,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #deji  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,augu/ #f1 #bjbj,mr4   
,wyd5 introduc$ ! foll[+ bill2 :i* 0    
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to provide =       
af=dable cov]age ( ,,covid-#ai vacc9es  
"u ,m$ic>e1 ,m$icaid1 & ! ,*ildr5's     
,heal? ,insurance ,program1 & = o!r     
purposes4  #a4 ,%ort title2 table (     
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,vacc9e ,& ,cov]age ,c]ta9ty
 ,act or ! ,,vacc ,act4  7b7 ,table (   
cont5ts ,! table ( cont5ts = ?is ,act is
 z foll[s3 ,sec4 #a4 ,%ort title2 table 
( cont5ts4,,title ,i--,ensur+ cov]age ( 
,,covid-#ai vaccines,sec4 #aja4 ,ensur+ 
af=dability ( f$]ally fund$ ,,covid-#ai 
vacc9es "u ,m$ic>e4,sec4 #ajb4 ,m&atory 
cov]age ( ,,covid-#ai vacc9es "u        
,m$icaid & ,,*ip4,sec4 #ajc4 ,inclusion 
( f$]ally fund$ ,,covid-#ai vacc9es "u  
,m$icaid drug rebate program2 cov]age ( 
,,covid-#ai vacc9es "u ,/ate p$iatric   
vacc9e di/ribution program4,sec4 #ajd4  

,tempor>y enhanc$ ,f$]al mat* = m$ical  
assi/ance = ,,covid-#ai vacc9es4,,title 
,,ii--,ensur+ cov]age "u ,medicaid,sec4 
#bja4 ,increas$ ,,fmap = m$ical         
assi/ance to newly eligible             
individuals4,sec4 #bjb4 ,m$icaid cov]age
 = citiz5s ( ,freely ,associat$         
,/ates4,,title ,,iii--,ensur+ cov]age 9 
! ,marketplace,sec4 #cja4 ,disreg>d (   
additional unemploym5t comp5sation =    
purposes ( premium tax cr$it & co/-%>+  
subsidies4  ,i ,ensur+ cov]age (        
,,covid-#ai vacc9es  #aja4 ,ensur+      
af=dability ( f$]ally fund$ ,,covid-#ai 
vacc9es "u ,m$ic>e  7a7 ,9 g5]al        
,section #ahcc ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciel7 is am5d$--  
7#a7 9 subsection 7a77#a77;,b71 by      
ins]t+ subject to subsection 7dd77#a7 7)
 respect to paym5t = f$]ally fund$      
,,covid-#ai vacc9es71 aft]              
#ahfa7s77#aj77;,a712 &  7#b7 by add+ at 
! end ! foll[+ new subsection3  7dd7    
,ensur+ af=dability ( f$]ally fund$     
,,covid-#ai vacc9es  7#a7 ,initial      

paym5t ,= purposes ( subsection         
7a77#a77;,b71 ! am\nt ( *>ges t are     
consid]$ reasonable ) respect to an     
applicable ,,covid-#ai vacc9e dur+ !    
fir/ ye> t su* vacc9e is adm9i/]$ "u ?is
 "p 7ref]r$ to 9 ?is subsection z !     
initial paym5t ye>7 %all n exce$ ! am\nt
 describ$ 9 p>agraph 7#c74  7#b7        
,applicable covid-#ai vacc9e  7,a7 ,9   
g5]al ,9 ?is subsection1 ! t]m          
applicable ,,covid-#ai vacc9e means a   
vacc9e-- 7i7 approv$ by ! ,food & ,drug 
,adm9i/ration "u section #cea ( !       
,public ,heal? ,s]vice ,act or au?oriz$ 
= em]g5cy use "u section #efd ( ! ,f$]al
 ,food1 ,drug1 & ,cosmetic ,act =       
immunization aga9/ ,,covid-#ai2 &  7ii7 
^: manufactur] 0 provid$ fund+ = rese>* 
or developm5t ( su* vacc9e or = !       
manufacture ( su* vacc9e "u a contract )
 ! ,f$]al ,gov]nm5t 7includ+ !          
,biodef5se ,advanc$ ,rese>* &           
,developm5t ,au?ority ( ! ,dep>tm5t (   
,heal? & ,human ,s]vices7 or "u a ,f$]al
 grant program us+ funds made available 

"u ! ,coronavirus ,aid1 ,relief1 &      
,economic ,security ,act 7,public ,law  
#aaf-acf71 or subsequ5tly enact$        
legislation4  7,b7 ,nonapplication to   
vacc9es pur*as$ = ,f$]al di/ribution    
,su* t]m %all n include any doses ( su* 
vacc9e t are pur*as$ "u a ,f$]al        
contract or grant agreem5t describ$ 9   
p>agraph 7#b77;,b7 = ,f$]al di/ribution4
  7#c7 ,am\nt describ$ ,! am\nt describ$
 9 ?is p>agraph1 ) respect to an        
applicable ,,covid-#ai vacc9e1 is !     
,f$]al procurem5t co/ p] dose acc\nt+ = 
,f$]al co/s "u all ,f$]al contracts or  
grant agreem5ts describ$ 9 p>agraph     
7#b77;,b7 = ! initial supply ord] )     
respect to su* vacc9e1 n includ+ ! co/ (
 any option to buy future doses ( su*   
vacc9e "u su* contracts or agreem5ts4   
7#d7 ,paym5t 9 subsequ5t ye>s ,=        
provisions relat+ to paym5t = an        
applicable ,,covid-#ai vacc9e 9 ye>s    
aft] ! initial paym5t ye>1 see section  
#ahdb7o77#a77;,a77iv7 7relat+ to paym5t 
am\nt equal to #ie p]c5t ( ! av]age     

:olesale price74  7#e7 ,rebate if price 
increases fa/] ?an inflation  7,a7 ,9   
g5]al ,subject to subp>agraph 7,b71 !   
,secret>y %all e/abli% a process "u :i*1
 ) respect to an applicable ,,covid-#ai 
vacc9e ( a manufactur]1 effective beg9n+
 ) ! fir/ ye> aft] ! initial paym5t ye>1
 if ! am\nt ( paym5t = ! vacc9e "u ?is  
"p increases fa/] ?an inflation )       
respect to a rebate p]iod specifi$ by ! 
,secret>y1 ! manufactur] ( su* vacc9e   
%all1 n lat] ?an #cj days aft] receipt f
 ! ,secret>y ( ! rebate am\nt = su*     
rebate p]iod1 provide a rebate to !     
,secret>y t is equal to ! am\nt specifi$
 9 subp>agraph 7,c7 = su* vacc9e &      
rebate p]iod4  7,b7 ,exceptions ,!      
process e/abli%$ "u ?is p>agraph %all   
provide = ! foll[+ exceptions ) respect 
to an applicable ,,covid-#ai vacc9e ( a 
manufactur]3 7i7 ,if ! ,secret>y        
det]m9es t !re are exceptional          
circum/ances1 su* z a sub/antial        
increase 9 developm5t or manufactur+    
co/s due to circum/ances outside !      

control ( ! manufactur]4  7ii7 ,!       
manufactur] demon/rates1 to !           
satisfaction ( ! ,secret>y1 t x has     
significantly improv$ ! cl9ical efficacy
 or safety ( su* vacc9e relative to its 
cl9ical efficacy or safety :5 x 0 fir/  
procur$ or contract$ = by ! ,f$]al      
,gov]nm5t4 ,= purposes ( ! prec$+       
s5t5ce1 a manufactur] may demon/rate !  
improv$ cl9ical efficacy or safety ( a  
p>ticul> ,,covid-#ai vacc9e accord+ to a
 process e/abli%$ by ! ,advisory        
,committee on ,immunization ,practices  
at ! ,c5t]s = ,disease ,control 9       
coord9ation ) ! ,food & ,drug           
,adm9i/ration4 ,! results ( any         
assessm5t "u ?is clause ) respect to an 
applicable ,,covid-#ai vacc9e %all be   
made public4  7,c7 ,rebate am\nt ,!     
am\nt ( a rebate "u ?is subp>agraph1 )  
respect to an applicable ,,covid-#ai    
vacc9e ( a manufactur]1 is ! product (--
 7i7 ! total numb] ( doses ( su* vacc9e 
adm9i/]$ dur+ ! rebate p]iod2 &  7ii7 ! 
am\nt 7if any7 by :i*-- 7,i7 ! am\nt (  

paym5t = ! vacc9e "u ?is "p dur+ !      
rebate p]iod2 exce$s  7,,ii7 !          
inflation-adju/$ paym5t am\nt det]m9$ "u
 subp>agraph 7,d7 ( ?is p>agraph = su*  
vacc9e dur+ ! rebate p]iod4  7,d7       
,det]m9ation ( inflation-adju/$ paym5t  
am\nt ,! inflation-adju/$ paym5t am\nt  
det]m9$ "u ?is subp>agraph = an         
applicable ,,covid-#ai vacc9e = a rebate
 p]iod is-- 7i7 ! am\nt ( paym5t = !    
vacc9e "u ?is "p dur+ ! initial paym5t  
ye> z describ$ 9 p>agraph 7#a72 increas$
 by  7ii7 ! p]c5tage by :i* ! rebate    
p]iod ,,cpi-,u 7z def9$ 9 subp>agraph   
7,f77 = ! rebate p]iod exce$s ! b5*m>k  
p]iod ,,cpi-,u 7z def9$ 9 subp>agraph   
7,e774  7,e7 ,b5*m>k p]iod ,,cpi-,u ,!  
t]m b5*m>k p]iod ,,cpi-,u means !       
consum] price index = all urban consum]s
 7,unit$ ,/ates city av]age7 = ! fir/   
cal5d> qu>t] 9 ! initial paym5t ye>4    
7,f7 ,rebate p]iod ,,cpi-,u ,! t]m      
rebate p]iod ,,cpi-,u means1 ) respect  
to a rebate p]iod1 ! consum] price index
 = all urban consum]s 7,unit$ ,/ates    

city av]age7 = ! la/ mon? ( ! cal5d>    
qu>t] t is two cal5d> qu>t]s prior to ! 
rebate p]iod4  7,g7 ,provision (        
in=mation ,a manufactur] ( an applicable
 ,,covid-#ai vacc9e %all provide to !   
,secret>y su* in=mation1 at su* "t & 9  
su* mann] z ! ,secret>y specifies1 z is 
ne$$ to c>ry out ?is p>agraph4  7,h7    
,rebate deposits ,am\nts paid z rebates 
"u ?is p>agraph %all be deposit$ into ! 
,f$]al ,supplem5t>y ,m$ical ,insurance  
,tru/ ,fund e/abli%$ "u section #ahda4  
7,i7 ,en=cem5t  7i7 ,civil money p5alty 
7,i7 ,9 g5]al ,! ,secret>y %all impose a
 civil money p5alty on a manufactur] t  
fails to comply ) ! requirem5ts "u ?is  
p>agraph ) respect to provid+ a rebate =
 an applicable ,,covid-#ai vacc9e = a   
rebate p]iod = ea* su* failure 9 an     
am\nt equal to ! sum (-- 7aa7 ! rebate  
am\nt specifi$ pursuant to subp>agraph  
7,c7 = su* vacc9e = su* rebate p]iod2 & 
7bb7 #be p]c5t ( su* am\nt4  7,,ii7     
,application ,! provisions ( section    
#aabh;,a 7o!r ?an subsections 7a7 7)    

respect to am\nts ( p5alties or         
additional assessm5ts7 & 7b77 %all apply
 to a civil money p5alty "u ?is clause 9
 ! same mann] z su* provisions apply to 
a p5alty or proce$+ "u section          
#aabh;,a7a74  7ii7 ,no paym5t =         
manufactur]s :o fail to pay p5alty ,if !
 manufactur] ( an applicable ,,covid-#ai
 vacc9e fails to pay a civil money      
p5alty "u clause 7i7 ) respect to !     
failure to provide a rebate = an        
applicable ,,covid-#ai vacc9e = a rebate
 p]iod by a date specifi$ by ! ,secret>y
 aft] ! imposition ( su* p5alty1 no     
paym5t %all be available "u ?is "p = su*
 vacc9e = cal5d> qu>t]s beg9n+ on or    
aft] su* date until ! ,secret>y det]m9es
 ! manufactur] has paid ! p5alty due "u 
su* clause4  7,j7 ,implem5tation ,!re   
%all be no adm9i/rative or judicial     
review "u section #ahfi1 section #ahgh1 
or o!rwise1 ( ! det]m9ation ( ! rebate  
am\nt = an applicable ,,covid-#ai vacc9e
 "u subp>agraph 7,c71 includ+ !         
det]m9ation (-- 7i7 ! total numb] (     

,,covid-#ai vacc9es adm9i/]$ dur+ !     
rebate p]iod "u subp>agraph 7,c77i72 &  
7ii7 ! inflation-adju/$ paym5t am\nt "u 
subp>agraph 7,d74  4  7b7 ,con=m+       
am5dm5t ,section #ahdb7o77#a77;,a77iv7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acieu7o77#a77;,a77iv77 is am5d$ by    
/rik+ ,a vacc9e & ins]t+ ,subject to    
section #ahcc7;dd77#a7 7relat+ to paym5t
 = an applicable ,,covid-#ai vacc9e dur+
 initial paym5t ye>71 a vacc9e4  #ajb4  
,m&atory cov]age ( ,,covid-#ai vacc9es  
"u ,m$icaid & ,,*ip  7a7 ,m$icaid  7#a7 
,9 g5]al ,section #aije7;a77#d7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7a77#d77 is am5d$-- 7,a7 by /rik+
 & 7,d7 & ins]t+ 7,d72 &  7,b7 by /rik+ 
! semicolon at ! end & ins]t+ 2 & 7,e7 a
 ,,covid-#ai vacc9e lic5s$ "u section   
#cea ( ! ,public ,heal? ,s]vice ,act1 or
 approv$ or au?oriz$ "u sections #eje or
 #efd ( ! ,f$]al ,food1 ,drug1 &        
,cosmetic ,act1 & adm9i/ration ( !      
vacc9e24  7#b7 ,prohibition ( co/ %>+   
7,a7 ,9 g5]al ,subsections 7a77#b7 &    

7b77#b7 ( section #aiaf ( ! ,social     
,security ,act 7#db ,u4,s4,c4 #acifo7   
are ea* am5d$-- 7i7 9 subp>agraph 7,f71 
by /rik+ or at ! end2  7ii7 9           
subp>agraph 7,g71 by /rik+ 2 & & ins]t+ 
1 or2 &  7iii7 by add+ at ! end ! foll[+
 subp>agraph3  7,h7 a ,,covid-#ai vacc9e
 lic5s$ "u section #cea ( ! ,public     
,heal? ,s]vice ,act1 or approv$ or      
au?oriz$ "u sections #eje or #efd ( !   
,f$]al ,food1 ,drug1 & ,cosmetic ,act1 &
 ! adm9i/ration ( su* vacc9e2 &  4  7,b7
 ,application to alt]native co/ %>+     
,section #aiaf;,a7b77#c77;,b7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acifo-#a7;b77#c77;,b77 is am5d$-- 7i7 9
 clause 7xi71 by /rik+ any visit &      
ins]t+ any s]vice2 &  7ii7 by add+ at ! 
end ! foll[+ clause3  7xii7 ,a          
,,covid-#ai vacc9e lic5s$ "u section    
#cea ( ! ,public ,heal? ,s]vice ,act1 or
 approv$ or au?oriz$ "u sections #eje or
 #efd ( ! ,f$]al ,food1 ,drug1 &        
,cosmetic ,act1 & ! adm9i/ration ( su*  
vacc9e4  4  7,c7 ,cl>ification ,!       

am5dm5ts made by ?is subsection %all    
apply ) respect to a ,/ate plan ( a     
t]ritory 9 ! same mann] z ! am5dm5ts    
apply to a ,/ate plan ( #a ( ! #ej      
,/ates or ! ,di/rict ( ,columbia4  7b7  
,,*ip  7#a7 ,9 g5]al ,section #bajc7;c7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acig;cc7c77 is am5d$ by add+ 
at ! end ! foll[+ p>agraph3  7#aa7      
,cov]age ( ,,covid-#ai vacc9es          
,reg>dless ( ! type ( cov]age elect$ by 
a ,/ate "u subsection 7a71 *ild heal?   
assi/ance provid$ "u su* cov]age =      
t>get$ l[-income *ildr5 &1 9 ! case ( a 
,/ate t ,/ate elects to provide         
pregnancy-relat$ assi/ance "u su*       
cov]age pursuant to section #baab1 su*  
pregnancy-relat$ assi/ance = t>get$     
l[-income pregnant wom5 7z def9$ 9      
section #baab7;d77 %all include cov]age 
( a ,,covid-#ai vacc9e lic5s$ "u section
 #cea ( ! ,public ,heal? ,s]vice ,act1  
or approv$ or au?oriz$ "u sections #eje 
or #efd ( ! ,f$]al ,food1 ,drug1 &      
,cosmetic ,act1 & ! adm9i/ration ( su*  

vacc9e4  4  7#b7 ,prohibition ( co/ %>+ 
,section #bajc7;e77#b7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acig;cc7e77#b771 z am5d$ by section    
#fjjd7;b77#c7 ( ! ,families ,fir/       
,coronavirus ,response ,act1 is am5d$-- 
7,a7 9 ! p>agraph head]1 by ins]t+ a    
,,covid-#ai vacc9e1 be=e or             
pregnancy-relat$ assi/ance2 &  7,b7 by  
/rik+ visits describ$ 9 section         
#aiaf7;a77#b77;,g71 or & ins]t+ s]vices 
describ$ 9 section #aiaf7;a77#b77;,g71  
vacc9es describ$ 9 section              
#aiaf7;a77#b77;,h71 or4  #ajc4          
,inclusion ( f$]ally fund$ ,,covid-#ai  
vacc9es "u ,m$icaid drug rebate program2
 cov]age ( ,,covid-#ai vacc9es "u ,/ate 
p$iatric vacc9e di/ribution program  7a7
 ,inclusion 9 ,m$icaid drug rebate      
program  7#a7 ,9 g5]al ,section #aibg ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acifr-#h7 is am5d$-- 7,a7 9 subsection 
7b77#a77;,a71 by ins]t+ 7or1 9 ! case ( 
an applicable ,,covid-#ai vacc9e        
adm9i/]$ aft] ,july #a1 #bjbj1 an am\nt 

specifi$ 9 subsection 7l77 aft] #aiij2  
7,b7 9 subsection 7k7-- 7i7 9 p>agraph  
7#b7-- 7,i7 9 subp>agraph 7,b7-- 7aa7 9 
! matt] prec$+ clause 7i71 by ins]t+    
7except 9 ! case ( an applicable        
,,covid-#ai vacc9e7 aft] o!r ?an a      
vacc9e2 &  7bb7 9 clause 7iii71 by /rik+
 2 & & ins]t+ a semicolon2  7,,ii7 9    
subp>agraph 7,c71 by /rik+ ! p]iod at ! 
end & ins]t+ 2 &2 &  7,,iii7 by add+ at 
! end ! foll[+ new subp>agraph3  7,d7 an
 applicable ,,covid-#ai vacc9e4  2 &    
7ii7 by add+ at ! end ! foll[+ new      
p>agraph3  7#ab7 ,applicable ,,covid-#ai
 vacc9e ,! t]m applicable ,,covid-#ai   
vacc9e has ! mean+ giv5 su* t]m 9       
section #ahcc7;dd77#b74  2 &  7,c7 by   
add+ at ! end ! foll[+ new subsection3  
7l7 ,det]m9ation ( am\nt ( rebate =     
applicable ,,covid-#ai vacc9es  7#a7 ,9 
g5]al ,! am\nt ( ! rebate specifi$ 9 ?is
 subsection = a rebate p]iod ) respect  
to an applicable ,,covid-#ai vacc9e %all
 be equal to ! product (-- 7,a7 ! total 
numb] ( units ( ! vacc9e paid = "u !    

,/ate plan 9 ! rebate p]iod 7z report$  
by ! ,/ate72 &  7,b7 ! diff]5ce betwe5 !
 av]age manufactur] price & !           
inflation-adju/$ ,f$]al procurem5t price
 7z def9$ 9 p>agraph 7#b77 = ! vacc9e4  
7#b7 ,inflation-adju/$ ,f$]al procurem5t
 price ,= purposes ( ?is section1 ! t]m 
inflation-adju/$ ,f$]al procurem5t price
 means1 ) respect to an applicable      
,,covid-#ai vacc9e & a rebate p]iod--   
7,a7 = rebate p]iods occurr+ dur+ ! fir/
 #ab-mon? p]iod t su* vacc9e is provid$ 
to ,/ate plans "u ?is title1 ! am\nt    
specifi$ = ! vacc9e "u section          
#ahcc7;dd77#c72 &  7,b7 = rebate p]iods 
occurr+ aft] su* #ab-mon? p]iod-- 7i7 ! 
am\nt specifi$ = ! vacc9e "u section    
#ahcc7;dd77#c72 increas$ by  7ii7 !     
p]c5tage by :i* ! consum] price index = 
all urban consum]s 7,unit$ ,/ates city  
av]age7 = ! mon? be=e ! mon? 9 :i* !    
rebate p]iod beg9s exce$s su* index = ! 
mon? 9 :i* su* #ab-mon? p]iod beg9s4    
7#c7 ,exceptions ,no rebate %all be     
payable ) respect to an applicable      

,,covid-#ai vacc9e ( a manufactur] & a  
rebate p]iod occurr+ aft] ! #ab-mon?    
p]iod describ$ 9 p>agraph 7#b77;,a7 if !
 ,secret>y det]m9es t an exception      
describ$ 9 section #ahcc7;dd77#e77;,b7  
applies ) respect to ! vacc9e = ! rebate
 p]iod4  4  7#b7 ,prohibition on prior  
au?orization ,section #aibg7;d77#a77;,a7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acifr-#h7;d77#a77;,a77 is    
am5d$ by ins]t+ o!r ?an an applicable   
,,covid-#ai vacc9e aft] cov]$ outpati5t 
drug4  7#c7 ,no exclusion ( applicable  
,,covid-#ai vacc9es ,section            
#aibg7;d77#g7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifr-#h7;d77#g77 is   
am5d$ by add+ at ! end ! foll[+3  7,d7  
,applicable ,,covid-#ai vacc9es4  4  7b7
 ,ensur+ cov]age & af=dability "u ,/ate 
p$iatric vacc9e di/ribution program     
,section #aibh ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acifs7 is am5d$--  
7#a7 9 subsection 7a77#a7-- 7,a7 9      
subp>agraph 7,a71 by /rik+ 2 & & ins]t+ 
a semicolon2  7,b7 9 subp>agraph 7,b71  

by /rik+ ! p]iod & ins]t+ 2 &2 &  7,c7  
by add+ at ! end ! foll[+ subp>agraph3  
7,c7 ea* vacc9e-eligible *ild 7z def9$ 9
 subsection 7b77 is entitl$ to receive a
 ,,covid-#ai vacc9e f a program-regi/]$ 
provid] )\t *>ge =-- 7i7 ! co/ ( su*    
vacc9e2 or  7ii7 ! adm9i/ration ( su*   
vacc9e4  2  7#b7 9 subsection 7c77#b71  
by add+ at ! end ! foll[+ subp>agraph3  
7,d7 ,! provid] w provide & adm9i/] a   
,,covid-#ai vacc9e to a vacc9e-eligible 
*ild 9 accordance ) ! same requirem5ts z
 ! requirem5ts t apply "u ! prec$+      
subp>agraphs to ! provision &           
adm9i/ration ( a qualifi$ p$iatric      
vacc9e to su* a *ild4  2  7#c7 9        
subsection 7d77#c71 by add+ at ! end !  
foll[+ new subp>agraph3  7,d7           
,limitation on price increases =        
applicable ,,covid-#ai vacc9es  7i7 ,9  
g5]al ,subject to clause 7ii71 ) respect
 to any contract ent]$ into "u ?is      
subsection = an applicable ,,covid-#ai  
vacc9e aft] ! fir/ su* contract ent]$   
into ) respect to su* vacc9e1 no price =

 ! pur*ase ( su* vacc9e =               
vacc9e-eligible *ildr5 %all be agre$ to 
by ! ,secret>y "u ?is subsection if !   
price p] dose ( su* vacc9e 7includ+ any 
deliv]y co/s & any applicable excise tax
 e/abli%$ "u section #daca ( ! ,int]nal 
,rev5ue ,code ( #aihf7 exce$s-- 7,i7 !  
price p] dose = ! vacc9e 9 effect "u !  
fir/ contract ent]$ into "u ?is         
subsection = ! pur*ase ( su* vacc9e2    
increas$ by  7,,ii7 ! p]c5tage increase 
9 ! consum] price index = all urban     
consum]s 7all items2 ,unit$ ,/ates city 
av]age7 f ! mon? be=e su* fir/ contract 
is ent]$ into to ! mon? be=e ! mon? 9   
:i* ! contract involv$ is ent]$ into4   
7ii7 ,exception ,! limitation describ$ 9
 clause 7i7 %all n apply ) respect to an
 applicable ,,covid-#ai vacc9e & a      
contract if ! ,secret>y det]m9es t an   
exception describ$ 9 section            
#ahcc7;dd77#e77;,b7 applies ) respect to
 ! vacc9e = ! contract p]iod4  2 &  7#d7
 9 subsection 7h71 by add+ at ! end !   
foll[+ new p>agraph3  7#aj7 ,,covid-#ai 

vacc9e2 applicable ,,covid-#ai vacc9e   
7,a7 ,,covid-#ai vacc9e ,! t]m          
,,covid-#ai vacc9e means a ,,covid-#ai  
vacc9e lic5s$ "u section #cea ( !       
,public ,heal? ,s]vice ,act1 or approv$ 
or au?oriz$ "u section #eje or #efd ( ! 
,f$]al ,food1 ,drug1 & ,cosmetic ,act1  
provid$ t su* vacc9e is includ$ on ! li/
 "u subsection 7e74  7,b7 ,applicable   
,,covid-#ai vacc9e ,! t]m applicable    
,,covid-#ai vacc9e means a vacc9e       
describ$ 9 section #ahcc7;dd77#b71      
provid$ t su* vacc9e is includ$ on ! li/
 "u subsection 7e74  4  7c7 ,effective  
date ,! am5dm5ts made by ?is section    
take effect on ! date ( enactm5t ( ?is  
,act & apply to rebate agreem5ts ent]$  
into on or aft] su* date )\t reg>d to   
:e!r f9al regulations to c>ry out su*   
am5dm5ts h be5 promulgat$ z ( su* date4 
#ajd4 ,tempor>y enhanc$ ,f$]al mat* =   
m$ical assi/ance = ,,covid-#ai vacc9es  
7a7 ,9 g5]al ,section #aije ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #acif;d7  
is am5d$-- 7#a7 9 subsection 7b71 by    

/rik+ & 7ff7 & ins]t+ 7ff71 & 7gg72 &   
7#b7 by add+ at ! end ! foll[+ new      
subsection3  7gg7 ,tempor>y enhanc$     
,f$]al mat* = ,,covid-#ai vacc9e &      
adm9i/ration  7#a7 ,9 g5]al ,not)/&+    
subsection 7b71 ) respect to m$ical     
assi/ance = vacc9es & ! adm9i/ration (  
vacc9es describ$ 9 subsection           
7a77#d77;,e7 t is furni%$ dur+ ! p]iod  
describ$ 9 p>agraph 7#b71 ! ,f$]al      
m$ical assi/ance p]c5tage = a ,/ate %all
 be equal to #ajj p]c5t4  7#b7 ,p]iod   
describ$ ,! p]iod describ$ 9 ?is        
p>agraph is ! p]iod t-- 7,a7 beg9s ) !  
date ( enactm5t ( ?is subsection2 &     
7,b7 ends ) ! date t is #a ye> aft] !   
la/ day ( ! em]g5cy p]iod def9$ 9       
p>agraph 7#a77;,b7 ( section #aace7;g74 
4  7b7 ,exclusion f t]ritorial caps     
,section #aajh ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acjh7 is am5d$--   
7#a7 9 subsection 7f71 9 ! matt] prec$+ 
p>agraph 7#a71 by /rik+ subsection 7g7 &
 section #aice7;e77#a77;,b7 & ins]t+    
subsections 7g7 & 7h7 & section         

#aice7;e77#a77;,b72 &  7#b7 by add+ at !
 end ! foll[+3  7h7 ,exclusion f caps ( 
am\nts attributable to c]ta9 increas$   
,,fmap ,any paym5t made to a t]ritory = 
a fiscal ye> 9 :i* ! ,f$]al m$ical      
assi/ance p]c5tage = ! t]ritory is      
det]m9$ "u section #aije7;gg7 %all n be 
tak5 into acc\nt = purposes ( apply+    
paym5t limits "u subsections 7f7 & 7g7  
to ! ext5t t su* paym5t exce$s ! am\nt (
 ! paym5t t w\ld h be5 made to !        
t]ritory = ! ye> if ! ,f$]al m$ical     
assi/ance p]c5tage = ! t]ritory _h be5  
det]m9$ )\t reg>d to su* section4  4    
,,ii ,ensur+ cov]age "u ,m$icaid  #bja4 
,increas$ ,,fmap = m$ical assi/ance to  
newly eligible individuals  7a7 ,9 g5]al
 ,section #aije ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #acif;d7 is am5d$-- 
7#a7 9 subsection 7y77#a7-- 7,a7 9      
subp>agraph 7,a71 by /rik+ #bjad1 #bjae1
 & #bjaf & ins]t+ ea* ( ! fir/ #c       
consecutive #ab-mon? p]iods 9 :i* !     
,/ate provides m$ical assi/ance to newly
 eligible individuals2  7,b7 9          

subp>agraph 7,b71 by /rik+ #bjag &      
ins]t+ ! f\r? consecutive #ab-mon? p]iod
 9 :i* ! ,/ate provides m$ical assi/ance
 to newly eligible individuals2  7,c7 9 
subp>agraph 7,c71 by /rik+ #bjah &      
ins]t+ ! fif? consecutive #ab-mon? p]iod
 9 :i* ! ,/ate provides m$ical assi/ance
 to newly eligible individuals2  7,d7 9 
subp>agraph 7,d71 by /rik+ #bjai &      
ins]t+ ! six? consecutive #ab-mon? p]iod
 9 :i* ! ,/ate provides m$ical assi/ance
 to newly eligible individuals2 &  7,e7 
9 subp>agraph 7,e71 by /rik+ #bjbj & ea*
 ye> !reaft] & ins]t+ ! sev5?           
consecutive #ab-mon? p]iod 9 :i* ! ,/ate
 provides m$ical assi/ance to newly     
eligible individuals & ea* su* p]iod    
!reaft]2 &  7#b7 9 subsection           
7z77#b77;,b77i77,,ii71 by ins]t+ 7z 9   
effect on ! day be=e ! enactm5t ( !     
,vacc9e ,& ,cov]age ,c]ta9ty ,act7 aft] 
subsection 7y77#a74  7b7 ,retroactive   
application ,! am5dm5ts made by         
subsection 7a77#a7 %all take effect z if
 includ$ 9 ! enactm5t ( ,public ,law    

#aaa-adh & %all apply to am\nts exp5d$  
by any ,/ate = m$ical assi/ance = newly 
eligible individuals describ$ 9         
subclause 7,,viii7 ( section            
#aijb7;a77#aj77;,a77i7 ( ! ,social      
,security ,act "u a ,/ate ,m$icaid plan 
7or a waiv] ( su* plan7 dur+ ! p]iod    
be=e ! date ( enactm5t ( ?is ,act4      
#bjb4 ,m$icaid cov]age = citiz5s (      
,freely ,associat$ ,/ates  7a7 ,9 g5]al 
,section #djb7;b77#b7 ( ! ,p]sonal      
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif 7#h        
,u4,s4,c4 #afab7;b77#b77 is am5d$ by    
add+ at ! end ! foll[+ new subp>agraph3 
7,g7 ,m$icaid exception = citiz5s (     
,freely ,associat$ ,/ates ,) respect to 
eligibility = b5efits = ! designat$     
,f$]al program def9$ 9 p>agraph         
7#c77;,c7 7relat+ to ! ,m$icaid         
program71 section #dja7;a7 & p>agraph   
7#a7 %all n apply to any individual :o  
lawfully resides 9 #a ( ! #ej ,/ates or 
! ,di/rict ( ,columbia 9 accordance ) ! 
,compacts ( ,free ,association betwe5 ! 

,gov]nm5t ( ! ,unit$ ,/ates & !         
,gov]nm5ts ( ! ,f$]at$ ,/ates (         
,micronesia1 ! ,republic ( ! ,m>%all    
,isl&s1 & ! ,republic ( ,palau & %all n 
apply1 at ! option ( ! ,gov]nor ( ,pu]to
 ,rico1 ! ,virg9 ,isl&s1 ,guam1 !       
,nor!rn ,m>iana ,isl&s1 or ,am]ican     
,samoa z communicat$ to ! ,secret>y (   
,heal? & ,human ,s]vices 9 writ+1 to any
 individual :o lawfully resides 9 !     
respective t]ritory 9 accordance ) su*  
,compacts4  4  7b7 ,exception to #e-,ye>
 limit$ eligibility ,section #djc7;d7 ( 
su* ,act 7#h ,u4,s4,c4 #afac7;d77 is    
am5d$-- 7#a7 9 p>agraph 7#a71 by /rik+  
or at ! end2  7#b7 9 p>agraph 7#b71 by  
/rik+ ! p]iod at ! end & ins]t+ 2 or2 & 
7#c7 by add+ at ! end ! foll[+ new      
p>agraph3  7#c7 an individual describ$ 9
 section #djb7;b77#b77;,g71 b only )    
respect to ! designat$ ,f$]al program   
def9$ 9 section #djb7;b77#c77;,c74  4   
7c7 ,def9ition ( qualifi$ ali5 ,section 
#dca7;b7 ( su* ,act 7#h ,u4,s4,c4       
#afda7;b77 is am5d$-- 7#a7 9 p>agraph   

7#f71 by /rik+ 2 or at ! end & ins]t+ a 
comma2  7#b7 9 p>agraph 7#g71 by /rik+ !
 p]iod at ! end & ins]t+ 1 or2 &  7#c7  
by add+ at ! end ! foll[+ new p>agraph3 
7#h7 an individual :o lawfully resides 9
 ! ,unit$ ,/ates 9 accordance ) a       
,compact ( ,free ,association ref]r$ to 
9 section #djb7;b77#b77;,g71 b only )   
respect to ! designat$ ,f$]al program   
def9$ 9 section #djb7;b77#c77;,c7       
7relat+ to ! ,m$icaid program74  4  7d7 
,application to ,/ate plans ,section    
#aijb7;a77#aj77;,a77i7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#aj77;,a77i77 is am5d$ by    
ins]t+ aft] subclause 7,,ix7 ! foll[+3  
7,x7 :o are describ$ 9 section          
#djb7;b77#b77;,g7 ( ! ,p]sonal          
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif & eligible 
= b5efits "u ?is title by reason (      
application ( su* section2  4  7e7      
,con=m+ am5dm5ts ,section #aajh ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acjh71 z am5d$ by section #ajd1 is     

am5d$-- 7#a7 9 subsection 7f71 9 ! matt]
 prec$+ p>agraph 7#a71 by /rik+         
subsections 7g7 & 7h7 & ins]t+          
subsections 7g71 7h71 & 7i72 &  7#b7 by 
add+ at ! end ! foll[+3  7i7 ,exclusion 
( m$ical assi/ance exp5ditures = citiz5s
 ( ,freely ,associat$ ,/ates            
,exp5ditures = m$ical assi/ance provid$ 
to an individual describ$ 9 section     
#dca7;b77#h7 ( ! ,p]sonal               
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif 7#h        
,u4,s4,c4 #afda7;b77#h77 %all n be tak5 
into acc\nt = purposes ( apply+ paym5t  
limits "u subsections 7f7 & 7g74  4  7f7
 ,effective date ,! am5dm5ts made by ?is
 section %all apply to b5efits = items &
 s]vices furni%$ on or aft] ! date ( !  
enactm5t ( ?is ,act4  ,,iii ,ensur+     
cov]age 9 ! ,m>ketplace  #cja4 ,disreg>d
 ( additional unemploym5t comp5sation = 
purposes ( premium tax cr$it & co/-%>+  
subsidies  7a7 ,9 g5]al ,section        
#cf;,b7d77#b77;,b7 ( ! ,int]nal ,rev5ue 
,code ( #aihf is am5d$-- 7#a7 by        

r$esignat+ clauses 7i71 7ii71 & 7iii7 z 
subclauses 7,i71 7,,ii71 & 7,,iii71     
respectively1 & by mov+ su* subclauses  
#b ems to ! "r2  7#b7 by /rik+ adju/$   
gross income increas$ by & ins]t+ adju/$
 gross income-- 7i7 decreas$ by ! am\nt 
( any ,f$]al p&emic unemploym5t         
comp5sation paid to an individual "u    
section #bajd ( division ,a ( ! ,,c>es  
,act dur+ ! taxable ye>2 &  7ii7        
increas$ by--  2 &  7#c7 by add+ at !   
end ! foll[+ new flu% s5t5ce3 ,clause   
7i7 %all n apply to ! ext5t t su*       
decrease results 9 a h\sehold income = !
 taxpay] :i* is less ?an #ajj p]c5t ( ! 
pov]ty l9e = a family ( ! size involv$4 
4  7b7 ,tempor>y susp5sion ( recapture (
 excess advance paym5ts ,section        
#cf;,b7f77#b7 ( ! ,int]nal ,rev5ue ,code
 ( #aihf is am5d$ by add+ at ! end !    
foll[+ new subp>agraph3  7,c7 ,special  
rule = #bjbj & #bjba ,subp>agraph 7,a7  
%all n apply to any taxable ye> beg9n+ 9
 #bjbj or #bjba4  4  7c7 ,effective date
 ,! am5dm5ts made by ?is section %all   

apply to taxable ye>s beg9n+ aft]       
,decemb] #ca1 #bjai4