[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3243 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 3243

To amend titles XIX and XXI of the Social Security Act, titles I and II 
 of the Patient Protection and Affordable Care Act, and other Acts for 
  the purpose of eliminating certain health entitlement programs and 
                         reducing the deficit.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 24, 2011

 Mr. Rehberg introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend titles XIX and XXI of the Social Security Act, titles I and II 
 of the Patient Protection and Affordable Care Act, and other Acts for 
  the purpose of eliminating certain health entitlement programs and 
                         reducing the deficit.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``The Common Sense 
Deficit Reduction Act of 2011''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Medicaid expansion for certain adults.
Sec. 3. Elimination of Medicaid coverage of former foster care 
                            children.
Sec. 4. Removal of requirement of minimal essential coverage for 
                            Medicaid benchmark benefits.
Sec. 5. Elimination of Medicaid premium assistance requirement.
Sec. 6. Elimination of Medicaid and CHIP MAGI requirements.
Sec. 7. Elimination of increased FMAP for CHIP.
Sec. 8. Restoration of CHIP appropriation amounts under CHIPRA.
Sec. 9. Treatment of children who are unable to be enrolled in CHIP due 
                            to a funding shortfall.
Sec. 10. Grants to improve CHIP outreach and enrollment.
Sec. 11. Additional one-time appropriations for CHIP.
Sec. 12. Repeal of PPACA Premium tax credits and cost-sharing 
                            subsidies.
Sec. 13. Treatment of individual mandate.
Sec. 14. Repeal of CLASS Act.

SEC. 2. MEDICAID EXPANSION FOR CERTAIN ADULTS.

    (a) Mandatory Populations.--Section 1902 of the Social Security Act 
(42 U.S.C. 1396a) is amended--
            (1) in subsection (a)(10)--
                    (A) in subparagraph (A)(i)--
                            (i) by inserting ``or'' at the end of 
                        subclause (VI); and
                            (ii) by striking subclause (VIII); and
                    (B) in the matter following subparagraph (G) by 
                striking ``(XV) the medical assistance made available 
                to an individual described in subparagraph (A)(i)(VIII) 
                shall be limited to medical assistance described in 
                subsection (k)(1)'';
            (2) by striking subsection (k); and
            (3) in subsection (l)(2)(C) by striking ``(or, beginning 
        January 1, 2014, 133 percent)''.
    (b) Optional Population.--Section 1902 of the Social Security Act 
(42 U.S.C. 1396a) is further amended--
            (1) in subsection (a)(10)(A)(ii) by striking subclause 
        (XX); and
            (2) by striking subsection (hh).
    (c) Elimination of Funding.--Section 1905 of the Social Security 
Act (42 U.S.C. 1396d), is amended--
            (1) in subsection (a), in the matter preceding paragraph 
        (1), by striking clauses (xiv) and (xv);
            (2) in subsection (b), in the first sentence, by striking 
        ``(y),'' before ``(z),''; and
            (3) by striking subsection (y).
    (d) Conforming Amendments.--
            (1) Section 1903 of the Social Security Act (42 U.S.C. 
        1396b) is amended--
                    (A) in subsection (f)(4), by striking 
                ``1902(a)(10)(A)(i)(VIII),'' and 
                ``1902(a)(10)(A)(ii)(XX),''; and
                    (B) in subsection (i)--
                            (i) by inserting ``or'' at the end of 
                        paragraph (24);
                            (ii) by striking ``; or'' at the end of 
                        paragraph (25) and inserting a period; and
                            (iii) by striking paragraph (26).
            (2) Section 1920 of the Social Security Act (42 U.S.C. 
        1396r-1) is amended by striking subsection (e).
            (3) Section 1937(a)(1)(B) of such Act (42 U.S.C. 1396u-
        7(a)(1)(B)) is amended by striking ``subclause (VIII) of 
        section 1902(a)(10)(A)(i) or under''.

SEC. 3. ELIMINATION OF MEDICAID COVERAGE OF FORMER FOSTER CARE 
              CHILDREN.

    (a) In General.--Section 1902(a)(10)(A)(i) of the Social Security 
Act (42 U.S.C. 1396a) is amended by striking subclause (IX).
    (b) Conforming Amendments.--
            (1) Section 1902(a)(10) of such Act (42 U.S.C. 
        1396a(a)(10)) is amended in the matter following subparagraph 
        (G)--
                    (A) by inserting ``and'' before ``XVI if an 
                individual''; and
                    (B) by striking ``and (XVII) if an individual is 
                described in subclause (IX) of subparagraph (A)(i) and 
                is also described in subclause (VIII) of that 
                subparagraph, the medical assistance shall be made 
                available to the individual through subclause (IX) 
                instead of through subclause (VIII)''.
            (2) Section 1903(f)(4) of such Act (42 U.S.C. 1396b(f)(4)) 
        is amended by striking ``1902(a)(10)(A)(i)(IX),''.
            (3) Section 1937(a)(2)(B)(viii) of such Act (42 U.S.C. 
        1396u-7(a)(2)(B)(viii)) is amended by striking ``, or the 
        individual qualifies for medical assistance on the basis of 
        section 1902(a)(10)(A)(i)(IX)''.

SEC. 4. REMOVAL OF REQUIREMENT OF MINIMAL ESSENTIAL COVERAGE FOR 
              MEDICAID BENCHMARK BENEFITS.

    Section 1937(b) of the Social Security Act (42 U.S.C. 1396-7(b)) is 
amended--
            (1) in paragraph (1), in the matter preceding subparagraph 
        (A), by striking ``subject to paragraphs (5) and (6)'';
            (2) in paragraph (2)--
                    (A) in the matter preceding subparagraph (A), by 
                striking ``subject to paragraphs (5) and (6)'';
                    (B) in subparagraph (A)--
                            (i) by striking clauses (iv) and (v); and
                            (ii) by redesignating clauses (vi) and 
                        (vii) as clauses (iv) and (v), respectively; 
                        and
                    (C) in subparagraph (C)--
                            (i) by redesignating clauses (i) and (ii) 
                        as clauses (iii) and (iv), respectively; and
                            (ii) by inserting before clause (iii), as 
                        so redesignated, the following:
                            ``(i) Coverage of prescription drugs.
                            ``(ii) Mental health services.''; and
            (3) by striking paragraphs (5) and (6).

SEC. 5. ELIMINATION OF MEDICAID PREMIUM ASSISTANCE REQUIREMENT.

    Section 2003 of the Patient Protection and Affordable Care Act is 
repealed and the provisions of law amended by such section are restored 
as if such section had never been enacted.

SEC. 6. ELIMINATION OF MEDICAID AND CHIP MAGI REQUIREMENTS.

    (a) Medicaid.--Section 1902(e) of the Social Security Act (42 
U.S.C. 1396a(e)) is amended by striking paragraph (14).
    (b) CHIP.--
            (1) In general.--Section 2102(b)(1)(B) of such Act (42 
        U.S.C. 1397bb) is amended--
                    (A) by inserting ``and'' at the end of clause 
                (iii);
                    (B) by striking ``and'' at the end of clause (iv); 
                and
                    (C) by striking clause (v).
            (2) Elimination of related eligibility rule.--Section 
        2101(f) of the Patient Protection and Affordable Care Act is 
        repealed.
    (c) Conforming Amendments.--
            (1) Section 1902(a)(17) of such Act (42 U.S.C. 
        1396a(a)(17)) is amended by striking ``(e)(14)''.
            (2) Section 2105(d)(1) of such Act (42 U.S.C. 1397ee(d)(1)) 
        is amended by striking ``, except as required under section 
        1902(e)(14)''.
            (3) Section 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)) 
        is amended by striking subparagraph (F) (relating to income 
        determined using modified adjusted gross income and household 
        income).

SEC. 7. ELIMINATION OF INCREASED FMAP FOR CHIP.

    Section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) is 
amended by striking ``Notwithstanding the preceding sentence, during 
the period that begins on October 1, 2015, and ends on September 30, 
2019, the enhanced FMAP determined for a State for a fiscal year (or 
for any portion of a fiscal year occurring during such period) shall be 
increased by 23 percentage points, but in no case shall exceed 100 
percent. The increase in the enhanced FMAP under the preceding sentence 
shall not apply with respect to determining the payment to a State 
under subsection (a)(1) for expenditures described in subparagraph 
(D)(iv), paragraphs (8), (9), (11) of subsection (c), or clause (4) of 
the first sentence of section 1905(b).''.

SEC. 8. RESTORATION OF CHIP APPROPRIATION AMOUNTS UNDER CHIPRA.

    (a) Restoration of CHIPRA Appropriation Amounts.--Section 2104(a) 
of the Social Security Act (42 U.S.C. 1397dd(a)) is amended--
            (1) in paragraph (15), by inserting ``and'' after the 
        semicolon at the end; and
            (2) by striking paragraphs (16) through (18) and inserting 
        the following:
            ``(16) for fiscal year 2013, for purposes of making 2 
        semiannual allotments--
                    ``(A) $2,850,000,000 for the period beginning on 
                October 1, 2012, and ending on March 31, 2013, and
                    ``(B) $2,850,000,000 for the period beginning on 
                April 1, 2013, and ending on September 30, 2013.''.
    (b) Conforming Amendments.--
            (1) Section 2104(m) of such Act (42 U.S.C. 1397dd(m)) is 
        amended--
                    (A) in the heading, by striking ``2015'' and 
                inserting ``2013'';
                    (B) in paragraph (2)--
                            (i) in paragraph heading, by striking 
                        ``2014'' and inserting ``2012''; and
                            (ii) by striking subparagraph (B);
                    (C) in paragraph (3)--
                            (i) in the paragraph heading, by striking 
                        ``2015'' and inserting ``2013'';
                            (ii) in subparagraphs (A) and (B), by 
                        striking ``paragraph (18)'' each place it 
                        appears and inserting ``paragraph (16)'';
                            (iii) in subparagraph (C)--
                                    (I) by striking ``2014'' each place 
                                it appears and inserting ``2012''; and
                                    (II) by striking ``2015'' and 
                                inserting ``2013''; and
                            (iv) in subparagraph (D)--
                                    (I) in clause (i)(I), by striking 
                                ``subsection (a)(18)(A)'' and inserting 
                                ``subsection (a)(16)(A)''; and
                                    (II) in clause (ii)(II), by 
                                striking ``subsection (a)(18)(B)'' and 
                                inserting ``subsection (a)(16)(B)'';
                    (D) in paragraph (4), by striking ``2015'' and 
                inserting ``2013'';
                    (E) in paragraph (6)--
                            (i) in subparagraph (A), by striking 
                        ``2015'' and inserting ``2013''; and
                            (ii) in the flush text after and below 
                        subparagraph (B)(ii), by striking ``, fiscal 
                        year 2012, or fiscal year 2014'' and inserting 
                        ``or fiscal year 2012''; and
                    (F) in paragraph (8)--
                            (i) in the paragraph heading, by striking 
                        ``2015'' and inserting ``2013''; and
                            (ii) by striking ``2015'' and inserting 
                        ``2013''.
            (2) Section 2104(n) of such Act (42 U.S.C. 1397dd(n)) is 
        amended--
                    (A) in paragraph (2)--
                            (i) in subparagraph (A)(ii)--
                                    (I) by striking ``2014'' and 
                                inserting ``2012''; and
                                    (II) by striking ``2015'' and 
                                inserting ``2013''; and
                            (ii) in subparagraph (B)--
                                    (I) by striking ``2014'' and 
                                inserting ``2012''; and
                                    (II) by striking ``2015'' and 
                                inserting ``2013''; and
                    (B) in paragraph (3)(A), by striking ``fiscal year 
                2013, fiscal year 2014, or a semi-annual allotment 
                period for fiscal year 2015'' and inserting ``or a 
                semiannual allotment period for fiscal year 2013''.
            (3) Section 2105(g)(4) of such Act (42 U.S.C. 1397ee(g)(4)) 
        is amended--
                    (A) in the paragraph heading, by striking ``2015'' 
                and inserting ``2013''; and
                    (B) in subparagraph (A), striking ``2015'' and 
                inserting ``2013''.

SEC. 9. TREATMENT OF CHILDREN WHO ARE UNABLE TO BE ENROLLED IN CHIP DUE 
              TO A FUNDING SHORTFALL.

    Section 2105(d)(3) of the Social Security Act (42 U.S.C. 
1397ee(d)(3)) is amended by striking subparagraph (B).

SEC. 10. GRANTS TO IMPROVE CHIP OUTREACH AND ENROLLMENT.

    Section 2113 of the Social Security Act (42 U.S.C. 1397mm) is 
amended--
            (1) in subsection (a)(1), striking ``2015'' and inserting 
        ``2013''; and
            (2) in subsection (g), by striking ``$140,000,000 for the 
        period of fiscal years 2009 through 2015'' and inserting 
        ``$100,000,000 for the period of fiscal years 2009 through 
        2013''.

SEC. 11. ADDITIONAL ONE-TIME APPROPRIATIONS FOR CHIP.

    Section 108 of the Children's Health Insurance Program 
Reauthorization Act of 2009 (42 U.S.C. 1397ee note) is amended by 
striking ``$15,361,000,000 to accompany the allotment'' and all that 
follows through ``allotments provided from such subsection (a)(18)(A)'' 
and inserting ``$11,706,000,000 to accompany the allotment made for the 
period beginning on October 1, 2012, and ending on March 31, 2013, 
under section 2104(a)(16)(A) of the Social Security Act (42 U.S.C. 
1397dd(a)(16)(A)) (as added by section 101), to remain available until 
expended. Such amount shall be used to provide allotments to States 
under paragraph (3) of section 2104(m) of the Social Security Act (42 
U.S.C. 1397dd(i)), as added by section 102, for the first 6 months of 
fiscal year 2013 in the same manner as allotments are provided under 
subsection (a)(16)(A) of such section 2104 and subject to the same 
terms and conditions as apply to the allotments provided from such 
subsection (a)(16)(A).''.

SEC. 12. REPEAL OF PPACA PREMIUM TAX CREDITS AND COST-SHARING 
              SUBSIDIES.

    (a) Premium Tax Credits.--Section 36B of the Internal Revenue Code 
of 1986 is amended by striking subsection (a).
    (b) Cost-Sharing.--Section 1402 of the Patient Protection and 
Affordable Care Act is repealed.
    (c) Conforming Amendments To Eliminate References to Premium 
Assistance and Reductions in Cost-Sharing.--
            (1) Internal revenue code of 1986.--The Internal Revenue 
        Code of 1986 is amended--
                    (A) in section 36B, as amended by subsection (a)--
                            (i) in subsection (c)(2)(A)(ii), by 
                        striking ``(or through advance payment'' and 
                        all that follows through ``Act)'';
                            (ii) in subsection (f)--
                                    (I) by striking paragraphs (1) and 
                                (2);
                                    (II) in paragraph (3)(B), by 
                                striking ``without regard to the credit 
                                under this section or cost-sharing 
                                reductions under section 1402 of such 
                                Act'';
                                    (III) in paragraph (3), by striking 
                                subparagraphs (C) and (F); and
                                    (IV) in paragraph (3)(E), by 
                                striking ``necessary'' and all that 
                                follows; and
                            (iii) in subsection (g), by striking ``, 
                        including'' and all that follows through ``of 
                        the credit'';
                    (B) in section 280C, by striking subsection (g) 
                (relating to credit for health insurance premiums);
                    (C) in section 4980H(c), by striking paragraph (3);
                    (D) in section 5000A--
                            (i) in subsection (e)(1)--
                                    (I) in subparagraph (A), by 
                                striking ``for the taxable year 
                                described in section 1412(b)(1)(B) of 
                                the Patient Protection and Affordable 
                                Care Act'' and inserting ``for the most 
                                recent taxable year for which the 
                                Secretary of Health and Human Services, 
                                after consultation with the Secretary 
                                of the Treasury, determines information 
                                is available''; and
                                    (II) in subparagraph (B)(ii), by 
                                striking ``, reduced by the amount of 
                                the credit allowable under section 36B 
                                for the taxable year (determined as if 
                                the individual was covered by a 
                                qualified health plan offered through 
                                the Exchange for the entire taxable 
                                year)''; and
                            (ii) in subsection (e)(2), by striking 
                        ``described in section 1412(b)(1)(B) of the 
                        Patient Protection and Affordable Care Act'' 
                        and inserting ``described in paragraph 
                        (1)(A)'';
                    (E) in section 6055(b)(1), by amending clause (iii) 
                to read as follows:
                            ``(iii) in the case of minimum essential 
                        coverage which consists of health insurance 
                        coverage, information concerning whether or not 
                        the coverage is a qualified health plan offered 
                        through an Exchange established under section 
                        1311 of the Patient Protection and Affordable 
                        Care Act, and''; and
                    (F) in section 6103(l)(21)(A), in the matter before 
                clause (i), by striking ``any premium tax credit under 
                section 36B or any cost-sharing reduction under section 
                1402 of the Patient Protection and Affordable Care Act 
                or''.
            (2) Fair labor standards act of 1938.--The Fair Labor 
        Standards Act of 1938 (29 U.S.C. 201 et seq.) is amended--
                    (A) in section 18B(a)--
                            (i) in paragraph (1), by inserting ``and'' 
                        after the semicolon at the end; and
                            (ii) by striking paragraph (2); and
                    (B) in section 18C(a), by striking paragraph (1).
            (3) Public health service act amendments.--Title XXVII of 
        the Public Health Service Act (42 U.S.C. 300gg et seq.) is 
        amended--
                    (A) in section 2705(l)(3)(A)--
                            (i) by striking the em dash before clause 
                        (i) and inserting ``will not result in any 
                        decrease in coverage.''; and
                            (ii) by striking clauses (i) and (ii); and
                    (B) in section 2793(c)--
                            (i) by inserting ``and'' at the end of 
                        paragraph (3);
                            (ii) by striking ``; and'' at the end of 
                        paragraph (4); and
                            (iii) by striking paragraph (5).
            (4) Patient protection and affordable care act 
        amendments.--The Patient Protection and Affordable Care Act 
        (Public Law 111-148, as amended) is amended--
                    (A) in section 1311(d)(4)--
                            (i) in subparagraph (G), by striking 
                        ``after the application of any premium tax 
                        credit'' and all that follows through ``section 
                        1402''; and
                            (ii) in subparagraph (I), by striking 
                        clause (ii);
                    (B) in section 1311(i)(3)(B), by striking ``, and 
                the availability of premium tax credits'' and all that 
                follows through ``section 1402'';
                    (C) in section 1331(d)(3)(A)(i) is amended by 
                inserting ``and section 8 of the Common Sense Deficit 
                Reduction Act of 2011 had not been enacted'' before the 
                period at the end;
                    (D) in section 1332(a)--
                            (i) in paragraph (2), by striking 
                        subparagraph (C); and
                            (ii) in paragraph (3), by striking 
                        ``premium tax credits, cost-sharing 
                        reductions'';
                    (E) in section 1334(c) by striking paragraph (3);
                    (F) in section 1401(c)(1)(A), by striking clause 
                (i);
                    (G) in section 1411--
                            (i) in subsection (a)(1)--
                                    (I) by striking ``or who is 
                                claiming a premium tax credit or 
                                reduced cost-sharing,''; and
                                    (II) by striking ``sections 
                                1312(f)(3), 1402(e), and 1412(d)'' and 
                                inserting ``section 1312(f)(3)'';
                            (ii) in subsection (a), by striking 
                        paragraph (2);
                            (iii) in subsection (b), by striking 
                        paragraphs (3) and (4); and
                            (iv) in subsection (e)--
                                    (I) in paragraph (2), by amending 
                                subparagraph (A) to read as follows:
                    ``(A) Eligibility for enrollment.--If information 
                provided by an applicant under paragraphs (1) and (2) 
                of subsection (b) is verified under subsections (c) and 
                (d) the individual's eligibility to enroll through the 
                Exchange shall be satisfied.''; and
                                    (II) in paragraph (4)(B), by 
                                striking clause (iii);
                    (H) by striking section 1412;
                    (I) in section 1413(e)(1), by striking ``, 
                including the premium tax credits under section 36B of 
                the Internal Revenue Code of 1986 and cost-sharing 
                reductions under section 1402'';
                    (J) by striking section 1415; and
                    (K) in section 2901, by striking subsection (a).
            (5) Social security act.--Section 1943(b) of the Social 
        Security Act (42 U.S.C. 1396w-3(b)) is amended--
                    (A) in paragraph (1)(C)--
                            (i) by striking ``and, if applicable, 
                        premium assistance'' and all that follows 
                        through ``section 1412 of the Patient 
                        Protection and Affordable Care Act),''; and
                            (ii) by striking ``reduced cost-sharing for 
                        eligible individuals under section 1402 of the 
                        Patient Protection and Affordable Care Act, and 
                        any other'' and inserting ``any'';
                    (B) in paragraph (1)(D), by striking ``, child 
                health assistance, or premium assistance,'' and 
                inserting ``or child health assistance,'';
                    (C) by striking paragraph (2); and
                    (D) in paragraph (4), by striking ``and who is 
                eligible to receive premium credit assistance for the 
                purchase of a qualified health plan under section 36B 
                of the Internal Revenue Code of 1986''.

SEC. 13. TREATMENT OF INDIVIDUAL MANDATE.

    Section 1311(d)(4)(H) of the Patient Protection and Affordable Care 
Act is amended--
            (1) in clause (i), by striking ``or'' after the semicolon 
        at the end;
            (2) in clause (ii), by inserting ``or'' after the semicolon 
        at the end; and
            (3) by adding at the end the following new clause:
                            ``(iii) the individual would have qualified 
                        for premium assistance under section 36B of the 
                        Internal Revenue Code of 1986, medical 
                        assistance under title XIX of the Social 
                        Security Act, child health assistance under 
                        title XXI of such Act, or reduced cost-sharing 
                        under section 1402, but for the enactment of 
                        the Common Sense Deficit Reduction Act of 
                        2011;''.

SEC. 14. REPEAL OF CLASS ACT.

    (a) In General.--Title XXXII of the Public Health Service Act (42 
U.S.C. 30011 et seq.) is repealed.
    (b) Conforming Amendments.--
            (1) Section 1902(a) of the Social Security Act (42 U.S.C. 
        1396a(a)) is amended--
                    (A) in paragraph (80), by inserting ``and'' after 
                the semicolon at the end; and
                    (B) by striking paragraphs (81) and (82).
            (2) Section 8002 of the Patient Protection and Affordable 
        Care Act is amended by striking subsections (c) and (f).
            (3) Section 6021(d) of the Deficit Reduction Act of 2005 
        (42 U.S.C. 1396p note) is amended--
                    (A) in paragraph (2)(A)--
                            (i) in clause (ii), by inserting ``and'' at 
                        the end;
                            (ii) in clause (iii), by striking ``; and'' 
                        at the end and inserting a period; and
                            (iii) by striking clause (iv); and
                    (B) in paragraph (3), by striking ``2015'' and 
                inserting ``2012''.
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