,,ii #aae? ,,congress #a/ ,session ,s4 #eed ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,m>* #g1 #bjag,mr4 ,paul 7= himself & ,mr4 ,lee7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to provide = reconciliation pursuant to section #bjjb ( ! concurr5t resolution on ! budget = fiscal ye> #bjag4 ,i ,heal?1 ,education1 ,labor1 & ,p5sions #aja4 ,! prev5tion & public heal? fund 7a7 ,9 g5]al ,subsection 7b7 ( section #djjb ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #cjju-#aa7 is am5d$ by /rik+ p>agraphs 7#c7 ?r\gh 7#h74 7b7 ,rescission ( unobligat$ funds ,( ! funds made available by su* section #djjb1 ! unobligat$ balance is resc9d$4 #ajb4 ,community heal? c5t] program ,effective z if includ$ 9 ! enactm5t ( ! ,m$ic>e ,access & ,,*ip ,reau?orization ,act ( #bjae 7,public ,law #aad-aj1 #abi2 ,/at4 #hg71 p>agraph 7#a7 ( section #bba7;a7 ( su* ,act is am5d$ by ins]t+ 1 an additional #bce1jjj1jjj = fiscal ye> #bjag1 & #bce1jjj1jjj = fiscal ye> #bjah aft] ?r\gh #bjag4 #ajc4 ,re9surance1 risk corridor1 & risk adju/m5t programs 7a7 ,transitional re9surance program = individual m>ket ,section #acda ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjfa7 is am5d$ by add+ at ! end ! foll[+3 7e7 ,no =ce & effect ,effective ,janu>y #a1 #bjah1 ! ,secret>y %all n make paym5ts "u ?is section4 4 #ajd4 ,support = ,/ate response to sub/ance abuse public heal? crisis & urg5t m5tal heal? ne$s 7a7 ,9 g5]al ,!re are au?oriz$ to be appropriat$1 & are appropriat$1 out ( monies 9 ! ,treasury n o!rwise obligat$1 #gej1jjj1jjj = ea* ( fiscal ye>s #bjah & #bjai1 to ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y7 to aw>d grants to ,/ates to address ! sub/ance abuse public heal? crisis or to respond to urg5t m5tal heal? ne$s )9 ! ,/ate4 ,9 aw>d+ grants "u ?is section1 ! ,secret>y may give pref]5ce to ,/ates ) an incid5ce or preval5ce ( sub/ance use disord]s t is sub/antial relative to o!r ,/ates or to ,/ates t id5tify m5tal heal? ne$s )9 _! communities t are urg5t relative to su* ne$s ( o!r ,/ates4 ,funds appropriat$ "u ?is subsection %all rema9 available until exp5d$4 7b7 ,use ( funds ,grants aw>d$ to a ,/ate "u subsection 7a7 %all be us$ = "o or m ( ! foll[+ public heal?-relat$ activities3 7#a7 ,improv+ ,/ate prescription drug monitor+ programs4 7#b7 ,implem5t+ prev5tion activities1 & evaluat+ su* activities to id5tify effective /rategies to prev5t sub/ance abuse4 7#c7 ,tra9+ = heal? c>e practition]s1 su* z be/ practices = prescrib+ opioids1 pa9 managem5t1 recogniz+ pot5tial cases ( sub/ance abuse1 ref]ral ( pati5ts to treatm5t programs1 & ov]dose prev5tion4 7#d7 ,support+ access to heal? c>e s]vices provid$ by f$]ally c]tifi$ opioid treatm5t programs or o!r appropriate heal? c>e provid]s to treat sub/ance use disord]s or m5tal heal? ne$s4 7#e7 ,o!r public heal?-relat$ activities1 z ! ,/ate det]m9es appropriate1 relat$ to address+ ! sub/ance abuse public heal? crisis or respond+ to urg5t m5tal heal? ne$s )9 ! ,/ate4 ,,ii ,f9ance #bja4 ,recapture excess advance paym5ts ( premium tax cr$its ,subp>agraph 7,b7 ( section #cf;,b7f77#b7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new clause3 7iii7 ,nonapplicability ( limitation ,?is subp>agraph %all n apply to taxable ye>s end+ aft] ,decemb] #ca1 #bjag1 & be=e ,janu>y #a1 #bjbj4 4 #bjb4 ,premium tax cr$it & co/-,%>+ subsidies 7a7 ,repeal ( premium tax cr$it ,subp>t ,c ( "p ,,iv ( sub*apt] ,a ( *apt] #a ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ section #cf;,b4 7b7 ,repeal ( co/-,%>+ subsidy ,section #adjb ( ! ,pati5t ,protection & ,af=dable ,c>e ,act is repeal$4 7c7 ,repeal ( eligibility det]m9ations ,! foll[+ sections ( ! ,pati5t ,protection & ,af=dable ,c>e ,act are repeal$3 7#a7 ,section #adaa 7o!r ?an subsection 7i71 ! la/ s5t5ce ( subsection 7e77#d77;,a77ii71 & su* provisions ( su* section solely to ! ext5t relat$ to ! application ( ! la/ s5t5ce ( subsection 7e77#d77;,a77ii774 7#b7 ,section #adab4 7d7 ,protect+ ,am]icans by repeal ( disclosure au?ority ,to c>ry out eligibility requirem5ts = c]ta9 programs 7#a7 ,9 g5]al ,p>agraph 7#ba7 ( section #fajc7l7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,d7 ,t]m9ation ,no disclosure may be made "u ?is p>agraph aft] ,decemb] #ca1 #bjai4 4 7e7 ,effective dates 7#a7 ,premium tax cr$it ,! am5dm5t made by subsection 7a7 %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjai4 7#b7 ,co/ %>+-subsidies & eligibility det]m9ations ,! repeals 9 subsection 7b7 & 7c7 %all take effect on ,decemb] #ca1 #bjai4 7#c7 ,protect+ ,am]icans by resc9d+ disclosure au?ority ,! am5dm5ts made by subsection 7d7 %all take effect on ,decemb] #ca1 #bjai4 #bjc4 ,small bus9ess tax cr$it 7a7 ,9 g5]al ,section #de,r ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new subsection3 7j7 ,%all n apply ,?is section %all n apply ) respect to am\nts paid or incurr$ 9 taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjai4 4 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to am\nts paid or incurr$ 9 taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjai4 #bjd4 ,individual m&ate 7a7 ,9 g5]al ,section #ejjj;,a7c7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$-- 7#a7 9 p>agraph 7#b77;,b7-- 7,a7 by /rik+ aft] #bjae 9 clause 7iii7 & ins]t+ 9 #bjaf1 & 7,b7 by add+ at ! end ! foll[+ new clause3 7iv7 ,z]o p]c5t = taxable ye>s beg9n+ aft] #bjaf4 1 & 7#b7 9 p>agraph 7#c7-- 7,a7 by /rik+ #fie 9 subp>agraph 7,a7 & ins]t+ #j1 7,b7 by /rik+ & #cbe = #bjad 9 subp>agraph 7,b7 & ins]t+ 1 #cbe1 = #bjad1 & #fie = #bjaf1 & 7,c7 by /rik+ subp>agraph 7,d74 7b7 ,effective date ,! am5dm5ts made by ?is section %all apply to mon?s beg9n+ aft] ,decemb] #ca1 #bjaf4 #bje4 ,employ] m&ate 7a7 ,9 g5]al 7#a7 ,p>agraph 7#a7 ( section #dihj;,h7c7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by ins]t+ 7#j 9 ! case ( mon?s beg9n+ aft] ,decemb] #ca1 #bjaf7 aft] #b1jjj4 7#b7 ,p>agraph 7#a7 ( section #dihj;,h7b7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by ins]t+ 7#j 9 ! case ( mon?s beg9n+ aft] ,decemb] #ca1 #bjaf7 aft] #c1jjj4 7b7 ,effective date ,! am5dm5ts made by ?is section %all apply to mon?s beg9n+ aft] ,decemb] #ca1 #bjaf4 #bjf4 ,f$]al paym5ts to ,/ates 7a7 ,9 g5]al ,not)/&+ section #ejd7;a71 #aijb7;a77#bc71 #aijc7;a71 #bjjb1 #bjje7;a77#d71 #bajb7;a77#g71 or #baje7;a77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #gjd7;a71 #acif;a7a77#bc71 #acif;b7a71 #acig;a1 #acig;d7a77#d71 #acig;bb7a77#g71 #acig;ee7a77#a771 or ! t]ms ( any ,m$icaid waiv] 9 effect on ! date ( enactm5t ( ?is ,act t is approv$ "u section #aaae or #aiae ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae1 #acifn71 = ! #a-ye> p]iod beg9n+ on ! date ( enactm5t ( ?is ,act1 no ,f$]al funds provid$ f a program ref]r$ to 9 ?is subsection t is consid]$ direct sp5d+ = any ye> may be made available to a ,/ate = paym5ts to a prohibit$ entity1 :e!r made directly to ! prohibit$ entity or ?r\gh a manag$ c>e organization "u contract ) ! ,/ate4 7b7 ,def9itions ,9 ?is section3 7#a7 ,prohibit$ entity ,! t]m prohibit$ entity means an entity1 includ+ its affiliates1 subsidi>ies1 successors1 & cl9ics-- 7,a7 t1 z ( ! date ( enactm5t ( ?is ,act-- 7i7 is an organization describ$ 9 section #eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code ( #aihf & exempt f tax "u section #eja7;a7 ( su* ,code2 7ii7 is an ess5tial community provid] describ$ 9 section #aef4bce ( title #de1 ,code ( ,f$]al ,regulations 7z 9 effect on ! date ( enactm5t ( ?is ,act71 t is prim>ily engag$ 9 family plann+ s]vices1 reproductive heal?1 & relat$ m$ical c>e2 & 7iii7 provides = abortions1 o!r ?an an abortion-- 7,i7 if ! pregnancy is ! result ( an act ( rape or ince/2 or 7,,ii7 9 ! case :]e a woman suff]s f a physical disord]1 physical injury1 or physical illness t w\ld1 z c]tifi$ by a physician1 place ! woman 9 dang] ( dea? unless an abortion is p]=m$1 includ+ a life-endang]+ physical condition caus$ by or aris+ f ! pregnancy itself2 & 7,b7 = :i* ! total am\nt ( ,f$]al & ,/ate exp5ditures "u ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 9 fiscal ye> #bjad made directly to ! entity & to any affiliates1 subsidi>ies1 successors1 or cl9ics ( ! entity1 or made to ! entity & to any affiliates1 subsidi>ies1 successors1 or cl9ics ( ! entity z "p ( a nationwide heal? c>e provid] network1 exce$$ #cej1jjj1jjj4 7#b7 ,direct sp5d+ ,! t]m direct sp5d+ has ! mean+ giv5 t t]m "u section #bej7;c7 ( ! ,balanc$ ,budget & ,em]g5cy ,deficit ,control ,act ( #aihe 7#b ,u4,s4,c4 #ijj7;c774 #bjg4 ,m$icaid ,! ,social ,security ,act 7#db ,u4,s4,c4 #cja et seq47 is am5d$-- 7#a7 9 section #aijb-- 7,a7 9 subsection 7a77#aj77;,a71 9 ea* ( clauses 7i77,,viii7 & 7ii77,,xx71 by ins]t+ & end+ ,decemb] #ca1 #bjai1 aft] ,janu>y #a1 #bjad12 7,b7 9 subsection 7a77#dg77;,b71 by ins]t+ & provid$ t any su* election %all cease to be effective on ,janu>y #a1 #bjah1 & no su* election %all be made aft] t date be=e ! semicolon at ! end2 & 7,c7 9 subsection 7l77#b77;,c71 by ins]t+ & end+ ,decemb] #ca1 #bjai1 aft] ,janu>y #a1 #bjad12 7#b7 9 section #aije-- 7,a7 9 ! fir/ s5t5ce ( subsection 7b71 by ins]t+ 7#ej p]c5t on or aft] ,janu>y #a1 #bjbj7 aft] #ee p]c5t2 7,b7 9 subsection 7y77#a71 by /rik+ ! semicolon at ! end ( subp>agraph 7,d7 & all t foll[s ?r\gh !reaft]2 & 7,c7 9 subsection 7z77#b7-- 7i7 9 subp>agraph 7,a71 by /rik+ ea* ye> !reaft] & ins]t+ ?r\gh #bjai2 & 7ii7 9 subp>agraph 7,b77ii77,,vi71 by /rik+ & ea* subsequ5t ye>2 7#c7 9 section #aiae7k77#b71 by /rik+ dur+ ! p]iod describ$ 9 p>agraph 7#a7 & ins]t+ on or aft] ! date ref]r$ to 9 p>agraph 7#a7 & be=e ,janu>y #a1 #bjbj2 7#d7 9 section #aibj7;e71 by add+ at ! end ! foll[+3 ,?is subsection %all n apply aft] ,decemb] #ca1 #bjai42 7#e7 9 section #aicg7;b77#e71 by add+ at ! end ! foll[+3 ,?is p>agraph %all n apply aft] ,decemb] #ca1 #bjai42 & 7#f7 9 section #aidc7;a71 by ins]t+ & be=e ,janu>y #a1 #bjbj1 aft] ,janu>y #a1 #bjad14 #bjh4 ,repeal ( ,,d% allotm5t r$uctions ,section #aibc7;f7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7;f77 is am5d$ by /rik+ p>agraphs 7#g7 & 7#h74 #bji4 ,repeal ( ! tax on employee heal? insurance premiums & heal? plan b5efits 7a7 ,9 g5]al ,*apt] #dc ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ section #dihj;,i4 7b7 ,effective date ,! am5dm5t made by subsection 7a7 %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjai4 #baj4 ,repeal ( tax on ov]-!-c\nt] m$ications 7a7 ,h,s,as ,subp>agraph 7,a7 ( section #bbc7;d77#b7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ ,su* t]m & all t foll[s ?r\gh ! p]iod4 7b7 ,ar*] ,m,s,as ,subp>agraph 7,a7 ( section #bbj7;d77#b7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ ,su* t]m & all t foll[s ?r\gh ! p]iod4 7c7 ,heal? flexible sp5d+ arrangem5ts & heal? reimbursem5t arrangem5ts ,section #ajf ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ subsection 7f74 7d7 ,effective dates 7#a7 ,di/ributions f sav+s acc\nts ,! am5dm5ts made by subsections 7a7 & 7b7 %all apply to am\nts paid ) respect to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 7#b7 ,reimbursem5ts ,! am5dm5t made by subsection 7c7 %all apply to exp5ses incurr$ ) respect to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 #baa4 ,repeal ( tax on heal? sav+s acc\nts 7a7 ,h,s,as ,section #bbc7;f77#d77;,a7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ #bj p]c5t & ins]t+ #aj p]c5t4 7b7 ,ar*] ,m,s,as ,section #bbj7;f77#d77;,a7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ #bj p]c5t & ins]t+ #ae p]c5t4 7c7 ,effective date ,! am5dm5ts made by ?is section %all apply to di/ributions made aft] ,decemb] #ca1 #bjag4 #bab4 ,repeal ( limitations on contributions to flexible sp5d+ acc\nts 7a7 ,9 g5]al ,section #abe ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ subsection 7i74 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 #bac4 ,repeal ( tax on prescription m$ications ,subsection 7j7 ( section #ijjh ( ! ,pati5t ,protection & ,af=dable ,c>e ,act is am5d$ to read z foll[s3 7j7 ,repeal ,?is section %all apply to cal5d> ye>s beg9n+ aft] ,decemb] #ca1 #bjaj1 & end+ be=e ,janu>y #a1 #bjah4 4 #bad4 ,repeal ( m$ical device excise tax 7a7 ,9 g5]al ,*apt] #cb ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ sub*apt] ,e4 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to sales 9 cal5d> qu>t]s beg9n+ aft] ,decemb] #ca1 #bjag4 #bae4 ,repeal ( heal? insurance tax ,subsection 7j7 ( section #ijaj ( ! ,pati5t ,protection & ,af=dable ,c>e ,act is am5d$ to read z foll[s3 7j7 ,repeal ,?is section %all apply to cal5d> ye>s beg9n+ aft] ,decemb] #ca1 #bjac1 & end+ be=e ,janu>y #a1 #bjag4 4 #baf4 ,repeal ( elim9ation ( d$uction = exp5ses allocable to m$ic>e "p ,d subsidy 7a7 ,9 g5]al ,section #aci;,a ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new s5t5ce3 ,?is section %all n be tak5 into acc\nt = purposes ( det]m9+ :e!r any d$uction is all[able ) respect to any co/ tak5 into acc\nt 9 det]m9+ su* paym5t44 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 #bag4 ,repeal ( *ronic c>e tax 7a7 ,9 g5]al ,subsection 7a7 ( section #bac ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ #aj p]c5t & ins]t+ #g4e p]c5t4 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 #bah4 ,repeal ( ,m$ic>e tax increase 7a7 ,9 g5]al ,subsection 7b7 ( section #caja ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ to read z foll[s3 7b7 ,hospital insurance ,9 addition to ! tax impos$ by ! prec$+ subsection1 !re is h]eby impos$ on ! income ( e individual a tax equal to #a4de p]c5t ( ! wages 7z def9$ 9 section #caba7;a77 receiv$ by su* individual ) respect to employm5t 7z def9$ 9 section #caba7;b74 4 7b7 ,,seca ,subsection 7b7 ( section #adja ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ to read z foll[s3 7b7 ,hospital insurance ,9 addition to ! tax impos$ by ! prec$+ subsection1 !re %all be impos$ = ea* taxable ye>1 on ! self-employm5t income ( e individual1 a tax equal to #b4i p]c5t ( ! am\nt ( ! self-employm5t income = su* taxable ye>4 4 7c7 ,effective date ,! am5dm5ts made by ?is section %all apply ) respect to remun]ation receiv$ aft]1 & taxable ye>s beg9n+ aft]1 ,decemb] #ca1 #bjag4 #bai4 ,repeal ( tann+ tax 7a7 ,9 g5]al ,! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ *apt] #di4 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to s]vices p]=m$ on or aft] ,decemb] #ca1 #bjag4 #bbj4 ,repeal ( net inve/m5t tax 7a7 ,9 g5]al ,subtitle ,a ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ *apt] #b;,a4 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 #bba4 ,remun]ation ,p>agraph 7#f7 ( section #afb7m7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,i7 ,t]m9ation ,?is p>agraph %all n apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjag4 4 #bbb4 ,economic sub/ance doctr9e 7a7 ,9 g5]al ,subsection 7o7 ( section #ggja ( ! ,int]nal ,rev5ue ,code ( #aihf is repeal$4 7b7 ,p5alty = und]paym5ts ,p>agraph 7#f7 ( section #fffb7;b7 ( ! ,int]nal ,rev5ue ,code ( #aihf is repeal$4 7c7 ,increas$ p5alty = nondisclos$ transactions ,subsection 7i7 ( section #fffb ( ! ,int]nal ,rev5ue ,code ( #aihf is repeal$4 7d7 ,reasonable cause exception = und]paym5ts ,p>agraph 7#b7 ( section #fffd7;c7 ( ! ,int]nal ,rev5ue ,code ( #aihf is repeal$4 7e7 ,reasonable cause exception = nondisclos$ transactions ,p>agraph 7#b7 ( section #fffd7;d7 ( ! ,int]nal ,rev5ue ,code ( #aihf is repeal$4 7f7 ,errone\s claim = refund or cr$it ,subsection 7c7 ( section #ffgf ( ! ,int]nal ,rev5ue ,code ( #aihf is repeal$4 7g7 ,effective date ,! repeals made by ?is section %all apply to transactions ent]$ into1 & to und]paym5ts1 und]/atem5ts1 or refunds & cr$its attributable to transactions ent]$ into1 aft] ,decemb] #ca1 #bjag4 #bbc4 ,budget>y sav+s = ext5d+ m$ic>e solv5cy ,z a result ( policies conta9$ 9 ?is ,act1 ! ,secret>y ( ! ,treasury %all transf] to ! ,f$]al ,hospital ,insurance ,tru/ ,fund "u section #ahag ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7 #cgi1cjj1jjj1jjj 7:i* repres5ts ! full am\nt ( on-budget sav+s dur+ ! p]iod ( fiscal ye>s #bjah ?r\gh #bjbg7 = ext5d+ ,m$ic>e solv5cy1 to rema9 available until exp5d$4