[House Report 115-159]
[From the U.S. Government Publishing Office]


115th Congress   }                                    {        Report
                        HOUSE OF REPRESENTATIVES
 1st Session     }                                    {       115-159

======================================================================



 
                              VETERAN ACT

                                _______
                                

  June 2, 2017.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mr. Brady of Texas, from the Committee on Ways and Means, submitted the 
                               following

                              R E P O R T

                             together with

                            DISSENTING VIEWS

                        [To accompany H.R. 2372]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Ways and Means, to whom was referred the 
bill (H.R. 2372) to amend the Internal Revenue Code of 1986 to 
clarify the rules relating to veteran health insurance and 
eligibility for the premium tax credit, having considered the 
same, report favorably thereon with an amendment and recommend 
that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. SUMMARY AND BACKGROUND...........................................2
          A. Purpose and Summary.................................     2
          B. Background and Need for Legislation.................     2
          C. Legislative History.................................     3
 II. EXPLANATION OF THE BILL..........................................3
          A. Clarification Relating to Veteran Health Insurance 
              and Eligibility for Premium Tax Credit.............     3
III. VOTES OF THE COMMITTEE...........................................5
 IV. BUDGET EFFECTS OF THE BILL......................................10
          A. Committee Estimate of Budgetary Effects.............    10
          B. Statement Regarding New Budget Authority and Tax 
              Expenditures Budget Authority......................    10
          C. Cost Estimate Prepared by the Congressional Budget 
              Office.............................................    10
  V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE......11
          A. Committee Oversight Findings and Recommendations....    11
          B. Statement of General Performance Goals and 
              Objectives.........................................    11
          C. Information Relating to Unfunded Mandates...........    12
          D. Applicability of House Rule XXI 5(b)................    12
          E. Tax Complexity Analysis.............................    12
          F. Congressional Earmarks, Limited Tax Benefits, and 
              Limited Tariff Benefits............................    12
          G. Duplication of Federal Programs.....................    12
          H. Disclosure of Directed Rule Makings.................    13
 VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED...........13
VII. DISSENTING VIEWS................................................27

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Veterans Equal Treatment Ensures 
Relief and Access Now Act'' or the ``VETERAN Act''.

SEC. 2. CLARIFICATION RELATING TO VETERAN HEALTH INSURANCE AND 
                    ELIGIBILITY FOR PREMIUM TAX CREDIT.

  (a) Amendment of Pre-2020 Credit.--
          (1) In general.--Section 36B(c)(2)(B)(i) of the Internal 
        Revenue Code of 1986, prior to any amendment by section 214 of 
        the American Health Care Act of 2017, is amended by adding at 
        the end the following: ``For purposes of the preceding 
        sentence, an individual shall not be treated as eligible for 
        coverage described in section 5000A(f)(1)(A)(v) unless such 
        individual is enrolled in such coverage.''.
          (2) Effective date.--The amendment made by this subsection 
        shall apply to taxable years ending after December 31, 2013.
  (b) Amendment of Post-2019 Credit.--
          (1) In general.--Section 36B(d) of such Code, as amended by 
        section 214 of the American Health Care Act of 2017 and in 
        effect for months beginning after December 31, 2019, is amended 
        by adding at the end the following:
``For purposes of paragraph (2)(B), an individual shall not be treated 
as eligible for coverage described in section 5000A(f)(1)(A)(v) unless 
such individual is enrolled in such coverage.''.
          (2) Effective date.--The amendment made by this subsection is 
        contingent upon the enactment of the American Health Care Act 
        of 2017 and shall apply (if at all) to months beginning after 
        December 31, 2019, in taxable years ending after such date.

                       I. SUMMARY AND BACKGROUND


                         A. Purpose and Summary

    The bill, H.R. 2372, as reported by the Committee on Ways 
and Means, codifies a Treasury regulation, under which, for 
purposes of eligibility for the premium tax credit under 
section 36B of the Internal Revenue Code (``Code''),\1\ an 
individual is not considered eligible for certain health care 
programs of the United States Department of Veterans Affairs 
(``VA health program'') unless enrolled in the program. In 
addition, H.R. 2372, as reported by the Committee on Ways and 
Means, amends H.R. 1628, the American Health Care Act of 2017, 
as passed by the House of Representatives on May 4, 2017, to 
provide a similar rule with respect to a new credit for the 
purchase of health insurance (effective for months beginning 
after December 31, 2019, in taxable years ending after that 
date).
---------------------------------------------------------------------------
    \1\All section references herein are to the Internal Revenue Code 
of 1986, as amended, unless otherwise stated.
---------------------------------------------------------------------------

                 B. Background and Need for Legislation

    Under present law and under the American Health Care Act of 
2017, an individual generally may not receive the premium 
assistance credit if the individual is eligible for certain 
types of health coverage from a source other than the 
individual insurance market, including coverage under certain 
VA health programs. However, under Treasury regulations, an 
individual is not considered eligible for coverage under 
certain VA health programs (and, therefore, not precluded from 
receiving the premium assistance credit) unless enrolled in the 
program. The bill amends the Code and the American Health Care 
Act of 2017 to include the rule from the regulations, thus 
assuring its continued application.
    On March 8, 2017, in fulfillment of the reconciliation 
instructions included in section 2002 of the Concurrent 
Resolution on the Budget for Fiscal Year 2017 (S. Con. Res. 3), 
the Committee marked up Budget Reconciliation Legislative 
Recommendations Relating to Repeal and Replace of Health-
Related Tax Policy. This submission included a special rule 
codifying the Treasury regulations. However, that language was 
later removed at the Committee on Rules in order to comply with 
Senate guidance regarding the Reconciliation process.

                         C. Legislative History


Background

    H.R. 2372 was introduced on May 4, 2017, and was referred 
to the Committee on Ways and Means.

Committee action

    The Committee on Ways and Means marked up H.R. 2372, the 
Veterans Equal Treatment Ensures Relief and Access Now Act (the 
VETERAN Act), on May 24, 2017, and ordered the bill, as 
amended, favorably reported (with a quorum being present).

Committee hearings

    Since the 112th Congress, the Committee on Ways and Means 
and its subcommittees have held a number of hearings on health 
reform that explored various parts of the health system and 
informed policy contained in the American Health Care Act. 
These hearings include:
           March 5, 2013--Hearing on Tax-Related 
        Provisions in the President's Health Care Law
           December 4, 2013--Hearing on the Challenges 
        of the Affordable Care Act
           March 14, 2016--Hearing on the Tax Treatment 
        of Health Care
           May 17, 2016--Member Day Hearing on Tax-
        Related Proposals to Improve Health Care

                      II. EXPLANATION OF THE BILL


 A. Clarification Relating to Veteran Health Insurance and Eligibility 
                         for Premium Tax Credit


                              PRESENT LAW

    A refundable tax credit (``premium assistance credit'') is 
provided for eligible individuals and families to subsidize the 
purchase of health insurance plans through an American Health 
Benefit Exchange (``Exchange''), referred to as ``qualified 
health plans.''\2\ In general, advance payments with respect to 
the premium assistance credit are made during the year directly 
to the insurer.\3\ However, eligible individuals may choose to 
pay their total health insurance premiums without advance 
payments and claim the credit at the end of the taxable year.
---------------------------------------------------------------------------
    \2\Sec. 36B, effective for taxable years ending after December 31, 
2013. Under the Affordable Care Act, an American Health Benefit 
Exchange is a source through which individuals can purchase health 
insurance coverage. As used herein, the Affordable Care Act (or 
``ACA'') refers to the combination of the Patient Protection and 
Affordable Care Act (``PPACA''), Pub. L. No. 111-148, and the 
Healthcare and Education Reconciliation Act of 2010 (``HCERA''), Pub. 
L. No. 111-152. Qualified health plan is defined in PPACA section 1301.
    \3\PPACA sections 411-1412 provide rules relating to eligibility 
for and receipt of advance payments.
---------------------------------------------------------------------------
    The premium assistance credit is generally available for 
individuals (single or joint filers) with household incomes 
between 100 and 400 percent of the Federal poverty level 
(``FPL'') for the family size involved.\4\ Household income is 
defined as the sum of: (1) the individual's modified adjusted 
gross income, plus (2) the aggregate modified adjusted gross 
incomes of all other individuals taken into account in 
determining the individual's family size (but only if the other 
individuals are required to file a tax return for the taxable 
year). Modified adjusted gross income is defined as adjusted 
gross income increased by: (1) any amount excluded from gross 
income for citizens or residents living abroad,\5\ (2) any tax-
exempt interest received or accrued during the tax year, and 
(3) the portion of the individual's social security benefits 
not included in gross income.\6\ To be eligible for the premium 
assistance credit, individuals who are married must file a 
joint return. Individuals who are listed as dependents on a 
return are not eligible for the premium assistance credit.
---------------------------------------------------------------------------
    \4\ Federal poverty level refers to the most recently published 
poverty guidelines determined by the Secretary of Health and Human 
Services. Levels for 2017 and previous years are available at https://
aspe.hhs.gov/prior-hhs-poverty-guidelines-and-federal-register-
references.
    \5\Sec. 911.
    \6\Under section 86, only a portion of an individual's social 
security benefits are included in gross income.
---------------------------------------------------------------------------
    An individual who is eligible for certain types of health 
coverage (``minimum essential coverage'') from a source other 
than the individual insurance market generally may not receive 
the premium assistance credit.\7\ Coverage under certain 
government-sponsored health programs constitutes minimum 
essential coverage, including coverage under certain 
comprehensive health care programs administered by the United 
States Department of Veterans Affairs (``designated Veterans 
Affairs health programs'').\8\ Although mere eligibility for 
minimum essential coverage from a source other than the 
individual insurance market generally precludes an individual 
from receiving the premium assistance credit, Treasury 
regulations provide that, in the case of one of the designated 
Veterans Affairs health programs, an individual is not 
considered eligible for coverage under such a program (and 
precluded from receiving the premium assistance credit) unless 
enrolled in the program.\9\ Thus, an individual who may be 
eligible for a designated Veterans Affairs health program, but 
is not actually enrolled in the program, may receive the 
premium assistance credit.
---------------------------------------------------------------------------
    \7\Minimum essential coverage is defined in section 5000A(f).
    \8\Under section 5000A(f)(1)(A)(v), certain health care programs 
available to veterans and family members may constitute minimum 
essential coverage, as determined by the Secretary of Veterans Affairs, 
in coordination with the Secretary of the Treasury and the Secretary of 
Health and Human Services. Regulations designate certain comprehensive 
health care programs administered by the Department of Veterans Affairs 
as minimum essential coverage. Treas. Reg. sec.1.5000A-2(b)(v).
    \9\Treas. Reg. sec. 1.36B-2(c)(2)(iii).
---------------------------------------------------------------------------

                  THE AMERICAN HEALTH CARE ACT OF 2017

    The American Health Care Act of 2017, as passed by the 
House of Representatives on May 4, 2017 (the ``AHCA''), amends 
various health-related provisions of the Code.\10\ Effective 
for months beginning after December 31, 2019, in taxable years 
ending after that date, the AHCA replaces the present-law 
premium assistance credit with a new credit and provides a new 
definition of ``qualified health plan'' to which the new credit 
applies.\11\ Similar to the present-law credit, under the AHCA, 
an individual eligible for health coverage from other sources, 
including coverage under a designated Veterans Affairs health 
program, generally may not receive the new premium assistance 
credit.
---------------------------------------------------------------------------
    \10\H.R. 1628, as passed by the House of Representatives on May 4, 
2017.
    \11\AHCA section 214. AHCA sections 201 and 202 amend the present-
law premium assistance credit for periods before the new credit becomes 
effective.
---------------------------------------------------------------------------

                           REASONS FOR CHANGE

    The Committee agrees with the interpretation contained in 
the Treasury regulations with respect to eligibility for 
designated Veterans Affairs health programs. The Committee 
wishes to codify this interpretation, thus ensuring its 
continued application under present law and under the AHCA.

                        EXPLANATION OF PROVISION

    The provision amends the statutory provisions relating to 
eligibility for the present-law premium assistance credit to 
codify the rule under which an individual is not considered 
eligible for coverage under a designated Veterans Affairs 
health program unless enrolled in the program. In addition, the 
provision amends the provision of the AHCA relating to 
eligibility for the new premium assistance credit to specify 
that an individual is not considered eligible for coverage 
under a designated Veterans Affairs health program unless 
enrolled in the program.

                             EFFECTIVE DATE

    The provision relating to the present-law premium 
assistance credit is effective for taxable years ending after 
December 31, 2013. The provision relating to the new premium 
assistance credit under the AHCA is contingent on enactment of 
the AHCA and will apply (if at all) to months beginning after 
December 31, 2019, in taxable years ending after that date.

                      III. VOTES OF THE COMMITTEE

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, the following statement is made 
concerning the vote of the Committee on Ways and Means in its 
consideration of H.R. 2372, the ``Veterans Equal Treatment 
Ensures Relief and Access Now Act'' (the ``VETERAN Act''), on 
May 24, 2017.
    Mr. Tiberi's motion to table Mr. Doggett's appeal of the 
ruling of the Chair was agreed to by a roll call vote of 23 
yeas and 15 nays (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........        X   .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........        X   .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........  ........  ........  .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................        X   ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................        X   ........  .........  Ms. Sanchez......  ........        X   .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........        X   .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........        X   .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

    Mr. Tiberi's motion to table Mr. Thompson's appeal of the 
ruling of the Chair was agreed to by a roll call vote of 23 
yeas and 15 nays (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........        X   .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........        X   .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........  ........        X   .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................        X   ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................        X   ........  .........  Ms. Sanchez......  ........        X   .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........        X   .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........  ........  .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

    The vote on the amendment by Mr. Davis to the amendment in 
the nature of a substitute to H.R. 2372, which would adjust the 
tax credit for certain veteran taxpayers, was not agreed to by 
a roll call vote of 23 nays to 16 yeas (with a quorum being 
present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................  ........        X   .........  Mr. Neal.........        X   ........  .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........        X   ........  .........
Mr. Nunes......................  ........        X   .........  Mr. Lewis........        X   ........  .........
Mr. Tiberi.....................  ........        X   .........  Mr. Doggett......        X   ........  .........
Mr. Reichert...................  ........        X   .........  Mr. Thompson.....        X   ........  .........
Mr. Roskam.....................  ........        X   .........  Mr. Larson.......        X   ........  .........
Mr. Buchanan...................  ........        X   .........  Mr. Blumenauer...        X   ........  .........
Mr. Smith (NE).................  ........        X   .........  Mr. Kind.........        X   ........  .........
Ms. Jenkins....................  ........        X   .........  Mr. Pascrell.....        X   ........  .........
Mr. Paulsen....................  ........        X   .........  Mr. Crowley......        X   ........  .........
Mr. Marchant...................  ........        X   .........  Mr. Davis........        X   ........  .........
Ms. Black......................  ........        X   .........  Ms. Sanchez......        X   ........  .........
Mr. Reed.......................  ........        X   .........  Mr. Higgins......        X   ........  .........
Mr. Kelly......................  ........        X   .........  Ms. Sewell.......        X   ........  .........
Mr. Renacci....................  ........        X   .........  Ms. DelBene......        X   ........  .........
Mr. Meehan.....................  ........        X   .........  Ms. Chu..........        X   ........  .........
Ms. Noem.......................  ........        X   .........
Mr. Holding....................  ........        X   .........
Mr. Smith (MO).................  ........        X   .........
Mr. Rice.......................  ........        X   .........
Mr. Schweikert.................  ........        X   .........
Ms. Walorski...................  ........        X   .........
Mr. Curbelo....................  ........        X   .........
Mr. Bishop.....................  ........        X   .........
----------------------------------------------------------------------------------------------------------------

    Mr. Nunes's motion to table Ms. DelBene's appeal of the 
ruling of the Chair was agreed to by a roll call vote of 22 
yeas and 16 nays (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........        X   .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........        X   .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........  ........        X   .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................        X   ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................  ........  ........  .........  Ms. Sanchez......  ........        X   .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........        X   .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........        X   .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

    Mr. Nunes's motion to table Ms. Sanchez's appeal of the 
ruling of the Chair was agreed to by a roll call vote of 22 
yeas and 15 nays (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........        X   .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........  ........  .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........  ........        X   .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................        X   ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................  ........  ........  .........  Ms. Sanchez......  ........        X   .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........        X   .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........        X   .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

    Mr. Nunes's motion to table Ms. Sewell's appeal of the 
ruling of the Chair was agreed to by a roll call vote of 22 
yeas and 13 nays (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........  ........  .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........  ........  .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........  ........        X   .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................        X   ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................  ........  ........  .........  Ms. Sanchez......  ........  ........  .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........        X   .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........        X   .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

    Mr. Nunes's motion to table Ms. Chu's appeal of the ruling 
of the Chair was agreed to by a roll call vote of 22 yeas and 
12 nays (with a quorum being present). The vote was as follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........  ........  .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........  ........  .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........  ........        X   .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................        X   ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................  ........  ........  .........  Ms. Sanchez......  ........  ........  .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........  ........  .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........        X   .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

    Mr. Nunes's motion to table Mr. Pascrell's appeal of the 
ruling of the Chair was agreed to by a roll call vote of 22 
yeas and 12 nays (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........  ........  .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........  ........  .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........  ........        X   .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................        X   ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................  ........  ........  .........  Ms. Sanchez......  ........  ........  .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........  ........  .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........        X   .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

    The legislation was ordered favorably transmitted to the 
House of Representatives as amended by a roll call vote of 22 
yeas and 14 nays (with a quorum being present). The vote was as 
follows:

----------------------------------------------------------------------------------------------------------------
         Representative             Yea       Nay     Present     Representative      Yea       Nay     Present
----------------------------------------------------------------------------------------------------------------
Mr. Brady......................        X   ........  .........  Mr. Neal.........  ........        X   .........
Mr. Johnson....................  ........  ........  .........  Mr. Levin........  ........        X   .........
Mr. Nunes......................        X   ........  .........  Mr. Lewis........  ........        X   .........
Mr. Tiberi.....................        X   ........  .........  Mr. Doggett......  ........        X   .........
Mr. Reichert...................        X   ........  .........  Mr. Thompson.....  ........        X   .........
Mr. Roskam.....................        X   ........  .........  Mr. Larson.......  ........        X   .........
Mr. Buchanan...................        X   ........  .........  Mr. Blumenauer...  ........        X   .........
Mr. Smith (NE).................        X   ........  .........  Mr. Kind.........        X   ........  .........
Ms. Jenkins....................        X   ........  .........  Mr. Pascrell.....  ........        X   .........
Mr. Paulsen....................  ........  ........  .........  Mr. Crowley......  ........        X   .........
Mr. Marchant...................        X   ........  .........  Mr. Davis........  ........        X   .........
Ms. Black......................  ........  ........  .........  Ms. Sanchez......  ........        X   .........
Mr. Reed.......................        X   ........  .........  Mr. Higgins......  ........        X   .........
Mr. Kelly......................        X   ........  .........  Ms. Sewell.......  ........        X   .........
Mr. Renacci....................        X   ........  .........  Ms. DelBene......  ........  ........  .........
Mr. Meehan.....................        X   ........  .........  Ms. Chu..........  ........        X   .........
Ms. Noem.......................        X   ........  .........
Mr. Holding....................        X   ........  .........
Mr. Smith (MO).................        X   ........  .........
Mr. Rice.......................        X   ........  .........
Mr. Schweikert.................        X   ........  .........
Ms. Walorski...................        X   ........  .........
Mr. Curbelo....................        X   ........  .........
Mr. Bishop.....................        X   ........  .........
----------------------------------------------------------------------------------------------------------------

                     IV. BUDGET EFFECTS OF THE BILL


               A. Committee Estimate of Budgetary Effects

    In compliance with clause 3(d) of rule XIII of the Rules of 
the House of Representatives, the following statement is made 
concerning the effects on the budget of the bill, H.R. 2372, as 
reported.
    The bill, as reported, is estimated to have no effect on 
Federal fiscal year budget receipts for fiscal years 2017-2027.
    Pursuant to clause 8 of rule XIII of the Rules of the House 
of Representatives, the following statement is made by the 
Joint Committee on Taxation with respect to the provisions of 
the bill amending the Internal Revenue Code of 1986: The gross 
budgetary effect (before incorporating macroeconomic effects) 
in any fiscal year is less than 0.25 percent of the current 
projected gross domestic product of the United States for that 
fiscal year; therefore, the bill is not ``major legislation'' 
for purposes of requiring that the estimate include the 
budgetary effects of changes in economic output, employment, 
capital stock and other macroeconomic variables.

B. Statement Regarding New Budget Authority and Tax Expenditures Budget 
                               Authority

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee states that the 
bill involves no new or increased budget authority. The 
Committee further states that the revenue provisions of the 
bill do not increase or decrease tax expenditures.

      C. Cost Estimate Prepared by the Congressional Budget Office

    In compliance with clause 3(c)(3) of rule XIII of the Rules 
of the House of Representatives, requiring a cost estimate 
prepared by the CBO, the following statement by CBO is 
provided.
                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, June 1, 2017.
Hon Kevin Brady,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 2372, the Veterans 
Equal Treatment Ensures Relief and Access Now Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Mark Booth.
            Sincerely,
                                                        Keith Hall.
    Enclosure.

H.R. 2372--Veterans Equal Treatment Ensures Relief and Access Now Act

    H.R. 2372 would amend the Internal Revenue Code to codify 
certain health-related regulations affecting veterans. 
Specifically, the bill would codify regulations that allow 
veterans who are eligible for, but do not elect to be covered 
by, certain Veterans Affairs health programs to qualify for 
premium assistance tax credits. Under current law, people can 
purchase health insurance through marketplaces and receive such 
credits to cover part or all of the premiums if, among other 
criteria, they have income below certain amounts and are not 
eligible for certain types of health coverage. H.R. 2372 also 
contains a contingency under which the provisions would apply 
upon enactment of the American Health Care Act of 2017, which 
would provide new credits and eligibility requirements.
    Because H.R. 2372 would in part codify existing regulations 
and in part be contingent upon enactment of subsequent 
legislation, the staff of the Joint Committee on Taxation 
estimates that the bill would have no effect on revenues or 
direct spending relative to current law; therefore pay-as-you-
go procedures do not apply. However, if the American Health 
Care Act of 2017 was enacted prior to this legislation, then 
relative to such new law the enactment of this bill could 
affect revenues or direct spending and, as a result, subsequent 
estimates of the effects of this legislation could change.
    CBO and JCT estimate that enacting the bill would not 
increase on-budget deficits or net direct spending by more than 
$5 billion in any of the four 10-year periods beginning in 
2028.
    JCT has determined that the bill contains no 
intergovernmental or private-sector mandates as defined in the 
Unfunded Mandates Reform Act.
    The CBO staff contact for this estimate is Mark Booth. The 
estimate was approved by John McClelland, Assistant Director 
for Tax Analysis.

     V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE


          A. Committee Oversight Findings and Recommendations

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee advises that the 
findings and recommendations of the Committee, based on 
oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated into 
the description portions of this report.

        B. Statement of General Performance Goals and Objectives

    With respect to clause 3(c)(4) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that the 
bill contains no measure that authorizes funding, so no 
statement of general performance goals and objectives for which 
any measure authorizes funding is required.

              C. Information Relating to Unfunded Mandates

    This information is provided in accordance with section 423 
of the Unfunded Mandates Reform Act of 1995 (Pub. L. No. 104-
4).
    The Committee has determined that the bill does not contain 
Federal mandates on the private sector. The Committee has 
determined that the bill does not impose a Federal 
intergovernmental mandate on State, local, or tribal 
governments.

                D. Applicability of House Rule XXI 5(b)

    Rule XXI 5(b) of the Rules of the House of Representatives 
provides, in part, that ``A bill or joint resolution, 
amendment, or conference report carrying a Federal income tax 
rate increase may not be considered as passed or agreed to 
unless so determined by a vote of not less than three-fifths of 
the Members voting, a quorum being present.'' The Committee has 
carefully reviewed the bill and states that the bill does not 
involve any Federal income tax rate increases within the 
meaning of the rule.

                       E. Tax Complexity Analysis

    Section 4022(b) of the Internal Revenue Service 
Restructuring and Reform Act of 1998 (``IRS Reform Act'') 
requires the staff of the Joint Committee on Taxation (in 
consultation with the Internal Revenue Service and the Treasury 
Department) to provide a tax complexity analysis. The 
complexity analysis is required for all legislation reported by 
the Senate Committee on Finance, the House Committee on Ways 
and Means, or any committee of conference if the legislation 
includes a provision that directly or indirectly amends the 
Internal Revenue Code of 1986 and has widespread applicability 
to individuals or small businesses.
    Pursuant to clause 3(h)(1) of rule XIII of the Rules of the 
House of Representatives, the staff of the Joint Committee on 
Taxation has determined that a complexity analysis is not 
required under section 4022(b) of the IRS Reform Act because 
the bill contains no provisions that amend the Internal Revenue 
Code of 1986 and that have ``widespread applicability'' to 
individuals or small businesses, within the meaning of the 
rule.

  F. Congressional Earmarks, Limited Tax Benefits, and Limited Tariff 
                                Benefits

    With respect to clause 9 of rule XXI of the Rules of the 
House of Representatives, the Committee has carefully reviewed 
the provisions of the bill and states that the provisions of 
the bill do not contain any congressional earmarks, limited tax 
benefits, or limited tariff benefits within the meaning of the 
rule.

                   G. Duplication of Federal Programs

    In compliance with Sec. 3(c)(5) of rule XIII of the Rules 
of the House of Representatives, the Committee states that no 
provision of the bill establishes or reauthorizes: (1) a 
program of the Federal Government known to be duplicative of 
another Federal program, (2) a program included in any report 
from the Government Accountability Office to Congress pursuant 
to section 21 of Public Law 111-139, or (3) a program related 
to a program identified in the most recent Catalog of Federal 
Domestic Assistance, published pursuant to section 6104 of 
title 31, United States Code.

                 H. Disclosure of Directed Rule Makings

    In compliance with Sec. 3(i) of H. Res. 5 (115th Congress), 
the following statement is made concerning directed rule 
makings: The Committee advises that the bill requires no 
directed rule makings within the meaning of such section.

       VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, and existing law in which no 
change is proposed is shown in roman):

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic, and existing law in which no change is 
proposed is shown in roman):

INTERNAL REVENUE CODE OF 1986

           *       *       *       *       *       *       *



Subtitle A--Income Taxes

           *       *       *       *       *       *       *


CHAPTER 1--NORMAL TAXES AND SURTAXES

           *       *       *       *       *       *       *


Subchapter A--Determination of Tax Liability

           *       *       *       *       *       *       *


PART IV--CREDITS AGAINST TAX

           *       *       *       *       *       *       *



Subpart C--Refundable Credits

           *       *       *       *       *       *       *


[The following shows current law section 36B of the Internal 
Revenue Code of 1986:]

SEC. 36B. REFUNDABLE CREDIT FOR COVERAGE UNDER A QUALIFIED HEALTH PLAN.

  (a) In General.--In the case of an applicable taxpayer, there 
shall be allowed as a credit against the tax imposed by this 
subtitle for any taxable year an amount equal to the premium 
assistance credit amount of the taxpayer for the taxable year.
  (b) Premium Assistance Credit Amount.--For purposes of this 
section--
          (1) In general.--The term ``premium assistance credit 
        amount'' means, with respect to any taxable year, the 
        sum of the premium assistance amounts determined under 
        paragraph (2) with respect to all coverage months of 
        the taxpayer occurring during the taxable year.
          (2) Premium assistance amount.--The premium 
        assistance amount determined under this subsection with 
        respect to any coverage month is the amount equal to 
        the lesser of--
                  (A) the monthly premiums for such month for 1 
                or more qualified health plans offered in the 
                individual market within a State which cover 
                the taxpayer, the taxpayer's spouse, or any 
                dependent (as defined in section 152) of the 
                taxpayer and which were enrolled in through an 
                Exchange established by the State under 1311 of 
                the Patient Protection and Affordable Care Act, 
                or
                  (B) the excess (if any) of--
                          (i) the adjusted monthly premium for 
                        such month for the applicable second 
                        lowest cost silver plan with respect to 
                        the taxpayer, over
                          (ii) an amount equal to 1/12 of the 
                        product of the applicable percentage 
                        and the taxpayer's household income for 
                        the taxable year.
          (3) Other terms and rules relating to premium 
        assistance amounts.--For purposes of paragraph (2)--
                  (A) Applicable percentage.--
                          (i) In general.--Except as provided 
                        in clause (ii), the applicable 
                        percentage for any taxable year shall 
                        be the percentage such that the 
                        applicable percentage for any taxpayer 
                        whose household income is within an 
                        income tier specified in the following 
                        table shall increase, on a sliding 
                        scale in a linear manner, from the 
                        initial premium percentage to the final 
                        premium percentage specified in such 
                        table for such income tier:


 
------------------------------------------------------------------------
     In the case of
    household income
(expressed as a percent    The initial premium       The final premium
of poverty line) within      percentage is--          percentage is--
  the following income
         tier:
------------------------------------------------------------------------
Up to 133%               2.0%                     2.0%
133% up to 150%          3.0%                     4.0%
150% up to 200%          4.0%                     6.3%
200% up to 250%          6.3%                     8.05%
250% up to 300%          8.05%                    9.5%
300% up to 400%          9.5%                     9.5%
------------------------------------------------------------------------

                          (ii) Indexing.--
                                  (I) In general.--Subject to 
                                subclause (II), in the case of 
                                taxable years beginning in any 
                                calendar year after 2014, the 
                                initial and final applicable 
                                percentages under clause (i) 
                                (as in effect for the preceding 
                                calendar year after application 
                                of this clause) shall be 
                                adjusted to reflect the excess 
                                of the rate of premium growth 
                                for the preceding calendar year 
                                over the rate of income growth 
                                for the preceding calendar 
                                year.
                                  (II) Additional adjustment.--
                                Except as provided in subclause 
                                (III), in the case of any 
                                calendar year after 2018, the 
                                percentages described in 
                                subclause (I) shall, in 
                                addition to the adjustment 
                                under subclause (I), be 
                                adjusted to reflect the excess 
                                (if any) of the rate of premium 
                                growth estimated under 
                                subclause (I) for the preceding 
                                calendar year over the rate of 
                                growth in the consumer price 
                                index for the preceding 
                                calendar year.
                                  (III) Failsafe.--Subclause 
                                (II) shall apply for any 
                                calendar year only if the 
                                aggregate amount of premium tax 
                                credits under this section and 
                                cost-sharing reductions under 
                                section 1402 of the Patient 
                                Protection and Affordable Care 
                                Act for the preceding calendar 
                                year exceeds an amount equal to 
                                0.504 percent of the gross 
                                domestic product for the 
                                preceding calendar year.
                  (B) Applicable second lowest cost silver 
                plan.--The applicable second lowest cost silver 
                plan with respect to any applicable taxpayer is 
                the second lowest cost silver plan of the 
                individual market in the rating area in which 
                the taxpayer resides which--
                          (i) is offered through the same 
                        Exchange through which the qualified 
                        health plans taken into account under 
                        paragraph (2)(A) were offered, and
                          (ii) provides--
                                  (I) self-only coverage in the 
                                case of an applicable 
                                taxpayer--
                                          (aa) whose tax for 
                                        the taxable year is 
                                        determined under 
                                        section 1(c) (relating 
                                        to unmarried 
                                        individuals other than 
                                        surviving spouses and 
                                        heads of households) 
                                        and who is not allowed 
                                        a deduction under 
                                        section 151 for the 
                                        taxable year with 
                                        respect to a dependent, 
                                        or
                                          (bb) who is not 
                                        described in item (aa) 
                                        but who purchases only 
                                        self-only coverage, and
                                  (II) family coverage in the 
                                case of any other applicable 
                                taxpayer.
                If a taxpayer files a joint return and no 
                credit is allowed under this section with 
                respect to 1 of the spouses by reason of 
                subsection (e), the taxpayer shall be treated 
                as described in clause (ii)(I) unless a 
                deduction is allowed under section 151 for the 
                taxable year with respect to a dependent other 
                than either spouse and subsection (e) does not 
                apply to the dependent.
                  (C) Adjusted monthly premium.--The adjusted 
                monthly premium for an applicable second lowest 
                cost silver plan is the monthly premium which 
                would have been charged (for the rating area 
                with respect to which the premiums under 
                paragraph (2)(A) were determined) for the plan 
                if each individual covered under a qualified 
                health plan taken into account under paragraph 
                (2)(A) were covered by such silver plan and the 
                premium was adjusted only for the age of each 
                such individual in the manner allowed under 
                section 2701 of the Public Health Service Act. 
                In the case of a State participating in the 
                wellness discount demonstration project under 
                section 2705(d) of the Public Health Service 
                Act, the adjusted monthly premium shall be 
                determined without regard to any premium 
                discount or rebate under such project.
                  (D) Additional benefits.--If--
                          (i) a qualified health plan under 
                        section 1302(b)(5) of the Patient 
                        Protection and Affordable Care Act 
                        offers benefits in addition to the 
                        essential health benefits required to 
                        be provided by the plan, or
                          (ii) a State requires a qualified 
                        health plan under section 1311(d)(3)(B) 
                        of such Act to cover benefits in 
                        addition to the essential health 
                        benefits required to be provided by the 
                        plan,
                the portion of the premium for the plan 
                properly allocable (under rules prescribed by 
                the Secretary of Health and Human Services) to 
                such additional benefits shall not be taken 
                into account in determining either the monthly 
                premium or the adjusted monthly premium under 
                paragraph (2).
                  (E) Special rule for pediatric dental 
                coverage.--For purposes of determining the 
                amount of any monthly premium, if an individual 
                enrolls in both a qualified health plan and a 
                plan described in section 1311(d)(2)(B)(ii) (I) 
                of the Patient Protection and Affordable Care 
                Act for any plan year, the portion of the 
                premium for the plan described in such section 
                that (under regulations prescribed by the 
                Secretary) is properly allocable to pediatric 
                dental benefits which are included in the 
                essential health benefits required to be 
                provided by a qualified health plan under 
                section 1302(b)(1)(J) of such Act shall be 
                treated as a premium payable for a qualified 
                health plan.
  (c) Definition and Rules Relating to Applicable Taxpayers, 
Coverage Months, and Qualified Health Plan.--For purposes of 
this section--
          (1) Applicable taxpayer.--
                  (A) In general.--The term ``applicable 
                taxpayer'' means, with respect to any taxable 
                year, a taxpayer whose household income for the 
                taxable year equals or exceeds 100 percent but 
                does not exceed 400 percent of an amount equal 
                to the poverty line for a family of the size 
                involved.
                  (B) Special rule for certain individuals 
                lawfully present in the United States.--If--
                          (i) a taxpayer has a household income 
                        which is not greater than 100 percent 
                        of an amount equal to the poverty line 
                        for a family of the size involved, and
                          (ii) the taxpayer is an alien 
                        lawfully present in the United States, 
                        but is not eligible for the medicaid 
                        program under title XIX of the Social 
                        Security Act by reason of such alien 
                        status,
                the taxpayer shall, for purposes of the credit 
                under this section, be treated as an applicable 
                taxpayer with a household income which is equal 
                to 100 percent of the poverty line for a family 
                of the size involved.
                  (C) Married couples must file joint return.--
                If the taxpayer is married (within the meaning 
                of section 7703) at the close of the taxable 
                year, the taxpayer shall be treated as an 
                applicable taxpayer only if the taxpayer and 
                the taxpayer's spouse file a joint return for 
                the taxable year.
                  (D) Denial of credit to dependents.--No 
                credit shall be allowed under this section to 
                any individual with respect to whom a deduction 
                under section 151 is allowable to another 
                taxpayer for a taxable year beginning in the 
                calendar year in which such individual's 
                taxable year begins.
          (2) Coverage month.--For purposes of this 
        subsection--
                  (A) In general.--The term ``coverage month'' 
                means, with respect to an applicable taxpayer, 
                any month if--
                          (i) as of the first day of such month 
                        the taxpayer, the taxpayer's spouse, or 
                        any dependent of the taxpayer is 
                        covered by a qualified health plan 
                        described in subsection (b)(2)(A) that 
                        was enrolled in through an Exchange 
                        established by the State under section 
                        1311 of the Patient Protection and 
                        Affordable Care Act, and
                          (ii) the premium for coverage under 
                        such plan for such month is paid by the 
                        taxpayer (or through advance payment of 
                        the credit under subsection (a) under 
                        section 1412 of the Patient Protection 
                        and Affordable Care Act).
                  (B) Exception for minimum essential 
                coverage.--
                          (i) In general.--The term ``coverage 
                        month'' shall not include any month 
                        with respect to an individual if for 
                        such month the individual is eligible 
                        for minimum essential coverage other 
                        than eligibility for coverage described 
                        in section 5000A(f)(1)(C) (relating to 
                        coverage in the individual market). For 
                        purposes of the preceding sentence, an 
                        individual shall not be treated as 
                        eligible for coverage described in 
                        section 5000A(f)(1)(A)(v) unless such 
                        individual is enrolled in such 
                        coverage.
                          (ii) Minimum essential coverage.--The 
                        term ``minimum essential coverage'' has 
                        the meaning given such term by section 
                        5000A(f).
                  (C) Special rule for employer-sponsored 
                minimum essential coverage.--For purposes of 
                subparagraph (B)--
                          (i) Coverage must be affordable.--
                        Except as provided in clause (iii), an 
                        employee shall not be treated as 
                        eligible for minimum essential coverage 
                        if such coverage--
                                  (I) consists of an eligible 
                                employer-sponsored plan (as 
                                defined in section 
                                5000A(f)(2)), and
                                  (II) the employee's required 
                                contribution (within the 
                                meaning of section 
                                5000A(e)(1)(B)) with respect to 
                                the plan exceeds 9.5 percent of 
                                the applicable taxpayer's 
                                household income.
                        This clause shall also apply to an 
                        individual who is eligible to enroll in 
                        the plan by reason of a relationship 
                        the individual bears to the employee.
                          (ii) Coverage must provide minimum 
                        value.--Except as provided in clause 
                        (iii), an employee shall not be treated 
                        as eligible for minimum essential 
                        coverage if such coverage consists of 
                        an eligible employer-sponsored plan (as 
                        defined in section 5000A(f)(2)) and the 
                        plan's share of the total allowed costs 
                        of benefits provided under the plan is 
                        less than 60 percent of such costs.
                          (iii) Employee or family must not be 
                        covered under employer plan.--Clauses 
                        (i) and (ii) shall not apply if the 
                        employee (or any individual described 
                        in the last sentence of clause (i)) is 
                        covered under the eligible employer-
                        sponsored plan or the grandfathered 
                        health plan.
                          (iv) Indexing.--In the case of plan 
                        years beginning in any calendar year 
                        after 2014, the Secretary shall adjust 
                        the 9.5 percent under clause (i)(II) in 
                        the same manner as the percentages are 
                        adjusted under subsection 
                        (b)(3)(A)(ii).
          (3) Definitions and other rules.--
                  (A) Qualified health plan.--The term 
                ``qualified health plan'' has the meaning given 
                such term by section 1301(a) of the Patient 
                Protection and Affordable Care Act, except that 
                such term shall not include a qualified health 
                plan which is a catastrophic plan described in 
                section 1302(e) of such Act.
                  (B) Grandfathered health plan.--The term 
                ``grandfathered health plan'' has the meaning 
                given such term by section 1251 of the Patient 
                Protection and Affordable Care Act.
          (4) Special rules for qualified small employer health 
        reimbursement arrangements.--
                  (A) In general.--The term ``coverage month'' 
                shall not include any month with respect to an 
                employee (or any spouse or dependent of such 
                employee) if for such month the employee is 
                provided a qualified small employer health 
                reimbursement arrangement which constitutes 
                affordable coverage.
                  (B) Denial of double benefit.--In the case of 
                any employee who is provided a qualified small 
                employer health reimbursement arrangement for 
                any coverage month (determined without regard 
                to subparagraph (A)), the credit otherwise 
                allowable under subsection (a) to the taxpayer 
                for such month shall be reduced (but not below 
                zero) by the amount described in subparagraph 
                (C)(i)(II) for such month.
                  (C) Affordable coverage.--For purposes of 
                subparagraph (A), a qualified small employer 
                health reimbursement arrangement shall be 
                treated as constituting affordable coverage for 
                a month if--
                          (i) the excess of--
                                  (I) the amount that would be 
                                paid by the employee as the 
                                premium for such month for 
                                self-only coverage under the 
                                second lowest cost silver plan 
                                offered in the relevant 
                                individual health insurance 
                                market, over
                                  (II) \1/12\ of the employee's 
                                permitted benefit (as defined 
                                in section 9831(d)(3)(C)) under 
                                such arrangement, does not 
                                exceed--
                          (ii) \1/12\ of 9.5 percent of the 
                        employee's household income.
                  (D) Qualified small employer health 
                reimbursement arrangement.--For purposes of 
                this paragraph, the term ``qualified small 
                employer health reimbursement arrangement'' has 
                the meaning given such term by section 
                9831(d)(2).
                  (E) Coverage for less than entire year.--In 
                the case of an employee who is provided a 
                qualified small employer health reimbursement 
                arrangement for less than an entire year, 
                subparagraph (C)(i)(II) shall be applied by 
                substituting ``the number of months during the 
                year for which such arrangement was provided'' 
                for ``12''.
                  (F) Indexing.--In the case of plan years 
                beginning in any calendar year after 2014, the 
                Secretary shall adjust the 9.5 percent amount 
                under subparagraph (C)(ii) in the same manner 
                as the percentages are adjusted under 
                subsection (b)(3)(A)(ii).
  (d) Terms Relating to Income and Families.--For purposes of 
this section--
          (1) Family size.--The family size involved with 
        respect to any taxpayer shall be equal to the number of 
        individuals for whom the taxpayer is allowed a 
        deduction under section 151 (relating to allowance of 
        deduction for personal exemptions) for the taxable 
        year.
          (2) Household income.--
                  (A) Household income.--The term ``household 
                income'' means, with respect to any taxpayer, 
                an amount equal to the sum of--
                          (i) the modified adjusted gross 
                        income of the taxpayer, plus
                          (ii) the aggregate modified adjusted 
                        gross incomes of all other individuals 
                        who--
                                  (I) were taken into account 
                                in determining the taxpayer's 
                                family size under paragraph 
                                (1), and
                                  (II) were required to file a 
                                return of tax imposed by 
                                section 1 for the taxable year.
                  (B) Modified adjusted gross income.--The term 
                ``modified adjusted gross income'' means 
                adjusted gross income increased by--
                          (i) any amount excluded from gross 
                        income under section 911,
                          (ii) any amount of interest received 
                        or accrued by the taxpayer during the 
                        taxable year which is exempt from tax, 
                        and
                          (iii) an amount equal to the portion 
                        of the taxpayer's social security 
                        benefits (as defined in section 86(d)) 
                        which is not included in gross income 
                        under section 86 for the taxable year.
          (3) Poverty line.--
                  (A) In general.--The term ``poverty line'' 
                has the meaning given that term in section 
                2110(c)(5) of the Social Security Act (42 
                U.S.C. 1397jj(c)(5)).
                  (B) Poverty line used.--In the case of any 
                qualified health plan offered through an 
                Exchange for coverage during a taxable year 
                beginning in a calendar year, the poverty line 
                used shall be the most recently published 
                poverty line as of the 1st day of the regular 
                enrollment period for coverage during such 
                calendar year.
  (e) Rules for Individuals Not Lawfully Present.--
          (1) In general.--If 1 or more individuals for whom a 
        taxpayer is allowed a deduction under section 151 
        (relating to allowance of deduction for personal 
        exemptions) for the taxable year (including the 
        taxpayer or his spouse) are individuals who are not 
        lawfully present--
                  (A) the aggregate amount of premiums 
                otherwise taken into account under clauses (i) 
                and (ii) of subsection (b)(2)(A) shall be 
                reduced by the portion (if any) of such 
                premiums which is attributable to such 
                individuals, and
                  (B) for purposes of applying this section, 
                the determination as to what percentage a 
                taxpayer's household income bears to the 
                poverty level for a family of the size involved 
                shall be made under one of the following 
                methods:
                          (i) A method under which--
                                  (I) the taxpayer's family 
                                size is determined by not 
                                taking such individuals into 
                                account, and
                                  (II) the taxpayer's household 
                                income is equal to the product 
                                of the taxpayer's household 
                                income (determined without 
                                regard to this subsection) and 
                                a fraction--
                                          (aa) the numerator of 
                                        which is the poverty 
                                        line for the taxpayer's 
                                        family size determined 
                                        after application of 
                                        subclause (I), and
                                          (bb) the denominator 
                                        of which is the poverty 
                                        line for the taxpayer's 
                                        family size determined 
                                        without regard to 
                                        subclause (I).
                          (ii) A comparable method reaching the 
                        same result as the method under clause 
                        (i).
          (2) Lawfully present.--For purposes of this section, 
        an individual shall be treated as lawfully present only 
        if the individual is, and is reasonably expected to be 
        for the entire period of enrollment for which the 
        credit under this section is being claimed, a citizen 
        or national of the United States or an alien lawfully 
        present in the United States.
          (3) Secretarial authority.--The Secretary of Health 
        and Human Services, in consultation with the Secretary, 
        shall prescribe rules setting forth the methods by 
        which calculations of family size and household income 
        are made for purposes of this subsection. Such rules 
        shall be designed to ensure that the least burden is 
        placed on individuals enrolling in qualified health 
        plans through an Exchange and taxpayers eligible for 
        the credit allowable under this section.
  (f) Reconciliation of Credit and Advance Credit.--
          (1) In general.--The amount of the credit allowed 
        under this section for any taxable year shall be 
        reduced (but not below zero) by the amount of any 
        advance payment of such credit under section 1412 of 
        the Patient Protection and Affordable Care Act.
          (2) Excess advance payments.--
                  (A) In general.--If the advance payments to a 
                taxpayer under section 1412 of the Patient 
                Protection and Affordable Care Act for a 
                taxable year exceed the credit allowed by this 
                section (determined without regard to paragraph 
                (1)), the tax imposed by this chapter for the 
                taxable year shall be increased by the amount 
                of such excess.
                  (B) Limitation on increase.--
                          (i) In general.--In the case of a 
                        taxpayer whose household income is less 
                        than 400 percent of the poverty line 
                        for the size of the family involved for 
                        the taxable year, the amount of the 
                        increase under subparagraph (A) shall 
                        in no event exceed the applicable 
                        dollar amount determined in accordance 
                        with the following table (one-half of 
                        such amount in the case of a taxpayer 
                        whose tax is determined under section 
                        1(c) for the taxable year):


 
------------------------------------------------------------------------
 If the household income (expressed
 as a percent of poverty line) is:     The applicable dollar amount is:
------------------------------------------------------------------------
Less than 200%                       $600
At least 200% but less than 300%     $1,500
At least 300% but less than 400%     $2,500
------------------------------------------------------------------------

                          (ii) Indexing of amount.--In the case 
                        of any calendar year beginning after 
                        2014, each of the dollar amounts in the 
                        table contained under clause (i) shall 
                        be increased by an amount equal to--
                                  (I) such dollar amount, 
                                multiplied by
                                  (II) the cost-of-living 
                                adjustment determined under 
                                section 1(f)(3) for the 
                                calendar year, determined by 
                                substituting ``calendar year 
                                2013'' for ``calendar year 
                                1992'' in subparagraph (B) 
                                thereof.
                        If the amount of any increase under 
                        clause (i) is not a multiple of $50, 
                        such increase shall be rounded to the 
                        next lowest multiple of $50.
          (3) Information requirement.--Each Exchange (or any 
        person carrying out 1 or more responsibilities of an 
        Exchange under section 1311(f)(3) or 1321(c) of the 
        Patient Protection and Affordable Care Act) shall 
        provide the following information to the Secretary and 
        to the taxpayer with respect to any health plan 
        provided through the Exchange:
                  (A) The level of coverage described in 
                section 1302(d) of the Patient Protection and 
                Affordable Care Act and the period such 
                coverage was in effect.
                  (B) The total premium for the coverage 
                without regard to the credit under this section 
                or cost-sharing reductions under section 1402 
                of such Act.
                  (C) The aggregate amount of any advance 
                payment of such credit or reductions under 
                section 1412 of such Act.
                  (D) The name, address, and TIN of the primary 
                insured and the name and TIN of each other 
                individual obtaining coverage under the policy.
                  (E) Any information provided to the Exchange, 
                including any change of circumstances, 
                necessary to determine eligibility for, and the 
                amount of, such credit.
                  (F) Information necessary to determine 
                whether a taxpayer has received excess advance 
                payments.
  (g) Regulations.--The Secretary shall prescribe such 
regulations as may be necessary to carry out the provisions of 
this section, including regulations which provide for--
          (1) the coordination of the credit allowed under this 
        section with the program for advance payment of the 
        credit under section 1412 of the Patient Protection and 
        Affordable Care Act, and
          (2) the application of subsection (f) where the 
        filing status of the taxpayer for a taxable year is 
        different from such status used for determining the 
        advance payment of the credit.
[The following shows proposed changes to section 36B of the 
Internal Revenue Code of 1986 as such section is proposed to 
read after amendment by section 214 of the American Health Care 
Act of 2017 (H.R. 1628, as engrossed in the House):]

SEC. 36B. REFUNDABLE CREDIT FOR COVERAGE UNDER A QUALIFIED HEALTH PLAN.

  (a) Allowance of Premium Tax Credit.--In the case of an 
individual, there shall be allowed as a credit against the tax 
imposed by this subtitle for the taxable year the sum of the 
monthly credit amounts with respect to such taxpayer for 
calendar months during such taxable year which are eligible 
coverage months appropriately taken into account under 
subsection (b)(2) with respect to the taxpayer or any 
qualifying family member of the taxpayer.
  (b) Monthly Credit Amounts.--
          (1) In general.--The monthly credit amount with 
        respect to any taxpayer for any calendar month is the 
        lesser of--
                  (A) the sum of the monthly limitation amounts 
                determined under subsection (c) with respect to 
                the taxpayer and the taxpayer's qualifying 
                family members for such month, or
                  (B) the amount paid for a qualified health 
                plan for the taxpayer and the taxpayer's 
                qualifying family members for such month.
          (2) Eligible coverage month requirement.--No amount 
        shall be taken into account under subparagraph (A) or 
        (B) of paragraph (1) with respect to any individual for 
        any month unless such month is an eligible coverage 
        month with respect to such individual.
  (c) Monthly Limitation Amounts.--
          (1) In general.--The monthly limitation amount with 
        respect to any individual for any eligible coverage 
        month during any taxable year is \1/12\ of--
                  (A) $2,000 in the case of an individual who 
                has not attained age 30 as of the beginning of 
                such taxable year,
                  (B) $2,500 in the case of an individual who 
                has attained age 30 but who has not attained 
                age 40 as of such time,
                  (C) $3,000 in the case of an individual who 
                has attained age 40 but who has not attained 
                age 50 as of such time,
                  (D) $3,500 in the case of an individual who 
                has attained age 50 but who has not attained 
                age 60 as of such time, and
                  (E) $4,000 in the case of an individual who 
                has attained age 60 as of such time.
          (2) Limitation based on modified adjusted gross 
        income.--The credit allowed under subsection (a) with 
        respect to any taxpayer for any taxable year shall be 
        reduced (but not below zero) by 10 percent of the 
        excess (if any) of--
                  (A) the taxpayer's modified adjusted gross 
                income (as defined in section 36B(d)(2)(B), as 
                in effect for taxable years beginning before 
                January 1, 2020) for such taxable year, over
                  (B) $75,000 (twice such amount in the case of 
                a joint return).
          (3) Other limitations.--
                  (A) Aggregate dollar limitation.--The sum of 
                the monthly limitation amounts taken into 
                account under this section with respect to any 
                taxpayer for any taxable year shall not exceed 
                $14,000.
                  (B) Maximum number of individuals taken into 
                account.--With respect to any taxpayer for any 
                month, monthly limitation amounts shall be 
                taken into account under this section only with 
                respect to the 5 oldest individuals with 
                respect to whom monthly limitation amounts 
                could (without regard to this subparagraph) 
                otherwise be so taken into account.
  (d) Eligible Coverage Month.--For purposes of this section, 
the term ``eligible coverage month'' means, with respect to any 
individual, any month if, as of the first day of such month, 
the individual meets the following requirements:
          (1) The individual is covered by a health insurance 
        coverage which is certified by the State in which such 
        insurance is offered as coverage that meets the 
        requirements for qualified health plans under 
        subsection (f).
          (2) The individual is not eligible for--
                  (A) coverage under a group health plan 
                (within the meaning of section 5000(b)(1)) 
                other than coverage under a plan substantially 
                all of the coverage of which is of excepted 
                benefits described in section 9832(c), or
                  (B) coverage described in section 
                5000A(f)(1)(A).
          (3) The individual is either--
                  (A) a citizen or national of the United 
                States, or
                  (B) a qualified alien (within the meaning of 
                section 431 of the Personal Responsibility and 
                Work Opportunity Reconciliation Act of 1996 (8 
                U.S.C. 1641)).
          (4) The individual is not incarcerated, other than 
        incarceration pending the disposition of charges.
For purposes of paragraph (2)(B), an individual shall not be 
treated as eligible for coverage described in section 
5000A(f)(1)(A)(v) unless such individual is enrolled in such 
coverage.
  (e) Qualifying Family Member.--For purposes of this section, 
the term ``qualifying family member'' means--
          (1) in the case of a joint return, the taxpayer's 
        spouse,
          (2) any dependent of the taxpayer, and
          (3) with respect to any eligible coverage month, any 
        child (as defined in section 152(f)(1)) of the taxpayer 
        who as of the end of the taxable year has not attained 
        age 27 if such child is covered for such month under a 
        qualified health plan which also covers the taxpayer 
        (in the case of a joint return, either spouse).
  (f) Qualified Health Plan.--For purposes of this section, the 
term ``qualified health plan'' means any health insurance 
coverage (as defined in section 9832(b)) if--
          (1) such coverage is offered in the individual health 
        insurance market within a State (within the meaning of 
        section 5000A(f)(1)(C)),
          (2) substantially all of such coverage is not of 
        excepted benefits described in section 9832(c),
          (3) such coverage does not consist of short-term 
        limited duration insurance (within the meaning of 
        section 2791(b)(5) of the Public Health Service Act),
          (4) such coverage is not a grandfathered health plan 
        (as defined in section 1251 of the Patient Protection 
        and Affordable Care Act) or a grandmothered health plan 
        (as defined in section 36B(c)(3)(C) as in effect for 
        taxable years beginning before January 1, 2020), and
          (5) such coverage does not include coverage for 
        abortions (other than any abortion necessary to save 
        the life of the mother or any abortion with respect to 
        a pregnancy that is the result of an act of rape or 
        incest).
  (g) Special Rules.--
          (1) Married couples must file joint return.--
                  (A) In general.--Except as provided in 
                subparagraph (B), if the taxpayer is married 
                (within the meaning of section 7703) at the 
                close of the taxable year, no credit shall be 
                allowed under this section to such taxpayer 
                unless such taxpayer and the taxpayer's spouse 
                file a joint return for such taxable year.
                  (B) Exception for certain taxpayers.--
                Subparagraph (A) shall not apply to any married 
                taxpayer who--
                          (i) is living apart from the 
                        taxpayer's spouse at the time the 
                        taxpayer files the tax return,
                          (ii) is unable to file a joint return 
                        because such taxpayer is a victim of 
                        domestic abuse or spousal abandonment,
                          (iii) certifies on the tax return 
                        that such taxpayer meets the 
                        requirements of clauses (i) and (ii), 
                        and
                          (iv) has not met the requirements of 
                        clauses (i), (ii), and (iii) for each 
                        of the 3 preceding taxable years.
          (2) Denial of credit to dependents.--
                  (A) In general.--No credit shall be allowed 
                under this section to any individual who is a 
                dependent with respect to another taxpayer for 
                a taxable year beginning in the calendar year 
                in which such individual's taxable year begins.
                  (B) Coordination with rule for older 
                children.--In the case of any individual who is 
                a qualifying family member described in 
                subsection (e)(3) with respect to another 
                taxpayer for any month, in determining the 
                amount of any credit allowable to such 
                individual under this section for any taxable 
                year of such individual which includes such 
                month, the monthly limitation amount with 
                respect to such individual for such month shall 
                be zero and no amount paid for any qualified 
                health plan with respect to such individual for 
                such month shall be taken into account.
          (3) Coordination with medical expense deduction.--
        Amounts described in subsection (b)(1)(B) with respect 
        to any month shall not be taken into account in 
        determining the deduction allowed under section 213 
        except to the extent that such amounts exceed the 
        amount described in subsection (b)(1)(A) with respect 
        to such month.
          (4) Coordination with advance payments of credit.--
        With respect to any taxable year--
                  (A) the amount which would (but for this 
                subsection) be allowed as a credit to the 
                taxpayer under subsection (a) shall be reduced 
                (but not below zero) by the aggregate amount 
                paid on behalf of such taxpayer under section 
                1412 of the Patient Protection and Affordable 
                Care Act for months beginning in such taxable 
                year, and
                  (B) the tax imposed by section 1 for such 
                taxable year shall be increased by the excess 
                (if any) of--
                          (i) the aggregate amount paid on 
                        behalf of such taxpayer under such 
                        section 1412 for months beginning in 
                        such taxable year, over
                          (ii) the amount which would (but for 
                        this subsection) be allowed as a credit 
                        to the taxpayer under subsection (a).
          (5) Special rules for qualified small employer health 
        reimbursement arrangements.--
                  (A) In general.--If the taxpayer or any 
                qualifying family member of the taxpayer is 
                provided a qualified small employer health 
                reimbursement arrangement for an eligible 
                coverage month, the sum determined under 
                subsection (b)(1)(A) with respect to the 
                taxpayer shall be reduced (but not below zero) 
                by \1/12\ of the permitted benefit (as defined 
                in section 9831(d)(3)(C)) under such 
                arrangement for each such month such 
                arrangement is provided to such taxpayer.
                  (B) Qualified small employer health 
                reimbursement arrangement.--For purposes of 
                this paragraph, the term ``qualified small 
                employer health reimbursement arrangement'' has 
                the meaning given such term by section 
                9831(d)(2).
                  (C) Coverage for less than entire year.--In 
                the case of an employee who is provided a 
                qualified small employer health reimbursement 
                arrangement for less than an entire year, 
                subparagraph (A) shall be applied by 
                substituting ``the number of months during the 
                year for which such arrangement was provided'' 
                for ``12''.
          (6) Certain rules related to nonqualified health 
        plans.--The rules of section 36B(c)(3)(D), as in effect 
        for taxable years beginning before January 1, 2020, 
        shall apply with respect to subsection (f)(5).
          (7) Inflation adjustment.--
                  (A) In general.--In the case of any taxable 
                year beginning in a calendar year after 2020, 
                each dollar amount in subsection (c)(1), the 
                $75,000 amount in subsection (c)(2)(B), and the 
                dollar amount in subsection (c)(3)(A), shall be 
                increased by an amount equal to--
                          (i) such dollar amount, multiplied by
                          (ii) the cost-of-living adjustment 
                        determined under section 1(f)(3) for 
                        the calendar year in which the taxable 
                        year begins, determined--
                                  (I) by substituting 
                                ``calendar year 2019'' for 
                                ``calendar year 1992'' in 
                                subparagraph (B) thereof, and
                                  (II) by substituting for the 
                                CPI referred to section 
                                1(f)(3)(A) the amount that such 
                                CPI would have been if the 
                                annual percentage increase in 
                                CPI with respect to each year 
                                after 2019 had been one 
                                percentage point greater.
                  (B) Terms related to CPI.--
                          (i) Annual percentage increase.--For 
                        purposes of subparagraph (A)(ii)(II), 
                        the term ``annual percentage increase'' 
                        means the percentage (if any) by which 
                        CPI for any year exceeds CPI for the 
                        prior year.
                          (ii) Other terms.--Terms used in this 
                        paragraph which are also used in 
                        section 1(f)(3) shall have the same 
                        meanings as when used in such section.
                  (C) Rounding.--Any increase determined under 
                subparagraph (A) shall be rounded to the 
                nearest multiple of $50.
          (8) Rules related to State certification of qualified 
        health plans.--A certification shall not be taken into 
        account under subsection (d)(1) unless such 
        certification is made available to the public and meets 
        such other requirements as the Secretary may provide.
          (9) Regulations.--The Secretary may prescribe such 
        regulations and other guidance as may be necessary or 
        appropriate to carry out this section and section 1412 
        of the Patient Protection and Affordable Care Act.

           *       *       *       *       *       *       *


                         VII. DISSENTING VIEWS

    H.R. 2372 (Johnson, R-TX) would allow veterans who are not 
enrolled in military-related coverage to access tax credits (as 
modified by the American Health Care Act (AHCA), H.R. 1628) for 
the purchase of health insurance in the individual market. This 
legislation amends the AHCA, which, while passed out of the 
House, is not yet law.
    This legislation is only necessary because of gimmickry in 
the underlying AHCA. Section 2 of H.R. 2372 was originally part 
of the AHCA legislation, but it was removed in the Manager's 
Amendment in the Ways and Means Committee. It would have 
triggered a budget process (Byrd Rule), which would have 
required the Republicans to submit the AHCA to the Veteran's 
Affairs Committee. H.R. 2372 would reinsert the provision.
    As passed by the House in early May, the AHCA would 
prohibit any veteran eligible for government healthcare (such 
as VA and TRICARE) from receiving a tax credit even if the 
veteran has a non-group health plan. The important word is 
``eligible''--this could affect veterans who have never used 
the VA system and are not enrolled.
    Veterans decline VA or TRICARE health care services for a 
wide variety of reasons, including enrollment requirements 
(i.e., length of consecutive service and time period of 
service, tiered prioritization of enrollment eligibility, and 
separation from service conditions), access issues (e.g., 
living far from VA services), and availability of other 
coverage options (e.g., employer-sponsored insurance).
    Veterans are already protected under current law; this is a 
Republican attempt to repeal current law health coverage and 
protections that has caused the issue. Under current law, 
veterans are protected both if they are eligible for 15949 
military-related coverage and do not enroll, or if they enroll 
in partial benefits, military-related coverage that does not 
meet the essential health benefits test. The purpose of Mr. 
Johnson's bill is to ensure that the House-passed AHCA 
legislation is consistent with current law in its treatment of 
veterans.
    However, it is not clear that H.R. 2372 would protect 
veterans who are enrolled in military-related coverage for 
limited benefits or services, as is provided by current 
regulations. The Republican AHCA does not have a minimum 
standard for coverage and allows states to waive essential 
health benefits; therefore, veterans enrolled for treatment of 
service-connected disability could be prohibited from receiving 
tax credits to help them secure coverage for other health care 
needs.
    H.R. 2372 masquerades as help for veterans, but fails to 
address underlying flaws in the Republican health care bill 
that harm veterans. H.R. 2372 does not fix any of the problems 
for veterans caused by the AHCA bill, including loss of health 
insurance coverage, higher out-of-pocket costs, loss of 
essential benefits and treatments, or caps or limits on annual 
or lifetime coverage.
    According to estimates by the independent, nonpartisan 
Congressional Budget Office (CBO), the AHCA would result in 23 
million Americans losing health insurance coverage. This stems 
from a combination of inadequate out-of-pocket assistance, 
significant reductions in Medicaid enrollment and a change in 
rating practices that would allow insurers to charge 
significantly more for individuals with pre-existing 
conditions.
    The Johnson bill does nothing to improve the inadequate tax 
credits under the MICA, which it amends. Under the AHCA, tax 
credits to purchase coverage do not account for the differences 
in the cost of coverage across the country or family incomes--
which would make coverage completely unaffordable for countless 
American families. On top of that, this bill does nothing to 
eliminate the age tax in the AHCA, meaning older veterans would 
face significantly higher premiums.
    The AHCA would allow pre-existing condition discrimination 
under its state waivers. Before Affordable Care Act (ACA) 
market reforms, military service was a condition for 
underwriting and discrimination.
    The AHCA, as amended by the Johnson bill, would slash 
Medicaid coverage, jeopardizing affordable health coverage for 
the more than two million veterans who rely on Medicaid for 
their insurance. Millions more spouses and children of veterans 
rely on Medicaid; they too would be harmed. The AHCA cuts $834 
billion from Medicaid and the Trump Administration's budget 
proposes even deeper cuts. More than 40 percent of working-age 
veterans with Medicaid had no other source of coverage. The 
AHCA would jeopardize basic living standards and needed care 
for veterans who are struggling to make ends meet to pay for 
tax cuts for the rich. Medicaid provides the following that are 
critical for veterans' health: mental health services; 
substance abuse and addiction services; physical therapy 
services; and general wellness care.
    Amendments offered during consideration of H.R. 2372. 
Democrats offered a series of amendments to highlight the 
shortcomings of H.R. 2372 and the larger MICA, all but one were 
ruled non-germane by Chairman Kevin Brady (R-TX) and all but 
two of those ruled non-germane were appealed by Democratic 
Members. The appeals were then defeated by party-line votes. 
The one germane amendment offered by Congressman Davis (D-IL) 
was defeated by a party-line vote.
    Congressman Doggett (D-TX) offered an amendment to 
reinstate the fee on brand pharmaceutical manufacturers, which 
helps fund Medicare. In repealing this fee, the Republican 
health legislation would increase Medicare Part B premiums by 
$8.7 billion. Striking the pharma fee from the House Republican 
plan would protect beneficiaries' Medicare premiums. At a time 
of rising pharmaceutical profits and limited Social Security 
cost-of-living increases, this amendment would have helped 
ensure Medicare costs remain reasonable for beneficiaries.
    Congressman Thompson (D-CA) offered an amendment to 
reinstate the tax on high-income earners which directly funds 
the Medicare Part A Trust Fund. The Republican health plan 
would repeal this tax, shortening the life of Medicare while 
giving a substantial tax break to the richest Americans. This 
amendment would prevent $75 billion being taken from the 
Medicare Trust Fund, which would reduce the solvency of the 
Medicare Trust Fund by one year.
    Congressman Davis (D-IL) offered an amendment to adjust the 
tax credits in the Republican proposal to protect veterans 
under 400 percent of the poverty level to ensure that they 
would not pay more than 10 percent of their annual income 
toward the cost of health insurance premiums. While the 
Republican legislation gives billions of dollars in tax breaks 
to the wealthiest and most financially secure individuals, Mr. 
Davis' amendment would have provided a small measure of 
protection for middle-income and working-class veterans. Under 
current law, tax credits are based on income and premium costs 
for families earning less than 400 percent of the poverty 
level. For instance, between 2016 and 2017, under current law, 
advanced premium tax credits kept premiums paid by individuals 
flat for 83 percent of Marketplace enrollees (about 10.1 
million people) who received them. The Republican health bill 
would repeal this current law protection, which is embedded in 
the design of the tax credit.
    Congressman Higgins (D-NY) offered an amendment to prevent 
veterans from being subject to the five-to-one (5:1) age rating 
established in the AHCA. Under the AHCA, older individuals 
could be charged 5+ times as much as younger individuals. 
However, unlike the current tax credits, which adjust to the 
cost of premiums, the AHCA tax credits are age adjusted well 
below the 5:1 ratio. This leads to seniors paying much more for 
health insurance coverage. As CBO noted in an updated score 
released in the middle of our mark-up, a 64-year-old senior 
could see his or her net premiums increase by more than $16,000 
under the AHCA due to increased age rating and smaller premium 
tax credits than are available under current law. Rather than 
join with Democrats to protect veterans from the age tax, 
Republican members hid behind parliamentary tricks to avoid 
voting to support the veterans in their Districts.
    Congresswoman DelBene (D-WA) offered an amendment to ensure 
that the current law protections for individuals with pre-
existing conditions remain in place by rescinding the state 
waiver authority established in the AHCA. This provision of the 
AHCA would allow states to waive essential health benefits and 
allow insurance companies to, once again, discriminate against 
people with pre-existing conditions. As currently drafted, the 
Republican health bill undermines the guarantee that all health 
insurance policies cover essential health benefits like 
prescription drugs, mental health services, opioid addiction 
treatment, and maternity care. The AHCA threatens to bring back 
annual and lifetime limits on healthcare as prohibition of 
these limits only apply to essential health benefits. 
Therefore, this AHCA provision threatens not only individual 
market coverage but also employer-sponsored insurance.
    In fact, CBO stated that the waiver provision could have 
particularly detrimental consequences in their latest analysis: 
``However, the agencies estimate that about one-sixth of the 
population resides in areas in which the nongroup market would 
start to become unstable beginning in 2020. That instability 
would result from market responses to decisions by some states 
to waive two provisions of federal law, as would be permitted 
under H.R. 1628. One type of waiver would allow states to 
modify the requirements governing essential health benefits 
(EHBs), which set minimum standards for the benefits that 
insurance in the 15943 nongroup and small-group markets must 
cover. A second type of waiver would allow insurers to set 
premiums on the basis of an individual's health status if the 
person had not demonstrated continuous coverage. . . .''
    Before the ACA, 43 states and the District of Columbia 
allowed insurance companies to charge higher premiums to people 
with pre-existing conditions. As CBO noted, ``In addition, 
premiums would vary significantly according to health status 
and the types of benefits provided, and less healthy people 
would face extremely high premiums, despite the additional 
funding that would be available under H.R. 1628 to help reduce 
premiums. Over time, it would become more difficult for less 
healthy people (including people with preexisting medical 
conditions) in those states to purchase insurance because their 
premiums would continue to increase rapidly.'' This provision 
of the AHCA would have disastrous consequences for the millions 
of Americans with pre-existing conditions, including veterans.
    Congresswoman Sanchez (D-CA) offered an amendment to 
prevent gender discrimination against female veterans under the 
AHCA state-waivers, which would once again allow for insurance 
companies to discriminate against preexisting conditions, 
including being a woman. CBO, in fact, noted that pregnant 
women could face thousands of dollars more in out-of-pocket 
costs under the Republican health bill.
    Congresswoman Sewell (D-AL) offered an amendment to prevent 
states from enforcing future Medicaid work requirements on 
veterans receiving Medicaid. Research has shown that Medicaid 
work requirements would cause millions of enrollees with 
substantial health needs to lose coverage. Veterans have worked 
tirelessly on behalf of our country and should not be denied 
services for lack of employment.
    Congresswoman Chu (D-CA) offered an amendment that would 
require qualified health plans purchased with a tax credit 
under the AHCA include mental health, behavioral health, and 
substance abuse treatment benefits. This amendment would insure 
mental health services are not put out of reach for worlcing 
families because of artificially high premiums or out-of-pocket 
costs. This need is particularly important for veterans. 
According to a 2015 survey from the Iraq and Afghanistan 
Veterans of America, 58 percent of participating veterans 
reported having a mental health issue as a direct result of 
their service. A study from JAMA Psychiatry found the rate of 
post-traumatic stress disorder (PTSD) among veterans to be 15 
times higher than civilians. And, according the Department of 
Veterans Affairs, suicide rates are 41 percent higher than the 
general population for deployed veterans, and 61 percent higher 
than the general population for non-deployed veterans. But, 
instead of addressing the dire need for mental health services 
for this vulnerable population, the underlying bill that H.R. 
2372 amends would allow states to waive current protections and 
allow insurers to offer plans without essential health 
benefits, including mental health benefits. These waivers would 
permit insurers to charge people with pre-existing conditions--
like, for example, PTSD--more for coverage.
    Congressman Pascrell (D-NJ) offered an amendment to allow 
any individual suffering from Traumatic Brain Injury (TBI) to 
maintain current premium tax credits. TBI is one of the 
signature injuries of the wars in Iraq and Afghanistan, and 
many of our veterans are grappling with the consequences of 
these injuries. The RAND Corporation estimated that nearly 20 
percent of the men and women deployed to Iraq and Afghanistan 
sustained a brain injury while in the line of duty. More than 
five million Americans are living with a life-long disability 
as a result of a TBI, and individuals that sustain moderate and 
severe TBIs require substantial medical care to recover and 
cope with their injuries. Access to the supports and services 
that they need to return to school and work and continue with 
their everyday lives often results in significant out-of-pocket 
costs even with health coverage. TBI survivors cannot afford to 
lose their insurance, nor can they afford any additional costs.
    Congressman Kind (D-WI) offered an amendment to protect 
veterans from being charged more for pre-existing conditions 
under states that allow health status to be used for rating. 
Under current law, veterans are not allowed to be charged 
higher insurance premiums because of a pre-existing condition. 
The AHCA would allow states to apply for a waiver to current 
law to allow insurance companies charge higher insurance 
premiums because a person has a pre-existing health condition 
like heart disease, autism, or traumatic brain injury. Before 
the ACA, 43 states and the District of Columbia allowed 
insurance companies to charge higher premiums to people with 
pre-existing conditions. This provision of the AHCA would have 
disastrous consequences for the millions of Americans with 
preexisting conditions, including veterans.
    The Republicans rejected all of the Democratic amendments 
that would have nominally improved the flawed Republican health 
care bill. The Johnson bill does not fix any of the underlying 
flaws that would cause veterans to lose coverage or pay higher 
out-of-pocket costs. There are numerous actions Congress could 
take to improve health care for veterans. Enacting a technical 
fix for a bill that isn't even law yet doesn't pass muster as 
being a legitimate effort to improve care and coverage for 
America's veterans. For these reasons, we oppose H.R. 2372.
                                                   Richard E. Neal,
                                                        Ranking Member.

                                  [all]