medicare, medicaid, and schip balanced budget refinement act of 1999 medicare, medicaid, and schip balanced budget refinement act of 1999 the medicare, medicaid, and schip balanced budget refinement act of 1999 (also called the balanced budget refinement act or bbra) is a federal law of the united states, enacted in 1999. the bbra was first introduced into the house as h.r. 3075 on october 14, 1999, by rep. william m. thomas (r-ca) with 75 cosponsors. it was read twice and then referred to the senate committee on finance. the bill was then slightly altered and reintroduced by thomas as h.r. 3426 on november 17, 1999. after referral to the house committees on ways and means and commerce, it was incorporated by cross-reference in the conference report into h.r. 3194 on november 18, 1999. the h.r. 3194 bill had been introduced by rep. ernest j. istook, jr. (r-ok) on november 2, 1999, and was enacted with official title: making consolidated appropriations for the fiscal year ending september 30, 2000, and for other purposes. the state health insurance trial (schip or s. h. 1 - t) was administered by the united states department of health and human services. medicare, medicaid, and schip balanced budget refinement act of 1999long titlemedicare, medicaid, and schip balanced budget refinement act of 1999acronyms (colloquial)balanced budget refinement act or bbraenacted bythe 106th united states congresscitationspublic law106-113statutes at large113 stat. 1501codificationacts amendedbalanced budget act of 1997social security acttitles amended42u.s.c. sections amended42 usc §1395legislative historyintroduced in the house as h.r. 3426 by william m. thomas (r–ca) on november 17, 1999committee consideration by committee on ways and means, committee on commercereported by the joint conference committee on november 18, 1999; agreed to by the house on november 18, 1999 (296 - 135) and by the senate on november 19, 1999 (74-24)signed into law by president bill clinton on november 29, 1999 the bbra was signed by president bill clinton on november 29, 1999, after passing in congress.