Weather
The Pine Tree, News for Calaveras County and Beyond Weather
Amador Angels Camp Arnold Bear Valley Copperopolis Murphys San Andreas Valley Springs Moke Hill/West Point Tuolumne
News
Business Directory
Weather & Roads
Sports
Real Estate
Search
Weekly & Grocery Ads
Entertainment
Life & Style
Government
Law Enforcement
Business
Wine News
Health & Fitness
Home & Garden
Food & Dining
Religion & Faith
Frogtown USA
Legal Notices
Calendar
Polls
Columns
Free Classifieds
Letters to the Editor
Obituaries
About Us

Coming Soon...
Friday, May 26
All Day Don't Miss The Big Memorial Weekend Sale At Ebbetts Pass Lumber
All Day Help The Arnold Library Celebrate Their 50th Anniversary This Week!
08:00 AM Peddlers' Faire
08:00 AM St. Patrick's, Angels Camp Altar Society Rummage Sale
02:00 PM Meet The Authors At Arnold Branch Library On May 26
Saturday, May 27
All Day Don't Miss The Big Memorial Weekend Sale At Ebbetts Pass Lumber
All Day Help The Arnold Library Celebrate Their 50th Anniversary This Week!
All Day The Big Greenhorn Creek Community Yard Sale is May 27th!
08:00 AM 3rd Annual Heroes Fun Run
All Day St. Patrick's, Angels Camp Altar Society Rummage Sale
08:30 AM Calaveras Door of Hope Announces the 3rd Annual "Heroes Fun Run" and Family Fun Day May 27th, 2017 a
09:00 AM Twain Harte Chamber Chili Cook-Off
09:00 AM 39th Annual Arnold Spring Peddler's Faire
09:00 AM FREE FAMILY FUN DAY
10:00 AM Independence Hall Needs Your Stuff! Accepting Donations Every Saturday!!
06:00 PM The 2017 Sequoia Woods Country Club Saturday Patio Parties
06:30 PM Silent Movie Night Featuring "Alice in Wonderland" At Ironstone On May 27th.
06:45 PM Jerry Douglas Presents The Earls of Leicester at Twisted Oak Winery May 27th
Sunday, May 28
All Day Help The Arnold Library Celebrate Their 50th Anniversary This Week!
Until 04:00 PM St. Patrick's, Angels Camp Altar Society Rummage Sale
Until 04:00 PM 39th Annual Arnold Spring Peddler's Faire
Monday, May 29
10:45 AM Sierra Grief Support Groups
Wednesday, May 31
All Day Overeaters Anonymous meeting
Thursday, Jun 1
05:30 PM Calaveras Big Trees State Park UC California Naturalist Certification Course ~ June 2017
Friday, Jun 2
09:30 AM VINEYARD TOUR AND BBQ
07:00 PM Don't Miss The "First Fridays" Dinner Show With Jill Warren At Sequoia Woods
Saturday, Jun 3
09:00 AM NATURE BLITZ ~ Field Studies & Exploration At Calaveras Big Trees State Park
10:00 AM Independence Hall Needs Your Stuff! Accepting Donations Every Saturday!!
12:00 PM Chicken in a Barrel
Sunday, Jun 4
02:00 PM LECTURE "Gold Rush Medicine" by Dr. Bob LaPerriere
Monday, Jun 5
10:45 AM Sierra Grief Support Groups
Wednesday, Jun 7
All Day Overeaters Anonymous meeting
11:30 AM International Trade Development Workshop Coming To Sonora On June 7th
Thursday, Jun 8
06:00 PM Calaveras Uncorked Wine Education Series
06:00 PM CALAVERAS UNCORKED WINE EDUCATION SERIES with Steve Millier

Search Announcements




Log In
Username

Password

Remember Me



Posted by: thepinetree on 05/04/2017 11:43 AM Updated by: thepinetree on 05/04/2017 11:43 AM
Expires: 01/01/2022 12:00 AM
:

House Republicans Pass "American Healthcare Act", Now It Moves To Senate.

Washington, DC...The House Republicans narrowly advanced the "American Healthcare Act" on to the Senate. Many of the Obamacare mandates have been stripped in this bill including individual and employer mandates. The full text of the bill in its' current form is below.





Union Calendar No. 30
115th CONGRESS
1st Session
H. R. 1628

[Report No. 115-52]

To provide for reconciliation pursuant to title II of the concurrent
resolution on the budget for fiscal year 2017.


_______________________________________________________________________


IN THE HOUSE OF REPRESENTATIVES

March 20, 2017

Mrs. Black from the Committee on the Budget, reported the following
bill; which was committed to the Committee of the Whole House on the
State of the Union and ordered to be printed

_______________________________________________________________________

A BILL



To provide for reconciliation pursuant to title II of the concurrent
resolution on the budget for fiscal year 2017.





Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``American Health Care Act of 2017''.

SEC. 2. TABLE OF CONTENTS.

The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--ENERGY AND COMMERCE

Subtitle A--Patient Access to Public Health Programs

Sec. 101. The Prevention and Public Health Fund.
Sec. 102. Community health center program.
Sec. 103. Federal payments to States.
Subtitle B--Medicaid Program Enhancement

Sec. 111. Repeal of Medicaid provisions.
Sec. 112. Repeal of Medicaid expansion.
Sec. 113. Elimination of DSH cuts.
Sec. 114. Reducing State Medicaid costs.
Sec. 115. Safety net funding for non-expansion States.
Sec. 116. Providing incentives for increased frequency of eligibility
redeterminations.
Subtitle C--Per Capita Allotment for Medical Assistance

Sec. 121. Per capita allotment for medical assistance.
Subtitle D--Patient Relief and Health Insurance Market Stability

Sec. 131. Repeal of cost-sharing subsidy.
Sec. 132. Patient and State Stability Fund.
Sec. 133. Continuous health insurance coverage incentive.
Sec. 134. Increasing coverage options.
Sec. 135. Change in permissible age variation in health insurance
premium rates.
TITLE II--COMMITTEE ON WAYS AND MEANS

Subtitle A--Repeal and Replace of Health-Related Tax Policy

Sec. 201. Recapture excess advance payments of premium tax credits.
Sec. 202. Additional modifications to premium tax credit.
Sec. 203. Premium tax credit.
Sec. 204. Small business tax credit.
Sec. 205. Individual mandate.
Sec. 206. Employer mandate.
Sec. 207. Repeal of the tax on employee health insurance premiums and
health plan benefits.
Sec. 208. Repeal of tax on over-the-counter medications.
Sec. 209. Repeal of increase of tax on health savings accounts.
Sec. 210. Repeal of limitations on contributions to flexible spending
accounts.
Sec. 211. Repeal of medical device excise tax.
Sec. 212. Repeal of elimination of deduction for expenses allocable to
medicare part D subsidy.
Sec. 213. Repeal of increase in income threshold for determining
medical care deduction.
Sec. 214. Repeal of Medicare tax increase.
Sec. 215. Refundable tax credit for health insurance coverage.
Sec. 216. Maximum contribution limit to health savings account
increased to amount of deductible and out-
of-pocket limitation.
Sec. 217. Allow both spouses to make catch-up contributions to the same
health savings account.
Sec. 218. Special rule for certain medical expenses incurred before
establishment of health savings account.
Subtitle B--Repeal of Certain Consumer Taxes

Sec. 221. Repeal of tax on prescription medications.
Sec. 222. Repeal of health insurance tax.
Subtitle C--Repeal of Tanning Tax

Sec. 231. Repeal of tanning tax.
Subtitle D--Remuneration From Certain Insurers

Sec. 241. Remuneration from certain insurers.
Subtitle E--Repeal of Net Investment Income Tax

Sec. 251. Repeal of net investment income tax.

TITLE I--ENERGY AND COMMERCE

Subtitle A--Patient Access to Public Health Programs

SEC. 101. THE PREVENTION AND PUBLIC HEALTH FUND.

(a) In General.--Subsection (b) of section 4002 of the Patient
Protection and Affordable Care Act (42 U.S.C. 300u-11), as amended by
section 5009 of the 21st Century Cures Act, is amended--
(1) in paragraph (2), by adding ``and'' at the end;
(2) in paragraph (3)--
(A) by striking ``each of fiscal years 2018 and
2019'' and inserting ``fiscal year 2018''; and
(B) by striking the semicolon at the end and
inserting a period; and
(3) by striking paragraphs (4) through (8).
(b) Rescission of Unobligated Funds.--Of the funds made available
by such section 4002, the unobligated balance at the end of fiscal year
2018 is rescinded.

SEC. 102. 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. 103. 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 the 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
$350,000,000.
(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)).

Subtitle B--Medicaid Program Enhancement

SEC. 111. REPEAL OF MEDICAID PROVISIONS.

The Social Security Act is amended--
(1) in section 1902 (42 U.S.C. 1396a)--
(A) 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; and
(B) in subsection (l)(2)(C), by inserting ``and
ending December 31, 2019,'' after ``January 1, 2014,'';
(2) in section 1915(k)(2) (42 U.S.C. 1396n(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''; and
(3) in section 1920(e) (42 U.S.C. 1396r-1(e)), by striking
``under clause (i)(VIII), clause (i)(IX), or clause (ii)(XX) of
subsection (a)(10)(A)'' and inserting ``under clause (i)(VIII)
or clause (ii)(XX) of section 1902(a)(10)(A) before January 1,
2020, section 1902(a)(10)(A)(i)(IX),''.

SEC. 112. REPEAL OF MEDICAID EXPANSION.

(a) In General.--Section 1902(a)(10)(A) of the Social Security Act
(42 U.S.C. 1396a(a)(10)(A)) is amended--
(1) in clause (i)(VIII), by inserting ``at the option of a
State,'' after ``January 1, 2014,''; and
(2) in clause (ii)(XX), by inserting ``and ending December
31, 2019,'' after ``2014,''.
(b) Termination of EFMAP for New ACA Expansion Enrollees.--Section
1905 of the Social Security Act (42 U.S.C. 1396d) is amended--
(1) in subsection (y)(1), in the matter preceding
subparagraph (A), by striking ``with respect to'' and all that
follows through ``shall be'' and inserting ``with respect to
amounts expended before January 1, 2020, by such State for
medical assistance for newly eligible individuals described in
subclause (VIII) of section 1902(a)(10)(A)(i) who are enrolled
under the State plan (or a waiver of the plan) before such date
and with respect to amounts expended after such date by such
State for medical assistance for individuals described in such
subclause who were enrolled under such plan (or waiver of such
plan) as of December 31, 2019, and who do not have a break in
eligibility for medical assistance under such State plan (or
waiver) for more than one month after such date, shall be'';
and
(2) in subsection (z)(2)--
(A) in subparagraph (A), by striking ``medical
assistance for individuals'' and all that follows
through ``shall be'' and inserting ``amounts expended
before January 1, 2020, by such State for medical
assistance for individuals described in section
1902(a)(10)(A)(i)(VIII) who are nonpregnant childless
adults with respect to whom the State may require
enrollment in benchmark coverage under section 1937 and
who are enrolled under the State plan (or a waiver of
the plan) before such date and with respect to amounts
expended after such date by such State for medical
assistance for individuals described in such section,
who are nonpregnant childless adults with respect to
whom the State may require enrollment in benchmark
coverage under section 1937, who were enrolled under
such plan (or waiver of such plan) as of December 31,
2019, and who do not have a break in eligibility for
medical assistance under such State plan (or waiver)
for more than one month after such date, shall be'';
and
(B) in subparagraph (B)(ii)--
(i) in subclause (III), by adding ``and''
at the end; and
(ii) by striking subclauses (IV), (V), and
(VI) and inserting the following new subclause:
``(IV) 2017 and each subsequent year is 80
percent.''.
(c) Sunset of Essential Health Benefits Requirement.--Section
1937(b)(5) of the Social Security Act (42 U.S.C. 1396u-7(b)(5)) is
amended by adding at the end the following: ``This paragraph shall not
apply after December 31, 2019.''.

SEC. 113. ELIMINATION OF DSH CUTS.

Section 1923(f) of the Social Security Act (42 U.S.C. 1396r-4(f))
is amended--
(1) in paragraph (7)--
(A) in subparagraph (A)--
(i) in clause (i)--
(I) in the matter preceding
subclause (I), by striking ``2025'' and
inserting ``2019''; and
(ii) in clause (ii)--
(I) in subclause (I), by adding
``and'' at the end;
(II) in subclause (II), by striking
the semicolon at the end and inserting
a period; and
(III) by striking subclauses (III)
through (VIII); and
(B) by adding at the end the following new
subparagraph:
``(C) Exemption from exemption for non-expansion
states.--
``(i) In general.--In the case of a State
that is a non-expansion State for a fiscal
year, subparagraph (A)(i) shall not apply to
the DSH allotment for such State and fiscal
year.
``(ii) No change in reduction for expansion
states.--In the case of a State that is an
expansion State for a fiscal year, the DSH
allotment for such State and fiscal year shall
be determined as if clause (i) did not apply.
``(iii) Non-expansion and expansion state
defined.--
``(I) The term `expansion State'
means with respect to a fiscal year, a
State that, as of July 1 of the
preceding fiscal year, provides for
eligibility under clause (i)(VIII) or
(ii)(XX) of section 1902(a)(10)(A) for
medical assistance under this title (or
a waiver of the State plan approved
under section 1115).
``(II) The term `non-expansion
State' means, with respect to a fiscal
year, a State that is not an expansion
State.''; and
(2) in paragraph (8), by striking ``fiscal year 2025'' and
inserting ``fiscal year 2019''.

SEC. 114. REDUCING STATE MEDICAID COSTS.

(a) Letting States Disenroll High Dollar Lottery Winners.--
(1) In general.--Section 1902 of the Social Security Act
(42 U.S.C. 1396a) is amended--
(A) in subsection (a)(17), by striking ``(e)(14),
(e)(14)'' and inserting ``(e)(14), (e)(15)''; and
(B) in subsection (e)--
(i) in paragraph (14) (relating to modified
adjusted gross income), by adding at the end
the following new subparagraph:
``(J) Treatment of certain lottery winnings and
income received as a lump sum.--
``(i) In general.--In the case of an
individual who is the recipient of qualified
lottery winnings (pursuant to lotteries
occurring on or after January 1, 2020) or
qualified lump sum income (received on or after
such date) and whose eligibility for medical
assistance is determined based on the
application of modified adjusted gross income
under subparagraph (A), a State shall, in
determining such eligibility, include such
winnings or income (as applicable) as income
received--
``(I) in the month in which such
winnings or income (as applicable) is
received if the amount of such winnings
or income is less than $80,000;
``(II) over a period of 2 months if
the amount of such winnings or income
(as applicable) is greater than or
equal to $80,000 but less than $90,000;
``(III) over a period of 3 months
if the amount of such winnings or
income (as applicable) is greater than
or equal to $90,000 but less than
$100,000; and
``(IV) over a period of 3 months
plus 1 additional month for each
increment of $10,000 of such winnings
or income (as applicable) received, not
to exceed a period of 120 months (for
winnings or income of $1,260,000 or
more), if the amount of such winnings
or income is greater than or equal to
$100,000.
``(ii) Counting in equal installments.--For
purposes of subclauses (II), (III), and (IV) of
clause (i), winnings or income to which such
subclause applies shall be counted in equal
monthly installments over the period of months
specified under such subclause.
``(iii) Hardship exemption.--An individual
whose income, by application of clause (i),
exceeds the applicable eligibility threshold
established by the State, may continue to be
eligible for medical assistance to the extent
that the State determines, under procedures
established by the State under the State plan
(or in the case of a waiver of the plan under
section 1115, incorporated in such waiver), or
as otherwise established by such State in
accordance with such standards as may be
specified by the Secretary, that the denial of
eligibility of the individual would cause an
undue medical or financial hardship as
determined on the basis of criteria established
by the Secretary.
``(iv) Notifications and assistance
required in case of loss of eligibility.--A
State shall, with respect to an individual who
loses eligibility for medical assistance under
the State plan (or a waiver of such plan) by
reason of clause (i), before the date on which
the individual loses such eligibility, inform
the individual of the date on which the
individual would no longer be considered
ineligible by reason of such clause to receive
medical assistance under the State plan or
under any waiver of such plan and the date on
which the individual would be eligible to
reapply to receive such medical assistance.
``(v) Qualified lottery winnings defined.--
In this subparagraph, the term `qualified
lottery winnings' means winnings from a
sweepstakes, lottery, or pool described in
paragraph (3) of section 4402 of the Internal
Revenue Code of 1986 or a lottery operated by a
multistate or multijurisdictional lottery
association, including amounts awarded as a
lump sum payment.
``(vi) Qualified lump sum income defined.--
In this subparagraph, the term `qualified lump
sum income' means income that is received as a
lump sum from one of the following sources:
``(I) Monetary winnings from
gambling (as defined by the Secretary
and including monetary winnings from
gambling activities described in
section 1955(b)(4) of title 18, United
States Code).
``(II) Income received as liquid
assets from the estate (as defined in
section 1917(b)(4)) of a deceased
individual.''; and
(ii) by striking ``(14) Exclusion'' and
inserting ``(15) Exclusion''.
(2) Rules of construction.--
(A) Interception of lottery winnings allowed.--
Nothing in the amendment made by paragraph (1)(B)(i)
shall be construed as preventing a State from
intercepting the State lottery winnings awarded to an
individual in the State to recover amounts paid by the
State under the State Medicaid plan under title XIX of
the Social Security Act for medical assistance
furnished to the individual.
(B) Applicability limited to eligibility of
recipient of lottery winnings or lump sum income.--
Nothing in the amendment made by paragraph (1)(B)(i)
shall be construed, with respect to a determination of
household income for purposes of a determination of
eligibility for medical assistance under the State plan
under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) (or a waiver of such plan) made by
applying modified adjusted gross income under
subparagraph (A) of section 1902(e)(14) of such Act (42
U.S.C. 1396a(e)(14)), as limiting the eligibility for
such medical assistance of any individual that is a
member of the household other than the individual (or
the individual's spouse) who received qualified lottery
winnings or qualified lump-sum income (as defined in
subparagraph (J) of such section 1902(e)(14), as added
by paragraph (1)(B)(i) of this subsection).
(b) Repeal of Retroactive Eligibility.--
(1) In general.--
(A) State plan requirements.--Section 1902(a)(34)
of the Social Security Act (42 U.S.C. 1396a(a)(34)) is
amended by striking ``in or after the third month
before the month in which he made application'' and
inserting ``in or after the month in which the
individual made application''.
(B) Definition of medical assistance.--Section
1905(a) of the Social Security Act (42 U.S.C. 1396d(a))
is amended by striking ``in or after the third month
before the month in which the recipient makes
application for assistance'' and inserting ``in or
after the month in which the recipient makes
application for assistance''.
(2) Effective date.--The amendments made by paragraph (1)
shall apply to medical assistance with respect to individuals
whose eligibility for such assistance is based on an
application for such assistance made (or deemed to be made) on
or after October 1, 2017.
(c) Ensuring States Are Not Forced to Pay for Individuals
Ineligible for the Program.--
(1) In general.--Section 1137(f) of the Social Security Act
(42 U.S.C. 1320b-7(f)) is amended--
(A) by striking ``Subsections (a)(1) and (d)'' and
inserting ``(1) Subsections (a)(1) and (d)''; and
(B) by adding at the end the following new
paragraph:
``(2)(A) Subparagraphs (A) and (B)(ii) of subsection (d)(4) shall
not apply in the case of an initial determination made on or after the
date that is 6 months after the date of the enactment of this paragraph
with respect to the eligibility of an alien described in subparagraph
(B) for benefits under the program listed in subsection (b)(2).
``(B) An alien described in this subparagraph is an individual
declaring to be a citizen or national of the United States with respect
to whom a State, in accordance with section 1902(a)(46)(B), requires--
``(i) pursuant to 1902(ee), the submission of a social
security number; or
``(ii) pursuant to 1903(x), the presentation of
satisfactory documentary evidence of citizenship or
nationality.''.
(2) No payments for medical assistance provided before
presentation of evidence.--Section 1903(i)(22) of the Social
Security Act (42 U.S.C. 1396b(i)(22)) is amended--
(A) by striking ``with respect to amounts
expended'' and inserting ``(A) with respect to amounts
expended'';
(B) by inserting ``and'' at the end; and
(C) by adding at the end the following new
subparagraph:
``(B) in the case of a State that elects to provide a
reasonable period to present satisfactory documentary evidence
of such citizenship or nationality pursuant to paragraph (2)(C)
of section 1902(ee) or paragraph (4) of subsection (x) of this
section, for amounts expended for medical assistance for such
an individual (other than an individual described in paragraph
(2) of such subsection (x)) during such period;''.
(3) Conforming amendments.--Section 1137(d)(4) of the
Social Security Act (42 U.S.C. 1320b-7(d)(4)) is amended--
(A) in subparagraph (A), in the matter preceding
clause (i), by inserting ``subject to subsection
(f)(2),'' before ``the State''; and
(B) in subparagraph (B)(ii), by inserting ``subject
to subsection (f)(2),'' before ``pending such
verification''.
(d) Updating Allowable Home Equity Limits in Medicaid.--
(1) In general.--Section 1917(f)(1) of the Social Security
Act (42 U.S.C. 1396p(f)(1)) is amended--
(A) in subparagraph (A), by striking
``subparagraphs (B) and (C)'' and inserting
``subparagraph (B)'';
(B) by striking subparagraph (B);
(C) by redesignating subparagraph (C) as
subparagraph (B); and
(D) in subparagraph (B), as so redesignated, by
striking ``dollar amounts specified in this paragraph''
and inserting ``dollar amount specified in subparagraph
(A)''.
(2) Effective date.--
(A) In general.--The amendments made by paragraph
(1) shall apply with respect to eligibility
determinations made after the date that is 180 days
after the date of the enactment of this section.
(B) Exception for state legislation.--In the case
of a State plan under title XIX of the Social Security
Act that the Secretary of Health and Human Services
determines requires State legislation in order for the
respective plan to meet any requirement imposed by
amendments made by this subsection, the respective plan
shall not be regarded as failing to comply with the
requirements of such title solely on the basis of its
failure to meet such an additional requirement before
the first day of the first calendar quarter beginning
after the close of the first regular session of the
State legislature that begins after the date of the
enactment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year
legislative session, each year of the session shall be
considered to be a separate regular session of the
State legislature.

SEC. 115. SAFETY NET FUNDING FOR NON-EXPANSION STATES.

Title XIX of the Social Security Act is amended by inserting after
section 1923 (42 U.S.C. 1396r-4) the following new section:

``adjustment in payment for services of safety net providers in non-
expansion states

``Sec. 1923A. (a) In General.--Subject to the limitations of this
section, for each year during the period beginning with 2018 and ending
with 2021, each State that is one of the 50 States or the District of
Columbia and that, as of July 1 of the preceding year, did not provide
for eligibility under clause (i)(VIII) or (ii)(XX) of section
1902(a)(10)(A) for medical assistance under this title (or a waiver of
the State plan approved under section 1115) (each such State or
District referred to in this section for the year as a `non-expansion
State') may adjust the payment amounts otherwise provided under the
State plan under this title (or a waiver of such plan) to health care
providers that provide health care services to individuals enrolled
under this title (in this section referred to as `eligible providers').
``(b) Increase in Applicable FMAP.--Notwithstanding section
1905(b), the Federal medical assistance percentage applicable with
respect to expenditures attributable to a payment adjustment under
subsection (a) for which payment is permitted under subsection (c)
shall be equal to--
``(1) 100 percent for calendar quarters in calendar years
2018, 2019, 2020, and 2021; and
``(2) 95 percent for calendar quarters in calendar year
2022.
``(c) Limitations; Disqualification of States.--
``(1) Annual allotment limitation.--Payment under section
1903(a) shall not be made to a State with respect to any
payment adjustment made under this section for all calendar
quarters in a year in excess of the $2,000,000,000 multiplied
by the ratio of--
``(A) the population of the State with income below
138 percent of the poverty line in 2015 (as determined
based the table entitled `Health Insurance Coverage
Status and Type by Ratio of Income to Poverty Level in
the Past 12 Months by Age' for the universe of the
civilian noninstitutionalized population for whom
poverty status is determined based on the 2015 American
Community Survey 1-Year Estimates, as published by the
Bureau of the Census), to
``(B) the sum of the populations under subparagraph
(A) for all non-expansion States.
``(2) Limitation on payment adjustment amount for
individual providers.--The amount of a payment adjustment under
subsection (a) for an eligible provider may not exceed the
provider's costs incurred in furnishing health care services
(as determined by the Secretary and net of payments under this
title, other than under this section, and by uninsured
patients) to individuals who either are eligible for medical
assistance under the State plan (or under a waiver of such
plan) or have no health insurance or health plan coverage for
such services.
``(d) Disqualification in Case of State Coverage Expansion.--If a
State is a non-expansion for a year and provides eligibility for
medical assistance described in subsection (a) during the year, the
State shall no longer be treated as a non-expansion State under this
section for any subsequent years.''.

SEC. 116. PROVIDING INCENTIVES FOR INCREASED FREQUENCY OF ELIGIBILITY
REDETERMINATIONS.

(a) In General.--Section 1902(e)(14) of the Social Security Act (42
U.S.C. 1396a(e)(14)) (relating to modified adjusted gross income), as
amended by section 114(a)(1), is further amended by adding at the end
the following:
``(K) Frequency of eligibility redeterminations.--
Beginning on October 1, 2017, and notwithstanding
subparagraph (H), in the case of an individual whose
eligibility for medical assistance under the State plan
under this title (or a waiver of such plan) is
determined based on the application of modified
adjusted gross income under subparagraph (A) and who is
so eligible on the basis of clause (i)(VIII) or clause
(ii)(XX) of subsection (a)(10)(A), a State shall
redetermine such individual's eligibility for such
medical assistance no less frequently than once every 6
months.''.
(b) Civil Monetary Penalty.--Section 1128A(a) of the Social
Security Act (42 U.S.C. 1320a-7a(a)) is amended, in the matter
following paragraph (10), by striking ``(or, in cases under paragraph
(3)'' and inserting the following: ``(or, in cases under paragraph (1)
in which an individual was knowingly enrolled on or after October 1,
2017, pursuant to section 1902(a)(10)(A)(i)(VIII) for medical
assistance under the State plan under title XIX whose income does not
meet the income threshold specified in such section or in which a claim
was presented on or after October 1, 2017, as a claim for an item or
service furnished to an individual described in such section but whose
enrollment under such State plan is not made on the basis of such
individual's meeting the income threshold specified in such section,
$20,000 for each such individual or claim; in cases under paragraph
(3)''.
(c) Increased Administrative Matching Percentage.--For each
calendar quarter during the period beginning on October 1, 2017, and
ending on December 31, 2019, the Federal matching percentage otherwise
applicable under section 1903(a) of the Social Security Act (42 U.S.C.
1396b(a)) with respect to State expenditures during such quarter that
are attributable to meeting the requirement of section 1902(e)(14)
(relating to determinations of eligibility using modified adjusted
gross income) of such Act shall be increased by 5 percentage points
with respect to State expenditures attributable to activities carried
out by the State (and approved by the Secretary) to increase the
frequency of eligibility redeterminations required by subparagraph (K)
of such section (relating to eligibility redeterminations made on a 6-
month basis) (as added by subsection (a)).

Subtitle C--Per Capita Allotment for Medical Assistance

SEC. 121. PER CAPITA ALLOTMENT FOR MEDICAL ASSISTANCE.

Title XIX of the Social Security Act is amended--
(1) in section 1903 (42 U.S.C. 1396b)--
(A) in subsection (a), in the matter before
paragraph (1), by inserting ``and section 1903A(a)''
after ``except as otherwise provided in this section'';
and
(B) in subsection (d)(1), by striking ``to which''
and inserting ``to which, subject to section
1903A(a),''; and
(2) by inserting after such section 1903 the following new
section:

``SEC. 1903A. PER CAPITA-BASED CAP ON PAYMENTS FOR MEDICAL ASSISTANCE.

``(a) Application of Per Capita Cap on Payments for Medical
Assistance Expenditures.--
``(1) In general.--If a State has excess aggregate medical
assistance expenditures (as defined in paragraph (2)) for a
fiscal year (beginning with fiscal year 2020), the amount of
payment to the State under section 1903(a)(1) for each quarter
in the following fiscal year shall be reduced by 1/4 of the
excess aggregate medical assistance payments (as defined in
paragraph (3)) for that previous fiscal year. In this section,
the term `State' means only the 50 States and the District of
Columbia.
``(2) Excess aggregate medical assistance expenditures.--In
this subsection, the term `excess aggregate medical assistance
expenditures' means, for a State for a fiscal year, the amount
(if any) by which--
``(A) the amount of the adjusted total medical
assistance expenditures (as defined in subsection
(b)(1)) for the State and fiscal year; exceeds
``(B) the amount of the target total medical
assistance expenditures (as defined in subsection (c))
for the State and fiscal year.
``(3) Excess aggregate medical assistance payments.--In
this subsection, the term `excess aggregate medical assistance
payments' means, for a State for a fiscal year, the product
of--
``(A) the excess aggregate medical assistance
expenditures (as defined in paragraph (2)) for the
State for the fiscal year; and
``(B) the Federal average medical assistance
matching percentage (as defined in paragraph (4)) for
the State for the fiscal year.
``(4) Federal average medical assistance matching
percentage.--In this subsection, the term `Federal average
medical assistance matching percentage' means, for a State for
a fiscal year, the ratio (expressed as a percentage) of--
``(A) the amount of the Federal payments that would
be made to the State under section 1903(a)(1) for
medical assistance expenditures for calendar quarters
in the fiscal year if paragraph (1) did not apply; to
``(B) the amount of the medical assistance
expenditures for the State and fiscal year.
``(b) Adjusted Total Medical Assistance Expenditures.--Subject to
subsection (g), the following shall apply:
``(1) In general.--In this section, the term `adjusted
total medical assistance expenditures' means, for a State--
``(A) for fiscal year 2016, the product of--
``(i) the amount of the medical assistance
expenditures (as defined in paragraph (2)) for
the State and fiscal year, reduced by the
amount of any excluded expenditures (as defined
in paragraph (3)) for the State and fiscal year
otherwise included in such medical assistance
expenditures; and
``(ii) the 1903A FY16 population percentage
(as defined in paragraph (4)) for the State; or
``(B) for fiscal year 2019 or a subsequent fiscal
year, the amount of the medical assistance expenditures
(as defined in paragraph (2)) for the State and fiscal
year that is attributable to 1903A enrollees, reduced
by the amount of any excluded expenditures (as defined
in paragraph (3)) for the State and fiscal year
otherwise included in such medical assistance
expenditures.
``(2) Medical assistance expenditures.--In this section,
the term `medical assistance expenditures' means, for a State
and fiscal year, the medical assistance payments as reported by
medical service category on the Form CMS-64 quarterly expense
report (or successor to such a report form, and including
enrollment data and subsequent adjustments to any such report,
in this section referred to collectively as a `CMS-64 report')
that directly result from providing medical assistance under
the State plan (including under a waiver of the plan) for which
payment is (or may otherwise be) made pursuant to section
1903(a)(1).
``(3) Excluded expenditures.--In this section, the term
`excluded expenditures' means, for a State and fiscal year,
expenditures under the State plan (or under a waiver of such
plan) that are attributable to any of the following:
``(A) DSH.--Payment adjustments made for
disproportionate share hospitals under section 1923.
``(B) Medicare cost-sharing.--Payments made for
medicare cost-sharing (as defined in section
1905(p)(3)).
``(C) Safety net provider payment adjustments in
non-expansion states.--Payment adjustments under
subsection (a) of section 1923A for which payment is
permitted under subsection (c) of such section.
``(4) 1903A fy 16 population percentage.--In this
subsection, the term `1903A FY16 population percentage' means,
for a State, the Secretary's calculation of the percentage of
the actual medical assistance expenditures, as reported by the
State on the CMS-64 reports for calendar quarters in fiscal
year 2016, that are attributable to 1903A enrollees (as defined
in subsection (e)(1)).
``(c) Target Total Medical Assistance Expenditures.--
``(1) Calculation.--In this section, the term `target total
medical assistance expenditures' means, for a State for a
fiscal year, the sum of the products, for each of the 1903A
enrollee categories (as defined in subsection (e)(2)), of--
``(A) the target per capita medical assistance
expenditures (as defined in paragraph (2)) for the
enrollee category, State, and fiscal year; and
``(B) the number of 1903A enrollees for such
enrollee category, State, and fiscal year, as
determined under subsection (e)(4).
``(2) Target per capita medical assistance expenditures.--
In this subsection, the term `target per capita medical
assistance expenditures' means, for a 1903A enrollee category,
State, and a fiscal year, an amount equal to--
``(A) the provisional FY19 target per capita amount
for such enrollee category (as calculated under
subsection (d)(5)) for the State; increased by
``(B) the percentage increase in the medical care
component of the consumer price index for all urban
consumers (U.S. city average) from September of 2019 to
September of the fiscal year involved.
``(d) Calculation of FY19 Provisional Target Amount for Each 1903A
Enrollee Category.--Subject to subsection (g), the following shall
apply:
``(1) Calculation of base amounts for fiscal year 2016.--
For each State the Secretary shall calculate (and provide
notice to the State not later than April 1, 2018, of) the
following:
``(A) The amount of the adjusted total medical
assistance expenditures (as defined in subsection
(b)(1)) for the State for fiscal year 2016.
``(B) The number of 1903A enrollees for the State
in fiscal year 2016 (as determined under subsection
(e)(4)).
``(C) The average per capita medical assistance
expenditures for the State for fiscal year 2016 equal
to--
``(i) the amount calculated under
subparagraph (A); divided by
``(ii) the number calculated under
subparagraph (B).
``(2) Fiscal year 2019 average per capita amount based on
inflating the fiscal year 2016 amount to fiscal year 2019 by
cpi-medical.--The Secretary shall calculate a fiscal year 2019
average per capita amount for each State equal to--
``(A) the average per capita medical assistance
expenditures for the State for fiscal year 2016
(calculated under paragraph (1)(C)); increased by
``(B) the percentage increase in the medical care
component of the consumer price index for all urban
consumers (U.S. city average) from September, 2016 to
September, 2019.
``(3) Aggregate and average expenditures per capita for
fiscal year 2019.--The Secretary shall calculate for each State
the following:
``(A) The amount of the adjusted total medical
assistance expenditures (as defined in subsection
(b)(1)) for the State for fiscal year 2019.
``(B) The number of 1903A enrollees for the State
in fiscal year 2019 (as determined under subsection
(e)(4)).
``(4) Per capita expenditures for fiscal year 2019 for each
1903a enrollee category.--The Secretary shall calculate (and
provide notice to each State not later than January 1, 2020,
of) the following:
``(A)(i) For each 1903A enrollee category, the
amount of the adjusted total medical assistance
expenditures (as defined in subsection (b)(1)) for the
State for fiscal year 2019 for individuals in the
enrollee category, calculated by excluding from medical
assistance expenditures those expenditures attributable
to expenditures described in clause (iii) or non-DSH
supplemental expenditures (as defined in clause (ii)).
``(ii) In this paragraph, the term `non-DSH
supplemental expenditure' means a payment to a provider
under the State plan (or under a waiver of the plan)
that--
``(I) is not made under section 1923;
``(II) is not made with respect to a
specific item or service for an individual;
``(III) is in addition to any payments made
to the provider under the plan (or waiver) for
any such item or service; and
``(IV) complies with the limits for
additional payments to providers under the plan
(or waiver) imposed pursuant to section
1902(a)(30)(A), including the regulations
specifying upper payment limits under the State
plan in part 447 of title 42, Code of Federal
Regulations (or any successor regulations).
``(iii) An expenditure described in this clause is
an expenditure that meets the criteria specified in
subclauses (I), (II), and (III) of clause (ii) and is
authorized under section 1115 for the purposes of
funding a delivery system reform pool, uncompensated
care pool, a designated state health program, or any
other similar expenditure (as defined by the
Secretary).
``(B) For each 1903A enrollee category, the number
of 1903A enrollees for the State in fiscal year 2019 in
the enrollee category (as determined under subsection
(e)(4)).
``(C) For fiscal year 2016, the State's non-DSH
supplemental payment percentage is equal to the ratio
(expressed as a percentage) of--
``(i) the total amount of non-DSH
supplemental expenditures (as defined in
subparagraph (A)(ii)) for the State for fiscal
year 2016; to
``(ii) the amount described in subsection
(b)(1)(A) for the State for fiscal year 2016.
``(D) For each 1903A enrollee category an average
medical assistance expenditures per capita for the
State for fiscal year 2019 for the enrollee category
equal to--
``(i) the amount calculated under
subparagraph (A) for the State, increased by
the non-DSH supplemental payment percentage for
the State (as calculated under subparagraph
(C)); divided by
``(ii) the number calculated under
subparagraph (B) for the State for the enrollee
category.
``(5) Provisional fy19 per capita target amount for each
1903a enrollee category.--Subject to subsection (f)(2), the
Secretary shall calculate for each State a provisional FY19 per
capita target amount for each 1903A enrollee category equal to
the average medical assistance expenditures per capita for the
State for fiscal year 2019 (as calculated under paragraph
(4)(D)) for such enrollee category multiplied by the ratio of--
``(A) the product of--
``(i) the fiscal year 2019 average per
capita amount for the State, as calculated
under paragraph (2); and
``(ii) the number of 1903A enrollees for
the State in fiscal year 2019, as calculated
under paragraph (3)(B); to
``(B) the amount of the adjusted total medical
assistance expenditures for the State for fiscal year
2019, as calculated under paragraph (3)(A).
``(e) 1903A Enrollee; 1903A Enrollee Category.--Subject to
subsection (g), for purposes of this section, the following shall
apply:
``(1) 1903A enrollee.--The term `1903A enrollee' means,
with respect to a State and a month, any Medicaid enrollee (as
defined in paragraph (3)) for the month, other than such an
enrollee who for such month is in any of the following
categories of excluded individuals:
``(A) CHIP.--An individual who is provided, under
this title in the manner described in section
2101(a)(2), child health assistance under title XXI.
``(B) IHS.--An individual who receives any medical
assistance under this title for services for which
payment is made under the third sentence of section
1905(b).
``(C) Breast and cervical cancer services eligible
individual.--An individual who is entitled to medical
assistance under this title only pursuant to section
1902(a)(10)(A)(ii)(XVIII).
``(D) Partial-benefit enrollees.--An individual
who--
``(i) is an alien who is entitled to
medical assistance under this title only
pursuant to section 1903(v)(2);
``(ii) is entitled to medical assistance
under this title only pursuant to subclause
(XII) or (XXI) of section 1902(a)(10)(A)(ii)
(or pursuant to a waiver that provides only
comparable benefits);
``(iii) is a dual eligible individual (as
defined in section 1915(h)(2)(B)) and is
entitled to medical assistance under this title
(or under a waiver) only for some or all of
medicare cost-sharing (as defined in section
1905(p)(3)); or
``(iv) is entitled to medical assistance
under this title and for whom the State is
providing a payment or subsidy to an employer
for coverage of the individual under a group
health plan pursuant to section 1906 or section
1906A (or pursuant to a waiver that provides
only comparable benefits).
``(2) 1903A enrollee category.--The term `1903A enrollee
category' means each of the following:
``(A) Elderly.--A category of 1903A enrollees who
are 65 years of age or older.
``(B) Blind and disabled.--A category of 1903A
enrollees (not described in the previous subparagraph)
who are eligible for medical assistance under this
title on the basis of being blind or disabled.
``(C) Children.--A category of 1903A enrollees (not
described in a previous subparagraph) who are children
under 19 years of age.
``(D) Expansion enrollees.--A category of 1903A
enrollees (not described in a previous subparagraph)
for whom the amounts expended for medical assistance
are subject to an increase or change in the Federal
medical assistance percentage under subsection (y) or
(z)(2), respectively, of section 1905.
``(E) Other nonelderly, nondisabled, non-expansion
adults.--A category of 1903A enrollees who are not
described in any previous subparagraph.
``(3) Medicaid enrollee.--The term `Medicaid enrollee'
means, with respect to a State for a month, an individual who
is eligible for medical assistance for items or services under
this title and enrolled under the State plan (or a waiver of
such plan) under this title for the month.
``(4) Determination of number of 1903a enrollees.--The
number of 1903A enrollees for a State and fiscal year, and, if
applicable, for a 1903A enrollee category, is the average
monthly number of Medicaid enrollees for such State and fiscal
year (and, if applicable, in such category) that are reported
through the CMS-64 report under (and subject to audit under)
subsection (h).
``(f) Special Payment Rules.--
``(1) Application in case of research and demonstration
projects and other waivers.--In the case of a State with a
waiver of the State plan approved under section 1115, section
1915, or another provision of this title, this section shall
apply to medical assistance expenditures and medical assistance
payments under the waiver, in the same manner as if such
expenditures and payments had been made under a State plan
under this title and the limitations on expenditures under this
section shall supersede any other payment limitations or
provisions (including limitations based on a per capita
limitation) otherwise applicable under such a waiver.
``(2) Treatment of states expanding coverage after fiscal
year 2016.--In the case of a State that did not provide for
medical assistance for the 1903A enrollee category described in
subsection (e)(2)(D) during fiscal year 2016 but which provides
for such assistance for such category in a subsequent year, the
provisional FY19 per capita target amount for such enrollee
category under subsection (d)(5) shall be equal to the
provisional FY19 per capita target amount for the 1903A
enrollee category described in subsection (e)(2)(E).
``(3) In case of state failure to report necessary data.--
If a State for any quarter in a fiscal year (beginning with
fiscal year 2019) fails to satisfactorily submit data on
expenditures and enrollees in accordance with subsection
(h)(1), for such fiscal year and any succeeding fiscal year for
which such data are not satisfactorily submitted--
``(A) the Secretary shall calculate and apply
subsections (a) through (e) with respect to the State
as if all 1903A enrollee categories for which such
expenditure and enrollee data were not satisfactorily
submitted were a single 1903A enrollee category; and
``(B) the growth factor otherwise applied under
subsection (c)(2)(B) shall be decreased by 1 percentage
point.
``(g) Recalculation of Certain Amounts for Data Errors.--The
amounts and percentage calculated under paragraphs (1) and (4)(C) of
subsection (d) for a State for fiscal year 2016, and the amounts of the
adjusted total medical assistance expenditures calculated under
subsection (b) and the number of Medicaid enrollees and 1903A enrollees
determined under subsection (e)(4) for a State for fiscal year 2016,
fiscal year 2019, and any subsequent fiscal year, may be adjusted by
the Secretary based upon an appeal (filed by the State in such a form,
manner, and time, and containing such information relating to data
errors that support such appeal, as the Secretary specifies) that the
Secretary determines to be valid, except that any adjustment by the
Secretary under this subsection for a State may not result in an
increase of the target total medical assistance expenditures exceeding
2 percent.
``(h) Required Reporting and Auditing of CMS-64 Data; Transitional
Increase in Federal Matching Percentage for Certain Administrative
Expenses.--
``(1) Reporting.--In addition to the data required on form
Group VIII on the CMS-64 report form as of January 1, 2017, in
each CMS-64 report required to be submitted (for each quarter
beginning on or after October 1, 2018), the State shall include
data on medical assistance expenditures within such categories
of services and categories of enrollees (including each 1903A
enrollee category and each category of excluded individuals
under subsection (e)(1)) and the numbers of enrollees within
each of such enrollee categories, as the Secretary determines
are necessary (including timely guidance published as soon as
possible after the date of the enactment of this section) in
order to implement this section and to enable States to comply
with the requirement of this paragraph on a timely basis.
``(2) Auditing.--The Secretary shall conduct for each State
an audit of the number of individuals and expenditures reported
through the CMS-64 report for fiscal year 2016, fiscal year
2019, and each subsequent fiscal year, which audit may be
conducted on a representative sample (as determined by the
Secretary).
``(3) Temporary increase in federal matching percentage to
support improved data reporting systems for fiscal years 2018
and 2019.--For amounts expended during calendar quarters
beginning on or after October 1, 2017, and before October 1,
2019--
``(A) the Federal matching percentage applied under
section 1903(a)(3)(A)(i) shall be increased by 10
perce


Comments - Make a comment
The comments are owned by the poster. We are not responsible for its content. We value free speech but remember this is a public forum and we hope that people would use common sense and decency. If you see an offensive comment please email us at news@thepinetree.net
No Subject
Posted on: 2017-05-04 11:52:36   By: Anonymous
 
Well
It looks like us older folks are the people that this Govt wants to leave behind
My parents lied to me when they said hard work will pay off
Only being a rich petulant child pays off now
Thank You to all that voted for this unqualified a_hole
You have successfully ruined the rest of my life
With Obama we had a voice
Not with this PRICK

[Reply ]

    Re:
    Posted on: 2017-05-04 11:59:52   By: Anonymous
     
    I'm happy that an entitled looser like you feels bad. Good luck with that.

    [Reply ]

      Re:
      Posted on: 2017-05-04 12:47:43   By: Anonymous
       
      The word you're looking for is LOSER, not looser. Looser is what you are in the bottom end of your gastrointestinal system.

      [Reply ]

        No Subject
        Posted on: 2017-05-04 21:09:21   By: Anonymous
         


        [Reply ]

    Re:
    Posted on: 2017-05-04 12:09:06   By: Anonymous
     
    You had Medicare before Obama, you had Medicare during Obama, you'll have Medicare during Trump...the rest of us working stiffs are still paying for your medical expenses by paying into Medicare...what's the problem here, exactly?

    [Reply ]

      Re:
      Posted on: 2017-05-04 12:18:03   By: Anonymous
       
      Don't be so sure! Next Medicare and Social Security will be yanked- republicans will see to it that we have NOTHING! As long as they have ALL they want, that is!!

      [Reply ]

      Re:
      Posted on: 2017-05-04 13:08:47   By: Anonymous
       
      Well oh well informed one according to the Republicans Budget committee this will lead to 24 Million people without coverage over the next two years. Must make you proud.

      [Reply ]

        Re:
        Posted on: 2017-05-04 15:56:54   By: Anonymous
         
        Actually, 24 million losing coverage was for the previous, not quite as bad Republican replacement bill. This bill has not even be scored by the Congressional Budget Office. That means that Republicans voted for it without even knowing what consequences it would have on affordability or access to health insurance.

        Anyone who thinks Republicans care about them is really not paying attention.

        [Reply ]

        Re:
        Posted on: 2017-05-04 17:13:13   By: Anonymous
         
        There would have been a LOT more then 24 million when Obamacare imploded.

        [Reply ]

          Re:
          Posted on: 2017-05-04 21:11:56   By: Anonymous
            Edited By: thepinetree
          On: 2017-05-05 08:55:10


          [Reply ]

      Re:
      Posted on: 2017-05-04 18:57:14   By: Anonymous
       
      Not necessarily. Medicare, likely. Medicaid being reviewed. And God forbid you have any pre-existing conditions.

      [Reply ]

    Making America Great Again!
    Posted on: 2017-05-04 16:10:59   By: Anonymous
     
    This is what it looks like reclaiming our country from Democrat Socialism, one battle at a time.

    Thank you President Trump for keeping your promises.
    Making America Great Again.

    [Reply ]

VOTE THEM OUT!!!
Posted on: 2017-05-04 12:19:38   By: Anonymous
 
For those who are devastated by republicans taking away what is critical to them - my suggestion is to PLEASE vote for Democrats in order to vote republicans OUT next November when many congressional terms are up for reelection. YOU have a say relative to the party in control of the House and Senate and the party in control determines your "take-aways" or no "take-aways". Your vote is critical.

[Reply ]

    Senate
    Posted on: 2017-05-04 12:52:59   By: Anonymous
     
    Wait until the Senate votes. If the Senate listens to the majority, the AMA, AARP, and and the Ins Cos , they will not pass this bill.
    When you read the bill, it becomes clear the main reason for passage was the pressure of the .01%, who didn't like paying 2.8% for the 99% to have affordable health care ins.

    The $Billionaires Won This Time , We All Lost

    [Reply ]

      Re: Senate
      Posted on: 2017-05-04 15:35:55   By: Anonymous
       
      I hope this bill becomes law so the Demorats will shut their filthy mouths. If you whiners still need to complain then leave the country.

      [Reply ]

        No Subject
        Posted on: 2017-05-04 15:50:00   By: Anonymous
         
        We wish the republicans would leave - they are the bottom of all of our problems!

        [Reply ]

        Re: Senate
        Posted on: 2017-05-04 15:53:45   By: Anonymous
         
        There is not even a small chance this bill will become law. Senate Republicans have already said they will not even take it up but will write their own version. That's how bad this bill is. Can't be fixed; need to scrap it.

        Stupid, stupid Republican House members. They put themselves on record as voting for this bill which will be hated in their districts and it doesn't even have a chance of getting through the Senate. For many of them their only hope for staying in office is that their district is so Gerrymandered they can't lose.



        [Reply ]

          Re: Senate
          Posted on: 2017-05-04 16:12:00   By: Anonymous
           
          Obama Care has imploded , get a grip , you'll still be able to ride the system , you wouldn't admit even it is better !

          [Reply ]

            Re: Senate
            Posted on: 2017-05-04 19:01:47   By: Anonymous
             
            It is scary funny that the GOP now calls out the Democrats for not supporting their ideas when they blocked Obama at every turn previously. Millions and millions of you will be dropped from medical coverage. So you won't be penalized, big deal. You also won't be getting that free coverage you have come to expect in a county hospital model. And have any pre-existing conditions? Too bad, you should have taken better care of yourself. That was the message from several GOP lawmakers this week who literally said we shouldn't have to take care of people who didn't take care of themselves. When I read enough crap here, am beginning to think there may be some modicum of truth to that.

            [Reply ]

          Re: Senate
          Posted on: 2017-05-04 19:03:41   By: Anonymous
           
          Just in case you haven't been paying attention, this is not the health care coverage that GOP lawmakers will be getting. Got to ask yourself if it's not good enough for their families, why should it be for you?

          [Reply ]

    Re: VOTE THEM OUT!!!
    Posted on: 2017-05-04 16:45:56   By: Anonymous
     
    I'm tired of every American Tax Payer having to be Taxed to death to pay for everybody else.Ancient Rome did this same thing to all nations they controlled until the rebellion of it's citizens in earnest.

    I do not know about all of you where Republican, Democrat, Green Party, Libertarian or what ever party line you cling to, but I an American Citizen am thoroughly Taxed Enough Already.

    There must be a balance but I do not believe in all sincerity we the American Citizens will find it in any Political Party Line now forced upon us.

    [Reply ]

      Re: VOTE THEM OUT!!!
      Posted on: 2017-05-05 14:02:32   By: Anonymous
       
      says The Snarky And Condescending Moron who Capitalizes thE First Letter of Seemingly Random Words In a cHildish Word Salad Of Gibberish, Vomited, Unsolicited, to this Silly weB Page.

      People Who Live iN glASS Houses....

      [Reply ]

        Re: VOTE THEM OUT!!!
        Posted on: 2017-05-05 16:51:04   By: Anonymous
         
        Posts the Liberal who never payed attention in School. Loser!!!

        [Reply ]

No Subject
Posted on: 2017-05-04 19:11:11   By: Anonymous
 
Sure hope those of you so excited about the new plan don't have any loved ones with cancer, bipolar disorder and other pre-existing conditions. Those costs are about to go through the roof - if you can get coverage at all. Yes, they're already talking about this at county hospitals.

[Reply ]

    Re:
    Posted on: 2017-05-04 21:05:43   By: Anonymous
     
    Don't worry bout continuing coverage.
    Trumpcare has a built in program to provide bus fare to Mexico for those who like socialized medicine.

    If you like your current plan, you can keep your plan.

    [Reply ]

      Re:
      Posted on: 2017-05-04 21:09:55   By: Anonymous
        Edited By: thepinetree
      On: 2017-05-05 08:51:37


      [Reply ]

        Re:
        Posted on: 2017-05-05 14:22:16   By: Anonymous
         


        [Reply ]

No Subject
Posted on: 2017-05-05 19:53:10   By: Anonymous
 
Donald Trump is a piece of trash! I was a republican until the religious loonies came around after Clinton. I'm embarrassed to see what the party has become.

[Reply ]

No Subject
Posted on: 2017-05-06 12:11:38   By: Anonymous
 
The copy of the proposed healthcare plan that is posted does not appear to be complete. The list of Subsections is listed up to #251 but the actual document only covers up to about #221?

[Reply ]


What's Related
These might interest you as well
Photo Albums

Local News

phpws Business Directory

RSS News Feeds

Web Pages


Mark Twain Medical Center
Meadowmont Pharmacy
Century 21 Sierra Properties
Bear Valley Real Estate
Bear Valley Cross Country
Cedar Creek Realty
Middleton's Furniture
Cave, Mine & Zip Lines
Bistro Espresso
Pinnacle Physical Therapy
Chatom Winery
Bear Valley Mountain Resort
Paul D. Bertini Premier Properties

Ebbetts Pass Scenic Byway
Sierra Logging Museum
Calaveras Mentoriing Jenny's Kitchen


Copyright © The Pine Tree 2005-2017