[House Report 115-382]
[From the U.S. Government Publishing Office]


115th Congress    }                                   {         Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                   {        115-382

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



 
 PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 3922) TO EXTEND FUNDING 
       FOR CERTAIN PUBLIC HEALTH PROGRAMS, AND FOR OTHER PURPOSES

                                _______
                                

  November 1, 2017.--Referred to the House Calendar and ordered to be 
                                printed

                                _______
                                

               Mr. Burgess, from the Committee on Rules, 
                        submitted the following

                              R E P O R T

                       [To accompany H. Res. 601]

    The Committee on Rules, having had under consideration 
House Resolution 601, by a record vote of 7 to 3, report the 
same to the House with the recommendation that the resolution 
be adopted.

                SUMMARY OF PROVISIONS OF THE RESOLUTION

    The resolution provides for consideration of H.R. 3922, the 
Community Health And Medical Professionals Improve Our Nation 
Act of 2017, under a closed rule. The resolution provides one 
hour of debate equally divided and controlled by the chair and 
ranking minority member of the Committee on Energy and 
Commerce. The resolution waives all points of order against 
consideration of the bill. The resolution provides that the 
amendment printed in part A of this Report, modified by the 
amendment printed in part B of this Report, shall be considered 
as adopted and the bill, as amended, shall be considered as 
read. The resolution waives all points of order against 
provisions in the bill, as amended. The resolution provides one 
motion to recommit with or without instructions.

                         EXPLANATION OF WAIVERS

    Although the resolution waives all points of order against 
consideration of the bill, the Committee is not aware of any 
points of order. The waiver is prophylactic in nature.
    The waiver of all points of order against provisions in the 
bill, as amended, includes a waiver of the following:
            Clause 4 of rule XXI, which prohibits 
        reporting a bill or joint resolution carrying an 
        appropriation from a committee not having jurisdiction 
        to report an appropriation.
            Clause 5(a) of rule XXI, which prohibits a 
        bill or joint resolution carrying a tax or tariff 
        measure from being reported by a committee not having 
        jurisdiction to report tax or tariff measures.

                            COMMITTEE VOTES

    The results of each record vote on an amendment or motion 
to report, together with the names of those voting for and 
against, are printed below:

Rules Committee record vote No. 135

    Motion by Ms. Slaughter to make in order and provide the 
appropriate waivers to amendment # 6, offered by Rep. Pallone 
Jr. (NJ), which extends funding for critically important 
healthcare programs such as the Children's Health Insurance 
Program (CHIP) and Community Health Centers that were last 
authorized in the bipartisan Medicare Access and CHIP 
Reauthorization Act of 2015. The amendment does so without 
making it harder for people to keep their health insurance or 
gutting funding for public health programs supported by the 
Prevention Fund. Instead, it fully pays for these policies with 
a commonsense offset. Defeated: 3-7

----------------------------------------------------------------------------------------------------------------
                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Mr. Cole........................................          Nay   Ms. Slaughter.....................          Yea
Mr. Woodall.....................................          Nay   Mr. McGovern......................          Yea
Mr. Burgess.....................................          Nay   Mr. Hastings of Florida...........          Yea
Mr. Collins.....................................          Nay   Mr. Polis.........................  ............
Mr. Byrne.......................................  ............
Mr. Newhouse....................................          Nay
Mr. Buck........................................          Nay
Ms. Cheney......................................  ............
Mr. Sessions, Chairman..........................          Nay
----------------------------------------------------------------------------------------------------------------

Rules Committee record vote No. 136

    Motion by Mr. Cole to report the rule. Adopted: 7-3

----------------------------------------------------------------------------------------------------------------
                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Mr. Cole........................................          Yea   Ms. Slaughter.....................          Nay
Mr. Woodall.....................................          Yea   Mr. McGovern......................          Nay
Mr. Burgess.....................................          Yea   Mr. Hastings of Florida...........          Nay
Mr. Collins.....................................          Yea   Mr. Polis.........................  ............
Mr. Byrne.......................................  ............
Mr. Newhouse....................................          Yea
Mr. Buck........................................          Yea
Ms. Cheney......................................  ............
Mr. Sessions, Chairman..........................          Yea
----------------------------------------------------------------------------------------------------------------

        SUMMARY OF THE AMENDMENT IN PART A CONSIDERED AS ADOPTED

    Walden (OR): Reauthorizes the CHIP program and extend 
various public health programs.

        SUMMARY OF THE AMENDMENT IN PART B CONSIDERED AS ADOPTED

    Walden (OR): Relating to the Prevention and Public Health 
Fund, and adjustments to Medicare Part B and Part D premium 
subsidies for higher income individuals.

            PART A--TEXT OF AMENDMENT CONSIDERED AS ADOPTED

  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Continuing Community Health 
And Medical Professional Programs to Improve Our Nation, 
Increase National Gains, and Help Ensure Access for Little 
Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery 
Stable Act of 2017'' or the ``CHAMPIONING HEALTHY KIDS Act''.

SEC. 2. TABLE OF CONTENTS.

  The table of contents for this Act is as follows:

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

                        DIVISION A--CHAMPION ACT

Sec. 100. Short title.

              TITLE I--EXTENSION OF PUBLIC HEALTH PROGRAMS

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

                            TITLE II--OFFSETS

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

                      DIVISION B--HEALTHY KIDS ACT

Sec. 300. Short title.

     TITLE I--CHIP EXTENSION AND OTHER MEDICAID AND CHIP PROVISIONS

Sec. 301. Five-year funding extension of the Children's Health Insurance 
          Program.
Sec. 302. Extension of certain programs and demonstration projects.
Sec. 303. Extension of outreach and enrollment program.
Sec. 304. Extension and reduction of additional Federal financial 
          participation for CHIP.
Sec. 305. Modifying reductions in Medicaid DSH allotments.
Sec. 306. Puerto Rico and the Virgin Islands Medicaid payments.

                            TITLE II--OFFSETS

Sec. 401. Medicaid third party liability provisions.
Sec. 402. Treatment of lottery winnings and other lump-sum income for 
          purposes of income eligibility under Medicaid.

                        DIVISION A--CHAMPION ACT

SEC. 100. SHORT TITLE.

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

              TITLE I--EXTENSION OF PUBLIC HEALTH PROGRAMS

SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS, THE NATIONAL HEALTH 
                    SERVICE CORPS, AND TEACHING HEALTH CENTERS THAT 
                    OPERATE GME PROGRAMS.

  (a) Community Health Centers Funding.--Section 10503(b)(1)(E) 
of the Patient Protection and Affordable Care Act (42 U.S.C. 
254b-2(b)(1)(E)) is amended by striking ``2017'' and inserting 
``2019''.
  (b) Other Community Health Centers Provisions.--Section 330 
of the Public Health Service Act (42 U.S.C. 254b) is amended--
          (1) in subsection (b)(1)(A)(ii), by striking 
        ``abuse'' and inserting ``use disorder'';
          (2) in subsection (b)(2)(A), by striking ``abuse'' 
        and inserting ``use disorder'';
          (3) in subsection (c)--
                  (A) in paragraph (1), by striking 
                subparagraphs (B) through (D);
                  (B) by striking ``(1) In general'' and all 
                that follows through ``The Secretary'' and 
                inserting the following:
          ``(1) Centers.--The Secretary''; and
                  (C) in paragraph (1), as amended, by 
                redesignating clauses (i) through (v) as 
                subparagraphs (A) through (E) and moving the 
                margin of each of such redesignated 
                subparagraph 2 ems to the left;
          (4) by striking subsection (d) and inserting the 
        following:
  ``(d) Improving Quality of Care.--
          ``(1) Supplemental awards.--The Secretary may award 
        supplemental grant funds to health centers funded under 
        this section to implement evidence-based models for 
        increasing access to high-quality primary care 
        services, which may include models related to--
                  ``(A) improving the delivery of care for 
                individuals with multiple chronic conditions;
                  ``(B) workforce configuration;
                  ``(C) reducing the cost of care;
                  ``(D) enhancing care coordination;
                  ``(E) expanding the use of telehealth and 
                technology-enabled collaborative learning and 
                capacity building models;
                  ``(F) care integration, including integration 
                of behavioral health, mental health, or 
                substance use disorder services; and
                  ``(G) addressing emerging public health or 
                substance use disorder issues to meet the 
                health needs of the population served by the 
                health center.
          ``(2) Sustainability.--In making supplemental awards 
        under this subsection, the Secretary may consider 
        whether the health center involved has submitted a plan 
        for continuing the activities funded under this 
        subsection after supplemental funding is expended.
          ``(3) Special consideration.--The Secretary may give 
        special consideration to applications for supplemental 
        funding under this subsection that seek to address 
        significant barriers to access to care in areas with a 
        greater shortage of health care providers and health 
        services relative to the national average.'';
          (5) in subsection (e)(1)--
                  (A) in subparagraph (B)--
                          (i) by striking ``2 years'' and 
                        inserting ``1 year''; and
                          (ii) by adding at the end the 
                        following: ``The Secretary shall not 
                        make a grant under this paragraph 
                        unless the applicant provides 
                        assurances to the Secretary that within 
                        120 days of receiving grant funding for 
                        the operation of the health center, the 
                        applicant will submit, for approval by 
                        the Secretary, an implementation plan 
                        to meet the requirements of subsection 
                        (k)(3). The Secretary may extend such 
                        120-day period for achieving compliance 
                        upon a demonstration of good cause by 
                        the health center.''; and
                  (B) in subparagraph (C)--
                          (i) in the subparagraph heading, by 
                        striking ``and plans'';
                          (ii) by striking ``or plan (as 
                        described in subparagraphs (B) and (C) 
                        of subsection (c)(1))'';
                          (iii) by striking ``or plan, 
                        including the purchase'' and inserting 
                        the following: ``including--
                          ``(i) the purchase'';
                          (iv) by inserting ``, which may 
                        include data and information systems'' 
                        after ``of equipment'';
                          (v) by striking the period at the end 
                        and inserting a semicolon; and
                          (vi) by adding at the end the 
                        following:
                          ``(ii) the provision of training and 
                        technical assistance; and
                          ``(iii) other activities that--
                                  ``(I) reduce costs associated 
                                with the provision of health 
                                services;
                                  ``(II) improve access to, and 
                                availability of, health 
                                services provided to 
                                individuals served by the 
                                centers;
                                  ``(III) enhance the quality 
                                and coordination of health 
                                services; or
                                  ``(IV) improve the health 
                                status of communities.'';
          (6) in subsection (e)(5)(B)--
                  (A) in the heading of subparagraph (B), by 
                striking ``and plans''; and
                  (B) by striking ``and subparagraphs (B) and 
                (C) of subsection (c)(1) to a health center or 
                to a network or plan'' and inserting ``to a 
                health center or to a network'';
          (7) in subsection (e), by adding at the end the 
        following:
          ``(6) New access points and expanded services.--
                  ``(A) Approval of new access points.--
                          ``(i) In general.--The Secretary may 
                        approve applications for grants under 
                        subparagraph (A) or (B) of paragraph 
                        (1) to establish new delivery sites.
                          ``(ii) Special consideration.--In 
                        carrying out clause (i), the Secretary 
                        may give special consideration to 
                        applicants that have demonstrated the 
                        new delivery site will be located 
                        within a sparsely populated area, or an 
                        area which has a level of unmet need 
                        that is higher relative to other 
                        applicants.
                          ``(iii) Consideration of 
                        applications.--In carrying out clause 
                        (i), the Secretary shall approve 
                        applications for grants in such a 
                        manner that the ratio of the medically 
                        underserved populations in rural areas 
                        which may be expected to use the 
                        services provided by the applicants 
                        involved to the medically underserved 
                        populations in urban areas which may be 
                        expected to use the services provided 
                        by the applicants is not less than two 
                        to three or greater than three to two.
                          ``(iv) Service area overlap.--If in 
                        carrying out clause (i) the applicant 
                        proposes to serve an area that is 
                        currently served by another health 
                        center funded under this section, the 
                        Secretary may consider whether the 
                        award of funding to an additional 
                        health center in the area can be 
                        justified based on the unmet need for 
                        additional services within the 
                        catchment area.
                  ``(B) Approval of expanded service 
                applications.--
                          ``(i) In general.--The Secretary may 
                        approve applications for grants under 
                        subparagraph (A) or (B) of paragraph 
                        (1) to expand the capacity of the 
                        applicant to provide required primary 
                        health services described in subsection 
                        (b)(1) or additional health services 
                        described in subsection (b)(2).
                          ``(ii) Priority expansion projects.--
                        In carrying out clause (i), the 
                        Secretary may give special 
                        consideration to expanded service 
                        applications that seek to address 
                        emerging public health or behavioral 
                        health, mental health, or substance 
                        abuse issues through increasing the 
                        availability of additional health 
                        services described in subsection (b)(2) 
                        in an area in which there are 
                        significant barriers to accessing care.
                          ``(iii) Consideration of 
                        applications.--In carrying out clause 
                        (i), the Secretary shall approve 
                        applications for grants in such a 
                        manner that the ratio of the medically 
                        underserved populations in rural areas 
                        which may be expected to use the 
                        services provided by the applicants 
                        involved to the medically underserved 
                        populations in urban areas which may be 
                        expected to use the services provided 
                        by such applicants is not less than two 
                        to three or greater than three to 
                        two.'';
          (8) in subsection (h)--
                  (A) in paragraph (1), by striking ``and 
                children and youth at risk of homelessness'' 
                and inserting ``, children and youth at risk of 
                homelessness, homeless veterans, and veterans 
                at risk of homelessness''; and
                  (B) in paragraph (5)--
                          (i) by striking subparagraph (B);
                          (ii) by redesignating subparagraph 
                        (C) as subparagraph (B); and
                          (iii) in subparagraph (B) (as so 
                        redesignated)--
                                  (I) in the subparagraph 
                                heading, by striking ``abuse'' 
                                and inserting ``use disorder''; 
                                and
                                  (II) by striking ``abuse'' 
                                and inserting ``use disorder'';
          (9) in subsection (k)--
                  (A) in paragraph (2)--
                          (i) in the paragraph heading, by 
                        inserting ``unmet'' before ``need'';
                          (ii) in the matter preceding 
                        subparagraph (A), by inserting ``or 
                        subsection (e)(6)'' after ``subsection 
                        (e)(1)'';
                          (iii) in subparagraph (A), by 
                        inserting ``unmet'' before ``need for 
                        health services'';
                          (iv) in subparagraph (B), by striking 
                        ``and'' at the end;
                          (v) in subparagraph (C), by striking 
                        the period at the end and inserting ``; 
                        and''; and
                          (vi) by adding after subparagraph (C) 
                        the following:
                  ``(D) in the case of an application for a 
                grant pursuant to subsection (e)(6), a 
                demonstration that the applicant has consulted 
                with appropriate State and local government 
                agencies, and health care providers regarding 
                the need for the health services to be provided 
                at the proposed delivery site.'';
                  (B) in paragraph (3)--
                          (i) in the matter preceding 
                        subparagraph (A), by inserting ``or 
                        subsection (e)(6)'' after ``subsection 
                        (e)(1)(B)'';
                          (ii) in subparagraph (B), by striking 
                        ``in the catchment area of the center'' 
                        and inserting ``, including other 
                        health care providers that provide care 
                        within the catchment area, local 
                        hospitals, and specialty providers in 
                        the catchment area of the center, to 
                        provide access to services not 
                        available through the health center and 
                        to reduce the non-urgent use of 
                        hospital emergency departments'';
                          (iii) in subparagraph (H)(ii), by 
                        inserting ``who shall be directly 
                        employed by the center'' after 
                        ``approves the selection of a director 
                        for the center'';
                          (iv) in subparagraph (L), by striking 
                        ``and'' at the end;
                          (v) in subparagraph (M), by striking 
                        the period and inserting ``; and''; and
                          (vi) by inserting after subparagraph 
                        (M), the following:
                  ``(N) the center has written policies and 
                procedures in place to ensure the appropriate 
                use of Federal funds in compliance with 
                applicable Federal statutes, regulations, and 
                the terms and conditions of the Federal 
                award.''; and
                  (C) by striking paragraph (4);
          (10) in subsection (l), by adding at the end the 
        following: ``Funds expended to carry out activities 
        under this subsection and operational support 
        activities under subsection (m) shall not exceed 3 
        percent of the amount appropriated for this section for 
        the fiscal year involved.'';
          (11) in subsection (q)(4), by adding at the end the 
        following: ``A waiver provided by the Secretary under 
        this paragraph may not remain in effect for more than 1 
        year and may not be extended after such period. An 
        entity may not receive more than one waiver under this 
        paragraph in consecutive years.'';
          (12) in subsection (r)(3)--
                  (A) by striking ``appropriate committees of 
                Congress a report concerning the distribution 
                of funds under this section'' and inserting the 
                following: ``Committee on Health, Education, 
                Labor, and Pensions of the Senate, and the 
                Committee on Energy and Commerce of the House 
                of Representatives, a report including, at a 
                minimum--
                  ``(A) the distribution of funds for carrying 
                out this section'';
                  (B) by striking ``populations. Such report 
                shall include an assessment'' and inserting the 
                following: ``populations;
                  ``(B) an assessment'';
                  (C) by striking ``and the rationale for any 
                substantial changes in the distribution of 
                funds.'' and inserting a semicolon; and
                  (D) by adding at the end the following:
                  ``(C) the distribution of awards and funding 
                for new or expanded services in each of rural 
                areas and urban areas;
                  ``(D) the distribution of awards and funding 
                for establishing new access points, and the 
                number of new access points created;
                  ``(E) the amount of unexpended funding for 
                loan guarantees and loan guarantee authority 
                under title XVI;
                  ``(F) the rationale for any substantial 
                changes in the distribution of funds;
                  ``(G) the rate of closures for health centers 
                and access points;
                  ``(H) the number and reason for any grants 
                awarded pursuant to subsection (e)(1)(B); and
                  ``(I) the number and reason for any waivers 
                provided pursuant to subsection (q)(4).'';
          (13) in subsection (r), by adding at the end the 
        following new paragraph:
          ``(5) Funding for participation of health centers in 
        all of us research program.--In addition to any amounts 
        made available pursuant to paragraph (1) of this 
        subsection, section 402A of this Act, or section 10503 
        of the Patient Protection and Affordable Care Act, 
        there is authorized to be appropriated, and there is 
        appropriated, out of any monies in the Treasury not 
        otherwise appropriated, to the Secretary $25,000,000 
        for fiscal year 2018 to support the participation of 
        health centers in the All of Us Research Program under 
        the Precision Medicine Initiative under section 498E of 
        this Act.''; and
          (14) by striking subsection (s).
  (c) National Health Service Corps.--Section 10503(b)(2)(E) of 
the Patient Protection and Affordable Care Act (42 U.S.C. 254b-
2(b)(2)(E)) is amended by striking ``2017'' and inserting 
``2019''.
  (d) Teaching Health Centers That Operate Graduate Medical 
Education Programs.--
          (1) Payments.--Subsection (a) of section 340H of the 
        Public Health Service Act (42 U.S.C. 256h) is amended 
        to read as follows:
  ``(a) Payments.--
          ``(1) In general.--Subject to subsection (h)(2), the 
        Secretary shall make payments under this section for 
        direct expenses and indirect expenses to qualified 
        teaching health centers that are listed as sponsoring 
        institutions by the relevant accrediting body for, as 
        appropriate--
                  ``(A) maintenance of existing approved 
                graduate medical residency training programs;
                  ``(B) expansion of existing approved graduate 
                medical residency training programs; and
                  ``(C) establishment of new approved graduate 
                medical residency training programs.
          ``(2) Priority.--In making payments pursuant to 
        paragraph (1)(C), the Secretary shall give priority to 
        qualified teaching health centers that--
                  ``(A) serve a health professional shortage 
                area with a designation in effect under section 
                332 or a medically underserved community (as 
                defined in section 799B); or
                  ``(B) are located in a rural area (as defined 
                in section 1886(d)(2)(D) of the Social Security 
                Act).''.
          (2) Funding.--Subsection (g) of section 340H of the 
        Public Health Service Act (42 U.S.C. 256h) is amended--
                  (A) by striking ``To carry out'' and 
                inserting the following:
          ``(1) In general.--To carry out'';
                  (B) by striking ``and $15,000,000 for the 
                first quarter of fiscal year 2018'' and 
                inserting ``and $126,500,000 for each of fiscal 
                years 2018 and 2019, to remain available until 
                expended''; and
                  (C) by adding at the end the following:
          ``(2) Administrative expenses.--Of the amount made 
        available to carry out this section for any fiscal 
        year, the Secretary may not use more than 5 percent of 
        such amount for the expenses of administering this 
        section.''.
          (3) Annual reporting.--Subsection (h)(1) of section 
        340H of the Public Health Service Act (42 U.S.C. 256h) 
        is amended--
                  (A) by redesignating subparagraph (D) as 
                subparagraph (H); and
                  (B) by inserting after subparagraph (C) the 
                following:
                  ``(D) The number of patients treated by 
                residents described in paragraph (4).
                  ``(E) The number of visits by patients 
                treated by residents described in paragraph 
                (4).
                  ``(F) Of the number of residents described in 
                paragraph (4) who completed their residency 
                training at the end of such residency academic 
                year, the number and percentage of such 
                residents entering primary care practice 
                (meaning any of the areas of practice listed in 
                the definition of a primary care residency 
                program in section 749A).
                  ``(G) Of the number of residents described in 
                paragraph (4) who completed their residency 
                training at the end of such residency academic 
                year, the number and percentage of such 
                residents who entered practice at a health care 
                facility--
                          ``(i) primarily serving a health 
                        professional shortage area with a 
                        designation in effect under section 332 
                        or a medically underserved community 
                        (as defined in section 799B); or
                          ``(ii) located in a rural area (as 
                        defined in section 1886(d)(2)(D) of the 
                        Social Security Act).''.
          (4) Report on training costs.--Not later than March 
        31, 2019, the Secretary of Health and Human Services 
        shall submit to the Congress a report on the direct 
        graduate expenses of approved graduate medical 
        residency training programs, and the indirect expenses 
        associated with the additional costs of teaching 
        residents, of qualified teaching health centers (as 
        such terms are used or defined in section 340H of the 
        Public Health Service Act (42 U.S.C. 256h)).
          (5) Definition.--Subsection (j) of section 340H of 
        the Public Health Service Act (42 U.S.C. 256h) is 
        amended--
                  (A) by redesignating paragraphs (2) and (3) 
                as paragraphs (3) and (4), respectively; and
                  (B) by inserting after paragraph (1) the 
                following:
          ``(2) New approved graduate medical residency 
        training program.--The term `new approved graduate 
        medical residency training program' means an approved 
        graduate medical residency training program for which 
        the sponsoring qualified teaching health center has not 
        received a payment under this section for a previous 
        fiscal year (other than pursuant to subsection 
        (a)(1)(C)).''.
          (6) Technical correction.--Subsection (f) of section 
        340H (42 U.S.C. 256h) is amended by striking 
        ``hospital'' each place it appears and inserting 
        ``teaching health center''.
          (7) Payments for previous fiscal years.--The 
        provisions of section 340H of the Public Health Service 
        Act (42 U.S.C. 256h), as in effect on the day before 
        the date of enactment of this Act, shall continue to 
        apply with respect to payments under such section for 
        fiscal years before fiscal year 2018.
  (e) Application.--Amounts appropriated pursuant to this 
section for fiscal year 2018 or 2019 are subject to the 
requirements contained in Public Law 115-31 for funds for 
programs authorized under sections 330 through 340 of the 
Public Health Service Act (42 U.S.C. 254b-256).
  (f) Conforming Amendments.--Section 3014(h) of title 18, 
United States Code, is amended--
          (1) in paragraph (1), by striking ``, as amended by 
        section 221 of the Medicare Access and CHIP 
        Reauthorization Act of 2015,''; and
          (2) in paragraph (4), by inserting ``and section 
        101(e) of the Community Health And Medical 
        Professionals Improve Our Nation Act of 2017'' after 
        ``section 221(c) of the Medicare Access and CHIP 
        Reauthorization Act of 2015''.

SEC. 102. EXTENSION FOR SPECIAL DIABETES PROGRAMS.

  (a) Special Diabetes Program for Type I Diabetes.--Section 
330B(b)(2)(C) of the Public Health Service Act (42 U.S.C. 254c-
2(b)(2)(C)) is amended by striking ``2017'' and inserting 
``2019''.
  (b) Special Diabetes Program for Indians.--Subparagraph (D) 
of section 330C(c)(2) of the Public Health Service Act (42 
U.S.C. 254c-3(c)(2)) is amended to read as follows:
                  ``(D) $150,000,000 for each of fiscal years 
                2018 and 2019.''.

SEC. 103. EXTENSION FOR FAMILY-TO-FAMILY HEALTH INFORMATION CENTERS.

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

SEC. 104. YOUTH EMPOWERMENT PROGRAM; PERSONAL RESPONSIBILITY EDUCATION.

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

``SEC. 510. YOUTH EMPOWERMENT PROGRAM.

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

                           TITLE II--OFFSETS

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

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

SEC. 202. PREVENTION AND PUBLIC HEALTH FUND.

  Section 4002(b) of the Patient Protection and Affordable Care 
Act (42 U.S.C. 300u-11(b)) is amended by striking paragraphs 
(3) through (8) and inserting the following new paragraphs:
          ``(3) for fiscal year 2018, $900,000,000;
          ``(4) for fiscal year 2019, $600,000,000;
          ``(5) for each of fiscal years 2020 through 2026, $0; 
        and
          ``(6) for fiscal year 2027 and each fiscal year 
        thereafter, $2,000,000,000.''.

                      DIVISION B--HEALTHY KIDS ACT

SEC. 300. SHORT TITLE.

  This division may be cited as the ``Helping Ensure Access for 
Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance 
Delivery Stable Act of 2017'' or the ``HEALTHY KIDS Act''.

     TITLE I--CHIP EXTENSION AND OTHER MEDICAID AND CHIP PROVISIONS

SEC. 301. FIVE-YEAR FUNDING EXTENSION OF THE CHILDREN'S HEALTH 
                    INSURANCE PROGRAM.

  (a) Appropriation; Total Allotment.--Section 2104(a) of the 
Social Security Act (42 U.S.C. 1397dd(a)) is amended--
          (1) in paragraph (19), by striking ``and'';
          (2) in paragraph (20), by striking the period at the 
        end and inserting a semicolon; and
          (3) by adding at the end the following new 
        paragraphs:
          ``(21) for fiscal year 2018, $21,500,000,000;
          ``(22) for fiscal year 2019, $22,600,000,000;
          ``(23) for fiscal year 2020, $23,700,000,000;
          ``(24) for fiscal year 2021, $24,800,000,000; and
          ``(25) for fiscal year 2022, for purposes of making 2 
        semi-annual allotments--
                  ``(A) $2,850,000,000 for the period beginning 
                on October 1, 2021, and ending on March 31, 
                2022; and
                  ``(B) $2,850,000,000 for the period beginning 
                on April 1, 2022, and ending on September 30, 
                2022.''.
  (b) Allotments.--
          (1) In general.--Section 2104(m) of the Social 
        Security Act (42 U.S.C. 1397dd(m)) is amended--
                  (A) in paragraph (2)--
                          (i) in the heading, by striking 
                        ``through 2016'' and inserting 
                        ``through 2022''; and
                          (ii) in subparagraph (B)--
                                  (I) in the matter preceding 
                                clause (i), by striking 
                                ``(19)'' and inserting 
                                ``(24)'';
                                  (II) in clause (ii), in the 
                                matter preceding subclause (I), 
                                by inserting ``(other than 
                                fiscal year 2022)'' after 
                                ``even-numbered fiscal year''; 
                                and
                                  (III) in clause (ii)(I), by 
                                inserting ``(or, in the case of 
                                fiscal year 2018, under 
                                paragraph (4))'' after ``clause 
                                (i)'';
                  (B) in paragraph (5)--
                          (i) by striking ``or (4)'' and 
                        inserting ``(4), or (10)''; and
                          (ii) by striking ``or 2017'' and 
                        inserting ``, 2017, or 2022'';
                  (C) in paragraph (7)--
                          (i) in subparagraph (A), by striking 
                        ``2017'' and inserting ``2022'';
                          (ii) in subparagraph (B), in the 
                        matter preceding clause (i), by 
                        inserting ``(or, in the case of fiscal 
                        year 2018, by not later than the date 
                        that is 60 days after the date of the 
                        enactment of the HEALTHY KIDS Act)'' 
                        after ``before the August 31 preceding 
                        the beginning of the fiscal year''; and
                          (iii) in the matter following 
                        subparagraph (B), by striking ``or 
                        fiscal year 2016'' and inserting 
                        ``fiscal year 2016, fiscal year 2018, 
                        fiscal year 2020, or fiscal year 
                        2022'';
                  (D) in paragraph (9)--
                          (i) in the heading, by striking 
                        ``fiscal years 2015 and 2017'' and 
                        inserting ``certain fiscal years'';
                          (ii) by striking ``or (4)'' and 
                        inserting ``, (4), or (10)''; and
                          (iii) by striking ``or fiscal year 
                        2017'' and inserting ``, 2017, or 
                        2022''; and
                  (E) by adding at the end the following new 
                paragraph:
          ``(10) For fiscal year 2022.--
                  ``(A) First half.--Subject to paragraphs (5) 
                and (7), from the amount made available under 
                subparagraph (A) of paragraph (25) of 
                subsection (a) for the semi-annual period 
                described in such subparagraph, increased by 
                the amount of the appropriation for such period 
                under section 301(b)(3) of the HEALTHY KIDS 
                Act, the Secretary shall compute a State 
                allotment for each State (including the 
                District of Columbia and each commonwealth and 
                territory) for such semi-annual period in an 
                amount equal to the first half ratio (described 
                in subparagraph (D)) of the amount described in 
                subparagraph (C).
                  ``(B) Second half.--Subject to paragraphs (5) 
                and (7), from the amount made available under 
                subparagraph (B) of paragraph (25) of 
                subsection (a) for the semi-annual period 
                described in such subparagraph, the Secretary 
                shall compute a State allotment for each State 
                (including the District of Columbia and each 
                commonwealth and territory) for such semi-
                annual period in an amount equal to the amount 
                made available under such subparagraph, 
                multiplied by the ratio of--
                          ``(i) the amount of the allotment to 
                        such State under subparagraph (A); to
                          ``(ii) the total of the amount of all 
                        of the allotments made available under 
                        such subparagraph.
                  ``(C) Full year amount based on growth factor 
                updated amount.--The amount described in this 
                subparagraph for a State is equal to the sum 
                of--
                          ``(i) the amount of the State 
                        allotment for fiscal year 2021 
                        determined under paragraph (2)(B)(i); 
                        and
                          ``(ii) the amount of any payments 
                        made to the State under subsection (n) 
                        for fiscal year 2021,
                multiplied by the allotment increase factor 
                under paragraph (6) for fiscal year 2022.
                  ``(D) First half ratio.--The first half ratio 
                described in this subparagraph is the ratio 
                of--
                          ``(i) the sum of--
                                  ``(I) the amount made 
                                available under subsection 
                                (a)(25)(A); and
                                  ``(II) the amount of the 
                                appropriation for such period 
                                under section 301(b)(3) of the 
                                HEALTHY KIDS Act; to
                          ``(ii) the sum of--
                                  ``(I) the amount described in 
                                clause (i); and
                                  ``(II) the amount made 
                                available under subsection 
                                (a)(25)(B).''.
          (2) Technical amendment.--Section 2104(m)(2)(A) of 
        such Act (42 U.S.C. 1397dd(m)(2)(A)) is amended by 
        striking ``the allotment increase factor under 
        paragraph (5)'' each place it appears and inserting 
        ``the allotment increase factor under paragraph (6)''.
          (3) One-time appropriation for fiscal year 2022.--
        There is appropriated to the Secretary of Health and 
        Human Services, out of any money in the Treasury not 
        otherwise appropriated, $20,200,000,000 to accompany 
        the allotment made for the period beginning on October 
        1, 2021, and ending on March 31, 2022, under paragraph 
        (25)(A) of section 2104(a) of the Social Security Act 
        (42 U.S.C. 1397dd(a)) (as added by subsection (a)(3)), 
        to remain available until expended. Such amount shall 
        be used to provide allotments to States under paragraph 
        (10) of section 2104(m) of such Act (as added by 
        subsection (b)(1)(E)) for the first 6 months of fiscal 
        year 2022 in the same manner as allotments are provided 
        under subsection (a)(25)(A) of such section 2104 and 
        subject to the same terms and conditions as apply to 
        the allotments provided from such subsection 
        (a)(25)(A).
  (c) Extension of the Child Enrollment Contingency Fund.--
Section 2104(n) of the Social Security Act (42 U.S.C. 
1397dd(n)) is amended--
          (1) in paragraph (2)--
                  (A) in subparagraph (A)(ii)--
                          (i) by striking ``2010, 2011, 2012, 
                        2013, 2014, and 2016'' and inserting 
                        ``2010 through 2014, 2016, and 2018 
                        through 2021''; and
                          (ii) by striking ``fiscal year 2015 
                        and fiscal year 2017'' and inserting 
                        ``fiscal years 2015, 2017, and 2022''; 
                        and
                  (B) in subparagraph (B)--
                          (i) by striking ``2010, 2011, 2012, 
                        2013, 2014, and 2016'' and inserting 
                        ``2010 through 2014, 2016, and 2018 
                        through 2021''; and
                          (ii) by striking ``fiscal year 2015 
                        and fiscal year 2017'' and inserting 
                        ``fiscal years 2015, 2017, and 2022''; 
                        and
          (2) in paragraph (3)(A), in the matter preceding 
        clause (i), by striking ``or a semi-annual allotment 
        period for fiscal year 2015 or 2017'' and inserting 
        ``or in any of fiscal years 2018 through 2021 (or a 
        semi-annual allotment period for fiscal year 2015, 
        2017, or 2022)''.
  (d) Extension of Qualifying States Option.--Section 
2105(g)(4) of the Social Security Act (42 U.S.C. 1397ee(g)(4)) 
is amended--
          (1) in the heading, by striking ``through 2017'' and 
        inserting ``through 2022''; and
          (2) in subparagraph (A), by striking ``2017'' and 
        inserting ``2022''.
  (e) Extension of Express Lane Eligibility Option.--Section 
1902(e)(13)(I) of the Social Security Act (42 U.S.C. 
1396a(e)(13)(I)) is amended by striking ``2017'' and inserting 
``2022''.
  (f) Assurance of Affordability Standard for Children and 
Families.--
          (1) In general.--Section 2105(d)(3) of the Social 
        Security Act (42 U.S.C. 1397ee(d)(3)) is amended--
                  (A) in the paragraph heading, by striking 
                ``until october 1, 2019'' and inserting 
                ``through september 30, 2022''; and
                  (B) in subparagraph (A), in the matter 
                preceding clause (i)--
                          (i) by striking ``2019'' and 
                        inserting ``2022''; and
                          (ii) by striking ``The preceding 
                        sentence shall not be construed as 
                        preventing a State during such period'' 
                        and inserting ``During the period that 
                        begins on October 1, 2019, and ends on 
                        September 30, 2022, the preceding 
                        sentence shall only apply with respect 
                        to children in families whose income 
                        does not exceed 300 percent of the 
                        poverty line (as defined in section 
                        2110(c)(5)) applicable to a family of 
                        the size involved. The preceding 
                        sentences shall not be construed as 
                        preventing a State during any such 
                        periods''.
          (2) Conforming amendments.--Section 1902(gg)(2) of 
        the Social Security Act (42 U.S.C. 1396a(gg)(2)) is 
        amended--
                  (A) in the paragraph heading, by striking 
                ``until october 1, 2019'' and inserting 
                ``through september 30, 2022''; and
                  (B) by striking ``September 30, 2019,'' and 
                inserting ``September 30, 2022 (but during the 
                period that begins on October 1, 2019, and ends 
                on September 30, 2022, only with respect to 
                children in families whose income does not 
                exceed 300 percent of the poverty line (as 
                defined in section 2110(c)(5)) applicable to a 
                family of the size involved)''.
  (g) CHIP Look-alike Plans.--
          (1) Blending risk pools.--Section 2107 of the Social 
        Security Act (42 U.S.C. 1397gg) is amended by adding at 
        the end the following:
  ``(g) Use of Blended Risk Pools.--
          ``(1) In general.--Nothing in this title (or any 
        other provision of Federal law) shall be construed as 
        preventing a State from considering children enrolled 
        in a qualified CHIP look-alike program and children 
        enrolled in a State child health plan under this title 
        (or a waiver of such plan) as members of a single risk 
        pool.
          ``(2) Qualified chip look-alike program.--In this 
        subsection, the term `qualified CHIP look-alike 
        program' means a State program--
                  ``(A) under which children who are under the 
                age of 19 and are not eligible to receive 
                medical assistance under title XIX or child 
                health assistance under this title may purchase 
                coverage through the State that provides 
                benefits that are at least identical to the 
                benefits provided under the State child health 
                plan under this title (or a waiver of such 
                plan); and
                  ``(B) that is funded exclusively through non-
                Federal funds, including funds received by the 
                State in the form of premiums for the purchase 
                of such coverage.''.
          (2) Coverage rule.--
                  (A) In general.--Section 5000A(f)(1) of the 
                Internal Revenue Code of 1986 is amended in 
                subparagraph (A)(iii), by inserting ``or under 
                a qualified CHIP look-alike program (as defined 
                in section 2107(g) of the Social Security 
                Act)'' before the comma at the end.
                  (B) Effective date.--The amendment made by 
                subparagraph (A) shall apply with respect to 
                taxable years beginning after December 31, 
                2017.

SEC. 302. EXTENSION OF CERTAIN PROGRAMS AND DEMONSTRATION PROJECTS.

  (a) Childhood Obesity Demonstration Project.--Section 
1139A(e)(8) of the Social Security Act (42 U.S.C. 1320b-
9a(e)(8)) is amended--
          (1) by striking ``and $10,000,000'' and inserting ``, 
        $10,000,000''; and
          (2) by inserting after ``2017'' the following: ``, 
        and $25,000,000 for the period of fiscal years 2018 
        through 2022''.
  (b) Pediatric Quality Measures Program.--Section 1139A(i) of 
the Social Security Act (42 U.S.C. 1320b-9a(i)) is amended--
          (1) by striking ``Out of any'' and inserting the 
        following:
          ``(1) In general.--Out of any'';
          (2) by striking ``there is appropriated for each'' 
        and inserting ``there is appropriated--
                  ``(A) for each'';
          (3) by striking ``, and there is appropriated for the 
        period'' and inserting ``;
                  ``(B) for the period'';
          (4) by striking ``. Funds appropriated under this 
        subsection shall remain available until expended.'' and 
        inserting ``; and''; and
          (5) by adding at the end the following:
                  ``(C) for the period of fiscal years 2018 
                through 2022, $75,000,000 for the purpose of 
                carrying out this section (other than 
                subsections (e), (f), and (g)).
          ``(2) Availability.--Funds appropriated under this 
        subsection shall remain available until expended.''.

SEC. 303. EXTENSION OF OUTREACH AND ENROLLMENT PROGRAM.

  (a) In General.--Section 2113 of the Social Security Act (42 
U.S.C. 1397mm) is amended--
          (1) in subsection (a)(1), by striking ``2017'' and 
        inserting ``2022''; and
          (2) in subsection (g)--
                  (A) by striking ``and $40,000,000'' and 
                inserting ``, $40,000,000''; and
                  (B) by inserting after ``2017'' the 
                following: ``, and $100,000,000 for the period 
                of fiscal years 2018 through 2022''.
  (b) Making Organizations That Use Parent Mentors Eligible to 
Receive Grants.--Section 2113(f) of the Social Security Act (42 
U.S.C. 1397mm(f)) is amended--
          (1) in paragraph (1)(E), by striking ``or community-
        based doula programs'' and inserting ``, community-
        based doula programs, or parent mentors''; and
          (2) by adding at the end the following new paragraph:
          ``(5) Parent mentor.--The term `parent mentor' means 
        an individual who--
                  ``(A) is a parent or guardian of at least one 
                child who is an eligible child under this title 
                or title XIX; and
                  ``(B) is trained to assist families with 
                children who have no health insurance coverage 
                with respect to improving the social 
                determinants of the health of such children, 
                including by providing--
                          ``(i) education about health 
                        insurance coverage, including, with 
                        respect to obtaining such coverage, 
                        eligibility criteria and application 
                        and renewal processes;
                          ``(ii) assistance with completing and 
                        submitting applications for health 
                        insurance coverage;
                          ``(iii) a liaison between families 
                        and representatives of State plans 
                        under title XIX or State child health 
                        plans under this title;
                          ``(iv) guidance on identifying 
                        medical and dental homes and community 
                        pharmacies for children; and
                          ``(v) assistance and referrals to 
                        successfully address social 
                        determinants of children's health, 
                        including poverty, food insufficiency, 
                        and housing.''.
  (c) Exclusion From Modified Adjusted Gross Income.--Section 
1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) is 
amended--
          (1) in the first paragraph (14), relating to income 
        determined using modified adjusted gross income, by 
        adding at the end the following new subparagraph:
                  ``(J) Exclusion of parent mentor compensation 
                from income determination.--Any nominal amount 
                received by an individual as compensation, 
                including a stipend, for participation as a 
                parent mentor (as defined in paragraph (5) of 
                section 2113(f)) in an activity or program 
                funded through a grant under such section shall 
                be disregarded for purposes of determining the 
                income eligibility of such individual for 
                medical assistance under the State plan or any 
                waiver of such plan.''; and
          (2) by striking ``(14) Exclusion'' and inserting 
        ``(15) Exclusion''.

SEC. 304. EXTENSION AND REDUCTION OF ADDITIONAL FEDERAL FINANCIAL 
                    PARTICIPATION FOR CHIP.

  Section 2105(b) of the Social Security Act (42 U.S.C. 
1397ee(b)) is amended in the second sentence by inserting ``and 
during the period that begins on October 1, 2019, and ends on 
September 30, 2020, the enhanced FMAP determined for a State 
for a fiscal year (or for any portion of a fiscal year 
occurring during such period) shall be increased by 11.5 
percentage points'' after ``23 percentage points,''.

SEC. 305. MODIFYING REDUCTIONS IN MEDICAID DSH ALLOTMENTS.

  Section 1923(f)(7)(A) of the Social Security Act (42 U.S.C. 
1396r-4(f)(7)(A)) is amended--
          (1) in clause (i), in the matter preceding subclause 
        (I), by striking ``2018'' and inserting ``2020''; and
          (2) in clause (ii), by striking subclauses (I) 
        through (VIII) and inserting the following:
                                  ``(I) $4,000,000,000 for 
                                fiscal year 2020; and
                                  ``(II) $8,000,000,000 for 
                                each of fiscal years 2021 
                                through 2025.''.

SEC. 306. PUERTO RICO AND THE VIRGIN ISLANDS MEDICAID PAYMENTS.

  (a) Increased Cap.--Section 1108(g) of the Social Security 
Act (42 U.S.C. 1308(g)) is amended--
          (1) in paragraph (2)--
                  (A) in subparagraph (A), by inserting ``(or, 
                with respect to fiscal years 2018 and 2019, 
                increased by such percentage increase plus one 
                percentage point)'' after ``beginning of the 
                fiscal year''; and
                  (B) in subparagraph (B), by inserting ``(or, 
                with respect to fiscal years 2018 and 2019, 
                increased by such percentage increase plus one 
                percentage point)'' after ``percentage increase 
                referred to in subparagraph (A)'';
          (2) in paragraph (5)--
                  (A) in subparagraph (A), by striking 
                ``subparagraph (B)'' and inserting 
                ``subparagraphs (B), (C), (D), (E), and (F)''; 
                and
                  (B) by adding at the end the following new 
                subparagraphs:
          ``(C) The amount of the increase otherwise provided 
        under subparagraph (A) for Puerto Rico shall be further 
        increased by $880,000,000.
          ``(D)(i) For the period beginning October 1, 2017, 
        and ending December 31, 2019, the amount of the 
        increase otherwise provided under subparagraph (A) for 
        Puerto Rico shall be further increased by $120,000,000 
        if the Financial Oversight and Management Board for 
        Puerto Rico established under section 101 of the Puerto 
        Rico Oversight, Management, and Economic Stability Act 
        (48 U.S.C. 2121) certifies by a majority vote that 
        Puerto Rico has taken reasonable and appropriate steps 
        during such period to--
                  ``(I) reduce fraud, waste, and abuse under 
                the program under title XIX;
                  ``(II) implement strategies to reduce 
                unnecessary, inefficient, or excessive spending 
                under title XIX;
                  ``(III) improve the use and availability of 
                Medicaid data for program operation and 
                oversight; and
                  ``(IV) improve the quality of care and 
                patient experience for individuals enrolled 
                under the program under title XIX.
          ``(ii) As a condition of any additional increase 
        pursuant to clause (i), not later than October 1, 2018, 
        Puerto Rico shall submit to the Financial Oversight and 
        Management Board for Puerto Rico a report regarding 
        steps taken to achieve each of the goals described in 
        subclauses (I) through (IV) of clause (i).
          ``(E) Payments under section 1903(a)(8) for a quarter 
        of a fiscal year shall not be taken into account in 
        applying subsection (f) (as increased in accordance 
        with this paragraph and paragraphs (1), (2), (3), and 
        (4)) to Puerto Rico or the Virgin Islands for such 
        fiscal year.
          ``(F)(i) For the period beginning October 1, 2017, 
        and ending December 31, 2019, the amount of the 
        increase otherwise provided under subparagraph (A) for 
        the Virgin Islands shall be further increased by an 
        amount equal to the per capita equivalent of the total 
        amount of the increase provided for Puerto Rico under 
        subparagraphs (C) and (D) for such period.
          ``(ii) For purposes of clause (i), the term `per 
        capita equivalent' means the ratio of--
                  ``(I) the population of the Virgin Islands, 
                as determined by the most recent census 
                estimate released by the Bureau of the Census 
                before September 4, 2017; to
                  ``(II) the population of Puerto Rico, as so 
                determined.''.
  (b) Federal Match for Medical Personnel and Fraud 
Reduction.--Section 1903(a) of the Social Security Act (42 
U.S.C. 1396b(a)) is amended--
          (1) in paragraph (2)(A), by inserting ``subject to 
        paragraph (8),'' before ``an amount'';
          (2) in paragraph (6)--
                  (A) in subparagraph (B), by inserting 
                ``subject to paragraph (8),'' before ``75 per 
                centum''; and
                  (B) by striking at the end ``plus'';
          (3) in paragraph (7), by striking at the end the 
        period and inserting ``; plus'' ; and
          (4) by adding at the end the following new paragraph:
          ``(8) for quarters during the period beginning 
        January 1, 2018, and ending December 31, 2019, 
        paragraphs (2)(A) and (6) shall apply with respect to 
        Puerto Rico and the Virgin Islands as if--
                  ``(A) the reference to `75 per centum' in 
                paragraph (2)(A) were a reference to `90 per 
                centum'; and
                  ``(B) the reference to `75 per centum' in 
                paragraph (6)(B) were a reference to `90 per 
                centum'.''.

                           TITLE II--OFFSETS

SEC. 401. MEDICAID THIRD PARTY LIABILITY PROVISIONS.

  (a) Medicaid Third Party Liability.--
          (1) Delay of bipartisan budget act of 2013 third 
        party liability provisions.--
                  (A) In general.--Section 202(c) of the 
                Bipartisan Budget Act of 2013 (Public Law 113-
                67; 127 Stat. 1177; 42 U.S.C. 1396a note), as 
                amended by section 211 of the Protecting Access 
                to Medicare Act of 2014 (Public Law 113-93; 128 
                Stat. 1047; 42 U.S.C. 1396a note) and section 
                220 of the Medicare Access and CHIP 
                Reauthorization Act of 2015 (Public Law 114-
                10), is amended by striking ``2017'' and 
                inserting ``2019''.
                  (B) Effective date; treatment.--The amendment 
                made by subparagraph (A) shall take effect on 
                September 30, 2017, and shall apply with 
                respect to any open claims, including claims 
                generated or filed, after such date.
          (2) Clarification of definitions applicable to third 
        party liability.--
                  (A) In general.--Section 1902 of the Social 
                Security Act (42 U.S.C. 1396a) is amended by 
                adding at the end the following new subsection:
  ``(nn) Responsible Third Party and Health Insurer 
Definitions.--For purposes of subsection (a)(25) and section 
1903(d)(2)(B):
          ``(1) Responsible third party.--The term `responsible 
        third party' means a health insurer, a pharmacy benefit 
        manager to the extent the pharmacy benefit manager 
        provides information under this title for the purpose 
        of coordinating benefits, an accountable care 
        organization under section 1899, or any other party 
        that is, by statute, contract, or agreement, legally 
        responsible for payment of a claim for a health care 
        item or service. Such term does not include a party if 
        payment by such party has been made or can reasonably 
        be expected to be made under a workmen's compensation 
        law or plan of the United States or a State, or under 
        an automobile or liability insurance policy or plan 
        (including a self-insured plan), or under no fault 
        insurance.
          ``(2) Health insurer.--The term `health insurer' 
        means a group health plan, as defined in section 607(1) 
        of the Employee Retirement Income Security Act of 1974, 
        a self-insured plan, a fully-insured plan, a service 
        benefit plan, a medicaid managed care plan under 
        section 1903(m) or 1932, and any other health plan 
        determined appropriate by the Secretary.''.
                  (B) Conforming amendments.--Section 
                1902(a)(25) of the Social Security Act (42 
                U.S.C. 1396a(a)(25)) is amended--
                          (i) in subparagraph (A), in the 
                        matter preceding clause (i), by 
                        striking ``third parties'' and all that 
                        follows through ``item or service)'' 
                        and inserting ``responsible third 
                        parties'';
                          (ii) in subparagraph (G), by striking 
                        ``health insurer'' and all that follows 
                        through ``item or service)'' and 
                        inserting ``responsible third party'';
                          (iii) in subparagraph (I), in the 
                        matter preceding clause (i), by 
                        striking ``health insurers'' and all 
                        that follows through ``item or 
                        service'' and inserting ``responsible 
                        third parties''; and
                          (iv) by inserting ``responsible'' 
                        before ``third'' each place it appears 
                        in subparagraphs (A)(i), (A)(ii), (C), 
                        (D), and (H).
          (3) Removal of special treatment of certain types of 
        care and payments under medicaid third party liability 
        rules.--Section 1902(a)(25) of the Social Security Act 
        (42 U.S.C. 1396a(a)(25)), as amended by section 202(c) 
        of the Bipartisan Budget Act of 2013 (after application 
        of paragraph (1)), is amended--
                  (A) in subparagraph (E)--
                          (i) in the matter preceding clause 
                        (i), by striking ``prenatal or 
                        preventive'' and all that follows 
                        through ``State plan'' and inserting 
                        ``items and services provided under the 
                        program required under the State plan 
                        pursuant to paragraph (62)''; and
                          (ii) in clause (i)--
                                  (I) by striking ``such 
                                service'' and inserting ``such 
                                items and services''; and
                                  (II) by striking each place 
                                it appears ``such services'' 
                                and inserting ``such items and 
                                services'' each such place; and
                  (B) by striking subparagraph (F).
          (4) Clarification of role of health insurers with 
        respect to third party liability.--
                  (A) In general.--Section 1902(a)(25) of the 
                Social Security Act (42 U.S.C. 1396a(a)(25)), 
                as amended by paragraph (3), is further amended 
                by inserting after subparagraph (E) the 
                following new subparagraph:
                  ``(F) that--
                          ``(i) in the case of a State that 
                        provides medical assistance under this 
                        title through a contract with a health 
                        insurer, such contract shall specify 
                        any responsibility of such health 
                        insurer (or other entity) with respect 
                        to recovery of payment from responsible 
                        third parties pursuant to the 
                        delegation or transfer by the State to 
                        such insurer (or other entity) of a 
                        right described in subparagraph 
                        (I)(ii); and
                          ``(ii) in the case of a State that 
                        under a contract described in clause 
                        (i) delegates or transfers to a health 
                        insurer (or other entity) a right 
                        described in such clause, the State 
                        shall provide assurances to the 
                        Secretary that the State laws referred 
                        to in subparagraph (I), with respect to 
                        each responsibility of such health 
                        insurer (or other entity) specified 
                        under such clause, confer to such 
                        health insurer (or other entity) the 
                        authority of the State with respect to 
                        the requirements specified in clauses 
                        (i) through (iv) of such subparagraph 
                        (I);''.
                  (B) Treatment of collected amounts.--Section 
                1903(d)(2)(B) of the Social Security Act (42 
                U.S.C. 1396b(d)(2)(B)) is amended by adding at 
                the end the following: ``For purposes of this 
                subparagraph, reimbursements made by a 
                responsible third party to health insurers (as 
                defined in section 1902(nn)) pursuant to 
                section 1902(a)(25)(F)(ii) shall be treated in 
                the same manner as reimbursements made to a 
                State under the previous sentence.''.
          (5) Increasing state flexibility with respect to 
        third party liability.--Section 1902(a)(25)(I) of the 
        Social Security Act (42 U.S.C. 1396a(a)(25)(I)) is 
        amended--
                  (A) in clause (i), by striking ``medical 
                assistance under the State plan'' and inserting 
                ``medical assistance under a State plan (or 
                under a waiver of the plan)'';
                  (B) by striking clause (ii) and inserting the 
                following new clause:
                          ``(ii) accept--
                                  ``(I) any State's right of 
                                recovery and the assignment to 
                                any State of any right of an 
                                individual or other entity to 
                                payment from the party for an 
                                item or service for which 
                                payment has been made under the 
                                respective State's plan (or 
                                under a waiver of the plan); 
                                and
                                  ``(II) as a valid 
                                authorization of the 
                                responsible third party for the 
                                furnishing of an item or 
                                service to an individual 
                                eligible to receive medical 
                                assistance under this title, an 
                                authorization made on behalf of 
                                such individual under the State 
                                plan (or under a waiver of such 
                                plan) for the furnishing of 
                                such item or service to such 
                                individual;'';
                  (C) in clause (iii)--
                          (i) by striking ``respond to'' and 
                        inserting ``not later than 60 days 
                        after receiving''; and
                          (ii) by striking ``; and'' at the end 
                        and inserting ``, respond to such 
                        inquiry; and''; and
                  (D) in clause (iv), by inserting ``a failure 
                to obtain a prior authorization,'' after 
                ``claim form,''.
          (6) State incentive to pursue third party liability 
        for newly eligibles.--Section 1903(d)(2)(B) of the 
        Social Security Act (42 U.S.C. 1396b(d)(2)(B)), as 
        amended by paragraph (4)(B), is further amended by 
        adding at the end the following: ``In the case of 
        expenditures for medical assistance provided during 
        2017 and subsequent years for individuals described in 
        subclause (VIII) of section 1902(a)(10)(A)(i), in 
        determining the amount, if any, of overpayment under 
        this subparagraph with respect to such medical 
        assistance, the Secretary shall apply the Federal 
        medical assistance percentage for the State under 
        section 1905(b), notwithstanding the application of 
        section 1905(y).''.
  (b) Compliance With Third Party Insurance Reporting.--Section 
1905 of the Social Security Act (42 U.S.C. 1396d) is amended by 
adding at the end the following new subsection:
  ``(ee) Notwithstanding subsection (b), for any year beginning 
after 2019, if a State fails to comply with the requirements of 
section 1902(a)(25) with respect to each calendar quarter in 
such year, the Secretary may reduce the Federal medical 
assistance percentage by 0.1 percentage point for calendar 
quarters in each subsequent year in which the State fails to so 
comply.''.
  (c) Application to CHIP.--
          (1) In general.--Section 2107(e)(1) of the Social 
        Security Act (42 U.S.C. 1397gg(e)(1)) is amended--
                  (A) by redesignating subparagraphs (B) 
                through (R) as subparagraphs (C) through (S), 
                respectively; and
                  (B) by inserting after subparagraph (A) the 
                following new subparagraph:
                  ``(B) Section 1902(a)(25) (relating to third 
                party liability).''.
          (2) Mandatory reporting.--Section 1902(a)(25)(I)(i) 
        of the Social Security Act (42 U.S.C. 
        1396a(a)(25)(I)(i)), as amended by subsection (a)(5), 
        is further amended--
                  (A) by striking ``(and, at State option, 
                child'' and inserting ``and child''; and
                  (B) by striking ``title XXI)'' and inserting 
                ``title XXI''.
  (d) Training on Third Party Liability.--Section 1936 of the 
Social Security Act (42 U.S.C. 1396u-6) is amended--
          (1) in subsection (b)(4), by striking ``and quality 
        of care'' and inserting ``, quality of care, and the 
        liability of responsible third parties (as defined in 
        section 1902(nn))''; and
          (2) by adding at the end the following new 
        subsection:
  ``(f) Third Party Liability Training.--With respect to 
education or training activities carried out pursuant to 
subsection (b)(4) with respect to the liability of responsible 
third parties (as defined in section 1902(nn) for payment for 
items and services furnished under State plans (or under 
waivers of such plans)) under this title, the Secretary shall--
          ``(1) publish (and update on an annual basis) on the 
        public Internet website of the Centers for Medicare & 
        Medicaid Services a dedicated Internet page containing 
        best practices to be used in assessing such liability;
          ``(2) monitor efforts to assess such liability and 
        analyze the challenges posed by that assessment;
          ``(3) distribute to State agencies administering the 
        State plan under this title information related to such 
        efforts and challenges; and
          ``(4) provide guidance to such State agencies with 
        respect to State oversight of efforts under a medicaid 
        managed care plan under section 1903(m) or 1932 to 
        assess such liability.''.
  (e) Development of Model Uniform Fields for States To Report 
Third Party Information.--Not later than January 1, 2019, the 
Secretary of Health and Human Services shall, in consultation 
with the States, develop and make available to the States a 
model uniform reporting set of reporting fields and 
accompanying guidance documentation that States shall use for 
purposes of--
          (1) reporting information to the Secretary within the 
        Transformed Medicaid Statistical Information System (T-
        MSIS) (or a successor system); and
          (2) collecting information that identifies 
        responsible third parties (as defined in subsection 
        (nn) of section 1902 of the Social Security Act (42 
        U.S.C. 1396a), as added by subsection (a)(2)(A)) and 
        other relevant information for ascertaining the legal 
        responsibility of such third parties to pay for care 
        and services available under the State plan (or under a 
        waiver of the plan) under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.) or under the 
        State child health plan under title XXI of such Act (42 
        U.S.C. 1397 et seq.).
  (f) Effective Date.--
          (1) In general.--Except as provided in paragraph (2), 
        this section and the amendments made by this section 
        (other than as specified in the preceding provisions of 
        this section) shall take effect on October 1, 2019, and 
        shall apply to medical assistance or child health 
        assistance provided on or after such date.
          (2) Exception if state legislation required.--In the 
        case of a State plan for medical assistance under title 
        XIX of the Social Security Act (42 U.S.C. 1396 et 
        seq.), or a State child health plan for child health 
        assistance under title XXI of such Act (42 U.S.C. 
        1397aa et seq.), that the Secretary of Health and Human 
        Services determines requires State legislation (other 
        than legislation appropriating funds) in order for the 
        plan to meet the additional requirement imposed by the 
        amendments made under this section, such plan shall not 
        be regarded as failing to comply with the requirements 
        of such title solely on the basis of its failure to 
        meet this additional requirement before the first day 
        of the first calendar quarter beginning after the close 
        of the first regular session of the State legislature 
        that begins after the date of the enactment of this 
        Act. For purposes of the previous sentence, in the case 
        of a State that has a 2-year legislative session, each 
        year of such session shall be deemed to be a separate 
        regular session of the State legislature.

SEC. 402. TREATMENT OF LOTTERY WINNINGS AND OTHER LUMP-SUM INCOME FOR 
                    PURPOSES OF INCOME ELIGIBILITY UNDER MEDICAID.

  (a) In General.--Section 1902 of the Social Security Act (42 
U.S.C. 1396a) is amended--
          (1) in subsection (a)(17), by striking ``(e)(14), 
        (e)(14)'' and inserting ``(e)(14), (e)(15)''; and
          (2) in subsection (e)(14), as amended by section 
        303(c), by adding at the end the following new 
        subparagraph:
                  ``(K) Treatment of certain lottery winnings 
                and income received as a lump sum.--
                          ``(i) In general.--In the case of an 
                        individual who is the recipient of 
                        qualified lottery winnings (pursuant to 
                        lotteries occurring on or after January 
                        1, 2018) or qualified lump sum income 
                        (received on or after such date) and 
                        whose eligibility for medical 
                        assistance is determined based on the 
                        application of modified adjusted gross 
                        income under subparagraph (A), a State 
                        shall, in determining such eligibility, 
                        include such winnings or income (as 
                        applicable) as income received--
                                  ``(I) in the month in which 
                                such winnings or income (as 
                                applicable) is received if the 
                                amount of such winnings or 
                                income is less than $80,000;
                                  ``(II) over a period of 2 
                                months if the amount of such 
                                winnings or income (as 
                                applicable) is greater than or 
                                equal to $80,000 but less than 
                                $90,000;
                                  ``(III) over a period of 3 
                                months if the amount of such 
                                winnings or income (as 
                                applicable) is greater than or 
                                equal to $90,000 but less than 
                                $100,000; and
                                  ``(IV) over a period of 3 
                                months plus 1 additional month 
                                for each increment of $10,000 
                                of such winnings or income (as 
                                applicable) received, not to 
                                exceed a period of 120 months 
                                (for winnings or income of 
                                $1,260,000 or more), if the 
                                amount of such winnings or 
                                income is greater than or equal 
                                to $100,000.
                          ``(ii) Counting in equal 
                        installments.--For purposes of 
                        subclauses (II), (III), and (IV) of 
                        clause (i), winnings or income to which 
                        such subclause applies shall be counted 
                        in equal monthly installments over the 
                        period of months specified under such 
                        subclause.
                          ``(iii) Hardship exemption.--An 
                        individual whose income, by application 
                        of clause (i), exceeds the applicable 
                        eligibility threshold established by 
                        the State, shall continue to be 
                        eligible for medical assistance to the 
                        extent that the State determines, under 
                        procedures established by the State (in 
                        accordance with standards specified by 
                        the Secretary), that the denial of 
                        eligibility of the individual would 
                        cause an undue medical or financial 
                        hardship as determined on the basis of 
                        criteria established by the Secretary.
                          ``(iv) Notifications and assistance 
                        required in case of loss of 
                        eligibility.--A State shall, with 
                        respect to an individual who loses 
                        eligibility for medical assistance 
                        under the State plan (or a waiver of 
                        such plan) by reason of clause (i)--
                                  ``(I) before the date on 
                                which the individual loses such 
                                eligibility, inform the 
                                individual--
                                          ``(aa) of the 
                                        individual's 
                                        opportunity to enroll 
                                        in a qualified health 
                                        plan offered through an 
                                        Exchange established 
                                        under title I of the 
                                        Patient Protection and 
                                        Affordable Care Act 
                                        during the special 
                                        enrollment period 
                                        specified in section 
                                        9801(f)(3) of the 
                                        Internal Revenue Code 
                                        of 1986 (relating to 
                                        loss of Medicaid or 
                                        CHIP coverage); and
                                          ``(bb) of the date on 
                                        which the individual 
                                        would no longer be 
                                        considered ineligible 
                                        by reason of clause (i) 
                                        to receive medical 
                                        assistance under the 
                                        State plan or under any 
                                        waiver of such plan and 
                                        be eligible to reapply 
                                        to receive such medical 
                                        assistance; and
                                  ``(II) provide technical 
                                assistance to the individual 
                                seeking to enroll in such a 
                                qualified health plan.
                          ``(v) Qualified lottery winnings 
                        defined.--In this subparagraph, the 
                        term `qualified lottery winnings' means 
                        winnings from a sweepstakes, lottery, 
                        or pool described in paragraph (3) of 
                        section 4402 of the Internal Revenue 
                        Code of 1986 or a lottery operated by a 
                        multistate or multijurisdictional 
                        lottery association, including amounts 
                        awarded as a lump sum payment.
                          ``(vi) Qualified lump sum income 
                        defined.--In this subparagraph, the 
                        term `qualified lump sum income' means 
                        income that is received as a lump sum 
                        from one of the following sources:
                                  ``(I) Monetary winnings from 
                                gambling (as defined by the 
                                Secretary and including 
                                gambling activities described 
                                in section 1955(b)(4) of title 
                                18, United States Code).
                                  ``(II) Damages received, 
                                whether by suit or agreement 
                                and whether as lump sums or as 
                                periodic payments (other than 
                                monthly payments), on account 
                                of causes of action other than 
                                causes of action arising from 
                                personal physical injuries or 
                                physical sickness.
                                  ``(III) Income received as 
                                liquid assets from the estate 
                                (as defined in section 
                                1917(b)(4)) of a deceased 
                                individual.''.
  (b) Rules of Construction.--
          (1) Interception of lottery winnings allowed.--
        Nothing in the amendment made by subsection (a)(2) 
        shall be construed as preventing a State from 
        intercepting the State lottery winnings awarded to an 
        individual in the State to recover amounts paid by the 
        State under the State Medicaid plan under title XIX of 
        the Social Security Act (42 U.S.C. 1396 et seq.) for 
        medical assistance furnished to the individual.
          (2) Applicability limited to eligibility of recipient 
        of lottery winnings or lump sum income.--Nothing in the 
        amendment made by subsection (a)(2) shall be construed, 
        with respect to a determination of household income for 
        purposes of a determination of eligibility for medical 
        assistance under the State plan under title XIX of the 
        Social Security Act (42 U.S.C. 1396 et seq.) (or a 
        waiver of such plan) made by applying modified adjusted 
        gross income under subparagraph (A) of section 
        1902(e)(14) of such Act (42 U.S.C. 1396a(e)(14)), as 
        limiting the eligibility for such medical assistance of 
        any individual that is a member of the household other 
        than the individual who received qualified lottery 
        winnings or qualified lump-sum income (as defined in 
        subparagraph (K) of such section 1902(e)(14), as added 
        by subsection (a)(2) of this section).
                              ----------                              


            PART B--TEXT OF AMENDMENT CONSIDERED AS ADOPTED

  Amend section 202 to read as follows:

SEC. 202. PREVENTION AND PUBLIC HEALTH FUND.

  Section 4002(b) of the Patient Protection and Affordable Care 
Act (42 U.S.C. 300u-11(b)) is amended by striking paragraphs 
(3) through (8) and inserting the following new paragraphs:
          ``(3) for fiscal year 2018, $900,000,000;
          ``(4) for fiscal year 2019, $500,000,000;
          ``(5) for fiscal year 2020, $500,000,000;
          ``(6) for fiscal year 2021, $500,000,000;
          ``(7) for fiscal year 2022, $500,000,000;
          ``(8) for fiscal year 2023, $500,000,000;
          ``(9) for fiscal year 2024, $500,000,000;
          ``(10) for fiscal year 2025, $750,000,000;
          ``(11) for fiscal year 2026, $1,000,000,000; and
          ``(12) for fiscal year 2027 and each fiscal year 
        thereafter, $2,000,000,000.''.

  Add at the end of title II of division B the following (and 
conform the table of contents accordingly):

SEC. 403. ADJUSTMENTS TO MEDICARE PART B AND PART D PREMIUM SUBSIDIES 
                    FOR HIGHER INCOME INDIVIDUALS.

  (a) In General.--Section 1839(i)(3)(C)(i)(II) of the Social 
Security Act (42 U.S.C. 1395r(i)(3)(C)(i)(II)) is amended, in 
the table, by striking the last row and inserting the following 
new rows:

    ``More than $160,000 but less than $500,000...............80 percent
    At least $500,000....................................100 percent.''.

  (b) Joint Returns.--Section 1839(i)(3)(C)(ii) of the Social 
Security Act (42 U.S.C. 1395r(i)(3)(C)(ii)) is amended by 
inserting before the period the following: ``except, with 
respect to the dollar amounts applied in the last row of the 
table under subclause (II) of such clause (and the second 
dollar amount specified in the second to last row of such 
table), clause (i) shall be applied by substituting dollar 
amounts which are 175 percent of such dollar amounts for the 
calendar year''.
  (c) Inflation Adjustment.--Section 1839(i) of the Social 
Security Act (42 U.S.C. 1395r(i)) is amended--
          (1) in paragraph (5)--
                  (A) in subparagraph (A), by striking ``In the 
                case'' and inserting ``Subject to subparagraph 
                (C), in the case'';
                  (B) in subparagraph (B), by striking 
                ``subparagraph (A)'' and inserting 
                ``subparagraph (A) or (C)''; and
                  (C) by adding at the end the following new 
                subparagraph:
                  ``(C) Treatment of adjustments for certain 
                higher income individuals.--
                          ``(i) In general.--Subparagraph (A) 
                        shall not apply with respect to each 
                        dollar amount in paragraph (3) of 
                        $500,000.
                          ``(ii) Adjustment beginning 2027.--In 
                        the case of any calendar year beginning 
                        after 2026, each dollar amount in 
                        paragraph (3) of $500,000 shall be 
                        increased by an amount equal to--
                                  ``(I) such dollar amount, 
                                multiplied by
                                  ``(II) the percentage (if 
                                any) by which the average of 
                                the Consumer Price Index for 
                                all urban consumers (United 
                                States city average) for the 
                                12-month period ending with 
                                August of the preceding 
                                calendar year exceeds such 
                                average for the 12-month period 
                                ending with August 2025.''; and
          (2) in paragraph (6)(B), by inserting ``(other than 
        $500,000)'' after ``the dollar amounts''.

                                  [all]