; (2) in subparagraph (C)(i)— (A) by striking fiscal years 2011 through 2017 each place it appears and inserting fiscal years 2011 through 2019 ; and (B) by striking or portion of fiscal year ; and (3) in subparagraph (D)— (A) in the heading, by striking Temporary applicable percentage increase and inserting Applicable percentage increase beginning with fiscal year 2011 ; (B) by striking fiscal years 2011 through 2017, and inserting fiscal years 2011 through 2019 ; and (C) by striking or the portion of fiscal year each place it appears. 4. Budget neutral pay-for For fiscal year 2018 and each subsequent fiscal year, the Secretary of Health and Human Services shall adjust payments under section 1886(d) of the Social Security Act ( 42 U.S.C. 1395ww(d) ) in a manner such that the estimated aggregate amount of expenditures under such section for such fiscal year with application of the amendments made by sections 2 and 3 of this Act is equal to the estimated aggregate amount of expenditures under such section for such fiscal year without application of such amendments.