,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #bbbd  ,,in ,,the ,,house ,,of  
,,representatives  ,april #bh1 #bjag,mr4
 ,smith of ,nebraska 7for himself1 ,mr4 
,kelly of ,pennsylvania1 ,mr4 ,long1    
,mr4 ,barr1 and ,mr4 ,byrne7 introduced 
the following bill2 which was referred  
to the ,committee on ,ways and ,means   
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to apply     
budget neutrality on a ,state-specific  
basis in the calculation of the         
,medicare hospital wage index floor for 
non-rural areas4  #a4 ,short title ,this
 ,act may be cited as the ,repeal of the
 ,obamacare ,bay ,state ,boondoggle     
,act4  #b4 ,applying budget neutrality  
on a ,state-specific basis in the       
calculation of the ,medicare hospital   
wage index floor for non-rural areas    
7a7 ,in general ,section                
#ahhf7;d77#c77;,e7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acieww7d77#c77;,e77 is amended by      
adding at the end the following new     

clause3  7iv7 ,application of budget    
neutrality relating to floor on wage    
area index in non-rural areas  7,i7     
,application on a ,state-specific basis 
,in the case of discharges occurring on 
or after ,april #a1 #bjag1 for purposes 
of applying section #ddaj7;b7 of the    
,balanced ,budget ,act of #aiig1 the    
,secretary shall administer such section
 #ddaj7;b7 and paragraph 7e7 of section 
#dab4fd of title #db1 ,code of ,federal 
,regulations1 as if paragraph           
7e77#d77;ii7 of such section #dab4fd1 as
 in effect on the day before the date of
 the enactment of this clause1 had never
 applied and by using the methodology   
promulgated in the ,federal ,register on
 ,august #ai1 #bjjh 7#gc ,fed4 ,reg4    
#dhegj7 7applied as if such methodology 
had been fully implemented for fiscal   
year #bjaa using a #ajj percent         
,state-specific adjustment to the area  
wage index74  7,,ii7 ,construction      
,nothing in subclause 7,i7 shall be     
construed as preventing the ,secretary1 

for discharges occurring on or after    
,april #a1 #bjag1 from modifying the    
regulations under such section #dab4fd  
to be consistent with subclause 7,i7 in 
carrying out the budget neutrality      
requirements of such section #ddaj7;b74 
4  7b7 ,conforming amendment terminating
 application of budget neutrality on a  
nationwide basis ,section #cada of the  
,patient ,protection and ,affordable    
,care ,act 7#db ,u4,s4,c4 #acieww note7 
is amended by inserting and before      
,april #a1 #bjag1 after #bjaj14