[Congressional Record Volume 168, Number 133 (Saturday, August 6, 2022)]
[Senate]
[Page S4334]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 5385. Mr. KENNEDY submitted an amendment intended to be proposed 
to amendment SA 5194 proposed by Mr. Schumer to the bill H.R. 5376, to 
provide for reconciliation pursuant to title II of S. Con. Res. 14; 
which was ordered to lie on the table; as follows:

        At the appropriate place, insert the following:

     SEC. ___. PROVIDING DISCOUNTED INSULIN TO LOW- AND MIDDLE-
                   INCOME AMERICANS.

       (a) In General.--There is appropriated to the Secretary of 
     Health and Human Services (referred to in this section as the 
     ``Secretary''), out of any monies in the Treasury not 
     otherwise appropriated, $3,100,000,000 for fiscal year 2023, 
     to remain available through September 30, 2026, for making 
     payments to Federally-qualified health centers for purposes 
     of covering direct costs incurred by such centers for making 
     discounted insulin and epinephrine available to qualifying 
     center patients, as described in subsection (b).
       (b) Insulin and Epinephrine Affordability.--
       (1) In general.--If a Federally-qualified health center 
     participates in the drug discount program under section 340B 
     of the Public Health Service Act (42 U.S.C. 256b) and makes 
     insulin or injectable epinephrine available to its patients, 
     such center shall provide insulin and injectable epinephrine 
     at or below the discounted price paid by the center or 
     subgrantee of the center under the drug discount program 
     under such section 340B (plus a minimal administration fee) 
     to qualifying center patients through fiscal year 2026.
       (2) Limitation.--As applicable, the cost of insulin and 
     injectable epinephrine made available to patients pursuant to 
     this subsection shall not exceed the cost of such insulin and 
     injectable epinephrine pursuant to the schedule of fees or 
     payment under section 330(k)(3)(G) of the Public Health 
     Service Act (42 U.S.C. 254b(k)(3)(G)).
       (c) Payments.--The Secretary shall make prospective 
     quarterly payments to Federally-qualified health centers in 
     an amount that equals the sum of the following:
       (1) The product of--
       (A) the number of units of insulin furnished to qualifying 
     center patients in the previous quarter; and
       (B) the direct costs of procuring and making available each 
     such unit of insulin at the discounted rate provided for 
     under this section.
       (2) The product of--
       (A) the number of units of injectable epinephrine furnished 
     to qualifying center patients in the previous quarter; and
       (B) the direct costs of procuring and making available each 
     such unit of injectable epinephrine at the discounted rate 
     provided for under this section.
       (d) Use of Payments.--Payments made to Federally-qualified 
     health centers under this section shall be used for the sole 
     purpose of covering direct costs incurred by such centers in 
     making insulin and injectable epinephrine available to 
     qualifying center patients under subsection (b).
       (e) Definitions.--In this section:
       (1) Federally-qualified health center.--The term 
     ``Federally-qualified health center'' has the meaning given 
     such term in section 1905(l)(2)(B) of the Social Security Act 
     (42 U.S.C. 1396d(l)(2)(B)).
       (2) Qualifying center patient.--The term ``qualifying 
     center patient'' means a patient of a Federally-qualified 
     health center whose household income is equal to or less than 
     350 percent of the Federal poverty line and who--
       (A) has a cost-sharing requirement under a health insurance 
     plan for insulin or injectable epinephrine under which the 
     patient out-of-pocket share is more than 20 percent of the 
     total amount charged by the center for insulin or 
     epinephrine;
       (B) has a high unmet deductible under a health insurance 
     plan; or
       (C) has no health insurance.
       (f) Prevention and Public Health Fund Offset.--Section 
     4002(b) of the Patient Protection and Affordable Care Act (42 
     U.S.C. 300u-11) is amended--
       (1) in paragraph (6), by striking ``each of fiscal years 
     2022 and 2023'' and inserting ``fiscal year 2022'';
       (2) by striking paragraphs (7) and (8);
       (3) by redesignating paragraph (9) as paragraph (8); and
       (4) by inserting after paragraph (6) the following:
       ``(7) for fiscal year 2027, $1,800,000,000; and''.
                                 ______