[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3922 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 262
115th CONGRESS
  1st Session
                                H. R. 3922

                      [Report No. 115-359, Part I]

  To extend funding for certain public health programs, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 3, 2017

  Mr. Walden 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

                            October 19, 2017

  Reported from the Committee on Energy and Commerce with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

                            October 19, 2017

The Committee on Ways and Means discharged; committed to the Committee 
 of the Whole House on the State of the Union and ordered to be printed
[For text of introduced bill, see copy of bill as introduced on October 
                                3, 2017]


_______________________________________________________________________

                                 A BILL


 
  To extend funding for certain public health programs, and for other 
                               purposes.


 


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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Community Health And Medical 
Professionals Improve Our Nation Act of 2017'' or the ``CHAMPION Act''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.

              TITLE I--EXTENSION OF PUBLIC HEALTH PROGRAMS

Sec. 101. Extension for community health centers and the National 
                            Health Service Corps.
Sec. 102. Extension for special diabetes programs.
Sec. 103. Reauthorization of program of payments to teaching health 
                            centers that operate graduate medical 
                            education programs.
Sec. 104. Extension for family-to-family health information centers.
Sec. 105. Youth empowerment program; personal responsibility education.

                           TITLE II--OFFSETS

Sec. 201. Providing for qualified health plan grace period requirements 
                            for issuer receipt of advance payments of 
                            cost-sharing reductions and premium tax 
                            credits that are more consistent with State 
                            law grace period requirements.
Sec. 202. Prevention and Public Health Fund.

              TITLE I--EXTENSION OF PUBLIC HEALTH PROGRAMS

SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS AND THE NATIONAL 
              HEALTH SERVICE CORPS.

    (a) Community Health Centers Funding.--Section 10503(b)(1)(E) of 
the Patient Protection and Affordable Care Act (42 U.S.C. 254b-
2(b)(1)(E)) is amended by striking ``2017'' and inserting ``2019''.
    (b) Other Community Health Centers Provisions.--Section 330 of the 
Public Health Service Act (42 U.S.C. 254b) is amended--
            (1) in subsection (b)(1)(A)(ii), by striking ``abuse'' and 
        inserting ``use disorder'';
            (2) in subsection (b)(2)(A), by striking ``abuse'' and 
        inserting ``use disorder'';
            (3) in subsection (c)--
                    (A) in paragraph (1), by striking subparagraphs (B) 
                through (D);
                    (B) by striking ``(1) In general'' and all that 
                follows through ``The Secretary'' and inserting the 
                following:
            ``(1) Centers.--The Secretary''; and
                    (C) in paragraph (1), as amended, by redesignating 
                clauses (i) through (v) as subparagraphs (A) through 
                (E) and moving the margin of each of such redesignated 
                subparagraph 2 ems to the left;
            (4) by striking subsection (d) and inserting the following:
    ``(d) Improving Quality of Care.--
            ``(1) Supplemental awards.--The Secretary may award 
        supplemental grant funds to health centers funded under this 
        section to implement evidence-based models for increasing 
        access to high-quality primary care services, which may include 
        models related to--
                    ``(A) improving the delivery of care for 
                individuals with multiple chronic conditions;
                    ``(B) workforce configuration;
                    ``(C) reducing the cost of care;
                    ``(D) enhancing care coordination;
                    ``(E) expanding the use of telehealth and 
                technology-enabled collaborative learning and capacity 
                building models;
                    ``(F) care integration, including integration of 
                behavioral health, mental health, or substance use 
                disorder services; and
                    ``(G) addressing emerging public health or 
                substance use disorder issues to meet the health needs 
                of the population served by the health center.
            ``(2) Sustainability.--In making supplemental awards under 
        this subsection, the Secretary may consider whether the health 
        center involved has submitted a plan for continuing the 
        activities funded under this subsection after supplemental 
        funding is expended.
            ``(3) Special consideration.--The Secretary may give 
        special consideration to applications for supplemental funding 
        under this subsection that seek to address significant barriers 
        to access to care in areas with a greater shortage of health 
        care providers and health services relative to the national 
        average.'';
            (5) in subsection (e)(1)--
                    (A) in subparagraph (B)--
                            (i) by striking ``2 years'' and inserting 
                        ``1 year''; and
                            (ii) by adding at the end the following: 
                        ``The Secretary shall not make a grant under 
                        this paragraph unless the applicant provides 
                        assurances to the Secretary that within 120 
                        days of receiving grant funding for the 
                        operation of the health center, the applicant 
                        will submit, for approval by the Secretary, an 
                        implementation plan to meet the requirements of 
                        subsection (l)(3). The Secretary may extend 
                        such 120-day period for achieving compliance 
                        upon a demonstration of good cause by the 
                        health center.''; and
                    (B) in subparagraph (C)--
                            (i) in the subparagraph heading, by 
                        striking ``and plans'';
                            (ii) by striking ``or plan (as described in 
                        subparagraphs (B) and (C) of subsection 
                        (c)(1))'';
                            (iii) by striking ``or plan, including the 
                        purchase'' and inserting the following: 
                        ``including--
                            ``(i) the purchase'';
                            (iv) by inserting ``, which may include 
                        data and information systems'' after ``of 
                        equipment'';
                            (v) by striking the period at the end and 
                        inserting a semicolon; and
                            (vi) by adding at the end the following:
                            ``(ii) the provision of training and 
                        technical assistance; and
                            ``(iii) other activities that--
                                    ``(I) reduce costs associated with 
                                the provision of health services;
                                    ``(II) improve access to, and 
                                availability of, health services 
                                provided to individuals served by the 
                                centers;
                                    ``(III) enhance the quality and 
                                coordination of health services; or
                                    ``(IV) improve the health status of 
                                communities.'';
            (6) in subsection (e)(5)(B)--
                    (A) in the heading of subparagraph (B), by striking 
                ``and plans''; and
                    (B) by striking ``and subparagraphs (B) and (C) of 
                subsection (c)(1) to a health center or to a network or 
                plan'' and inserting ``to a health center or to a 
                network'';
            (7) by striking subsection (s);
            (8) by redesignating subsections (g) through (r) as 
        subsections (h) through (s), respectively;
            (9) by inserting after subsection (f), the following:
    ``(g) New Access Points and Expanded Services.--
            ``(1) Approval of new access points.--
                    ``(A) In general.--The Secretary may approve 
                applications for grants under subparagraph (A) or (B) 
                of subsection (e)(1) to establish new delivery sites.
                    ``(B) Special consideration.--In carrying out 
                subparagraph (A), the Secretary may give special 
                consideration to applicants that have demonstrated the 
                new delivery site will be located within a sparsely 
                populated area, or an area which has a level of unmet 
                need that is higher relative to other applicants.
                    ``(C) Consideration of applications.--In carrying 
                out subparagraph (A), the Secretary shall approve 
                applications for grants under subparagraphs (A) and (B) 
                of subsection (e)(1) in such a manner that the ratio of 
                the medically underserved populations in rural areas 
                which may be expected to use the services provided by 
                the applicants involved to the medically underserved 
                populations in urban areas which may be expected to use 
                the services provided by the applicants is not less 
                than two to three or greater than three to two.
                    ``(D) Service area overlap.--If in carrying out 
                subparagraph (A) the applicant proposes to serve an 
                area that is currently served by another health center 
                funded under this section, the Secretary may consider 
                whether the award of funding to an additional health 
                center in the area can be justified based on the unmet 
                need for additional services within the catchment area.
            ``(2) Approval of expanded service applications.--
                    ``(A) In general.--The Secretary may approve 
                applications for grants under subparagraph (A) or (B) 
                of subsection (e)(1) to expand the capacity of the 
                applicant to provide required primary health services 
                described in subsection (b)(1) or additional health 
                services described in subsection (b)(2).
                    ``(B) Priority expansion projects.--In carrying out 
                subparagraph (A), the Secretary may give special 
                consideration to expanded service applications that 
                seek to address emerging public health or behavioral 
                health, mental health, or substance abuse issues 
                through increasing the availability of additional 
                health services described in subsection (b)(2) in an 
                area in which there are significant barriers to 
                accessing care.
                    ``(C) Consideration of applications.--In carrying 
                out subparagraph (A), the Secretary shall approve 
                applications for applicants in such a manner that the 
                ratio of the medically underserved populations in rural 
                areas which may be expected to use the services 
                provided by the applicants involved to the medically 
                underserved populations in urban areas which may be 
                expected to use the services provided by such 
                applicants is not less than two to three or greater 
                than three to two.'';
            (10) in subsection (i) (as so redesignated)--
                    (A) in paragraph (1), by striking ``and children 
                and youth at risk of homelessness'' and inserting ``, 
                children and youth at risk of homelessness, homeless 
                veterans, and veterans at risk of homelessness''; and
                    (B) in paragraph (5)--
                            (i) by striking subparagraph (B);
                            (ii) by redesignating subparagraph (C) as 
                        subparagraph (B); and
                            (iii) in subparagraph (B) (as so 
                        redesignated)--
                                    (I) in the subparagraph heading, by 
                                striking ``abuse'' and inserting ``use 
                                disorder''; and
                                    (II) by striking ``abuse'' and 
                                inserting ``use disorder'';
            (11) in subsection (l) (as so redesignated)--
                    (A) in paragraph (2)--
                            (i) in the paragraph heading, by inserting 
                        ``unmet'' before ``need'';
                            (ii) in the matter preceding subparagraph 
                        (A), by inserting ``and an application for a 
                        grant under subsection (g)'' after ``subsection 
                        (e)(1)'';
                            (iii) in subparagraph (A), by inserting 
                        ``unmet'' before ``need for health services'';
                            (iv) in subparagraph (B), by striking 
                        ``and'' at the end;
                            (v) in subparagraph (C), by striking the 
                        period at the end and inserting ``; and''; and
                            (vi) by adding after subparagraph (C) the 
                        following:
                    ``(D) in the case of an application for a grant 
                pursuant to subsection (g)(1), a demonstration that the 
                applicant has consulted with appropriate State and 
                local government agencies, and health care providers 
                regarding the need for the health services to be 
                provided at the proposed delivery site.'';
                    (B) in paragraph (3)--
                            (i) in the matter preceding subparagraph 
                        (A), by inserting ``or subsection (g)'' after 
                        ``subsection (e)(1)(B)'';
                            (ii) in subparagraph (B), by striking ``in 
                        the catchment area of the center'' and 
                        inserting ``, including other health care 
                        providers that provide care within the 
                        catchment area, local hospitals, and specialty 
                        providers in the catchment area of the center, 
                        to provide access to services not available 
                        through the health center and to reduce the 
                        non-urgent use of hospital emergency 
                        departments'';
                            (iii) in subparagraph (H)(ii), by inserting 
                        ``who shall be directly employed by the 
                        center'' after ``approves the selection of a 
                        director for the center'';
                            (iv) in subparagraph (L), by striking 
                        ``and'' at the end;
                            (v) in subparagraph (M), by striking the 
                        period and inserting ``; and''; and
                            (vi) by inserting after subparagraph (M), 
                        the following:
                    ``(N) the center has written policies and 
                procedures in place to ensure the appropriate use of 
                Federal funds in compliance with applicable Federal 
                statutes, regulations, and the terms and conditions of 
                the Federal award.''; and
                    (C) by striking paragraph (4);
            (12) in subsection (m) (as so redesignated), by adding at 
        the end the following: ``Funds expended to carry out activities 
        under this subsection and operational support activities under 
        subsection (n) shall not exceed 3 percent of the amount 
        appropriated for this section for the fiscal year involved.'';
            (13) in subsection (q) (as so redesignated), by striking 
        ``grants for new health centers under subsections (c) and (e)'' 
        and inserting ``operating grants under subsection (e), 
        applications for new access points and expanded service 
        pursuant to subsection (g)'';
            (14) in subsection (r)(4) (as so redesignated), by adding 
        at the end the following: ``A waiver provided by the Secretary 
        under this paragraph may not remain in effect for more than 1 
        year and may not be extended after such period. An entity may 
        not receive more than one waiver under this paragraph in 
        consecutive years.'';
            (15) in subsection (s)(3) (as so redesignated)--
                    (A) by striking ``appropriate committees of 
                Congress a report concerning the distribution of funds 
                under this section'' and inserting the following: 
                ``Committee on Health, Education, Labor, and Pensions 
                of the Senate, and the Committee on Energy and Commerce 
                of the House of Representatives, a report including, at 
                a minimum--
                    ``(A) the distribution of funds for carrying out 
                this section'';
                    (B) by striking ``populations. Such report shall 
                include an assessment'' and inserting the following: 
                ``populations;
                    ``(B) an assessment'';
                    (C) by striking ``and the rationale for any 
                substantial changes in the distribution of funds.'' and 
                inserting a semicolon; and
                    (D) by adding at the end the following:
                    ``(C) the distribution of awards and funding for 
                new or expanded services in each of rural areas and 
                urban areas;
                    ``(D) the distribution of awards and funding for 
                establishing new access points, and the number of new 
                access points created;
                    ``(E) the amount of unexpended funding for loan 
                guarantees and loan guarantee authority under title 
                XVI;
                    ``(F) the rationale for any substantial changes in 
                the distribution of funds;
                    ``(G) the rate of closures for health centers and 
                access points;
                    ``(H) the number and reason for any grants awarded 
                pursuant to subsection (e)(1)(B); and
                    ``(I) the number and reason for any waivers 
                provided pursuant to subsection (r)(4).''; and
            (16) in subsection (s) (as so redesignated) by adding at 
        the end the following new paragraph:
            ``(5) Funding for participation of health centers in all of 
        us research program.--In addition to any amounts made available 
        pursuant to subsection (d) of this section, paragraph (1) of 
        this subsection, section 402A of this Act, or section 10503 of 
        the Patient Protection and Affordable Care Act, there is 
        authorized to be appropriated, and there is appropriated, out 
        of any monies in the Treasury not otherwise appropriated, to 
        the Secretary $25,000,000 for fiscal year 2018 to support the 
        participation of health centers in the All of Us Research 
        Program under the Precision Medicine Initiative under section 
        498E of this Act.''.
    (c) National Health Service Corps.--Section 10503(b)(2)(E) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(2)(E)) 
is amended by striking ``2017'' and inserting ``2019''.
    (d) Application.--Amounts appropriated pursuant to this section for 
fiscal year 2018 or 2019 are subject to the requirements contained in 
Public Law 115-31 for funds for programs authorized under sections 330 
through 340 of the Public Health Service Act (42 U.S.C. 254b-256).
    (e) Conforming Amendments.--Section 3014(h) of title 18, United 
States Code, is amended--
            (1) in paragraph (1), by striking ``, as amended by section 
        221 of the Medicare Access and CHIP Reauthorization Act of 
        2015,''; and
            (2) in paragraph (4), by inserting ``and section 101(d) of 
        the Community Health And Medical Professionals Improve Our 
        Nation Act of 2017'' after ``section 221(c) of the Medicare 
        Access and CHIP Reauthorization Act of 2015''.

SEC. 102. EXTENSION FOR SPECIAL DIABETES PROGRAMS.

    (a) Special Diabetes Program for Type I Diabetes.--Section 
330B(b)(2)(C) of the Public Health Service Act (42 U.S.C. 254c-
2(b)(2)(C)) is amended by striking ``2017'' and inserting ``2019''.
    (b) Special Diabetes Program for Indians.--Section 330C(c)(2) of 
the Public Health Service Act (42 U.S.C. 254c-3(c)(2)) is amended--
            (1) in subparagraph (C), by striking ``and'' at the end;
            (2) in subparagraph (D), by striking the period at the end 
        and inserting ``and $112,500,000 for the period consisting of 
        the second, third, and fourth quarters of fiscal year 2018; 
        and''; and
            (3) by adding at the end the following:
                    ``(E) $150,000,000 for fiscal year 2019.''.

SEC. 103. REAUTHORIZATION OF PROGRAM OF PAYMENTS TO TEACHING HEALTH 
              CENTERS THAT OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS.

    (a) Payments.--Subsection (a) of section 340H of the Public Health 
Service Act (42 U.S.C. 256h) is amended to read as follows:
    ``(a) Payments.--
            ``(1) In general.--Subject to subsection (h)(2), the 
        Secretary shall make payments under this section for direct 
        expenses and indirect expenses to qualified teaching health 
        centers that are listed as sponsoring institutions by the 
        relevant accrediting body for--
                    ``(A) maintenance of existing approved graduate 
                medical residency training programs;
                    ``(B) expansion of existing approved graduate 
                medical residency training programs; and
                    ``(C) establishment of new approved graduate 
                medical residency training programs, as appropriate.
            ``(2) Priority.--In making payments pursuant to paragraph 
        (1)(C), the Secretary shall give priority to qualified teaching 
        health centers that--
                    ``(A) serve a health professional shortage area 
                with a designation in effect under section 332 or a 
                medically underserved community (as defined in section 
                799B); or
                    ``(B) are located in a rural area (as defined in 
                section 1886(d)(2)(D) of the Social Security Act).''.
    (b) Funding.--Subsection (g) of section 340H of the Public Health 
Service Act (42 U.S.C. 256h) is amended--
            (1) by striking ``To carry out'' and inserting the 
        following:
            ``(1) In general.--To carry out'';
            (2) by striking ``and $15,000,000 for the first quarter of 
        fiscal year 2018'' and inserting ``, $15,000,000 for the first 
        quarter of fiscal year 2018, $111,500,000 for the period 
        consisting of the second, third, and fourth quarters of fiscal 
        year 2018, and $126,500,000 for fiscal year 2019, to remain 
        available until expended''; and
            (3) by adding at the end the following:
            ``(2) Administrative expenses.--Of the amount made 
        available to carry out this section for any fiscal year, the 
        Secretary may not use more than 5 percent of such amount for 
        the expenses of administering this section.''.
    (c) Annual Reporting.--Subsection (h)(1) of section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended--
            (1) by redesignating subparagraph (D) as subparagraph (H); 
        and
            (2) by inserting after subparagraph (C) the following:
                    ``(D) The number of patients treated by residents 
                described in paragraph (4).
                    ``(E) The number of visits by patients treated by 
                residents described in paragraph (4).
                    ``(F) Of the number of residents described in 
                paragraph (4) who completed their residency training at 
                the end of such residency academic year, the number and 
                percentage of such residents entering primary care 
                practice (meaning any of the areas of practice listed 
                in the definition of a primary care residency program 
                in section 749A).
                    ``(G) Of the number of residents described in 
                paragraph (4) who completed their residency training at 
                the end of such residency academic year, the number and 
                percentage of such residents who entered practice at a 
                health care facility--
                            ``(i) primarily serving a health 
                        professional shortage area with a designation 
                        in effect under section 332 or a medically 
                        underserved community (as defined in section 
                        799B); or
                            ``(ii) located in a rural area (as defined 
                        in section 1886(d)(2)(D) of the Social Security 
                        Act).''.
    (d) Report on Training Costs.--Not later than March 31, 2019, the 
Secretary of Health and Human Services shall submit to the Congress a 
report on the direct graduate expenses of approved graduate medical 
residency training programs, and the indirect expenses associated with 
the additional costs of teaching residents, of qualified teaching 
health centers (as such terms are used or defined in section 340H of 
the Public Health Service Act (42 U.S.C. 256h)).
    (e) Definition.--Subsection (j) of section 340H of the Public 
Health Service Act (42 U.S.C. 256h) is amended--
            (1) by redesignating paragraphs (2) and (3) as paragraphs 
        (3) and (4), respectively; and
            (2) by inserting after paragraph (1) the following:
            ``(2) New approved graduate medical residency training 
        program.--The term `new approved graduate medical residency 
        training program' means an approved graduate medical residency 
        training program for which the sponsoring qualified teaching 
        health center has not received a payment under this section for 
        a previous fiscal year (other than pursuant to subsection 
        (a)(1)(C)).''.
    (f) Technical Correction.--Subsection (f) of section 340H (42 
U.S.C. 256h) is amended by striking ``hospital'' each place it appears 
and inserting ``teaching health center''.
    (g) Payments for Previous Fiscal Years.--The provisions of section 
340H of the Public Health Service Act (42 U.S.C. 256h), as in effect on 
the day before the date of enactment of this Act, shall continue to 
apply with respect to payments under such section for fiscal years 
before fiscal year 2018.

SEC. 104. EXTENSION FOR FAMILY-TO-FAMILY HEALTH INFORMATION CENTERS.

    Section 501(c) of the Social Security Act (42 U.S.C. 701(c)) is 
amended--
            (1) in paragraph (1)(A)--
                    (A) in clause (v), by striking ``and'' at the end;
                    (B) in clause (vi), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by adding at the end the following new clause:
            ``(vii) $6,000,000 for each of fiscal years 2018 and 
        2019.'';
            (2) in paragraph (3)(C), by inserting before the period the 
        following: ``, and with respect to fiscal years 2018 and 2019, 
        such centers shall also be developed in all territories and at 
        least one such center shall be developed for Indian tribes''; 
        and
            (3) by amending paragraph (5) to read as follows:
    ``(5) For purposes of this subsection--
            ``(A) the term `Indian tribe' has the meaning given such 
        term in section 4 of the Indian Health Care Improvement Act (25 
        U.S.C. 1603);
            ``(B) the term `State' means each of the 50 States and the 
        District of Columbia; and
            ``(C) the term `territory' means Puerto Rico, Guam, 
        American Samoa, the Virgin Islands, and the Northern Mariana 
        Islands.''.

SEC. 105. YOUTH EMPOWERMENT PROGRAM; PERSONAL RESPONSIBILITY EDUCATION.

    (a) Youth Empowerment Program.--
            (1) In general.--Section 510 of the Social Security Act (42 
        U.S.C. 710) is amended to read as follows:

``SEC. 510. YOUTH EMPOWERMENT PROGRAM.

    ``(a) In General.--
            ``(1) Allotments to states.--For the purpose described in 
        subsection (b), the Secretary shall, for each of fiscal years 
        2018 and 2019, allot to each State which has transmitted an 
        application for the fiscal year under section 505(a) an amount 
        equal to the product of--
                    ``(A) the amount appropriated pursuant to 
                subsection (e)(1) for the fiscal year, minus the amount 
                reserved under subsection (e)(2) for the fiscal year; 
                and
                    ``(B) the proportion that the number of low-income 
                children in the State bears to the total of such 
                numbers of children for all the States.
            ``(2) Other allotments.--
                    ``(A) Other entities.--For the purpose described in 
                subsection (b), the Secretary shall, for each of fiscal 
                years 2018 and 2019, for any State which has not 
                transmitted an application for the fiscal year under 
                section 505(a), allot to one or more entities in the 
                State the amount that would have been allotted to the 
                State under paragraph (1) if the State had submitted 
                such an application.
                    ``(B) Process.--The Secretary shall select the 
                recipients of allotments under subparagraph (A) by 
                means of a competitive grant process under which--
                            ``(i) not later than 30 days after the 
                        deadline for the State involved to submit an 
                        application for the fiscal year under section 
                        505(a), the Secretary publishes a notice 
                        soliciting grant applications; and
                            ``(ii) not later than 120 days after such 
                        deadline, all such applications must be 
                        submitted.
    ``(b) Purpose.--
            ``(1) In general.--Except for research under paragraph (5) 
        and information collection and reporting under paragraph (6), 
        the purpose of an allotment under subsection (a) to a State (or 
        to another entity in the State pursuant to subsection (a)(2)) 
        is to enable the State or other entity to implement education 
        exclusively on sexual risk avoidance (meaning voluntarily 
        refraining from sexual activity).
            ``(2) Required components.--Education on sexual risk 
        avoidance pursuant to an allotment under this section shall--
                    ``(A) ensure that the unambiguous and primary 
                emphasis and context for each topic described in 
                paragraph (3) is a message to youth that normalizes the 
                optimal health behavior of avoiding nonmarital sexual 
                activity;
                    ``(B) be medically accurate and complete;
                    ``(C) be age-appropriate; and
                    ``(D) be based on adolescent learning and 
                developmental theories for the age group receiving the 
                education.
            ``(3) Topics.--Education on sexual risk avoidance pursuant 
        to an allotment under this section shall address each of the 
        following topics:
                    ``(A) The holistic individual and societal benefits 
                associated with personal responsibility, self-
                regulation, goal setting, healthy decisionmaking, and a 
                focus on the future.
                    ``(B) The advantage of refraining from nonmarital 
                sexual activity in order to improve the future 
                prospects and physical and emotional health of youth.
                    ``(C) The increased likelihood of avoiding poverty 
                when youth attain self-sufficiency and emotional 
                maturity before engaging in sexual activity.
                    ``(D) The foundational components of healthy 
                relationships and their impact on the formation of 
                healthy marriages and safe and stable families.
                    ``(E) How other youth risk behaviors, such as drug 
                and alcohol usage, increase the risk for teen sex.
                    ``(F) How to resist and avoid, and receive help 
                regarding, sexual coercion and dating violence, 
                recognizing that even with consent teen sex remains a 
                youth risk behavior.
            ``(4) Contraception.--Education on sexual risk avoidance 
        pursuant to an allotment under this section shall ensure that--
                    ``(A) any information provided on contraception is 
                medically accurate and ensures that students understand 
                that contraception offers physical risk reduction, but 
                not risk elimination; and
                    ``(B) the education does not include 
                demonstrations, simulations, or distribution of 
                contraceptive devices.
            ``(5) Research.--
                    ``(A) In general.--A State or other entity 
                receiving an allotment pursuant to subsection (a) may 
                use up to 20 percent of such allotment to build the 
                evidence base for sexual risk avoidance education by 
                conducting or supporting research.
                    ``(B) Requirements.--Any research conducted or 
                supported pursuant to subparagraph (A) shall be--
                            ``(i) rigorous;
                            ``(ii) evidence-based; and
                            ``(iii) designed and conducted by 
                        independent researchers who have experience in 
                        conducting and publishing research in peer-
                        reviewed outlets.
            ``(6) Information collection and reporting.--A State or 
        other entity receiving an allotment pursuant to subsection (a) 
        shall, as specified by the Secretary--
                    ``(A) collect information on the programs and 
                activities funded through the allotment; and
                    ``(B) submit reports to the Secretary on the data 
                from such programs and activities.
    ``(c) National Evaluation.--
            ``(1) In general.--The Secretary shall--
                    ``(A) in consultation with appropriate State and 
                local agencies, conduct one or more rigorous 
                evaluations of the education funded through this 
                section and associated data; and
                    ``(B) submit a report to the Congress on the 
                results of such evaluations, together with a summary of 
                the information collected pursuant to subsection 
                (b)(6).
            ``(2) Consultation.--In conducting the evaluations required 
        by paragraph (1), including the establishment of evaluation 
        methodologies, the Secretary shall consult with relevant 
        stakeholders.
    ``(d) Applicability of Certain Provisions.--
            ``(1) Sections 503, 507, and 508 apply to allotments under 
        subsection (a) to the same extent and in the same manner as 
        such sections apply to allotments under section 502(c).
            ``(2) Sections 505 and 506 apply to allotments under 
        subsection (a) to the extent determined by the Secretary to be 
        appropriate.
    ``(e) Funding.--
            ``(1) In general.--To carry out this section, there is 
        appropriated, out of any money in the Treasury not otherwise 
        appropriated, $75,000,000 for each of fiscal years 2018 and 
        2019.
            ``(2) Reservation.--The Secretary shall reserve, for each 
        of fiscal years 2018 and 2019, not more than 20 percent of the 
        amount appropriated pursuant to paragraph (1) for administering 
        the program under this section, including the conducting of 
        national evaluations and the provision of technical assistance 
        to the recipients of allotments.''.
            (2) Effective date.--The amendment made by this section 
        takes effect on October 1, 2017.
    (b) Personal Responsibility Education.--
            (1) In general.--Section 513 of the Social Security Act (42 
        U.S.C. 713) is amended--
                    (A) in subsection (a)(1)(A), by striking ``2017'' 
                and inserting ``2019''; and
                    (B) in subsection (a)(4)--
                            (i) in subparagraph (A), by striking 
                        ``2017'' each place it appears and inserting 
                        ``2019''; and
                            (ii) in subparagraph (B)--
                                    (I) in the subparagraph heading, by 
                                striking ``3-year grants'' and 
                                inserting ``Competitive prep grants''; 
                                and
                                    (II) in clause (i), by striking 
                                ``solicit applications to award 3-year 
                                grants in each of fiscal years 2012 
                                through 2017'' and inserting ``continue 
                                through fiscal year 2019 grants awarded 
                                for any of fiscal years 2015 through 
                                2017'';
                    (C) in subsection (c)(1), by inserting after 
                ``youth with HIV/AIDS,'' the following: ``victims of 
                human trafficking,''; and
                    (D) in subsection (f), by striking ``2017'' and 
                inserting ``2019''.
            (2) Effective date.--The amendments made by this subsection 
        take effect on October 1, 2017.

                           TITLE II--OFFSETS

SEC. 201. PROVIDING FOR QUALIFIED HEALTH PLAN GRACE PERIOD REQUIREMENTS 
              FOR ISSUER RECEIPT OF ADVANCE PAYMENTS OF COST-SHARING 
              REDUCTIONS AND PREMIUM TAX CREDITS THAT ARE MORE 
              CONSISTENT WITH STATE LAW GRACE PERIOD REQUIREMENTS.

    (a) In General.--Section 1412(c) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18082(c)) is amended--
            (1) in paragraph (2)--
                    (A) in subparagraph (B)(iv)(II), by striking ``a 3-
                month grace period'' and inserting ``a grace period 
                specified in subparagraph (C)''; and
                    (B) by adding at the end the following new 
                subparagraphs:
                    ``(C) Grace period specified.--For purposes of 
                subparagraph (B)(iv)(II), the grace period specified in 
                this subparagraph is--
                            ``(i) for plan years beginning before 
                        January 1, 2018, a 3-month grace period; and
                            ``(ii) for plan years beginning on or after 
                        January 1, 2018--
                                    ``(I) in the case of an Exchange 
                                operating in a State that has a State 
                                law grace period in place, such State 
                                law grace period; and
                                    ``(II) in the case of an Exchange 
                                operating in a State that does not have 
                                a State law grace period in place, a 1-
                                month grace period.
                    ``(D) State law grace period.--For purposes of 
                subparagraph (C), the term `State law grace period' 
                means, with respect to a State, a grace period for 
                nonpayment of premiums before discontinuing coverage 
                that is applicable under the State law to health 
                insurance coverage offered in the individual market of 
                the State.''; and
            (2) in paragraph (3), by adding at the end the following 
        new sentence: ``The requirements of paragraph (2)(B)(iv) apply 
        to an issuer of a qualified health plan receiving an advanced 
        payment under this paragraph in the same manner and to the same 
        extent that such requirements apply to an issuer of a qualified 
        health plan receiving an advanced payment under paragraph 
        (2)(A).''.
    (b) Report on Aligning Grace Periods for Medicaid, Medicare, and 
Exchange Plans.--Not later than two years after the date of full 
implementation of subsection (a), the Comptroller General of the United 
States shall submit to Congress a report on--
            (1) the effects on consumers of aligning grace periods 
        applied under the Medicaid program under title XIX of the 
        Social Security Act, under the Medicare program under parts C 
        and D of title XVIII of such Act, and under qualified health 
        plans offered on an Exchange established under title I of the 
        Patient Protection and Affordable Care Act, including the 
        extent to which such an alignment of grace periods may help to 
        avoid enrollment status confusion for individuals under such 
        Medicaid program, Medicare program, and qualified health plans; 
        and
            (2) the extent to which such an alignment of grace periods 
        may reduce fraud, waste, and abuse under the Medicaid program.

SEC. 202. PREVENTION AND PUBLIC HEALTH FUND.

    Section 4002(b) of the Patient Protection and Affordable Care Act 
(42 U.S.C. 300u-11(b)) is amended by striking paragraphs (3) through 
(8) and inserting the following new paragraphs:
            ``(3) for fiscal year 2018, $900,000,000;
            ``(4) for fiscal year 2019, $500,000,000;
            ``(5) for fiscal year 2020, $500,000,000;
            ``(6) for fiscal year 2021, $500,000,000;
            ``(7) for fiscal year 2022, $500,000,000;
            ``(8) for fiscal year 2023, $500,000,000;
            ``(9) for fiscal year 2024, $500,000,000;
            ``(10) for fiscal year 2025, $750,000,000;
            ``(11) for fiscal year 2026, $1,000,000,000; and
            ``(12) for fiscal year 2027 and each fiscal year 
        thereafter, $2,000,000,000.''.
                                                 Union Calendar No. 262

115th CONGRESS

  1st Session

                               H. R. 3922

                      [Report No. 115-359, Part I]

_______________________________________________________________________

                                 A BILL

  To extend funding for certain public health programs, and for other 
                               purposes.

_______________________________________________________________________

                            October 19, 2017

  Reported from the Committee on Energy and Commerce with an amendment

                            October 19, 2017

The Committee on Ways and Means discharged; committed to the Committee 
 of the Whole House on the State of the Union and ordered to be printed