and inserting 10 percent . (b) Effective date The amendments made by this section shall apply to distributions made in taxable years beginning after December 31, 2023. 8. Treatment of health care sharing ministries (a) Inclusion as medical expenses Paragraph (2) of section 223(d) of the Internal Revenue Code of 1986, as amended by sections 4 and 5, is further amended by adding at the end the following new subparagraph: (E) Inclusion of health care sharing ministries The term qualified medical expenses shall include amounts paid by a member of a health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii) without regard to subclause (IV) thereof) for— (i) the sharing of medical expenses among members, and (ii) administrative fees of the ministry. . (b) Health care sharing ministry not To be treated as health insurance Subsection (c) of section 223 of the Internal Revenue Code of 1986, as amended by sections 2 and 5, is further amended by adding at the end the following new paragraph: (5) Treatment of health care sharing ministries A health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii) without regard to subclause (IV) thereof) shall not be treated as a health plan or insurance for purposes of this title. . (c) Effective date The amendments made by this section shall apply to taxable years beginning after December 31, 2023. 9. Health care sharing ministry fees treated as medical care (a) In general Section 213(d) of the Internal Revenue Code of 1986, as amended by section 6, is further amended by adding at the end the following new paragraph: (13) Health care sharing ministries Amounts paid for membership in a health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii) without regard to subclause (IV) thereof) shall be treated as amounts paid for medical care. . (b) Effective date The amendment made by this section shall apply to taxable years beginning after December 31, 2023.