; (3) by striking medical assistance for such services and vaccines and inserting medical assistance for such services ; and (4) by inserting , and (6) with respect to medical assistance for vaccines described in subsection (a)(13)(B), the Federal medical assistance percentage, as determined under this subsection and subsection (y) (without regard to paragraph (1)(C) of such subsection), shall be increased by 1 percentage point before the first period.