To create a point of order against any changes to the Medicare program, the Medicaid program, or the number of Americans enrolled in private health insurance coverage, in a manner that would result in reduced revenue to hospitals, health care centers, and physicians and other health care providers, thereby reducing their investments in health care delivery system reforms that improve patient health outcomes and reduce costs.

SA 143. Ms. CANTWELL (for herself, Mr. Carper, Mr. Bennet, Mrs.
Shaheen, Mr. Murphy, Ms. Warren, Mr. King, Mr. Van Hollen, Ms.
Klobuchar, Mr. Whitehouse, Mr. Warner, and Ms. Duckworth) submitted an
amendment intended to be proposed by her to the concurrent resolution
S. Con. Res. 3, setting forth the congressional budget for the United
States Government for fiscal year 2017 and setting forth the
appropriate budgetary levels for fiscal years 2018 through 2026; as
follows:

At the end of title IV, add the following:

SEC. 4__. POINT OF ORDER AGAINST ANY CHANGES TO THE MEDICARE
PROGRAM, THE MEDICAID PROGRAM, OR THE NUMBER OF
AMERICANS ENROLLED IN PRIVATE HEALTH INSURANCE
COVERAGE, IN A MANNER THAT WOULD RESULT IN
REDUCED REVENUE TO HOSPITALS, HEALTH CARE
CENTERS, AND PHYSICIANS AND OTHER HEALTH CARE
PROVIDERS, THEREBY REDUCING THEIR INVESTMENTS
IN HEALTH CARE DELIVERY SYSTEM REFORMS THAT
IMPROVE PATIENT HEALTH OUTCOMES AND REDUCE
COSTS.

(a) Findings.--The Senate finds the following:
(1) The Affordable Care Act is moving the health care
system of the United States from a fee-for-service system
that frequently incentivizes the overutilization of health
care services and wasteful health care spending to a value-
and performance-based health care system that promotes
patient-centered and team-based care to keep Americans as
healthy as possible, improve health outcomes, and lower
health care costs.
(2) Because of the investments in health care delivery
system reforms made by the Affordable Care Act, a third of
Medicare payments to health care providers are now based on
the overall quality of patient care and health outcomes
achieved by such providers.
(b) Point of Order.--It shall not be in order in the Senate
to consider any bill, joint resolution, motion, amendment,
amendment between the Houses, or conference report that would
change the Medicare program, the Medicaid program, or the
number of Americans enrolled in private health insurance
coverage, in a manner that would result in reduced revenue to
hospitals, health care centers, and physicians and other
health care providers, thereby reducing their investments in
health care delivery system reforms that improve patient
health outcomes and reduce costs.
(c) Waiver and Appeal.--Subsection (b) may be waived or
suspended in the Senate only by an affirmative vote of three-
fifths of the Members, duly chosen and sworn. An affirmative
vote of three-fifths of the Members of the Senate, duly
chosen and sworn, shall be required to sustain an appeal of
the ruling of the Chair on a point of order raised under
subsection (b).
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