< Back to H.R. 3787 (104th Congress, 1995–1996)

Text of the Healthy Start Act of 1996

This bill was introduced on July 11, 1996, in a previous session of Congress, but was not enacted. The text of the bill below is as of Jul 11, 1996 (Introduced).

Source: GPO

HR 3787 IH

104th CONGRESS

2d Session

H. R. 3787

To amend the Social Security Act to provide for a program of health insurance for children under 13 years of age and for mothers-to-be.

IN THE HOUSE OF REPRESENTATIVES

July 11, 1996

Mr. GIBBONS (for himself, Mr. RANGEL, Mr. STARK, Mr. MILLER of California, Mr. LAFALCE, Mr. LANTOS, Mr. HILLIARD, and Ms. NORTON) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned


A BILL

To amend the Social Security Act to provide for a program of health insurance for children under 13 years of age and for mothers-to-be.

    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 ‘Healthy Start Act of 1996’.

SEC. 2. HEALTH INSURANCE FOR CHILDREN AND MOTHERS-TO-BE.

    (a) IN GENERAL- The Social Security Act is amended by adding at the end the following new title:

‘TITLE XXI--HEALTHY START

‘SEC. 2100. ESTABLISHMENT OF PROGRAM OF HEALTH INSURANCE FOR CHILDREN AND MOTHERS-TO-BE.

    ‘There is hereby established a program of health insurance for children under 13 years of age and mothers-to-be.

‘Part A--Eligibility

‘SEC. 2101. GENERAL ELIGIBILITY.

    ‘(a) CHILDREN-

      ‘(1) IN GENERAL- Every individual--

        ‘(A) who is a child (as defined in paragraph (2)),

        ‘(B) whose principal place of abode is in the United States,

        ‘(C) who is a citizen or national of the United States or a permanent resident alien (as defined in subsection (d)), and

        ‘(D) who is not covered under a qualified health plan (as defined in subsection (e)),

      is, upon registration under section 2102, entitled to benefits under this title as a child.

      ‘(2) CHILD DEFINED- In this title, the term ‘child’ means an individual from birth until the end of the month in which the individual attains 13 years of age.

    ‘(b) MOTHERS-

      ‘(1) IN GENERAL- Every woman--

        ‘(A) who is a pregnant woman (as defined in paragraph (2)),

        ‘(B) whose principal place of abode is in the United States,

        ‘(C) who is a citizen or national of the United States or a permanent resident alien (as defined in subsection (d)), and

        ‘(D) who is not covered under a qualified health plan (as defined in subsection (e)),

      is entitled to benefits under this title as a pregnant woman.

      ‘(2) PREGNANT WOMAN DEFINED- In this title, the term ‘pregnant woman’ means a woman during the period--

        ‘(A) beginning on the date she receives the examination or test which forms the basis for the certification of pregnancy under section 2102(b)(1), and

        ‘(B) ending on the last day of the month in which the 60-day period (beginning on the date of termination of the pregnancy) ends.

    ‘(c) PREGNANT CHILDREN- In the case of an individual who is entitled under this section to benefits under this title as a child and as a pregnant woman, the individual is entitled to benefits as both.

    ‘(d) PERMANENT RESIDENT ALIEN DEFINED- In this section, the term ‘permanent resident alien’ means an alien lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law, and includes an alien granted asylum under section 208 of the Immigration and Nationality Act or lawfully admitted as a temporary resident under section 210, 210A, or 245A of such Act.)

    ‘(e) QUALIFIED HEALTH PLAN- In this section, the term ‘qualified health plan’ means a plan of health insurance or coverage, an employee welfare benefit plan that provides health benefits, or other plan (other than under this title) under Federal or State law that provides coverage of benefits which the Secretary of Health and Human Services determines is substantially equivalent to the coverage of benefits provided under this title.

‘SEC. 2102. REGISTRATION; CERTIFICATION OF PREGNANCY.

    ‘(a) REGISTRATION OF CHILDREN-

      ‘(1) IN GENERAL- The Secretary shall establish a process for the registration of children at the time of birth in the United States or at the time of immigration into the United States or other acquisition of lawful permanent resident status in the United States.

      ‘(2) TRANSITIONAL REGISTRATION- The Secretary also shall establish a process for the registration of children born before the effective date of benefits under this title.

      ‘(3) EFFECT OF FAILURE TO REGISTER- The failure of a child to be registered under this subsection shall not be considered to deny the child’s entitlement to benefits under this title, but merely to delay payment with respect to such benefits under this title.

    ‘(b) CERTIFICATION OF PREGNANCY AND REGISTRATION OF PREGNANT WOMEN-

      ‘(1) CERTIFICATION OF PREGNANCY- A certification of pregnancy for purposes of this title--

        ‘(A) may be made by a physician (or such other qualified health professionals as the Secretary may designate) on the basis of such tests or procedures as the Secretary may specify,

        ‘(B) shall be stated on such form as the Secretary shall specify, and

        ‘(C) shall be filed with the Secretary in a manner specified by the Secretary.

      ‘(2) REGISTRATION- The Secretary shall establish a process for the registration of pregnant women in connection with the filing of a certification of pregnancy under paragraph (1)(C).

‘SEC. 2103. COVERAGE PERIOD.

    ‘(a) IN GENERAL- No payments may be made under this part with respect to the expenses of an individual unless such expenses were incurred by such individual during a period which, with respect to the individual, is a coverage period under this section.

    ‘(b) CHILDREN- With respect to an individual entitled to benefits under this title as a child, the coverage period shall begin on the first date (on or after the effective date of benefits under this title) on which the individual meets the requirements for such entitlement under section 2101(a) and shall end on the day before the first month in which the individual no longer meets such requirements.

    ‘(c) PREGNANT WOMEN- With respect to an individual entitled to benefits under this title as a pregnant woman, the coverage period shall begin on the first date (on or after the effective date of benefits under this title) on which the individual meets the requirements for such entitlement under section 2101(b) and shall end on the day before the first month in which the individual no longer meets such requirements.

‘Part B--Benefits

‘SEC. 2111. SCOPE OF BENEFITS FOR CHILDREN.

    ‘(a) IN GENERAL- Except as provided in the succeeding provisions of this section, the benefits provided to an individual by the program established by this part shall consist of the same benefits that are available under title XVIII to individuals entitled to benefits under part A of that title and enrolled under part B of that title.

    ‘(b) WELL CHILD SERVICES-

      ‘(1) IN GENERAL- In addition to the benefits described in subsection (a), in the case of an individual entitled to benefits under this title as a child, the benefits under this title shall include entitlement to have payment made (in the same manner as for physicians’ services under part B of title XVIII) for the following, without the application of deductibles, coinsurance, or copayments, subject to the periodicity schedule established with respect to the services under paragraph (2):

        ‘(A) Newborn and well-baby care, including normal newborn care and pediatrician services for high-risk deliveries.

        ‘(B) Well-child care, including routine office visits, routine immunizations (including the vaccine itself), routine laboratory tests, and preventive dental care.

      ‘(2) PERIODICITY SCHEDULE- The Secretary, in consultation with the American Academy of Pediatrics, shall establish a schedule of periodicity which reflects the general, appropriate frequency with which services listed in paragraph (1) should be provided to healthy children.

‘SEC. 2112. SCOPE OF BENEFITS FOR PREGNANT WOMEN.

    ‘(a) IN GENERAL- In the case of an individual entitled to benefits under this title as a pregnant woman, the benefits under this title shall consist of entitlement to have payment made for the following, without the application of deductibles, coinsurance, or copayments, subject to the periodicity schedule established with respect to the services under subsection (b):

      ‘(1) Prenatal care, including care for all complications of pregnancy.

      ‘(2) Inpatient labor and delivery services.

      ‘(3) Postnatal care.

      ‘(4) Postnatal family planning services.

    ‘(b) PERIODICITY SCHEDULE- The Secretary, in consultation with the American College of Obstetrics and Gynecology, shall establish a schedule of periodicity which reflects the general, appropriate frequency with which services listed in subsection (a) should be provided to pregnant women without complications of pregnancy.

‘SEC. 2113. EXCLUSIONS.

    ‘(a) IN GENERAL- Except as provided in subsections (b) and (c), section 1862 shall apply to expenses incurred for items and services provided under this title the same manner as such section applies to items and services provided under title XVIII.

    ‘(b) BENEFITS EXCEPTION-

      ‘(1) CHILDRENS’ SERVICES- In applying section 1862(a) with respect to services described in section 2111(b)(1) (relating to well-child services), payment shall not be denied under paragraph (1), (7), or (12) of such section 1862(a) if the services are provided in accordance with the periodicity schedule described in section 2111(b)(2).

      ‘(2) SERVICES FOR PREGNANT WOMEN- In applying section 1862(a) with respect to services described in section 2112(a) (other than paragraph (2) thereof), payment shall not be denied under paragraph (1) or (7) of such section 1862(a) if the services are provided in accordance with the periodicity schedule described in section 2112(b).

    ‘(c) COORDINATION OF PAYMENTS- Payment shall not be made under this title with respect to benefits to the extent that payment for such benefits may be made under title XVIII.

‘Part C--Payment for Benefits and Financing

‘SEC. 2121. PAYMENTS FOR BENEFITS.

    ‘(a) IN GENERAL- Except as otherwise provided in this section--

      ‘(1) payment of benefits under this title with respect to benefits shall be made in the same amounts and on the same basis as payment may be made with respect to such benefits under title XVIII, and

      ‘(2) the provisions of sections 1814, 1833, 1842, 1848, and 1886 shall apply to payment of benefits under this title in the same manner as they apply to benefits under title XVIII.

    ‘(b) NO COST-SHARING FOR CERTAIN SERVICES- No deductibles, coinsurance, copayments, or other cost-sharing shall be imposed with respect to--

      ‘(1) well-child care services described in section 2111(b)(1), and

      ‘(2) items and services for which an individual is entitled under this title as a pregnant woman.

    ‘(c) ADJUSTMENT OF PAYMENTS-

      ‘(1) ESTABLISHMENT OF NEW DRGS AND WEIGHTS- In making payment under this title with respect to inpatient hospital services, the Secretary shall make such adjustments in the diagnosis-related groups and weighting factors with respect to discharges within such groups, otherwise established under section 1886(d)(4) as may be necessary--

        ‘(A) to reflect the types of discharges occurring under this title which are not occurring under title XVIII, and

        ‘(B) to provide for a weighting factor, for cesarean section deliveries, which is 95 percent of the weighting factor that otherwise would be established.

      ‘(2) PAYMENT FOR OBSTETRICAL SERVICES-

        ‘(A) GLOBAL FEE- In making payment under this title with respect to the group of obstetrical services typical of treatment throughout a course of pregnancy, the Secretary shall establish, as a schedule under section 1848, a global fee with respect to such group of services.

        ‘(B) BONUS FOR EARLY PRESENTATION- The fee schedule amount with respect to obstetrical services under this title shall be increased by 5 percent in the case of services furnished to women who have presented for prenatal care during the first trimester.

        ‘(C) DISINCENTIVE FOR CESAREAN SECTIONS- The fee schedule amount otherwise established with respect to a cesarean section shall be 95 percent of the fee schedule amount otherwise established.

    ‘(c) CONDITIONS OF AND LIMITATIONS ON PAYMENTS- The provisions of sections 1814 and 1835 shall apply to payment for services under this title in the same manner as they apply to payment for services under parts A and B, respectively, of title XVIII.

    ‘(d) USE OF TRUST FUND- In carrying out this section, any reference in title XVIII to a trust fund shall be treated as a reference to the Children Health Insurance Trust Fund established under section 2122.

‘SEC. 2122. CHILDREN HEALTH INSURANCE TRUST FUND.

    ‘(a) ESTABLISHMENT- (1) There is hereby created on the books of the Treasury of the United States a trust

fund to be known as the ‘Children Health Insurance Trust Fund’ (in this section referred to as the ‘Trust Fund’). The Trust Fund shall consist of such gifts and bequests as may be made as provided in section 201(i)(1) and amounts appropriated under paragraph (2).

    ‘(2) There are hereby appropriated to the Trust Fund amounts equivalent to 100 percent of the premium taxes imposed by section 59B of the Internal Revenue Code of 1986, and such additional amounts as the Congress provides. The amounts appropriated by the preceding sentence in relation to premium taxes shall be transferred from time to time from the general fund in the Treasury to the Trust Fund, such amounts to be determined on the basis of estimates by the Secretary of the Treasury of the taxes, paid to or deposited into the Treasury; and proper adjustments shall be made in amounts subsequently transferred to the extent prior estimates were in excess of or were less than the taxes specified in such sentence.

    ‘(b) INCORPORATION OF PROVISIONS-

      ‘(1) IN GENERAL- Subject to paragraph (2), the provisions of subsections (b) through (e) and (g) through (j) of section 1817 shall apply to the Trust Fund in the same manner as they apply to the Federal Hospital Insurance Trust Fund.

      ‘(2) EXCEPTIONS- In applying paragraph (1)--

        ‘(A) the Board of Trustees and Managing Trustee of the Trust Fund shall be composed of the members of the Board of Trustees and the Managing Trustee, respectively, of the Federal Hospital Insurance Trust Fund; and

        ‘(B) any reference in section 1817 to the Federal Hospital Insurance Trust Fund or to title XVIII (or part A thereof) is deemed a reference to the Trust Fund under this section and this title, respectively.

‘SEC. 2123. APPLICABLE TITLE XXI PREMIUM.

    ‘For purposes of section 59B of the Internal Revenue Code of 1986, the Secretary shall, during September of each year (beginning with 1997), determine a title XXI applicable premium for months in the succeeding calendar year. Such premium for months in a year shall be such amount as the Secretary estimates so that--

      ‘(1) 12 times the product of such amount and the average number of families with individuals entitled to benefits under section 2101 in any month in the year, is equal to

      ‘(2) the total of the benefits and administrative costs which the Secretary estimates will be payable from the Children Health Insurance Trust Fund for services performed and related administrative costs incurred in such year.

    In calculating the amount under paragraph (2), the Secretary shall include an appropriate amount for a contingency margin.

‘Part D--General Provisions

‘SEC. 2131. INCORPORATION OF CERTAIN MEDICARE PROVISIONS.

    ‘(a) USE OF CARRIERS AND INTERMEDIARIES- The Secretary shall provide for the administration of this title through the use of fiscal intermediaries and carriers in the same manner as title XVIII is carried out through the use of such fiscal intermediaries and carriers.

    ‘(b) DEFINITIONS- Except as otherwise provided in this title, the definitions contained in section 1861 shall apply for purposes of this title in the same manner as they apply for purposes of title XVIII.

    ‘(c) CERTIFICATION, PROVIDER QUALIFICATION, ETC- The provisions of sections 1863 through 1875, sections 1878 through 1880, section 1883, section 1885, and sections 1887 through 1892 shall apply to this title in the same manner as they apply to title XVIII.

    ‘(d) HEALTH MAINTENANCE ORGANIZATIONS AND COMPETITIVE MEDICAL PLANS-

      ‘(1) IN GENERAL- Except as provided in this subsection, section 1876 shall apply to individuals entitled to benefits under this title in the same manner as such section applies to individuals entitled to benefits under part A, and enrolled under part B, of title XVIII.

      ‘(2) LIMITATION TO REASONABLE COST REIMBURSEMENT CONTRACTS FOR PREGNANT WOMEN-

        ‘(A) IN GENERAL- The provisions of section 1876 relating only to risk-sharing contracts (and not to reasonable cost reimbursement contracts) shall not apply to individuals entitled to benefits under this title only as pregnant women.

        ‘(B) REPORT- Not later than January 1, 1997, the Secretary shall submit to the Congress a report concerning recommendations on how the provisions of section 1876 relating to risk-sharing contracts may be adapted to apply to benefits provided under this title to pregnant women.

      ‘(3) APPLICATION- In applying section 1876 under this section--

        ‘(A) the provisions of such section relating only to individuals enrolled under part B of title XVIII shall not apply;

        ‘(B) any reference to a Trust Fund established under title XVIII and to benefits under such title is deemed a reference to the Children Health Insurance Trust Fund and to benefits under this title;

        ‘(C) the adjusted average per capita cost and the adjusted community rate shall be determined on the basis of benefits under this title; and

        ‘(D) subsection (f) shall not apply.

‘SEC. 2132. INCORPORATION OF PEER REVIEW PROVISIONS AND FRAUD AND ABUSE PROVISIONS.

    ‘The provisions of sections 1121 through 1126, sections 1128 through 1128B, section 1134, section 1138, and part B of title XI shall apply to this title in the same manner as they apply to title XVIII.’.

    (b) CONFORMING AMENDMENTS-

      (1) Section 201(g)(1)(A) of the Social Security Act (42 U.S.C. 401(g)(1)(A)) is amended by striking ‘and the Federal Supplementary Medical Insurance Trust Fund’ and inserting ‘, Federal Supplementary Medical Insurance Trust Fund, and the Children Health Insurance Trust Fund’.

      (2) Section 201(i)(1) of such Act (42 U.S.C. 401(i)(1)) is amended by striking ‘and the Federal Supplementary Medical Insurance Trust Fund’ and inserting ‘, Federal Supplementary Medical Insurance Trust Fund, and the Children Health Insurance Trust Fund’.

    (c) EFFECTIVE DATE- The amendments made by this section shall take effect on the date of the enactment of this Act, except that no benefits shall be available under title XXI of the Social Security Act for items or services furnished before January 1, 1998.

SEC. 3. PREMIUM FOR COVERAGE OF UNINSURED CHILDREN AND MOTHERS-TO-BE.

    (a) GENERAL RULE- Subchapter A of chapter 1 of the Internal Revenue Code of 1986 (relating to determination of tax liability) is amended by adding at the end the following new part:

‘PART VIII--PREMIUM FOR COVERAGE OF UNINSURED CHILDREN AND MOTHERS-TO-BE

‘Sec. 59B. Premium for coverage of uninsured children and mothers-to-be.

‘SEC. 59B. PREMIUM FOR COVERAGE OF UNINSURED CHILDREN AND MOTHERS-TO-BE.

    ‘(a) IMPOSITION OF TAX- In the case of an individual, there is hereby imposed (in addition to any other tax imposed by this subtitle) a tax for the taxable year in the amount equal to the title XXI premium liability (if any) of such individual for such taxable year.

    ‘(b) EXEMPTION FOR LOW-INCOME INDIVIDUALS-

      ‘(1) IN GENERAL- No tax shall be imposed by subsection (a) on any taxpayer whose modified adjusted gross income for the taxable year does not exceed the threshold amount.

      ‘(2) PHASE-IN OF TAX-

        ‘(A) IN GENERAL- If the modified adjusted gross income of the taxpayer for the taxable year exceeds the threshold amount by less than $10,000, the amount of the tax imposed by subsection (a) for such taxable year shall be the phase-in percentage of the title XXI premium liability of such taxpayer for such taxable year.

        ‘(B) PHASE-IN PERCENTAGE- For purposes of subparagraph (A), the phase-in percentage shall be determined under tables prescribed by the Secretary which--

          ‘(i) shall have income brackets of not more than $50, and

          ‘(ii) provide for a ratable increase in the amount of tax imposed by subsection (a) for modified adjusted gross incomes between the threshold amount and the sum of the threshold amount and $10,000.

    ‘(c) TITLE XXI PREMIUM LIABILITY- For purposes of this section--

      ‘(1) IN GENERAL- The title XXI premium liability of any individual for any taxable year is the sum of--

        ‘(A) the applicable title XXI premiums for each month of the taxable year as of the first day of which any dependent of the individual is a title XXI covered individual who has not attained age 13, and

        ‘(B) the applicable title XXI premium for the month of the taxable year during which the taxpayer (or spouse of the taxpayer) gives birth to any child if for such month the individual giving birth is a title XXI covered individual.

      ‘(2) APPLICABLE TITLE XXI PREMIUM- The term ‘applicable title XXI premium’ means, with respect to a month, such premium as determined under section 2123 of the Social Security Act for that month.

    ‘(d) TITLE XXI COVERED INDIVIDUAL- For purposes of this section--

      ‘(1) IN GENERAL- A dependent shall be treated as a title XXI covered individual for any month unless--

        ‘(A) for such month, such dependent is covered under a qualified health plan, and

        ‘(B) the taxpayer furnishes to the Secretary (at such time and in such manner as the Secretary may prescribe) the required certification of such coverage for such month.

      A similar rule shall apply to a woman for the month in which such woman gives birth to a child.

      ‘(2) QUALIFIED HEALTH PLAN- The term ‘qualified health plan’ means a plan of health insurance or coverage, an employee welfare benefit plan that provides health benefits, or other plan (other than under title XXI of the Social Security Act) under Federal or State law that provides coverage of benefits which the Secretary of Health and Human Services determines is substantially equivalent to the coverage of benefits provided under title XXI of the Social Security Act.

    ‘(e) OTHER DEFINITIONS AND SPECIAL RULES- For purposes of this section--

      ‘(1) THRESHOLD AMOUNT-

        ‘(A) IN GENERAL- Except as provided in subparagraph (B), the term ‘threshold amount’ means--

          ‘(i) $20,000 in the case of a return with respect to which 3 or fewer personal exemptions are allowable under section 151, and

          ‘(ii) $25,000 in the case of a return with respect to which 4 or more personal exemptions are allowable under section 151.

        ‘(B) CERTAIN SEPARATE RETURNS- The threshold amount shall be zero in the case of a taxpayer who--

          ‘(i) is married as of the close of the taxable year but does not file a joint return for such taxable year, and

          ‘(ii) does not live apart from his spouse at all times during the last 6 months of the taxable year.

        ‘(C) INFLATION ADJUSTMENTS- In the case of a taxable year beginning in a calendar year after 1998, each dollar amount contained in subparagraph (A) shall be increased by an amount equal to--

          ‘(i) such dollar amount, multiplied by

          ‘(ii) the cost-of-living adjustment determined under section 1(f)(3) for the calendar year in which the taxable year begins, by substituting ‘calendar year 1997’ for ‘calendar year 1992’ in subparagraph (B) thereof.

      ‘(2) MODIFIED ADJUSTED GROSS INCOME- The term ‘modified adjusted gross income’ means adjusted gross income--

        ‘(A) determined without regard to sections 911, 931, and 933, and

        ‘(B) increased by the amount of interest received or accrued by the individual during the taxable year which is exempt from tax.

      The determination under the preceding sentence shall be made without regard to any carryover or carryback.

      ‘(3) DEPENDENT- The term ‘dependent’ means, with respect to periods in any calendar year, any individual if an exemption is allowable under section 151(c) with respect to such individual to the

taxpayer for a taxable year beginning in such calendar year.

      ‘(4) REQUIRED CERTIFICATION- The term ‘required certification’ means the statement required to be provided under section 6050Q(b) (or a copy thereof) or any other statement approved by the Secretary for purposes of this section.

    ‘(f) COORDINATION WITH OTHER PROVISIONS-

      ‘(1) TREATMENT AS MEDICAL EXPENSE- For purposes of section 213, the tax imposed by this section for any taxable year shall be treated as an expense paid during such taxable year for medical care of the taxpayer.

      ‘(2) NOT TREATED AS TAX FOR CERTAIN PURPOSES- The tax imposed by this section shall not be treated as a tax imposed by this chapter for purposes of determining--

        ‘(A) the amount of any credit allowable under this chapter, or

        ‘(B) the amount of the minimum tax imposed by section 55.

      ‘(3) TREATMENT UNDER SUBTITLE F- For purposes of subtitle F, the tax imposed by this section shall be treated as if it were a tax imposed by section 1.

    ‘(g) EXEMPTIONS-

      ‘(1) IN GENERAL- No tax shall be imposed by this section on any individual for any taxable year if such individual is a nonresident alien.

      ‘(2) CERTAIN INDIVIDUALS NOT TAKEN INTO ACCOUNT IN DETERMINING AMOUNT OF TAX- For purposes of this section, an individual shall be treated as not being a title XXI covered individual for any month if--

        ‘(A) the principal place of abode of such individual as of the first day of such month is outside the United States, or

        ‘(B) as of the first day of such month, there is in effect for such individual a qualified religious exemption.

      ‘(3) QUALIFIED RELIGIOUS EXEMPTION- For purposes of paragraph (2)--

        ‘(A) IN GENERAL- The term ‘qualified religious exemption’ means an exemption granted by the Secretary of Health and Human Services to an individual--

          ‘(i) who is a member of a recognized religious sect or division thereof with respect to which such Secretary makes the findings referred to in subparagraphs (C), (D), and (E) of section 1402(g)(1),

          ‘(ii) who is an adherent of established tenets or teachings of such sect or division as described in such section, and

          ‘(iii) who submits an application for such exemption which contains or is accompanied by the evidence described in section 1402(g)(1)(A) and a waiver described in section 1402(g)(1)(B).

        For purposes of the clause (iii), section 1402(g)(1)(B) shall be treated as including a reference to title XXI of the Social Security Act.

        ‘(B) LIMITATION- An exemption granted under this paragraph shall cease to apply beginning on the date such Secretary determines that the individual, or the sect or division, ceased to meet the requirements of subparagraph (A).

      ‘(4) SPECIAL RULE FOR INDIVIDUALS RESIDING ABROAD WHO RECEIVE TITLE XXI SERVICES- Paragraph (2)(A) shall not apply to any individual for any taxable year if, at any time during such taxable year, such individual receives services under title XXI of the Social Security Act.

    ‘(h) REGULATIONS- The Secretary may prescribe such regulations as may be appropriate to carry out the purposes of this section, including regulations, prescribed after consultation with the Secretary of Health and Human Services, treating health plans of foreign governments or foreign employers outside the United States as qualified health plans.’

    (b) TECHNICAL AMENDMENTS-

      (1) Subsection (a) of section 6012 of such Code is amended by inserting after paragraph (9) the following new paragraph:

      ‘(10) Every individual who has a title XXI premium liability (as defined in section 59B) for the taxable year.’

      (2) Subparagraph (A) of section 1(f)(6) of such Code is amended by inserting ‘section 59B(e)(1)(C),’ after paragraph (2)(A),’.

    (c) CLERICAL AMENDMENT- The table of parts for subchapter A of chapter 1 is amended by adding at the end the following new item:

‘Part VIII. Individual share of title XXI premiums.’

    (d) EFFECTIVE DATE- The amendments made by this section shall apply to months beginning after December 31, 1997, in taxable years ending after such date.

SEC. 4. REPORTING REQUIREMENTS.

    (a) IN GENERAL- Subpart B of part III of subchapter A of chapter 61 of the Internal Revenue Code of 1986 (relating to information concerning transactions with others) is amended by adding at the end the following new sections:

‘SEC. 6050Q. RETURNS RELATING TO QUALIFIED HEALTH PLANS.

    ‘(a) REQUIREMENT OF REPORTING- The administrator of any qualified health plan (as defined in section 59B(d)) shall make a return for each calendar year setting forth--

      ‘(1) the name and TIN of each individual covered under such plan or program at any time during such taxable year as a primary insured or as the spouse of a primary insured,

      ‘(2) the name and TIN (to the extent available) of each individual covered under such plan or program at any time during such taxable year as a dependent (as defined in section 59B(e)(3)) of a primary insured, and

      ‘(3) the months during such calendar year for which such individuals were so covered.

    Such return shall be made at such time and in such form as the Secretary may by regulations prescribe.

    ‘(b) STATEMENTS TO PRIMARY INSURED INDIVIDUALS- Every administrator required to make a return under subsection (a) shall furnish to each individual whose name is required to be set forth in such return by reason of being a primary insured a written statement showing--

      ‘(1) the name of the qualified health plan and the address of its administrator, and

      ‘(2) the information required to be shown on the return with respect to such primary insured.

    The written statement required under the preceding sentence shall be furnished to the person on or before January 31 of the year following the calendar year for which the return under subsection (a) was required to be made.

    ‘(c) STATEMENT TO SPOUSE OR DEPENDENTS OF PRIMARY INSURED ON REQUEST- At the request of an individual who, at any time during a calendar year, was the spouse or a dependent (as defined in section 59B(e)(3)) of a primary insured who is required to receive a statement under subsection (b) from an administrator, such administrator shall furnish to such individual a copy of such statement with respect to such insured for such calendar year.’

    (b) UNIFORM PENALTY PROVISIONS MADE APPLICABLE-

      (1) Subparagraph (B) of section 6724(d)(1) of such Code is amended by inserting after the item relating to clause (viii) the following new item (and redesignating the following clauses accordingly):

          ‘(ix) section 6050Q(a) (relating to returns regarding qualified health plans),’.

      (2) Paragraph (2) of section 6724(d) of such Code is amended by inserting after subparagraph (P) the following new subparagraph (and by redesignating the following subparagraphs accordingly):

        ‘(Q) subsection (b) or (c) of section 6050Q (relating to returns regarding qualified health plans),’.

    (c) CLERICAL AMENDMENT- The table of sections for subpart B of part III of subchapter A of chapter 61 of such Code is amended by adding at the end the following new item:

‘Sec. 6050Q. Returns relating to qualified health plans.’

    (d) EFFECTIVE DATE- The amendments made by this section shall apply to calendar years after 1997.