Title IX, SEC. 9102. CAPPED FEDERAL ALLIANCE PAYMENTS. (a) Capped Entitlement. (1) Payment. The Secretary shall provide for each calendar quarter (beginning on or after January 1, 1996) for payment to each regional alliance of an amount equal to the capped Federal alliance payment amount (as defined in subsection (b)(1)) for the regional alliance for the quarter. (2) Entitlement. This section constitutes budget authority in advance of appropriations Acts, and represents the obligation of the Federal Government to provide for the payment to regional alliances of the capped Federal alliance payment under this section. (b) Capped Federal Alliance Payment Amount. (1) In general. In this section, the term ``capped Federal alliance payment amount'' means, for a regional alliance for a calendar quarter in a year and subject to subsection (e), the amount by which (A) \1/4\ of the total payment obligation (described in paragraph (2)) for the alliance for the year, exceeds (B) \1/4\ of the total amounts receivable (described in paragraph (3)) by the alliance for the year. (2) Total payment obligation. The total payment obligation described in this paragraph for an alliance for a year is the total amount payable by the alliance for the following: (A) Plan payments (and certain cost sharing reductions). Payments to regional alliance health plans under section 1351 (including amounts attributable to cost sharing reductions under section 1371, not including a reduction under subsection (c)(2) thereof) not otherwise counted. (B) Alliance administrative expenses. Payments retained by the regional alliance for administration (in accordance with section 1352). (3) Total amounts receivable. The total amounts receivable by a regional alliance for a year is the sum of the following: (A) Premiums. The amount payable to the regional alliance for the family share of premiums, employer premiums, and liabilities owed the alliance under subpart B of part 1, not taking into account any failure to make or collect such payments. (B) Other government payments. The amounts payable to the regional alliance under sections 9001, 9011, and 9101, and payable under section 1895 of the Social Security Act during the year. (4) No payment for certain amounts. (A) Uncollected alliance premiums. Each regional alliance is responsible, under section 1345(a), for the collection of all amounts owed the alliance (whether by individuals, employers, or others and whether on the basis of premiums owed, incorrect amounts of discounts or premium, cost sharing, or other reductions made, or otherwise), and no amounts are payable by the Federal Goverment under this section with respect to the failure to collect any such amounts. (B) Administrative errors. (i) In general. Each participating State is responsible, under section 1202(g), for the payment to regional alliances in the State of amounts attributable to administrative errors (described in clause (ii)). (ii) Administrative errors described. The administrative errors described in this clause include the following: (I) An eligibility error rate for premium discounts, liability reductions, and cost sharing reductions under sections 6104 and 6123, section 6113, and section 1371, respectively, to the extent the applicable error rate exceeds the maximum permissible error rate, specified by the applicable Secretary under section 1361(b)(1)(C), with respect to the section involved. (II) Misappropriations or other regional alliance expenditures that the Secretary finds are attributable to malfeasance or misfeasance by the regional alliance or the State. (5) Special rules for single-payer states. In applying this subsection in the case of a single-payer State, the Secretary shall develop and apply a methodology for computing an amount of payment (with respect to each calendar quarter) that is equivalent to the amount of payment that would have been made to all regional alliances in the State for the quarter if the State were not a single-payer State. (c) Determination of Capped Federal Alliance Payment Amounts. (1) Reports. At such time as the Secretary may require before the beginning of each fiscal year, each regional alliance shall submit to the Secretary such information as the Secretary may require to estimate the capped Federal alliance payment amount under this section for the succeeding calendar year (and the portion of such year that falls in such fiscal year). (2) Estimation. Before the beginning of each year, the Secretary shall estimate for each regional alliance the capped Federal alliance payment amount for calendar quarters in such year. Such estimate shall be based on factors including prior financial experience in the alliance, future estimates of income, wages, and employment, and other characteristics of the area found relevant by the Secretary. The Secretary shall transmit to Congress, on a timely basis consistent with the timely appropriation of funds under this section, a report that specifies an estimate of the total capped Federal alliance payment amounts owed to States under this section for the fiscal and calendar year involved. (d) Payments to Regional Alliances. Subject to subsection (e), the provisions of section 9101(b) apply to payments under this section in the same manner as they apply to payments under section 9101. (e) Cap on Payments. (1) In general. The total amount of the capped Federal alliance payments made under this section for quarters in a fiscal year may not exceed the cap specified under paragraph (2) for the fiscal year. (2) Cap. Subject to paragraphs (4) and (6) (A) Fiscal years 1996 through 2000. The cap under this paragraph (i) for fiscal year 1996, is $10.5 billion, (ii) for fiscal year 1997, is $28.8 billion, (iii) for fiscal year 1998, is $73.8 billion, (iv) for fiscal year 1999, is $75.1 billion, and (v) for fiscal year 2000, is $78.8 billion. (B) Subsequent fiscal year. The cap under this paragraph for a fiscal year after fiscal year 2000 is the cap under this paragraph for the previous fiscal year (not taking into account paragraph (4)) multiplied by the product of the factors described in subparagraph (C) for that fiscal year and for each previous year after fiscal year 2000. (C) Factor. The factor described in this subparagraph for a fiscal year is 1 plus the following: (i) CPI. The percentage change in the CPI for the fiscal year, determined based upon the percentage change in the average of the CPI for the 12-month period ending with May 31 of the previous fiscal year over such average for the preceding 12-month period. (ii) Population. The average annual percentage change in the population of the United States during the 3-year period ending in the preceding calendar year, determined by the Board based on data supplied by the Bureau of the Census. (iii) Real gdp per capita. The average annual percentage change in the real, per capita gross domestic product of the United States during the 3-year period ending in the preceding calendar year, determined by the Board based on data supplied by the Department of Commerce. (3) Carryforward. If the total of the capped Federal alliance payment amounts for all regional alliances for all calendar quarters in a fiscal year is less than the cap specified in paragraph (2) for the fiscal year, then the amount of such surplus shall be accumulated and will be available in the case of a year in which the cap would otherwise be breached. (4) Notification. (A) In general. If the Secretary anticipates that the amount of the cap, plus any carryforward from a previous year accumulated under paragraph (3), will not be sufficient for a fiscal year, the Secretary shall notify the President, the Congress, and each regional alliance. Such notification shall include information about the anticipated amount of the shortfall and the anticipated time when the shortfall will first occur. (B) Required action. Within 30 days after receiving such a notice, the President shall submit to Congress a report containing specific legislative recommendations for actions which would eliminate the shortfall. (5) Congressional consideration. (A) Expedited consideration. If a joint resolution the substance of which approves the specific recommendations submitted under paragraph (4)(A) is introduced, subject to subparagraph (B), the provisions of section 2908 (other than subsection (a)) of the Defense Base Closure and Realignment Act of 1990 shall apply to the consideration of the joint resolution in the same manner as such provisions apply to a joint resolution described in section 2908(a) of such Act. (B) Special rules. For purposes of applying subparagraph (A) with respect to such provisions, any reference to the Committee on Armed Services of the House of Representatives shall be deemed a reference to an appropriate Committee of the House of Representatives (specified by the Speaker of the House of Representatives at the time of submission of recommendations under paragraph (4)) and any reference to the Committee on Armed Services of the Senate shall be deemed a reference to an appropriate Committee of the House of Representatives (specified by the Majority Leader of the Senate at the time of submission of such recommendations). (6) Method for adjusting the cap for changes in inflation. If the inflation rate, as measured by the percentage increase in the CPI, is projected to be significantly different from the inflation rate projected by the Council of Economic Advisors to the President as of October 1993, the Secretary may adjust the caps under paragraph (2) so as to reflect such deviation from the projection.