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                 CONGRESSIONAL BUDGET OFFICE
                             COST ESTIMATE

                                                              October 19, 2017


                                H.R. 3921
                       HEALTHY KIDS Act of 2017

        As ordered reported by the House Committee on Energy and Commerce
                              on October 4, 2017


SUMMARY

H.R. 3921 would extend federal funding for the Children's Health Insurance Program
(CHIP) for five years, increase Medicaid funding for Puerto Rico and the Virgin Islands,
and change policies that require other sources of health coverage to pay claims before
Medicaid. The bill also would modify payments to hospitals that treat a disproportionate
share of uninsured and Medicaid patients and require states to count lottery winnings as
income for purposes of determining Medicaid eligibility. Finally, H.R. 3921 would make
adjustments to Medicare premium subsidies for higher-income individuals.

On net, CBO estimates that implementing the legislation would reduce the deficit by
$1.1 billion over the 2018-2027 period. Because enacting H.R. 3921 would affect direct
spending and revenues, pay-as-you-go procedures apply.

CBO estimates that enacting H.R. 3921 would not increase net direct spending or
on-budget deficits in one or more of the four consecutive 10-year periods beginning in
2028.

H.R. 3921 contains no intergovernmental or private-sector mandates as defined in the
Unfunded Mandates Reform Act (UMRA).


ESTIMATED COST TO THE FEDERAL GOVERNMENT

The estimated budgetary effect of H.R. 3921 is shown in the following table. The costs of
this legislation fall within budget function 550 (health).

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