1.This Act may be cited as the
State-Based Health Care Reform
Act
.
2.Congress makes the following
findings:
(1)Health care
remains one of the most important domestic issues for Americans.
(2)According to the
Census Bureau, 45,800,000 Americans were uninsured in 2004. Over 8,000,000 of
these individuals were children. The number of uninsured has increased by
6,000,000 since 2000.
(3)According to the
Commonwealth Fund, many of the uninsured are employed, and an increasing number
are from middle-income families:
(A)Two in five
working-age Americans with annual incomes between $20,000 and $40,000 were
uninsured for at least part of 2005. In 2001, just over one-quarter of those
with moderate incomes were uninsured.
(B)Of the estimated
48,000,000 American adults who spent any time uninsured in 2005, two-thirds
were in families where at least one person was working full time.
(4)The uninsured
face serious financial problems, and often have to choose between medical care
and other basic necessities. According to the Commonwealth Fund, more than half
of uninsured adults reported medical debt or problems paying bills. Of those,
nearly half used up all their savings to pay their bills. Two of five were
unable to pay for basic necessities like food, heat, or rent because of medical
bills.
(5)Health outcomes
for the uninsured are worse than health outcomes for those who are covered.
According to the Institute of Medicine, the number of excess deaths among
uninsured adults ages 25 to 64 is estimated at around 18,000 a year. Fifty-nine
percent of uninsured adults who had a chronic illness, such as diabetes or
asthma, did not fill a prescription or skipped their medications because they
could not afford them.
(6)The cost of
providing care to the uninsured weighs heavily on the United States economy.
The United States spends twice as much as any other industrialized nation on
health care, and more than the United Kingdom’s entire gross domestic product.
According to the Kaiser Family Foundation, $124,600,000,000 was spent on care
provided to individuals who were uninsured for all or part of 2004. Despite
this spending, the United States ranks second to last among industrialized
countries in infant mortality rates.
3.It is the purpose of this Act to establish a
program to award grants to States for the establishment of State-based projects
to—
(1)increase health
care coverage for uninsured individuals in selected States within the 5-year
period beginning on the date of enactment of this Act;
(2)ensure
high-quality health care coverage that provides adequate access to providers,
services, and benefits;
(3)improve the
efficiency of health care spending and lower the cost of health care for the
participating State; and
(4)encourage
universal health care coverage within States.
<enum>I</enum><header>Health care
coverage</header>
<section id="IDF51F0EC40B9549BEB89DCDC3AEEDC122"><enum>101.</enum><header>State-based
health care coverage program</header>
<subsection id="IDF2DDB30FF350432E9C2AC972B94A74DB"><enum>(a)</enum><header>Applications by
States, Multi-State Regions, Local Governments, and Tribes</header>
<paragraph id="ID43B9AD6E318048F498E6E7CD3BB96C7B"><enum>(1)</enum><header>State
application</header><text>A State, in consultation with local governments,
Indian tribes, and Indian organizations involved in the provision of health
care (referred to in this Act as a <quote>State</quote>), may apply for a State
health care reform grant for the entire State (or for regions of two or more
States) under paragraph (2).</text>
</paragraph><paragraph id="ID7AD49EE1E1EC4260A80B4706509FCC48"><enum>(2)</enum><header>Submission of
application</header><text>In accordance with this section, each State desiring
to implement a State health care reform program shall submit an application to
the Health Care Reform Task Force established under subsection (b) (referred to
in this section as the <quote>Task Force</quote>) for approval.</text>
</paragraph><paragraph id="ID46843059085A4D9292C3D257E446D9CF"><enum>(3)</enum><header>Local
government and other applications</header>
<subparagraph id="ID7F42CA8F4FD14655A71BFA114464F304"><enum>(A)</enum><header>In
general</header><text>Where a State fails to submit an application under this
section, a unit of local government of such State, or a consortium of such
units of local governments, may submit an application directly to the Task
Force for programs or projects under this section. Such an application shall be
subject to the requirements of this section.</text>
</subparagraph><subparagraph id="ID5925FBF3339B4C6C82B788F72ED8A02B"><enum>(B)</enum><header>Other
applications</header><text>Subject to such additional regulations as the
Secretary may prescribe, a unit of local government, Indian tribe, or Indian
health organization may submit an application under this section, whether or
not the State submits such an application, if such unit, tribe, or organization
can demonstrate unique demographic needs or a significant population size that
warrants a substate program under this subsection.</text>
</subparagraph></paragraph></subsection><subsection id="ID9B5F922626D740E588E029611CEEC162"><enum>(b)</enum><header>Health Care
Reform Task Force</header><text></text>
<paragraph id="IDEF7ACA1665E24E4790C6C352EC7CD591"><enum>(1)</enum><header>Establishment</header><text>Not
later than 180 days after the date of the enactment of this Act, the Secretary
shall establish a Health Care Reform Task Force in accordance with this
subsection.</text>
</paragraph><paragraph id="idCD3F0446A16D4E52B8F7C5E96927D9B8"><enum>(2)</enum><header>Membership</header><text></text>
<subparagraph id="ID1E1EBCDEB585429DBC0BBF26FA9177B9"><enum>(A)</enum><header>In
general</header><text>The Task Force shall be comprised of not less than 20
members to be appointed by the Comptroller General in accordance with
subparagraph (B) and the Secretary.</text>
</subparagraph><subparagraph id="idF2AB66EFD5904C59A743AC02B4692E12"><enum>(B)</enum><header>Appointed
members</header><text>With respect to the members appointed by the Comptroller
General under subparagraph (A)—</text>
<clause id="id763B051B079A4C5BA1E1B1EDC46DFEA6"><enum>(i)</enum><text>such members
shall include consumers of health services who represent individuals who have
not had health insurance coverage during the 2-year period prior to the
appointment and who have had a chronic illness and are disabled;</text>
</clause><clause id="id174B56B26C1F441CAD988B5954861533"><enum>(ii)</enum><text>such members
shall include individuals—</text>
<subclause id="id8EE735C5589949C8AC9E38734ECCB7BC"><enum>(I)</enum><text>with expertise in
the financing of, and paying for, benefits and access to care;</text>
</subclause><subclause id="id09734F5002974941B9FB5A099B5095A6"><enum>(II)</enum><text>representing
business and labor; and</text>
</subclause><subclause id="id4909A175BEB146B9B00FBBBD967D6BBA"><enum>(III)</enum><text>who are health
care providers;</text>
</subclause></clause><clause id="id7A19033989204F12ABCBBE49FC30D812"><enum>(iii)</enum><text>such members
shall include individuals with expertise and experience in State health policy,
State government, and local government;</text>
</clause><clause id="idC3C55AB0F2B64EF99219CB9074752D24"><enum>(iv)</enum><text>such members
shall have a broad geographic representation and be balanced between urban and
rural areas; and</text>
</clause><clause id="id07DB1D3D5BE64A7BA8EBAFCC9C81E62E"><enum>(v)</enum><text>such members
shall not include elected officials or paid employees or representatives of
associations or advocacy organizations involved in the health care
system.</text>
</clause></subparagraph></paragraph><paragraph id="idB8ED6840C0F140F1BA5E5A3EE22E2642"><enum>(3)</enum><header>General
duties</header><text>The Task Force shall—</text>
<subparagraph id="ID7DD73E9FB67C4800AAEBC4305FFA7873"><enum>(A)</enum><text>formally approve
the application of a State for a grant under this section and the
administration of a reform program within the State;</text>
</subparagraph><subparagraph id="IDCAB312746C1847A787C1E6B5D43AEF91"><enum>(B)</enum><text>establish minimum
performance measures with respect to coverage, quality, and cost of State
programs, as described under subsection (c)(1);</text>
</subparagraph><subparagraph id="ID3E52F135B696428B9C063BCA791248DF"><enum>(C)</enum><text>conduct a
thorough review of the grant application from a State and carry on a dialogue
with such State applicants concerning possible modifications and
adjustments;</text>
</subparagraph><subparagraph id="ID465C46ECABC2498FB24B3A67A43D7AEC"><enum>(D)</enum><text>be responsible
for monitoring the status and progress achieved under programs and projects
granted under this section; and</text>
</subparagraph><subparagraph id="IDDAC38D68D92A49E3BF3EA610ECC98465"><enum>(E)</enum><text>report to the
public concerning progress made by States with respect to the performance
measures and goals established under this Act, the periodic progress of the
State relative to its State performance measures and goals, and the State
program application procedures, by region and State jurisdiction.</text>
</subparagraph></paragraph><paragraph id="ID16A3FC820FBA4E7690447C2B2A8D359F"><enum>(4)</enum><header>Period of
appointment; representation requirements; vacancies</header><text>Members shall
be appointed for the life of the Task Force. In appointing members under
paragraph (1)(A), the Comptroller General shall ensure the representation of
urban and rural areas and an appropriate geographic distribution of such
members. Any vacancy on the Task Force shall not affect its powers, but shall
be filled within a reasonable period of time and in the same manner as the
original appointment.</text>
</paragraph><paragraph id="ID98188B23DD26443D9DFBEABE1F8E3AB2"><enum>(5)</enum><header>Chairperson,
meetings</header>
<subparagraph id="IDFD6929C7B85A444A946AF3E43BFB2979"><enum>(A)</enum><header>Chairperson</header><text>The
Task Force shall select a Chairperson from among its members.</text>
</subparagraph><subparagraph id="IDD7917791391A451AAFFE632DD45E9A43"><enum>(B)</enum><header>Quorum</header><text>A
majority of the members of the Task Force shall constitute a quorum, but a
lesser number of members may hold hearings.</text>
</subparagraph><subparagraph id="IDAB0932A9D69942C38800F48488069AFF"><enum>(C)</enum><header>Meetings</header><text>Not
later than 30 days after the date on which all members of the Task Force have
been appointed, the Task Force shall hold its first meeting. The Task Force
shall meet at the call of the Chairperson.</text>
</subparagraph></paragraph><paragraph id="IDA70161AB613B4F1DB97C05E1011E9001"><enum>(6)</enum><header>Powers of the
task force</header>
<subparagraph id="ID33F6FF7C2C5941F3A4EE418598527E39"><enum>(A)</enum><header>Negotiations
with states</header><text>The Task Force may conduct detailed discussions and
negotiations with States submitting applications under this section, either
individually or in groups, to facilitate a final set of recommendations for
purposes of subsection (c)(4)(B). Such negotiations shall be conducted in a
public forum.</text>
</subparagraph><subparagraph id="id13CC37CBD30F4266ACC885576F3B64F2"><enum>(B)</enum><header>Subcommittees</header><text>The
Task Force may establish such subcommittees as the Task Force determines are
necessary to increase the efficiency of the Task Force.</text>
</subparagraph><subparagraph id="ID5A8C81B48ECE419D95861EDDC868A699"><enum>(C)</enum><header>Hearings</header><text>The
Task Force may hold hearings, so long as the Task Force determines such
meetings to be necessary in order to carry out the purposes of this Act, sit
and act at such times and places, take such testimony, and receive such
evidence as the Task Force considers advisable to carry out the purposes of
this subsection.</text>
</subparagraph><subparagraph id="ID3C9E054E9A36445DB51310812FB3A2E6"><enum>(D)</enum><header>Annual
meeting</header><text>In addition to other meetings the Task Force may hold,
the Task Force shall hold an annual meeting with the participating States under
this section for the purpose of having States report progress toward the
purposes in section 3 and for an exchange of information.</text>
</subparagraph><subparagraph id="ID4C441B98B9F742BAA00B4B8C20D76FFA"><enum>(E)</enum><header>Information</header><text>The
Task Force may obtain information directly from any Federal department or
agency as the Task Force considers necessary to carry out the provisions of
this subsection. Upon request of the Chairperson of the Task Force, the head of
such department or agency shall furnish such information to the Task
Force.</text>
</subparagraph><subparagraph id="idFD90C9D951CB4D59A2D55C80FFF5BD87"><enum>(F)</enum><header>Contracting</header><text>The
Task Force may enter into contracts with qualified independent organizations
(such as Mathematica or the Institute of Medicine) to obtain necessary
information for the development of the performance standards, reporting
requirements, financing mechanisms, or any other matters determined by the Task
Force to be appropriate and reasonable.</text>
</subparagraph><subparagraph id="ID1A209CFFCAAB4AC1BA318ABA5C833A24"><enum>(G)</enum><header>Postal
services</header><text>The Task Force may use the United States mails in the
same manner and under the same conditions as other departments and agencies of
the Federal Government.</text>
</subparagraph></paragraph><paragraph id="IDFD1FA8A841674686BEDCB391BB51A4B1"><enum>(7)</enum><header>Personnel
matters</header>
<subparagraph id="ID155D0DFBA7D84ED889CB6E561D89120D"><enum>(A)</enum><header>Compensation</header><text>Each
member of the Task Force who is not an officer or employee of the Federal
Government shall be compensated at a rate equal to the daily equivalent of the
annual rate of basic pay prescribed for level IV of the Executive Schedule
under section 5315 of title 5, United States Code, for each day (including
travel time) during which such member is engaged in the performance of the
duties of the Task Force. All members of the Task Force who are officers or
employees of the United States shall serve without compensation in addition to
that received for their services as officers or employees of the United
States.</text>
</subparagraph><subparagraph id="IDCCD4DE2A64D04A5CBA06448695500C61"><enum>(B)</enum><header>Travel
expenses</header><text>The members of the Task Force 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 Task Force.</text>
</subparagraph><subparagraph id="ID4C10F582FB0A46549C26F6E55DEB5A13"><enum>(C)</enum><header>Staff</header><text>The
Chairperson of the Task Force may, without regard to the civil service laws and
regulations, appoint and terminate personnel as may be necessary to enable the
Task Force to perform its duties.</text>
</subparagraph><subparagraph id="IDCDCC55593BE340529984D84E9B38226F"><enum>(D)</enum><header>Detail of
government employees</header><text>Any Federal Government employee may be
detailed to the Task Force without reimbursement, and such detail shall be
without interruption or loss of civil service status or privilege.</text>
</subparagraph><subparagraph id="ID8C162C86FD0E45FCBB7A23A092E37609"><enum>(E)</enum><header>Temporary and
intermittent services</header><text>The Chairperson of the Task Force 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.</text>
</subparagraph></paragraph><paragraph id="IDD075F6902A7549BC99AA18594D551396"><enum>(8)</enum><header>Funding</header><text>For
the purpose of carrying out this subsection, there are authorized to be
appropriated $4,000,000 for fiscal year 2007 and each fiscal year
thereafter.</text>
</paragraph></subsection><subsection id="IDDDD256AF756D40E1A1E32D3258C28FD4"><enum>(c)</enum><header>State
Plan</header>
<paragraph id="ID08F43B8FFAAC4C948271B488788145A3"><enum>(1)</enum><header>In
general</header><text>A State that seeks to receive a grant to operate a
program under this section shall prepare and submit to the Task Force, as part
of the application under subsection (a), a State health care plan that—</text>
<subparagraph id="IDB1D8F38AF20043B0A4058CC3114021CB"><enum>(A)</enum><text>designates the
lead State entity that will be responsible for administering the State
program;</text>
</subparagraph><subparagraph id="ID3825090079B04822BEBF497F6A8FE6B2"><enum>(B)</enum><text>contains a list
of the minimum benefits that will be provided to all individuals covered under
the State program, which shall, at a minimum, provide for coverage that is
comparable to the coverage provided for benefits under any of the plans offered
under the Federal Employees Health Benefits Program under chapter 89 of title
5, United States Code or the minimum benefits required under the program under
title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.);</text>
</subparagraph><subparagraph id="ID02B8E4A8B4B440279D34707668F06B79"><enum>(C)</enum><text>includes specific
target dates for decreasing the number of uninsured individuals in the State;
and</text>
</subparagraph><subparagraph id="IDD49AB61FF3244FA4A24B772CC51846EA"><enum>(D)</enum><text>otherwise
complies with this subsection.</text>
</subparagraph></paragraph><paragraph id="IDAF54668C8FD144418241E705DEE3A33C"><enum>(2)</enum><header>Coverage</header><text>With
respect to coverage for uninsured individuals in the State, the State plan
shall—</text>
<subparagraph id="ID46637B245F2E451CB3DD5B087D92680F"><enum>(A)</enum><text>provide and
describe the manner in which the State will ensure that an increased number of
such individuals residing within the State will have expanded access to health
care coverage with a specific 5-year target for reduction in the number of
uninsured individuals through either private or public program expansion, or
both, such description to include the manner in which the State will ensure
expanded access to health care coverage for low-income individuals within the
5-year target period;</text>
</subparagraph><subparagraph id="ID4F72E7BDC45243E4910932C4146E109E"><enum>(B)</enum><text>provide for
improvements in the availability of appropriate health care services that will
increase access to care in urban, rural, and frontier areas of the State with
medically underserved populations or where there is an inadequate supply of
health care providers; and</text>
</subparagraph><subparagraph id="id67D41C6BF6F2428B8BF540880A9007A7"><enum>(C)</enum><text>describe the
minimum benefits package that will be provided to every beneficiary, including
information on affordability for beneficiaries.</text>
</subparagraph></paragraph><paragraph id="ID803B34F86D9748CFB0807552DC341A5D"><enum>(3)</enum><header>Effectiveness
and efficiency</header><text>The State plan shall include provisions to improve
the effectiveness and efficiency of health care in the State, including
provisions to attempt to reduce the overall health care costs within the
State.</text>
</paragraph><paragraph id="IDF7F51285F096473AB77978F36EE72143"><enum>(4)</enum><header>Costs</header>
<subparagraph id="idE0EE02F444124955878EA8599E6588D4"><enum>(A)</enum><header>In
general</header><text>With respect to the costs of health care provided under
the program, the State plan shall—</text>
<clause id="ID0481F613B293410199194E38702B6567"><enum>(i)</enum><text>describe the
public and private sector financing to be provided for the State health
program;</text>
</clause><clause id="IDDD5F726CC4B04B4C83A69E310CBEC393"><enum>(ii)</enum><text>estimate the
amount of Federal, State, and local expenditures, as well as the costs to
business and individuals under the State health program;</text>
</clause><clause id="ID08D477B9AFD74684843760E63D7DEF6D"><enum>(iii)</enum><text>describe how
the State plan will ensure the financial solvency of the State health program;
and</text>
</clause><clause id="idA29F4B47F5A14E26A1F79197A8269D77"><enum>(iv)</enum><text>contain
assurances that the State will comply with the premium and cost sharing
limitations described in subparagraph (B).</text>
</clause></subparagraph><subparagraph id="id28345D53D83048299704646676B8BB24"><enum>(B)</enum><header>Premium and
cost sharing limitations</header>
<clause id="id820CC40EAFAA4F1DB4549307AEA2832B"><enum>(i)</enum><header>Premiums</header><text>In
providing health care coverage under a State program under this Act, the State
shall ensure that—</text>
<subclause id="idBDF10B0BF5EF461895A79541CCE222F1"><enum>(I)</enum><text>with respect to
an individual whose family income is at or below 100 percent of the poverty
line, the State program shall not require—</text>
<item id="idF49427356E944883940EF064DE592D7A"><enum>(aa)</enum><text>the
payment of premiums for such coverage; or</text>
</item><item id="id088065A85BDE45F4ABEB1BDF8827ABE0"><enum>(bb)</enum><text>the
payment of cost sharing for such coverage in an amount that exceeds .5 percent
of the family's income for the year involved;</text>
</item></subclause><subclause id="idF1C8988183944C018F6356477AB11159"><enum>(II)</enum><text>with respect to
an individual whose family income is greater than 100 percent, but at or below
200 percent, of the poverty line, the State program shall not require—</text>
<item id="id27F1EBB989CA4F57ADE06FF312F6770A"><enum>(aa)</enum><text>the
payment of premiums for such coverage in excess of 20 percent of the average
cost of providing benefits to an individual or family or 3 percent of the
amount of the family's income for the year involved; or</text>
</item><item commented="no" display-inline="no-display-inline" id="id38EF916EE684411B9962717B07A7F5BE"><enum>(bb)</enum><text>the payment of
cost sharing for such coverage in an amount that, together with the premium
amount, does not exceed 5 percent of the family's income for the year involved;
and</text>
</item></subclause><subclause id="id15165A71769E43B382190C318F88DA5C"><enum>(III)</enum><text>with respect to
an individual whose family income is greater than 200 percent, but at or below
300 percent, of the poverty line, the State program shall not require—</text>
<item id="idF39F2AB6D238456F8B8F15A2CF13F796"><enum>(aa)</enum><text>the
payment of premiums for such coverage in excess of 20 percent of the average
cost of providing benefits to an individual or family or 5 percent of the
amount of the family's income for the year involved; or</text>
</item><item commented="no" display-inline="no-display-inline" id="id98FBE0F1B8D14BEAB114CE49FE259002"><enum>(bb)</enum><text>the payment of
cost sharing for such coverage in an amount that, together with the premium
amount, does not exceed 7 percent of the family's income for the year
involved.</text>
</item></subclause></clause><clause commented="no" display-inline="no-display-inline" id="id577D13841D184AC2AD0D4E305078F5B1"><enum>(ii)</enum><header>Definition</header><text>For
purposes of this subparagraph, the term <quote>poverty line</quote> has the
meaning given such term in section 2110(c)(5) of the Social Security Act (42
U.S.C. 1397jj(c)(5)).</text>
</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id8DD682D868804BD4AEF1A19E46A710B6"><enum>(5)</enum><header>Protection for
lower income individuals</header><text>The State plan may only vary premiums,
deductibles, coinsurance, and other cost sharing under the plan based on the
family income of the family involved in a manner that does not favor
individuals from families with higher income over individuals from families
with lower income.</text>
</paragraph></subsection><subsection id="IDC2FC1DCDD76444118502ED59C7A7C622"><enum>(d)</enum><header>Review;
Determination; and Project Period</header>
<paragraph id="IDF48307370578479DB8D61E6910124C31"><enum>(1)</enum><header>Initial
review</header><text>With respect to a State application for a grant under
subsection (a), the Secretary and the Task Force shall, not later than 90 days
after receipt of such application, complete an initial review of such State
application, an analysis of the scope of the proposal, and a determination of
whether additional information is needed from the State. The Task Force shall
advise the State within such 90-day period of the need to submit additional
information.</text>
</paragraph><paragraph id="ID38AA967897FF4EF5A9EFAE66D0996C9B"><enum>(2)</enum><header>Final
determination</header><text>Not later than 90 days after completion of the
initial review under paragraph (1), the Task Force shall determine whether to
approve such application. Such application may be approved only if
<fraction>2/3</fraction> of the members of the Task Force vote to approve such
application.</text>
</paragraph><paragraph id="ID3779B000B20742BFBFD1D6890213BE9C"><enum>(3)</enum><header>Program or
project period</header><text>A State program or project may be approved for a
period of not to exceed 5 years and may be extended for subsequent 5-year
periods upon approval by the Task Force and the Secretary, based upon
achievement of targets, except that a shorter period may be requested by a
State and granted by the Secretary.</text>
</paragraph></subsection><subsection id="ID82AF3EC25E214712AC01BEAEB948B1B9"><enum>(e)</enum><header>Required
Congressional action</header><text>It is the sense of the Senate that, not
later than 45 days after receiving the report submitted under subsection
(g)(2), each committee to which such report is submitted should hold at least 1
hearing concerning such report and the recommendations contained in such
report.</text>
</subsection><subsection id="ID994F8989A9D1444B876C18A472E3FD57"><enum>(f)</enum><header>Funding</header>
<paragraph id="IDD4F0B81A4B4C4CBE9CEC01EF52F22A32"><enum>(1)</enum><header>In
general</header><text>The Secretary shall provide a grant to a State that has
an application approved under subsection (d)(2) to enable such State to carry
out the State health program under the grant.</text>
</paragraph><paragraph id="ID6468534FA5344ECA9B244B08D773F09C"><enum>(2)</enum><header>Amount of
grant</header><text>The amount of a grant provided to a State under paragraph
(1) shall be determined based upon the recommendations of the Task Force,
subject to the amount appropriated under subsection (k).</text>
</paragraph><paragraph id="ID7BD35E8C6DB541EDA4EEE43D88539BA8"><enum>(3)</enum><header>Matching
requirement</header><text>To be eligible to receive a grant under paragraph
(1), a State shall provide assurances to the Secretary that the State shall
contribute to the costs of carrying out activities under the grant an amount
equal to not less than the product of—</text>
<subparagraph id="idFB9521EBC9C643E5AED24EA11DB6522E"><enum>(A)</enum><text>the amount of the
grant; and</text>
</subparagraph><subparagraph id="id8443280149C84F32B87203CB03DE4E22"><enum>(B)</enum><text>the sum of the
enhanced FMAP for the State (as defined in section 2105(b) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1397ee(b))) and 5 percent.</text>
</subparagraph></paragraph><paragraph id="ID4C4D9FCFC9DD474E90C9388469B0FCA7"><enum>(4)</enum><header>Maintenance of
effort</header><text>A State, in utilizing the proceeds of a grant received
under paragraph (1), shall maintain the expenditures of the State for health
care coverage purposes for the support of direct health care delivery at a
level equal to not less than the level of such expenditures maintained by the
State for the fiscal year preceding the fiscal year for which the grant is
received.</text>
</paragraph></subsection><subsection id="ID4B02C62BFE514B64A59CD4F079EBD4C1"><enum>(g)</enum><header>Reports</header>
<paragraph id="ID9DFD003128EC4D14A52BA5EAA41B1FC5"><enum>(1)</enum><header>By
states</header><text>Each State that has received a grant under subsection
(f)(1) shall submit to the Task Force an annual report for the period
representing the respective State’s fiscal year, that shall contain a
description of the results, with respect to health care coverage, quality, and
costs, of the State program.</text>
</paragraph><paragraph id="ID5BB9D1409E0540E18EFADB4C069629AE"><enum>(2)</enum><header>By task
force</header><text>At the end of the 5-year period beginning on the date on
which the Secretary awards the first grant under paragraph (1), the Task Force
established under subsection (b) shall prepare and submit to the appropriate
committees of Congress, a report on the progress made by States receiving
grants under paragraph (1) in meeting the goals of expanded coverage, improved
quality, and cost containment through performance measures established during
the 5-year period of the grant. Such report shall contain—</text>
<subparagraph id="ID6B27BE0182314E509E623C6DE6F7331D"><enum>(A)</enum><text>the
recommendation of the Task Force concerning any future action that Congress
should take concerning health care reform, including whether or not to extend
the program established under this subsection;</text>
</subparagraph><subparagraph id="ID76D711E310824EB8904923B2B2B2808B"><enum>(B)</enum><text>an evaluation of
the effectiveness of State health care coverage reforms in—</text>
<clause id="ID74518046D2D74552B53FB0F9147BDE0F"><enum>(i)</enum><text>expanding health
care coverage for State residents;</text>
</clause><clause id="ID79C38A3CDA4F46A085FC73C29E2D7D7E"><enum>(ii)</enum><text>improving the
quality of health care provided in the States; and</text>
</clause><clause id="ID55143855041045F8803F9DF7BCDE3ED6"><enum>(iii)</enum><text>reducing or
containing health care costs in the States;</text>
</clause></subparagraph><subparagraph id="ID1932F2108A284A07965D09FF93D1D82A"><enum>(C)</enum><text>recommendations
regarding the advisability of increasing Federal financial assistance for State
ongoing or future health program initiatives, including the amount and source
of such assistance; and</text>
</subparagraph><subparagraph id="IDA51ED001E5144D188E6823390E21CE44"><enum>(D)</enum><text>recommendations
concerning whether any particular State program should serve as a model for
implementation as a national health care reform program.</text>
</subparagraph></paragraph></subsection><subsection id="ID13E11DC37D8A427E89100E62265C0420"><enum>(h)</enum><header>Protections for
Federal Programs</header>
<paragraph id="ID7EA269E569A24F4796EAC90C2A0FB79D"><enum>(1)</enum><header>In
general</header><text>Nothing in this Act, or in section 1115 of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1315)
shall be construed as authorizing the Secretary, the Task Force, a State, or
any other person or entity to alter or affect in any way the provisions of
titles XIX and XXI of such Act (42 U.S.C. 1396 et seq. and 1397 et seq.) or the
regulations implementing such titles.</text>
</paragraph><paragraph id="IDCB7ED2692C96442888051AA16A891C9A"><enum>(2)</enum><header>Maintenance of
effort</header><text>No payment may be made under this section if the State
adopts criteria for benefits, income, and resource standards and methodologies
for purposes of determining an individual’s eligibility for medical assistance
under the State plan under title XIX that are more restrictive than those
applied as of the date of enactment of this Act.</text>
</paragraph></subsection><subsection id="IDEE274AC1288F4BF5BF447C98CFF87D75"><enum>(i)</enum><header>Miscellaneous
Provisions</header>
<paragraph id="IDDBED437F534D421E845459BEA3F63EF3"><enum>(1)</enum><header>Application of
certain requirements</header>
<subparagraph id="ID97B79099420F4B62977AE2377996B192"><enum>(A)</enum><header>Restriction on
application of preexisting condition exclusions</header>
<clause id="ID26FB8ABDC4724EC6AC9499347DBBED67"><enum>(i)</enum><header>In
general</header><text>Subject to subparagraph (B), a State shall not permit the
imposition of any preexisting condition exclusion for covered benefits under a
program or project under this section.</text>
</clause><clause id="ID0CCD926181B940C4BFC8EC92A7CD713A"><enum>(ii)</enum><header>Group health
plans and group health insurance coverage</header><text>If the State program or
project provides for benefits through payment for, or a contract with, a group
health plan or group health insurance coverage, the program or project may
permit the imposition of a preexisting condition exclusion but only insofar and
to the extent that such exclusion is permitted under the applicable provisions
of part 7 of subtitle B of title I of the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name> and title XXVII of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name>.</text>
</clause></subparagraph><subparagraph id="ID3A558FEC30D64E2AB977D1CC464AFD1F"><enum>(B)</enum><header>Compliance with
other requirements</header><text>Coverage offered under the program or project
shall comply with the requirements of subpart 2 of part A of title XXVII of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> insofar as
such requirements apply with respect to a health insurance issuer that offers
group health insurance coverage.</text>
</subparagraph></paragraph><paragraph id="IDB08D95B85EB4456E81D94286480286EB"><enum>(2)</enum><header>Prevention of
duplicative payments</header>
<subparagraph id="ID271E23AD8FBE4A1098902D408BD668D8"><enum>(A)</enum><header>Other health
plans</header><text>No payment shall be made to a State under this section for
expenditures for health assistance provided for an individual to the extent
that a private insurer (as defined by the Secretary by regulation and including
a group health plan (as defined in section 607(1) of the
<act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name>), a service benefit plan, and a health maintenance
organization) would have been obligated to provide such assistance but for a
provision of its insurance contract which has the effect of limiting or
excluding such obligation because the individual is eligible for or is provided
health assistance under the plan.</text>
</subparagraph><subparagraph id="IDD8F3DB008C4B466FBCE20EE3CB20E4A5"><enum>(B)</enum><header>Other federal
governmental programs</header><text>Except as provided in any other provision
of law, no payment shall be made to a State under this section for expenditures
for health assistance provided for an individual to the extent that payment has
been made or can reasonably be expected to be made promptly (as determined in
accordance with regulations) under any other federally operated or financed
health care insurance program, other than an insurance program operated or
financed by the Indian Health Service, as identified by the Secretary. For
purposes of this paragraph, rules similar to the rules for overpayments under
section 1903(d)(2) of the <act-name parsable-cite="SSA">Social Security
Act</act-name> shall apply.</text>
</subparagraph></paragraph><paragraph id="ID213EC5C0420A4611B5A0B03FFBBAAE6C"><enum>(3)</enum><header>Application of
certain general provisions</header><text>The following sections of the
<act-name parsable-cite="SSA">Social Security Act</act-name> shall apply to
States under this section in the same manner as they apply to a State under
such title XIX:</text>
<subparagraph id="ID40E64B85851E43749295A4FAAAA2F8C7"><enum>(A)</enum><header>Title xix
provisions</header>
<clause id="ID5EBCD03BC19C4F25969774B11380F5EA"><enum>(i)</enum><text>Section
1902(a)(4)(C) (relating to conflict of interest standards).</text>
</clause><clause id="ID7FFB6D88284D4D16BA9DC83A8E13CCCE"><enum>(ii)</enum><text>Paragraphs (2),
(16), and (17) of section 1903(i) (relating to limitations on payment).</text>
</clause><clause id="ID855547EC31744DC2AFCB11ADC9F0E1A6"><enum>(iii)</enum><text>Section 1903(w)
(relating to limitations on provider taxes and donations).</text>
</clause><clause id="ID6E51F59121CA4E849E432D442F2A14A9"><enum>(iv)</enum><text>Section 1920A
(relating to presumptive eligibility for children).</text>
</clause></subparagraph><subparagraph id="IDD0D4D0148E5944D2A54E1E90EFD7F856"><enum>(B)</enum><header>Title xi
provisions</header>
<clause id="ID56F04B4480424F43BB3708829DF41DC5"><enum>(i)</enum><text>Section 1116
(relating to administrative and judicial review), but only insofar as
consistent with this title.</text>
</clause><clause id="IDC8A82C3D0693465F83AF423FE3BEE358"><enum>(ii)</enum><text>Section 1124
(relating to disclosure of ownership and related information).</text>
</clause><clause id="IDADE7408D7D404F62B3D112737CE9C5D0"><enum>(iii)</enum><text>Section 1126
(relating to disclosure of information about certain convicted
individuals).</text>
</clause><clause id="ID5DE76A031BA14FA98505BC735951D402"><enum>(iv)</enum><text>Section 1128A
(relating to civil monetary penalties).</text>
</clause><clause id="IDD69D4FF0A8DC497498A6A2931E07D19F"><enum>(v)</enum><text>Section 1128B(d)
(relating to criminal penalties for certain additional charges).</text>
</clause><clause id="ID4659B0E7BD0D441FBF04E55BD4EB3073"><enum>(vi)</enum><text>Section 1132
(relating to periods within which claims must be filed).</text>
</clause></subparagraph></paragraph><paragraph id="IDCC47FA3C446747788D256FE34E83E0B7"><enum>(4)</enum><header>Relation to
other laws</header>
<subparagraph id="ID804B033BF3FC4E169E83510F4A09F457"><enum>(A)</enum><header>HIPAA</header><text>Health
benefits coverage provided under a State program or project under this section
shall be treated as creditable coverage for purposes of part 7 of subtitle B of
title I of the <act-name parsable-cite="ERISA">Employee Retirement Income
Security Act of 1974</act-name>, title XXVII of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>, and
subtitle K of the Internal Revenue Code of 1986.</text>
</subparagraph><subparagraph id="ID9EE4C8DEDD7A4CB0AD579D65C52CA2FE"><enum>(B)</enum><header>ERISA</header><text>Nothing
in this section shall be construed as affecting or modifying section 514 of the
<act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name> (29 U.S.C. 1144) with respect to a group health plan (as
defined in section 2791(a)(1) of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name> (42 U.S.C. 300gg–91(a)(1))).</text>
</subparagraph></paragraph></subsection><subsection id="ID0A4939F5BB14436C93748D667667B69C"><enum>(j)</enum><header>Authorizations</header>
<paragraph id="idDB03B6DA8AAB46E59AB7ADB01A2EDBAA"><enum>(1)</enum><header>In
general</header><text>There are appropriated in each of fiscal years 2007
through 2016 to carry out this Act, an amount equal to the amount of savings to
the Federal Government in each such fiscal year as a result of the enactment of
the provisions of title II.</text>
</paragraph><paragraph id="id391663D922C940CE9B00C83212C06076"><enum>(2)</enum><header>Use of
funds</header><text>Amounts appropriated for a fiscal year under paragraph (1)
and not expended may be used in subsequent fiscal years to carry out this
section.</text>
</paragraph><paragraph id="id8EF645D66F584E2BB86E4FFA05B57262"><enum>(3)</enum><header>Limitation</header><text>Notwithstanding
any other provision of this Act, the total amount of funds appropriated to
carry out this Act through fiscal year 2016 shall not exceed
$32,000,000,000.</text>
</paragraph></subsection></section><enum>II</enum><header>Offsets</header>
<section id="ID84c3459435554ee9ace55af71bfe7686"><enum>201.</enum><header>Increase in
rebates for covered outpatient drugs</header><text display-inline="no-display-inline">Section 1927(c)(1)(B)(i) of the Social
Security Act (42 U.S.C. 1396r–8(c)(1)(B)(i)) is amended—</text>
<paragraph id="IDf5d5f286b03a4030aebf634824c0f66e"><enum>(1)</enum><text>in subclause
(IV), by striking <quote>and</quote> after the semicolon;</text>
</paragraph><paragraph id="ID4089f09b01764c099b7e078aa2cbda33"><enum>(2)</enum><text>in subclause
(V)—</text>
<subparagraph id="ID2b5e3fb684ce418a95f6b7f73d924f36"><enum>(A)</enum><text>by inserting
<quote>and before January 1, 2007,</quote> after <quote>1995,</quote>;
and</text>
</subparagraph><subparagraph id="IDd9273e1b83b142e1a72c97fd7d0949fd"><enum>(B)</enum><text>by striking the
period and inserting <quote>; and</quote>; and</text>
</subparagraph></paragraph><paragraph id="IDe95bc14021944a1fa3dfbd64b813ab64"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="idD293413A9C9F4290829039EDDD0EF171" style="OLC">
<subclause id="IDa63c8660f6244affafcd31482329cdb2"><enum>(VI)</enum><text>after December
31, 2006, is 20
percent.</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HD3DF535144574910B854BCABE42D3141"><enum>202.</enum><header>Student Aid
Reward Program</header><text display-inline="no-display-inline">Part G of title
IV of the <act-name parsable-cite="HEA65">Higher Education Act of
1965</act-name> is amended by inserting after section 489 (20 U.S.C. 1096) the
end the following:</text>
<quoted-block act-name="Higher" display-inline="no-display-inline" id="H2562A24334744052A0E5FDC5CFA9B13" style="OLC">
<section id="H921BCAB80ACD4290A5A17119FD755367"><enum>489A.</enum><header>Student Aid
Reward Program</header>
<subsection id="H5C5801C7EB9B40279697C8690BAEB8B"><enum>(a)</enum><header>Program
authorized</header><text>The Secretary shall carry out a Student Aid Reward
Program to encourage institutions of higher education to participate in the
student loan program under this title that is most cost-effective for
taxpayers.</text>
</subsection><subsection id="H13AFE86CF9C34593B7B7499F8500F5BF"><enum>(b)</enum><header>Program
requirements</header><text>In carrying out the Student Aid Reward Program, the
Secretary shall—</text>
<paragraph id="H873D589E52B049E1BAB8F111DEF37C7F"><enum>(1)</enum><text display-inline="yes-display-inline">provide to each institution of higher
education participating in the student loan program under this title that is
most cost-effective for taxpayers a Student Aid Reward Payment, in an amount
determined in accordance with
<internal-xref idref="H43AF055D35724E42AAA155B11404C286" legis-path="460A.(c)">subsection (c)</internal-xref>, to encourage the
institution to participate in that student loan program;</text>
</paragraph><paragraph id="H2EEBB63174894B1EAF3F9F00BC88C5"><enum>(2)</enum><text>require each
institution of higher education receiving a payment under this section to
provide student loans under that student loan program for a period of 5 years
from the date the payment is made;</text>
</paragraph><paragraph id="H93DE04F816794108889CDFA8C63F0013"><enum>(3)</enum><text>where appropriate,
require that funds paid to institutions of higher education under this section
be used to award students a supplement to such students’ Pell Grants under
subpart 1 of part A;</text>
</paragraph><paragraph id="H06E0554A41B04479A4E528F6004D952C"><enum>(4)</enum><text>permit such funds
to also be used to award lower and middle income graduate students need-based
grants; and</text>
</paragraph><paragraph id="H81362ADB6D6E4EB0A59939562BCED0C7"><enum>(5)</enum><text>encourage all
institutions of higher education to participate in the Student Aid Reward
Program.</text>
</paragraph></subsection><subsection id="H43AF055D35724E42AAA155B11404C286"><enum>(c)</enum><header>Amount</header><text display-inline="yes-display-inline">The amount of a Student Aid Reward Payment
under this section shall be not less than 50 percent, and not more than 75
percent, of the savings to the Federal Government generated by the
institution’s participation in the student loan program under this title that
is most cost-effective for taxpayers instead of the institution’s participation
in the student loan program not cost-effective for taxpayers.</text>
</subsection><subsection id="H7C58466797624CE9B57B2F7C5969A855"><enum>(d)</enum><header>Trigger to
ensure cost neutrality</header>
<paragraph id="HB1A8243873114567A3339D096F61F82D"><enum>(1)</enum><header>Limit to ensure
cost neutrality</header><text>Notwithstanding
<internal-xref idref="H43AF055D35724E42AAA155B11404C286" legis-path="460A.(c)">subsection (c)</internal-xref>, the Secretary shall not
distribute Student Aid Reward Payments under the Student Aid Reward Program
that, in the aggregate, exceed the Federal savings resulting from
implementation of the Student Aid Reward Program.</text>
</paragraph><paragraph id="H86C5BD8AAE984688B5D527F5A5F1EAA6"><enum>(2)</enum><header>Federal
savings</header><text display-inline="yes-display-inline">In calculating
Federal savings, as used in
<internal-xref idref="HB1A8243873114567A3339D096F61F82D" legis-path="460A.(d)(1)">paragraph (1)</internal-xref>, the Secretary shall
determine Federal savings on loans made to students at institutions of higher
education that participate the student loan program under this title that is
most cost-effective for taxpayers and that, on the date of enactment of the
Student Aid Reward Program, participated in the student loan program that is
not the most cost-effective for taxpayers, resulting from the difference
of—</text>
<subparagraph id="HC8538B01AC0A4531899DE35B08F24F00"><enum>(A)</enum><text display-inline="yes-display-inline">the Federal cost of loan volume made under
the student loan program under this title that is most cost-effective for
taxpayers; and</text>
</subparagraph><subparagraph id="HD95FFCEF0A5346CA877F592944A8B026"><enum>(B)</enum><text>the Federal cost
of an equivalent type and amount of loan volume made, insured, or guaranteed
under the student loan program under this title that is not the most
cost-effective for taxpayers.</text>
</subparagraph></paragraph><paragraph id="HB4371569B6BA47CAB157AC79D6B02EA"><enum>(3)</enum><header>Distribution
rules</header><text>If the Federal savings determined under
<internal-xref idref="H86C5BD8AAE984688B5D527F5A5F1EAA6" legis-path="460A.(d)(2)">paragraph (2)</internal-xref> is not sufficient to
distribute full Student Aid Reward Payments under the Student Aid Reward
Program, the Secretary shall—</text>
<subparagraph id="HB8EDAB3045EE44A6B86FC1919D4381EC"><enum>(A)</enum><text display-inline="yes-display-inline">first make Student Aid Reward Payments to
those institutions of higher education that participated in the student loan
program under this title that is not the most cost-effective for taxpayers on
the date of enactment of the Student Aid Reward Program; and</text>
</subparagraph><subparagraph id="HF4776E38A9DC43C0985462005C82EB54"><enum>(B)</enum><text>with any remaining
Federal savings after making Payments under
<internal-xref idref="HB8EDAB3045EE44A6B86FC1919D4381EC" legis-path="460A.(d)(3)(A)">subparagraph (A)</internal-xref>, make Student Aid
Reward Payments to the institutions of higher education not described in
<internal-xref idref="HB8EDAB3045EE44A6B86FC1919D4381EC" legis-path="460A.(d)(3)(A)">subparagraph (A)</internal-xref> on a pro-rata
basis.</text>
</subparagraph></paragraph><paragraph id="H61546709FE1E47DEAA4F5266FFAF4350"><enum>(4)</enum><header>Distribution to
students</header><text>Any institution of higher education that receives a
Student Aid Reward Payment under this section—</text>
<subparagraph id="H78461DAF042945198765572F654B3200"><enum>(A)</enum><text>shall distribute,
where appropriate, part or all of such payment among the students of such
institution who are Pell Grant recipients by awarding such students a
supplemental grant; and</text>
</subparagraph><subparagraph id="H7334BE2732C74F2FA540AAE5C6CCCB8F"><enum>(B)</enum><text>may distribute
part of such payment as a supplemental grant to graduate students in financial
need.</text>
</subparagraph></paragraph><paragraph id="HA97890D2FC914FD2A37ECDD5AD13227E"><enum>(5)</enum><header>Estimates,
adjustments, and carry over</header>
<subparagraph id="H2864F23E8CA141CFA0F0F3534C0B138"><enum>(A)</enum><header>Estimates and
adjustments</header><text display-inline="yes-display-inline">The Secretary may
make Student Aid Reward Payments to institutions of higher education on the
basis of estimates, using the best data available at the beginning of an
academic/fiscal year. If the Secretary determines thereafter that loan program
costs for that academic/fiscal year were different than such estimate, the
Secretary shall adjust (reduce or increase) subsequent Student Aid Reward
Payments rewards paid to such institutions of higher education to reflect such
difference.</text>
</subparagraph><subparagraph id="HA8E96940BF404EC5001CC3FACD456CF1"><enum>(B)</enum><header>Carry
over</header><text>Any institution of higher education that receives a reduced
Student Aid Reward Payment under
<internal-xref idref="HF4776E38A9DC43C0985462005C82EB54" legis-path="460A.(d)(3)(B)">paragraph (3)(B)</internal-xref>, shall remain
eligible for the unpaid portion of such institution’s financial reward payment,
as well as any additional financial reward payments for which the institution
is otherwise eligible, in subsequent academic or fiscal years.</text>
</subparagraph></paragraph></subsection><subsection id="H9AEA1F05B738478294FBF6FC03AD4730"><enum>(e)</enum><header>Definition</header><text display-inline="yes-display-inline">For purposes of this section—</text>
<paragraph id="H328157866DBA46DDA9A54D91B85DEBEE"><enum>(1)</enum><text>the student loan
program under this title that is most cost-effective for taxpayers is the loan
program under part B or D of this title that has the lowest overall cost to the
Federal Government (including administrative costs) for the loans authorized by
such parts; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HFB8780E8596749FDA0D54453DCBBBEEA"><enum>(2)</enum><text display-inline="yes-display-inline">the student loan program under this title
that is not most cost-effective for taxpayers is the loan program under part B
or D of this title that does not have the lowest overall cost to the Federal
Government (including administrative costs) for the loans authorized by such
parts.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="id437A66047A5E4FE5A03DA375AEA1A64D"><enum>203.</enum><header>Aviation
security service passenger fees</header><text display-inline="no-display-inline">Section 44940 of title 49, United States
Code, is amended—</text>
<paragraph id="id62D33CE09E2B469BB5CD4E3F6118138F"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)(1), by inserting
<quote>in an amount equal to $5.00 per one-way trip</quote> after
<quote>uniform fee</quote>;</text>
</paragraph><paragraph id="id3F15D4F2CA344E3CBCB209FA71DBD63C"><enum>(2)</enum><text>by striking
subsection (c); and</text>
</paragraph><paragraph id="idD28A0F0A0EFB4609970134133C002D0B"><enum>(3)</enum><text>in subsection
(d)—</text>
<subparagraph id="idB90896267C194A2B9E5962448F9C98F9"><enum>(A)</enum><text>in paragraph (2),
by striking <quote>subsection (d)</quote> each place it appears and inserting
<quote>this subsection</quote>; and</text>
</subparagraph><subparagraph id="id41F5EF19C5A141F4B5D795F05CF7C42C"><enum>(B)</enum><text>in paragraph (3),
by striking <quote>in accordance with paragraph (1)</quote> and inserting
<quote>under subsection (a)(2)</quote>.</text>
</subparagraph></paragraph></section><section id="idB943B019F65647F89F3B70BB52C0B9A4"><enum>204.</enum><header>Extension of
FCC spectrum auction authority</header><text display-inline="no-display-inline">Section 309(j)(11) of the Communications Act
of 1934 (47 U.S.C. 309(j)(11)) is amended by striking <quote>2011</quote> and
inserting <quote>2016</quote>.</text>
</section><section id="id60861A616E064AE68CDF98E78E016516"><enum>205.</enum><header>Extension of
fees for certain customs services</header><text display-inline="no-display-inline">Section 13031(j)(3)(A) and (B) of the
Consolidated Omnibus Budget Reconciliation Act of 1985 (19 U.S.C. 58c(j)(3)(A)
and (B)) is amended by striking <quote>2014</quote> each place it appears and
inserting <quote>2016</quote>.</text>
</section>