[Congressional Record Volume 163, Number 125 (Tuesday, July 25, 2017)]
[Senate]
[Pages S4197-S4199]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 267. Mr. McCONNELL proposed an amendment to the bill H.R. 1628, to 
provide for reconciliation pursuant to title II of the concurrent 
resolution on the budget for fiscal year 2017; as follows:


[[Page S4198]]


  

       Strike all after the first word and insert the following:

     1. SHORT TITLE.

       This Act may be cited as the ``Obamacare Repeal 
     Reconciliation Act of 2017''.

                                TITLE I

     SEC. 101. RECAPTURE EXCESS ADVANCE PAYMENTS OF PREMIUM TAX 
                   CREDITS.

       Subparagraph (B) of section 36B(f)(2) of the Internal 
     Revenue Code of 1986 is amended by adding at the end the 
     following new clause:
       ``(iii) Nonapplicability of limitation.--This subparagraph 
     shall not apply to taxable years ending after December 31, 
     2017, and before January 1, 2020.''.

     SEC. 102. PREMIUM TAX CREDIT.

       (a) Premium Tax Credit.--
       (1) Repeal.--
       (A) In general.--Subpart C of part IV of subchapter A of 
     chapter 1 of the Internal Revenue Code of 1986 is amended by 
     striking section 36B.
       (B) Effective date.--The amendment made by this paragraph 
     shall apply to taxable years beginning after December 31, 
     2019.
       (b) Repeal of Eligibility Determinations.--
       (1) In general.--The following sections of the Patient 
     Protection and Affordable Care Act are repealed:
       (A) Section 1411 (other than subsection (i), the last 
     sentence of subsection (e)(4)(A)(ii), and such provisions of 
     such section solely to the extent related to the application 
     of the last sentence of subsection (e)(4)(A)(ii)).
       (B) Section 1412.
       (2) Effective date.--The repeals in paragraph (1) shall 
     take effect on January 1, 2020.
       (c) Protecting Americans by Repeal of Disclosure Authority 
     To Carry Out Eligibility Requirements for Certain Programs.--
       (1) In general.--Paragraph (21) of section 6103(l) of the 
     Internal Revenue Code of 1986 is amended by adding at the end 
     the following new subparagraph:
       ``(D) Termination.--No disclosure may be made under this 
     paragraph after December 31, 2019.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall take effect on January 1, 2020.

     SEC. 103. SMALL BUSINESS TAX CREDIT.

       (a) Sunset.--
       (1) In general.--Section 45R of the Internal Revenue Code 
     of 1986 is amended by adding at the end the following new 
     subsection:
       ``(j) Shall Not Apply.--This section shall not apply with 
     respect to amounts paid or incurred in taxable years 
     beginning after December 31, 2019.''.
       (2) Effective date.--The amendment made by this subsection 
     shall apply to taxable years beginning after December 31, 
     2019.

     SEC. 104. INDIVIDUAL MANDATE.

       (a) In General.--Section 5000A(c) of the Internal Revenue 
     Code of 1986 is amended--
       (1) in paragraph (2)(B)(iii), by striking ``2.5 percent'' 
     and inserting ``Zero percent'', and
       (2) in paragraph (3)--
       (A) by striking ``$695'' in subparagraph (A) and inserting 
     ``$0'', and
       (B) by striking subparagraph (D).
       (b) Effective Date.--The amendments made by this section 
     shall apply to months beginning after December 31, 2015.

     SEC. 105. EMPLOYER MANDATE.

       (a) In General.--
       (1) Paragraph (1) of section 4980H(c) of the Internal 
     Revenue Code of 1986 is amended by inserting ``($0 in the 
     case of months beginning after December 31, 2015)'' after 
     ``$2,000''.
       (2) Paragraph (1) of section 4980H(b) of the Internal 
     Revenue Code of 1986 is amended by inserting ``($0 in the 
     case of months beginning after December 31, 2015)'' after 
     ``$3,000''.
       (b) Effective Date.--The amendments made by this section 
     shall apply to months beginning after December 31, 2015.

     SEC. 106. FEDERAL PAYMENTS TO STATES.

       (a) In General.--Notwithstanding section 504(a), 
     1902(a)(23), 1903(a), 2002, 2005(a)(4), 2102(a)(7), or 
     2105(a)(1) of the Social Security Act (42 U.S.C. 704(a), 
     1396a(a)(23), 1396b(a), 1397a, 1397d(a)(4), 1397bb(a)(7), 
     1397ee(a)(1)), or the terms of any Medicaid waiver in effect 
     on the date of enactment of this Act that is approved under 
     section 1115 or 1915 of the Social Security Act (42 U.S.C. 
     1315, 1396n), for the 1-year period beginning on the date of 
     enactment of this Act, no Federal funds provided from a 
     program referred to in this subsection that is considered 
     direct spending for any year may be made available to a State 
     for payments to a prohibited entity, whether made directly to 
     the prohibited entity or through a managed care organization 
     under contract with the State.
       (b) Definitions.--In this section:
       (1) Prohibited entity.--The term ``prohibited entity'' 
     means an entity, including its affiliates, subsidiaries, 
     successors, and clinics--
       (A) that, as of the date of enactment of this Act--
       (i) is an organization described in section 501(c)(3) of 
     the Internal Revenue Code of 1986 and exempt from tax under 
     section 501(a) of such Code;
       (ii) is an essential community provider described in 
     section 156.235 of title 45, Code of Federal Regulations (as 
     in effect on the date of enactment of this Act), that is 
     primarily engaged in family planning services, reproductive 
     health, and related medical care; and
       (iii) provides for abortions, other than an abortion--

       (I) if the pregnancy is the result of an act of rape or 
     incest; or
       (II) in the case where a woman suffers from a physical 
     disorder, physical injury, or physical illness that would, as 
     certified by a physician, place the woman in danger of death 
     unless an abortion is performed, including a life-endangering 
     physical condition caused by or arising from the pregnancy 
     itself; and

       (B) for which the total amount of Federal and State 
     expenditures under the Medicaid program under title XIX of 
     the Social Security Act in fiscal year 2014 made directly to 
     the entity and to any affiliates, subsidiaries, successors, 
     or clinics of the entity, or made to the entity and to any 
     affiliates, subsidiaries, successors, or clinics of the 
     entity as part of a nationwide health care provider network, 
     exceeded $1,000,000.
       (2) Direct spending.--The term ``direct spending'' has the 
     meaning given that term under section 250(c) of the Balanced 
     Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 
     900(c)).

     SEC. 107. MEDICAID.

       The Social Security Act (42 U.S.C. 301 et seq.) is 
     amended--
       (1) in section 1902--
       (A) in subsection (a)(10)(A), in each of clauses (i)(VIII) 
     and (ii)(XX), by inserting ``and ending December 31, 2019,'' 
     after ``January 1, 2014,''; and
       (B) in subsection (a)(47)(B), by inserting ``and provided 
     that any such election shall cease to be effective on January 
     1, 2020, and no such election shall be made after that date'' 
     before the semicolon at the end;
       (2) in section 1905--
       (A) in the first sentence of subsection (b), by inserting 
     ``(50 percent on or after January 1, 2020)'' after ``55 
     percent'';
       (B) in subsection (y)(1), by striking the semicolon at the 
     end of subparagraph (D) and all that follows through 
     ``thereafter''; and
       (C) in subsection (z)(2)--
       (i) in subparagraph (A), by inserting ``through 2019'' 
     after ``each year thereafter''; and
       (ii) in subparagraph (B)(ii)(VI), by striking ``and each 
     subsequent year'';
       (3) in section 1915(k)(2), by striking ``during the period 
     described in paragraph (1)'' and inserting ``on or after the 
     date referred to in paragraph (1) and before January 1, 
     2020'';
       (4) in section 1920(e), by adding at the end the following: 
     ``This subsection shall not apply after December 31, 2019.'';
       (5) in section 1937(b)(5), by adding at the end the 
     following: ``This paragraph shall not apply after December 
     31, 2019.''; and
       (6) in section 1943(a), by inserting ``and before January 
     1, 2020,'' after ``January 1, 2014,''.

     SEC. 108. REPEAL OF DSH ALLOTMENT REDUCTIONS.

       Section 1923(f) of the Social Security Act (42 U.S.C. 
     1396r-4(f)) is amended by striking paragraphs (7) and (8).

     SEC. 109. REPEAL OF THE TAX ON EMPLOYEE HEALTH INSURANCE 
                   PREMIUMS AND HEALTH PLAN BENEFITS.

       (a) In General.--Chapter 43 of the Internal Revenue Code of 
     1986 is amended by striking section 4980I.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to taxable years beginning after December 31, 
     2019.
       (c) Subsequent Effective Date.--The amendment made by 
     subsection (a) shall not apply to taxable years beginning 
     after December 31, 2025, and chapter 43 of the Internal 
     Revenue Code of 1986 is amended to read as such chapter would 
     read if such subsection had never been enacted.

     SEC. 110. REPEAL OF TAX ON OVER-THE-COUNTER MEDICATIONS.

       (a) HSAs.--Subparagraph (A) of section 223(d)(2) of the 
     Internal Revenue Code of 1986 is amended by striking ``Such 
     term'' and all that follows through the period.
       (b) Archer MSAs.--Subparagraph (A) of section 220(d)(2) of 
     the Internal Revenue Code of 1986 is amended by striking 
     ``Such term'' and all that follows through the period.
       (c) Health Flexible Spending Arrangements and Health 
     Reimbursement Arrangements.--Section 106 of the Internal 
     Revenue Code of 1986 is amended by striking subsection (f).
       (d) Effective Dates.--
       (1) Distributions from savings accounts.--The amendments 
     made by subsections (a) and (b) shall apply to amounts paid 
     with respect to taxable years beginning after December 31, 
     2016.
       (2) Reimbursements.--The amendment made by subsection (c) 
     shall apply to expenses incurred with respect to taxable 
     years beginning after December 31, 2016.

     SEC. 111. REPEAL OF TAX ON HEALTH SAVINGS ACCOUNTS.

       (a) HSAs.--Section 223(f)(4)(A) of the Internal Revenue 
     Code of 1986 is amended by striking ``20 percent'' and 
     inserting ``10 percent''.
       (b) Archer MSAs.--Section 220(f)(4)(A) of the Internal 
     Revenue Code of 1986 is amended by striking ``20 percent'' 
     and inserting ``15 percent''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to distributions made after December 31, 2016.

     SEC. 112. REPEAL OF LIMITATIONS ON CONTRIBUTIONS TO FLEXIBLE 
                   SPENDING ACCOUNTS.

       (a) In General.--Section 125 of the Internal Revenue Code 
     of 1986 is amended by striking subsection (i).
       (b) Effective Date.--The amendment made by this section 
     shall apply to plan years beginning after December 31, 2017.

[[Page S4199]]

  


     SEC. 113. REPEAL OF TAX ON PRESCRIPTION MEDICATIONS.

       Subsection (j) of section 9008 of the Patient Protection 
     and Affordable Care Act is amended to read as follows:
       ``(j) Repeal.--This section shall apply to calendar years 
     beginning after December 31, 2010, and ending before January 
     1, 2018.''.

     SEC. 114. REPEAL OF MEDICAL DEVICE EXCISE TAX.

       Section 4191 of the Internal Revenue Code of 1986 is 
     amended by adding at the end the following new subsection:
       ``(d) Applicability.--The tax imposed under subsection (a) 
     shall not apply to sales after December 31, 2017.''.

     SEC. 115. REPEAL OF HEALTH INSURANCE TAX.

       Subsection (j) of section 9010 of the Patient Protection 
     and Affordable Care Act is amended by striking ``, and'' at 
     the end of paragraph (1) and all that follows through 
     ``2017''.

     SEC. 116. REPEAL OF ELIMINATION OF DEDUCTION FOR EXPENSES 
                   ALLOCABLE TO MEDICARE PART D SUBSIDY.

       (a) In General.--Section 139A of the Internal Revenue Code 
     of 1986 is amended by adding at the end the following new 
     sentence: ``This section shall not be taken into account for 
     purposes of determining whether any deduction is allowable 
     with respect to any cost taken into account in determining 
     such payment.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2016.

     SEC. 117. REPEAL OF CHRONIC CARE TAX.

       (a) In General.--Subsection (a) of section 213 of the 
     Internal Revenue Code of 1986 is amended by striking ``10 
     percent'' and inserting ``7.5 percent''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2016.

     SEC. 118. REPEAL OF MEDICARE TAX INCREASE.

       (a) In General.--Subsection (b) of section 3101 of the 
     Internal Revenue Code of 1986 is amended to read as follows:
       ``(b) Hospital Insurance.--In addition to the tax imposed 
     by the preceding subsection, there is hereby imposed on the 
     income of every individual a tax equal to 1.45 percent of the 
     wages (as defined in section 3121(a)) received by such 
     individual with respect to employment (as defined in section 
     3121(b).''.
       (b) SECA.--Subsection (b) of section 1401 of the Internal 
     Revenue Code of 1986 is amended to read as follows:
       ``(b) Hospital Insurance.--In addition to the tax imposed 
     by the preceding subsection, there shall be imposed for each 
     taxable year, on the self-employment income of every 
     individual, a tax equal to 2.9 percent of the amount of the 
     self-employment income for such taxable year.''.
       (c) Effective Date.--The amendments made by this section 
     shall apply with respect to remuneration received after, and 
     taxable years beginning after, December 31, 2017.

     SEC. 119. REPEAL OF TANNING TAX.

       (a) In General.--The Internal Revenue Code of 1986 is 
     amended by striking chapter 49.
       (b) Effective Date.--The amendment made by this section 
     shall apply to services performed after September 30, 2017.

     SEC. 120. REPEAL OF NET INVESTMENT TAX.

       (a) In General.--Subtitle A of the Internal Revenue Code of 
     1986 is amended by striking chapter 2A.
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2016.

     SEC. 121. REMUNERATION.

       Paragraph (6) of section 162(m) of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following 
     new subparagraph:
       ``(I) Termination.--This paragraph shall not apply to 
     taxable years beginning after December 31, 2016.''.

                                TITLE II

     SEC. 201. THE PREVENTION AND PUBLIC HEALTH FUND.

       Subsection (b) of section 4002 of the Patient Protection 
     and Affordable Care Act (42 U.S.C. 300u-11) is amended--
       (1) in paragraph (3), by striking ``each of fiscal years 
     2018 and 2019'' and inserting ``fiscal year 2018''; and
       (2) by striking paragraphs (4) through (8).

     SEC. 202. SUPPORT FOR STATE RESPONSE TO SUBSTANCE ABUSE 
                   PUBLIC HEALTH CRISIS AND URGENT MENTAL HEALTH 
                   NEEDS.

       (a) In General.--There are authorized to be appropriated, 
     and are appropriated, out of monies in the Treasury not 
     otherwise obligated, $750,000,000 for each of fiscal years 
     2018 and 2019, to the Secretary of Health and Human Services 
     (referred to in this section as the ``Secretary'') to award 
     grants to States to address the substance abuse public health 
     crisis or to respond to urgent mental health needs within the 
     State. In awarding grants under this section, the Secretary 
     may give preference to States with an incidence or prevalence 
     of substance use disorders that is substantial relative to 
     other States or to States that identify mental health needs 
     within their communities that are urgent relative to such 
     needs of other States. Funds appropriated under this 
     subsection shall remain available until expended.
       (b) Use of Funds.--Grants awarded to a State under 
     subsection (a) shall be used for one or more of the following 
     public health-related activities:
       (1) Improving State prescription drug monitoring programs.
       (2) Implementing prevention activities, and evaluating such 
     activities to identify effective strategies to prevent 
     substance abuse.
       (3) Training for health care practitioners, such as best 
     practices for prescribing opioids, pain management, 
     recognizing potential cases of substance abuse, referral of 
     patients to treatment programs, and overdose prevention.
       (4) Supporting access to health care services provided by 
     Federally certified opioid treatment programs or other 
     appropriate health care providers to treat substance use 
     disorders or mental health needs.
       (5) Other public health-related activities, as the State 
     determines appropriate, related to addressing the substance 
     abuse public health crisis or responding to urgent mental 
     health needs within the State.

     SEC. 203. COMMUNITY HEALTH CENTER PROGRAM.

       Effective as if included in the enactment of the Medicare 
     Access and CHIP Reauthorization Act of 2015 (Public Law 114-
     10, 129 Stat. 87), paragraph (1) of section 221(a) of such 
     Act is amended by inserting ``, and an additional 
     $422,000,000 for fiscal year 2017'' after ``2017''.

     SEC. 204. FUNDING FOR COST-SHARING PAYMENTS.

       There is appropriated to the Secretary of Health and Human 
     Services, out of any money in the Treasury not otherwise 
     appropriated, such sums as may be necessary for payments for 
     cost-sharing reductions authorized by the Patient Protection 
     and Affordable Care Act (including adjustments to any prior 
     obligations for such payments) for the period beginning on 
     the date of enactment of this Act and ending on December 31, 
     2019. Notwithstanding any other provision of this Act, 
     payments and other actions for adjustments to any obligations 
     incurred for plan years 2018 and 2019 may be made through 
     December 31, 2020.

     SEC. 205. REPEAL OF COST-SHARING SUBSIDY PROGRAM.

       (a) In General.--Section 1402 of the Patient Protection and 
     Affordable Care Act (42 U.S.C. 18071) is repealed.
       (b) Effective Date.--The repeal made by subsection (a) 
     shall apply to cost-sharing reductions (and payments to 
     issuers for such reductions) for plan years beginning after 
     December 31, 2019.
                                 ______