,i  #aacth ,,congress  #b;d ,session    
,h4 ,r4 #ejih  ,,in ,,the ,,house ,,of  
,,representatives  ,july #ad1 #bjad ,mr4
 ,daines introduced the following bill2 
which was referred to the ,committee on 
,ways and ,means  ,a ,,bill  ,to amend  
the ,internal ,revenue ,code of #aihf to
 temporarily exempt from the employer   
health insurance mandate certain        
,medicare and ,medicaid providers4  #a4 
,short title ,this ,act may be cited as 
the ,ensuring ,medicaid and ,medicare   
,access to ,providers ,act4  #b4        
,certain ,medicare and ,medicaid        
providers temporarily exempt from       
employer health insurance mandate  7a7  
,in general ,section #dihj;,h7c77#b7 of 
the ,internal ,revenue ,code of #aihf is
 amended by adding at the end the       
following new subparagraph3  7,f7       
,exception for certain ,medicare and    
,medicaid providers  7i7 ,in general ,in
 the case of any month beginning in     
#bjad or #bjae1 the term applicable     
large employer shall not include any    

employer who is a specified ,medicare   
and ,medicaid provider with respect to  
the calendar year in which such month   
begins4  7ii7 ,specified ,medicare and  
,medicaid provider ,the term specified  
,medicare and ,medicaid provider means1 
with respect to any calendar year1 any  
employer if the total specified         
,medicare and ,medicaid payments        
received by such employer during the    
applicable period equals or exceeds #fj 
percent of the total gross receipts of  
such employer for such period4  7iii7   
,specified ,medicare and ,medicaid      
payments ,the term specified ,medicare  
and ,medicaid payments means--  7,i7 any
 payment made to the employer under     
title ,,xix of the ,social ,security    
,act for the furnishing of items and    
services included as medical assistance 
7as defined in section #aije7;a7 of the 
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7a777 under such title1 and      
7,,ii7 any payment made to the employer 
under title ,,xviii of such ,act for the

 furnishing of items and services to    
individuals entitled to benefits under  
part ,a of such title or enrolled under 
part ,b of such title1 including dual   
eligible individuals 7as defined in     
section #aiae7;h77#b77;,b7 of such ,act 
7#db ,u4,s4,c4 #acifn7h77#b77;,b7774    
7iv7 ,treatment of payment for items and
 services furnished through a health    
plan ,in applying clause 7iii7 with     
respect to the payment for items and    
services furnished to individuals       
enrolled in a health plan under a       
contract under title ,,xviii or ,,xix of
 the ,social ,security ,act1 payment for
 such items and services under such plan
 shall be treated as payment under such 
respective title4  7v7 ,applicable      
period  7,i7 ,in general ,for purposes  
of this subparagraph1 the term          
applicable period means1 with respect to
 any calendar year1 the #c taxable years
 ending before the beginning of such    
calendar year4  7,,ii7 ,application of  
certain rules ,rules similar to the     

rules of subparagraphs 7,a71 7,c71 and  
7,d7 of section #ddh7;c77#c7 shall apply
 for purposes of this clause4  7,,iii7  
,special rule for first taxable year of 
existence ,in the case of an employer no
 taxable year of which ends before the  
beginning of the calendar year1 the     
applicable period for such calendar year
 shall be the period beginning on the   
date that such employer came into       
existence and ending with the close of  
such calendar year4  4  7b7 ,effective  
date ,the amendment made by this section
 shall apply to months beginning after  
,december #ca1 #bjac4