Of a perfecting nature.

SA 267. Mr. McCONNELL proposed an amendment to the bill H.R. 1628, to
provide for reconciliation pursuant to title II of the concurrent
resolution on the budget for fiscal year 2017; as follows:

[[Page S4198]]

Strike all after the first word and insert the following:

1. SHORT TITLE.

This Act may be cited as the ``Obamacare Repeal
Reconciliation Act of 2017''.

TITLE I

SEC. 101. RECAPTURE EXCESS ADVANCE PAYMENTS OF PREMIUM TAX
CREDITS.

Subparagraph (B) of section 36B(f)(2) of the Internal
Revenue Code of 1986 is amended by adding at the end the
following new clause:
``(iii) Nonapplicability of limitation.--This subparagraph
shall not apply to taxable years ending after December 31,
2017, and before January 1, 2020.''.

SEC. 102. PREMIUM TAX CREDIT.

(a) Premium Tax Credit.--
(1) Repeal.--
(A) In general.--Subpart C of part IV of subchapter A of
chapter 1 of the Internal Revenue Code of 1986 is amended by
striking section 36B.
(B) Effective date.--The amendment made by this paragraph
shall apply to taxable years beginning after December 31,
2019.
(b) Repeal of Eligibility Determinations.--
(1) In general.--The following sections of the Patient
Protection and Affordable Care Act are repealed:
(A) Section 1411 (other than subsection (i), the last
sentence of subsection (e)(4)(A)(ii), and such provisions of
such section solely to the extent related to the application
of the last sentence of subsection (e)(4)(A)(ii)).
(B) Section 1412.
(2) Effective date.--The repeals in paragraph (1) shall
take effect on January 1, 2020.
(c) Protecting Americans by Repeal of Disclosure Authority
To Carry Out Eligibility Requirements for Certain Programs.--
(1) In general.--Paragraph (21) of section 6103(l) of the
Internal Revenue Code of 1986 is amended by adding at the end
the following new subparagraph:
``(D) Termination.--No disclosure may be made under this
paragraph after December 31, 2019.''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect on January 1, 2020.

SEC. 103. SMALL BUSINESS TAX CREDIT.

(a) Sunset.--
(1) In general.--Section 45R of the Internal Revenue Code
of 1986 is amended by adding at the end the following new
subsection:
``(j) Shall Not Apply.--This section shall not apply with
respect to amounts paid or incurred in taxable years
beginning after December 31, 2019.''.
(2) Effective date.--The amendment made by this subsection
shall apply to taxable years beginning after December 31,
2019.

SEC. 104. INDIVIDUAL MANDATE.

(a) In General.--Section 5000A(c) of the Internal Revenue
Code of 1986 is amended--
(1) in paragraph (2)(B)(iii), by striking ``2.5 percent''
and inserting ``Zero percent'', and
(2) in paragraph (3)--
(A) by striking ``$695'' in subparagraph (A) and inserting
``$0'', and
(B) by striking subparagraph (D).
(b) Effective Date.--The amendments made by this section
shall apply to months beginning after December 31, 2015.

SEC. 105. EMPLOYER MANDATE.

(a) In General.--
(1) Paragraph (1) of section 4980H(c) of the Internal
Revenue Code of 1986 is amended by inserting ``($0 in the
case of months beginning after December 31, 2015)'' after
``$2,000''.
(2) Paragraph (1) of section 4980H(b) of the Internal
Revenue Code of 1986 is amended by inserting ``($0 in the
case of months beginning after December 31, 2015)'' after
``$3,000''.
(b) Effective Date.--The amendments made by this section
shall apply to months beginning after December 31, 2015.

SEC. 106. FEDERAL PAYMENTS TO STATES.

(a) In General.--Notwithstanding section 504(a),
1902(a)(23), 1903(a), 2002, 2005(a)(4), 2102(a)(7), or
2105(a)(1) of the Social Security Act (42 U.S.C. 704(a),
1396a(a)(23), 1396b(a), 1397a, 1397d(a)(4), 1397bb(a)(7),
1397ee(a)(1)), or the terms of any Medicaid waiver in effect
on the date of enactment of this Act that is approved under
section 1115 or 1915 of the Social Security Act (42 U.S.C.
1315, 1396n), for the 1-year period beginning on the date of
enactment of this Act, no Federal funds provided from a
program referred to in this subsection that is considered
direct spending for any year may be made available to a State
for payments to a prohibited entity, whether made directly to
the prohibited entity or through a managed care organization
under contract with the State.
(b) Definitions.--In this section:
(1) Prohibited entity.--The term ``prohibited entity''
means an entity, including its affiliates, subsidiaries,
successors, and clinics--
(A) that, as of the date of enactment of this Act--
(i) is an organization described in section 501(c)(3) of
the Internal Revenue Code of 1986 and exempt from tax under
section 501(a) of such Code;
(ii) is an essential community provider described in
section 156.235 of title 45, Code of Federal Regulations (as
in effect on the date of enactment of this Act), that is
primarily engaged in family planning services, reproductive
health, and related medical care; and
(iii) provides for abortions, other than an abortion--

(I) if the pregnancy is the result of an act of rape or
incest; or
(II) in the case where a woman suffers from a physical
disorder, physical injury, or physical illness that would, as
certified by a physician, place the woman in danger of death
unless an abortion is performed, including a life-endangering
physical condition caused by or arising from the pregnancy
itself; and

(B) for which the total amount of Federal and State
expenditures under the Medicaid program under title XIX of
the Social Security Act in fiscal year 2014 made directly to
the entity and to any affiliates, subsidiaries, successors,
or clinics of the entity, or made to the entity and to any
affiliates, subsidiaries, successors, or clinics of the
entity as part of a nationwide health care provider network,
exceeded $1,000,000.
(2) Direct spending.--The term ``direct spending'' has the
meaning given that term under section 250(c) of the Balanced
Budget and Emergency Deficit Control Act of 1985 (2 U.S.C.
900(c)).

SEC. 107. MEDICAID.

The Social Security Act (42 U.S.C. 301 et seq.) is
amended--
(1) in section 1902--
(A) in subsection (a)(10)(A), in each of clauses (i)(VIII)
and (ii)(XX), by inserting ``and ending December 31, 2019,''
after ``January 1, 2014,''; and
(B) in subsection (a)(47)(B), by inserting ``and provided
that any such election shall cease to be effective on January
1, 2020, and no such election shall be made after that date''
before the semicolon at the end;
(2) in section 1905--
(A) in the first sentence of subsection (b), by inserting
``(50 percent on or after January 1, 2020)'' after ``55
percent'';
(B) in subsection (y)(1), by striking the semicolon at the
end of subparagraph (D) and all that follows through
``thereafter''; and
(C) in subsection (z)(2)--
(i) in subparagraph (A), by inserting ``through 2019''
after ``each year thereafter''; and
(ii) in subparagraph (B)(ii)(VI), by striking ``and each
subsequent year'';
(3) in section 1915(k)(2), by striking ``during the period
described in paragraph (1)'' and inserting ``on or after the
date referred to in paragraph (1) and before January 1,
2020'';
(4) in section 1920(e), by adding at the end the following:
``This subsection shall not apply after December 31, 2019.'';
(5) in section 1937(b)(5), by adding at the end the
following: ``This paragraph shall not apply after December
31, 2019.''; and
(6) in section 1943(a), by inserting ``and before January
1, 2020,'' after ``January 1, 2014,''.

SEC. 108. REPEAL OF DSH ALLOTMENT REDUCTIONS.

Section 1923(f) of the Social Security Act (42 U.S.C.
1396r-4(f)) is amended by striking paragraphs (7) and (8).

SEC. 109. REPEAL OF THE TAX ON EMPLOYEE HEALTH INSURANCE
PREMIUMS AND HEALTH PLAN BENEFITS.

(a) In General.--Chapter 43 of the Internal Revenue Code of
1986 is amended by striking section 4980I.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to taxable years beginning after December 31,
2019.
(c) Subsequent Effective Date.--The amendment made by
subsection (a) shall not apply to taxable years beginning
after December 31, 2025, and chapter 43 of the Internal
Revenue Code of 1986 is amended to read as such chapter would
read if such subsection had never been enacted.

SEC. 110. REPEAL OF TAX ON OVER-THE-COUNTER MEDICATIONS.

(a) HSAs.--Subparagraph (A) of section 223(d)(2) of the
Internal Revenue Code of 1986 is amended by striking ``Such
term'' and all that follows through the period.
(b) Archer MSAs.--Subparagraph (A) of section 220(d)(2) of
the Internal Revenue Code of 1986 is amended by striking
``Such term'' and all that follows through the period.
(c) Health Flexible Spending Arrangements and Health
Reimbursement Arrangements.--Section 106 of the Internal
Revenue Code of 1986 is amended by striking subsection (f).
(d) Effective Dates.--
(1) Distributions from savings accounts.--The amendments
made by subsections (a) and (b) shall apply to amounts paid
with respect to taxable years beginning after December 31,
2016.
(2) Reimbursements.--The amendment made by subsection (c)
shall apply to expenses incurred with respect to taxable
years beginning after December 31, 2016.

SEC. 111. REPEAL OF TAX ON HEALTH SAVINGS ACCOUNTS.

(a) HSAs.--Section 223(f)(4)(A) of the Internal Revenue
Code of 1986 is amended by striking ``20 percent'' and
inserting ``10 percent''.
(b) Archer MSAs.--Section 220(f)(4)(A) of the Internal
Revenue Code of 1986 is amended by striking ``20 percent''
and inserting ``15 percent''.
(c) Effective Date.--The amendments made by this section
shall apply to distributions made after December 31, 2016.

SEC. 112. REPEAL OF LIMITATIONS ON CONTRIBUTIONS TO FLEXIBLE
SPENDING ACCOUNTS.

(a) In General.--Section 125 of the Internal Revenue Code
of 1986 is amended by striking subsection (i).
(b) Effective Date.--The amendment made by this section
shall apply to plan years beginning after December 31, 2017.

[[Page S4199]]

SEC. 113. REPEAL OF TAX ON PRESCRIPTION MEDICATIONS.

Subsection (j) of section 9008 of the Patient Protection
and Affordable Care Act is amended to read as follows:
``(j) Repeal.--This section shall apply to calendar years
beginning after December 31, 2010, and ending before January
1, 2018.''.

SEC. 114. REPEAL OF MEDICAL DEVICE EXCISE TAX.

Section 4191 of the Internal Revenue Code of 1986 is
amended by adding at the end the following new subsection:
``(d) Applicability.--The tax imposed under subsection (a)
shall not apply to sales after December 31, 2017.''.

SEC. 115. REPEAL OF HEALTH INSURANCE TAX.

Subsection (j) of section 9010 of the Patient Protection
and Affordable Care Act is amended by striking ``, and'' at
the end of paragraph (1) and all that follows through
``2017''.

SEC. 116. REPEAL OF ELIMINATION OF DEDUCTION FOR EXPENSES
ALLOCABLE TO MEDICARE PART D SUBSIDY.

(a) In General.--Section 139A of the Internal Revenue Code
of 1986 is amended by adding at the end the following new
sentence: ``This section shall not be taken into account for
purposes of determining whether any deduction is allowable
with respect to any cost taken into account in determining
such payment.''.
(b) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after December 31,
2016.

SEC. 117. REPEAL OF CHRONIC CARE TAX.

(a) In General.--Subsection (a) of section 213 of the
Internal Revenue Code of 1986 is amended by striking ``10
percent'' and inserting ``7.5 percent''.
(b) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after December 31,
2016.

SEC. 118. REPEAL OF MEDICARE TAX INCREASE.

(a) In General.--Subsection (b) of section 3101 of the
Internal Revenue Code of 1986 is amended to read as follows:
``(b) Hospital Insurance.--In addition to the tax imposed
by the preceding subsection, there is hereby imposed on the
income of every individual a tax equal to 1.45 percent of the
wages (as defined in section 3121(a)) received by such
individual with respect to employment (as defined in section
3121(b).''.
(b) SECA.--Subsection (b) of section 1401 of the Internal
Revenue Code of 1986 is amended to read as follows:
``(b) Hospital Insurance.--In addition to the tax imposed
by the preceding subsection, there shall be imposed for each
taxable year, on the self-employment income of every
individual, a tax equal to 2.9 percent of the amount of the
self-employment income for such taxable year.''.
(c) Effective Date.--The amendments made by this section
shall apply with respect to remuneration received after, and
taxable years beginning after, December 31, 2017.

SEC. 119. REPEAL OF TANNING TAX.

(a) In General.--The Internal Revenue Code of 1986 is
amended by striking chapter 49.
(b) Effective Date.--The amendment made by this section
shall apply to services performed after September 30, 2017.

SEC. 120. REPEAL OF NET INVESTMENT TAX.

(a) In General.--Subtitle A of the Internal Revenue Code of
1986 is amended by striking chapter 2A.
(b) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after December 31,
2016.

SEC. 121. REMUNERATION.

Paragraph (6) of section 162(m) of the Internal Revenue
Code of 1986 is amended by adding at the end the following
new subparagraph:
``(I) Termination.--This paragraph shall not apply to
taxable years beginning after December 31, 2016.''.

TITLE II

SEC. 201. THE PREVENTION AND PUBLIC HEALTH FUND.

Subsection (b) of section 4002 of the Patient Protection
and Affordable Care Act (42 U.S.C. 300u-11) is amended--
(1) in paragraph (3), by striking ``each of fiscal years
2018 and 2019'' and inserting ``fiscal year 2018''; and
(2) by striking paragraphs (4) through (8).

SEC. 202. SUPPORT FOR STATE RESPONSE TO SUBSTANCE ABUSE
PUBLIC HEALTH CRISIS AND URGENT MENTAL HEALTH
NEEDS.

(a) In General.--There are authorized to be appropriated,
and are appropriated, out of monies in the Treasury not
otherwise obligated, $750,000,000 for each of fiscal years
2018 and 2019, to the Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') to award
grants to States to address the substance abuse public health
crisis or to respond to urgent mental health needs within the
State. In awarding grants under this section, the Secretary
may give preference to States with an incidence or prevalence
of substance use disorders that is substantial relative to
other States or to States that identify mental health needs
within their communities that are urgent relative to such
needs of other States. Funds appropriated under this
subsection shall remain available until expended.
(b) Use of Funds.--Grants awarded to a State under
subsection (a) shall be used for one or more of the following
public health-related activities:
(1) Improving State prescription drug monitoring programs.
(2) Implementing prevention activities, and evaluating such
activities to identify effective strategies to prevent
substance abuse.
(3) Training for health care practitioners, such as best
practices for prescribing opioids, pain management,
recognizing potential cases of substance abuse, referral of
patients to treatment programs, and overdose prevention.
(4) Supporting access to health care services provided by
Federally certified opioid treatment programs or other
appropriate health care providers to treat substance use
disorders or mental health needs.
(5) Other public health-related activities, as the State
determines appropriate, related to addressing the substance
abuse public health crisis or responding to urgent mental
health needs within the State.

SEC. 203. COMMUNITY HEALTH CENTER PROGRAM.

Effective as if included in the enactment of the Medicare
Access and CHIP Reauthorization Act of 2015 (Public Law 114-
10, 129 Stat. 87), paragraph (1) of section 221(a) of such
Act is amended by inserting ``, and an additional
$422,000,000 for fiscal year 2017'' after ``2017''.

SEC. 204. FUNDING FOR COST-SHARING PAYMENTS.

There is appropriated to the Secretary of Health and Human
Services, out of any money in the Treasury not otherwise
appropriated, such sums as may be necessary for payments for
cost-sharing reductions authorized by the Patient Protection
and Affordable Care Act (including adjustments to any prior
obligations for such payments) for the period beginning on
the date of enactment of this Act and ending on December 31,
2019. Notwithstanding any other provision of this Act,
payments and other actions for adjustments to any obligations
incurred for plan years 2018 and 2019 may be made through
December 31, 2020.

SEC. 205. REPEAL OF COST-SHARING SUBSIDY PROGRAM.

(a) In General.--Section 1402 of the Patient Protection and
Affordable Care Act (42 U.S.C. 18071) is repealed.
(b) Effective Date.--The repeal made by subsection (a)
shall apply to cost-sharing reductions (and payments to
issuers for such reductions) for plan years beginning after
December 31, 2019.
______