This division may be cited as the “CHIP and Public Health Funding Extension Act”.
Division C — Health Provisions
DIVISION C Health Provisions
TITLE I Public Health Extenders
SEC. 3101. Extension for Community Health Centers, the National Health Service Corps, and Teaching Health Centers That Operate Gme Programs.
Community Health Centers Funding.— Section 10503(b)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b–2(b)(1)) is amended—
in subparagraph (D), by striking “ and” at the end; and
by inserting after subparagraph (E) the following:
“(F) $550,000,000 for the period of the first and second quarters of fiscal year 2018; and”
National Health Service Corps.— Section 10503(b)(2) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b–2(b)(2)) is amended—
in subparagraph (D), by striking “ and” at the end;
in subparagraph (E), by striking the period at the end and inserting “ ; and”; and
by inserting after subparagraph (E) the following:
“(F) $65,000,000 for period of the first and second quarters of fiscal year 2018.”
Teaching Health Centers That Operate Graduate Medical Education Programs.— Subsection (g) of section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended—
by striking “ To carry out” and inserting the following:
“(1) In general.—To carry out”
by striking “ and $15,000,000 for the first quarter of fiscal year 2018” and inserting “ and $30,000,000 for the period of the first and second quarters of fiscal year 2018, to remain available until expended”; and
by adding at the end the following:
“(2) Administrative expenses.—Of the amount made available to carry out this section for any fiscal year, the Secretary may not use more than 5 percent of such amount for the expenses of administering this section.”
Application.— Amounts appropriated pursuant to this section are subject to the requirements contained in Public Law 115–31 for funds for programs authorized under sections 330 through 340 of the Public Health Service Act (42 U.S.C. 254b–256).
in paragraph (1), by striking “ section 10503(b)(1)(E) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(1)(E)), as amended by section 221 of the Medicare Access and CHIP Reauthorization Act of 2015” and inserting “ subparagraphs (E) and (F) of section 10503(b)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(1))”; and
in paragraph (4), by inserting “ and section 3101(d) of the CHIP and Public Health Funding Extension Act” after “ section 221(c) of the Medicare Access and CHIP Reauthorization Act of 2015”.
SEC. 3102. Extension for Special Diabetes Programs.
Special Diabetes Program for Type I Diabetes.— Section 330B(b)(2) of the Public Health Service Act (42 U.S.C. 254c–2(b)(2)) is amended—
in subparagraph (B), by striking “ and” at the end;
in subparagraph (C), by striking the period at the end and inserting “ ; and”; and
by inserting after subparagraph (C) the following:
“(D) $37,500,000 for the period of the first and second quarters of fiscal year 2018, to remain available until expended.”
Special Diabetes Program for Indians.— Subparagraph (D) of section 330C(c)(2) of the Public Health Service Act (42 U.S.C. 254c–3(c)(2)) is amended by inserting “ and $37,500,000 for the second quarter of fiscal year 2018” before the period at the end.
SEC. 3103. Prevention and Public Health Fund.
Section 4002(b) of the Patient Protection and Affordable Care Act (42 U.S.C. 300u–11(b)) is amended—
in paragraph (3), by striking “ each of fiscal years 2018 and 2019” and inserting “ fiscal year 2018”;
by redesignating paragraphs (4) through (8) as paragraphs (5) through (9);
by inserting after paragraph (3) the following new paragraph:
“(4) for fiscal year 2019, $800,000,000;”
in paragraph (5), as so redesignated, by striking “ $1,000,000,000” and inserting “ $800,000,000”; and
in paragraph (6), as so redesignated, by striking “ $1,500,000,000” and inserting “ $1,250,000,000”.
TITLE II Children’s Health Insurance Program (chip)
SEC. 3201. Funding Extension of the Children’s Health Insurance Program.
Appropriation; Total Allotment.— Section 2104(a) of the Social Security Act (42 U.S.C. 1397dd(a)) is amended—
in paragraph (19), by striking “ and”;
in paragraph (20), by striking the period at the end and inserting “ ; and”; and
by adding at the end the following new paragraph:
“(21) for fiscal year 2018, for purposes of making 1 semi-annual allotment—
“(A) $2,850,000,000 for the period beginning on October 1, 2017, and ending on March 31, 2018.”
Allotments.—
in paragraph (2)(B)(ii), in the matter preceding subclause (I), by inserting “ and paragraph (10)” after “ clauses (iii) and (iv)”;
in paragraph (5)—
by striking “ or (4)” and inserting “ (4), or (10)”; and
by striking “ or 2017” and inserting “ , 2017, or 2018”;
in paragraph (9)—
in the heading, by striking “ fiscal years 2015 and 2017” and inserting “ certain fiscal years”;
by striking “ or (4)” and inserting “ , (4), or (10)”; and
by striking “ or fiscal year 2017” and inserting “ , 2017, or 2018”; and
by adding at the end the following new paragraph:
“(10) For fiscal year 2018.—
“(A) First half.—
“(i) In general.—Subject to paragraphs (5) and (7), from the amount made available under subparagraph (A) of paragraph (21) of subsection (a) for the semi-annual period described in such subparagraph, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to ½ of the amount described in clause (ii) for the State.
“(ii) Full year amount based on growth factor updated amount.—The amount described in this clause for a State is equal to the sum of—
“(I) the sum of the 2 semi-annual allotments made to the State under paragraph (4) for fiscal year 2017; and
“(II) the amount of any payments made to the State under subsection (n) for fiscal year 2017,
in the paragraph heading, by striking “ 2010 through 2016” and inserting “ beginning with fiscal year 2010”; and
by striking “ the allotment increase factor under paragraph (5)” each place it appears and inserting “ the allotment increase factor under paragraph (6)”.
Application of regular expenditure rules.— Amounts allotted to a State under section 2104(m)(10)(A) of the Social Security Act (42 U.S.C. 1397dd(m)(10)(A)) (as added by paragraph (1)) shall be subject to the same requirements of title XXI of such Act and applicable regulations of the Secretary of Health and Human Services as apply to other allotments made to States for a fiscal year under section 2104 of such Act.
Extension of CHIP Allocation Redistribution Special Rule for Certain Shortfall States.—
In general.— Section 2104(f)(2)(B)(ii) of the Social Security Act (42 U.S.C. 1397dd(f)(2)(B)), as amended by section 201 of Public Law 115–90, is amended—
in the clause heading, by striking “ first quarter” and inserting “ first half”;
by redesignating subclause (III) as subclause (VI); and
by striking subclauses (I) and (II) and inserting the following:
“(I) In general.—For each month beginning during the period beginning on October 1, 2017, and ending March 31, 2018, subject to the succeeding subclauses of this clause, the Secretary shall redistribute any amounts available for redistribution under paragraph (1) for fiscal year 2018, to each State that is an emergency shortfall State for the month (as defined in subclause (II)) such amount as the Secretary determines will eliminate the estimated shortfall described in subclause (II) for such State for the month (as may be adjusted under subparagraph (C)) before the Secretary may redistribute such amounts to any shortfall State that is not an emergency shortfall State. In the case of any amounts redistributed under this subclause to a State that is not an emergency shortfall State, such amounts shall be determined in accordance with clause (i).
“(II) Emergency shortfall state defined.—For purposes of this clause, the term ‘emergency shortfall State’ means, with respect to a month beginning during the period beginning October 1, 2017, and ending March 31, 2018, a shortfall State for which the Secretary estimates, in accordance with subparagraph (A) (unless otherwise specified in this subclause) and on a monthly basis using the most recent data available to the Secretary as of such month, that the projected expenditures under the State child health plan and under section 2105(g) (calculated as if the reference under section 2105(g)(4)(A) to ‘2017’ were a reference to ‘2018’ and insofar as the allotments are available to the State under this subsection or subsection (e) or (m)) for such month will exceed the sum of the amounts described in clauses (i) through (iii) of subparagraph (A) for such month, including after application of any amount redistributed under paragraph (1) for a previous month for fiscal year 2018 in accordance with this clause, to such State. A shortfall State may be an emergency shortfall State under the previous sentence without regard to whether any amounts were redistributed to such State under paragraph (1) for a previous month in fiscal year 2018.
“(III) Funds redistributed in the order in which states realize funding shortfalls.—The Secretary shall redistribute the amounts available for redistribution under paragraph (1) to emergency shortfall States described in subclause (II) in the order in which such States realize monthly funding shortfalls under this title for fiscal year 2018. The Secretary shall only make redistributions under this clause to the extent that such amounts are available for such redistributions.
“(IV) Proration rule.—If the amounts available for redistribution under paragraph (1) for a month during the period described in subclause (I) are less than the total amounts of the estimated shortfalls determined for the month for emergency shortfall States described in subclause (II), the amount computed under subclause (I) for each emergency shortfall State shall be reduced proportionally.
“(V) Unobligated redistributed funds.—The Secretary shall withhold any funds redistributed under paragraph (1) for fiscal year 2018 before January 1, 2018, but which have not been obligated for amounts expended by a State as of that date, and shall redistribute such funds in accordance with the preceding subclauses of this clause.”
Rule of construction.— Nothing in the amendments made by paragraph (1) shall be construed as authorizing the Secretary of Health and Human Services to de-obligate any funds redistributed under clause (ii) of section 2104(f)(2)(B) of the Social Security Act (42 U.S.C. 1397dd(f)(2)(B)) that have been obligated for amounts expended by an emergency shortfall State described in such clause as of January 1, 2018.