To amend the Internal Revenue Code of 1986 to apply a 39.6 percent individual income tax rate, and to provide additional funding and specify eligible providers under the Rural Health Transformation Program.

SA 2812. Ms. COLLINS proposed an amendment to amendment SA 2360
proposed by Mr. Thune (for Mr. Graham) to the bill H.R. 1, to provide
for reconciliation pursuant to title II of H. Con. Res. 14; as follows:

At the appropriate place, insert the following:

SEC. _____. 39.6 PERCENT INCOME TAX RATE BRACKET.

(a) In General.--Section 1(j)(2) is amended by
redesignating subparagraph (F) as subparagraph (G) and by
inserting after subparagraph (E) the following new
subparagraph:
``(F) 39.6 percent rate bracket.--Notwithstanding
subparagraphs (A) through (E), in prescribing the tables
under this subsection for purposes of paragraph (3)(B)--
``(i) the excess, if any, of taxable income over--

``(I) $50,000,000, in the case of married individuals
filing joint returns and surviving spouses, and
``(II) $25,000,000, in any other case,

shall be taxed at a rate of 39.6 percent, and
``(ii) paragraph (3)(B)(i) shall be applied with respect to
such $50,000,000 and $25,000,000 amounts by substituting
`2025' for `2017'.''.
(b) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2025.

SEC. _____. MODIFICATIONS TO RURAL HEALTH TRANSFORMATION
PROGRAM.

(a) Additional Funding.--Section 2105(h)(1)(A) of the
Social Security Act, as added by section 71401(a), is
amended--

[[Page S4133]]

(1) in clause (i), by striking ``$10,000,000,000'' and
inserting ``$22,500,000,000''; and
(2) in clause (ii), by striking ``$10,000,000,000'' and
inserting ``$22,500,000,000''.
(b) Health Care Providers.--Section 2105(h) of the Social
Security Act, as added by section 71401(a) and amended by
subsection (a), is amended--
(1) in paragraph (6)(B), by striking ``health care
providers,'' and inserting ``rural health facilities (as
defined in paragraph (3)(D)) or health care providers
described in paragraph (7), or'';
(2) by redesignating paragraphs (7) and (8) as paragraphs
(8) and (9), respectively; and
(3) by inserting after paragraph (6) the following:
``(7) Health care providers.--The following health care
providers are described in this paragraph:
``(A) A hospital classified as a rural referral center
under section 1886(d)(5)(C).
``(B) A long-term care hospital (as defined in section
1861(ccc)).
``(C) A hospital operated by an Indian Tribe or the Indian
Health Service.
``(D) A provider of ambulance services.
``(E) A community health center.
``(F) A provider or supplier that is enrolled with a State
Medicaid plan under title XIX (or a waiver of such plan) in
accordance with subsections (a)(77) and (kk) of section 1902
(including enrolled pursuant to section 1902(a)(78) or
section 1932(d)(6)) that received funds as a rural provider
under the Phase Four distribution of the Provider Relief Fund
established in the Coronavirus Aid, Relief, and Economic
Security Act (Public Law 116-136).
``(G) A provider or supplier that is enrolled with a State
Medicaid plan under title XIX (or a waiver of such plan) in
accordance with subsections (a)(77) and (kk) of section 1902
(including enrolled pursuant to section 1902(a)(78) or
section 1932(d)(6)) that received funds under section 1150C.
``(H) A hospital that--
``(i) is located in an urban area (as defined in section
1886(d)(2)(D)); and
``(ii) operates 1 or more approved medical residency
training program under section 1886(h).
``(I) A not-for-profit hospital that is located in an urban
area (as defined in section 1886(d)(2)(D)).
``(J) A hospital described in section 1886(d)(1)(B)(ii).
``(K) A hospital described in section 1886(d)(1)(B)(v).
``(L) A hospital that is defined or deemed to be a
disproportionate share hospital for purposes of receiving a
payment adjustment under section 1923 for the most recent
fiscal year for which such payment adjustments are made.
``(M) A facility that provides inpatient or outpatient
rehabilitation services that is enrolled with a State
Medicaid plan under title XIX (or a waiver of such plan) in
accordance with subsections (a)(77) and (kk) of section 1902
(including enrolled pursuant to section 1902(a)(78) or
section 1932(d)(6)).
``(N) A facility that provides inpatient or outpatient
psychiatric services (including an inpatient psychiatric
hospital for individuals under age 21 (as described in
section 1905(h)) or an institution for mental diseases
providing medical assistance under a State Medicaid plan
under title XIX (or a waiver of such plan) to individuals 65
years of age or older) that is enrolled with a State Medicaid
plan under title XIX (or a waiver of such plan) in accordance
with subsections (a)(77) and (kk) of section 1902 (including
enrolled pursuant to section 1902(a)(78) or section
1932(d)(6)).
``(O) A facility described in section 1905(d).
``(P) A facility that provides for individuals with
intellectual or developmental disabilities--
``(i) services described in section 433.56(a)(4) of title
42, Code of Federal Regulations; or
``(ii) home and community-based services authorized under
subsections (b), (c), (i), (j), or (k) of section 1915,
section 1115, or a State plan amendment under title XIX that
supports individuals with intellectual or developmental
disabilities who are eligible for such services through
meeting an institutional level of care.
``(Q) A skilled nursing facility (as defined in section
1819(a)).
``(R) A nursing facility (as defined in section 1919(a)).
``(S) An assisted living or residential care facility that
is enrolled with a State Medicaid plan under title XIX (or a
waiver of such plan) in accordance with subsections (a)(77)
and (kk) of section 1902 (including enrolled pursuant to
section 1902(a)(78) or section 1932(d)(6)).
``(T) A provider of home health care services.
``(U) A provider of hospice care.
``(V) An institution for mental diseases (as defined in
section 1905(i)).
``(W) A subsection (d) hospital (as defined in paragraph
(1)(B) of section 1886(d)) that receives or is eligible to
receive disproportionate share hospital payments under
paragraph (5)(F) of such section.
``(X) A hospital participating in the Rural Community
Hospital (RCH) demonstration program under section 410A of
the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003.
``(Y) A community behavioral health provider who relies
heavily on payments provided under a State Medicaid plan
under title XIX or a waiver of such plan.''.
______