[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4583 Introduced in House (IH)]







105th CONGRESS
  2d Session
                                H. R. 4583

 To amend title XIX of the Social Security Act to allow States to use 
the funds available under the State children's health insurance program 
for an enhanced matching rate for coverage of additional children under 
                         the Medicaid Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 16, 1998

    Ms. Dunn (for herself, Mr. White, Mr. McDermott, Mr. Dicks, Mr. 
Nethercutt, Mr. Hastings of Washington, Mrs. Linda Smith of Washington, 
 Mr. Metcalf, Mr. Adam Smith of Washington, Mr. Ramstad, Mr. Sabo, and 
  Mr. Peterson of Minnesota) introduced the following bill; which was 
                 referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend title XIX of the Social Security Act to allow States to use 
the funds available under the State children's health insurance program 
for an enhanced matching rate for coverage of additional children under 
                         the Medicaid Program.

    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 ``Children's Health Equity Act of 
1998''.

SEC. 2. USE OF STATE CHILDREN'S HEALTH INSURANCE PROGRAM FUNDS FOR 
              ENHANCED MATCHING RATE FOR COVERAGE OF ADDITIONAL 
              CHILDREN UNDER THE MEDICAID PROGRAM.

    (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended--
            (1) in subsection (b), by striking ``or subsection (u)(3)'' 
        and inserting ``, subsection (u)(3), or subsection (u)(4)(A)''; 
        and
            (2) in subsection (u) (as added by section 4911(a)(2) of 
        the Balanced Budget Act of 1997 and as amended by section 162 
        of Public Law 105-100)--
                    (A) by redesignating paragraph (4) as paragraph 
                (5); and
                    (B) by inserting after paragraph (3) the following 
                new paragraph:
    ``(4)(A) For purposes of subsection (b), the expenditures described 
in this subparagraph are expenditures for medical assistance for 
waivered low-income children described in subparagraph (B) but--
            ``(i) only in the case of children residing in a State 
        described in subparagraph (C); and
            ``(ii) only to the extent the number of full-year 
        equivalent waivered low-income children enrolled under the 
        State plan under this title for the fiscal year exceeds the 
        number of waivered low-income children described in 
        subparagraph (D)(i) for the State for the fiscal year.
    ``(B) For purposes of this paragraph, the term `waivered low-income 
child' means a child whose family income exceeds the minimum income 
level required to be established for the age of such child under 
section 1902(l)(2) in order for the child to be eligible for medical 
assistance under this title, but does not exceed the medicaid 
applicable income level (as defined in section 2110(b)(4) but 
determined as if `June 1, 1997' were substituted for `March 31, 1997') 
for that child.
    ``(C) A State described in this subparagraph is a State that--
            ``(i) has under a waiver authorized by the Secretary or 
        under section 1902(r)(2) established a medicaid applicable 
        income level (as defined in section 2110(b)(4) but determined 
        as if `June 1, 1997' were substituted for `March 31, 1997') for 
        children under 19 years of age residing in the State that is at 
        or above 200 percent of the poverty line; and
            ``(ii) demonstrates to the satisfaction of the Secretary a 
        commitment to reach and enroll children who are eligible for, 
        but not enrolled under, the State plan through means, such as 
        the following:
                    ``(I) Eliminating the assets test for eligibility 
                of waivered low-income children.
                    ``(II) Using shortened and simplified applications 
                for such children.
                    ``(III) Allowing applications for such children to 
                be submitted by mail or through telephone.
                    ``(IV) Outstationing State eligibility workers at 
                sites that are frequented by families with children, 
                including schools, child care centers, churches, 
                centers providing Head Start services, local offices of 
                the special supplemental food program for women, 
                infants and young children (WIC) established under 
                section 17 of the Child Nutrition Act of 1966, 
                community centers, Job Corps centers established under 
                part B of title IV of the Job Training Partnership Act 
                or subtitle C of title I of the Workforce Investment 
                Act of 1998, sites offering the recognized equivalent 
                of a secondary school degree, offices of tribal 
                organizations (as defined in section 4(l) of the Indian 
                Self-Determination and Education Assistance Act), and 
                Social Security Administration field offices.
                    ``(V) Using presumptive eligibility for waivered 
                low-income children.
                    ``(VI) Collaborating with public and private 
                entities to conduct outreach campaigns to enroll such 
                children.
    ``(D)(i) For purposes of subparagraph (A)(ii), the number of 
waivered low-income children for a State described in this clause for--
            ``(I) fiscal year 1998, is equal to the number of full-year 
        equivalent waivered low-income children enrolled under the 
        State plan under this title for fiscal year 1997; and
            ``(II) fiscal year 1999 or a succeeding fiscal year, is 
        equal to the number of waivered low-income children determined 
        under this clause for the preceding fiscal year increased by 
        the number of percentage points determined under clause (ii) 
        for the State for the fiscal year involved.
    ``(ii) The number of percentage points determined under this clause 
for a State for a fiscal year is equal to the number of percentage 
points by which--
            ``(I) the arithmetic average of the total number of 
        children in the State set forth in the 3 most recent March 
        supplements to the Current Population Survey of the Bureau of 
        the Census before the beginning of the fiscal year; exceeds
            ``(II) the arithmetic average of such total number set 
        forth in the second, third, and fourth most recent March 
        supplements to such Survey before the beginning of the fiscal 
        year.
    ``(E) For purposes of section 2104(d) (regarding the reduction of 
an allotment under title XXI) the amount determined under paragraph (2) 
of that section shall, with respect to expenditures described in 
subparagraph (A), only take into account the amount by which--
            ``(i) the payments made to a State for such expenditures 
        for a fiscal year on the basis of an enhanced FMAP under the 
        fourth sentence of subsection (b); exceed
            ``(ii) the amount of payments that would have been made for 
        the expenditures if the enhanced FMAP did not apply.
    ``(F) Each State shall submit to the Secretary such information, at 
such time and in such manner, as the Secretary determines is necessary 
to ensure that the requirements of this paragraph are satisfied. The 
Secretary shall ensure that information is provided under this 
subsection in a manner that is consistent with other reporting 
requirements for information required to be submitted by a State under 
this title and title XXI, and avoids duplication of reporting 
requirements.
    ``(G) The Secretary shall regularly examine the payments made to a 
State for the expenditures described in subparagraph (A) to confirm 
that the payments are attributable to expenditures described in such 
subparagraph.''.
    (b) Conforming Amendments.--
            (1) Section 1902(a)(10)(A)(ii)(XIV) of the Social Security 
        Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XIV)) is amended by striking 
        ``1905(u)(2)(C)'' and inserting ``1905(u)(2)(B)''.
            (2) Section 2104(d)(2) of the Social Security Act (42 
        U.S.C. 1397dd(d)(2)) is amended by inserting ``subject to 
        section 1905(u)(4)(E),'' after ``(2)''.
    (c) Effective Date.--The amendments made by this section shall be 
effective as if included in the enactment of section 4911 of the 
Balanced Budget Act of 1997 (Public Law 105-33; 111 Stat. 570).

SEC. 3. EXPANSION OF PRESUMPTIVE ELIGIBILITY OPTION FOR CHILDREN UNDER 
              THE MEDICAID PROGRAM.

    (a) In General.--Section 1920A(b)(3)(A)(i) of the Social Security 
Act (42 U.S.C. 1396r-1a(b)(3)(A)(i)) is amended--
            (1) by striking ``or (II)'' and inserting ``, (II)''; and
            (2) by inserting before the semicolon ``, eligibility for 
        assistance under the State plan under part A of title IV, 
        eligibility of a child to receive medical assistance under the 
        State plan under this title or title XXI, (III) is a staff 
        member of an elementary school or secondary school, as such 
        terms are defined in section 14101 of the Elementary and 
        Secondary Education Act of 1965 (20 U.S.C. 8801), a child care 
        resource and referral center, or an agency administering a 
        State plan under part D of title IV, or (IV) is so designated 
        by the State''.
    (b) Conforming Amendments.--Section 1920A of such Act (42 U.S.C. 
1396r-1a) is amended--
            (1) in subsection (b)(3)(A)(ii), by striking ``paragraph 
        (1)(A)'' and inserting ``paragraph (2)(A)''; and
            (2) in subsection (c)(2), in the matter preceding 
        subparagraph (A), by striking ``subsection (b)(1)(A)'' and 
        inserting ``subsection (b)(2)(A)''.
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