1.Short title; table of
contents
(a)This Act may be cited as the Access to Affordable
Health Care Act
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—EXPANSION OF ACCESS TO AFFORDABLE HEALTH CARE FOR SMALL
BUSINESSES
Subtitle A—Small Business Tax Credit
Sec. 101. Credit for employee health insurance
expenses.
Subtitle B—Grants to States for Small Business Purchasing
Groups
Sec. 121. Grants for small employer purchasing
groups.
Sec. 122. Qualified small employer purchasing
groups.
Subtitle C—Health Benefits Information for Small
Employers
Sec. 131. Grant program to facilitate health benefits
information for small employers.
Subtitle D—Grant Program to Encourage State
Innovation
Sec. 141. Grant program to encourage State
innovation.
TITLE II—EXPANSION OF ACCESS TO AFFORDABLE HEALTH CARE FOR
INDIVIDUALS AND FAMILIES
Subtitle A—Internal Revenue Code Provisions
Sec. 201. Refundable health insurance costs credit.
Sec. 202. Advance Payment of credit to issuers of qualified
health insurance.
Subtitle B—Elimination of SCHIP Funding Shortfalls
Sec. 206. Elimination of SCHIP funding shortfalls for fiscal
year 2007.
Subtitle C—FamilyCare
Sec. 211. Renaming of title XXI
program.
Sec. 212. FamilyCare coverage of parents under the medicaid
program and title XXI.
Sec. 213. Optional coverage of children through age 20 under
the medicaid program and title
XXI.
Sec. 214. Sense of the Senate Regarding Authority To Use SCHIP
Funds To Purchase Family Coverage.
Subtitle D—Simplified Enrollment
Sec. 221. Automatic enrollment of children born to title
XXI parents.
Sec. 222. Application of simplified title XXI
procedures under the medicaid program.
Subtitle E—State Option to Extend Medicaid Coverage to Certain
Low-Income Individuals
Sec. 231. State option to extend medicaid coverage to certain
low-income individuals.
Subtitle F—Grants to Promote Innovative Outreach and
Enrollment Under Medicaid and SCHIP
Sec. 251. Grants to promote innovative outreach and enrollment
under medicaid and SCHIP.
Sec. 252. State option to provide for simplified determinations
of a child’s financial eligibility for medical assistance under medicaid or
child health assistance under SCHIP.
Subtitle G—Demonstration Programs to Improve Medicaid and
SCHIP Outreach to Homeless Individuals and Families
Sec. 261. Demonstration programs to improve medicaid and SCHIP
outreach to homeless individuals and families.
TITLE III—STRENGTHENING THE HEALTH CARE SAFETY NET
Sec. 301. Increase in funding for the consolidated health
Centers program.
TITLE IV—EXPANSION OF ACCESS TO HEALTH CARE IN RURAL AND
UNDERSERVED AREAS
Sec. 401. Expansion of funding.
Sec. 402. Loan repayment and scholarship programs.
TITLE V—EXPANDED ACCESS TO AFFORDABLE LONG-TERM CARE
Sec. 501. Treatment of premiums on qualified Long-Term care
insurance contracts.
Sec. 502. Credit for taxpayers with Long-Term care
needs.
Sec. 503. Additional consumer protections for Long-Term care
insurance.
TITLE VI—PROMOTING HEALTHIER LIFESTYLES
Sec. 601. Community partnerships to promote healthy
lifestyles.
Sec. 602. Worksite wellness grant program.
Sec. 603. Comprehensive school health education.
TITLE VII—MEDICARE FAIRNESS
Subtitle A—Medicare Value and Quality
Demonstration
Sec. 701. Findings.
Sec. 702. Demonstration project to encourage the provision of
high-quality, cost-effective inpatient hospital services.
Sec. 703. Demonstration project to encourage the provision of
high-quality, cost-effective physicians’ services.
Subtitle B—Graduate Medical Education
Demonstration
Sec. 711. Clinical rotation demonstration project.
<enum>I</enum><header>EXPANSION OF
ACCESS TO AFFORDABLE HEALTH CARE FOR SMALL BUSINESSES</header>
<subtitle id="ID03EC9EFBDDE14171A44E815D35667366"><enum>A</enum><header>Small Business
Tax Credit</header>
<section id="ID0BC43D7CDCD4464C8C658A2AECA347FC"><enum>101.</enum><header>Credit for
employee health insurance expenses</header>
<subsection id="ID74832A986C6D46EA8BB650318587A2D2"><enum>(a)</enum><header>In
General</header><text>Subpart D of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to business-related credits) is amended
by inserting after section 45M the following:</text>
<quoted-block id="ID93AA0CCA646E41F6B99CD0B7141F7C6C" style="OLC">
<section id="ID4BF5C8475223450194AC29C58D7F1696"><enum>45N.</enum><header>Employee
health insurance expenses</header>
<subsection id="IDB524389579E5491FA807935ECECB81DE"><enum>(a)</enum><header>General
Rule</header><text>For purposes of section 38, in the case of an employer, the
employee health insurance expenses credit determined under this section is an
amount equal to the applicable percentage of the amount paid by the taxpayer
during the taxable year for qualified employee health insurance
expenses.</text>
</subsection><subsection id="ID8FBAD1918E1645FBB227A7836E6DAEAF"><enum>(b)</enum><header>Applicable
Percentage</header><text>For purposes of subsection (a), the applicable
percentage is equal to—</text>
<paragraph id="ID92EC87319E9942F08976C5490A028C48"><enum>(1)</enum><text>50 percent in the
case of an employer with less than 10 employees,</text>
</paragraph><paragraph id="IDCB684E0756254353B23EBAA7727820C5"><enum>(2)</enum><text>30 percent in the
case of an employer with more than 9 but less than 26 employees, and</text>
</paragraph><paragraph id="id43B59D0A1A6B4F8CBA69805EDAC3CB59"><enum>(3)</enum><text>zero percent for
any other employer.</text>
</paragraph></subsection><subsection id="IDCAFD1767B84C4361A53A5E9F3FAF818C"><enum>(c)</enum><header>Per Employee
Dollar Limitation</header><text>The amount of qualified employee health
insurance expenses taken into account under subsection (a) with respect to any
qualified employee for any taxable year shall not exceed—</text>
<paragraph id="ID55D4C05B086041C592F0FA8D45AC7A73"><enum>(1)</enum><text>$2,000 in the
case of self-only coverage, and</text>
</paragraph><paragraph id="IDCBB5725800B84D94BDD69A086B7B8C1D"><enum>(2)</enum><text>$4,000 in the
case of family coverage (as defined in section 223(c)(4)).</text>
</paragraph></subsection><subsection id="ID2A12BA397F514C87A2F33E235628D50C"><enum>(d)</enum><header>Special Rules
and Definitions</header><text>For purposes of this section—</text>
<paragraph id="ID919D57744FF841A0A0AB09460F9A097E"><enum>(1)</enum><header>Eligibility for
credit</header><text>No credit shall be allowed under subsection (a) with
respect to any employer for any period if more than 20 percent of the number of
employees employed by the employer during the period are highly compensated
employees (within the meaning of section 414(q)).</text>
</paragraph><paragraph id="ID1867D777AF3B4EF490BF3310405E725C"><enum>(2)</enum><header>Determination
of employment</header>
<subparagraph id="ID471A2F780E8244E3852ABCD3D1BFB911"><enum>(A)</enum><header>In
general</header><text>An employer shall be considered an employer described in
paragraph (1) or (2) of subsection (b) if such employer employed an average of
the number of employees described in such paragraph on business days during
either of the 2 preceding calendar years. For purposes of the preceding
sentence, a preceding calendar year may be taken into account only if the
employer was in existence throughout such year.</text>
</subparagraph><subparagraph id="ID0DF06AC52C8249D3932C46A8F28C2BA7"><enum>(B)</enum><header>Employers not
in existence in preceding year</header><text>In the case of an employer which
was not in existence throughout the 1st preceding calendar year, the
determination under subparagraph (A) 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.</text>
</subparagraph></paragraph><paragraph id="ID1F154947DD9B463F8EE62ED6856833F4"><enum>(3)</enum><header>Qualified
employee health insurance expenses</header>
<subparagraph id="IDABF9CFEF944841048CB8D5100191A7B8"><enum>(A)</enum><header>In
general</header><text>The term <term>qualified employee health insurance
expenses</term> means any amount paid by an employer for health insurance
coverage to the extent such amount—</text>
<clause id="ID2558BEDDBF7B40B0922E636B7C3899A7"><enum>(i)</enum><text>is attributable
to coverage provided to any employee while such employee is a qualified
employee; and</text>
</clause><clause id="IDA5FD91B1A7E447BDB1CDAEE5C12BEE0B"><enum>(ii)</enum><text>is at least 50
percent of the premium for such coverage.</text>
</clause></subparagraph><subparagraph id="IDE6A725C1D3284CD9A4173F4A7C80CE11"><enum>(B)</enum><header>Exception for
amounts paid under salary reduction arrangements</header><text>No amount paid
or incurred for health insurance coverage pursuant to a salary reduction
arrangement shall be taken into account under subparagraph (A).</text>
</subparagraph><subparagraph id="ID8B6E820F92674201931401DB2C7A6371"><enum>(C)</enum><header>Health
insurance coverage</header><text>The term <term>health insurance
coverage</term> has the meaning given such term by section 9832(b)(1).</text>
</subparagraph></paragraph><paragraph id="IDFD2F430B3CC7457B88D3B5218BF1F3C2"><enum>(4)</enum><header>Qualified
employee</header>
<subparagraph id="IDAFCEE8B840FB408B835DBF33FD2BC79A"><enum>(A)</enum><header>In
general</header><text>The term <term>qualified employee</term> means, with
respect to any period, an employee of an employer if the total amount of wages
paid or incurred by such employer to such employee at an annual rate during the
taxable year is not less than $5,000.</text>
</subparagraph><subparagraph id="ID5B98883B094E46E59E9EC6D51B5AB90B"><enum>(B)</enum><header>Treatment of
certain employees</header><text>For purposes of subparagraph (A), the term
<term>employee</term>—</text>
<clause id="IDABD19787DB9944D5B40860D344761D77"><enum>(i)</enum><text>shall not include
an employee within the meaning of section 401(c)(1), but</text>
</clause><clause id="ID7F128C9D98434093AD6327A5FDE4D010"><enum>(ii)</enum><text>shall include a
leased employee within the meaning of section 414(n).</text>
</clause></subparagraph><subparagraph id="IDE3D088064FA846A09901B09DD439FEFD"><enum>(C)</enum><header>Wages</header><text>The
term <term>wages</term> has the meaning given such term by section 3121(a)
(determined without regard to any dollar limitation contained in such
section).</text>
</subparagraph></paragraph></subsection><subsection id="ID75E75538D9DD412F845E6D57E59822FE"><enum>(e)</enum><header>Certain Rules
Made Applicable</header><text>For purposes of this section, rules similar to
the rules of section 52 shall apply.</text>
</subsection><subsection id="ID1CC17447E12048DC9A29EEA313822ED4"><enum>(f)</enum><header>Denial of
Double Benefit</header><text>No deduction or credit under any other provision
of this chapter shall be allowed with respect to qualified employee health
insurance expenses taken into account under subsection
(a).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDD4584D8CCCAA4F3FB4BF89F2ACBC093E"><enum>(b)</enum><header>Credit To Be
Part of General Business Credit</header><text>Section 38(b) of the Internal
Revenue Code of 1986 (relating to current year business credit) is amended by
striking <quote>plus</quote> at the end of paragraph (29), by striking the
period at the end of paragraph (30) and inserting <quote>, plus</quote>, and by
inserting after paragraph (30) the following:</text>
<quoted-block id="ID7A35FE8FAD2647F7828E09A18A1C16D5" style="OLC">
<paragraph id="IDA7EE8D1132CE45DB840F39F2DC9871EF"><enum>(31)</enum><text>the employee
health insurance expenses credit determined under section
45N.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="ID1072DE0289024783ABAA7A00D5B52DEB"><enum>(c)</enum><header>Clerical
Amendment</header><text>The table of sections for subpart D of part IV of
subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by
adding at the end the following:</text>
<quoted-block id="IDD42FA713E25E4B13B6D634673905B315" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 45N. Employee health insurance
expenses.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDB5CB679301AF4F899288718CA52244AE"><enum>(d)</enum><header>Effective
Date</header><text>The amendments made by this section shall apply to amounts
paid or incurred in taxable years beginning after December 31, 2007.</text>
</subsection></section></subtitle><subtitle id="IDE76C74C8BC654D918FD0FB257680405B"><enum>B</enum><header>Grants to States
for Small Business Purchasing Groups</header>
<section id="IDADFC3375756442688679610F6C1DD547"><enum>121.</enum><header>Grants for
small employer purchasing groups</header>
<subsection id="IDD611BFB346AA42B194523A3343B0777C"><enum>(a)</enum><header>In
General</header><text>The Secretary of Labor (referred to in this section as
the <quote>Secretary</quote>) shall award grants to States to assist such
States in planning, developing, and operating qualified small employer
purchasing groups.</text>
</subsection><subsection id="IDFAD1C516BA5C4EE1840BFE8082224F0D"><enum>(b)</enum><header>Application
Requirements</header><text>To be eligible to receive a grant under this
section, a State shall prepare and submit to the Secretary an application in
such form, at such time, and containing such information, certifications, and
assurances as the Secretary shall reasonably require.</text>
</subsection><subsection id="IDDD70884834544CF0929D5FA32AC2A334"><enum>(c)</enum><header>Use of
Funds</header><text>Amounts awarded under this section may be used to finance
the costs associated with planning, developing, and operating a qualified small
employer purchasing group that meets the requirements of section 122. Such
costs may include the costs associated with—</text>
<paragraph id="ID91329798F92D41E49876DC346E80B9AA"><enum>(1)</enum><text>engaging in
education and outreach efforts to inform small employers, insurers, and the
public about the small employer purchasing group;</text>
</paragraph><paragraph id="IDE7E0033791C54C28BCBAF69A13CE059C"><enum>(2)</enum><text>soliciting bids
and negotiating with insurers to make available group health plans;</text>
</paragraph><paragraph id="IDB9FEB22B80EB4BCB89527C6044B586E5"><enum>(3)</enum><text>preparing the
documentation required to receive certification by the Secretary as a qualified
small employer purchasing group; and</text>
</paragraph><paragraph id="ID71EED528CDBB477C81A48DF0AEF971CE"><enum>(4)</enum><text>such other
activities determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="IDAA92039BEDB34A6FB15BC00792636628"><enum>(d)</enum><header>Authorization
of Appropriations</header><text>There are authorized to be appropriated to
carry out this section, such sums as may be necessary for each of fiscal years
2008 through 2012.</text>
</subsection></section><section id="IDA4489024DE91412693A2A50CC234F690"><enum>122.</enum><header>Qualified
small employer purchasing groups</header>
<subsection id="ID9ABF0145613C4AF29A37F34F7B4219CA"><enum>(a)</enum><header>Qualified Small
Employer Purchasing Groups Described</header>
<paragraph id="ID98B8AA8DDF7540189F7504707B51A034"><enum>(1)</enum><header>In
general</header><text>A qualified small employer purchasing group is an entity
that—</text>
<subparagraph id="ID2729AB9EACB540BCA9B06525166DEB1F"><enum>(A)</enum><text>is a nonprofit
entity certified under State law;</text>
</subparagraph><subparagraph id="IDF5F61531D5CA4829B5B6E7606D1C3035"><enum>(B)</enum><text>has a membership
consisting solely of small employers;</text>
</subparagraph><subparagraph id="ID539F88B6FAD54C158CD49F47F938E440"><enum>(C)</enum><text>is administered
solely under the authority and control of its member employers;</text>
</subparagraph><subparagraph id="ID7C27C3C0857843E49FBDAA4CE7CBDEB6"><enum>(D)</enum><text>with respect to
each State in which its members are located, consists of not fewer than the
number of small employers established by the State as appropriate for such a
group;</text>
</subparagraph><subparagraph id="ID90F4401FE7C940AC90EA7EC1347C9D51"><enum>(E)</enum><text>offers a program
under which group health plans are offered to eligible employees and eligible
individuals (including the dependents of such employees and individuals)
through its member employers; and</text>
</subparagraph><subparagraph id="ID89529B1395AE4D3C93CEDB0DE76C67BE"><enum>(F)</enum><text>an insurer,
agent, broker, or any other individual or entity engaged in the sale of
insurance—</text>
<clause id="ID9451A3B433094D57AFE3FED7A4A49BA5"><enum>(i)</enum><text>does not form or
underwrite; and</text>
</clause><clause id="ID93B386ECC3B74125826B3E58207307DD"><enum>(ii)</enum><text>does not hold or
control any right to vote with respect to.</text>
</clause></subparagraph></paragraph><paragraph id="ID1479D984B4494F13ADDADFA9BEDEF31F"><enum>(2)</enum><header>Special
rule</header><text>Notwithstanding paragraph (1)(B), an employer member of a
small employer purchasing group that has been certified by the State as meeting
the requirements of paragraph (1) may retain its membership in the group if the
number of employees of the employer increases such that the employer is no
longer a small employer.</text>
</paragraph></subsection><subsection id="ID965AB65D338C475795F0AEF525D2F512"><enum>(b)</enum><header>Board of
Directors</header><text>Each qualified small employer purchasing group
established under this section shall be governed by a board of directors or
have active input from an advisory board consisting of individuals and
businesses participating in the group.</text>
</subsection><subsection id="ID9FEEEDCD8BCC478DA8EDA81ECEEE0703"><enum>(c)</enum><header>Membership</header>
<paragraph id="ID53DA5F8240B44C768F75A0DB74928F46"><enum>(1)</enum><header>In
general</header><text>A qualified small employer purchasing group shall accept
all small employers residing within the area served by the group as members if
such employers request such membership.</text>
</paragraph><paragraph id="ID69162DD7F06A43F9ACBB3655BAFAB8A5"><enum>(2)</enum><header>Voting</header><text>Members
of a qualified small employer purchasing group shall have voting rights
consistent with the rules established by the State.</text>
</paragraph></subsection><subsection id="ID6A7D6DA4930F4F79980DCAA8188E5E50"><enum>(d)</enum><header>Duties of
Qualified Small Employer Purchasing Groups</header><text>Each qualified small
employer purchasing group shall—</text>
<paragraph id="ID892A98225ED14E00854DA0F32257A148"><enum>(1)</enum><text>enter into
agreements with insurers offering qualified group health plans;</text>
</paragraph><paragraph id="ID1676D01DA8204A999750EC2D3D45D083"><enum>(2)</enum><text>enter into
agreements with small employers for the purchase of health insurance;</text>
</paragraph><paragraph id="IDEFFAE41D3C8A49FF91008F49A602F936"><enum>(3)</enum><text>enroll only
eligible employees, eligible individuals, and the dependents of such employees
and individuals in group health plans; and</text>
</paragraph><paragraph id="IDDF46D363F7184EA59E559A1CABA20465"><enum>(4)</enum><text>provide enrollee
information to the State.</text>
</paragraph></subsection><subsection id="ID6E1BB7E2B3AC477BBA4E926148B2AB3D"><enum>(e)</enum><header>Limitation on
Activities</header><text>A qualified small employer purchasing group shall
not—</text>
<paragraph id="IDEA2FD7DF9CE94894AE17906218F375E4"><enum>(1)</enum><text>perform any
activity involving approval or enforcement of payment rates for
providers;</text>
</paragraph><paragraph id="ID2636BE4917D746C0AAEDDF0FDA9F3EC2"><enum>(2)</enum><text>assume financial
risk in relation to any such health plan; or</text>
</paragraph><paragraph id="ID0ACFEF6D267D4EA68B40E567D0AC7AFA"><enum>(3)</enum><text>perform other
activities identified by the State as being inconsistent with the performance
of its duties.</text>
</paragraph></subsection><subsection id="ID5C067E28F5A74967B176AE74C8823813"><enum>(f)</enum><header>Rules of
Construction</header>
<paragraph id="IDDFF7E1B9A8C54AC9B2C9A9CD6BF7CC52"><enum>(1)</enum><header>Establishment
not required</header><text>Nothing in this section shall be construed as
requiring that a State organize, operate, or otherwise establish a qualified
small employer purchasing group, or otherwise require the establishment of
purchasing groups.</text>
</paragraph><paragraph id="ID2F90B5800BC54E0CAEF9351A3AA20780"><enum>(2)</enum><header>Voluntary
participation</header><text>Nothing in this section shall be construed as
requiring any individual or small employer to purchase a group health plan
exclusively through a qualified small employer purchasing group.</text>
</paragraph></subsection><subsection id="ID6573DA4D87CA42A19AFC5E71117182E2"><enum>(g)</enum><header>Definition</header><text>In
this subtitle, the term <term>small employer</term> means an employer that
employs at least 1, but not more than 50, employees. Such term shall include
sole proprietorships and self-employed individuals.</text>
</subsection></section></subtitle><subtitle id="IDE2D68440BAC14AFBB5E7D943F990CB0D"><enum>C</enum><header>Health Benefits
Information for Small Employers</header>
<section id="ID9E7279CF0DF84B14B6A7E781C46C4D71"><enum>131.</enum><header>Grant program
to facilitate health benefits information for small employers</header>
<subsection id="IDCAD7009C5A5149D4BE478B0B21458CE6"><enum>(a)</enum><header>In
General</header><text>The Small Business Administration shall award grants to 1
or more States, local governments, and nonprofit organizations for the purposes
of—</text>
<paragraph id="ID27E6F4D92A0E495D9220817E23D37267"><enum>(1)</enum><text>demonstrating new
and effective ways to provide information about the benefits of health
insurance to small employers, including tax benefits, increased productivity of
employees, and decreased turnover of employees;</text>
</paragraph><paragraph id="ID14D4718F62E84FF3BE1CE47B6BF2CFE5"><enum>(2)</enum><text>making small
employers aware of their current rights in the marketplace under Federal and
State health insurance reform laws; and</text>
</paragraph><paragraph id="IDD0AB1912292E4C7BA3D65F2B7A99A83C"><enum>(3)</enum><text>making small
employers aware of the tax treatment of insurance premiums.</text>
</paragraph></subsection><subsection id="ID484941217CD44D52B30EE29C8F08AD87"><enum>(b)</enum><header>Authorization</header><text>There
is authorized to be appropriated to carry out this section, such sums as may be
necessary for each of fiscal years 2008 through 2012.</text>
</subsection></section></subtitle><subtitle id="IDD7CF3F1E26A94BE4BF2AB397333B1B3A"><enum>D</enum><header>Grant Program To
Encourage State Innovation</header>
<section id="ID93CF13E483B84F00BBA79EE425C8636C"><enum>141.</enum><header>Grant program
to encourage State innovation</header>
<subsection id="IDD81D2D25652D47D99393241E5B7AEC12"><enum>(a)</enum><header>In
General</header><text>The Secretary of Health and Human Services (in this
section referred to as the <quote>Secretary</quote>) shall establish a program
(in this section referred to as the <quote>program</quote>) to award
demonstration grants under this section to States to allow States to
demonstrate the effectiveness of innovative ways to increase access to health
insurance through market reforms and other innovative means. Such innovative
means may include any of the following:</text>
<paragraph id="IDF387585DAB1F41419B9590010E6A863E"><enum>(1)</enum><text>Alternative group
purchasing or pooling arrangements, such as purchasing cooperatives for small
businesses, reinsurance pools, or high risk pools.</text>
</paragraph><paragraph id="IDB0B4F29BB5A74583BB8107AFD2079196"><enum>(2)</enum><text>Individual or
small group market reforms.</text>
</paragraph><paragraph id="ID58FFFF83439647029EC25D77F6A07650"><enum>(3)</enum><text>Consumer
education and outreach.</text>
</paragraph><paragraph id="ID134E38C9057B4F7998EBE96FFAF6E807"><enum>(4)</enum><text>Subsidies to
individuals, employers, or both, in obtaining health insurance.</text>
</paragraph></subsection><subsection id="IDCF886C17D023455CBA0A222B4196A93D"><enum>(b)</enum><header>Scope;
Duration</header><text>The program shall be limited to not more than 10 States
and to a total period of 5 years, beginning on the date the first demonstration
grant is made.</text>
</subsection><subsection id="IDB49CEBD4B4FA4BFAAE6E1C932FA080FA"><enum>(c)</enum><header>Conditions for
Demonstration Grants</header>
<paragraph id="IDB1B15A652FD2459BA0C14EC0694DF447"><enum>(1)</enum><header>In
general</header><text>The Secretary may not provide for a demonstration grant
to a State under the program unless the Secretary finds that under the proposed
demonstration grant—</text>
<subparagraph id="ID670241D7F46543A6B48D1376C3B71E31"><enum>(A)</enum><text>the State will
provide for demonstrated increase of access for some portion of the existing
uninsured population through a market innovation (other than merely through a
financial expansion of a program initiated before the date of enactment of this
Act);</text>
</subparagraph><subparagraph id="IDE5D0FA3A087E421DB317557F6FD20850"><enum>(B)</enum><text>the State will
comply with applicable Federal laws;</text>
</subparagraph><subparagraph id="ID1589D2E24CDE45E495C8BB7EF8A65FFB"><enum>(C)</enum><text>the State will
not discriminate among participants on the basis of any health status-related
factor (as defined in section 2791(d)(9) of the <act-name parsable-cite="PHSA">Public Health Service Act </act-name>(42 U.S.C.
300gg–91(d)(9)), except to the extent a State wishes to focus on populations
that otherwise would not obtain health insurance because of such factors;
and</text>
</subparagraph><subparagraph id="ID662E9875ED334EF2B0BB2C93FD4B5C7A"><enum>(D)</enum><text>the State will
provide for such evaluation, in coordination with the evaluation required under
subsection (d), as the Secretary may specify.</text>
</subparagraph></paragraph><paragraph id="ID2C5DC461AE7846E984E255E7920886D9"><enum>(2)</enum><header>Application</header><text>The
Secretary shall not provide a demonstration grant under the program to a State
unless—</text>
<subparagraph id="ID3FB95CF9CE43420D9E40F18875E99D77"><enum>(A)</enum><text>the State submits
to the Secretary such an application, in such a form and manner, as the
Secretary specifies;</text>
</subparagraph><subparagraph id="ID9F6CAD89D6764F989DF187E8BA6CF5DD"><enum>(B)</enum><text>the application
includes information regarding how the demonstration grant will address issues
such as governance, targeted population, expected cost, and the continuation
after the completion of the demonstration grant period; and</text>
</subparagraph><subparagraph id="ID4163E6E8C4D6450A93142769E430F06D"><enum>(C)</enum><text>the Secretary
determines that the demonstration grant will be used consistent with this
section.</text>
</subparagraph></paragraph><paragraph id="IDBD0C599FEACB445A871A726087DF91BE"><enum>(3)</enum><header>Focus</header><text>A
demonstration grant proposal under this section need not cover all uninsured
individuals in a State or all health care benefits with respect to such
individuals.</text>
</paragraph></subsection><subsection id="ID3105FDD76B104FF9B2796F94307D0A19"><enum>(d)</enum><header>Evaluation</header><text>The
Secretary shall enter into a contract with an appropriate entity outside the
Department of Health and Human Services to conduct an overall evaluation of the
program at the end of the program period. Such evaluation shall include an
analysis of improvements in access, costs, quality of care, or choice of
coverage, under different demonstration grants.</text>
</subsection><subsection id="IDEDA6AB2B4CD54A3D9038B1FD1A042914"><enum>(e)</enum><header>Option To
Provide for Initial Planning Grants</header><text>Notwithstanding the previous
provisions of this section, under the program the Secretary may provide for a
portion of the amounts appropriated under subsection (f) (not to exceed
$5,000,000) to be made available to any State for initial planning grants to
permit States to develop demonstration grant proposals under the previous
provisions of this section.</text>
</subsection><subsection id="IDCA2482EE0AE840C59751022976E4BE9A"><enum>(f)</enum><header>Authorization
of Appropriations</header><text>There are authorized to be appropriated such
sums as may be necessary to carry out this section. Amounts appropriated under
this subsection shall remain available until expended.</text>
</subsection><subsection id="ID07C4294C659D4A129C06B60F979C0A02"><enum>(g)</enum><header>State
Defined</header><text>In this section, the term <term>State</term> has the
meaning given such term for purposes of title XIX of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1396 et
seq.).</text>
</subsection></section></subtitle><enum>II</enum><header>EXPANSION OF
ACCESS TO AFFORDABLE HEALTH CARE FOR INDIVIDUALS AND FAMILIES</header>
<subtitle id="ID61F51C3353574D648121887273444461"><enum>A</enum><header>Internal Revenue
Code Provisions</header>
<section id="ID377E2843014947A9A4509A1DBC66FAF5"><enum>201.</enum><header>Refundable
health insurance costs credit</header>
<subsection id="IDBAC02EF00C2547EA8DAB277AFD16DBF2"><enum>(a)</enum><header>Allowance of
Credit</header>
<paragraph id="IDC5863A87BE7B4E32B9CB207AB25769B4"><enum>(1)</enum><header>In
general</header><text>Subpart C of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to refundable personal credits) is
amended by redesignating section 36 as section 37 and inserting after section
35 the following:</text>
<quoted-block id="ID9300184F3C414B70BFEE4357DD90701F" style="OLC">
<section id="ID269ACD7F33B34AA68865D80C9332242A"><enum>36.</enum><header>Health
insurance costs for uninsured eligible individuals</header>
<subsection id="ID7F78AE484CDF444D9D30960E50F279F8"><enum>(a)</enum><header>Allowance of
Credit</header><text>In the case of an uninsured eligible individual, there
shall be allowed as a credit against the tax imposed by this subtitle for the
taxable year an amount equal to the amount paid by the taxpayer during such
taxable year for qualified health insurance for the taxpayer and the taxpayer’s
spouse and dependents.</text>
</subsection><subsection id="ID64B89DC6DB3A4D01B9DBA324BB8FBD08"><enum>(b)</enum><header>Limitations</header>
<paragraph id="ID4410A205FA144A0E9D2B94F301760C07"><enum>(1)</enum><header>In
general</header><text>The amount allowed as a credit under subsection (a) to
the taxpayer for the taxable year shall not exceed the lesser of—</text>
<subparagraph id="ID10C7EE14F41847628386CA52F4920B30"><enum>(A)</enum><text>the sum of the
monthly limitations for coverage months during such taxable year for the
individuals referred to in subsection (a) for whom the taxpayer paid during the
taxable year any amount for coverage under qualified health insurance,
or</text>
</subparagraph><subparagraph id="IDEA9B0F3C84634791AD0597CE3FCEAC3F"><enum>(B)</enum><text>90 percent of the
amount paid by the taxpayer during such taxable year for qualified health
insurance for such individuals.</text>
</subparagraph></paragraph><paragraph id="IDB8DBCF640B124E89BF1DD44764B63DA4"><enum>(2)</enum><header>Monthly
limitation</header>
<subparagraph id="ID4D08FD2BF4BD4F25AC8507D864138CAB"><enum>(A)</enum><header>In
general</header><text>The monthly limitation for an individual for each
coverage month of such individual during the taxable year is the amount equal
to <fraction>1/12</fraction> of—</text>
<clause id="ID6A7DCA51AA1147288143EFB0C939CA1F"><enum>(i)</enum><text>$1,000 if such
individual is the taxpayer,</text>
</clause><clause id="ID0E5E16F52D964C339B9FF6BCF81F561F"><enum>(ii)</enum><text>$1,000
if—</text>
<subclause id="IDCAE4CD5B636A4C25895FF4BABD44B248"><enum>(I)</enum><text>such individual
is the spouse of the taxpayer,</text>
</subclause><subclause id="ID53A8141A42DB4C0D83BD3DFB4C1DC89F"><enum>(II)</enum><text>the taxpayer and
such spouse are married as of the first day of such month, and</text>
</subclause><subclause id="ID1544690F8DE8432DBDD64935047DA53A"><enum>(III)</enum><text>the taxpayer
files a joint return for the taxable year, and</text>
</subclause></clause><clause id="IDF41553AF404444ADA5971287053FC104"><enum>(iii)</enum><text>$500 if such
individual is an individual for whom a deduction under section 151(c) is
allowable to the taxpayer for such taxable year.</text>
</clause></subparagraph><subparagraph id="ID1F15F5D2F39F47BAB17A95E6DE66C595"><enum>(B)</enum><header>Limitation to 2
dependents</header><text>Not more than 2 individuals may be taken into account
by the taxpayer under subparagraph (A)(iii).</text>
</subparagraph><subparagraph id="ID9735D55024C848FCB61F5AB4F9345161"><enum>(C)</enum><header>Special rule
for married individuals</header><text>In the case of an individual—</text>
<clause id="ID7D9C8F554BE049A98273693D37CF4C7A"><enum>(i)</enum><text>who is married
(within the meaning of section 7703) as of the close of the taxable year but
does not file a joint return for such year, and</text>
</clause><clause id="ID6FE6B65801E14476A58CDBCC5BA9BD56"><enum>(ii)</enum><text>who does not
live apart from such individual’s spouse at all times during the taxable
year,</text>
</clause><continuation-text continuation-text-level="subparagraph">the
limitation imposed by subparagraph (B) shall be divided equally between the
individual and the individual’s spouse unless they agree on a different
division.</continuation-text></subparagraph></paragraph><paragraph id="ID52C941B4A9A8450E9C356DA5E184FE08"><enum>(3)</enum><header>Phaseout of
credit</header>
<subparagraph id="ID2682D14E2B6D480897943524CD5DBD8E"><enum>(A)</enum><header>In
general</header><text>The amount which would (but for this paragraph) be taken
into account under subsection (a) shall be reduced (but not below zero) by the
amount determined under subparagraph (B).</text>
</subparagraph><subparagraph id="ID065FB0B9B2FD43E7A3CA0B8AE180925B"><enum>(B)</enum><header>Amount of
reduction</header><text>The amount determined under this subparagraph is the
amount which bears the same ratio to the amount which would be so taken into
account for the taxable year as—</text>
<clause id="ID969459C9CCD444B49DB8AC9E0C0038F8"><enum>(i)</enum><text>the excess
of—</text>
<subclause id="ID37758966860144D59038ABFC703FF176"><enum>(I)</enum><text>the taxpayer’s
modified adjusted gross income for the preceding taxable year, over</text>
</subclause><subclause id="ID33AED4F0F34E4B2BA9206571759EA337"><enum>(II)</enum><text>$15,000 ($25,000
in the case of family coverage), bears to</text>
</subclause></clause><clause id="ID5F09255CC80145E897022D059271A4A3"><enum>(ii)</enum><text>$15,000 ($35,000
in the case of family coverage).</text>
</clause></subparagraph><subparagraph id="ID79D0FFFEA2F24539B0CFDF164AB12EBB"><enum>(C)</enum><header>Modified
adjusted gross income</header><text>The term <term>modified adjusted gross
income</term> means adjusted gross income determined—</text>
<clause id="IDAD65BEC5F4D140F6844B81A9C32A3E7A"><enum>(i)</enum><text>without regard to
this section and sections 911, 931, and 933, and</text>
</clause><clause id="ID4904D9C45C4A49179DC84DEF1FD029CF"><enum>(ii)</enum><text>after
application of sections 86, 135, 137, 219, 221, and 469.</text>
</clause></subparagraph></paragraph><paragraph id="IDD6D5F50A9C7640FC8C877E7BA7EFDA0D"><enum>(4)</enum><header>Coverage
month</header><text>For purposes of this subsection—</text>
<subparagraph id="IDB53D5358D5134E7389F26F4C9E4462C0"><enum>(A)</enum><header>In
general</header><text>The term <term>coverage month</term> means, with respect
to an individual, any month if—</text>
<clause id="IDBA951076FAA14A3CBFDE825EC5303E48"><enum>(i)</enum><text>as of the first
day of such month such individual is covered by qualified health insurance,
and</text>
</clause><clause id="IDEFA075275F634D21B89BE4FC3291E116"><enum>(ii)</enum><text>the premium for
coverage under such insurance for such month is paid by the taxpayer.</text>
</clause></subparagraph><subparagraph id="IDDB767DB4F38546CF82DAB2E246406225"><enum>(B)</enum><header>Employer-subsidized
coverage</header>
<clause id="ID4411DBDDFD7E40F5BE44555DC5B19E58"><enum>(i)</enum><header>In
general</header><text>Such term shall not include any month for which such
individual is eligible to participate in any subsidized health plan (within the
meaning of section 162(l)(2)) maintained by any employer of the taxpayer or of
the spouse of the taxpayer.</text>
</clause><clause id="ID38E7401E285B4B66B3CA9B18BE6490A5"><enum>(ii)</enum><header>Premiums to
nonsubsidized plans</header><text>If an employer of the taxpayer or the spouse
of the taxpayer maintains a health plan which is not a subsidized health plan
(as so defined) and which constitutes qualified health insurance, employee
contributions to the plan shall be treated as amounts paid for qualified health
insurance.</text>
</clause></subparagraph><subparagraph id="ID4744AD7B8A2A4ADCB9EF4DD9CE8BCF34"><enum>(C)</enum><header>Cafeteria plan
and flexible spending account beneficiaries</header><text>Such term shall not
include any month during a taxable year if any amount is not includible in the
gross income of the taxpayer for such year under section 106 with respect
to—</text>
<clause id="IDBF97570F6BB5432DB5320509D6CAA35A"><enum>(i)</enum><text>a
benefit chosen under a cafeteria plan (as defined in section 125(d)), or</text>
</clause><clause id="IDA68CF8A106D84B8580E6912DD393B4CA"><enum>(ii)</enum><text>a benefit
provided under a flexible spending or similar arrangement.</text>
</clause></subparagraph><subparagraph id="ID4A09A48019BB4E1D9198E699F5E3B19E"><enum>(D)</enum><header>Medicare and
medicaid</header><text>Such term shall not include any month with respect to an
individual if, as of the first day of such month, such individual—</text>
<clause id="ID879E29FBDA7640B88461AF51164B4C45"><enum>(i)</enum><text>is entitled to
any benefits under title XVIII of the <act-name parsable-cite="SSA">Social
Security Act</act-name>, or</text>
</clause><clause id="ID1931CB87F6ED45E5B92FD5DCB3E05CBB"><enum>(ii)</enum><text>is a participant
in the program under title XIX or XXI of such Act.</text>
</clause></subparagraph><subparagraph id="IDB8C06C0D37294CB4B53B06D540C3ACD6"><enum>(E)</enum><header>Certain other
coverage</header><text>Such term shall not include any month during a taxable
year with respect to an individual if, at any time during such year, any
benefit is provided to such individual under—</text>
<clause id="ID5B89DB69E3BC48FDB461934BFDC05907"><enum>(i)</enum><text>chapter 89 of
title 5, United States Code,</text>
</clause><clause id="ID4A1D7329B488450ABD8A54F0CD4D0692"><enum>(ii)</enum><text>chapter 55 of
title 10, United States Code,</text>
</clause><clause id="IDDD58A5EB322E4D16858DC6495C21415B"><enum>(iii)</enum><text>chapter 17 of
title 38, United States Code, or</text>
</clause><clause id="ID3836D9E6A93F4CF98D884A1701B954D8"><enum>(iv)</enum><text>any medical care
program under the <act-name parsable-cite="IHCIA">Indian Health Care
Improvement Act</act-name>.</text>
</clause></subparagraph><subparagraph id="IDB7C8948786F442D5A138C93DBB88C7DB"><enum>(F)</enum><header>Prisoners</header><text>Such
term shall not include any month with respect to an individual if, as of the
first day of such month, such individual is imprisoned under Federal, State, or
local authority.</text>
</subparagraph><subparagraph id="ID62CD3E66CE7C4EBEA9F42047F53526F0"><enum>(G)</enum><header>Insufficient
presence in united states</header><text>Such term shall not include any month
during a taxable year with respect to an individual if such individual is
present in the United States on fewer than 183 days during such year
(determined in accordance with section 7701(b)(7)).</text>
</subparagraph></paragraph><paragraph id="IDD05DC5E4B2B74A7E898CE114DF331DC1"><enum>(5)</enum><header>Coordination
with deduction for health insurance costs of self-employed
individuals</header><text>In the case of a taxpayer who is eligible to deduct
any amount under section 162(l) for the taxable year, this section shall apply
only if the taxpayer elects not to claim any amount as a deduction under such
section for such year.</text>
</paragraph></subsection><subsection id="ID2CD76A32654D4B2DA503AA65A51FA5C1"><enum>(c)</enum><header>Qualified
Health Insurance</header><text>For purposes of this section, the term
<term>qualified health insurance</term> means health insurance coverage (as
defined in section 9832(b)(1)), including coverage under a COBRA continuation
provision (as defined in section 9832(d)(1)).</text>
</subsection><subsection id="IDFE4AD2B0CCCE4043BA2D9B8462A5B9BA"><enum>(d)</enum><header>Archer MSA
Contributions</header><text>If a deduction would be allowed under section 220
to the taxpayer for a payment for the taxable year to the Archer MSA of an
individual, subsection (a) shall not apply to the taxpayer for such taxable
year.</text>
</subsection><subsection id="IDB36BE8FB72C3441F96069D9079FEF02D"><enum>(e)</enum><header>Special
Rules</header>
<paragraph id="ID613A894FF86E43ADAABB0A77DEA98F1D"><enum>(1)</enum><header>Coordination
with medical expense deduction</header><text>The amount which would (but for
this paragraph) be taken into account by the taxpayer under section 213 for the
taxable year shall be reduced by the credit (if any) allowed by this section to
the taxpayer for such year.</text>
</paragraph><paragraph id="IDC44678C6604A44BC96786629D33283A8"><enum>(2)</enum><header>Denial of
credit to dependents</header><text>No credit shall be allowed under this
section to any individual with respect to whom a deduction under section 151 is
allowable to another taxpayer for a taxable year beginning in the calendar year
in which such individual’s taxable year begins.</text>
</paragraph><paragraph id="ID3028126C787B45C89F50DF6EC97661E1"><enum>(3)</enum><header>Coordination
with advance payment</header><text>Rules similar to the rules of section 32(g)
shall apply to any credit to which this section applies.</text>
</paragraph></subsection><subsection id="IDDDCA90CB486E487C953B9680FC67271D"><enum>(f)</enum><header>Expenses Must
Be Substantiated</header><text>A payment for insurance to which subsection (a)
applies may be taken into account under this section only if the taxpayer
substantiates such payment in such form as the Secretary may prescribe.</text>
</subsection><subsection id="ID7C2929931C194B6DB0C9CAC8E6669938"><enum>(g)</enum><header>Regulations</header><text>The
Secretary shall prescribe such regulations as may be necessary to carry out the
purposes of this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="IDA28D75DF542D42CF970C5D39582BD76D"><enum>(b)</enum><header>Information
Reporting</header>
<paragraph id="IDE3F98FD60FA54D91A41373ECD8353AB4"><enum>(1)</enum><header>In
general</header><text>Subpart B of part III of subchapter A of chapter 61 of
the Internal Revenue Code of 1986 (relating to information concerning
transactions with other persons) is amended by inserting after section 6050V
the following:</text>
<quoted-block id="ID4A26F341D1FC45D0AE35A799B31AC0C6" style="OLC">
<section id="ID2052380327DB44498F54C917F16B8AB3"><enum>6050W.</enum><header>Returns
relating to payments for qualified health insurance</header>
<subsection id="IDA40116469E43474997B5FA72BE229C61"><enum>(a)</enum><header>In
General</header><text>Any person who, in connection with a trade or business
conducted by such person, receives payments during any calendar year from any
individual for coverage of such individual or any other individual under
creditable health insurance, shall make the return described in subsection (b)
(at such time as the Secretary may by regulations prescribe) with respect to
each individual from whom such payments were received.</text>
</subsection><subsection id="ID6D0E8D228CB047F7831DCB53A03B4654"><enum>(b)</enum><header>Form and Manner
of Returns</header><text>A return is described in this subsection if such
return—</text>
<paragraph id="ID5063274502C440F6BE52B1C7D01C778B"><enum>(1)</enum><text>is in such form
as the Secretary may prescribe, and</text>
</paragraph><paragraph id="IDCAAA25D008E740E5A7C3F35C9E38FC7D"><enum>(2)</enum><text>contains—</text>
<subparagraph id="ID8928DBB33E654B4EB799B40B1F7CC5BB"><enum>(A)</enum><text>the name,
address, and TIN of the individual from whom payments described in subsection
(a) were received,</text>
</subparagraph><subparagraph id="ID7997F648A9CA45DBA82E5C4D9A328E5E"><enum>(B)</enum><text>the name,
address, and TIN of each individual who was provided by such person with
coverage under creditable health insurance by reason of such payments and the
period of such coverage,</text>
</subparagraph><subparagraph id="IDE8C66197F96746E29B2D6741F3B1067B"><enum>(C)</enum><text>the aggregate
amount of payments described in subsection (a),</text>
</subparagraph><subparagraph id="ID07C896E0361540B3AD45DDE941A0C544"><enum>(D)</enum><text>the qualified
health insurance credit advance amount (as defined in section 7527A(e))
received by such person with respect to the individual described in
subparagraph (A), and</text>
</subparagraph><subparagraph id="ID19B04075641E4EE682E913888A891983"><enum>(E)</enum><text>such other
information as the Secretary may reasonably prescribe.</text>
</subparagraph></paragraph></subsection><subsection id="ID53214D95BB6243A5AE8A2FBF2D4FF588"><enum>(c)</enum><header>Creditable
Health Insurance</header><text>For purposes of this section, the term
<term>creditable health insurance</term> means qualified health insurance (as
defined in section 36(c)).</text>
</subsection><subsection id="ID1EA5E0EF8AC341AA93DA38EB9B9019C6"><enum>(d)</enum><header>Statements To
Be Furnished to Individuals With Respect to Whom Information Is
Required</header><text>Every person required to make a return under subsection
(a) shall furnish to each individual whose name is required under subsection
(b)(2)(A) to be set forth in such return a written statement showing—</text>
<paragraph id="ID63D82D7F959D414AB7BCDFAF263E394E"><enum>(1)</enum><text>the name and
address of the person required to make such return and the phone number of the
information contact for such person,</text>
</paragraph><paragraph id="ID891DB224C5564D9EB5B5BDA3AC966026"><enum>(2)</enum><text>the aggregate
amount of payments described in subsection (a) received by the person required
to make such return from the individual to whom the statement is required to be
furnished,</text>
</paragraph><paragraph id="ID19E24DE345754CBB81AEE5D94A836FE2"><enum>(3)</enum><text>the information
required under subsection (b)(2)(B) with respect to such payments, and</text>
</paragraph><paragraph id="ID6CA788B15F0841098F00B02D927B21A4"><enum>(4)</enum><text>the qualified
health insurance credit advance amount (as defined in section 7528(e)) received
by such person with respect to the individual described in paragraph
(2).</text>
</paragraph><continuation-text continuation-text-level="subsection">The
written statement required under the preceding sentence shall be furnished on
or before January 31 of the year following the calendar year for which the
return under subsection (a) is required to be made.</continuation-text></subsection><subsection id="ID9018E7CB792149268B61635D01092B2F"><enum>(e)</enum><header>Returns Which
Would Be Required To Be Made by 2 or More Persons</header><text>Except to the
extent provided in regulations prescribed by the Secretary, in the case of any
amount received by any person on behalf of another person, only the person
first receiving such amount shall be required to make the return under
subsection
(a).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="ID76F03A2E0ADF422287E97C9A919EBED5"><enum>(2)</enum><header>Assessable
penalties</header>
<subparagraph id="IDAF51BA9D870C40C9809C4A305B1948E4"><enum>(A)</enum><text>Subparagraph (B)
of section 6724(d)(1) of such Code (relating to definitions) is amended by
striking <quote>and</quote> at the end of clause (xx) and by inserting after
clause (xx) the following:</text>
<quoted-block id="ID277217D68EC84BBABC175B30BBBBA286" style="OLC">
<clause id="ID60ED92968EBC471EAF22FD88528CA17E"><enum>(xxi)</enum><text>section 6050U
(relating to returns relating to payments for qualified health insurance),
and</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="IDD4CE6BF4585A401BB63D763822DCF157"><enum>(B)</enum><text>Paragraph (2) of
section 6724(d) of such Code is amended by striking <quote>or</quote> at the
end of subparagraph (BB), by striking the period at the end of the subparagraph
(CC) and inserting <quote>, or</quote>, and by adding at the end the
following:</text>
<quoted-block id="ID879B5936BBCD43FF9939D6C80DB60ADF" style="OLC">
<subclause id="ID6EBCB333AF3449A98320EE6199366543" indent="up2"><enum>(DD)</enum><text>section 6050U(d) (relating to
returns relating to payments for qualified health
insurance).</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="IDE2BD1413367F48EBB078B6EF9FA5D1AA"><enum>(3)</enum><header>Clerical
amendment</header><text>The table of sections for subpart B of part III of
subchapter A of chapter 61 of such Code is amended by inserting after the item
relating to section 6050V the following:</text>
<quoted-block id="IDB11C40562D5B4E8098FDE3C17DAE202D" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 6050W. Returns relating to payments
for qualified health
insurance.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="ID5A532A55EC054CA4BD4733155C1B5BC4"><enum>(c)</enum><header>Criminal
Penalty for Fraud</header><text>Subchapter B of chapter 75 of the Internal
Revenue Code of 1986 (relating to other offenses) is amended by adding at the
end the following:</text>
<quoted-block id="IDF0B10D4EDDEA4621817DA5CBAA9D4B0C" style="OLC">
<section id="IDBB2E7639EA1F4D66B85FB6417BCF2889"><enum>7276.</enum><header>Penalties for
offenses relating to health insurance tax credit</header><text display-inline="no-display-inline">Any person who knowingly misuses Department
of the Treasury names, symbols, titles, or initials to convey the false
impression of association with, or approval or endorsement by, the Department
of the Treasury of any insurance products or group health coverage in
connection with the credit for health insurance costs under section 36 shall on
conviction thereof be fined not more than $10,000, or imprisoned not more than
1 year, or
both.</text>
</section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDEF0AA9ACF81D4455BA7563C8FDF2A1E8"><enum>(d)</enum><header>Conforming
Amendments</header>
<paragraph id="ID2AD7C68BEBA7441EB53D8EC061E59C05"><enum>(1)</enum><text>Section 162(l) of
the Internal Revenue Code of 1986 is amended by adding at the end the
following:</text>
<quoted-block id="IDD403402C956E40B08199F087539EF700" style="OLC">
<paragraph id="ID5D3F6A2D907A4ED38444129E1B421B49"><enum>(6)</enum><header>Election to
have subsection apply</header><text>No deduction shall be allowed under
paragraph (1) for a taxable year unless the taxpayer elects to have this
subsection apply for such
year.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="ID298A610F4B0F4D4383AAFD604A756EFE"><enum>(2)</enum><text>Paragraph (2) of
section 1324(b) of title 31, United States Code, is amended by inserting before
the period <quote>, or from section 36 of such Code</quote>.</text>
</paragraph><paragraph id="IDC47B576645A44C4A811A123EFD960E97"><enum>(3)</enum><text>The table of
sections for subpart C of part IV of subchapter A of chapter 1 of the Internal
Revenue Code of 1986 is amended by striking the last item and inserting the
following:</text>
<quoted-block id="ID36A8CF525B1B42B3A9C383773BB62BFB" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 36. Health insurance costs for
uninsured eligible individuals.</toc-entry>
<toc-entry level="section">Sec. 37. Overpayments of
tax.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="IDF2124159A5C64F28B3B6BF2B7A5139F7"><enum>(4)</enum><text>The table of
sections for subchapter B of chapter 75 of such Code is amended by adding at
the end the following:</text>
<quoted-block id="ID9922F5753E8C4F4DA861012DD55F05A2" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 7276. Penalties for offenses relating
to health insurance tax
credit.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="ID39DDC502F3964DA996DB9F5678145D92"><enum>(e)</enum><header>Effective
Dates</header>
<paragraph id="ID061CC175285F4DCAAD1497CCE5EEB8B1"><enum>(1)</enum><header>In
general</header><text>Except as provided in paragraph (2), the amendments made
by this section shall apply to taxable years beginning after December 31, 2006,
without regard to whether final regulations to carry out such amendments have
been promulgated by such date.</text>
</paragraph><paragraph id="ID1973592A90BC48DF982CAA810BE7D30C"><enum>(2)</enum><header>Penalties</header><text>The
amendments made by subsections (c) and (d)(4) shall take effect on the date of
the enactment of this Act.</text>
</paragraph></subsection></section><section id="IDB5850044821D4B16B6F5D32FCBA18BB1"><enum>202.</enum><header>Advance
payment of credit to issuers of qualified health insurance</header>
<subsection id="ID416669A55E074DA49FDDD5D5A4F43ED3"><enum>(a)</enum><header>In
General</header><text>Chapter 77 of the Internal Revenue Code of 1986 (relating
to miscellaneous provisions) is amended by inserting after section 7527 the
following:</text>
<quoted-block id="IDC4A53680B5C543F4802D240D67AD3E22" style="OLC">
<section id="IDA73D868E09CD4E209BE5038F9A2C918D"><enum>7527A.</enum><header>Advance
Payment of health insurance credit for purchasers of qualified health
insurance</header>
<subsection id="ID3EE5D2024B2B45C5B6299025D8373E1E"><enum>(a)</enum><header>General
Rule</header><text>Every plan sponsor of a group health plan providing, or
qualified health insurance issuer of, qualified health insurance to an eligible
individual shall—</text>
<paragraph id="IDB40800B5BF784645910B6683CB028589"><enum>(1)</enum><text>make qualified
premium payments with respect to such individual in an amount equal to the
qualified health insurance credit advance amount, and</text>
</paragraph><paragraph id="IDA42DED8B9C6C4348B371364F99661FC8"><enum>(2)</enum><text>treat such
payments in the manner provided in subsection (g).</text>
</paragraph></subsection><subsection id="IDF8C4F2C4F24446788D69EE5650EDE735"><enum>(b)</enum><header>Eligible
Individual</header><text>For purposes of this section, the term <term>eligible
individual</term> means any individual—</text>
<paragraph id="ID3294B950C47E4E3887C7B215DAFC0EF1"><enum>(1)</enum><text>who purchases
qualified health insurance (as defined in section 36(c)), and</text>
</paragraph><paragraph id="ID138F69A8210F43E2B785A4650AD11C68"><enum>(2)</enum><text>for whom a
qualified health insurance credit eligibility certificate is in effect.</text>
</paragraph></subsection><subsection id="IDC57B05F81CBC4602A17F512A988F7154"><enum>(c)</enum><header>Definitions</header><text>For
purposes of this section—</text>
<paragraph id="IDEFD27083E86F47B191EE3D89C91E1702"><enum>(1)</enum><header>Qualified
health insurance issuer</header><text>The term <term>qualified health insurance
issuer</term> means a health insurance issuer described in section 9832(b)(2)
(determined without regard to the last sentence thereof) offering coverage in
connection with a group health plan.</text>
</paragraph><paragraph id="ID6B53BA4F80014E2E80A2CEF60B6EF1B6"><enum>(2)</enum><header>Group health
plan</header><text>The term <term>group health plan</term> has the meaning
given such term by section 5000(b)(1) (determined without regard to subsection
(d) thereof).</text>
</paragraph><paragraph id="ID5EB0850265A148F3AEBA80E2528517DF"><enum>(3)</enum><header>Qualified
premium payments</header><text>The term <term>qualified premium payments</term>
means any amount paid or incurred, cost incurred, or health coverage value
provided, with respect to qualified health insurance for an eligible individual
and the individual’s spouse and dependents. For purposes of the preceding
sentence, in the case of a group health plan, the health coverage value is
equal to the applicable premium under the plan for the qualified health
insurance coverage provided to an eligible individual and the individual’s
spouse and dependents, as determined under section 4980B.</text>
</paragraph></subsection><subsection id="IDFC751AC16B0D4626A9F2C688FD7C2F39"><enum>(d)</enum><header>Qualified
Health Insurance Credit Eligibility Certificate</header><text>For purposes of
this section, a qualified health insurance credit eligibility certificate is a
statement furnished by an individual to a plan sponsor of a group health plan
or qualified health insurance issuer which—</text>
<paragraph id="IDCA71D8E7B2344FF0BF9DECB05A2E69FE"><enum>(1)</enum><text>certifies that
the individual will be eligible to receive the credit provided by section 36
for the taxable year,</text>
</paragraph><paragraph id="IDEF7DD67762074C518D593F88225FF62B"><enum>(2)</enum><text>estimates the
amount of such credit for such taxable year, and</text>
</paragraph><paragraph id="ID33EF7915759E4952AF403F45C03B8090"><enum>(3)</enum><text>provides such
other information as the Secretary may require for purposes of this
section.</text>
</paragraph></subsection><subsection id="ID528B3127ABDA4A649DA128AF966323C2"><enum>(e)</enum><header>Qualified
Health Insurance Credit Advance Amount</header><text>For purposes of this
section, the term <term>qualified health insurance credit advance amount</term>
means, with respect to any plan sponsor of a group health plan providing, or
qualified health insurance issuer of, qualified health insurance, the amount of
credit allowable under section 36 to the individual for the taxable year which
is attributable to the insurance provided to the individual by such sponsor or
issuer.</text>
</subsection><subsection id="ID0DCB3C70529A4CCBADBFCA5CC75C073F"><enum>(f)</enum><header>Required
Documentation for Receipt of Payments of Advance Amount</header><text>No
payment of a qualified health insurance credit advance amount with respect to
any eligible individual may be made under subsection (a) unless the plan
sponsor of the group health plan or qualified health insurance issuer provides
to the Secretary—</text>
<paragraph id="IDD48C5CADCF60472D9C2149332192C8DD"><enum>(1)</enum><text>the qualified
health insurance credit eligibility certificate of such individual, and</text>
</paragraph><paragraph id="ID7DE25F2B7FEC4B5B8787E9827D0807EE"><enum>(2)</enum><text>the return
relating to such individual under section 6050W.</text>
</paragraph></subsection><subsection id="IDC8490E12766546628195326A4449DC7C"><enum>(g)</enum><header>Qualified
Premium Payments To Be Treated as Payments of Withholding Amounts and Certain
Employer Tax</header>
<paragraph id="IDE5BEE0968BEC45519C0A9956BF070E8D"><enum>(1)</enum><header>In
general</header><text>For purposes of this title, qualified premium payments
made or costs incurred by the sponsor of a group health plan, or any entity
designated by the sponsor to make such payments or incur such costs—</text>
<subparagraph id="ID9F29AA7B51B140AAB08109D4FEA297EE"><enum>(A)</enum><text>shall not be
treated as compensation, and</text>
</subparagraph><subparagraph id="IDE65730A068C34AA9904C73FD4D454FFE"><enum>(B)</enum><text>shall be treated,
in such manner as provided by the Secretary, as made out of—</text>
<clause id="IDAB2A4C1ED7D7493E8471FCB756A33BCD"><enum>(i)</enum><text>amounts required
to be deposited by the taxpayer as estimated income tax under section 6654 or
6655,</text>
</clause><clause id="ID63DF818D4BDF42CAB3F333ADD225D8A1"><enum>(ii)</enum><text>amounts required
to be deducted and withheld under section 3401 (relating to wage
withholding),</text>
</clause><clause id="ID1275978F009B4C0BB3F2324C0294615D"><enum>(iii)</enum><text>amounts of the
taxes imposed under section 3111(a) or 50 percent of taxes imposed under
section 1401(a) (relating to FICA employer taxes), or</text>
</clause><clause id="ID62986077D3C04A9C8E3E79D8C2C0A28E"><enum>(iv)</enum><text>amounts required
to be deducted under section 3102 with respect to taxes imposed under section
3101(a) or 50 percent of taxes imposed under section 1401(a) (relating to FICA
employee taxes),</text>
</clause><continuation-text continuation-text-level="subparagraph">as if
such sponsor, or such designated entity, had paid to the Secretary an amount
equal to such payments.</continuation-text></subparagraph></paragraph><paragraph id="IDF7D0A107ECB844FD8599B3A3AF769771"><enum>(2)</enum><header>Qualified
premium payments exceed taxes due</header><text>In the case of any entity, if
for any time period the aggregate qualified premium payments exceed the amounts
described in paragraph (1)(B), the Secretary shall reduce amounts described in
such paragraph for any succeeding time period as necessary to reflect such
excess.</text>
</paragraph><paragraph id="ID5A201E253B0C4B8E8DF3D95C66B43EAD"><enum>(3)</enum><header>Failure to make
qualified premium payments</header><text>For purposes of this title (including
penalties), failure to make a qualified premium payment with respect to an
eligible individual at the time provided therefor shall be treated as the
failure at such time to deduct and withhold under chapter 24 of such Code in an
amount equal to the amount of such qualified premium payments.</text>
</paragraph></subsection><subsection id="ID5BA0CDC9E7534A699663F30CABB2524A"><enum>(h)</enum><header>Regulations</header><text>The
Secretary shall prescribe such regulations as may be necessary to carry out the
purposes of this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="ID826B378C0F714E268A5F896A95E42839"><enum>(b)</enum><header>Clerical
Amendment</header><text>The table of sections for chapter 77 of the Internal
Revenue Code of 1986 is amended by inserting after the item relating to section
7527 the following:</text>
<quoted-block id="ID37342B2EFE884B799D68F250159049E0" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 7527A. Advance payment of health
insurance credit for purchasers of qualified health
insurance.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDD3EA3735DF7B4F2F91B6A1B2143AF287"><enum>(c)</enum><header>Effective
Date</header><text>The amendments made by this section shall take effect on
January 1, 2008, without regard to whether final regulations to carry out such
amendments have been promulgated by such date.</text>
</subsection></section></subtitle><subtitle id="id6D504A28081B42A3A14504EBEF38FBEF"><enum>B</enum><header>Elimination of
SCHIP Funding Shortfalls</header>
<section id="idFB2E718D41684B82B64E16E7132BA04C"><enum>206.</enum><header>Elimination of
SCHIP funding shortfalls for fiscal year 2007</header>
<subsection id="H48ED54A982E5424CA18D5212B6E93404"><enum>(a)</enum><header>In
general</header><text>Section 2104(h) of the Social Security Act (42 U.S.C.
1397dd(h)), as added by section 201 of the National Institutes of Health Reform
Act of 2006, is amended to read as follows:</text>
<quoted-block id="HDE7C2E2CEE1E40258176F89B10F83B7E">
<subsection id="HBD29442527A7423F8550CDE9BE87400"><enum>(h)</enum><header>Special rule for
redistribution of unspent fiscal year 2004 allotments and additional allotments
To eliminate fiscal year 2007 funding shortfalls</header>
<paragraph id="H0A77F136041F43C397863BA600BF06F0"><enum>(1)</enum><header>Special rule for
redistribution of fiscal year 2004 allotments</header>
<subparagraph id="H8A53CB0F29494E71B455B8E37C8B9B44"><enum>(A)</enum><header>In
general</header><text>In the case of a State that expends all of its allotment
under subsection (b) or (c) of this section for fiscal year 2004 by the end of
fiscal year 2006 and is an initial shortfall State described in subparagraph
(B), the Secretary shall redistribute to the State under subsection (f) of this
section (from the fiscal year 2004 allotments of other States) the following
amount:</text>
<clause id="H36825A0453ED4CCC9DEA1B7CEFCFE151"><enum>(i)</enum><header>State</header><text>In
the case of one of the 50 States or the District of Columbia, the amount
specified in subparagraph (C)(i) (less the total of the amounts under clause
(ii)), multiplied by the ratio of the amount specified in subparagraph (C)(ii)
for the State to the amount specified in subparagraph (C)(iii).</text>
</clause><clause id="H29F9F3F81C21446A8011BC60786F1BCB"><enum>(ii)</enum><header>Territory</header><text>In
the case of a commonwealth or territory described in subsection (c)(3), an
amount that bears the same ratio to 1.05 percent of the amount specified in
subparagraph (C)(i) as the ratio of the commonwealth's or territory's fiscal
year 2004 allotment under subsection (c) bears to the total of all such
allotments for such fiscal year under such subsection.</text>
</clause></subparagraph><subparagraph id="H29B376478A1D4B048C6BFB40F528B34"><enum>(B)</enum><header>Initial shortfall
state described</header><text>For purposes of subparagraph (A), an initial
shortfall State is a State with a State child health plan approved under this
title for which the Secretary estimates, on the basis of the most recent data
available to the Secretary as of the date of the enactment of this subsection,
that the projected Federal expenditures under such plan for such State for
fiscal year 2007 will exceed the sum of—</text>
<clause id="H5CE1572DFD58430B8007E9D6BFC52416"><enum>(i)</enum><text>the amount of the
State's allotments for each of fiscal years 2005 and 2006 that will not be
expended by the end of fiscal year 2006; and</text>
</clause><clause id="H418F09B47D404929826D436D15FBCCD8"><enum>(ii)</enum><text>the amount of the
State's allotment for fiscal year 2007.</text>
</clause></subparagraph><subparagraph id="HE1AF90CA58F3489F9B38F5CEBAC1736E"><enum>(C)</enum><header>Amounts used in
computing redistributions for fiscal year 2004 allotments</header><text>For
purposes of subparagraph (A)(i)—</text>
<clause id="H8BFBAFEBB7E84EC9918603CE72F8D1BA"><enum>(i)</enum><text>the amount
specified in this clause is the total amount of unspent fiscal year 2004
allotments available for redistribution under subsection (f);</text>
</clause><clause id="H8A2E3785CA344A11A5A38CFAE1DDB800"><enum>(ii)</enum><text display-inline="yes-display-inline">the amount specified in this clause for an
initial shortfall State is the amount the Secretary determines will eliminate
the estimated shortfall described in subparagraph (B) for the State; and</text>
</clause><clause id="HCC65A72A672F4068875834684EEA5168"><enum>(iii)</enum><text display-inline="yes-display-inline">the amount specified in this clause is the
total sum of the amounts specified in clause (ii) for all initial shortfall
States.</text>
</clause></subparagraph></paragraph><paragraph id="HA93F0C5E7C03445E8CD9E853B8A817B"><enum>(2)</enum><header>Additional
allotments to eliminate fiscal year 2007 funding shortfalls remaining after
redistribution of unspent fiscal year 2004 allotments</header>
<subparagraph id="HAF1C342E63AF4AA6AE22DC1482113969"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">In addition to the
allotments provided under subsection (b) and (c) for fiscal year 2007, the
Secretary shall allot to each remaining shortfall State described in
subparagraph (B) such amount as the Secretary determines will eliminate the
estimated shortfall described in such subparagraph for the State.</text>
</subparagraph><subparagraph id="HD5EA59860C474FC1B55D46A25E47F127"><enum>(B)</enum><header>Remaining
shortfall state described</header><text>For purposes of subparagraph (A), a
remaining shortfall State is a State (including a commonwealth or territory
described in subsection (c)(3)) with a State child health plan approved under
this title for which the Secretary estimates, on the basis of the most recent
data available to the Secretary as of the date of the enactment of this
subsection, that the projected Federal expenditures under such plan for such
State for fiscal year 2007 will exceed the sum of—</text>
<clause id="H694306889E6340BB8B99BF5F231B6431"><enum>(i)</enum><text>the amount of the
State's allotments for each of fiscal years 2005 and 2006 that will not be
expended by the end of fiscal year 2006;</text>
</clause><clause id="H7020685084F14D4CB00039B64863FD57"><enum>(ii)</enum><text>the amount of the
State's allotment for fiscal year 2007; and</text>
</clause><clause id="HA7DE62D841D3491DA1A0D5D4805202C1"><enum>(iii)</enum><text>the amount, if
any, of unspent allotments for fiscal year 2004 that are to be redistributed to
the State during fiscal year 2007 in accordance with subsection (f) and
paragraph (1).</text>
</clause></subparagraph><subparagraph id="H490D7FD77B344883B7BDAF4E9D28F"><enum>(C)</enum><header>1-year
availability; no redistribution of unexpended additional
allotments</header><text>Notwithstanding subsections (e) and (f), amounts
allotted to a remaining shortfall State pursuant to this paragraph shall only
remain available for expenditure by the State through September 30, 2007. Any
amounts of such allotments that remain unexpended as of such date shall not be
subject to redistribution under subsection (f) and shall revert to the Treasury
on October 1, 2007.</text>
</subparagraph><subparagraph id="HF8B7E981077D4AD3A115C8FDC3EAE900"><enum>(D)</enum><header>Appropriation;
allotment authority</header><text>For the purpose of providing additional
allotments to remaining shortfall States under this paragraph there is
appropriated, out of any funds in the Treasury not otherwise appropriated, such
sums as are necessary for fiscal year
2007.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HB29E8DCC0C8F42B1BF9D42114F51BA90"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by this section apply to items and
services furnished on or after October 1, 2006, without regard to whether or
not regulations implementing such amendments have been issued.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H99601A5E2C2B4627BC4391ADF2A55F98"><enum>(c)</enum><header>Period of
effectiveness</header><text display-inline="yes-display-inline">Section
2104(h)(2) of the Social Security Act (as added by subsection (a)) shall
terminate on September 30, 2007, and shall be considered to have expired
notwithstanding section 257 of the Balanced Budget and Emergency Deficit
Control Act of 1985 (2 U.S.C. 907).</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id60EDFE12DEF74B5E809486B7BFF3743C"><enum>(d)</enum><header>Effect on
provisions added by the National Institutes of Health Reform Act of
2006</header><text>The Social Security Act shall be administered as if section
2104(h) of such Act, as added by section 201(a) of the National Institutes of
Health Reform Act, had not been enacted.</text>
</subsection></section></subtitle><subtitle id="IDEB55C738B8A6461AAB71E6F99B3C4EF6"><enum>C</enum><header>FamilyCare</header>
<section id="ID9BBB9182773540A3B70E03BA36ED736D"><enum>211.</enum><header>Renaming of
title <enum-in-header>XXI </enum-in-header>program</header>
<subsection id="IDDFC80FCE3AB248BB96D869007A8D991F"><enum>(a)</enum><header>In
General</header><text>The heading of title XXI of the
<act-name parsable-cite="SSA">Social Security Act </act-name>(42 U.S.C. 1397aa
et seq.) is amended to read as follows:</text>
<quoted-block act-name="Social Security Act" id="IDD54F2F69AFA1472FB2B6001628974143" style="OLC">
<title id="ID4B39B18FE57F4F768C8D329884A2ADCB"><enum>XXI</enum><header>FAMILYCARE
PROGRAM</header>
.
(b)Any reference in any provision of Federal law or
regulation to SCHIP
or State children’s health insurance
program
under title XXI of the Social
Security Act shall be deemed a reference to the FamilyCare program
under such title.
212.FamilyCare
coverage of parents under the Medicaid program and title
XXI
(a)Incentives To
Implement FamilyCare Coverage
(1)
(A)Establishment
of new optional eligibility categorySection 1902(a)(10)(A)(ii)
of the Social Security Act (42 U.S.C.
1396a(a)(10)(A)(ii)) is amended—
(i)by
striking or
at the end of subclause (XVIII);
(ii)by
adding or
at the end of subclause (XIX); and
(iii)by adding at
the end the following:
(XX)who are
individuals described in subsection (k)(1) (relating to parents of
categorically eligible
children);
.
(B)Section 1902 of the Social Security Act is further amended by
inserting after subsection (j) the following:
(k)(1)(A)Individuals described
in this paragraph are individuals—
(i)who are the parents of an individual
who is under 19 years of age (or such higher age as the State may have elected
under section 1902(l)(1)(D)) and who is eligible for medical assistance under
subsection (a)(10)(A);
(ii)who are not otherwise eligible for
medical assistance under such subsection, under section 1931, or under a waiver
approved under section 1115 or otherwise (except under subsection
(a)(10)(A)(ii)(XX)); and
(iii)whose family income exceeds the
income level applicable under the State plan under part A of title IV as in
effect as of July 16, 1996, but does not exceed the highest income level
applicable to a child in the family under this title.
(B)In establishing an income eligibility
level for individuals described in this paragraph, a State may vary such level
consistent with the various income levels established under subsection (l)(2)
based on the ages of children described in subsection (l)(1) in order to
ensure, to the maximum extent possible, that such individuals shall be enrolled
in the same program as their children.
(C)An individual may not be treated as
being described in this paragraph unless, at the time of the individual’s
enrollment under this title, the child referred to in subparagraph (A)(i) of
the individual is also enrolled under this title.
(D)In this subsection, the term
parent includes an individual treated as a caregiver for purposes
of carrying out section 1931.
(2)In the case of a parent described in
paragraph (1) who is also the parent of a child who is eligible for child
health assistance under title XXI, the State may elect (on a uniform basis) to
cover all such parents under section 2111 or under this
title.
.
(C)Enhanced
matching funds available if certain conditions metSection 1905
of the Social Security Act (42 U.S.C.
1396d) is amended—
(i)in
the fourth sentence of subsection (b), by striking or subsection
(u)(3)
and inserting , (u)(3), or (u)(4)
; and
(ii)in
subsection (u)—
(I)by redesignating
paragraph (4) as paragraph (6), and
(II)by inserting
after paragraph (3) the following:
(4)For purposes of subsection (b) and
section 2105(a)(1)—
(A)The
expenditures described in this subparagraph are the expenditures described in
the following clauses (i) and (ii):
(i)If the
conditions described in clause (iii) are met, expenditures for medical
assistance for parents described in section 1902(k)(1) and for parents who
would be described in such section but for the fact that they are eligible for
medical assistance under section 1931 or under a waiver approved under section
1115.
(ii)Expenditures for medical assistance for pregnant women
under section 1902(l)(1)(A) in a family the income of which exceeds the income
level applicable under section 1902(l)(2)(A) to a family of the size involved
as of January 1, 2007.
(iii)The
conditions described in this clause are the following:
(I)The State has a State child health plan
under title XXI which (whether implemented under such title or under this
title) has an effective income level for children that is at least 200 percent
of the poverty line.
(II)Such State child health plan does not
limit the acceptance of applications, does not use a waiting list for children
who meet eligibility standards to qualify for assistance, and provides benefits
to all children in the State who apply for and meet eligibility
standards.
(III)The State plans under this title and
title XXI do not provide coverage for parents with higher family income without
covering parents with a lower family income.
(IV)The State does not apply an income level
for parents that is lower than the effective income level (expressed as a
percent of the poverty line) that has been specified under the State plan under
title XIX (including under a waiver authorized by the Secretary or under
section 1902(r)(2)), as of January 1, 2007, to be eligible for medical
assistance as a parent under this title.
(iv)For
purposes of this subsection:
(I)The term parent has the
meaning given such term for purposes of section 1902(k)(1).
(II)The term poverty line has
the meaning given such term in section
2110(c)(5).
.
(D)Appropriation
from title xxi allotment for certain medicaid expansion
costsSection 2105(a)(1) of the Social Security Act is amended by striking
and
at the end of subparagraph (C), by striking the period at
the end of subparagraph (D) and inserting ; and
, and by adding
at the end the following:
(E)for making
expenditures for medical assistance that is attributable to expenditures
described in section
1905(u)(4)(A).
.
(E)Only counting
enhanced portion for coverage of additional pregnant
womenSection 1905 of the Social
Security Act (42 U.S.C. 1396d) is amended—
(i)in
the fourth sentence of subsection (b), by inserting (except in the case
of expenditures described in subsection (u)(5))
after do not
exceed
; and
(ii)in
subsection (u), by inserting after paragraph (4) (as inserted by subparagraph
(C)), the following:
(5)For purposes of the fourth sentence
of subsection (b) and section 2105(a), the following payments under this title
do not count against a State’s allotment under section 2104:
(A)Regular fmap for expenditures for
pregnant women with income above january 1, 2007 income level and below 185
percent of povertyThe portion of the payments made for
expenditures described in paragraph (4)(A)(ii) that represents the amount that
would have been paid if the enhanced FMAP had not been substituted for the
Federal medical assistance
percentage.
.
(2)
(A)Title XXI of the Social
Security Act (42 U.S.C. 1397aa et seq.) is amended by adding at the
end the following:
2111.Optional
FamilyCare coverage of parents of targeted low-income children
(a)Notwithstanding any other provision of this title, a
State child health plan may provide for coverage, through an amendment to its
State child health plan under section 2102, of FamilyCare assistance for
individuals who are targeted low-income parents in accordance with this
section, but only if—
(1)the State meets
the conditions described in section 1905(u)(4)(A)(iii); and
(2)the State elects
to provide medical assistance under section 1902(a)(10)(A)(ii)(XX), under
section 1931, or under a waiver under section 1115 to individuals described in
section 1902(k)(1)(A)(i) and elects an applicable income level for such
individuals that consistent with paragraphs (1)(B) and (2) of section 1902(k),
ensures to the maximum extent possible, that those individuals shall be
enrolled in the same program as their children if their children are eligible
for coverage under title XIX (including under a waiver authorized by the
Secretary or under section
1902(r)(2)).
.
(b)For
purposes of this title:
(1)The term FamilyCare assistance has the
meaning given the term child health assistance in section 2110(a) as if any
reference to targeted low-income children were a reference to targeted
low-income parents.
(2)Targeted
low-income parentThe term targeted low-income
parent has the meaning given the term targeted low-income child in
section 2110(b) as if the reference to a child were deemed a reference to a
parent (as defined in paragraph (3)) of the child; except that in applying such
section—
(A)there shall be
substituted for the income level described in paragraph (1)(B)(ii)(I) the
applicable income level in effect for a targeted low-income child;
(B)in paragraph (3),
January 1, 2007, shall be substituted for July 1, 1997; and
(C)in paragraph (4),
January 1, 2007, shall be substituted for March 31, 1997.
(3)The
term parent includes an individual treated as a caregiver for
purposes of carrying out section 1931.
(4)Optional
treatment of pregnant women as parentsA State child health plan
may treat a pregnant woman who is not otherwise a parent as a targeted
low-income parent for purposes of this section but only if the State has
established an income level under section 1902(l)(2)(A)(i) for pregnant women
that is at least 185 percent of the income official poverty line described in
such section.
(c)References to
Terms and Special RulesIn the case of, and with respect to, a
State providing for coverage of FamilyCare assistance to targeted low-income
parents under subsection (a), the following special rules apply:
(1)Any reference in
this title (other than subsection (b)) to a targeted low-income child is deemed
to include a reference to a targeted low-income parent.
(2)Any such
reference to child health assistance with respect to such parents is deemed a
reference to FamilyCare assistance.
(3)In applying
section 2103(e)(3)(B) in the case of a family provided coverage under this
section, the limitation on total annual aggregate cost-sharing shall be applied
to the entire family.
(4)In applying
section 2110(b)(4), any reference to section 1902(l)(2) or 1905(n)(2)
(as selected by a State)
is deemed a reference to the income level
applicable to parents under section 1931 or under a waiver approved under
section 1115, or, in the case of a pregnant woman described in subsection
(b)(4), the income level established under section 1902(l)(2)(A).
(5)In applying
section 2102(b)(3)(B), any reference to children is deemed a reference to
parents.
.
(B)Additional
allotment for states providing familycare
(i)Section 2104 of the Social
Security Act (42 U.S.C. 1397dd), as amended by this Act, is amended
by inserting after subsection (h) the following:
(i)Additional
Allotments for State Providing FamilyCare
(1)Appropriation;
total allotmentFor the purpose of providing additional
allotments to States to provide FamilyCare coverage under section 2111, there
is appropriated, out of any money in the Treasury not otherwise
appropriated—
(A)such sums as may
be necessary to provide such coverage for fiscal year 2008, and
(B)for fiscal year
2008 and each fiscal year thereafter, the amount of the allotment provided
under this paragraph for the preceding fiscal year increased by the percentage
increase (if any) in the medical care expenditure category of the Consumer
Price Index for All Urban Consumers (United States city average).
(2)State and
territorial allotments
(A)In addition to the allotments provided under subsections
(b), (c), (d), and (h), subject to paragraphs (3) and (4), of the amount
available for the additional allotments under paragraph (1) for a fiscal year,
the Secretary shall allot to each State with a State child health plan approved
under this title—
(i)in the case of
such a State other than a commonwealth or territory described in clause (ii),
the same proportion as the proportion of the State’s allotment under subsection
(b) (determined without regard to subsection (f)) to 98.95 percent of the total
amount of the allotments under such section for such States eligible for an
allotment under this subparagraph for such fiscal year; and
(ii)in the case of a
commonwealth or territory described in subsection (c)(3), the same proportion
as the proportion of the commonwealth’s or territory’s allotment under
subsection (c) (determined without regard to subsection (f)) to 1.05 percent of
the total amount of the allotments under such section for commonwealths and
territories eligible for an allotment under this subparagraph for such fiscal
year.
(B)Availability
and redistribution of unused allotmentsIn applying subsections
(e) and (f) with respect to additional allotments made available under this
subsection, the procedures established under such subsections shall ensure such
additional allotments are only made available to States which have elected to
provide coverage under section 2111.
(3)Use of
additional allotmentAdditional allotments provided under this
subsection are not available for amounts expended before October 1, 2007. Such
amounts are available for amounts expended on or after such date for child
health assistance for targeted low-income children, as well as for FamilyCare
assistance.
(4)Requiring
election to provide familycare coverageNo payments may be made
to a State under this title from an allotment provided under this subsection
unless the State has made an election to provide FamilyCare
assistance.
.
(ii)Section 2104 of the Social Security Act (42 U.S.C. 1397dd) is
amended—
(I)in subsection
(a), by inserting or subsection (i),
after subsection
(d),
;
(II)in subsection
(b)(1), by striking subsection (d)
and inserting
subsections (d) and (i)
; and
(III)in subsection
(c)(1), by inserting or subsection (i),
after subsection
(d)
.
(C)No cost-sharing
for pregnancy-related benefitsSection 2103(e)(2) of the
Social Security Act (42 U.S.C.
1397cc(e)(2)) is amended—
(i)in
the heading, by inserting and pregnancy-related
services
after preventive
services
; and
(ii)by
inserting before the period at the end the following: and for
pregnancy-related services
.
(3)The amendments made by this subsection apply to items and
services furnished on or after October 1, 2007, whether or not regulations
implementing such amendments have been issued.
(b)Optional
Application of Presumptive Eligibility Provisions to
ParentsSection 1920A of the Social
Security Act (42 U.S.C. 1396r–1a) is amended by adding at the end
the following:
(e)A State may elect
to apply the previous provisions of this section to provide for a period of
presumptive eligibility for medical assistance for a parent (as defined for
purposes of section 1902(k)(1)) of a child with respect to whom such a period
is provided under this
section.
.
(c)
(1)Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is
amended, in the matter before paragraph (1)—
(A)by striking
or
at the end of clause (xii);
(B)by inserting
or
at the end of clause (xiii); and
(C)by inserting
after clause (xiii) the following:
(xiv)who are parents described (or
treated as if described) in section
1902(k)(1),
.
(2)Section 1903(f)(4) of the
Social Security Act (42 U.S.C.
1396b(f)(4)) is amended by inserting 1902(a)(10)(A)(ii)(XX),
after 1902(a)(10)(A)(ii)(XVIII),
.
(3)Conforming
amendment relating to no waiting period for pregnant
womenSection 2102(b)(1)(B) of the Social Security Act (42 U.S.C. 1397bb(b)(1)(B))
is amended—
(A)by striking
, and
at the end of clause (i) and inserting a semicolon;
(B)by striking the
period at the end of clause (ii) and inserting ; and
; and
(C)by adding at the
end the following:
(iii)may not apply a
waiting period (including a waiting period to carry out paragraph (3)(C)) in
the case of a targeted low-income parent who is
pregnant.
.
213.Optional
coverage of children through age 20 under the Medicaid program and title
XXI
(a)
(1)Section 1902(l)(1)(D) of the
Social Security Act (42 U.S.C.
1396a(l)(1)(D)) is amended by inserting (or, at the election of a State,
20 or 21 years of age)
after 19 years of age
.
(2)
(A)Section
1902(e)(3)(A) of the Social Security Act
(42 U.S.C. 1396a(e)(3)(A)) is amended by inserting (or 1 year
less than the age the State has elected under subsection (l)(1)(D))
after 18 years of age
.
(B)Section
1902(e)(12) of the Social Security Act
(42 U.S.C. 1396a(e)(12)) is amended by inserting or such
higher age as the State has elected under subsection (l)(1)(D)
after
19 years of age
.
(C)Section
1920A(b)(1) of the Social Security Act
(42 U.S.C. 1396r–1a(b)(1)) is amended by inserting or such
higher age as the State has elected under section 1902(l)(1)(D)
after
19 years of age
.
(D)Section
1928(h)(1) of the Social Security Act
(42 U.S.C. 1396s(h)(1)) is amended by inserting or 1 year
less than the age the State has elected under section 1902(l)(1)(D)
before the period at the end.
(E)Section
1932(a)(2)(A) of the Social Security Act
(42 U.S.C. 1396u–2(a)(2)(A)) is amended by inserting (or such
higher age as the State has elected under section 1902(l)(1)(D))
after
19 years of age
.
(b)Section 2110(c)(1) of the
Social Security Act (42 U.S.C.
1397jj(c)(1)) is amended by inserting (or such higher age as the State
has elected under section 1902(l)(1)(D))
.
(c)The amendments made by this section take effect on October
1, 2007, and apply to medical assistance and child health assistance provided
on or after such date, whether or not regulations implementing such amendments
have been issued.
214.Sense of the
Senate Regarding Authority To Use SCHIP Funds To Purchase Family
CoverageIt is the sense of
the Senate that section 2105(c)(3) of the Social
Security Act (42 U.S.C. 1397ee(c)(3)) permits States to use funds
provided under the State children’s health insurance program established under
title XXI of that Act (42 U.S.C. 1397aa et seq.) to help low-income working
families and pregnant women eligible for assistance under that program pay
their share of employer-sponsored health insurance coverage.
D
221.Automatic
enrollment of children born to title XXI
parentsSection 2102(b)(1) of the
Social Security Act (42 U.S.C.
1397bb(b)(1)) is amended by adding at the end the following:
(C)Automatic
eligibility of children born to a parent being provided
familycareSuch eligibility standards shall provide for automatic
coverage of a child born to an individual who is provided assistance under this
title in the same manner as medical assistance would be provided under section
1902(e)(4) to a child described in such
section.
.
222.Application of
simplified title XXI procedures under the
Medicaid program
(a)Application
Under Medicaid
(1)Section 1902(l) of the Social Security Act (42 U.S.C. 1396a(l)) is
amended—
(A)in paragraph (3),
by inserting subject to paragraph (5),
, after
Notwithstanding subsection (a)(17),
; and
(B)by adding at the
end the following:
(5)With respect to determining the
eligibility of individuals under 19 years of age (or such higher age as the
State has elected under paragraph (1)(D)) for medical assistance under
subsection (a)(10)(A) and, separately, with respect to determining the
eligibility of individuals for medical assistance under subsection
(a)(10)(A)(ii)(XX), notwithstanding any other provision of this title, if the
State has established a State child health plan under title XXI—
(A)the State may not apply a resource
standard;
(B)the State shall use the same
simplified eligibility form (including, if applicable, permitting application
other than in person) as the State uses under such State child health plan with
respect to such individuals;
(C)the State shall provide for initial
eligibility determinations and redeterminations of eligibility using
verification policies, forms, and frequency that are no less restrictive than
the policies, forms, and frequency the State uses for such purposes under such
State child health plan with respect to such individuals; and
(D)the State shall not require a
face-to-face interview for purposes of initial eligibility determinations and
redeterminations unless the State requires such an interview for such purposes
under such child health plan with respect to such
individuals.
.
(2)The amendments made by paragraph (1) apply to determinations
of eligibility made on or after the date that is 1 year after the date of
enactment of this Act, whether or not regulations implementing such amendments
have been issued.
(b)
(1)Section 1920A(b)(3)(A)(i) of the
Social Security Act (42 U.S.C.
1396r–1a(b)(3)(A)(i)) is amended by inserting a child care resource and
referral agency,
after a State or tribal child support
enforcement agency,
.
(2)Application to
presumptive eligibility for pregnant women under medicaidSection
1920(b) of the Social Security Act (42
U.S.C. 1396r–1(b)) is amended by adding at the end after and below paragraph
(2) the following flush sentence:
The term
qualified provider includes a qualified entity as defined in
section
1920A(b)(3)..
(3)Application
under title xxi
(A)Section 2107(e)(1)(D) of the
Social Security Act (42 U.S.C.
1397gg(e)(1)) is amended to read as follows:
(D)Sections 1920 and
1920A (relating to presumptive
eligibility).
.
(B)Conforming
elimination of resource testSection 2102(b)(1)(A) of such Act
(42 U.S.C. 1397bb(b)(1)(A)) is amended—
(i)by
striking and resources (including any standards relating to spenddowns
and disposition of resources)
; and
(ii)by
adding at the end the following: Effective 1 year after the date of
enactment of the Access to Affordable Health Care Act, such standards may not
include the application of a resource standard or test.
.
(c)Automatic
Reassessment of Eligibility for Title XXI and
Medicaid Benefits for Children Losing Medicaid or Title
XXI Eligibility
(1)Loss of
medicaid eligibilitySection 1902(a) of the
Social Security Act (42 U.S.C.
1396a(a)) is amended—
(A)by striking
and
at the end of paragraph (69),
(B)by striking the
period at the end of paragraph (70) and inserting ; and
,
and
(C)by inserting
after paragraph (70) the following:
(71)provide, in the
case of a State with a State child health plan under title XXI, that before
medical assistance to a child (or a parent of a child) is discontinued under
this title, a determination of whether the child (or parent) is eligible for
benefits under title XXI shall be made and, if determined to be so eligible,
the child (or parent) shall be automatically enrolled in the program under such
title without the need for a new
application.
.
(2)Loss of title
xxi eligibility and coordination with medicaidSection 2102(b)
(42 U.S.C. 1397bb(b)) is amended—
(A)in paragraph (3),
by redesignating subparagraphs (D) and (E) as subparagraphs (E) and (F),
respectively, and by inserting after subparagraph (C) the following:
(D)that before
health assistance to a child (or a parent of a child) is discontinued under
this title, a determination of whether the child (or parent) is eligible for
benefits under title XIX is made and, if determined to be so eligible, the
child (or parent) is automatically enrolled in the program under such title
without the need for a new
application;
;
(B)by redesignating
paragraph (4) as paragraph (5); and
(C)by inserting
after paragraph (3) the following new paragraph:
(4)Coordination
with medicaidThe State shall coordinate the screening and
enrollment of individuals under this title and under title XIX consistent with
the following:
(A)Information that
is collected under this title or under title XIX which is needed to make an
eligibility determination under the other title shall be transmitted to the
appropriate administering entity under such other title in a timely manner so
that coverage is not delayed and families do not have to submit the same
information twice. Families shall be provided the information they need to
complete the application process for coverage under both titles and be given
appropriate notice of any determinations made on their applications for such
coverage.
(B)If a State does
not use a joint application under this title and such title, the State
shall—
(i)promptly inform a
child’s parent or caretaker in writing and, if appropriate, orally, that a
child has been found likely to be eligible under title XIX;
(ii)provide the
family with an application for medical assistance under such title and offer
information about what (if any) further information, documentation, or other
steps are needed to complete such application process;
(iii)offer
assistance in completing such application process; and
(iv)promptly
transmit the separate application under this title or the information obtained
through such application, and all other relevant information and documentation,
including the results of the screening process, to the State agency under title
XIX for a final determination on eligibility under such title.
(C)Applicants are
notified in writing of—
(i)benefits
(including restrictions on cost-sharing) under title XIX; and
(ii)eligibility
rules that prohibit children who have been screened eligible for medical
assistance under such title from being enrolled under this title, other than
provisional temporary enrollment while a final eligibility determination is
being made under such title.
(D)If the agency
administering this title is different from the agency administering a State
plan under title XIX, such agencies shall coordinate the screening and
enrollment of applicants for such coverage under both titles.
(E)The coordination
procedures established between the program under this title and under title XIX
shall apply not only to the initial eligibility determination of a family but
also to any renewals or redeterminations of such
eligibility.
.
(3)The amendments made by paragraphs (1) and (2) apply to
individuals who lose eligibility under the medicaid program under title XIX, or
under a State child health insurance plan under title XXI, respectively, of the
Social Security Act on or after
October 1, 2007 (or, if later, 60 days after the date of enactment of this
Act), whether or not regulations implementing such amendments have been
issued.
(d)Provision of
Medicaid and CHIP Applications and Information Under the School Lunch
ProgramSection 9(b)(2)(B)(iii) of the Richard B. Russell
National School Lunch Act (42 U.S.C.
1758(b)(2)(B)(iii)) is amended by adding at the end the following:
(III)Notice of
availability of health benefits under medicaid and
chipDescriptive material distributed in accordance with clause
(i) shall also contain information (provided on a form separate from the
application form for free and reduced price lunches) on the availability of
medical assistance under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) and of child health and
FamilyCare assistance under title XXI of such Act, including information on how
to obtain an application for assistance under such
programs.
.
(e)12 Months of
Continuous Eligibility
(1)Section
1902(e)(12) of the Social Security Act
(42 U.S.C. 1396a(e)(12)) is amended—
(A)by striking
At the option of the State, the plan may
and inserting
The plan shall
;
(B)by striking
an age specified by the State (not to exceed 19 years of age)
and inserting 19 years of age (or such higher age as the State has
elected under subsection (l)(1)(D)) or, at the option of the State, who is
eligible for medical assistance as the parent of such a child
;
and
(C)in subparagraph
(A), by striking a period (not to exceed 12 months)
and
inserting the 12-month period beginning on the date
.
(2)Section 2102(b)(2) of such Act (42 U.S.C. 1397bb(b)(2)) is
amended by adding at the end the following: Such methods shall provide
12 months of continuous eligibility for children under this title in the same
manner that section 1902(e)(12) provides 12 months of continuous eligibility
for children described in such section under title XIX. If a State has elected
to apply section 1902(e)(12) to parents, such methods may provide 12 months of
continuous eligibility for parents under this title in the same manner that
such section provides 12 months of continuous eligibility for parents described
in such section under title XIX.
.
(3)
(A)The amendments made by this subsection take effect on
October 1, 2007 (or, if later, 60 days after the date of enactment of this
Act), whether or not regulations implementing such amendments have been
issued.
EState Option To
Extend Medicaid Coverage to Certain Low-Income Individuals
231.State option
to extend Medicaid coverage to certain low-income individuals
(a)Section 1902(a)(10)(A)(ii) of the
Social Security Act (42 U.S.C.
1396a(a)(10)(A)(ii)), as amended by section 212(a)(1)(A), is amended—
(1)by striking
or
at the end of subclause (XIX);
(2)by adding
or
at the end of subclause (XX); and
(3)by adding at the
end the following:
(XXI)who are
individuals who are not otherwise eligible for medical assistance under this
subparagraph, or under a waiver approved under section 1115, or otherwise, as
of the date of enactment of this subclause and whose family income does not
exceed 125 percent of the income official poverty line (as defined by the
Office of Management and Budget and revised annually in accordance with section
673(2) of the Omnibus Budget Reconciliation Act of 1981) applicable to a family
of the size
involved;
.
(b)
(1)Medical
assistance eligibility categoriesSection 1905(a) of such Act (42
U.S.C. 1396d(a)), as amended by section 212(e)(1), is amended in the matter
preceding paragraph (1)—
(A)by striking
or
at the end of clause (xiii);
(B)by adding
or
at the end of clause (xiv); and
(C)by inserting
after clause (xiv) the following:
(xv)who are individuals described in
section
1902(a)(10)(A)(ii)(XX),
.
(2)Exemption from
upper income limitationSection 1903(f)(4) of such Act (42 U.S.C.
1396b(f)(4)), as amended by section 212(e)(2)(B), is amended by inserting
1902(a)(10)(A)(ii)(XXI),
after
1902(a)(10)(A)(ii)(XX),
.
(c)The amendments made by this subsection take effect on
October 1, 2007.
FGrants to Promote
Innovative Outreach and Enrollment Under Medicaid and SCHIP
251.Grants to
promote innovative outreach and enrollment under Medicaid and SCHIP
(a)Grants for
Expanded Outreach ActivitiesTitle XXI of the
Social Security Act (42 U.S.C. 1397aa
et seq.), as amended by section 212(a)(2), is amended by adding at the end the
following:
2112.Expanded
outreach activities
(a)The Secretary shall award grants to eligible entities
to—
(1)conduct
innovative outreach and enrollment efforts that are designed to increase the
enrollment and participation of eligible children under this title and title
XIX; and
(2)promote
understanding of the importance of health insurance coverage for prenatal care
and children.
(b)Priority for
Award of GrantsIn making grants under subsection (a), the
Secretary shall give priority to—
(1)eligible entities
that propose to target geographic areas with high rates of—
(A)eligible but
unenrolled children, including such children who reside in rural areas;
or
(B)racial and ethnic
minorities and health disparity populations, including those proposals that
address cultural and linguistic barriers to enrollment; and
(2)eligible entities
that plan to engage in outreach efforts with respect to individuals described
in paragraph (1) and that are—
(A)Federal health
safety net organizations; or
(B)faith-based
organizations or consortia.
(c)An
eligible entity that desires to receive a grant under this section shall submit
an application to the Secretary in such form and manner, and containing such
information, as the Secretary may decide. Such application shall
include—
(1)quality and
outcomes performance measures to evaluate the effectiveness of activities
funded by a grant awarded under this section to ensure that the activities are
meeting their goals; and
(2)an assurance that
the entity shall—
(A)conduct an
assessment of the effectiveness of such activities against such performance
measures; and
(B)collect and
report enrollment data and other information determined as a result of
conducting such assessments to the Secretary, in such form and manner as the
Secretary shall require.
(d)Dissemination
of Enrollment Data and Information Determined from Effectiveness Assessments;
Annual ReportThe Secretary shall—
(1)disseminate to
eligible entities and make publicly available the enrollment data and
information reported in accordance with subsection (c)(2)(B); and
(2)submit an annual
report to Congress on the outreach activities funded by grants awarded under
this section.
(e)In
this section:
(1)The term eligible entity means any of the
following:
(A)A State.
(B)A Federal health
safety net organization.
(C)A national,
local, or community-based public or nonprofit private organization.
(D)A faith-based
organization or consortia, to the extent that a grant awarded to such an entity
is consistent with the requirements of section 1955 of the
Public Health Service Act (42 U.S.C.
300x–65) relating to a grant award to nongovernmental entities.
(E)An elementary or
secondary school.
(2)Federal health
safety net organizationThe term Federal health safety net
organization means—
(A)an Indian tribe,
tribal organization, or an urban Indian organization receiving funds under
title V of the Indian Health Care Improvement
Act (25 U.S.C. 1651 et seq.);
(B)a
federally-qualified health center (as defined in section 1905(l)(2)(B));
(C)a hospital
defined as a disproportionate share hospital for purposes of section
1923;
(D)a covered entity
described in section 340B(a)(4) of the Public
Health Service Act (42 U.S.C. 256b(a)(4)); and
(E)any other entity
or a consortium that serves children under a federally-funded program,
including the special supplemental nutrition program for women, infants, and
children (WIC) established under section 17 of the
Child Nutrition Act of 1966 (42
U.S.C. 1786), the head start and early head start programs under the
Head Start Act (42 U.S.C. 9801 et
seq.), the school lunch program established under the Richard B. Russell
National School Lunch Act, and an
elementary or secondary school.
(3)Indians; indian
tribe; tribal organization; urban indian organization; service
unitThe terms Indian, Indian tribe,
tribal organization, urban Indian organization, and
Service Unit have the meanings given such terms in section 4 of
the Indian Health Care Improvement Act
(25 U.S.C. 1603).
(f)There
is appropriated, out of any money in the Treasury not otherwise appropriated,
$50,000,000 for each of fiscal years 2008 and 2009 for the purpose of awarding
grants under this section. Amounts appropriated and paid under the authority of
this section shall be in addition to amounts appropriated under section 2104
and paid to States in accordance with section
2105.
.
(b)Extending Use
of Outstationed Workers To Accept Title XXI
ApplicationsSection 1902(a)(55) of the
Social Security Act (42 U.S.C.
1396a(a)(55)) is amended by inserting , and applications for child
health assistance under title XXI
after
(a)(10)(A)(ii)(IX)
.
252.State option
to provide for simplified determinations of a child’s financial eligibility for
Medical assistance under medicaid or child health assistance under
SCHIP
(a)Section
1902(e) of the Social Security Act (42
U.S.C. 1396a(e)) is amended by adding at the end the following:
(13)(A)At the option of the
State, the plan may provide that financial eligibility requirements for medical
assistance are met for an individual who is under an age specified by the State
(except as provided in subparagraph (C), not to exceed 21 years of age) by
using a determination made within a reasonable period (as determined by the
State) before its use for this purpose, of the individual’s family or household
income, or if applicable for purposes of determining eligibility under this
title or title XXI, assets or resources, by a Federal or State agency, or a
public or private entity making such determination on behalf of such agency,
specified by the plan, including (but not limited to) an agency administering
the State program funded under part A of title IV, the
Food Stamp Act of 1977, the Richard
B. Russell National School Lunch Act,
or the Child Nutrition Act of 1966,
notwithstanding any differences in budget unit, disregard, deeming, or other
methodology, but only if—
(i)the agency has fiscal liabilities
or responsibilities affected or potentially affected by such determination;
and
(ii)any information furnished by the
agency pursuant to this subparagraph is used solely for purposes of determining
eligibility for medical assistance under this title or for child health
assistance under title XXI.
(B)Nothing in subparagraph (A) shall be
construed—
(i)to authorize the denial of medical
assistance under this title or of child health assistance under title XXI to an
individual who, without the application of this paragraph, would qualify for
such assistance;
(ii)to relieve a State of the
obligation under subsection (a)(8) to furnish medical assistance with
reasonable promptness after the submission of an initial application that is
evaluated or for which evaluation is requested pursuant to this paragraph;
or
(iii)to relieve a State of the
obligation to determine eligibility for medical assistance under this title or
for child health assistance under title XXI on a basis other than family or
household income (or, if applicable, assets or resources) if an individual is
determined ineligible for such assistance on the basis of information furnished
pursuant to this paragraph.
(C)At the option of a State, the
financial eligibility process described in subparagraph (A) may apply to an
individual who is older than age 21 if the individual’s eligibility for medical
assistance under this title is based on pregnancy or if the individual is a
parent, guardian, or other caretaker relative of an individual found eligible
under subparagraph
(A).
.
(b)Section
2107(e)(1) of the Social Security Act
(42 U.S.C. 1397gg(e)(1)) is amended by adding at the end the
following:
(E)Section
1902(e)(13) (relating to the State option to base an individual’s eligibility
for assistance on financial determinations made by a program providing
nutrition or other public assistance (except that the State option under
subparagraph (C) of such section shall apply under this title only if an
individual is
pregnant)).
.
(c)The amendments made by this section take effect on October
1, 2007.
GDemonstration
Programs To Improve Medicaid and SCHIP Outreach to Homeless Individuals and
Families
261.Demonstration
programs to improve Medicaid and SCHIP outreach to homeless individuals and
families
(a)The
Secretary of Health and Human Services may award demonstration grants to not
more than 7 States (or other qualified entities) to conduct innovative programs
that are designed to improve outreach to homeless individuals and families
under the programs described in subsection (b) with respect to enrollment of
such individuals and families under such programs and the provision of services
(and coordinating the provision of such services) under such programs.
(b)Programs for
Homeless DescribedThe programs described in this subsection are
as follows:
(1)The
program under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.).
(2)The
program under title XXI of the Social Security
Act (42 U.S.C. 1397aa et seq.).
(3)The
program under part A of title IV of the Social
Security Act (42 U.S.C. 601 et seq.).
(4)The program of grants under part B of title XIX of the
Public Health Service Act (42 U.S.C.
300x–1 et seq.).
(5)The program under the Food Stamp Act of 1977 (7 U.S.C. 2011 et
seq.).
(6)The program under the Workforce Investment Act of
1999 (29 U.S.C. 2801 et seq.).
(7)The
welfare-to-work program under section 403(a)(5) of the
Social Security Act (42 U.S.C.
603(a)(5)).
(8)Other public and private benefit programs that serve
low-income individuals.
(c)For
the purposes of carrying out this section, there is appropriated for fiscal
year 2008, out of any funds in the Treasury not otherwise appropriated,
$10,000,000, to remain available until expended.
<enum>III</enum><header>STRENGTHENING
THE HEALTH CARE SAFETY NET</header>
<section id="ID0D82734C3D98404DADA706435E2E61EF"><enum>301.</enum><header>Increase in
funding for the consolidated health centers program</header><text display-inline="no-display-inline">It is the sense of the Senate that the
amounts appropriated for consolidated health centers under section 330 of the
<act-name parsable-cite="PHSA">Public Health Service Act </act-name>(42 U.S.C.
254b) should be doubled over the 5-fiscal year period beginning with fiscal
year 2008.</text>
</section><enum>IV</enum><header>EXPANSION OF
ACCESS TO HEALTH CARE IN RURAL AND UNDERSERVED AREAS</header>
<section id="ID537A18BBDEE040858B9BBE3629CE0B9C"><enum>401.</enum><header>Expansion of
funding</header><text display-inline="no-display-inline">It is the sense of the
Senate that the amounts appropriated for National Health Service Corps under
subpart II of part D of title III of the <act-name parsable-cite="PHSA">Public
Health Service Act </act-name>(42 U.S.C. 254d et seq.) should be doubled over
the 5-fiscal year period beginning with fiscal year 2008 to assist in provide
support for physicians, dentists, and other health care clinicians who serve in
rural and inner city areas.</text>
</section><section id="ID9DCAB1116C5246019984C3E94625165E"><enum>402.</enum><header>Loan repayment
and scholarship programs</header><text display-inline="no-display-inline">Section 338C of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
254m) is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="ID18D2862226354F7DB65A9510FA939FFD" style="OLC">
<subsection id="ID05A9DD0985FF4E44BF83C2176E446768"><enum>(e)</enum><text>Notwithstanding
any other provision of this title, periods of obligated service may be served
and fulfilled on a part time basis if—</text>
<paragraph id="IDD5CD3D42DC19468187E54CFE04114871"><enum>(1)</enum><text>such part time
service is agreed to by both the placement site or sites and the recipient of
the scholarship or loan repayment; and</text>
</paragraph><paragraph id="ID2172A2F7C8F3464991C9FCFF4D8F6862"><enum>(2)</enum><text>the recipient’s
total obligation is
fulfilled.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>V</enum><header>EXPANDED ACCESS
TO AFFORDABLE LONG-TERM CARE</header>
<section id="IDCDD4C5957018453093FBEA8EA67BFC84"><enum>501.</enum><header>Treatment of
premiums on qualified long-term care insurance contracts</header>
<subsection id="ID1AC15DBD5670476284ADDFD3ABD1B57A"><enum>(a)</enum><header>In
General</header><text>Part VII of subchapter B of chapter 1 of the Internal
Revenue Code of 1986 (relating to additional itemized deductions) is amended by
redesignating section 224 as section 225 and by inserting after section 223 the
following new section:</text>
<quoted-block id="IDCA38B3FD2A154816951AE0058EA53DAC" style="OLC">
<section id="IDEF327A3BC2164A44977C4A87AC5DD151"><enum>224.</enum><header>Premiums on
qualified Long-Term care insurance contracts</header>
<subsection id="ID687D62D2249341F2A027E66094454CFC"><enum>(a)</enum><header>In
General</header><text>In the case of an individual, there shall be allowed as a
deduction an amount equal to the applicable percentage of the amount of
eligible long-term care premiums (as defined in section 213(d)(10)) paid during
the taxable year for coverage for the taxpayer, his spouse, and dependents
under a qualified long-term care insurance contract (as defined in section
7702B(b)).</text>
</subsection><subsection id="ID8924ECD4E07E4EB7A50DEE3BB529C11B"><enum>(b)</enum><header>Applicable
Percentage</header><text>For purposes of subsection (a)—</text>
<paragraph id="ID3FF42DBCB0964540814AB4E1B45F5A5F"><enum>(1)</enum><header>In
general</header><text>Except as otherwise provided in this subsection, the
applicable percentage shall be determined in accordance with the following
table based on the number of years of continuous coverage (as of the close of
the taxable year) of the individual under any qualified long-term care
insurance contracts (as defined in section 7702B(b)):</text>
<table line-rules="no-gen" table-type="subformat">
<tgroup cols="2">
<thead>
<row><entry colname="I23"><bold>If the number of years
of</bold></entry><entry colname="I07"><bold>The applicable
long-term</bold></entry>
</row>
<row><entry colname="I23"><bold> continuous coverage
is—</bold></entry><entry colname="I07"><bold>care percentage
is— </bold></entry>
</row>
</thead>
<tbody>
<row><entry colname="I26"> Less than 1</entry><entry colname="I07">60 </entry>
</row>
<row><entry colname="I26"> At least 1 but less than
2</entry><entry colname="I07">70 </entry>
</row>
<row><entry colname="I26"> At least 2 but less than
3</entry><entry colname="I07">80 </entry>
</row>
<row><entry colname="I26"> At least 3 but less than
4</entry><entry colname="I07">90 </entry>
</row>
<row><entry colname="I26"> At least 4</entry><entry colname="I07">100. </entry>
</row>
</tbody>
</tgroup>
</table>
</paragraph><paragraph id="IDAE0CC18C706D415A821EBB60604D81A6"><enum>(2)</enum><header>Special rules
for individuals who have attained age 55</header><text>In the case of an
individual who has attained age 55 as of the close of the taxable year, the
following table shall be substituted for the table in paragraph (1).</text>
<table line-rules="no-gen" table-type="subformat">
<tgroup cols="2">
<thead>
<row><entry colname="I23"><bold>If the number of years
of</bold></entry><entry colname="I07"><bold>The applicable
long-term</bold></entry>
</row>
<row><entry colname="I23"><bold> continuous coverage
is—</bold></entry><entry colname="I07"><bold>care percentage
is— </bold></entry>
</row>
</thead>
<tbody>
<row><entry colname="I26"> Less than 1</entry><entry colname="I07">70 </entry>
</row>
<row><entry colname="I26"> At least 1 but less than
2</entry><entry colname="I07">85 </entry>
</row>
<row><entry colname="I26"> At least 2</entry><entry colname="I07">100. </entry>
</row>
</tbody>
</tgroup>
</table>
</paragraph><paragraph id="ID7CC5706F92FC43FBB3D13B60C6255F1F"><enum>(3)</enum><header>Only coverage
after 2006 taken into account</header><text>Only coverage for periods after
December 31, 2006, shall be taken into account under this subsection.</text>
</paragraph><paragraph id="IDE7DEB1140CE0429F8239E40E33B92E62"><enum>(4)</enum><header>Continuous
coverage</header><text>An individual shall not fail to be treated as having
continuous coverage if the aggregate breaks in coverage during any 1-year
period are less than 60 days.</text>
</paragraph></subsection><subsection id="ID89B7F1EFDADD4AC68A74E5081C317CEA"><enum>(c)</enum><header>Coordination
With Other Deductions</header><text>Any amount paid by a taxpayer for any
qualified long-term care insurance contract to which subsection (a) applies
shall not be taken into account in computing the amount allowable to the
taxpayer as a deduction under section 162(l) or
213(a).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="ID1DA379F4474F4CBE9D5170F30D357630"><enum>(b)</enum><header>Long-Term Care
Insurance Permitted To Be Offered Under Cafeteria Plans and Flexible Spending
Arrangements</header>
<paragraph id="ID85D2726DA7D949DDAA13B3C27DE19F64"><enum>(1)</enum><header>Cafeteria
plans</header><text>Section 125(f) of the Internal Revenue Code of 1986
(defining qualified benefits) is amended by inserting before the period at the
end <quote>; except that such term shall include the payment of premiums for
any qualified long-term care insurance contract (as defined in section 7702B)
to the extent the amount of such payment does not exceed the eligible long-term
care premiums (as defined in section 213(d)(10)) for such
contract</quote>.</text>
</paragraph><paragraph id="IDA34C660B4FC04DBAB819CB80B13B7DEF"><enum>(2)</enum><header>Flexible
spending arrangements</header><text>Section 106 of such Code (relating to
contributions by an employer to accident and health plans) is amended by
striking subsection (c).</text>
</paragraph></subsection><subsection id="ID51E0A42C81D94028BA8B81313AFFCAD1"><enum>(c)</enum><header>Conforming
Amendments</header>
<paragraph id="ID27E54B44320B4CA2863E10709E6683E0"><enum>(1)</enum><text>Section 62(a) of
the Internal Revenue Code of 1986 is amended by inserting after paragraph (20)
the following new item:</text>
<quoted-block id="ID6D478F39BDE9403985DD2D216B3B224B" style="OLC">
<paragraph id="ID160B3712B1DF4068BBAE7232F1A80FC6"><enum>(21)</enum><header>Premiums on
qualified long-term care insurance contracts</header><text>The deduction
allowed by section
224.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="ID0119AF90C17F438A999F548464F31FF8"><enum>(2)</enum><text>The table of
sections for part VII of subchapter B of chapter 1 of such Code is amended by
striking the last item and inserting the following new items:</text>
<quoted-block id="ID9BC8CF9423B241148C2888FA6D764CDE" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 224. Premiums on qualified long-term
care insurance contracts.</toc-entry>
<toc-entry level="section">Sec. 225. Cross
reference.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="IDCA41D0F1CB4A43919E9BC82E9E80DEF2"><enum>(d)</enum><header>Effective
Date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2006.</text>
</subsection></section><section id="IDB72021A2733A4E77AF6FEE27F677C988"><enum>502.</enum><header>Credit for
taxpayers with long-term care needs</header>
<subsection id="ID75074063D89B4BF3960F91992E038B5D"><enum>(a)</enum><header>In
General</header><text>Subpart A of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to nonrefundable personal credits) is
amended by inserting after section 25D the following new section:</text>
<quoted-block id="IDBEB9A5486CD64C1F940990F5C6F02C28" style="OLC">
<section id="IDD5F2F29F2DAB4CA7A40F94B9EAE9103D"><enum>25E.</enum><header>Credit for
taxpayers with Long-Term care needs</header>
<subsection id="ID487B89BD6C0C41058A47D290E34C3D11"><enum>(a)</enum><header>Allowance of
Credit</header>
<paragraph id="IDF43BACA0982B4FE59402C3B5FC7F0E61"><enum>(1)</enum><header>In
general</header><text>There shall be allowed as a credit against the tax
imposed by this chapter for the taxable year an amount equal to the applicable
credit amount multiplied by the number of applicable individuals with respect
to whom the taxpayer is an eligible caregiver for the taxable year.</text>
</paragraph><paragraph id="ID92CC31C1278B4575A916B010A8B81B17"><enum>(2)</enum><header>Applicable
credit amount</header><text>For purposes of paragraph (1), the applicable
credit amount shall be determined in accordance with the following
table:</text>
<table line-rules="no-gen" table-type="subformat">
<tgroup cols="2">
<thead>
<row><entry colname="I22"><bold>“For taxable years
beginning</bold></entry><entry colname="I07"><bold>The
applicable</bold></entry>
</row>
<row><entry colname="I22"><bold> in calendar
year—</bold></entry><entry colname="I07"><bold>credit amount is—</bold></entry>
</row>
</thead>
<tbody>
<row><entry colname="I25"> 2005</entry><entry colname="I07">$1,000 </entry>
</row>
<row><entry colname="I25"> 2006</entry><entry colname="I07"> 1,500 </entry>
</row>
<row><entry colname="I25"> 2007</entry><entry colname="I07"> 2,000 </entry>
</row>
<row><entry colname="I25"> 2008</entry><entry colname="I07"> 2,500 </entry>
</row>
<row><entry colname="I25"> 2009 or thereafter</entry><entry colname="I07"> 3,000.</entry>
</row>
</tbody>
</tgroup>
</table>
</paragraph></subsection><subsection id="ID2B2368A3ACEB4D0EADD8232E875BB275"><enum>(b)</enum><header>Limitation
Based on Adjusted Gross Income</header>
<paragraph id="ID71F857BB3B3945E59F7031B2889F3D53"><enum>(1)</enum><header>In
general</header><text>The amount of the credit allowable under subsection (a)
shall be reduced (but not below zero) by $100 for each $1,000 (or fraction
thereof) by which the taxpayer’s modified adjusted gross income exceeds the
threshold amount. For purposes of the preceding sentence, the term
<term>modified adjusted gross income</term> means adjusted gross income
increased by any amount excluded from gross income under section 911, 931, or
933.</text>
</paragraph><paragraph id="ID0B6AEDA6D5AE48C8931A1A71054CA508"><enum>(2)</enum><header>Threshold
amount</header><text>For purposes of paragraph (1), the term <term>threshold
amount</term> means—</text>
<subparagraph id="ID22FBA81A23A64F55A02A57887389E406"><enum>(A)</enum><text>$150,000 in the
case of a joint return, and</text>
</subparagraph><subparagraph id="ID4F1545996FAC4818BDD9703546D95E0F"><enum>(B)</enum><text>$75,000 in any
other case.</text>
</subparagraph></paragraph><paragraph id="IDDB0E7FF170E74BC4A22EE2BEC146D184"><enum>(3)</enum><header>Indexing</header><text>In
the case of any taxable year beginning in a calendar year after 2007, each
dollar amount contained in paragraph (2) shall be increased by an amount equal
to the product of—</text>
<subparagraph id="ID37834E6DE0FF46FE81FB5004A62D17A1"><enum>(A)</enum><text>such dollar
amount, and</text>
</subparagraph><subparagraph id="ID4B4446374B4C4892B608F761A611CEC2"><enum>(B)</enum><text>the medical care
cost adjustment determined under section 213(d)(10)(B)(ii) for the calendar
year in which the taxable year begins, determined by substituting <quote>August
2006</quote> for <quote>August 1996</quote> in subclause (II) thereof.</text>
</subparagraph><continuation-text continuation-text-level="paragraph">If any
increase determined under the preceding sentence is not a multiple of $50, such
increase shall be rounded to the next lowest multiple of $50.</continuation-text></paragraph></subsection><subsection id="ID7567FCA7CBBB4F16B356977A14573888"><enum>(c)</enum><header>Definitions</header><text>For
purposes of this section—</text>
<paragraph id="ID6FA8D5A8BEBD45C3A1267C733E9F3336"><enum>(1)</enum><header>Applicable
individual</header>
<subparagraph id="IDF9B5C8BEC6E8411BA5D019B750A41506"><enum>(A)</enum><header>In
general</header><text>The term <term>applicable individual</term> means, with
respect to any taxable year, any individual who has been certified, before the
due date for filing the return of tax for the taxable year (without
extensions), by a physician (as defined in section 1861(r)(1) of the
<act-name parsable-cite="SSA">Social Security Act</act-name>) as being an
individual with long-term care needs described in subparagraph (B) for a
period—</text>
<clause id="IDC2CD65A3BB964FE2801596333F504AEF"><enum>(i)</enum><text>which is at least
180 consecutive days, and</text>
</clause><clause id="ID99CCC8B8AEAF4E9092C13B5A7369B782"><enum>(ii)</enum><text>a portion of
which occurs within the taxable year.</text>
</clause><continuation-text continuation-text-level="subparagraph">Such
term shall not include any individual otherwise meeting the requirements of the
preceding sentence unless within the 39<fraction>1/2</fraction>-month period
ending on such due date (or such other period as the Secretary prescribes) a
physician (as so defined) has certified that such individual meets such
requirements.</continuation-text></subparagraph><subparagraph id="ID215B3B92988349D2807DCB7FBD045A02"><enum>(B)</enum><header>Individuals
with long-term care needs</header><text>An individual is described in this
subparagraph if the individual meets any of the following requirements:</text>
<clause id="ID25A44FDB6DE24C39AB241266B66C29EC"><enum>(i)</enum><text>The individual is
at least 6 years of age and—</text>
<subclause id="ID6E2BFB9BCC2743A8BD36B6A9A11B993E"><enum>(I)</enum><text>is unable to
perform (without substantial assistance from another individual) at least 3
activities of daily living (as defined in section 7702B(c)(2)(B)) due to a loss
of functional capacity, or</text>
</subclause><subclause id="ID146B3AAC2A88442490AB3DF597C4839B"><enum>(II)</enum><text>requires
substantial supervision to protect such individual from threats to health and
safety due to severe cognitive impairment and is unable to perform, without
reminding or cuing assistance, at least 1 activity of daily living (as so
defined) or to the extent provided in regulations prescribed by the Secretary
(in consultation with the Secretary of Health and Human Services), is unable to
engage in age appropriate activities.</text>
</subclause></clause><clause id="ID7D892B5AF664450C8DC858B7922645F2"><enum>(ii)</enum><text>The individual
is at least 2 but not 6 years of age and is unable due to a loss of functional
capacity to perform (without substantial assistance from another individual) at
least 2 of the following activities: eating, transferring, or mobility.</text>
</clause><clause id="ID5376458C3935483F8B1760C562B352D5"><enum>(iii)</enum><text>The individual
is under 2 years of age and requires specific durable medical equipment by
reason of a severe health condition or requires a skilled practitioner trained
to address the individual’s condition to be available if the individual’s
parents or guardians are absent.</text>
</clause></subparagraph></paragraph><paragraph id="ID3CDCEEF0423345DCBE85CE2AE648D7ED"><enum>(2)</enum><header>Eligible
caregiver</header>
<subparagraph id="IDC29726D40E6A4998A291FFAE4D85A941"><enum>(A)</enum><header>In
general</header><text>A taxpayer shall be treated as an eligible caregiver for
any taxable year with respect to the following individuals:</text>
<clause id="ID00C68D609FFC4C76B45D673DE157A505"><enum>(i)</enum><text>The
taxpayer.</text>
</clause><clause id="ID57027F5BD0CD41C6893C3E46E9C58EB1"><enum>(ii)</enum><text>The taxpayer’s
spouse.</text>
</clause><clause id="IDA18B9ABCEABE408A962FD519BE92D7FD"><enum>(iii)</enum><text>An individual
with respect to whom the taxpayer is allowed a deduction under section 151 for
the taxable year.</text>
</clause><clause id="ID81C174BC80A341988EC5447717FB572C"><enum>(iv)</enum><text>An individual
who would be described in clause (iii) for the taxable year if section
151(c)(1)(A) were applied by substituting for the exemption amount an amount
equal to the sum of the exemption amount, the standard deduction under section
63(c)(2)(C), and any additional standard deduction under section 63(c)(3) which
would be applicable to the individual if clause (iii) applied.</text>
</clause><clause id="IDE6413EC97121408E8D0884AF36ADE7F8"><enum>(v)</enum><text>An individual who
would be described in clause (iii) for the taxable year if—</text>
<subclause id="ID086E4CF003C747F2B639D7195014F5CD"><enum>(I)</enum><text>the requirements
of clause (iv) are met with respect to the individual, and</text>
</subclause><subclause id="ID073B1F211D844EB9A3C09339B2F71527"><enum>(II)</enum><text>the requirements
of subparagraph (B) are met with respect to the individual in lieu of the
support test of section 152(a).</text>
</subclause></clause></subparagraph><subparagraph id="ID9A18C0AE857249E68AA1F379C687EBAE"><enum>(B)</enum><header>Residency
test</header><text>The requirements of this subparagraph are met if an
individual has as his principal place of abode the home of the taxpayer
and—</text>
<clause id="IDDF75AA359F2740B78958CBAD2ACCD181"><enum>(i)</enum><text>in the case of an
individual who is an ancestor or descendant of the taxpayer or the taxpayer’s
spouse, is a member of the taxpayer’s household for over half the taxable year,
or</text>
</clause><clause id="ID78A89D97B48642BC9A526024CB413890"><enum>(ii)</enum><text>in the case of
any other individual, is a member of the taxpayer’s household for the entire
taxable year.</text>
</clause></subparagraph><subparagraph id="ID65D445AFB253432680A5DB484D4910CE"><enum>(C)</enum><header>Special rules
where more than 1 eligible caregiver</header>
<clause id="IDCB39D1C72035468F985CADED4E1D3420"><enum>(i)</enum><header>In
general</header><text>If more than 1 individual is an eligible caregiver with
respect to the same applicable individual for taxable years ending with or
within the same calendar year, a taxpayer shall be treated as the eligible
caregiver if each such individual (other than the taxpayer) files a written
declaration (in such form and manner as the Secretary may prescribe) that such
individual will not claim such applicable individual for the credit under this
section.</text>
</clause><clause id="IDDEDCB371BF644F9F8E407CFC4D69C8F9"><enum>(ii)</enum><header>No
agreement</header><text>If each individual required under clause (i) to file a
written declaration under clause (i) does not do so, the individual with the
highest modified adjusted gross income (as defined in section 32(c)(5)) shall
be treated as the eligible caregiver.</text>
</clause><clause id="ID5F394FDE67224352B7B61E873F388FC0"><enum>(iii)</enum><header>Married
individuals filing separately</header><text>In the case of married individuals
filing separately, the determination under this subparagraph as to whether the
husband or wife is the eligible caregiver shall be made under the rules of
clause (ii) (whether or not one of them has filed a written declaration under
clause (i)).</text>
</clause></subparagraph></paragraph></subsection><subsection id="IDFEFE43CC6ED54514913627BFFE01A689"><enum>(d)</enum><header>Identification
Requirement</header><text>No credit shall be allowed under this section to a
taxpayer with respect to any applicable individual unless the taxpayer includes
the name and taxpayer identification number of such individual, and the
identification number of the physician certifying such individual, on the
return of tax for the taxable year.</text>
</subsection><subsection id="IDA207DBADE83048C68F8814EDC1FEA0D5"><enum>(e)</enum><header>Taxable Year
Must Be Full Taxable Year</header><text>Except in the case of a taxable year
closed by reason of the death of the taxpayer, no credit shall be allowable
under this section in the case of a taxable year covering a period of less than
12
months.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="ID91EBD575833D4AB6A7FEA19294B13D35"><enum>(b)</enum><header>Conforming
Amendments</header>
<paragraph id="ID9596397B828E462ABDBB4243F91DEB9F"><enum>(1)</enum><text>Section
6213(g)(2) of the Internal Revenue Code of 1986 is amended by striking
<quote>and</quote> at the end of subparagraph (L), by striking the period at
the end of subparagraph (M) and inserting <quote>, and</quote>, and by
inserting after subparagraph (M) the following new subparagraph:</text>
<quoted-block id="ID9E86D9CB2D85428FAADE02E9A498236D" style="OLC">
<subparagraph id="IDB04CB4757D474A0D929CEEDA622FE5D0"><enum>(N)</enum><text>an omission of a
correct TIN or physician identification required under section 25E(d) (relating
to credit for taxpayers with long-term care needs) to be included on a
return.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="ID7A9EB6931680495B9A559D0E1AEDF8CD"><enum>(2)</enum><text>The table of
sections for subpart A of part IV of subchapter A of chapter 1 of such Code is
amended by inserting after the item relating to section 25D the following new
item:</text>
<quoted-block id="ID9561E7070DF642DEADDF838AA2557E43" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 25E. Credit for taxpayers with
long-term care
needs.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="ID029DF3588D0C42D6B2E0CE827F8C3839"><enum>(c)</enum><header>Effective
Dates</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2006.</text>
</subsection></section><section id="ID9BD00AC79A50444CAB9F76E8033134C7"><enum>503.</enum><header>Additional
consumer protections for long-term care insurance</header>
<subsection id="ID81A488D0826248F49CF14017F4B7B294"><enum>(a)</enum><header>Additional
Protections Applicable to Long-Term Care Insurance</header><text>Subparagraphs
(A) and (B) of section 7702B(g)(2) of the Internal Revenue Code of 1986
(relating to requirements of model regulation and Act) are amended to read as
follows:</text>
<quoted-block id="IDB074321192D44FFEAEE69DA796BC98E5" style="OLC">
<subparagraph id="ID4E68C74F1450457A94FF00FB925CAD13"><enum>(A)</enum><header>In
general</header><text>The requirements of this paragraph are met with respect
to any contract if such contract meets—</text>
<clause id="IDC267ACF5331F4CC6B31CDA5A1876D25E"><enum>(i)</enum><header>Model
regulation</header><text>The following requirements of the model
regulation:</text>
<subclause id="ID918CF06C625B404E8B8D80F4A391CAC0"><enum>(I)</enum><text>Section 6A
(relating to guaranteed renewal or noncancellability), and the requirements of
section 6B of the model Act relating to such section 6A.</text>
</subclause><subclause id="IDCB50B926B064487A8ECDEAC00F8E06B3"><enum>(II)</enum><text>Section 6B
(relating to prohibitions on limitations and exclusions).</text>
</subclause><subclause id="ID3F2F8D62CBD94614A97CB6920BAAF472"><enum>(III)</enum><text>Section 6C
(relating to extension of benefits).</text>
</subclause><subclause id="ID79C89FB6634B4A72AE5096F2B75CCD47"><enum>(IV)</enum><text>Section 6D
(relating to continuation or conversion of coverage).</text>
</subclause><subclause id="IDC80BA81295DE489DB78920B5ABD7E7E5"><enum>(V)</enum><text>Section 6E
(relating to discontinuance and replacement of policies).</text>
</subclause><subclause id="IDAC698F4642CA417A83F68043FA2D4CEF"><enum>(VI)</enum><text>Section 7
(relating to unintentional lapse).</text>
</subclause><subclause id="ID383FABDEA13D464DAAEBF2984799A2E3"><enum>(VII)</enum><text>Section 8
(relating to disclosure), other than section 8F thereof.</text>
</subclause><subclause id="IDBAE88E5E47AD4BDA956509DB61F8793C"><enum>(VIII)</enum><text>Section 11
(relating to prohibitions against post claims underwriting).</text>
</subclause><subclause id="ID0B8ABE4A6D6B4B6A89FB4AEB09F616D5"><enum>(IX)</enum><text>Section 12
(relating to minimum standards).</text>
</subclause><subclause id="IDBF86EEB6B4E642BDAE93D1548AE86AE3"><enum>(X)</enum><text>Section 13
(relating to requirement to offer inflation protection), except that any
requirement for a signature on a rejection of inflation protection shall permit
the signature to be on an application or on a separate form.</text>
</subclause><subclause id="ID2604B36B09BF448B828C8E57F3E0D6D2"><enum>(XI)</enum><text>Section 25
(relating to prohibition against preexisting conditions and probationary
periods in replacement policies or certificates).</text>
</subclause><subclause id="IDD925145F057343CA9D0ADFF14919A3AF"><enum>(XII)</enum><text>The provisions
of section 26 relating to contingent nonforfeiture benefits, if the
policyholder declines the offer of a nonforfeiture provision described in
paragraph (4).</text>
</subclause></clause><clause id="ID8093F7B666D444C3BCFD7223961F4995"><enum>(ii)</enum><header>Model
act</header><text>The following requirements of the model Act:</text>
<subclause id="IDE007D9FD1EBB4378A68A2C9C47C1DF72"><enum>(I)</enum><text>Section 6C
(relating to preexisting conditions).</text>
</subclause><subclause id="IDC79D7BC3E89A4570BA53ABDECF4EFEE5"><enum>(II)</enum><text>Section 6D
(relating to prior hospitalization).</text>
</subclause><subclause id="IDD902A04114124C4AA77496ED610BE825"><enum>(III)</enum><text>The provisions
of section 8 relating to contingent nonforfeiture benefits, if the policyholder
declines the offer of a nonforfeiture provision described in paragraph
(4).</text>
</subclause></clause></subparagraph><subparagraph id="IDA8134C1483354330B4DCBA7274836D3B"><enum>(B)</enum><header>Definitions</header><text>For
purposes of this paragraph—</text>
<clause id="IDBC68CD443206431EA243C53AAF8F64D7"><enum>(i)</enum><header>Model
provisions</header><text>The terms <term>model regulation</term> and
<term>model Act</term> mean the long-term care insurance model regulation, and
the long-term care insurance model Act, respectively, promulgated by the
National Association of Insurance Commissioners (as adopted as of September
2000).</text>
</clause><clause id="ID97102050AC1E4E239AEC0F968AAF66E6"><enum>(ii)</enum><header>Coordination</header><text>Any
provision of the model regulation or model Act listed under clause (i) or (ii)
of subparagraph (A) shall be treated as including any other provision of such
regulation or Act necessary to implement the provision.</text>
</clause><clause id="IDE2B90469181046EEB9F1B8EC85C73E46"><enum>(iii)</enum><header>Determination</header><text>For
purposes of this section and section 4980C, the determination of whether any
requirement of a model regulation or the model Act has been met shall be made
by the
Secretary.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="ID02A7EAD90E0942F4987EB00721D00D33"><enum>(b)</enum><header>Excise
Tax</header><text>Paragraph (1) of section 4980C(c) of the Internal Revenue
Code of 1986 (relating to requirements of model provisions) is amended to read
as follows:</text>
<quoted-block id="IDE79F56F1A9024FD4B240320AFBAA87D7" style="OLC">
<paragraph id="ID5EC8E363D72141BEBDECFFB632F3E7C2"><enum>(1)</enum><header>Requirements of
model provisions</header>
<subparagraph id="ID117FA65081074903827D72A637A330EB"><enum>(A)</enum><header>Model
regulation</header><text>The following requirements of the model regulation
must be met:</text>
<clause id="ID5CE9663BF5EF4760A7C5F70D0F616B58"><enum>(i)</enum><text>Section 9
(relating to required disclosure of rating practices to consumer).</text>
</clause><clause id="IDC945DAFD7C6C4825BE8A09FF5C8E975D"><enum>(ii)</enum><text>Section 14
(relating to application forms and replacement coverage).</text>
</clause><clause id="IDA5F944C987E94F619E7875EA6206D327"><enum>(iii)</enum><text>Section 15
(relating to reporting requirements), except that the issuer shall also report
at least annually the number of claims denied during the reporting period for
each class of business (expressed as a percentage of claims denied), other than
claims denied for failure to meet the waiting period or because of any
applicable preexisting condition.</text>
</clause><clause id="ID794F2BA8068A4628A1CE846544742921"><enum>(iv)</enum><text>Section 22
(relating to filing requirements for marketing).</text>
</clause><clause id="IDD63BF8AB02BC4105AA39888E2B053286"><enum>(v)</enum><text>Section 23
(relating to standards for marketing), including inaccurate completion of
medical histories, other than paragraphs (1), (6), and (9) of section 23C,
except that—</text>
<subclause id="ID7F6D12F7724D4DB493F54B88F131DA2B"><enum>(I)</enum><text>in addition to
such requirements, no person shall, in selling or offering to sell a qualified
long-term care insurance contract, misrepresent a material fact; and</text>
</subclause><subclause id="ID87F0546D51904CFB9ACAA994B0E0D161"><enum>(II)</enum><text>no such
requirements shall include a requirement to inquire or identify whether a
prospective applicant or enrollee for long-term care insurance has accident and
sickness insurance.</text>
</subclause></clause><clause id="ID8FDF846567034A53B35856802F343A30"><enum>(vi)</enum><text>Section 24
(relating to suitability).</text>
</clause><clause id="ID588C0884B7B44CB0B958FD63ED624F5C"><enum>(vii)</enum><text>Section 29
(relating to standard format outline of coverage).</text>
</clause><clause id="ID936648409DE24032B592672382D79832"><enum>(viii)</enum><text>Section 30
(relating to requirement to deliver shopper’s guide).</text>
</clause><continuation-text continuation-text-level="subparagraph">The
requirements referred to in clause (vi) shall not include those portions of the
personal worksheet described in Appendix B relating to consumer protection
requirements not imposed by section 4980C or 7702B.</continuation-text></subparagraph><subparagraph id="ID0865C9F305F545BDAB3D76106078A5C7"><enum>(B)</enum><header>Model
act</header><text>The following requirements of the model Act must be
met:</text>
<clause id="ID23DACB91F72744759D3348FD0AC54E9D"><enum>(i)</enum><text>Section 6F
(relating to right to return), except that such section shall also apply to
denials of applications and any refund shall be made within 30 days of the
return or denial.</text>
</clause><clause id="ID7ADE8C48238741A68187722ACAAFD08D"><enum>(ii)</enum><text>Section 6G
(relating to outline of coverage).</text>
</clause><clause id="IDF77FD304915440068848DE8D3C81CF11"><enum>(iii)</enum><text>Section 6H
(relating to requirements for certificates under group plans).</text>
</clause><clause id="IDDE47FD63FC524AC9AF8E3E1E0FAAD916"><enum>(iv)</enum><text>Section 6I
(relating to policy summary).</text>
</clause><clause id="IDE3F60877F87D42AFA8FB6EBEBC222149"><enum>(v)</enum><text>Section 6J
(relating to monthly reports on accelerated death benefits).</text>
</clause><clause id="ID614D986773C2445B850BEB46C66E8A03"><enum>(vi)</enum><text>Section 7
(relating to incontestability period).</text>
</clause></subparagraph><subparagraph id="ID5A4F27F38B8144869D5BBAC2A38A76A1"><enum>(C)</enum><header>Definitions</header><text>For
purposes of this paragraph, the terms <term>model regulation</term> and
<term>model Act</term> have the meanings given such terms by section
7702B(g)(2)(B).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDD1FE0F2E624C45959141B4E4F3A82F05"><enum>(c)</enum><header>Effective
Date</header><text>The amendments made by this section shall apply to policies
issued more than 1 year after the date of the enactment of this Act.</text>
</subsection></section><enum>VI</enum><header>PROMOTING
HEALTHIER LIFESTYLES</header>
<section id="ID084B9322D8F34E83927DA389508B1D13"><enum>601.</enum><header>Community
partnerships to promote healthy lifestyles</header>
<subsection id="ID9567E7B41B4C49B08E519CB91394702E"><enum>(a)</enum><header>Grants</header><text>The
Secretary of Health and Human Services (referred to in this title as the
<quote>Secretary</quote>) shall award grants to States to enable such States to
provide assistance to eligible community partnerships that will carry out
activities to promote healthy lifestyles.</text>
</subsection><subsection id="IDB7C6E19DAAE142518E58C49E460B4497"><enum>(b)</enum><header>Eligibility</header>
<paragraph id="ID9B7DE52F85254086A7C1F03A09BE4806"><enum>(1)</enum><header>State</header><text>To
be eligible to receive a grant under subsection (a), a State shall prepare and
submit to the Secretary an application at such time, in such manner and
containing such information as the Secretary may require.</text>
</paragraph><paragraph id="ID35E95699DEF446F9AE3F130AE57902CA"><enum>(2)</enum><header>Community
partnership</header><text>To be eligible to receive assistance from a State
under a grant under subsection (a), an entity shall—</text>
<subparagraph id="ID7A1A42359772477F8F71B875318145C7"><enum>(A)</enum><text>be a partnership
consisting of one or more public and private organizations (such as hospitals,
health centers, other health care providers, employers, local educational
agencies, community organizations, and public health organizations); and</text>
</subparagraph><subparagraph id="ID68FED037D7C241938A377AA555B74AF0"><enum>(B)</enum><text>prepare and
submit to the State an application at such time, in such manner and containing
such information as the State may require, including a description of the
activities that the partnership will carry out with assistance provided under
this section.</text>
</subparagraph></paragraph></subsection><subsection id="ID2AF383D92A284E6A8643FAAFC670530C"><enum>(c)</enum><header>Activities</header><text>A
State shall use amounts received under a grant under this section to support
activities conducted by an eligible community partnership to promote health
lifestyles, including—</text>
<paragraph id="ID282F748C1F644A9996C06E04F957C639"><enum>(1)</enum><text>activities to
reduce the primary risk factors for diseases, such as smoking, obesity, and
sedentary lifestyles;</text>
</paragraph><paragraph id="ID5AC500DAF1E94D2B9677A2334AC41E1F"><enum>(2)</enum><text>implementing
employee health promotion programs in the workplace using best practices to
improve health access, education, and prevention promotion and disease
management;</text>
</paragraph><paragraph id="IDEDE7CA74731A497CAD39A9D0CC3BC43D"><enum>(3)</enum><text>activities to
decrease hospital inpatient admissions of individuals with chronic diseases;
and</text>
</paragraph><paragraph id="ID6B244A905F884A6381417B45B441C356"><enum>(4)</enum><text>the development
of programs relating to mental health and substance abuse.</text>
</paragraph></subsection><subsection id="ID66137785DD6849FDA0361CAE350D582E"><enum>(d)</enum><header>Authorization
of Appropriations</header><text>There are authorized to be appropriated to
carry out this section, such sums as may be necessary for each of fiscal years
2008 through 2012.</text>
</subsection></section><section id="IDA4BA348CB1C64AE59D338408D0AD3ED4"><enum>602.</enum><header>Worksite
wellness grant program</header>
<subsection id="ID949A4E58E6BB4138919E312FC9D4C537"><enum>(a)</enum><header>Grants</header><text>The
Secretary shall award grants to States (through State health departments or
other State agencies working in consultation with the State health agency) to
enable such States to provide assistance to employers that employ not to exceed
100 employees to enable such employers to establish and operate worksite
wellness programs for their employees.</text>
</subsection><subsection id="ID9E469A22DA584B83A9D984D29BB5C99B"><enum>(b)</enum><header>Application</header><text>To
be eligible to receive a grant under subsection (a), a State shall prepare and
submit to the Secretary an application at such time, in such manner, and
containing such information as the Secretary may require, including—</text>
<paragraph id="IDC4659BCB006044DF8596E85C00A38C3D"><enum>(1)</enum><text>a description of
the manner in which the State intends to use amounts received under the grant;
and</text>
</paragraph><paragraph id="ID66331B70AD334E04ADDEFC72CCD07ADC"><enum>(2)</enum><text>assurances that
the State will only use amounts provided under such grant to provide assistance
to employers that can demonstrate that they are in compliance with minimum
program characteristics (relative to scope and regularity of services offered)
that are developed by the Secretary in consultation with experts in public
health and representatives of small employers.</text>
</paragraph></subsection><subsection id="ID531CDB932B2F460EA43ECA2F4E3316C0"><enum>(c)</enum><header>Allocation</header><text>Grants
shall be allocated among States based on the population of individuals employed
by small employers in such States.</text>
</subsection><subsection id="ID8023F9ECC70C4046BB29B3C31CE70413"><enum>(d)</enum><header>Program
Characteristics</header><text>In developing minimum program characteristics
under subsection (b)(2), the Secretary shall ensure that all activities
established or enhanced under a grant under this section have clearly defined
goals and objectives and demonstrate how receipt of such assistance will help
to achieve established State or local health objectives based on the National
Health Promotion and Disease Prevention Objectives.</text>
</subsection><subsection id="ID59E126661D784BC798D5175A535AB648"><enum>(e)</enum><header>Use of
Funds</header><text>Amounts received under a grant awarded under subsection (a)
shall be used by a State to provide grants to employers (as described in
subsection (a)), nonprofit organizations, or public authorities, or to operate
State-based worksite wellness programs.</text>
</subsection><subsection id="ID8248CDDF6B5E4325AD885A3E2104DD67"><enum>(f)</enum><header>Special
Emphasis</header><text>In funding employer worksite wellness projects under
this section, a State shall give special emphasis to—</text>
<paragraph id="ID61EEA373562B40C88FBF8E67C3FF7AAE"><enum>(1)</enum><text>the development
of joint wellness programs between employers;</text>
</paragraph><paragraph id="IDD124127FCF5940D5BFEC726862F46B4B"><enum>(2)</enum><text>the development
of employee assistance programs dealing with substance abuse;</text>
</paragraph><paragraph id="ID3225621E8A8A4480B8F97DC727F40495"><enum>(3)</enum><text>maximizing the
use of, and coordination with, existing community resources such as nonprofit
health organizations; and</text>
</paragraph><paragraph id="ID5E37D499797447BA8DE813EF11CF1911"><enum>(4)</enum><text>encouraging the
participation of dependents of employees and retirees in wellness
programs.</text>
</paragraph></subsection><subsection id="ID185FE8DB34A4454F8A0A7447BD8D0D78"><enum>(g)</enum><header>Authorization
of Appropriations</header><text>There are authorized to be appropriated to
carry out this section, such sums as may be necessary for each of fiscal years
2008 through 2012.</text>
</subsection></section><section id="ID0B1F873EC95541299445A3BBCB9903F4"><enum>603.</enum><header>Comprehensive
school health education</header>
<subsection id="ID1BA35DA124DA496EBEE4041BEDE9B607"><enum>(a)</enum><header>In
General</header><text>The Secretary shall use amounts appropriated in each
fiscal year under subsection (d) to expand comprehensive school health
education programs administered by the Centers for Disease Control and
Prevention under sections 301 and 311 of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C. 241 and
243).</text>
</subsection><subsection id="IDC4D1362F5F954DD4923F4A7585D38C0A"><enum>(b)</enum><header>Specified Use
of Funds</header><text>In meeting the requirement of subsection (a), the
Secretary shall expand the number of children receiving planned, sequential
kindergarten through 12th grade comprehensive school education as a component
of comprehensive programs of school health, including—</text>
<paragraph id="IDB2683C3CFB58400290D09537EF5472A8"><enum>(1)</enum><text>physical
education programs that provide lifelong physical activity;</text>
</paragraph><paragraph id="ID2F0572F4301548478621E5A0D8558803"><enum>(2)</enum><text>healthy school
food service selections;</text>
</paragraph><paragraph id="ID7EF89B4C6F6744899FC19A25EBE921FD"><enum>(3)</enum><text>programs that
promote a healthy and safe school environment;</text>
</paragraph><paragraph id="IDCF68C528C4C64E078DBEBDD7ACDD81C1"><enum>(4)</enum><text>schoolsite health
promotion for faculty and staff;</text>
</paragraph><paragraph id="IDDF7EE652F27F43D49294D4F889C56BD6"><enum>(5)</enum><text>integrated school
and community health promotion efforts; and</text>
</paragraph><paragraph id="ID8D5C208CAE4449D283E822EFAC151314"><enum>(6)</enum><text>school nursing
disease prevention and health promotion services.</text>
</paragraph></subsection><subsection id="ID57E0B6B9E54349AAA81444AFD00C498D"><enum>(c)</enum><header>Coordination of
Existing Programs</header><text>The Secretary of Health and Human Services, the
Secretary of Education, and the Secretary of Agriculture, shall work
cooperatively to coordinate existing school health education programs within
the jurisdiction of their respective Departments in a manner that maximizes the
efficiency and effectiveness of Federal expenditures for such programs.</text>
</subsection><subsection id="IDD04A5C5B3716450A82A992DF52E4809C"><enum>(d)</enum><header>Authorization
of Appropriations</header><text>There are authorized to be appropriated to
carry out this section, such sums as may be necessary for each of fiscal years
2008 through 2012.</text>
</subsection></section><enum>VII</enum><header>MEDICARE
FAIRNESS</header>
<subtitle id="ID4E8AEF41CB684FFCA3BC82A85ACEC1F0"><enum>A</enum><header>Medicare Value
and Quality Demonstration</header>
<section id="ID1AB67C02392D491EB33D65BE19BC9521"><enum>701.</enum><header>Findings</header><text display-inline="no-display-inline">The Senate makes the following
findings:</text>
<paragraph id="IDFDAA08C8CBCA4A14B3096F6FA9161C56"><enum>(1)</enum><text>The United States
Government should reward physicians, hospitals, and other health care providers
that provide high-quality, cost-effective health care to beneficiaries under
the medicare program.</text>
</paragraph><paragraph id="ID28C9ADF0A13B43B38EFC34B58E7BFCA0"><enum>(2)</enum><text>The Journal of
the American Medical Association has published quality indicators in an article
entitled <quote>Quality of Medical Care Delivered to Medicare Beneficiaries: A
Profile at State and National Levels</quote>.</text>
</paragraph><paragraph id="ID622450DA07A04E36875CD3988B0B40A3"><enum>(3)</enum><text>The cost of
health care is—</text>
<subparagraph id="IDE2D5BB5CFDEB48CBBDFDF6B6C28329B3"><enum>(A)</enum><text>reflected in the
type and volume of physicians’ services and in physician ordering and
prescribing behavior; and</text>
</subparagraph><subparagraph id="IDD104DE0654294B83A7311C2926ED00EC"><enum>(B)</enum><text>reflected in the
amount of the average payment to hospitals under the medicare program for each
medicare beneficiary in each State.</text>
</subparagraph></paragraph><paragraph id="IDCB7300623EA94BCF92E4A8396A721A9F"><enum>(4)</enum><text>Physician and
hospital practice patterns contribute to the total cost and quality of care for
each medicare beneficiary in each State.</text>
</paragraph><paragraph id="ID95E4C6A0B80B4598840897C7D8B24E86"><enum>(5)</enum><text>The original
medicare fee-for-service program under parts A and B of title XVIII of the
<act-name parsable-cite="SSA">Social Security Act </act-name>does not include a
mechanism to pay for interventions designed to improve quality of care. While
the framework for payments to managed care organizations under the
Medicare+Choice program under part C of such title allows for the reallocation
of capitation revenues to cover such things as disease state management and
quality improvement infrastructure, even the most optimistic projections for
managed care enrollment leave the majority of medicare beneficiaries in the
original medicare fee-for-service program.</text>
</paragraph></section><section id="ID8805B1DB144A4D0380801DB059B3FD3E"><enum>702.</enum><header>Demonstration
project to encourage the provision of high-quality, cost-effective inpatient
hospital services</header>
<subsection id="ID8A44777E462447AD8E4081BD9A3E1D58"><enum>(a)</enum><header>Purpose</header><text>The
purpose of the demonstration project conducted under this section is to
encourage the provision of high-quality, cost-effective health care to
beneficiaries under the Medicare program under title XVIII of the
<act-name parsable-cite="SSA">Social Security Act </act-name>(42 U.S.C. 1395 et
seq.) by providing incentive payments to hospitals located in States in which
high-quality and cost-effective services are being provided in order to finance
further quality improvements.</text>
</subsection><subsection id="ID1348EF0BE82841C59517F0ECF7BE8078"><enum>(b)</enum><header>Demonstration
Project</header>
<paragraph id="ID2AB07EDDC94B404D978D4D937E94FA8E"><enum>(1)</enum><header>Establishment</header><text>Not
later than 6 months after the date of enactment of this Act, the Secretary
shall establish a demonstration project under which—</text>
<subparagraph id="ID85FDB332B1D944A38F7EBA4433FBDE0B"><enum>(A)</enum><text>the Secretary
provides bonus payments to providers of inpatient hospital services that
deliver high-quality health care at low costs in accordance with the
methodology established by the Agency for Healthcare Research and Quality under
paragraph (2); and</text>
</subparagraph><subparagraph id="ID5138F3323F584E22B37D504DF07DDC33"><enum>(B)</enum><text>the Secretary
funds a plan at each site to increase the number of providers of inpatient
hospital services that provide high-quality, low-cost health care to
beneficiaries under the Medicare program under title XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
</subparagraph></paragraph><paragraph id="IDB6CF4398E4B6422B99D58617AB07A395"><enum>(2)</enum><header>Value and
quality ranking methodology</header>
<subparagraph id="IDDCFFA822057545C3AA50703A7D5C1046"><enum>(A)</enum><header>In
general</header><text>The Agency for Healthcare Research and Quality shall
establish a value and quality ranking methodology under which the Secretary
awards bonus payments to providers of inpatient hospital services located in
those States that demonstrate that such providers in the State are providing
high value because of the high-quality, cost-effective health care services
being provided to medicare beneficiaries.</text>
</subparagraph><subparagraph id="ID279202A3D18C4AB2B65D165A6A52B937"><enum>(B)</enum><header>Basis</header><text>The
methodology established under subparagraph (A) shall be based on the Medicare
quality indicators determined by the Secretary to be appropriate.</text>
</subparagraph></paragraph><paragraph id="ID6EA7009745C94429B05C5DA95A779C93"><enum>(3)</enum><header>Sites</header><text>The
Secretary shall select 2 States in which to conduct the demonstration
project—</text>
<subparagraph id="ID74A6697B1C334315987A32DC88289779"><enum>(A)</enum><text>from among the
top 25 States (as ranked using the methodology established under paragraph (2))
that are also among the group of 25 States with the lowest per capita cost to
the Medicare program under title XVIII of the <act-name parsable-cite="SSA">Social Security Act </act-name>during the most recent
12-month period for which data are available; and</text>
</subparagraph><subparagraph id="IDF92F3768F99B4D9C9B579491EDB1ACC7"><enum>(B)</enum><text>based upon
information contained in applications submitted to the Secretary by such States
at such time, in such form and manner, and containing such information as the
Secretary may require.</text>
</subparagraph></paragraph><paragraph id="ID8338A45DF54847408557246D14C3CD65"><enum>(4)</enum><header>Duration of
project</header><text>The demonstration project shall be conducted over a
5-year period.</text>
</paragraph></subsection><subsection id="ID738821D016764E59A55EF9C13E0F8D35"><enum>(c)</enum><header>Reports</header><text>The
Secretary shall submit to the appropriate committees of Congress interim
reports on the demonstration project and a final report on the project within 6
months after the conclusion of the project together with recommendations for
such legislative or administrative action as the Secretary determines
appropriate.</text>
</subsection><subsection id="IDC49975B31A2F41EDA36E2A8020914341"><enum>(d)</enum><header>Waiver</header><text>The
Secretary shall waive such provisions of titles XI and XVIII of the
<act-name parsable-cite="SSA">Social Security Act </act-name>(42 U.S.C. 1301 et
seq. and 1395 et seq.) as may be necessary to conduct the demonstration project
under this section.</text>
</subsection><subsection id="ID7DF17CACE2DA4BDFACAC1BB25C4A0A5C"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="ID9C12D5F1CDF74F719A965A7E21A474CC"><enum>(1)</enum><header>Provider of
inpatient hospital services</header><text>The term <term>provider of inpatient
hospital services</term> means any individual or entity that receives payment
under the Medicare program under title XVIII of the
<act-name parsable-cite="SSA">Social Security Act </act-name>(42 U.S.C. 1395 et
seq.) for providing an inpatient hospital service (as defined in section
1861(b) of such Act (42 U.S.C. 1395x(b))).</text>
</paragraph><paragraph id="ID9BA2522E2036419F8B647DCC30131BB4"><enum>(2)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph></subsection><subsection id="ID5AF258BCD024471BAABEBC2DD1747ECA"><enum>(f)</enum><header>Funding</header><text>There
are appropriated from the Federal Hospital Insurance Trust Fund under section
1817 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (42
U.S.C. 1395i) such sums as the Secretary determines are necessary to conduct
the demonstration project under this section.</text>
</subsection></section><section id="ID94188CF8C870491FA958ED268CFAA18E"><enum>703.</enum><header>Demonstration
project to encourage the provision of high-quality, cost-effective physicians’
services</header>
<subsection id="ID133EEFED82BC4F34AE441863029B1299"><enum>(a)</enum><header>Purpose</header><text>The
purpose of the demonstration project conducted under this section is to
encourage the provision of high-quality, cost-effective health care to
beneficiaries under the Medicare program under title XVIII of the
<act-name parsable-cite="SSA">Social Security Act </act-name>(42 U.S.C. 1395 et
seq.) by providing incentive payments to physicians located in States in which
high-quality and cost-effective services are being provided in order to finance
further quality improvements.</text>
</subsection><subsection id="ID7AB909CEFAEB4AE78F9194F3BB64310C"><enum>(b)</enum><header>Demonstration
Project</header>
<paragraph id="ID5717A751B02142C881471087C46076B0"><enum>(1)</enum><header>Establishment</header><text>Not
later than 6 months after the date of enactment of this Act, the Secretary
shall establish a demonstration project under which—</text>
<subparagraph id="IDE748BC84F464478BB24F072BC8850001"><enum>(A)</enum><text>the Secretary
provides bonus payments to providers of physicians’ services that deliver
high-quality, cost-effective health care in accordance with the methodology
established by the Agency for Healthcare Research and Quality under paragraph
(2); and</text>
</subparagraph><subparagraph id="ID6B76D961F7D040FBAFB6B0E3E1AF815E"><enum>(B)</enum><text>the Secretary
funds a plan in each State to increase the number of providers of physicians’
services that provide high-quality, cost-effective health care to beneficiaries
under the medicare program under title XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
</subparagraph></paragraph><paragraph id="ID7EBB1C6D21FE4A32B15BD309DDB16512"><enum>(2)</enum><header>Value and
quality ranking methodology</header>
<subparagraph id="ID0F40209BD4BC40EA99AA1EFF16AF6897"><enum>(A)</enum><header>In
general</header><text>The Agency for Healthcare Research and Quality shall
establish a value and quality ranking methodology under which the Secretary
awards bonus payments to providers of physicians’ services located in those
States that demonstrate that such providers in the State are providing high
value because of the high-quality, cost-effective health care services being
provided to Medicare beneficiaries.</text>
</subparagraph><subparagraph id="ID7BF94929198D46ECBC882024279FAC87"><enum>(B)</enum><header>Basis</header><text>The
methodology established under subparagraph (A) shall be based on the Medicare
quality indicators determnined by the Secretary to be appropriate.</text>
</subparagraph></paragraph><paragraph id="ID8F7C1C32A7BE41D59FCF5107CAC66899"><enum>(3)</enum><header>Sites</header><text>The
Secretary shall select 2 States in which to conduct the demonstration
project—</text>
<subparagraph id="ID60916FF7AB584C69A261DE565DDBA563"><enum>(A)</enum><text>from among the
top 25 States (as ranked using the methodology established under paragraph (2))
that are also among the 25 States with the lowest per capita cost to the
Medicare program under title XVIII of the <act-name parsable-cite="SSA">Social
Security Act </act-name>during the most recent 12-month period for which data
are available; and</text>
</subparagraph><subparagraph id="IDFD1A4A1DFAC84A1A8748614B8AA92F7C"><enum>(B)</enum><text>based upon
information contained in applications submitted to the Secretary by such States
at such time, in such form and manner, and containing such information as the
Secretary may require.</text>
</subparagraph></paragraph><paragraph id="ID89BECFEE679946FABE263A3B150795A0"><enum>(4)</enum><header>Duration of
project</header><text>The demonstration project shall be conducted over a
5-year period.</text>
</paragraph></subsection><subsection id="ID242321B9CD21422E926CC3EEC758CDD8"><enum>(c)</enum><header>Reports</header><text>The
Secretary shall submit to the appropriate committees of Congress interim
reports on the demonstration project and a final report on the project within 6
months after the conclusion of the project together with recommendations for
such legislative or administrative action as the Secretary determines
appropriate.</text>
</subsection><subsection id="ID26FC9252E50F4EA8859AF6D718BE6D92"><enum>(d)</enum><header>Waiver</header><text>The
Secretary shall waive such provisions of titles XI and XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1301 et
seq. and 1395 et seq.) as may be necessary to conduct the demonstration project
under this section.</text>
</subsection><subsection id="IDF90C8DFA76B14381BDFBF7435B41A13B"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="IDBA5FEA1B28B146AA9B02170ADD92992E"><enum>(1)</enum><header>Provider of
physicians’ services</header><text>The term <term>provider of physicians’
services</term> means any individual or entity that receives payment under the
Medicare program under title XVIII of the <act-name parsable-cite="SSA">Social
Security Act</act-name> (42 U.S.C. 1395 et seq.) for providing physicians’
services (as defined in section 1861(q) of such Act (42 U.S.C.
1395x(q))).</text>
</paragraph><paragraph id="IDA3B271C155824135AFEA3D97D599063E"><enum>(2)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph></subsection><subsection id="ID51BD84082A1A47F397C8269FB6072DA2"><enum>(f)</enum><header>Funding</header><text>There
are appropriated from the Federal Supplementary Medical Insurance Trust Fund
under section 1841 of the <act-name parsable-cite="SSA">Social Security Act
</act-name>(42 U.S.C. 1395t) such sums as the Secretary determines are
necessary to conduct the demonstration project under this section.</text>
</subsection></section></subtitle><subtitle id="ID455AF4558343423DAA04E844729E5BA3"><enum>B</enum><header>Graduate Medical
Education Demonstration</header>
<section id="IDA8049A1D516C40A788D0617C5B3DBD6F"><enum>711.</enum><header>Clinical
rotation demonstration project</header>
<subsection id="ID943A03C0C53E49A59F6BE8522E38E46F"><enum>(a)</enum><header>Establishment</header><text>Not
later than 6 months after the date of enactment of this Act, the Secretary
shall establish a demonstration project that provides for demonstration grants
designed to provide financial or other incentives to hospitals to attract
educators and clinical practitioners so that hospitals that serve beneficiaries
under the Medicare program under title XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1395 et
seq.) who are residents of underserved areas may host clinical
rotations.</text>
</subsection><subsection id="ID2628C813BA5F4AA7B1BB0FAC0F370368"><enum>(b)</enum><header>Duration of
Project</header><text>The demonstration project shall be conducted over a
5-year period.</text>
</subsection><subsection id="ID7D9E863291C94F8C87B25A23B0A1EFBF"><enum>(c)</enum><header>Funding</header>
<paragraph id="ID610C392D9E8440EDB2C21B69327B7901"><enum>(1)</enum><header>In
general</header><text>Subject to paragraph (2), the Secretary shall pay the
costs of the demonstration project conducted under this section from the
Federal Hospital Insurance Trust Fund under section 1817 of the
<act-name parsable-cite="SSA">Social Security Act </act-name>(42 U.S.C.
1395i).</text>
</paragraph><paragraph id="IDE82B0BD0A23C4892B368B968982C323F"><enum>(2)</enum><header>Cap on
funding</header><text>The Secretary may not expend more than $20,000,000 to
conduct the demonstration project under this section.</text>
</paragraph><paragraph id="ID290006DD03D941AB8FE13CD2DC98A946"><enum>(3)</enum><header>Budget
neutrality for demonstration project</header><text>Notwithstanding any other
provision of law, the Secretary shall provide for an appropriate reduction in
the aggregate amount of additional payments made under subsection (d)(5)(B) of
section 1886 of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (42 U.S.C. 1395ww) for the indirect costs of medical education
and for direct graduate medical education costs under subsection (h) of such
section to reflect any increase in amounts expended from the Federal Hospital
Insurance Trust Fund as a result of the demonstration project conducted under
this section.</text>
</paragraph></subsection><subsection id="ID56BC278D295E4DF583A7FC6ED0F0F9C4"><enum>(d)</enum><header>Reports</header><text>The
Secretary shall submit to the appropriate committees of Congress interim
reports on the demonstration project and a final report on such project within
6 months after the conclusion of the project together with recommendations for
such legislative or administrative action as the Secretary determines
appropriate.</text>
</subsection><subsection id="IDEFF90A13B56643DABF57B9EDB5EAFF73"><enum>(e)</enum><header>Waiver</header><text>The
Secretary shall waive such provisions of titles XI and XVIII of the
<act-name parsable-cite="SSA">Social Security Act </act-name>(42 U.S.C. 1301 et
seq. and 1395 et seq.) as may be necessary to conduct the demonstration project
under this section.</text>
</subsection><subsection id="IDD2781803C86F49F88ECD21D8035954CC"><enum>(f)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="ID8A1F5328080E441C995797189F4ED81D"><enum>(1)</enum><header>Hospital</header><text>The
term <term>hospital</term> means any subsection (d) hospital (as defined in
section 1886(d)(1)(B) of the <act-name parsable-cite="SSA">Social Security Act
</act-name>(42 U.S.C. 1395ww(d)(1)(B)) that had indirect or direct costs of
medical education during the most recent cost reporting period preceding the
date of enactment of this Act.</text>
</paragraph><paragraph id="ID09197C5CC77D40BAA966445C661F9153"><enum>(2)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph><paragraph id="ID37CE4EE0E20C45D99C0839488F52C265"><enum>(3)</enum><header>Underserved
area</header><text>The term <term>underserved area</term> means such medically
underserved urban areas and medically underserved rural areas as the Secretary
may specify.</text>
</paragraph></subsection></section></subtitle>