[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3243 Introduced in House (IH)]
112th CONGRESS
1st Session
H. R. 3243
To amend titles XIX and XXI of the Social Security Act, titles I and II
of the Patient Protection and Affordable Care Act, and other Acts for
the purpose of eliminating certain health entitlement programs and
reducing the deficit.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 24, 2011
Mr. Rehberg introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend titles XIX and XXI of the Social Security Act, titles I and II
of the Patient Protection and Affordable Care Act, and other Acts for
the purpose of eliminating certain health entitlement programs and
reducing the deficit.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``The Common Sense
Deficit Reduction Act of 2011''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Medicaid expansion for certain adults.
Sec. 3. Elimination of Medicaid coverage of former foster care
children.
Sec. 4. Removal of requirement of minimal essential coverage for
Medicaid benchmark benefits.
Sec. 5. Elimination of Medicaid premium assistance requirement.
Sec. 6. Elimination of Medicaid and CHIP MAGI requirements.
Sec. 7. Elimination of increased FMAP for CHIP.
Sec. 8. Restoration of CHIP appropriation amounts under CHIPRA.
Sec. 9. Treatment of children who are unable to be enrolled in CHIP due
to a funding shortfall.
Sec. 10. Grants to improve CHIP outreach and enrollment.
Sec. 11. Additional one-time appropriations for CHIP.
Sec. 12. Repeal of PPACA Premium tax credits and cost-sharing
subsidies.
Sec. 13. Treatment of individual mandate.
Sec. 14. Repeal of CLASS Act.
SEC. 2. MEDICAID EXPANSION FOR CERTAIN ADULTS.
(a) Mandatory Populations.--Section 1902 of the Social Security Act
(42 U.S.C. 1396a) is amended--
(1) in subsection (a)(10)--
(A) in subparagraph (A)(i)--
(i) by inserting ``or'' at the end of
subclause (VI); and
(ii) by striking subclause (VIII); and
(B) in the matter following subparagraph (G) by
striking ``(XV) the medical assistance made available
to an individual described in subparagraph (A)(i)(VIII)
shall be limited to medical assistance described in
subsection (k)(1)'';
(2) by striking subsection (k); and
(3) in subsection (l)(2)(C) by striking ``(or, beginning
January 1, 2014, 133 percent)''.
(b) Optional Population.--Section 1902 of the Social Security Act
(42 U.S.C. 1396a) is further amended--
(1) in subsection (a)(10)(A)(ii) by striking subclause
(XX); and
(2) by striking subsection (hh).
(c) Elimination of Funding.--Section 1905 of the Social Security
Act (42 U.S.C. 1396d), is amended--
(1) in subsection (a), in the matter preceding paragraph
(1), by striking clauses (xiv) and (xv);
(2) in subsection (b), in the first sentence, by striking
``(y),'' before ``(z),''; and
(3) by striking subsection (y).
(d) Conforming Amendments.--
(1) Section 1903 of the Social Security Act (42 U.S.C.
1396b) is amended--
(A) in subsection (f)(4), by striking
``1902(a)(10)(A)(i)(VIII),'' and
``1902(a)(10)(A)(ii)(XX),''; and
(B) in subsection (i)--
(i) by inserting ``or'' at the end of
paragraph (24);
(ii) by striking ``; or'' at the end of
paragraph (25) and inserting a period; and
(iii) by striking paragraph (26).
(2) Section 1920 of the Social Security Act (42 U.S.C.
1396r-1) is amended by striking subsection (e).
(3) Section 1937(a)(1)(B) of such Act (42 U.S.C. 1396u-
7(a)(1)(B)) is amended by striking ``subclause (VIII) of
section 1902(a)(10)(A)(i) or under''.
SEC. 3. ELIMINATION OF MEDICAID COVERAGE OF FORMER FOSTER CARE
CHILDREN.
(a) In General.--Section 1902(a)(10)(A)(i) of the Social Security
Act (42 U.S.C. 1396a) is amended by striking subclause (IX).
(b) Conforming Amendments.--
(1) Section 1902(a)(10) of such Act (42 U.S.C.
1396a(a)(10)) is amended in the matter following subparagraph
(G)--
(A) by inserting ``and'' before ``XVI if an
individual''; and
(B) by striking ``and (XVII) if an individual is
described in subclause (IX) of subparagraph (A)(i) and
is also described in subclause (VIII) of that
subparagraph, the medical assistance shall be made
available to the individual through subclause (IX)
instead of through subclause (VIII)''.
(2) Section 1903(f)(4) of such Act (42 U.S.C. 1396b(f)(4))
is amended by striking ``1902(a)(10)(A)(i)(IX),''.
(3) Section 1937(a)(2)(B)(viii) of such Act (42 U.S.C.
1396u-7(a)(2)(B)(viii)) is amended by striking ``, or the
individual qualifies for medical assistance on the basis of
section 1902(a)(10)(A)(i)(IX)''.
SEC. 4. REMOVAL OF REQUIREMENT OF MINIMAL ESSENTIAL COVERAGE FOR
MEDICAID BENCHMARK BENEFITS.
Section 1937(b) of the Social Security Act (42 U.S.C. 1396-7(b)) is
amended--
(1) in paragraph (1), in the matter preceding subparagraph
(A), by striking ``subject to paragraphs (5) and (6)'';
(2) in paragraph (2)--
(A) in the matter preceding subparagraph (A), by
striking ``subject to paragraphs (5) and (6)'';
(B) in subparagraph (A)--
(i) by striking clauses (iv) and (v); and
(ii) by redesignating clauses (vi) and
(vii) as clauses (iv) and (v), respectively;
and
(C) in subparagraph (C)--
(i) by redesignating clauses (i) and (ii)
as clauses (iii) and (iv), respectively; and
(ii) by inserting before clause (iii), as
so redesignated, the following:
``(i) Coverage of prescription drugs.
``(ii) Mental health services.''; and
(3) by striking paragraphs (5) and (6).
SEC. 5. ELIMINATION OF MEDICAID PREMIUM ASSISTANCE REQUIREMENT.
Section 2003 of the Patient Protection and Affordable Care Act is
repealed and the provisions of law amended by such section are restored
as if such section had never been enacted.
SEC. 6. ELIMINATION OF MEDICAID AND CHIP MAGI REQUIREMENTS.
(a) Medicaid.--Section 1902(e) of the Social Security Act (42
U.S.C. 1396a(e)) is amended by striking paragraph (14).
(b) CHIP.--
(1) In general.--Section 2102(b)(1)(B) of such Act (42
U.S.C. 1397bb) is amended--
(A) by inserting ``and'' at the end of clause
(iii);
(B) by striking ``and'' at the end of clause (iv);
and
(C) by striking clause (v).
(2) Elimination of related eligibility rule.--Section
2101(f) of the Patient Protection and Affordable Care Act is
repealed.
(c) Conforming Amendments.--
(1) Section 1902(a)(17) of such Act (42 U.S.C.
1396a(a)(17)) is amended by striking ``(e)(14)''.
(2) Section 2105(d)(1) of such Act (42 U.S.C. 1397ee(d)(1))
is amended by striking ``, except as required under section
1902(e)(14)''.
(3) Section 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1))
is amended by striking subparagraph (F) (relating to income
determined using modified adjusted gross income and household
income).
SEC. 7. ELIMINATION OF INCREASED FMAP FOR CHIP.
Section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) is
amended by striking ``Notwithstanding the preceding sentence, during
the period that begins on October 1, 2015, and ends on September 30,
2019, 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 23 percentage points, but in no case shall exceed 100
percent. The increase in the enhanced FMAP under the preceding sentence
shall not apply with respect to determining the payment to a State
under subsection (a)(1) for expenditures described in subparagraph
(D)(iv), paragraphs (8), (9), (11) of subsection (c), or clause (4) of
the first sentence of section 1905(b).''.
SEC. 8. RESTORATION OF CHIP APPROPRIATION AMOUNTS UNDER CHIPRA.
(a) Restoration of CHIPRA Appropriation Amounts.--Section 2104(a)
of the Social Security Act (42 U.S.C. 1397dd(a)) is amended--
(1) in paragraph (15), by inserting ``and'' after the
semicolon at the end; and
(2) by striking paragraphs (16) through (18) and inserting
the following:
``(16) for fiscal year 2013, for purposes of making 2
semiannual allotments--
``(A) $2,850,000,000 for the period beginning on
October 1, 2012, and ending on March 31, 2013, and
``(B) $2,850,000,000 for the period beginning on
April 1, 2013, and ending on September 30, 2013.''.
(b) Conforming Amendments.--
(1) Section 2104(m) of such Act (42 U.S.C. 1397dd(m)) is
amended--
(A) in the heading, by striking ``2015'' and
inserting ``2013'';
(B) in paragraph (2)--
(i) in paragraph heading, by striking
``2014'' and inserting ``2012''; and
(ii) by striking subparagraph (B);
(C) in paragraph (3)--
(i) in the paragraph heading, by striking
``2015'' and inserting ``2013'';
(ii) in subparagraphs (A) and (B), by
striking ``paragraph (18)'' each place it
appears and inserting ``paragraph (16)'';
(iii) in subparagraph (C)--
(I) by striking ``2014'' each place
it appears and inserting ``2012''; and
(II) by striking ``2015'' and
inserting ``2013''; and
(iv) in subparagraph (D)--
(I) in clause (i)(I), by striking
``subsection (a)(18)(A)'' and inserting
``subsection (a)(16)(A)''; and
(II) in clause (ii)(II), by
striking ``subsection (a)(18)(B)'' and
inserting ``subsection (a)(16)(B)'';
(D) in paragraph (4), by striking ``2015'' and
inserting ``2013'';
(E) in paragraph (6)--
(i) in subparagraph (A), by striking
``2015'' and inserting ``2013''; and
(ii) in the flush text after and below
subparagraph (B)(ii), by striking ``, fiscal
year 2012, or fiscal year 2014'' and inserting
``or fiscal year 2012''; and
(F) in paragraph (8)--
(i) in the paragraph heading, by striking
``2015'' and inserting ``2013''; and
(ii) by striking ``2015'' and inserting
``2013''.
(2) Section 2104(n) of such Act (42 U.S.C. 1397dd(n)) is
amended--
(A) in paragraph (2)--
(i) in subparagraph (A)(ii)--
(I) by striking ``2014'' and
inserting ``2012''; and
(II) by striking ``2015'' and
inserting ``2013''; and
(ii) in subparagraph (B)--
(I) by striking ``2014'' and
inserting ``2012''; and
(II) by striking ``2015'' and
inserting ``2013''; and
(B) in paragraph (3)(A), by striking ``fiscal year
2013, fiscal year 2014, or a semi-annual allotment
period for fiscal year 2015'' and inserting ``or a
semiannual allotment period for fiscal year 2013''.
(3) Section 2105(g)(4) of such Act (42 U.S.C. 1397ee(g)(4))
is amended--
(A) in the paragraph heading, by striking ``2015''
and inserting ``2013''; and
(B) in subparagraph (A), striking ``2015'' and
inserting ``2013''.
SEC. 9. TREATMENT OF CHILDREN WHO ARE UNABLE TO BE ENROLLED IN CHIP DUE
TO A FUNDING SHORTFALL.
Section 2105(d)(3) of the Social Security Act (42 U.S.C.
1397ee(d)(3)) is amended by striking subparagraph (B).
SEC. 10. GRANTS TO IMPROVE CHIP OUTREACH AND ENROLLMENT.
Section 2113 of the Social Security Act (42 U.S.C. 1397mm) is
amended--
(1) in subsection (a)(1), striking ``2015'' and inserting
``2013''; and
(2) in subsection (g), by striking ``$140,000,000 for the
period of fiscal years 2009 through 2015'' and inserting
``$100,000,000 for the period of fiscal years 2009 through
2013''.
SEC. 11. ADDITIONAL ONE-TIME APPROPRIATIONS FOR CHIP.
Section 108 of the Children's Health Insurance Program
Reauthorization Act of 2009 (42 U.S.C. 1397ee note) is amended by
striking ``$15,361,000,000 to accompany the allotment'' and all that
follows through ``allotments provided from such subsection (a)(18)(A)''
and inserting ``$11,706,000,000 to accompany the allotment made for the
period beginning on October 1, 2012, and ending on March 31, 2013,
under section 2104(a)(16)(A) of the Social Security Act (42 U.S.C.
1397dd(a)(16)(A)) (as added by section 101), to remain available until
expended. Such amount shall be used to provide allotments to States
under paragraph (3) of section 2104(m) of the Social Security Act (42
U.S.C. 1397dd(i)), as added by section 102, for the first 6 months of
fiscal year 2013 in the same manner as allotments are provided under
subsection (a)(16)(A) of such section 2104 and subject to the same
terms and conditions as apply to the allotments provided from such
subsection (a)(16)(A).''.
SEC. 12. REPEAL OF PPACA PREMIUM TAX CREDITS AND COST-SHARING
SUBSIDIES.
(a) Premium Tax Credits.--Section 36B of the Internal Revenue Code
of 1986 is amended by striking subsection (a).
(b) Cost-Sharing.--Section 1402 of the Patient Protection and
Affordable Care Act is repealed.
(c) Conforming Amendments To Eliminate References to Premium
Assistance and Reductions in Cost-Sharing.--
(1) Internal revenue code of 1986.--The Internal Revenue
Code of 1986 is amended--
(A) in section 36B, as amended by subsection (a)--
(i) in subsection (c)(2)(A)(ii), by
striking ``(or through advance payment'' and
all that follows through ``Act)'';
(ii) in subsection (f)--
(I) by striking paragraphs (1) and
(2);
(II) in paragraph (3)(B), by
striking ``without regard to the credit
under this section or cost-sharing
reductions under section 1402 of such
Act'';
(III) in paragraph (3), by striking
subparagraphs (C) and (F); and
(IV) in paragraph (3)(E), by
striking ``necessary'' and all that
follows; and
(iii) in subsection (g), by striking ``,
including'' and all that follows through ``of
the credit'';
(B) in section 280C, by striking subsection (g)
(relating to credit for health insurance premiums);
(C) in section 4980H(c), by striking paragraph (3);
(D) in section 5000A--
(i) in subsection (e)(1)--
(I) in subparagraph (A), by
striking ``for the taxable year
described in section 1412(b)(1)(B) of
the Patient Protection and Affordable
Care Act'' and inserting ``for the most
recent taxable year for which the
Secretary of Health and Human Services,
after consultation with the Secretary
of the Treasury, determines information
is available''; and
(II) in subparagraph (B)(ii), by
striking ``, reduced by the amount of
the credit allowable under section 36B
for the taxable year (determined as if
the individual was covered by a
qualified health plan offered through
the Exchange for the entire taxable
year)''; and
(ii) in subsection (e)(2), by striking
``described in section 1412(b)(1)(B) of the
Patient Protection and Affordable Care Act''
and inserting ``described in paragraph
(1)(A)'';
(E) in section 6055(b)(1), by amending clause (iii)
to read as follows:
``(iii) in the case of minimum essential
coverage which consists of health insurance
coverage, information concerning whether or not
the coverage is a qualified health plan offered
through an Exchange established under section
1311 of the Patient Protection and Affordable
Care Act, and''; and
(F) in section 6103(l)(21)(A), in the matter before
clause (i), by striking ``any premium tax credit under
section 36B or any cost-sharing reduction under section
1402 of the Patient Protection and Affordable Care Act
or''.
(2) Fair labor standards act of 1938.--The Fair Labor
Standards Act of 1938 (29 U.S.C. 201 et seq.) is amended--
(A) in section 18B(a)--
(i) in paragraph (1), by inserting ``and''
after the semicolon at the end; and
(ii) by striking paragraph (2); and
(B) in section 18C(a), by striking paragraph (1).
(3) Public health service act amendments.--Title XXVII of
the Public Health Service Act (42 U.S.C. 300gg et seq.) is
amended--
(A) in section 2705(l)(3)(A)--
(i) by striking the em dash before clause
(i) and inserting ``will not result in any
decrease in coverage.''; and
(ii) by striking clauses (i) and (ii); and
(B) in section 2793(c)--
(i) by inserting ``and'' at the end of
paragraph (3);
(ii) by striking ``; and'' at the end of
paragraph (4); and
(iii) by striking paragraph (5).
(4) Patient protection and affordable care act
amendments.--The Patient Protection and Affordable Care Act
(Public Law 111-148, as amended) is amended--
(A) in section 1311(d)(4)--
(i) in subparagraph (G), by striking
``after the application of any premium tax
credit'' and all that follows through ``section
1402''; and
(ii) in subparagraph (I), by striking
clause (ii);
(B) in section 1311(i)(3)(B), by striking ``, and
the availability of premium tax credits'' and all that
follows through ``section 1402'';
(C) in section 1331(d)(3)(A)(i) is amended by
inserting ``and section 8 of the Common Sense Deficit
Reduction Act of 2011 had not been enacted'' before the
period at the end;
(D) in section 1332(a)--
(i) in paragraph (2), by striking
subparagraph (C); and
(ii) in paragraph (3), by striking
``premium tax credits, cost-sharing
reductions'';
(E) in section 1334(c) by striking paragraph (3);
(F) in section 1401(c)(1)(A), by striking clause
(i);
(G) in section 1411--
(i) in subsection (a)(1)--
(I) by striking ``or who is
claiming a premium tax credit or
reduced cost-sharing,''; and
(II) by striking ``sections
1312(f)(3), 1402(e), and 1412(d)'' and
inserting ``section 1312(f)(3)'';
(ii) in subsection (a), by striking
paragraph (2);
(iii) in subsection (b), by striking
paragraphs (3) and (4); and
(iv) in subsection (e)--
(I) in paragraph (2), by amending
subparagraph (A) to read as follows:
``(A) Eligibility for enrollment.--If information
provided by an applicant under paragraphs (1) and (2)
of subsection (b) is verified under subsections (c) and
(d) the individual's eligibility to enroll through the
Exchange shall be satisfied.''; and
(II) in paragraph (4)(B), by
striking clause (iii);
(H) by striking section 1412;
(I) in section 1413(e)(1), by striking ``,
including the premium tax credits under section 36B of
the Internal Revenue Code of 1986 and cost-sharing
reductions under section 1402'';
(J) by striking section 1415; and
(K) in section 2901, by striking subsection (a).
(5) Social security act.--Section 1943(b) of the Social
Security Act (42 U.S.C. 1396w-3(b)) is amended--
(A) in paragraph (1)(C)--
(i) by striking ``and, if applicable,
premium assistance'' and all that follows
through ``section 1412 of the Patient
Protection and Affordable Care Act),''; and
(ii) by striking ``reduced cost-sharing for
eligible individuals under section 1402 of the
Patient Protection and Affordable Care Act, and
any other'' and inserting ``any'';
(B) in paragraph (1)(D), by striking ``, child
health assistance, or premium assistance,'' and
inserting ``or child health assistance,'';
(C) by striking paragraph (2); and
(D) in paragraph (4), by striking ``and who is
eligible to receive premium credit assistance for the
purchase of a qualified health plan under section 36B
of the Internal Revenue Code of 1986''.
SEC. 13. TREATMENT OF INDIVIDUAL MANDATE.
Section 1311(d)(4)(H) of the Patient Protection and Affordable Care
Act is amended--
(1) in clause (i), by striking ``or'' after the semicolon
at the end;
(2) in clause (ii), by inserting ``or'' after the semicolon
at the end; and
(3) by adding at the end the following new clause:
``(iii) the individual would have qualified
for premium assistance under section 36B of the
Internal Revenue Code of 1986, medical
assistance under title XIX of the Social
Security Act, child health assistance under
title XXI of such Act, or reduced cost-sharing
under section 1402, but for the enactment of
the Common Sense Deficit Reduction Act of
2011;''.
SEC. 14. REPEAL OF CLASS ACT.
(a) In General.--Title XXXII of the Public Health Service Act (42
U.S.C. 30011 et seq.) is repealed.
(b) Conforming Amendments.--
(1) Section 1902(a) of the Social Security Act (42 U.S.C.
1396a(a)) is amended--
(A) in paragraph (80), by inserting ``and'' after
the semicolon at the end; and
(B) by striking paragraphs (81) and (82).
(2) Section 8002 of the Patient Protection and Affordable
Care Act is amended by striking subsections (c) and (f).
(3) Section 6021(d) of the Deficit Reduction Act of 2005
(42 U.S.C. 1396p note) is amended--
(A) in paragraph (2)(A)--
(i) in clause (ii), by inserting ``and'' at
the end;
(ii) in clause (iii), by striking ``; and''
at the end and inserting a period; and
(iii) by striking clause (iv); and
(B) in paragraph (3), by striking ``2015'' and
inserting ``2012''.
<all>