[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3659 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 3659

 To amend title XIX of the Social Security Act to improve the Federal 
medical assistance percentage used under the medicaid program, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 22, 1993

  Mrs. Maloney (for herself, Mr. Rangel, Mr. Gilman, Mr. Manton, Mr. 
      Nadler, Mr. Engel, Mrs. Lowey, Mr. Owens, Mr. Hinchey, Mr. 
Hochbrueckner, Mr. McNulty, Mr. Flake, Ms. Velazquez, Mr. Schumer, Mr. 
  Ackerman, Ms. Slaughter, Mr. Quinn, and Mr. Serrano) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend title XIX of the Social Security Act to improve the Federal 
medical assistance percentage used under the medicaid program, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Fair Funding Act of 1993''.

SEC. 2. CHANGE IN FEDERAL MEDICAL ASSISTANCE PERCENTAGE.

    (a) In General.--Subsection (b) of section 1905 of the Social 
Security Act (42 U.S.C. 1396d(b)) is amended to read as follows:
    ``(b)(1)(A) Except as provided in paragraph (3), the term `Federal 
medical assistance percentage' means, for each of the 50 States and the 
District of Columbia, 100 percent reduced by the product of the 
applicable percentage (as defined in subparagraph (B)) and the ratio 
of--
            ``(i) the per capita income ratio (as defined in 
        subparagraph (C)) of the State, to--
            ``(ii) the population in poverty ratio (as defined in 
        subparagraph (D)) of the State.
    ``(B)(i) For purposes of this subsection, the term `applicable 
percentage' means a percentage estimated by the Secretary with the 
advice of the General Accounting Office that, when applied under 
subparagraph (A), would result in an amount of aggregate payments under 
section 1903(a) for calendar years 1994 through 1998 equal to the 
amount of aggregate payments that would have been made under such 
section for quarters in such years if this subsection were applied as 
in effect on the day before the date of the enactment of the Medicaid 
Fair Funding Act of 1993.
    ``(ii) The applicable percentage estimated by the Secretary under 
clause (i) shall continue to apply with respect to quarters beginning 
after calendar year 1998.
    ``(C) For purposes of this subsection, the term `per capita income 
ratio' means--
            ``(i) an amount equal to the most recent 3-year average of 
        the total personal income of the State, as determined in 
        accordance with the provisions of section 1101(a)(8)(B), 
        divided by
            ``(ii) an amount equal to the total personal income of the 
        continental United States (including Alaska and Hawaii), as 
        determined under section 1101(a)(8)(B).
    ``(D) For purposes of this subsection, the term `population in 
poverty ratio' means--
            ``(i) an amount equal to the 3-year-average of the number 
        of individuals in the State whose family income is below the 
        income official poverty line (as defined by the Office of 
        Management and Budget and revised annually in accordance with 
        section 673(2) of the Omnibus Budget Reconciliation Act of 
        1981), divided by
            ``(ii) an amount equal to the sum of the averages 
        determined under clause (i) for the 50 States.
    ``(2) The Federal medical assistance percentage for Puerto Rico, 
the Virgin Islands, Guam, the Northern Mariana Islands, and American 
Samoa shall be 50 percent.
    ``(3)(A) Except as provided in subparagraph (B), the Federal 
medical assistance percentage shall in no case be less than 40 percent 
or greater than 83 percent.
    ``(B) The Federal medical assistance percentage shall be 100 
percent with respect to amounts expended as medical assistance for 
services which are received through an Indian Health Service facility 
whether operated by the Indian Health Service or by an Indian tribe or 
tribal organization (as defined in section 4 of the Indian Health Care 
Improvement Act).
    ``(4) For purposes of any provision of law other than a provision 
of this title, unless otherwise specifically provided, any reference to 
the `Federal medical assistance percentage' as defined in this section 
shall be considered a reference to such term as defined under this 
subsection as in effect on the day before the date of the enactment of 
the Medicaid Fair Funding Act of 1993.''.
    (b) Conforming Amendment.--Section 1118 of the Social Security Act 
(42 U.S.C. 1318) is amended by striking ``(as defined in section 
1905)'' and inserting ``(as defined in section 1905(b), as in effect on 
the day before the date of the enactment of the Medicaid Fair Funding 
Act of 1993)''.
    (c) Effective Date.--The amendments made by this section shall 
apply to payments made to States with respect to calendar quarters 
beginning on or after January 1, 1994.

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