TITLE I--CHIP EXTENSION AND OTHER MEDICAID AND CHIP PROVISIONS

(Sec. 101) This bill extends funding through FY2022 for the Children's Health Insurance Program (CHIP) and the Childhood Obesity Demonstration Project.

In addition, the bill reauthorizes through FY2022:

• the qualifying-states option (which allows states that provided coverage to now CHIP-eligible children prior to CHIP's enactment to continue to provide such coverage), and
• the express-lane eligibility option (which allows states to use eligibility findings from other public benefit programs to determine children's eligibility for Medicaid and CHIP).

Beginning in FY2020, the bill allows state child-health plans to adopt more restrictive eligibility standards with respect to children in families whose income exceeds 300% of the poverty line.

(Sec. 102) The bill extends funding through FY2022 for the Childhood Obesity Demonstration Project and the Pediatric Quality Measures Program.

(Sec. 103) The bill: (1) extends funding through FY2022 for specified outreach and enrollment grants, and (2) makes eligible for such grants "parent-mentors" who are trained to assist families with children who have no health-insurance coverage.

(Sec. 104) Current law provides states with an enhanced Federal Matching Assistance Percentage (FMAP) for child-health assistance through FY2019. The bill maintains the enhanced FMAP in FY2020, but halves the percentage-point increase.

(Sec. 105) The bill eliminates Medicaid payment reductions for disproportionate-share hospitals (which receive additional payment under Medicaid for treating a large share of low-income patients) in FY2018, but extends such reductions by two years (through FY2027).

(Sec. 106) The bill also increases Medicaid funding for Puerto Rico and the U.S. Virgin Islands through FY2019. Such funding shall be further increased through 2019 for both territories if Puerto Rico takes specified actions to improve its Medicaid program.

TITLE II--OFFSETS

(Sec. 201) The bill alters provisions related to third-party liability under Medicaid and CHIP.

(Sec. 202) The bill specifies how a state must treat qualified lottery winnings and lump-sum income for purposes of determining Medicaid eligibility.

(Sec. 203) The bill eliminates Medicare premium subsidies for beneficiaries with annual incomes exceeding $500,000.

This bill amends titles XI (General Provisions), XVIII (Medicare), XIX (Medicaid), and XXI (Children's Health Insurance Program) (CHIP) of the Social Security Act to extend funding for CHIP through FY2022 and otherwise revise CHIP, Medicaid, and Medicare.

The bill also extends funding through FY2022 for:

• the Child Enrollment Contingency Fund,
• the Childhood Obesity Demonstration Project,
• the Pediatric Quality Measures Program, and
• specified outreach and enrollment grants.

In addition, the bill reauthorizes through FY2022:

• the qualifying-states option (which allows states that provided coverage to now CHIP-eligible children prior to CHIP's enactment to continue to provide such coverage), and
• the express-lane eligibility option (which allows states to use eligibility findings from other public benefit programs to determine children's eligibility for Medicaid and CHIP).

Beginning in FY2020, the bill allows state child-health plans to adopt more restrictive eligibility standards with respect to children in families whose income exceeds 300% of the poverty line.

Current law provides states with an enhanced Federal Matching Assistance Percentage (FMAP) for child-health assistance through FY2019. The bill maintains the enhanced FMAP in FY2020, but halves the percentage-point increase.

The bill eliminates Medicaid payment reductions for disproportionate-share hospitals (which receive additional payment under Medicaid for treating a large share of low-income patients) in FY2018, but extends such reductions by two years (through FY2027).

The bill also increases Medicaid funding for Puerto Rico through FY2019. Such funding shall be further increased through 2019 if Puerto Rico takes specified actions to improve its Medicaid program.

In addition, the bill:

• alters provisions related to third-party liability under Medicaid and CHIP,
• specifies how a state must treat qualified lottery winnings and lump-sum income for purposes of determining Medicaid eligibility, and
• eliminates Medicare premium subsidies for beneficiaries with annual incomes exceeding $500,000.