which bears the same ratio to the amount of such excess
benefit as--
[(A) the cost of the applicable employer-
sponsored coverage provided by the provider to
the employee during such period, bears to
[(B) the aggregate cost of all applicable
employer-sponsored coverage provided to the
employee by all coverage providers during such
period.
[(4) Responsibility to calculate tax and applicable
shares.--
[(A) In general.--Each employer shall--
[(i) calculate for each taxable
period the amount of the excess benefit
subject to the tax imposed by
subsection (a) and the applicable share
of such excess benefit for each
coverage provider, and
[(ii) notify, at such time and in
such manner as the Secretary may
prescribe, the Secretary and each
coverage provider of the amount so
determined for the provider.
[(B) Special rule for multiemployer plans.--
In the case of applicable employer-sponsored
coverage made available to employees through a
multiemployer plan (as defined in section
414(f)), the plan sponsor shall make the
calculations, and provide the notice, required
under subparagraph (A).
[(d) Applicable Employer-Sponsored Coverage; Cost.--For
purposes of this section--
[(1) Applicable employer-sponsored coverage.--
[(A) In general.--The term ``applicable
employer-sponsored coverage'' means, with
respect to any employee, coverage under any
group health plan made available to the
employee by an employer which is excludable
from the employee's gross income under section
106, or would be so excludable if it were
employer-provided coverage (within the meaning
of such section 106).
[(B) Exceptions.--The term ``applicable
employer-sponsored coverage'' shall not
include--
[(i) any coverage (whether through
insurance or otherwise) described in
section 9832(c)(1) (other than
subparagraph (G) thereof) or for long-
term care, or
[(ii) any coverage under a separate
policy, certificate, or contract of
insurance which provides benefits
substantially all of which are for
treatment of the mouth (including any
organ or structure within the mouth) or
for treatment of the eye, or
[(iii) any coverage described in
section 9832(c)(3) the payment for
which is not excludable from gross
income and for which a deduction under
section 162(l) is not allowable.
[(C) Coverage includes employee paid
portion.--Coverage shall be treated as
applicable employer-sponsored coverage without
regard to whether the employer or employee pays
for the coverage.
[(D) Self-employed individual.--In the case
of an individual who is an employee within the
meaning of section 401(c)(1), coverage under
any group health plan providing health
insurance coverage shall be treated as
applicable employer-sponsored coverage if a
deduction is allowable under section 162(l)
with respect to all or any portion of the cost
of the coverage.
[(E) Governmental plans included.--Applicable
employer-sponsored coverage shall include
coverage under any group health plan
established and maintained primarily for its
civilian employees by the Government of the
United States, by the government of any State
or political subdivision thereof, or by any
agency or instrumentality of any such
government.
[(2) Determination of cost.--
[(A) In general.--The cost of applicable
employer- sponsored coverage shall be
determined under rules similar to the rules of
section 4980B(f)(4), except that in determining
such cost, any portion of the cost of such
coverage which is attributable to the tax
imposed under this section shall not be taken
into account and the amount of such cost shall
be calculated separately for self-only coverage
and other coverage. In the case of applicable
employer-sponsored coverage which provides
coverage to retired employees, the plan may
elect to treat a retired employee who has not
attained the age of 65 and a retired employee
who has attained the age of 65 as similarly
situated beneficiaries.
[(B) Health FSAS.--In the case of applicable
employer- sponsored coverage consisting of
coverage under a flexible spending arrangement
(as defined in section 106(c)(2)), the cost of
the coverage shall be equal to the sum of--
[(i) the amount of employer
contributions under any salary
reduction election under the
arrangement, plus
[(ii) the amount determined under
subparagraph (A) with respect to any
reimbursement under the arrangement in
excess of the contributions described
in clause (i).
[(C) Archer MSAS and HSAS.--In the case of
applicable employer-sponsored coverage
consisting of coverage under an arrangement
under which the employer makes contributions
described in subsection (b) or (d) of section
106, the cost of the coverage shall be equal to
the amount of employer contributions under the
arrangement.
[(D) Allocation on a monthly basis.--If cost
is determined on other than a monthly basis,
the cost shall be allocated to months in a
taxable period on such basis as the Secretary
may prescribe.
[(3) Employee.--The term ``employee'' includes any
former employee, surviving spouse, or other primary
insured individual.
[(e) Penalty for Failure to Properly Calculate Excess
Benefit.--
[(1) In general.--If, for any taxable period, the tax
imposed by subsection (a) exceeds the tax determined
under such subsection with respect to the total excess
benefit calculated by the employer or plan sponsor
under subsection (c)(4)--
[(A) each coverage provider shall pay the tax
on its applicable share (determined in the same
manner as under subsection (c)(4)) of the
excess, but no penalty shall be imposed on the
provider with respect to such amount, and
[(B) the employer or plan sponsor shall, in
addition to any tax imposed by subsection (a),
pay a penalty in an amount equal to such
excess, plus interest at the underpayment rate
determined under section 6621 for the period
beginning on the due date for the payment of
tax imposed by subsection (a) to which the
excess relates and ending on the date of
payment of the penalty.
[(2) Limitations on penalty.--
[(A) Penalty not to apply where failure not
discovered exercising reasonable diligence.--No
penalty shall be imposed by paragraph (1)(B) on
any failure to properly calculate the excess
benefit during any period for which it is
established to the satisfaction of the
Secretary that the employer or plan sponsor
neither knew, nor exercising reasonable
diligence would have known, that such failure
existed.
[(B) Penalty not to apply to failures
corrected within30 days.--No penalty shall be
imposed by paragraph (1)(B) on any such failure
if--
[(i) such failure was due to
reasonable cause and not to willful
neglect, and
[(ii) such failure is corrected
during the 30-day period beginning on
the 1st date that the employer knew, or
exercising reasonable diligence would
have known, that such failure existed.
[(C) Waiver by Secretary.--In the case of any
such failure which is due to reasonable cause
and not to willful neglect, the Secretary may
waive part or all of the penalty imposed by
paragraph (1), to the extent that the payment
of such penalty would be excessive or otherwise
inequitable relative to the failure involved.
[(f) Other Definitions and Special Rules.--For purposes of
this section--
[(1) Coverage determinations.--
[(A) In general.--Except as provided in
subparagraph (B), an employee shall be treated
as having self-only coverage with respect to
any applicable employer-sponsored coverage of
an employer.
[(B) Minimum essential coverage.--An employee
shall be treated as having coverage other than
self-only coverage only if the employee is
enrolled in coverage other than self-only
coverage in a group health plan which provides
minimum essential coverage (as defined in
section 5000A(f)) to the employee and at least
one other beneficiary, and the benefits
provided under such minimum essential coverage
do not vary based on whether any individual
covered under such coverage is the employee or
another beneficiary.
[(2) Qualified retiree.--The term ``qualified
retiree'' means any individual who--
[(A) is receiving coverage by reason of being
a retiree,
[(B) has attained age 55, and
[(C) is not entitled to benefits or eligible
for enrollment under the Medicare program under
title XVIII of the Social Security Act.
[(3) Employees engaged in high-risk profession.--The
term ``employees engaged in a high-risk profession''
means law enforcement officers (as such term is defined
in section 1204 of the Omnibus Crime Control and Safe
Streets Act of 1968), employees in fire protection
activities (as such term is defined in section 3(y) of
the Fair Labor Standards Act of 1938), individuals who
provide out- of-hospital emergency medical care
(including emergency medical technicians, paramedics,
and first-responders), individuals whose primary work
is longshore work (as defined in section 258(b) of the
Immigration and Nationality Act (8 U.S.C. 1288(b)),
determined without regard to paragraph (2) thereof),
and individuals engaged in the construction, mining,
agriculture (not including food processing), forestry,
and fishing industries. Such term includes an employee
who is retired from a high-risk profession described in
the preceding sentence, if such employee satisfied the
requirements of such sentence for a period of not less
than 20 years during the employee's employment.
[(4) Group health plan.--The term ``group health
plan'' has the meaning given such term by section
5000(b)(1).
[(5) Health insurance coverage; health insurance
issuer.--
[(A) Health insurance coverage.--The term
``health insurance coverage'' has the meaning
given such term by section 9832(b)(1) (applied
without regard to subparagraph (B) thereof,
except as provided by the Secretary in
regulations).
[(B) Health insurance issuer.--The term
``health insurance issuer'' has the meaning
given such term by section 9832(b)(2).
[(6) Person that administers the plan benefits.--The
term ``person that administers the plan benefits''
shall include the plan sponsor if the plan sponsor
administers benefits under the plan.
[(7) Plan sponsor.--The term ``plan sponsor'' has the
meaning given such term in section 3(16)(B) of the
Employee Retirement Income Security Act of 1974.
[(8) Taxable period.--The term ``taxable period''
means the calendar year or such shorter period as the
Secretary may prescribe. The Secretary may have
different taxable periods for employers of varying
sizes.
[(9) Aggregation rules.--All employers treated as a
single employer under subsection (b), (c), (m), or (o)
of section 414 shall be treated as a single employer.
[(10) Denial of deduction.--For denial of a deduction
for the tax imposed by this section, see section
275(a)(6).
[(g) Regulations.--The Secretary shall prescribe such
regulations as may be necessary to carry out this section.]
* * * * * * *
CHAPTER 48--MAINTENANCE OF MINIMUM ESSENTIAL COVERAGE
SEC. 5000A. REQUIREMENT TO MAINTAIN MINIMUM ESSENTIAL COVERAGE.
(a) Requirement to Maintain Minimum Essential Coverage.--An
applicable individual shall for each month beginning after 2013
ensure that the individual, and any dependent of the individual
who is an applicable individual, is covered under minimum
essential coverage for such month.
(b) Shared Responsibility Payment.--
(1) In general.--If a taxpayer who is an applicable
individual, or an applicable individual for whom the
taxpayer is liable under paragraph (3), fails to meet
the requirement of subsection (a) for 1 or more months,
then, except as provided in subsection (e), there is
hereby imposed on the taxpayer a penalty with respect
to such failures in the amount determined under
subsection (c).
(2) Inclusion with return.--Any penalty imposed by
this section with respect to any month shall be
included with a taxpayer's return under chapter 1 for
the taxable year which includes such month.
(3) Payment of penalty.--If an individual with
respect to whom a penalty is imposed by this section
for any month--
(A) is a dependent (as defined in section
152) of another taxpayer for the other
taxpayer's taxable year including such month,
such other taxpayer shall be liable for such
penalty, or
(B) files a joint return for the taxable year
including such month, such individual and the
spouse of such individual shall be jointly
liable for such penalty.
(c) Amount of Penalty.--
(1) In general.--The amount of the penalty imposed by
this section on any taxpayer for any taxable year with
respect to failures described in subsection (b)(1)
shall be equal to the lesser of--
(A) the sum of the monthly penalty amounts
determined under paragraph (2) for months in
the taxable year during which 1 or more such
failures occurred, or
(B) an amount equal to the national average
premium for qualified health plans which have a
bronze level of coverage, provide coverage for
the applicable family size involved, and are
offered through Exchanges for plan years
beginning in the calendar year with or within
which the taxable year ends.
(2) Monthly penalty amounts.--For purposes of
paragraph (1)(A), the monthly penalty amount with
respect to any taxpayer for any month during which any
failure described in subsection (b)(1) occurred is an
amount equal to \1/12\ of the greater of the following
amounts:
(A) Flat dollar amount.--An amount equal to
the lesser of--
(i) the sum of the applicable dollar
amounts for all individuals with
respect to whom such failure occurred
during such month, or
(ii) 300 percent of the applicable
dollar amount (determined without
regard to paragraph (3)(C)) for the
calendar year with or within which the
taxable year ends.
(B) Percentage of income.--An amount equal to
the following percentage of the excess of the
taxpayer's household income for the taxable
year over the amount of gross income specified
in section 6012(a)(1) with respect to the
taxpayer for the taxable year:
(i) 1.0 percent for taxable years
beginning in 2014.
[(ii) 2.0 percent for taxable years
beginning in 2015.
[(iii) 2.5 percent for taxable years
beginning after 2015.]
(3) Applicable dollar amount.--For purposes of
paragraph (1)--
(A) In general.--Except as provided in
subparagraphs (B) and (C), the applicable
dollar amount is $695.
(B) Phase in.--The applicable dollar amount
is $95 for [2014 and $325 for 2015.]2014.
(C) Special rule for individuals under
age18.--If an applicable individual has not
attained the age of 18 as of the beginning of a
month, the applicable dollar amount with
respect to such individual for the month shall
be equal to one-half of the applicable dollar
amount for the calendar year in which the month
occurs.
[(D) Indexing of amount.--In the case of any
calendar year beginning after 2016, the
applicable dollar amount shall be equal to
$695, increased by an amount equal to--
[(i) $695, multiplied by
[(ii) the cost-of-living adjustment
determined under section 1(f)(3) for
the calendar year, determined by
substituting ``calendar year 2015'' for
``calendar year 1992'' in subparagraph
(B) thereof.]
If the amount of any increase under clause (i)
is not a multiple of $50, such increase shall
be rounded to the next lowest multiple of $50.
(4) Terms relating to income and families.--For
purposes of this section--
(A) Family size.--The family size involved
with respect to any taxpayer shall be equal to
the number of individuals for whom the taxpayer
is allowed a deduction under section 151
(relating to allowance of deduction for
personal exemptions) for the taxable year.
(B) Household income.--The term ``household
income'' means, with respect to any taxpayer
for any taxable year, an amount equal to the
sum of--
(i) the modified adjusted gross
income of the taxpayer, plus
(ii) the aggregate modified adjusted
gross incomes of all other individuals
who--
(I) were taken into account
in determining the taxpayer's
family size under paragraph
(1), and
(II) were required to file a
return of tax imposed by
section 1 for the taxable year.
(C) Modified adjusted gross income.--The term
``modified adjusted gross income'' means
adjusted gross income increased by--
(i) any amount excluded from gross
income under section 911, and
(ii) any amount of interest received
or accrued by the taxpayer during the
taxable year which is exempt from tax.
(d) Applicable Individual.--For purposes of this section--
(1) In general.--The term ``applicable individual''
means, with respect to any month, an individual other
than an individual described in paragraph (2), (3), or
(4).
(2) Religious exemptions.--
(A) Religious conscience exemption.--Such
term shall not include any individual for any
month if such individual has in effect an
exemption under section 1311(d)(4)(H) of the
Patient Protection and Affordable Care Act
which certifies that such individual is--
(i) a member of a recognized
religious sect or division thereof
which is described in section
1402(g)(1), and
(ii) an adherent of established
tenets or teachings of such sect or
division as described in such section.
(B)Health care sharing ministry.--
(i) In general.--Such term shall not
include any individual for any month if
such individual is a member of a health
care sharing ministry for the month.
(ii) Health care sharing ministry.--
The term ``health care sharing
ministry'' means an organization--
(I) which is described in
section 501(c)(3) and is exempt
from taxation under section
501(a),
(II) members of which share a
common set of ethical or
religious beliefs and share
medical expenses among members
in accordance with those
beliefs and without regard to
the State in which a member
resides or is employed,
(III) members of which retain
membership even after they
develop a medical condition,
(IV) which (or a predecessor
of which) has been in existence
at all times since December 31,
1999, and medical expenses of
its members have been shared
continuously and without
interruption since at least
December 31, 1999, and
(V) which conducts an annual
audit which is performed by an
independent certified public
accounting firm in accordance
with generally accepted
accounting principles and which
is made available to the public
upon request.
(3) Individuals not lawfully present.--Such term
shall not include an individual for any month if for
the month the individual is not a citizen or national
of the United States or an alien lawfully present in
the United States.
(4) Incarcerated individuals.--Such term shall not
include an individual for any month if for the month
the individual is incarcerated, other than
incarceration pending the disposition of charges.
(e) Exemptions.--No penalty shall be imposed under subsection
(a) with respect to--
(1) Individuals who cannot afford coverage.--
(A) In general.--Any applicable individual
for any month if the applicable individual's
required contribution (determined on an annual
basis) for coverage for the month exceeds 8
percent of such individual's household income
for the taxable year described in section
1412(b)(1)(B) of the Patient Protection and
Affordable Care Act. For purposes of applying
this subparagraph, the taxpayer's household
income shall be increased by any exclusion from
gross income for any portion of the required
contribution made through a salary reduction
arrangement.
(B) Required contribution.--For purposes of
this paragraph, the term ``required
contribution'' means--
(i) in the case of an individual
eligible to purchase minimum essential
coverage consisting of coverage through
an eligible-employer-sponsored plan,
the portion of the annual premium which
would be paid by the individual
(without regard to whether paid through
salary reduction or otherwise) for
self-only coverage, or
(ii) in the case of an individual
eligible only to purchase minimum
essential coverage described in
subsection (f)(1)(C), the annual
premium for the lowest cost bronze plan
available in the individual market
through the Exchange in the State in
the rating area in which the individual
resides (without regard to whether the
individual purchased a qualified health
plan through the Exchange), reduced by
the amount of the credit allowable
under section 36B for the taxable year
(determined as if the individual was
covered by a qualified health plan
offered through the Exchange for the
entire taxable year).
(C) Special rules for individuals related to
employees.--For purposes of subparagraph
(B)(i), if an applicable individual is eligible
for minimum essential coverage through an
employer by reason of a relationship to an
employee, the determination under subparagraph
(A) shall be made by reference to required
contribution of the employee.
[(D) Indexing.--In the case of plan years
beginning in any calendar year after 2014,
subparagraph (A) shall be applied by
substituting for ``8 percent'' the percentage
the Secretary of Health and Human Services
determines reflects the excess of the rate of
premium growth between the preceding calendar
year and 2013 over the rate of income growth
for such period.]
(2) Taxpayers with income below filing threshold.--
Any applicable individual for any month during a
calendar year if the individual's household income for
the taxable year described in section 1412(b)(1)(B) of
the Patient Protection and Affordable Care Act is the
amount of gross income specified in section 6012(a)(1)
with respect to the taxpayer.
(3) Members of Indian tribes.--Any applicable
individual for any month during which the individual is
a member of an Indian tribe (as defined in section
45A(c)(6)).
(4) Months during short coverage gaps.--
(A) In general.--Any month the last day of
which occurred during a period in which the
applicable individual was not covered by
minimum essential coverage for a continuous
period of less than 3 months.
(B) Special rules.--For purposes of applying
this paragraph--
(i) the length of a continuous period
shall be determined without regard to
the calendar years in which months in
such period occur,
(ii) if a continuous period is
greater than the period allowed under
subparagraph (A), no exception shall be
provided under this paragraph for any
month in the period, and
(iii) if there is more than 1
continuous period described in
subparagraph (A) covering months in a
calendar year, the exception provided
by this paragraph shall only apply to
months in the first of such periods.
The Secretary shall prescribe rules for the
collection of the penalty imposed by this
section in cases where continuous periods
include months in more than 1 taxable year.
(5) Hardships.--Any applicable individual who for any
month is determined by the Secretary of Health and
Human Services under section 1311(d)(4)(H) to have
suffered a hardship with respect to the capability to
obtain coverage under a qualified health plan.
(f) Minimum Essential Coverage.--For purposes of this
section--
(1) In general.--The term ``minimum essential
coverage'' means any of the following:
(A) Government sponsored programs.--Coverage
under--
(i) the Medicare program under part A
of title XVIII of the Social Security
Act,
(ii) the Medicaid program under title
XIX of the Social Security Act,
(iii) the CHIP program under title
XXI of the Social Security Act,
(iv) medical coverage under chapter
55 of title 10, United States Code,
including coverage under the TRICARE
program;
(v) a health care program under
chapter 17 or 18 of title 38, United
States Code, as determined by the
Secretary of Veterans Affairs, in
coordination with the Secretary of
Health and Human Services and the
Secretary,
(vi) a health plan under section
2504(e) of title 22, United States Code
(relating to Peace Corps volunteers);
or
(vii) the Nonappropriated Fund Health
Benefits Program of the Department of
Defense, established under section 349
of the National Defense Authorization
Act for Fiscal Year 1995 (Public Law
103-337; 10 U.S.C. 1587 note).
(B) Employer-sponsored plan.--Coverage under
an eligible employer-sponsored plan.
(C) Plans in the individual market.--Coverage
under a health plan offered in the individual
market within a State.
(D) Grandfathered health plan.--Coverage
under a grandfathered health plan.
(E) Other coverage.--Such other health
benefits coverage, such as a State health
benefits risk pool, as the Secretary of Health
and Human Services, in coordination with the
Secretary, recognizes for purposes of this
subsection.
(2) Eligible employer-sponsored plan.--The term
``eligible employer-sponsored plan'' means, with
respect to any employee, a group health plan or group
health insurance coverage offered by an employer to the
employee which is--
(A) a governmental plan (within the meaning
of section 2791(d)(8) of the Public Health
Service Act), or
(B) any other plan or coverage offered in the
small or large group market within a State.
Such term shall include a grandfathered health plan
described in paragraph (1)(D) offered in a group
market.
(3) Excepted benefits not treated as minimum
essential coverage.--The term ``minimum essential
coverage'' shall not include health insurance coverage
which consists of coverage of excepted benefits--
(A) described in paragraph (1) of subsection
(c) of section 2791 of the Public Health
Service Act; or
(B) described in paragraph (2), (3), or (4)
of such subsection if the benefits are provided
under a separate policy, certificate, or
contract of insurance.
(4) Individuals residing outside United States or
residents of territories.--Any applicable individual
shall be treated as having minimum essential coverage
for any month--
(A) if such month occurs during any period
described in subparagraph (A) or (B) of section
911(d)(1) which is applicable to the
individual, or
(B) if such individual is a bona fide
resident of any possession of the United States
(as determined under section 937(a)) for such
month.
(5) Insurance-related terms.--Any term used in this
section which is also used in title I of the Patient
Protection and Affordable Care Act shall have the same
meaning as when used in such title.
(g) Administration and Procedure.--
(1) In general.--The penalty provided by this section
shall be paid upon notice and demand by the Secretary,
and except as provided in paragraph (2), shall be
assessed and collected in the same manner as an
assessable penalty under subchapter B of chapter 68.
(2) Special rules.--Notwithstanding any other
provision of law--
(A) Waiver of criminal penalties.--In the
case of any failure by a taxpayer to timely pay
any penalty imposed by this section, such
taxpayer shall not be subject to any criminal
prosecution or penalty with respect to such
failure.
(B) Limitations on liens and levies.--The
Secretary shall not--
(i) file notice of lien with respect
to any property of a taxpayer by reason
of any failure to pay the penalty
imposed by this section, or
(ii) levy on any such property with
respect to such failure.
(h) Termination.--This section shall not apply with respect
to any month beginning after December 31, 2014.
* * * * * * *
Subtitle F--Procedure and Administration
* * * * * * *
CHAPTER 61--INFORMATION AND RETURNS
* * * * * * *
Subchapter A--Returns and Records
* * * * * * *
PART III--INFORMATION RETURNS
* * * * * * *
Subpart C--Information Regarding Wages Paid Employees
SEC. 6051. RECEIPTS FOR EMPLOYEES.
(a) Requirement.--Every person required to deduct and
withhold from an employee a tax under section 3101 or 3402, or
who would have been required to deduct and withhold a tax under
section 3402 (determined without regard to subsection (n)) if
the employee had claimed no more than one withholding
exemption, or every employer engaged in a trade or business who
pays remuneration for services performed by an employee,
including the cash value of such remuneration paid in any
medium other than cash, shall furnish to each such employee in
respect of the remuneration paid by such person to such
employee during the calendar year, on or before January 31 of
the succeeding year, or, if his employment is terminated before
the close of such calendar year, within 30 days after the date
of receipt of a written request from the employee if such 30-
day period ends before January 31, a written statement showing
the following:
(1) the name of such person,
(2) the name of the employee (and his social security
account number if wages as defined in section 3121(a)
have been paid),
(3) the total amount of wages as defined in section
3401(a),
(4) the total amount deducted and withheld as tax
under section 3402,
(5) the total amount of wages as defined in section
3121(a),
(6) the total amount deducted and withheld as tax
under section 3101,
(8) the total amount of elective deferrals (within
the meaning of section 402(g)(3)) and compensation
deferred under section 457, including the amount of
designated Roth contributions (as defined in section
402A),
(9) the total amount incurred for dependent care
assistance with respect to such employee under a
dependent care assistance program described in section
129(d),
(10) in the case of an employee who is a member of
the Armed Forces of the United States, such employee's
earned income as determined for purposes of section 32
(relating to earned income credit),
(11) the amount contributed to any Archer MSA (as
defined in section 220(d)) of such employee or such
employee's spouse,
(12) the amount contributed to any health savings
account (as defined in section 223(d)) of such employee
or such employee's spouse,and
(13) the total amount of deferrals for the year under
a nonqualified deferred compensation plan (within the
meaning of section 409A(d))[, and].
[(14) the aggregate cost (determined under rules
similar to the rules of section 4980B(f)(4)) of
applicable employer-sponsored coverage (as defined in
section 4980I(d)(1)), except that this paragraph shall
not apply to--
[(A) coverage to which paragraphs (11) and
(12) apply, or
[(B) the amount of any salary reduction
contributions to a flexible spending
arrangement (within the meaning of section
125).]
In the case of compensation paid for service as a member of a
uniformed service, the statement shall show, in lieu of the
amount required to be shown by paragraph (5), the total amount
of wages as defined in section 3121(a), computed in accordance
with such section and section 3121(i)(2). In the case of
compensation paid for service as a volunteer or volunteer
leader within the meaning of the Peace Corps Act, the statement
shall show, in lieu of the amount required to be shown by
paragraph (5), the total amount of wages as defined in section
3121(a), computed in accordance with such section and section
3121(i)(3). In the case of tips received by an employee in the
course of his employment, the amounts required to be shown by
paragraphs (3) and (5) shall include only such tips as are
included in statements furnished to the employer pursuant to
section 6053(a). The amounts required to be shown by paragraph
(5) shall not include wages which are exempted pursuant to
sections 3101(c) and 3111(c) from the taxes imposed by sections
3101 and 3111. In the case of the amounts required to be shown
by paragraph (13), the Secretary may (by regulation) establish
a minimum amount of deferrals below which paragraph (13) does
not apply.
(b) Special Rule as to Compensation of Members of Armed
Forces.--In the case of compensation paid for service as a
member of the Armed Forces, the statement required by
subsection (a) shall be furnished if any tax was withheld
during the calendar year under section 3402, or if any of the
compensation paid during such year is includible in gross
income under chapter 1, or if during the calendar year any
amount was required to be withheld as tax under section 3101.
In lieu of the amount required to be shown by paragraph (3) of
subsection (a), such statement shall show as wages paid during
the calendar year the amount of such compensation paid during
the calendar year which is not excluded from gross income under
chapter 1 (whether or not such compensation constituted wages
as defined in section 3401(a)).
(c) Additional Requirements.--The statements required to be
furnished pursuant to this section in respect of any
remuneration shall be furnished at such other times, shall
contain such other information, and shall be in such form as
the Secretary may by regulations prescribe. The statements
required under this section shall also show the proportion of
the total amount withheld as tax under section 3101 which is
for financing the cost of hospital insurance benefits under
part A of title XVIII of the Social Security Act.
(d) Statements to Constitute Information Returns.--A
duplicate of any statement made pursuant to this section and in
accordance with regulations prescribed by the Secretary shall,
when required by such regulations, be filed with the Secretary.
(e) Railroad Employees.--
(1) Additional requirement.--Every person required to
deduct and withhold tax under section 3201 from an
employee shall include on or with the statement
required to be furnished such employee under subsection
(a) a notice concerning the provisions of this title
with respect to the allowance of a credit or refund of
the tax on wages imposed by section 3101(b) and the tax
on compensation imposed by section 3201 or 3211 which
is treated as a tax on wages imposed by section
3101(b).
(2) Information to be supplied to employees.--Each
person required to deduct and withhold tax under
section 3201 during any year from an employee who has
also received wages during such year subject to the tax
imposed by section 3101(b) shall, upon request of such
employee, furnish to him a written statement showing--
(A) the total amount of compensation with
respect to which the tax imposed by section
3201 was deducted,
(B) the total amount deducted as tax under
section 3201, and
(C) the portion of the total amount deducted
as tax under section 3201 which is for
financing the cost of hospital insurance under
part A of title XVIII of the Social Security
Act.
(f) Statements Required in Case of Sick Pay Paid by Third
Parties.--
(1) Statements required from payor.--
(A) In general.--If, during any calendar
year, any person makes a payment of third-party
sick pay to an employee, such person shall, on
or before January 15 of the succeeding year,
furnish a written statement to the employer in
respect of whom such payment was made showing--
(i) the name and, if there is
withholding under section 3402(o), the
social security number of such
employee,
(ii) the total amount of the third-
party sick pay paid to such employee
during the calendar year, and
(iii) the total amount (if any)
deducted and withheld from such sick
pay under section 3402.
For purposes of the preceding sentence, the
term ``third-party sick pay'' means any sick
pay (as defined in section 3402(o)(2)(C)) which
does not constitute wages for purposes of
chapter 24 (determined without regard to
section 3402(o)(1)).
(B) Special rules.--
(i) Statements are in lieu of other
reporting requirements.--The reporting
requirements of subparagraph (A) with
respect to any payments shall, with
respect to such payments, be in lieu of
the requirements of subsection (a) and
of section 6041.
(ii) Penalties made applicable.--For
purposes of sections 6674 and 7204, the
statements required to be furnished by
subparagraph (A) shall be treated as
statements required under this section
to be furnished to employees.
(2) Information required to be furnished by
employer.--Every employer who receives a statement
under paragraph (1)(A) with respect to sick pay paid to
any employee during any calendar year shall, on or
before January 31 of the succeeding year, furnish a
written statement to such employee showing--
(A) the information shown on the statement
furnished under paragraph (1)(A), and
(B) if any portion of the sick pay is
excludable from gross income under section
104(a)(3), the portion which is not so
excludable and the portion which is so
excludable.
To the extent practicable, the information required
under the preceding sentence shall be furnished on or
with the statement (if any) required under subsection
(a).
* * * * * * *
CHAPTER 65--ABATEMENTS, CREDITS, AND REFUNDS
* * * * * * *
Subchapter B--Rules of Special Application
* * * * * * *
SEC. 6416. CERTAIN TAXES ON SALES AND SERVICES.
(a) Condition to Allowance.--
(1) General rule.--No credit or refund of any
overpayment of tax imposed by chapter 31 (relating to
retail excise taxes), or chapter 32 (manufacturers
taxes), shall be allowed or made unless the person who
paid the tax establishes, under regulations prescribed
by the Secretary, that he--
(A) has not included the tax in the price of
the article with respect to which it was
imposed and has not collected the amount of the
tax from the person who purchased such article;
(B) has repaid the amount of the tax to the
ultimate purchaser of the article;
(C) in the case of an overpayment under
subsection (b)(2) of this section--
(i) has repaid or agreed to repay the
amount of the tax to the ultimate
vendor of the article, or
(ii) has obtained the written consent
of such ultimate vendor to the
allowance of the credit or the making
of the refund; or
(D) has filed with the Secretary the written
consent of the person referred to in
subparagraph (B) to the allowance of the credit
or the making of the refund.
(2) Exceptions.--This subsection shall not apply to--
(A) the tax imposed by section 4041 (relating
to tax on special fuels) on the use of any
liquid, and
(B) an overpayment of tax under paragraph
(1), (3)(A), (4), (5), or (6) of subsection (b)
of this section.
(3) Special rule.--For purposes of this subsection,
in any case in which the Secretary determines that an
article is not taxable, the term ``ultimate purchaser''
(when used in paragraph (1)(B) of this subsection)
includes a wholesaler, jobber, distributor, or retailer
who, on the 15th day after the date of such
determination, holds such article for sale; but only if
claim for credit or refund by reason of this paragraph
is filed on or before the date for filing the return
with respect to the taxes imposed under chapter 32 for
the first period which begins more than 60 days after
the date on such determination.
(4) Registered ultimate vendor or credit card issuer
to administer credits and refunds of gasoline tax.--
(A) In general.--For purposes of this
subsection, except as provided in subparagraph
(B), if an ultimate vendor purchases any
gasoline on which tax imposed by section 4081
has been paid and sells such gasoline to an
ultimate purchaser described in subparagraph
(C) or (D) of subsection (b)(2) (and such
gasoline is for a use described in such
subparagraph), such ultimate vendor shall be
treated as the person (and the only person) who
paid such tax, but only if such ultimate vendor
is registered under section 4101.
(B) Credit card issuer.--For purposes of this
subsection, if the purchase of gasoline
described in subparagraph (A) (determined
without regard to the registration status of
the ultimate vendor) is made by means of a
credit card issued to the ultimate purchaser,
paragraph (1) shall not apply and the person
extending the credit to the ultimate purchaser
shall be treated as the person (and the only
person) who paid the tax, but only if such
person--
(i) is registered under section 4101,
(ii) has established, under
regulations prescribed by the
Secretary, that such person--
(I) has not collected the
amount of the tax from the
person who purchased such
article, or
(II) has obtained the written
consent from the ultimate
purchaser to the allowance of
the credit or refund, and
(iii) has so established that such
person--
(I) has repaid or agreed to
repay the amount of the tax to
the ultimate vendor,
(II) has obtained the written
consent of the ultimate vendor
to the allowance of the credit
or refund, or
(III) has otherwise made
arrangements which directly or
indirectly provides the
ultimate vendor with
reimbursement of such tax.
If clause (i), (ii), or (iii) is not met by
such person extending the credit to the
ultimate purchaser, then such person shall
collect an amount equal to the tax from the
ultimate purchaser and only such ultimate
purchaser may claim such credit or payment.
(C) Timing of claims.--The procedure and
timing of any claim under subparagraph (A) or
(B) shall be the same as for claims under
section 6427(i)(4), except that the rules of
section 6427(i)(3)(B) regarding electronic
claims shall not apply unless the ultimate
vendor or credit card issuer has certified to
the Secretary for the most recent quarter of
the taxable year that all ultimate purchasers
of the vendor or credit card issuer are
certified and entitled to a refund under
subparagraph (C) or (D) of subsection (b)(2).
(b) Special Cases in Which Tax Payments Considered
Overpayments.--Under regulations prescribed by the Secretary,
credit or refund (without interest) shall be allowed or made in
respect of the overpayments determined under the following
paragraphs:
(1) Price readjustments.--
(A) In general.--Except as provided in
subparagraph (B) or (C), if the price of any
article in respect of which a tax, based on
such price, is imposed by chapter 31 or 32, is
readjusted by reason of the return or
repossession of the article or a covering or
container, or by a bona fide discount, rebate,
or allowance, including a readjustment for
local advertising (but only to the extent
provided in section 4216(e)(2) and (3)), the
part of the tax proportionate to the part of
the price repaid or credited to the purchaser
shall be deemed to be an overpayment.
(B) Further manufacture.--Subparagraph (A)
shall not apply in the case of an article in
respect of which tax was computed under section
4223(b)(2); but if the price for which such
article was sold is readjusted by reason of the
return or repossession of the article, the part
of the tax proportionate to the part of such
price repaid or credited to the purchaser shall
be deemed to be an overpayment.
(C) Adjustment of tire price.--No credit or
refund of any tax imposed by subsection (a) or
(b) of section 4071 shall be allowed or made by
reason of an adjustment of a tire pursuant to a
warranty or guarantee.
(2) Specified uses and resales.--The tax paid under
chapter 32 (or under subsection (a) or (d) of section
4041 in respect of sales or under section 4051) in
respect of any article shall be deemed to be an
overpayment if such article was, by any person--
(A) exported;
(B) used or sold for use as supplies for
vessels or aircraft;
(C) sold to a State or local government for
the exclusive use of a State or local
government;
(D) sold to a nonprofit educational
organization for its exclusive use;
(E) sold to a qualified blood collector
organization (as defined in section
7701(a)(49)) for such organization's exclusive
use in the collection, storage, or
transportation of blood;
(F) in the case of any tire taxable under
section 4071(a), sold to any person for use as
described in section 4221(e)(3); or
(G) in the case of gasoline, used or sold for
use in the production of special fuels referred
to in section 4041.
Subparagraphs (C), (D), and (E) shall not apply in the
case of any tax paid under section 4064. In the case of
the tax imposed by section 4131, subparagraphs (B),
(C), (D), and (E) shall not apply and subparagraph (A)
shall apply only if the use of the exported vaccine
meets such requirements as the Secretary may by
regulations prescribe. This paragraph shall not apply
in the case of any tax imposed under section 4041(a)(1)
or 4081 on diesel fuel or kerosene and any tax paid
under section 4121. Subparagraphs (C) and (D) shall not
apply in the case of any tax imposed on gasoline under
section 4081 if the requirements of subsection (a)(4)
are not met. In the case of taxes imposed by subchapter
C or D of chapter 32, subparagraph (E) shall not apply.
[In the case of the tax imposed by section 4191,
subparagraphs (B), (C), (D), and (E) shall not apply.]
(3) Tax-paid articles used for further manufacture,
etc..--If the tax imposed by chapter 32 has been paid
with respect to the sale of any article (other than
coal taxable under section 4121) by the manufacturer,
producer, or importer thereof and such article is sold
to a subsequent manufacturer or producer before being
used, such tax shall be deemed to be an overpayment by
such subsequent manufacturer or producer if--
(A) in the case of any article other than any
fuel taxable under section 4081, such article
is used by the subsequent manufacturer or
producer as material in the manufacture or
production of, or as a component part of--
(i) another article taxable under
chapter 32, or
(ii) an automobile bus chassis or an
automobile bus body, manufactured or
produced by him; or
(B) in the case of any fuel taxable under
section 4081, such fuel is used by the
subsequent manufacturer or producer, for
nonfuel purposes, as a material in the
manufacture or production of any other article
manufactured or produced by him.
(4) Tires.--If--
(A) the tax imposed by section 4071 has been
paid with respect to the sale of any tire by
the manufacturer, producer, or importer
thereof, and
(B) such tire is sold by any person on or in
connection with, or with the sale of, any other
article, such tax shall be deemed to be an
overpayment by such person if such other
article is--
(i) an automobile bus chassis or an
automobile bus body,
(ii) by such person exported, sold to
a State or local government for the
exclusive use of a State or local
government, sold to a nonprofit
educational organization for its
exclusive use, or used or sold for use
as supplies for vessels or aircraft, or
(iii) sold to a qualified blood
collector organization for its
exclusive use in connection with a
vehicle the organization certifies will
be primarily used in the collection,
storage, or transportation of blood.
(5) Return of certain installment accounts.--If--
(A) tax was paid under section 4216(d)(1) in
respect of any installment account,
(B) such account is, under the agreement
under which the account was sold, returned to
the person who sold such account, and
(C) the consideration is readjusted as
provided in such agreement,
the part of the tax paid under section 4216(d)(1)
allocable to the part of the consideration repaid or
credited to the purchaser of such account shall be
deemed to be an overpayment.
(6) Truck chassis, bodies, and semitrailers used for
further manufacture.--If--
(A) the tax imposed by section 4051 has been
paid with respect to the sale of any article,
and
(B) before any other use, such article is by
any person used as a component part of another
article taxable under section 4051 manufactured
or produced by him,
such tax shall be deemed to be an overpayment by such
person. For purposes of the preceding sentence, an
article shall be treated as having been used as a
component part of another article if, had it not been
broken or rendered useless in the manufacture or
production of such other article, it would have been so
used.
This subsection shall apply in respect of an article
only if the exportation or use referred to in the
applicable provision of this subsection occurs before
any other use, or, in the case of a sale or resale, the
use referred to in the applicable provision of this
subsection is to occur before any other use.
(c) Refund to Exporter or Shipper.--Under regulations
prescribed by the Secretary the amount of any tax imposed by
chapter 31, or chapter 32 erroneously or illegally collected in
respect of any article exported to a foreign country or shipped
to a possession of the United States may be refunded to the
exporter or shipper thereof, if the person who paid such tax
waives his claim to such amount.
(d) Credit on Returns.--Any person entitled to a refund of
tax imposed by chapter 31 or 32, paid to the Secretary may,
instead of filing a claim for refund, take credit therefor
against taxes imposed by such chapter due on any subsequent
return. The preceding sentence shall not apply to the tax
imposed by section 4081 in the case of refunds described in
section 4081(e).
(e) Accounting Procedures for Like Articles.--Under
regulations prescribed by the Secretary, if any person uses or
resells like articles, then for purposes of this section the
manufacturer, producer, or importer of any such article may be
identified, and the amount of tax paid under chapter 32 in
respect of such article may be determined--
(1) on a first-in-first-out basis,
(2) on a last-in-first-out basis, or
(3) in accordance with any other consistent method
approved by the Secretary.
(f) Meaning of Terms.--For purposes of this section, any term
used in this section has the same meaning as when used in
chapter 31, 32, or 33, as the case may be.
* * * * * * *
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets and
existing law in which no change is proposed is shown in roman):
PATIENT PROTECTION AND AFFORDABLE CARE ACT
* * * * * * *
TITLE III--IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH CARE
* * * * * * *
Subtitle E--Ensuring Medicare Sustainability
* * * * * * *
[SEC. 3403. INDEPENDENT MEDICARE ADVISORY BOARD.
[(a) Board.--
[(1) In general.--Title XVIII of the Social Security
Act (42 U.S.C. 1395 et seq.), as amended by section
3022, is amended by adding at the end the following new
section:
[``INDEPENDENT MEDICARE ADVISORY BOARD
[``Sec.1899A. (a) Establishment.--There is established an
independent board to be known as the `Independent Medicare
Advisory Board'.
[``(b) Purpose.--It is the purpose of this section to, in
accordance with the following provisions of this section,
reduce the per capita rate of growth in Medicare spending--
[``(1) by requiring the Chief Actuary of the Centers
for Medicare & Medicaid Services to determine in each
year to which this section applies (in this section
referred to as `a determination year') the projected
per capita growth rate under Medicare for the second
year following the determination year (in this section
referred to as `an implementation year');
[``(2) if the projection for the implementation year
exceeds the target growth rate for that year, by
requiring the Board to develop and submit during the
first year following the determination year (in this
section referred to as `a proposal year') a proposal
containing recommendations to reduce the Medicare per
capita growth rate to the extent required by this
section; and
[``(3) by requiring the Secretary to implement such
proposals unless Congress enacts legislation pursuant
to this section.
[``(c) Board Proposals.--
[``(1) Development.--
[``(A) In general.--The Board shall develop
detailed and specific proposals related to the
Medicare program in accordance with the
succeeding provisions of this section.
[``(B) Advisory reports.--Beginning January
15, 2014, the Board may develop and submit to
Congress advisory reports on matters related to
the Medicare program, regardless of whether or
not the Board submitted a proposal for such
year. Such a report may, for years prior to
2020, include recommendations regarding
improvements to payment systems for providers
of services and suppliers who are not otherwise
subject to the scope of the Board's
recommendations in a proposal under this
section. Any advisory report submitted under
this subparagraph shall not be subject to the
rules for congressional consideration under
subsection (d). In any year (beginning with
2014) that the Board is not required to submit
a proposal under this section, the Board shall
submit to Congress an advisory report on
matters related to the Medicare program.
[``(2) Proposals.--
[``(A) Requirements.--Each proposal submitted
under this section in a proposal year shall
meet each of the following requirements:
[``(i) If the Chief Actuary of the
Centers for Medicare & Medicaid
Services has made a determination under
paragraph (7)(A) in the determination
year, the proposal shall include
recommendations so that the proposal as
a whole (after taking into account
recommendations under clause (v)) will
result in a net reduction in total
Medicare program spending in the
implementation year that is at least
equal to the applicable savings target
established under paragraph (7)(B) for
such implementation year. In
determining whether a proposal meets
the requirement of the preceding
sentence, reductions in Medicare
program spending during the 3-month
period immediately preceding the
implementation year shall be counted to
the extent that such reductions are a
result of the implementation of
recommendations contained in the
proposal for a change in the payment
rate for an item or service that was
effective during such period pursuant
to subsection (e)(2)(A).
[``(ii) The proposal shall not
include any recommendation to ration
health care, raise revenues or Medicare
beneficiary premiums under section
1818, 1818A, or 1839, increase Medicare
beneficiary cost-sharing (including
deductibles, coinsurance, and
copayments), or otherwise restrict
benefits or modify eligibility
criteria.
[``(iii) In the case of proposals
submitted prior to December 31, 2018,
the proposal shall not include any
recommendation that would reduce
payment rates for items and services
furnished, prior to December 31, 2019,
by providers of services (as defined in
section 1861(u)) and suppliers (as
defined in section 1861(d)) scheduled,
pursuant to the amendments made by
section 3401 of the Patient Protection
and Affordable Care Act, to receive a
reduction to the inflationary payment
updates of such providers of services
and suppliers in excess of a reduction
due to productivity in a year in which
such recommendations would take effect.
[``(iv) As appropriate, the proposal
shall include recommendations to reduce
Medicare payments under parts C and D,
such as reductions in direct subsidy
payments to Medicare Advantage and
prescription drug plans specified under
paragraph (1) and (2) of section 1860D-
15(a) that are related to
administrative expenses (including
profits) for basic coverage, denying
high bids or removing high bids for
prescription drug coverage from the
calculation of the national average
monthly bid amount under section 1860D-
13(a)(4), and reductions in payments to
Medicare Advantage plans under clauses
(i) and (ii) of section 1853(a)(1)(B)
that are related to administrative
expenses (including profits) and
performance bonuses for Medicare
Advantage plans under section 1853(n).
Any such recommendation shall not
affect the base beneficiary premium
percentage specified under 1860D-13(a)
or the full premium subsidy under
section 1860D-14(a).
[``(v) The proposal shall include
recommendations with respect to
administrative funding for the
Secretary to carry out the
recommendations contained in the
proposal.
[``(vi) The proposal shall only
include recommendations related to the
Medicare program.
[``(vii) If the Chief Actuary of the
Centers for Medicare & Medicaid
Services has made a determination
described in subsection
(e)(3)(B)(i)(II) in the determination
year, the proposal shall be designed to
help reduce the growth rate described
in paragraph (8) while maintaining or
enhancing beneficiary access to quality
care under this title.
[``(B) Additional considerations.--In
developing and submitting each proposal under
this section in a proposal year, the Board
shall, to the extent feasible--
[``(i) give priority to
recommendations that extend Medicare
solvency;
[``(ii) include recommendations
that--
[``(I) improve the health
care delivery system and health
outcomes, including by
promoting integrated care, care
coordination, prevention and
wellness, and quality and
efficiency improvement; and
[``(II) protect and improve
Medicare beneficiaries' access
to necessary and evidence-based
items and services, including
in rural and frontier areas;
[``(iii) include recommendations that
target reductions in Medicare program
spending to sources of excess cost
growth;
[``(iv) consider the effects on
Medicare beneficiaries of changes in
payments to providers of services (as
defined in section 1861(u)) and
suppliers (as defined in section
1861(d));
[``(v) consider the effects of the
recommendations on providers of
services and suppliers with actual or
projected negative cost margins or
payment updates;
[``(vi) consider the unique needs of
Medicare beneficiaries who are dually
eligible for Medicare and the Medicaid
program under title XIX; and
[``(vii) take into account the data
and findings contained in the annual
reports under subsection (n) in order
to develop proposals that can most
effectively promote the delivery of
efficient, high quality care to
Medicare beneficiaries.
[``(C) No increase in total Medicare program
spending.--Each proposal submitted under this
section shall be designed in such a manner that
implementation of the recommendations contained
in the proposal would not be expected to
result, over the 10-year period starting with
the implementation year, in any increase in the
total amount of net Medicare program spending
relative to the total amount of net Medicare
program spending that would have occurred
absent such implementation.
[``(D) Consultation with MedPAC.--The Board
shall submit a draft copy of each proposal to
be submitted under this section to the Medicare
Payment Advisory Commission established under
section 1805 for its review. The Board shall
submit such draft copy by not later than
September 1 of the determination year.
[``(E) Review and comment by the Secretary.--
The Board shall submit a draft copy of each
proposal to be submitted to Congress under this
section to the Secretary for the Secretary's
review and comment. The Board shall submit such
draft copy by not later than September 1 of the
determination year. Not later than March 1 of
the submission year, the Secretary shall submit
a report to Congress on the results of such
review, unless the Secretary submits a proposal
under paragraph (5)(A) in that year.
[``(F) Consultations.--In carrying out its
duties under this section, the Board shall
engage in regular consultations with the
Medicaid and CHIP Payment and Access Commission
under section 1900.
[``(3) Submission of Board proposal to Congress and
the President.--
[``(A) In general.--
[``(i) In general.--Except as
provided in clause (ii) and subsection
(f)(3)(B), the Board shall submit a
proposal under this section to Congress
and the President on January 15 of each
year (beginning with 2014).
[``(ii) Exception.--The Board shall
not submit a proposal under clause (i)
in a proposal year if the year is--
[``(I) a year for which the
Chief Actuary of the Centers
for Medicare & Medicaid
Services makes a determination
in the determination year under
paragraph (6)(A) that the
growth rate described in clause
(i) of such paragraph does not
exceed the growth rate
described in clause (ii) of
such paragraph; or
[``(II) a year in which the
Chief Actuary of the Centers
for Medicare & Medicaid
Services makes a determination
in the determination year that
the projected percentage
increase (if any) for the
medical care expenditure
category of the Consumer Price
Index for All Urban Consumers
(United States city average)
for the implementation year is
less than the projected
percentage increase (if any) in
the Consumer Price Index for
All Urban Consumers (all items;
United States city average) for
such implementation year.
[``(iii) Start-up period.--The Board
may not submit a proposal under clause
(i) prior to January 15, 2014.
[``(B) Required information.--Each proposal
submitted by the Board under subparagraph
(A)(i) shall include--
[``(i) the recommendations described
in paragraph (2)(A)(i);
[``(ii) an explanation of each
recommendation contained in the
proposal and the reasons for including
such recommendation;
[``(iii) an actuarial opinion by the
Chief Actuary of the Centers for
Medicare & Medicaid Services certifying
that the proposal meets the
requirements of subparagraphs (A)(i)
and (C) of paragraph (2);
[``(iv) a legislative proposal that
implements the recommendations; and
[``(v) other information determined
appropriate by the Board.
[``(4) Presidential submission to Congress.--Upon
receiving a proposal from the Secretary under paragraph
(5), the President shall within 2 days submit such
proposal to Congress.
[``(5) Contingent secretarial development of
proposal.--If, with respect to a proposal year, the
Board is required, but fails, to submit a proposal to
Congress and the President by the deadline applicable
under paragraph (3)(A)(i), the Secretary shall develop
a detailed and specific proposal that satisfies the
requirements of subparagraphs (A) and (C) (and, to the
extent feasible, subparagraph (B)) of paragraph (2) and
contains the information required paragraph (3)(B)). By
not later than January 25 of the year, the Secretary
shall transmit--
[``(A) such proposal to the President; and
[``(B) a copy of such proposal to the
Medicare Payment Advisory Commission for its
review.
[``(6) Per capita growth rate projections by chief
actuary.--
[``(A) In general.--Subject to subsection
(f)(3)(A), not later than April 30, 2013, and
annually thereafter, the Chief Actuary of the
Centers for Medicare & Medicaid Services shall
determine in each such year whether--
[``(i) the projected Medicare per
capita growth rate for the
implementation year (as determined
under subparagraph (B)); exceeds
[``(ii) the projected Medicare per
capita target growth rate for the
implementation year (as determined
under subparagraph (C)).
[``(B) Medicare per capita growth rate.--
[``(i) In general.--For purposes of
this section, the Medicare per capita
growth rate for an implementation year
shall be calculated as the projected 5-
year average (ending with such year) of
the growth in Medicare program spending
(calculated as the sum of per capita
spending under each of parts A, B, and
D).
[``(ii) Requirement.--The projection
under clause (i) shall--
[``(I) to the extent that
there is projected to be a
negative update to the single
conversion factor applicable to
payments for physicians'
services under section 1848(d)
furnished in the proposal year
or the implementation year,
assume that such update for
such services is 0 percent
rather than the negative
percent that would otherwise
apply; and
[``(II) take into account any
delivery system reforms or
other payment changes that have
been enacted or published in
final rules but not yet
implemented as of the making of
such calculation.
[``(C) Medicare per capita target growth
rate.--For purposes of this section, the
Medicare per capita target growth rate for an
implementation year shall be calculated as the
projected 5-year average (ending with such
year) percentage increase in--
[``(i) with respect to a
determination year that is prior to
2018, the average of the projected
percentage increase (if any) in--
[``(I) the Consumer Price
Index for All Urban Consumers
(all items; United States city
average); and
[``(II) the medical care
expenditure category of the
Consumer Price Index for All
Urban Consumers (United States
city average); and
[``(ii) with respect to a
determination year that is after 2017,
the nominal gross domestic product per
capita plus 1.0 percentage point.
[``(7) Savings requirement.--
[``(A) In general.--If, with respect to a
determination year, the Chief Actuary of the
Centers for Medicare & Medicaid Services makes
a determination under paragraph (6)(A) that the
growth rate described in clause (i) of such
paragraph exceeds the growth rate described in
clause (ii) of such paragraph, the Chief
Actuary shall establish an applicable savings
target for the implementation year.
[``(B) Applicable savings target.--For
purposes of this section, the applicable
savings target for an implementation year shall
be an amount equal to the product of--
[``(i) the total amount of projected
Medicare program spending for the
proposal year; and
[``(ii) the applicable percent for
the implementation year.
[``(C) Applicable percent.--For purposes of
subparagraph (B), the applicable percent for an
implementation year is the lesser of--
[``(i) in the case of--
[``(I) implementation year
2015, 0.5 percent;
[``(II) implementation year
2016, 1.0 percent;
[``(III) implementation year
2017, 1.25 percent; and
[``(IV) implementation year
2018 or any subsequent
implementation year, 1.5
percent; and
[``(ii) the projected excess for the
implementation year (expressed as a
percent) determined under subparagraph
(A).
[``(8) Per capita rate of growth in national health
expenditures.--In each determination year (beginning in
2018), the Chief Actuary of the Centers for Medicare &
Medicaid Services shall project the per capita rate of
growth in national health expenditures for the
implementation year. Such rate of growth for an
implementation year shall be calculated as the
projected 5-year average (ending with such year)
percentage increase in national health care
expenditures.
[``(d) Congressional Consideration.--
[``(1) Introduction.--
[``(A) In general.--On the day on which a
proposal is submitted by the Board or the
President to the House of Representatives and
the Senate under subsection (c)(3)(A)(i) or
subsection (c)(4), the legislative proposal
(described in subsection (c)(3)(B)(iv))
contained in the proposal shall be introduced
(by request) in the Senate by the majority
leader of the Senate or by Members of the
Senate designated by the majority leader of the
Senate and shall be introduced (by request) in
the House by the majority leader of the House
or by Members of the House designated by the
majority leader of the House.
[``(B) Not in session.--If either House is
not in session on the day on which such
legislative proposal is submitted, the
legislative proposal shall be introduced in
that House, as provided in subparagraph (A), on
the first day thereafter on which that House is
in session.
[``(C) Any Member.--If the legislative
proposal is not introduced in either House
within 5 days on which that House is in session
after the day on which the legislative proposal
is submitted, then any Member of that House may
introduce the legislative proposal.
[``(D) Referral.--The legislation introduced
under this paragraph shall be referred by the
Presiding Officers of the respective Houses to
the Committee on Finance in the Senate and to
the Committee on Energy and Commerce and the
Committee on Ways and Means in the House of
Representatives.
[``(2) Committee consideration of proposal.--
[``(A) Reporting bill.--Not later than April
1 of any proposal year in which a proposal is
submitted by the Board or the President to
Congress under this section, the Committee on
Ways and Means and the Committee on Energy and
Commerce of the House of Representatives and
the Committee on Finance of the Senate may
report the bill referred to the Committee under
paragraph (1)(D) with committee amendments
related to the Medicare program.
[``(B) Calculations.--In determining whether
a committee amendment meets the requirement of
subparagraph (A), the reductions in Medicare
program spending during the 3-month period
immediately preceding the implementation year
shall be counted to the extent that such
reductions are a result of the implementation
provisions in the committee amendment for a
change in the payment rate for an item or
service that was effective during such period
pursuant to such amendment.
[``(C) Committee jurisdiction.--
Notwithstanding rule XV of the Standing Rules
of the Senate, a committee amendment described
in subparagraph (A) may include matter not
within the jurisdiction of the Committee on
Finance if that matter is relevant to a
proposal contained in the bill submitted under
subsection (c)(3).
[``(D) Discharge.--If, with respect to the
House involved, the committee has not reported
the bill by the date required by subparagraph
(A), the committee shall be discharged from
further consideration of the proposal.
[``(3) Limitation on changes to the Board
recommendations.--
[``(A) In general.--It shall not be in order
in the Senate or the House of Representatives
to consider any bill, resolution, or amendment,
pursuant to this subsection or conference
report thereon, that fails to satisfy the
requirements of subparagraphs (A)(i) and (C) of
subsection (c)(2).
[``(B) Limitation on changes to the Board
recommendations in other legislation.--It shall
not be in order in the Senate or the House of
Representatives to consider any bill,
resolution, amendment, or conference report
(other than pursuant to this section) that
would repeal or otherwise change the
recommendations of the Board if that change
would fail to satisfy the requirements of
subparagraphs (A)(i) and (C) of subsection
(c)(2).
[``(C) Limitation on changes to this
subsection.--It shall not be in order in the
Senate or the House of Representatives to
consider any bill, resolution, amendment, or
conference report that would repeal or
otherwise change this subsection.
[``(D) Waiver.--This paragraph may be waived
or suspended in the Senate only by the
affirmative vote of three-fifths of the
Members, duly chosen and sworn.
[``(E) Appeals.--An affirmative vote of
three-fifths of the Members of the Senate, duly
chosen and sworn, shall be required in the
Senate to sustain an appeal of the ruling of
the Chair on a point of order raised under this
paragraph.
[``(4) Expedited procedure.--
[``(A) Consideration.--A motion to proceed to
the consideration of the bill in the Senate is
not debatable.
[``(B) Amendment.--
[``(i) Time limitation.--Debate in
the Senate on any amendment to a bill
under this section shall be limited to
1 hour, to be equally divided between,
and controlled by, the mover and the
manager of the bill, and debate on any
amendment to an amendment, debatable
motion, or appeal shall be limited to
30 minutes, to be equally divided
between, and controlled by, the mover
and the manager of the bill, except
that in the event the manager of the
bill is in favor of any such amendment,
motion, or appeal, the time in
opposition thereto shall be controlled
by the minority leader or such leader's
designee.
[``(ii) Germane.--No amendment that
is not germane to the provisions of
such bill shall be received.
[``(iii) Additional time.--The
leaders, or either of them, may, from
the time under their control on the
passage of the bill, allot additional
time to any Senator during the
consideration of any amendment,
debatable motion, or appeal.
[``(iv) Amendment not in order.--It
shall not be in order to consider an
amendment that would cause the bill to
result in a net reduction in total
Medicare program spending in the
implementation year that is less than
the applicable savings target
established under subsection (c)(7)(B)
for such implementation year.
[``(v) Waiver and appeals.--This
paragraph may be waived or suspended in
the Senate only by the affirmative vote
of three-fifths of the Members, duly
chosen and sworn. An affirmative vote
of three-fifths of the Members of the
Senate, duly chosen and sworn, shall be
required in the Senate to sustain an
appeal of the ruling of the Chair on a
point of order raised under this
section.
[``(C) Consideration by the other House.--
[``(i) In general.--The expedited
procedures provided in this subsection
for the consideration of a bill
introduced pursuant to paragraph (1)
shall not apply to such a bill that is
received by one House from the other
House if such a bill was not introduced
in the receiving House.
[``(ii) Before passage.--If a bill
that is introduced pursuant to
paragraph (1) is received by one House
from the other House, after
introduction but before disposition of
such a bill in the receiving House,
then the following shall apply:
[``(I) The receiving House
shall consider the bill
introduced in that House
through all stages of
consideration up to, but not
including, passage.
[``(II) The question on
passage shall be put on the
bill of the other House as
amended by the language of the
receiving House.
[``(iii) After passage.--If a bill
introduced pursuant to paragraph (1) is
received by one House from the other
House, after such a bill is passed by
the receiving House, then the vote on
passage of the bill that originates in
the receiving House shall be considered
to be the vote on passage of the bill
received from the other House as
amended by the language of the
receiving House.
[``(iv) Disposition.--Upon
disposition of a bill introduced
pursuant to paragraph (1) that is
received by one House from the other
House, it shall no longer be in order
to consider the bill that originates in
the receiving House.
[``(v) Limitation.--Clauses (ii),
(iii), and (iv) shall apply only to a
bill received by one House from the
other House if the bill--
[``(I) is related only to the
program under this title; and
[``(II) satisfies the
requirements of subparagraphs
(A)(i) and (C) of subsection
(c)(2).
[``(D) Senate limits on debate.--
[``(i) In general.--In the Senate,
consideration of the bill and on all
debatable motions and appeals in
connection therewith shall not exceed a
total of 30 hours, which shall be
divided equally between the majority
and minority leaders or their
designees.
[``(ii) Motion to further limit
debate.--A motion to further limit
debate on the bill is in order and is
not debatable.
[``(iii) Motion or appeal.--Any
debatable motion or appeal is debatable
for not to exceed 1 hour, to be divided
equally between those favoring and
those opposing the motion or appeal.
[``(iv) Final disposition.--After 30
hours of consideration, the Senate
shall proceed, without any further
debate on any question, to vote on the
final disposition thereof to the
exclusion of all amendments not then
pending before the Senate at that time
and to the exclusion of all motions,
except a motion to table, or to
reconsider and one quorum call on
demand to establish the presence of a
quorum (and motions required to
establish a quorum) immediately before
the final vote begins.
[``(E) Consideration in conference.--
[``(i) In general.--Consideration in
the Senate and the House of
Representatives on the conference
report or any messages between Houses
shall be limited to 10 hours, equally
divided and controlled by the majority
and minority leaders of the Senate or
their designees and the Speaker of the
House of Representatives and the
minority leader of the House of
Representatives or their designees.
[``(ii) Time limitation.--Debate in
the Senate on any amendment under this
subparagraph shall be limited to 1
hour, to be equally divided between,
and controlled by, the mover and the
manager of the bill, and debate on any
amendment to an amendment, debatable
motion, or appeal shall be limited to
30 minutes, to be equally divided
between, and controlled by, the mover
and the manager of the bill, except
that in the event the manager of the
bill is in favor of any such amendment,
motion, or appeal, the time in
opposition thereto shall be controlled
by the minority leader or such leader's
designee.
[``(iii) Final disposition.--After 10
hours of consideration, the Senate
shall proceed, without any further
debate on any question, to vote on the
final disposition thereof to the
exclusion of all motions not then
pending before the Senate at that time
or necessary to resolve the differences
between the Houses and to the exclusion
of all other motions, except a motion
to table, or to reconsider and one
quorum call on demand to establish the
presence of a quorum (and motions
required to establish a quorum)
immediately before the final vote
begins.
[``(iv) Limitation.--Clauses (i)
through (iii) shall only apply to a
conference report, message or the
amendments thereto if the conference
report, message, or an amendment
thereto--
[``(I) is related only to the
program under this title; and
[``(II) satisfies the
requirements of subparagraphs
(A)(i) and (C) of subsection
(c)(2).
[``(F) Veto.--If the President vetoes the
bill debate on a veto message in the Senate
under this subsection shall be 1 hour equally
divided between the majority and minority
leaders or their designees.
[``(5) Rules of the Senate and House of
Representatives.--This subsection and subsection (f)(2)
are enacted by Congress--
[``(A) as an exercise of the rulemaking power
of the Senate and the House of Representatives,
respectively, and is deemed to be part of the
rules of each House, respectively, but
applicable only with respect to the procedure
to be followed in that House in the case of
bill under this section, and it supersedes
other rules only to the extent that it is
inconsistent with such rules; and
[``(B) with full recognition of the
constitutional right of either House to change
the rules (so far as they relate to the
procedure of that House) at any time, in the
same manner, and to the same extent as in the
case of any other rule of that House.
[``(e) Implementation of Proposal.--
[``(1) In general.--Notwithstanding any other
provision of law, the Secretary shall, except as
provided in paragraph (3), implement the
recommendations contained in a proposal submitted by
the Board or the President to Congress pursuant to this
section on August 15 of the year in which the proposal
is so submitted.
[``(2) Application.--
[``(A) In general.--A recommendation
described in paragraph (1) shall apply as
follows:
[``(i) In the case of a
recommendation that is a change in the
payment rate for an item or service
under Medicare in which payment rates
change on a fiscal year basis (or a
cost reporting period basis that
relates to a fiscal year), on a
calendar year basis (or a cost
reporting period basis that relates to
a calendar year), or on a rate year
basis (or a cost reporting period basis
that relates to a rate year), such
recommendation shall apply to items and
services furnished on the first day of
the first fiscal year, calendar year,
or rate year (as the case may be) that
begins after such August 15.
[``(ii) In the case of a
recommendation relating to payments to
plans under parts C and D, such
recommendation shall apply to plan
years beginning on the first day of the
first calendar year that begins after
such August 15.
[``(iii) In the case of any other
recommendation, such recommendation
shall be addressed in the regular
regulatory process timeframe and shall
apply as soon as practicable.
[``(B) Interim final rulemaking.--The
Secretary may use interim final rulemaking to
implement any recommendation described in
paragraph (1).
[``(3) Exceptions.--
[``(A) In general.--The Secretary shall not
implement the recommendations contained in a
proposal submitted in a proposal year by the
Board or the President to Congress pursuant to
this section if--
[``(i) prior to August 15 of the
proposal year, Federal legislation is
enacted that includes the following
provision: `This Act supercedes the
recommendations of the Board contained
in the proposal submitted, in the year
which includes the date of enactment of
this Act, to Congress under section
1899A of the Social Security Act.'; and
[``(ii) in the case of implementation
year 2020 and subsequent implementation
years, a joint resolution described in
subsection (f)(1) is enacted not later
than August 15, 2017.
[``(B) Limited additional exception.--
[``(i) In general.--Subject to clause
(ii), the Secretary shall not implement
the recommendations contained in a
proposal submitted by the Board or the
President to Congress pursuant to this
section in a proposal year (beginning
with proposal year 2019) if--
[``(I) the Board was required
to submit a proposal to
Congress under this section in
the year preceding the proposal
year; and
[``(II) the Chief Actuary of
the Centers for Medicare &
Medicaid Services makes a
determination in the
determination year that the
growth rate described in
subsection (c)(8) exceeds the
growth rate described in
subsection (c)(6)(A)(i).
[``(ii) Limited additional exception
may not be applied in two consecutive
years.--This subparagraph shall not
apply if the recommendations contained
in a proposal submitted by the Board or
the President to Congress pursuant to
this section in the year preceding the
proposal year were not required to be
implemented by reason of this
subparagraph.
[``(iii) No affect on requirement to
submit proposals or for congressional
consideration of proposals.--Clause (i)
and (ii) shall not affect--
[``(I) the requirement of the
Board or the President to
submit a proposal to Congress
in a proposal year in
accordance with the provisions
of this section; or
[``(II) Congressional
consideration of a legislative
proposal (described in
subsection (c)(3)(B)(iv))
contained such a proposal in
accordance with subsection (d).
[``(4) No affect on authority to implement certain
provisions.--Nothing in paragraph (3) shall be
construed to affect the authority of the Secretary to
implement any recommendation contained in a proposal or
advisory report under this section to the extent that
the Secretary otherwise has the authority to implement
such recommendation administratively.
[``(5) Limitation on review.--There shall be no
administrative or judicial review under section 1869,
section 1878, or otherwise of the implementation by the
Secretary under this subsection of the recommendations
contained in a proposal.
[``(f) Joint resolution Required To Discontinue the Board.--
[``(1) In general.--For purposes of subsection
(e)(3)(B), a joint resolution described in this
paragraph means only a joint resolution--
[``(A) that is introduced in 2017 by not
later than February 1 of such year;
[``(B) which does not have a preamble;
[``(C) the title of which is as follows:
`Joint resolution approving the discontinuation
of the process for consideration and automatic
implementation of the annual proposal of the
Independent Medicare Advisory Board under
section 1899A of the Social Security Act'; and
[``(D) the matter after the resolving clause
of which is as follows: `That Congress approves
the discontinuation of the process for
consideration and automatic implementation of
the annual proposal of the Independent Medicare
Advisory Board under section 1899A of the
Social Security Act.'.
[``(2) Procedure.--
[``(A) Referral.--A joint resolution
described in paragraph (1) shall be referred to
the Committee on Ways and Means and the
Committee on Energy and Commerce of the House
of Representatives and the Committee on Finance
of the Senate.
[``(B) Discharge.--In the Senate, if the
committee to which is referred a joint
resolution described in paragraph (1) has not
reported such joint resolution (or an identical
joint resolution) at the end of 20 days after
the joint resolution described in paragraph (1)
is introduced, such committee may be discharged
from further consideration of such joint
resolution upon a petition supported in writing
by 30 Members of the Senate, and such joint
resolution shall be placed on the calendar.
[``(C) Consideration.--
[``(i) In general.--In the Senate,
when the committee to which a joint
resolution is referred has reported, or
when a committee is discharged (under
subparagraph (C)) from further
consideration of a joint resolution
described in paragraph (1), it is at
any time thereafter in order (even
though a previous motion to the same
effect has been disagreed to) for a
motion to proceed to the consideration
of the joint resolution to be made, and
all points of order against the joint
resolution (and against consideration
of the joint resolution) are waived,
except for points of order under the
Congressional Budget act of 1974 or
under budget resolutions pursuant to
that Act. The motion is not debatable.
A motion to reconsider the vote by
which the motion is agreed to or
disagreed to shall not be in order. If
a motion to proceed to the
consideration of the joint resolution
is agreed to, the joint resolution
shall remain the unfinished business of
the Senate until disposed of.
[``(ii) Debate limitation.--In the
Senate, consideration of the joint
resolution, and on all debatable
motions and appeals in connection
therewith, shall be limited to not more
than 10 hours, which shall be divided
equally between the majority leader and
the minority leader, or their
designees. A motion further to limit
debate is in order and not debatable.
An amendment to, or a motion to
postpone, or a motion to proceed to the
consideration of other business, or a
motion to recommit the joint resolution
is not in order.
[``(iii) Passage.--In the Senate,
immediately following the conclusion of
the debate on a joint resolution
described in paragraph (1), and a
single quorum call at the conclusion of
the debate if requested in accordance
with the rules of the Senate, the vote
on passage of the joint resolution
shall occur.
[``(iv) Appeals.--Appeals from the
decisions of the Chair relating to the
application of the rules of the Senate
to the procedure relating to a joint
resolution described in paragraph (1)
shall be decided without debate.
[``(D) Other House acts first.--If, before
the passage by 1 House of a joint resolution of
that House described in paragraph (1), that
House receives from the other House a joint
resolution described in paragraph (1), then the
following procedures shall apply:
[``(i) The joint resolution of the
other House shall not be referred to a
committee.
[``(ii) With respect to a joint
resolution described in paragraph (1)
of the House receiving the joint
resolution--
[``(I) the procedure in that
House shall be the same as if
no joint resolution had been
received from the other House;
but
[``(II) the vote on final
passage shall be on the joint
resolution of the other House.
[``(E) Excluded days.--For purposes of
determining the period specified in
subparagraph (B), there shall be excluded any
days either House of Congress is adjourned for
more than 3 days during a session of Congress.
[``(F) Majority required for adoption.--A
joint resolution considered under this
subsection shall require an affirmative vote of
three-fifths of the Members, duly chosen and
sworn, for adoption.
[``(3) Termination.--If a joint resolution described
in paragraph (1) is enacted not later than August 15,
2017--
[``(A) the Chief Actuary of the Medicare &
Medicaid Services shall not--
[``(i) make any determinations under
subsection (c)(6) after May 1, 2017; or
[``(ii) provide any opinion pursuant
to subsection (c)(3)(B)(iii) after
January 16, 2018;
[``(B) the Board shall not submit any
proposals, advisory reports, or advisory
recommendations under this section or produce
the public report under subsection (n) after
January 16, 2018; and
[``(C) the Board and the consumer advisory
council under subsection (k) shall terminate on
August 16, 2018.
[``(g) Board Membership; Terms of Office; Chairperson;
Removal.--
[``(1) Membership.--
[``(A) In general.--The Board shall be
composed of--
[``(i) 15 members appointed by the
President, by and with the advice and
consent of the Senate; and
[``(ii) the Secretary, the
Administrator of the Center for
Medicare & Medicaid Services, and the
Administrator of the Health Resources
and Services Administration, all of
whom shall serve ex officio as
nonvoting members of the Board.
[``(B) Qualifications.--
[``(i) In general.--The appointed
membership of the Board shall include
individuals with national recognition
for their expertise in health finance
and economics, actuarial science,
health facility management, health
plans and integrated delivery systems,
reimbursement of health facilities,
allopathic and osteopathic physicians,
and other providers of health services,
and other related fields, who provide a
mix of different professionals, broad
geographic representation, and a
balance between urban and rural
representatives.
[``(ii) Inclusion.--The appointed
membership of the Board shall include
(but not be limited to) physicians and
other health professionals, experts in
the area of pharmaco-economics or
prescription drug benefit programs,
employers, third-party payers,
individuals skilled in the conduct and
interpretation of biomedical, health
services, and health economics research
and expertise in outcomes and
effectiveness research and technology
assessment. Such membership shall also
include representatives of consumers
and the elderly.
[``(iii) Majority nonproviders.--
Individuals who are directly involved
in the provision or management of the
delivery of items and services covered
under this title shall not constitute a
majority of the appointed membership of
the Board.
[``(C) Ethical disclosure.--The President
shall establish a system for public disclosure
by appointed members of the Board of financial
and other potential conflicts of interest
relating to such members. Appointed members of
the Board shall be treated as officers in the
executive branch for purposes of applying title
I of the Ethics in Government Act of 1978
(Public Law 95-521).
[``(D) Conflicts of interest.--No individual
may serve as an appointed member if that
individual engages in any other business,
vocation, or employment.
[``(E) Consultation with congress.--In
selecting individuals for nominations for
appointments to the Board, the President shall
consult with--
[``(i) the majority leader of the
Senate concerning the appointment of 3
members;
[``(ii) the Speaker of the House of
Representatives concerning the
appointment of 3 members;
[``(iii) the minority leader of the
Senate concerning the appointment of 3
members; and
[``(iv) the minority leader of the
House of Representatives concerning the
appointment of 3 members.
[``(2) Term of office.--Each appointed member shall
hold office for a term of 6 years except that--
[``(A) a member may not serve more than 2
full consecutive terms (but may be reappointed
to 2 full consecutive terms after being
appointed to fill a vacancy on the Board);
[``(B) a member appointed to fill a vacancy
occurring prior to the expiration of the term
for which that member's predecessor was
appointed shall be appointed for the remainder
of such term;
[``(C) a member may continue to serve after
the expiration of the member's term until a
successor has taken office; and
[``(D) of the members first appointed under
this section, 5 shall be appointed for a term
of 1 year, 5 shall be appointed for a term of 3
years, and 5 shall be appointed for a term of 6
years, the term of each to be designated by the
President at the time of nomination.
[``(3) Chairperson.--
[``(A) In general.--The Chairperson shall be
appointed by the President, by and with the
advice and consent of the Senate, from among
the members of the Board.
[``(B) Duties.--The Chairperson shall be the
principal executive officer of the Board, and
shall exercise all of the executive and
administrative functions of the Board,
including functions of the Board with respect
to--
[``(i) the appointment and
supervision of personnel employed by
the Board;
[``(ii) the distribution of business
among personnel appointed and
supervised by the Chairperson and among
administrative units of the Board; and
[``(iii) the use and expenditure of
funds.
[``(C) Governance.--In carrying out any of
the functions under subparagraph (B), the
Chairperson shall be governed by the general
policies established by the Board and by the
decisions, findings, and determinations the
Board shall by law be authorized to make.
[``(D) Requests for appropriations.--Requests
or estimates for regular, supplemental, or
deficiency appropriations on behalf of the
Board may not be submitted by the Chairperson
without the prior approval of a majority vote
of the Board.
[``(4) Removal.--Any appointed member may be removed
by the President for neglect of duty or malfeasance in
office, but for no other cause.
[``(h) Vacancies; Quorum; Seal; Vice Chairperson; Voting on
Reports.--
[``(1) Vacancies.--No vacancy on the Board shall
impair the right of the remaining members to exercise
all the powers of the Board.
[``(2) Quorum.--A majority of the appointed members
of the Board shall constitute a quorum for the
transaction of business, but a lesser number of members
may hold hearings.
[``(3) Seal.--The Board shall have an official seal,
of which judicial notice shall be taken.
[``(4) Vice Chairperson.--The Board shall annually
elect a Vice Chairperson to act in the absence or
disability of the Chairperson or in case of a vacancy
in the office of the Chairperson.
[``(5) Voting on proposals.--Any proposal of the
Board must be approved by the majority of appointed
members present.
[``(i) Powers of the Board.--
[``(1) Hearings.--The Board may hold such hearings,
sit and act at such times and places, take such
testimony, and receive such evidence as the Board
considers advisable to carry out this section.
[``(2) Authority to inform research priorities for
data collection.--The Board may advise the Secretary on
priorities for health services research, particularly
as such priorities pertain to necessary changes and
issues regarding payment reforms under Medicare.
[``(3) Obtaining official data.--The Board may secure
directly from any department or agency of the United
States information necessary to enable it to carry out
this section. Upon request of the Chairperson, the head
of that department or agency shall furnish that
information to the Board on an agreed upon schedule.
[``(4) Postal services.--The Board may use the United
States mails in the same manner and under the same
conditions as other departments and agencies of the
Federal Government.
[``(5) Gifts.--The Board may accept, use, and dispose
of gifts or donations of services or property.
[``(6) Offices.--The Board shall maintain a principal
office and such field offices as it determines
necessary, and may meet and exercise any of its powers
at any other place.
[``(j) Personnel Matters.--
[``(1) Compensation of members and chairperson.--Each
appointed member, other than the Chairperson, shall be
compensated at a rate equal to the annual rate of basic
pay prescribed for level III of the Executive Schedule
under section 5315 of title 5, United States Code. The
Chairperson shall be compensated at a rate equal to the
daily equivalent of the annual rate of basic pay
prescribed for level II of the Executive Schedule under
section 5315 of title 5, United States Code.
[``(2) Travel expenses.--The appointed members shall
be allowed travel expenses, including per diem in lieu
of subsistence, at rates authorized for employees of
agencies under subchapter I of chapter 57 of title 5,
United States Code, while away from their homes or
regular places of business in the performance of
services for the Board.
[``(3) Staff.--
[``(A) In general.--The Chairperson may,
without regard to the civil service laws and
regulations, appoint and terminate an executive
director and such other additional personnel as
may be necessary to enable the Board to perform
its duties. The employment of an executive
director shall be subject to confirmation by
the Board.
[``(B) Compensation.--The Chairperson may fix
the compensation of the executive director and
other personnel without regard to chapter 51
and subchapter III of chapter 53 of title 5,
United States Code, relating to classification
of positions and General Schedule pay rates,
except that the rate of pay for the executive
director and other personnel may not exceed the
rate payable for level V of the Executive
Schedule under section 5316 of such title.
[``(4) Detail of government employees.--Any Federal
Government employee may be detailed to the Board
without reimbursement, and such detail shall be without
interruption or loss of civil service status or
privilege.
[``(5) Procurement of temporary and intermittent
services.--The Chairperson may procure temporary and
intermittent services under section 3109(b) of title 5,
United States Code, at rates for individuals which do
not exceed the daily equivalent of the annual rate of
basic pay prescribed for level V of the Executive
Schedule under section 5316 of such title.
[``(k) Consumer Advisory Council.--
[``(1) In general.--There is established a consumer
advisory council to advise the Board on the impact of
payment policies under this title on consumers.
[``(2) Membership.--
[``(A) Number and appointment.--The consumer
advisory council shall be composed of 10
consumer representatives appointed by the
Comptroller General of the United States, 1
from among each of the 10 regions established
by the Secretary as of the date of enactment of
this section.
[``(B) Qualifications.--The membership of the
council shall represent the interests of
consumers and particular communities.
[``(3) Duties.--The consumer advisory council shall,
subject to the call of the Board, meet not less
frequently than 2 times each year in the District of
Columbia.
[``(4) Open meetings.--Meetings of the consumer
advisory council shall be open to the public.
[``(5) Election of officers.--Members of the consumer
advisory council shall elect their own officers.
[``(6) Application of FACA.--The Federal Advisory
Committee Act (5 U.S.C. App.) shall apply to the
consumer advisory council except that section 14 of
such Act shall not apply.
[``(l) Definitions.--In this section:
[``(1) Board; Chairperson; Member.--The terms
`Board', `Chairperson', and `Member' mean the
Independent Medicare Advisory Board established under
subsection (a) and the Chairperson and any Member
thereof, respectively.
[``(2) Medicare.--The term `Medicare' means the
program established under this title, including parts
A, B, C, and D.
[``(3) Medicare beneficiary.--The term `Medicare
beneficiary' means an individual who is entitled to, or
enrolled for, benefits under part A or enrolled for
benefits under part B.
[``(4) Medicare program spending.--The term `Medicare
program spending' means program spending under parts A,
B, and D net of premiums.
[``(m) Funding.--
[``(1) In general.--There are appropriated to the
Board to carry out its duties and functions--
[``(A) for fiscal year 2012, $15,000,000; and
[``(B) for each subsequent fiscal year, the
amount appropriated under this paragraph for
the previous fiscal year increased by the
annual percentage increase in the Consumer
Price Index for All Urban Consumers (all items;
United States city average) as of June of the
previous fiscal year.
[``(2) From trust funds.--Sixty percent of amounts
appropriated under paragraph (1) shall be derived by
transfer from the Federal Hospital Insurance Trust Fund
under section 1817 and 40 percent of amounts
appropriated under such paragraph shall be derived by
transfer from the Federal Supplementary Medical
Insurance Trust Fund under section 1841.
[``(n) Annual Public Report.--
[``(1) In general.--Not later than July 1, 2014, and
annually thereafter, the Board shall produce a public
report containing standardized information on system-
wide health care costs, patient access to care,
utilization, and quality-of-care that allows for
comparison by region, types of services, types of
providers, and both private payers and the program
under this title.
[``(2) Requirements.--Each report produced pursuant
to paragraph (1) shall include information with respect
to the following areas:
[``(A) The quality and costs of care for the
population at the most local level determined
practical by the Board (with quality and costs
compared to national benchmarks and reflecting
rates of change, taking into account quality
measures described in section 1890(b)(7)(B)).
[``(B) Beneficiary and consumer access to
care, patient and caregiver experience of care,
and the cost-sharing or out-of-pocket burden on
patients.
[``(C) Epidemiological shifts and demographic
changes.
[``(D) The proliferation, effectiveness, and
utilization of health care technologies,
including variation in provider practice
patterns and costs.
[``(E) Any other areas that the Board
determines affect overall spending and quality
of care in the private sector.
[``(o) Advisory Recommendations for Non-Federal Health Care
Programs.--
[``(1) In general.--Not later than January 15, 2015,
and at least once every two years thereafter, the Board
shall submit to Congress and the President
recommendations to slow the growth in national health
expenditures (excluding expenditures under this title
and in other Federal health care programs) while
preserving or enhancing quality of care, such as
recommendations--
[``(A) that the Secretary or other Federal
agencies can implement administratively;
[``(B) that may require legislation to be
enacted by Congress in order to be implemented;
[``(C) that may require legislation to be
enacted by State or local governments in order
to be implemented;
[``(D) that private sector entities can
voluntarily implement; and
[``(E) with respect to other areas determined
appropriate by the Board.
[``(2) Coordination.--In making recommendations under
paragraph (1), the Board shall coordinate such
recommendations with recommendations contained in
proposals and advisory reports produced by the Board
under subsection (c).
[``(3) Available to public.--The Board shall make
recommendations submitted to Congress and the President
under this subsection available to the public.''.
[(2)Lobbying cooling-off period for members of the
Independent Medicare Advisory Board.--Section 207(c) of
title 18, United States Code, is amended by inserting
at the end the following:
[``(3) Members of the Independent Medicare Advisory
Board.--
[``(A) In general.--Paragraph (1) shall apply
to a member of the Independent Medicare
Advisory Board under section 1899A.
[``(B) Agencies and Congress.--For purposes
of paragraph (1), the agency in which the
individual described in subparagraph (A) served
shall be considered to be the Independent
Medicare Advisory Board, the Department of
Health and Human Services, and the relevant
committees of jurisdiction of Congress,
including the Committee on Ways and Means and
the Committee on Energy and Commerce of the
House of Representatives and the Committee on
Finance of the Senate.''.
[(b) GAO Study and Report on Determination and Implementation
of Payment and Coverage Policies Under the Medicare Program.--
[(1) Initial study and report.--
[(A) Study.--The Comptroller General of the
United States (in this section referred to as
the ``Comptroller General'') shall conduct a
study on changes to payment policies,
methodologies, and rates and coverage policies
and methodologies under the Medicare program
under title XVIII of the Social Security Act as
a result of the recommendations contained in
the proposals made by the Independent Medicare
Advisory Board under section 1899A of such Act
(as added by subsection (a)), including an
analysis of the effect of such recommendations
on--
[(i) Medicare beneficiary access to
providers and items and services;
[(ii) the affordability of Medicare
premiums and cost-sharing (including
deductibles, coinsurance, and
copayments);
[(iii) the potential impact of
changes on other government or private-
sector purchasers and payers of care;
and
[(iv) quality of patient care,
including patient experience, outcomes,
and other measures of care.
[(B) Report.--Not later than July 1, 2015,
the Comptroller General shall submit to
Congress a report containing the results of the
study conducted under subparagraph (A),
together with recommendations for such
legislation and administrative action as the
Comptroller General determines appropriate.
[(2) Subsequent studies and reports.--The Comptroller
General shall periodically conduct such additional
studies and submit reports to Congress on changes to
Medicare payments policies, methodologies, and rates
and coverage policies and methodologies as the
Comptroller General determines appropriate, in
consultation with the Committee on Ways and Means and
the Committee on Energy and Commerce of the House of
Representatives and the Committee on Finance of the
Senate.
[(c) Conforming Amendments.--Section 1805(b) of the Social
Security Act (42 U.S.C. 1395b-6(b)) is amended--
[(1) by redesignating paragraphs (4) through (8) as
paragraphs (5) through (9), respectively; and
[(2) by inserting after paragraph (3) the following:
[``(4) Review and comment on the Independent Medicare
Advisory Board or secretarial proposal.--If the
Independent Medicare Advisory Board (as established
under subsection (a) of section 1899A) or the Secretary
submits a proposal to the Commission under such section
in a year, the Commission shall review the proposal
and, not later than March 1 of that year, submit to the
Committee on Ways and Means and the Committee on Energy
and Commerce of the House of Representatives and the
Committee on Finance of the Senate written comments on
such proposal. Such comments may include such
recommendations as the Commission deems
appropriate.''.]
* * * * * * *
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH CARE FOR ALL
AMERICANS
* * * * * * *
Subtitle C--Provisions Relating to Title III
* * * * * * *
[SEC. 10320. EXPANSION OF THE SCOPE OF, AND ADDITIONAL IMPROVEMENTS TO,
THE INDEPENDENT MEDICARE ADVISORY BOARD.
[(a) In general.--Section 1899A of the Social Security Act,
as added by section 3403, is amended--
[(1) in subsection (c)--
[(A) in paragraph (1)(B), by adding at the
end the following new sentence: ``In any year
(beginning with 2014) that the Board is not
required to submit a proposal under this
section, the Board shall submit to Congress an
advisory report on matters related to the
Medicare program.'';
[(B) in paragraph (2)(A)--
[(i) in clause (iv), by inserting
``or the full premium subsidy under
section 1860D-14(a)'' before the period
at the end of the last sentence; and
[(ii) by adding at the end the
following new clause:
[``(vii) If the Chief Actuary of the
Centers for Medicare & Medicaid
Services has made a determination
described in subsection
(e)(3)(B)(i)(II) in the determination
year, the proposal shall be designed to
help reduce the growth rate described
in paragraph (8) while maintaining or
enhancing beneficiary access to quality
care under this title.'';
[(C) in paragraph (2)(B)--
[(i) in clause (v), by striking
``and'' at the end;
[(ii) in clause (vi), by striking the
period at the end and inserting ``;
and''; and
[(iii) by adding at the end the
following new clause:
[``(vii) take into account the data
and findings contained in the annual
reports under subsection (n) in order
to develop proposals that can most
effectively promote the delivery of
efficient, high quality care to
Medicare beneficiaries.'';
[(D) in paragraph (3)--
[(i) in the heading, by striking
``Transmission of board proposal to
president'' and inserting ``Submission
of board proposal to congress and the
president'';
[(ii) in subparagraph (A)(i), by
striking ``transmit a proposal under
this section to the President'' and
insert ``submit a proposal under this
section to Congress and the
President''; and
[(iii) in subparagraph (A)(ii)--
[(I) in subclause (I), by
inserting ``or'' at the end;
[(II) in subclause (II), by
striking ``; or'' and inserting
a period; and
[(III) by striking subclause
(III);
[(E) in paragraph (4)--
[(i) by striking ``the Board under
paragraph (3)(A)(i) or''; and
[(ii) by striking ``immediately'' and
inserting ``within 2 days'';
[(F) in paragraph (5)--
[(i) by striking ``to but'' and
inserting ``but''; and
[(ii) by inserting ``Congress and''
after ``submit a proposal to''; and
[(G) in paragraph (6)(B)(i), by striking
``per unduplicated enrollee'' and inserting
``(calculated as the sum of per capita spending
under each of parts A, B, and D)'';
[(2) in subsection (d)--
[(A) in paragraph (1)(A)--
[(i) by inserting ``the Board or''
after ``a proposal is submitted by'';
and
[(ii) by inserting ``subsection
(c)(3)(A)(i) or'' after ``the Senate
under''; and
[(B) in paragraph (2)(A), by inserting ``the
Board or'' after ``a proposal is submitted
by'';
[(3) in subsection (e)--
[(A) in paragraph (1), by inserting ``the
Board or'' after ``a proposal submitted by'';
and
[(B) in paragraph (3)--
[(i) By striking ``Exception.--The
Secretary shall not be required to
implement the recommendations contained
in a proposal submitted in a proposal
year by'' and inserting
[``(A) In general.--The Secretary shall not
implement the recommendations contained in a
proposal submitted in a proposal year by the
Board or'';
[(ii) by redesignating subparagraphs
(A) and (B) as clauses (i) and (ii),
respectively, and indenting
appropriately; and
[(iii) by adding at the end the
following new subparagraph:
[``(B) Limited additional exception.--
[``(i) In general.--Subject to clause
(ii), the Secretary shall not implement
the recommendations contained in a
proposal submitted by the Board or the
President to Congress pursuant to this
section in a proposal year (beginning
with proposal year 2019) if--
[``(I) the Board was required
to submit a proposal to
Congress under this section in
the year preceding the proposal
year; and
[``(II) the Chief Actuary of
the Centers for Medicare &
Medicaid Services makes a
determination in the
determination year that the
growth rate described in
subsection (c)(8) exceeds the
growth rate described in
subsection (c)(6)(A)(i).
[``(ii)Limited additional exception
may not be applied in two consecutive
years.--This subparagraph shall not
apply if the recommendations contained
in a proposal submitted by the Board or
the President to Congress pursuant to
this section in the year preceding the
proposal year were not required to be
implemented by reason of this
subparagraph.
[``(iii)No affect on requirement to
submit proposals or for congressional
consideration of proposals.--Clause (i)
and (ii) shall not affect--
[``(I) the requirement of the
Board or the President to
submit a proposal to Congress
in a proposal year in
accordance with the provisions
of this section; or
[``(II) Congressional
consideration of a legislative
proposal (described in
subsection (c)(3)(B)(iv))
contained such a proposal in
accordance with subsection
(d).'';
[(4) in subsection (f)(3)(B)--
[(A) by striking ``or advisory reports to
Congress'' and inserting ``, advisory reports,
or advisory recommendations''; and
[(B) by inserting ``or produce the public
report under subsection (n)'' after ``this
section''; and
[(5) by adding at the end the following new
subsections:
[``(n) Annual Public Report.--
[``(1) In general.--Not later than July 1, 2014, and
annually thereafter, the Board shall produce a public
report containing standardized information on system-
wide health care costs, patient access to care,
utilization, and quality-of-care that allows for
comparison by region, types of services, types of
providers, and both private payers and the program
under this title.
[``(2) Requirements.--Each report produced pursuant
to paragraph (1) shall include information with respect
to the following areas:
[``(A) The quality and costs of care for the
population at the most local level determined
practical by the Board (with quality and costs
compared to national benchmarks and reflecting
rates of change, taking into account quality
measures described in section 1890(b)(7)(B)).
[``(B) Beneficiary and consumer access to
care, patient and caregiver experience of care,
and the cost-sharing or out-of-pocket burden on
patients.
[``(C) Epidemiological shifts and demographic
changes.
[``(D) The proliferation, effectiveness, and
utilization of health care technologies,
including variation in provider practice
patterns and costs.
[``(E) Any other areas that the Board
determines affect overall spending and quality
of care in the private sector.
[``(o) Advisory Recommendations for Non-Federal Health Care
Programs.--
[``(1) In general.--Not later than January 15, 2015,
and at least once every two years thereafter, the Board
shall submit to Congress and the President
recommendations to slow the growth in national health
expenditures (excluding expenditures under this title
and in other Federal health care programs) while
preserving or enhancing quality of care, such as
recommendations--
[``(A) that the Secretary or other Federal
agencies can implement administratively;
[``(B) that may require legislation to be
enacted by Congress in order to be implemented;
[``(C) that may require legislation to be
enacted by State or local governments in order
to be implemented;
[``(D) that private sector entities can
voluntarily implement; and
[``(E) with respect to other areas determined
appropriate by the Board.
[``(2)Coordination.--In making recommendations under
paragraph (1), the Board shall coordinate such
recommendations with recommendations contained in
proposals and advisory reports produced by the Board
under subsection (c).
[``(3) Available to public.--The Board shall make
recommendations submitted to Congress and the President
under this subsection available to the public.''.
[(b) Name Change.--Any reference in the provisions of, or
amendments made by, section 3403 to the ``Independent Medicare
Advisory Board'' shall be deemed to be a reference to the
``Independent Payment Advisory Board''.
[(c) Rule of Construction.--Nothing in the amendments made by
this section shall preclude the Independent Medicare Advisory
Board, as established under section 1899A of the Social
Security Act (as added by section 3403), from solely using data
from public or private sources to carry out the amendments made
by subsection (a)(4).]
* * * * * * *
VOTES OF THE COMMITTEE ON THE BUDGET
----------
Clause 3(b) of House Rule XIII requires each committee
report to accompany any bill or resolution of a public
character to include the total number of votes cast for and
against each roll call vote, on a motion to report and any
amendments offered to the measure or matter, together with the
names of those voting for and against.
Listed below are the actions taken in the Committee on the
Budget of the House of Representatives on the Restoring
Americans' Healthcare Freedom Reconciliation Act of 2015.
On October 9, 2015, the Committee met in open session, a
quorum being present.
Mr. Rokita asked unanimous consent that the Chair be
authorized, consistent with clause 4 of House Rule XVI, to
declare a recess at any time during the Committee meeting.
There was no objection to the unanimous consent request.
The Committee adopted and ordered reported the Restoring
Americans' Healthcare Freedom Reconciliation Act of 2015.
The Committee on the Budget took the following votes:
Mr. Rokita made a motion that the Committee report the bill
with the recommendation that the bill do pass.
The motion was agreed to by a roll call vote of 21 ayes to
11 noes.
ROLLCALL VOTE NO. 1
------------------------------------------------------------------------
Name & Answer Name & Answer
State Aye No Present State Aye No Present
------------------------------------------------------------------------
PRICE X VAN X
(GA) HOLLEN
(Chairma (MD)
n) (Ranking
)
------------------------------------------------------------------------
ROKITA X YARMUTH X
(IN) (KY)
------------------------------------------------------------------------
GARRETT X PASCRELL X
(NJ) (NJ)
------------------------------------------------------------------------
DIAZ-BALA X RYAN (OH) X
RT (FL)
------------------------------------------------------------------------
COLE (OK) X MOORE X
(WI)
------------------------------------------------------------------------
McCLINTOC X CASTOR X
K (CA) (FL)
------------------------------------------------------------------------
BLACK X McDERMOTT X
(TN) (WA)
------------------------------------------------------------------------
WOODALL X LEE (CA) X
(GA)
------------------------------------------------------------------------
BLACKBURN X POCAN X
(TN) (WI)
------------------------------------------------------------------------
HARTZLER X LUJAN
(MO) GRISHAM
(NM)
------------------------------------------------------------------------
RICE (SC) X DINGELL
(MI)
------------------------------------------------------------------------
STUTZMAN X LIEU (CA)
(IN)
------------------------------------------------------------------------
SANFORD NORCROSS X
(SC) (NJ)
------------------------------------------------------------------------
BUCHANAN X MOULTON X
(FL) (MA)
------------------------------------------------------------------------
WOMACK X .........
(AR)
------------------------------------------------------------------------
BRAT (VA) X .........
------------------------------------------------------------------------
BLUM (IA) X .........
------------------------------------------------------------------------
MOONEY X .........
(WV)
------------------------------------------------------------------------
GROTHMMAN X .........
(WI)
------------------------------------------------------------------------
PALMER X .........
(AL)
------------------------------------------------------------------------
MOOLENAAR X .........
(MI)
------------------------------------------------------------------------
WESTERMAN X
(AR)
------------------------------------------------------------------------
Mr. Rokita made a motion that, pursuant to clause 1 of rule
XXII, the Chair be authorized to offer motions to go to
conference and file any related conference report; the staff be
authorized to make any necessary technical and conforming
corrections prior to filing the bill, such as inserting the
short title of the bill; and the motion to reconsider be laid
on the table.
The motion was agreed to without objection.
MOTIONS ON THE RULE FOR CONSIDERATION OF THE RESTORING AMERICANS'
HEALTHCARE FREEDOM RECONCILIATION ACT OF 2015
A Motion Offered by Mr. Van Hollen
1. Representative Van Hollen moved that the Committee on
the Budget direct its Chairman to request on behalf of the
Committee that the rule for consideration of the reconciliation
bill make in order an amendment that would (1) strike all of
the underlying text, which is an irresponsible attack on
women's health care and the Affordable Care Act, and (2)
replace it with the text of H.R. 3708, which calls for
bipartisan negotiations to raise the discretionary spending
caps for fiscal year 2016 or, if those negotiations fail,
raises the defense and non-defense discretionary caps by equal
amounts to the President's requested level to allow
appropriations action to proceed and fund essential services at
necessary levels.
The motion was not agreed to by a roll call vote of 13 ayes
to 19 noes.
ROLLCALL VOTE NO. 2
------------------------------------------------------------------------
Name & Answer Name & Answer
State Aye No Present State Aye No Present
------------------------------------------------------------------------
PRICE X VAN X
(GA) HOLLEN
(Chairma (MD)
n) (Ranking
)
------------------------------------------------------------------------
ROKITA X YARMUTH X
(IN) (KY)
------------------------------------------------------------------------
GARRETT X PASCRELL X
(NJ) (NJ)
------------------------------------------------------------------------
DIAZ-BALA X RYAN (OH) X
RT (FL)
------------------------------------------------------------------------
COLE (OK) X MOORE X
(WI)
------------------------------------------------------------------------
McCLINTOC X CASTOR X
K (CA) (FL)
------------------------------------------------------------------------
BLACK X McDERMOTT X
(TN) (WA)
------------------------------------------------------------------------
WOODALL X LEE (CA) X
(GA)
------------------------------------------------------------------------
BLACKBURN X POCAN X
(TN) (WI)
------------------------------------------------------------------------
HARTZLER X LUJAN X
(MO) GRISHAM
(NM)
------------------------------------------------------------------------
RICE (SC) X DINGELL
(MI)
------------------------------------------------------------------------
STUTZMAN X LIEU (CA) X
(IN)
------------------------------------------------------------------------
SANFORD NORCROSS X
(SC) (NJ)
------------------------------------------------------------------------
BUCHANAN X MOULTON X
(FL) (MA)
------------------------------------------------------------------------
WOMACK X .........
(AR)
------------------------------------------------------------------------
BRAT (VA) X .........
------------------------------------------------------------------------
BLUM (IA) X .........
------------------------------------------------------------------------
MOONEY X .........
(WV)
------------------------------------------------------------------------
GROTHMMAN .........
(WI)
------------------------------------------------------------------------
PALMER .........
(AL)
------------------------------------------------------------------------
MOOLENAAR X .........
(MI)
------------------------------------------------------------------------
WESTERMAN X
(AR)
------------------------------------------------------------------------
Pursuant to a unanimous consent request made by Chairman
Price, Representative Palmer requested that the record reflect
he would have voted no on the roll call vote, but was unable to
be present because he was voting at the Committee on Oversight
and Government Reform when the vote in the Committee on the
Budget was called.
A Motion Offered by Mr. Rokita
2. Representative Rokita moved that the Chairman of the
Committee on the Budget be provided the discretion to request
the Committee on Rules report a rule that would make in order
an amendment to the Restoring Americans' Healthcare Freedom
Reconciliation Act of 2015, as reported.
The motion was agreed to by a roll call vote of 21 ayes to
13 noes.
ROLLCALL VOTE NO. 3
------------------------------------------------------------------------
Name & Answer Name & Answer
State Aye No Present State Aye No Present
------------------------------------------------------------------------
PRICE X VAN X
(GA) HOLLEN
(Chairma (MD)
n) (Ranking
)
------------------------------------------------------------------------
ROKITA X YARMUTH X
(IN) (KY)
------------------------------------------------------------------------
GARRETT X PASCRELL X
(NJ) (NJ)
------------------------------------------------------------------------
DIAZ-BALA X RYAN (OH) X
RT (FL)
------------------------------------------------------------------------
COLE (OK) X MOORE X
(WI)
------------------------------------------------------------------------
McCLINTOC X CASTOR X
K (CA) (FL)
------------------------------------------------------------------------
BLACK X McDERMOTT X
(TN) (WA)
------------------------------------------------------------------------
WOODALL X LEE (CA) X
(GA)
------------------------------------------------------------------------
BLACKBURN X POCAN X
(TN) (WI)
------------------------------------------------------------------------
HARTZLER X LUJAN X
(MO) GRISHAM
(NM)
------------------------------------------------------------------------
RICE (SC) X DINGELL
(MI)
------------------------------------------------------------------------
STUTZMAN X LIEU (CA) X
(IN)
------------------------------------------------------------------------
SANFORD NORCROSS X
(SC) (NJ)
------------------------------------------------------------------------
BUCHANAN X MOULTON X
(FL) (MA)
------------------------------------------------------------------------
WOMACK X .........
(AR)
------------------------------------------------------------------------
BRAT (VA) X .........
------------------------------------------------------------------------
BLUM (IA) X .........
------------------------------------------------------------------------
MOONEY X .........
(WV)
------------------------------------------------------------------------
GROTHMMAN X .........
(WI)
------------------------------------------------------------------------
PALMER X .........
(AL)
------------------------------------------------------------------------
MOOLENAAR X .........
(MI)
------------------------------------------------------------------------
WESTERMAN X
(AR)
------------------------------------------------------------------------
OTHER HOUSE REPORT REQUIREMENTS
----------
Committee Oversight Findings
Clause 3(c)(1) of rule XIII of the Rules of the House of
Representatives requires the report of a committee on a measure
to contain oversight findings and recommendations required
pursuant to clause (2)(b)(1) of rule X. The Committee on the
Budget has examined its activities over the past session and
has determined that there are no specific oversight findings on
the text of the reported bill.
Committee Cost Estimate
For purposes of clauses 3(c)(2) and (3) of rule XIII of the
Rules of the House of Representatives and section 308(a)(1) of
the Congressional Budget Act of 1974 (relating to estimates of
new budget authority, new spending autohrity, new credit
authority, or increased or decreased revenues or tax
expenditures), the committee report incorporates the cost
estimate prepared by the Director of the Congressional Budget
Office pursuant to sections 402 and 423 of the Congressional
Budget Act of 1974.
ESTIMATE OF THE BUDGETARY EFFECTS OF DRAFT LEGISLATION TO PROVIDE FOR RECONCILIATION
[Pursuant to Title II of the Concurrent Resolution on the Budget for Fiscal Year 2016, as posted on the website of the House Committee on the Budget on
October 8, 2015--without macroeconomic feedback]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Billions of dollars, by fiscal year 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2016-2020 2016-2025
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CHANGES IN DIRECT SPENDING
Title I--Committee on Education and the
Workforce:
Auto-Enrollment for Certain Large
Employers:
Estimated Budget Authority............ 0 0.1 0.2 0.4 0.5 0.5 0.5 0.6 0.6 0.7 1.3 4.3
Estimated Outlays..................... 0 0.1 0.2 0.4 0.5 0.5 0.5 0.6 0.6 0.7 1.3 4.3
Title II--Committee on Energy and
Commerce:
Prevention and Public Health Fund:
Estimated Budget Authority............ -1.0 -1.0 -1.3 -1.3 -1.5 -1.5 -2.0 -2.0 -2.0 -2.0 -6.0 -15.5
Estimated Outlays..................... -0.2 -0.5 -0.9 -1.1 -1.3 -1.4 -1.6 -1.8 -1.9 -2.0 -4.1 -12.7
Medicaid:
Estimated Budget Authority............ -0.2 * * * * * * * * 0 -0.2 -0.2
Estimated Outlays..................... -0.2 * * * * * * * * 0 -0.2 -0.2
Community Health Center Program
Estimated Budget Authority............ 0.2 0.2 0 0 0 0 0 0 0 0 0.5 0.5
Estimated Outlays..................... 0.1 0.2 0.1 * 0 0 0 0 0 0 0.5 0.5
Title III--Committee on Ways and Means:
Repeal Individual and Employer Mandates:
Estimated Budget Authority............ -8.7 -17.2 -21.0 -24.3 -26.4 -28.3 -30.3 -31.9 -33.7 -35.1 -97.6 -256.9
Estimated Outlays..................... -8.7 -17.2 -21.0 -24.3 -26.4 -28.3 -30.3 -31.9 -33.7 -35.1 -97.6 -256.9
Repeal Excise Tax on High-Premium
Insurance Plans:
Estimated Budget Authority............ 0 0 -0.7 -0.9 -1.4 -1.6 -2.4 -3.1 -3.9 -4.1 -3.0 -18.2
Estimated Outlays..................... 0 0 -0.7 -0.9 -1.4 -1.6 -2.4 -3.1 -3.9 -4.1 -3.0 -18.2
Repeal IPAB:
Estimated Budget Authority............ 0 0 0 0 0 0 0.6 1.5 1.9 3.1 0 7.1
Estimated Outlays..................... 0 0 0 0 0 0 0.6 1.5 1.9 3.1 0 7.1
Interaction Effects Across Titles:\a\
Estimated Budget Authority............ 0 * -0.1 -0.2 -0.3 -0.3 -0.3 -0.3 -0.2 -0.3 -0.7 -2.0
Estimated Outlays..................... 0 * -0.1 -0.2 -0.3 -0.3 -0.3 -0.3 -0.2 -0.3 -0.7 -2.0
Total Changes in Direct Spending:
Estimated Budget Authority............ -9.7 -17.9 -22.8 -26.2 -29.0 -31.1 -33.8 -35.3 -37.3 -37.7 -105.7 -281.0
Estimated Outlays..................... -9.1 -17.5 -22.4 -26.1 -28.8 -31.0 -33.4 -35.0 -37.2 -37.7 -103.8 -278.2
CHANGES IN REVENUES
Title I--Committee on Education and the
Workforce:
Auto-Enrollment for Certain Large 0 0.2 0.8 1.4 0.8 1.1 1.7 1.9 2.1 2.2 3.3 12.2
Employers..............................
Title III--Committee on Ways and Means:
Repeal Individual and Employer -10.1 -8.0 -8.0 -9.8 -10.5 -10.9 -11.9 -12.9 -13.5 -14.1 -46.4 -109.8
Mandates.............................
Repeal Medical Device Tax............. -1.4 -2.0 -2.1 -2.2 -2.3 -2.5 -2.6 -2.8 -2.9 -3.1 -10.0 -23.9
Repeal Excise Tax on High-Premium 0 0 -2.9 -8.1 -9.7 -11.5 -14.0 -17.1 -20.8 -25.0 -20.8 -109.3
Insurance Plans......................
Interaction Effects within Title III.... 0 0 * 2.1 2.0 1.7 1.7 1.6 1.6 1.4 4.1 12.1
Interaction Effects Across Titles\a\.... 0 0.3 1.0 1.7 2.3 2.5 2.5 2.8 3.1 3.4 5.2 19.4
Total Changes in Revenues............... -11.5 -9.4 -11.2 -15.0 -17.5 -19.7 -22.6 -26.5 -30.5 -35.2 -64.6 -199.3
On-Budget............................. -13.0 -13.7 -15.8 -19.7 -21.8 -24.1 -26.8 -30.2 -33.8 -37.7 -84.1 -236.6
Off-Budget\b\......................... 1.5 4.3 4.6 4.8 4.4 4.4 4.2 3.7 3.3 2.4 19.7 37.6
NET INCREASE OR DECREASE (-) IN THE DEFICIT FROM CHANGES IN DIRECT SPENDING AND REVENUES\c\
Impact on Deficit....................... 2.4 -8.0 -11.2 -11.1 -11.4 -11.4 -10.8 -8.5 -6.7 -2.4 -39.2 -78.9
On-Budget............................. 3.9 -3.8 -6.6 -6.4 -7.0 -6.0 -6.5 -4.8 -3.4 * -19.5 -41.3
Off-Budget\b\......................... -1.5 -4.3 -4.6 -4.8 -4.4 -4.4 -4.2 -3.7 -3.3 -2.4 -19.7 -37.6
Memorandum:
Net Effect on Deficit:
Title I............................... 0 -0.2 -0.6 -0.9 -0.2 -0.5 -1.1 -1.3 -1.4 -1.5 -2.0 -7.9
Title II.............................. -0.4 -0.3 -0.8 -1.1 -1.3 -1.4 -1.6 -1.8 -1.9 -2.0 -3.8 -12.5
Title III............................. 2.8 -7.2 -8.7 -7.2 -7.3 -6.7 -5.3 -2.3 -0.1 4.7 -27.5 -37.1
Interaction Effects Across Titles..... 0 -0.4 -1.1 -1.9 -2.5 -2.7 -2.8 -3.1 -3.3 -3.6 -5.9 -21.4
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Sources: Congressional Budget Office and the staff of the Joint Committee on Taxation
Notes: Numbers may not add up to totals because of rounding; IPAB = Independent Payment Advisory Board; * = an increase or decrease between zero and
$500 million; This legislation meets the threshold established in section 3112 of the Concurrent Resolution on the Budget for Fiscal Year 2016, which
requires that the CBO estimate incorporate macroeconomic effects. CBO has not yet completed an analysis of those effects. An estimate including that
analysis will be released at a later date
a. Includes the additional effects of combining the repeal of the auto-enrollment requirement for large employers with the repeal of the individual and
employer mandates
b. All off-budget effects would come from changes in revenues. (The payroll taxes for Social Security are classified as off-budget.)
c. CBO and JCT estimate that enacting the legislation would not increase net direct spending in either of the first two consecutive 10-year periods
beginning in 2026; at some point the costs of repealing IPAB would exceed the savings from the other provisions, but the agencies cannot determine
whether that would occur during the third or fourth 10-year period after 2026 or later. On a preliminary basis, the agencies estimate that enacting
the legislation would increase on-budget deficits by at least $5 billion in one or more of the four consecutive 10-year periods beginning in 2026
Macroeconomic Estimates
Clause 8 of rule XIII of the Rules of the House of
Representatives requires that the estimates provided under
section 402 of the Congressional Budget Act of 1974 for major
legislation to include, to the extent practicable, the
budgetary effects of changes in economic output, employment,
capital stock, and other macroeconomic variables resulting from
such legislation. It was not practicable for the Congressional
Budget Office to produce the macroeconomic estimates prior to
the deadline for filing this bill. It is anticipated that such
estimate will be available prior to the consideration of this
bill by the House, which will be made available on the
Congressional Budget Office's website.
Performance Goals and Objectives
Clause 3(c)(4) of rule XIII of the Rules of the House of
Representatives requires the report of a committee on a measure
to include a statement of general performance goals and
objectives, including outcome-related goals and objectives, for
which the measure authorizes funding. This bill is reported
pursuant to section 2002 of S. Con. Res. 11, the Concurrent
Resolution on the Budget for Fiscal Year 2016. The goals and
objectives of this bill are to reduce the deficit by at least
$3 billion over the 10-year period and clear the way for real
health care reform that meets the principles set forth in the
introduction of this report.
Constitutional Authority Statement
Clause 7(c)(1) of rule XII of the Rules of the House of
Representatives requires each report of a committee on a public
bill or public joint resolution contain a statement citing the
specific powers granted to Congress in the Constitution to
enact the law proposed by the bill or joint resolution. The
Committee on the Budget finds the Constitutional authority for
this legislation in Article I of the Constitution, Sections 5
and 8.
Changes in Existing Law Made by the Bill, as Reported
Clause 3(e) of rule XIII of the Rules of the House of
Representatives requires each report of a committee on a bill
or joint resolution contain the text of statutes that are
proposed to be repealed and a comparative print of that part of
the bill proposed to be amended whenever the bill repeals or
amends any statute. The required matter is included in the
report language for each title, or in the case of the Committee
on Ways and Means each subtitle, of the legislative
recommendations submitted by the appropriate authorizing
committees and reported to the House by the Committee on the
Budget.
Federal Mandates Statement
Section 423 of the Congressional Budget and Impoundment
Control Act of 1974 requires a statement of whether the
provisions of the reported bill include unfunded mandates. The
Congressional Budget Office has determined that the bill
contains no intergovernmental or private sector mandates within
the narrow definition of the Unfunded Mandates Reform Act of
1995. Any statements regarding unfunded mandates for the
legislative recommendations submitted by each of the
authorizing committees are included under the appropriate
titles.
Advisory on Earmarks
In accordance with clause 9 of rule XXI of the Rules of the
House of Representatives, the bill does not contain any
congressional earmarks, limited tax benefits, or limited tariff
benefits as defined in clause 9(e), 9(f), or 9(g) of rule XXI
of the Rules of the House of Representatives.
Duplication of Federal Programs
Section 3(g)(2) of H. Res. 5 requires reports for measures
creating or reauthorizing programs of the Federal Government to
include a statement indicating whether any such program is
known to be duplicative of another such program. The
reconciliation bill reported by the Committee on the Budget
does not establish or authorize any new Federal programs.
Disclosure of Directed Rulemakings
Section 3(i) of H. Res. 5 requires committee reports on any
bill or joint resolution to include a statement estimating the
number directed makings required by the measure. This bill does
not require any directed rulemakings.
VIEWS OF COMMITTEE MEMBERS
----------
Clause 2(c) of rule XIII of the Rules of the House of
Representatives requires each report by a committee on a public
matter to include any additional, minority, supplemental, or
dissenting views submitted pursuant to clause 2(l) of rule XI
by one or more members of the committee. In addition, this
report includes views from members of committees submitting
reconciliation recommendations pursuant to section 2002 of S.
Con. Res. 11 under the appropriate titles or subtitles, as the
case may be, of this report. The [minority and additional
views] of members of the Committee on the Budget are as
follows:
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 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.
TITLE I--COMMITTEE ON EDUCATION AND THE WORKFORCE
SEC. 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)).
TITLE II--COMMITTEE ON ENERGY AND COMMERCE
SEC. 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.
SEC. 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.
SEC. 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''.
TITLE III--COMMITTEE ON WAYS AND MEANS
Subtitle A--Revenue Provisions
SEC. 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.
SEC. 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.
SEC. 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.
SEC. 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.
Subtitle B--Repeal of Independent Payment Advisory Board
SEC. 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.