[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3471 Introduced in House (IH)]
107th CONGRESS
1st Session
H. R. 3471
To expand coverage options for unemployed workers to receive and pay
for COBRA health insurance benefits, and to provide for a program of
enhanced unemployment coverage.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 12, 2001
Mr. Moore (for himself, Mr. Leach, Mr. Lewis of Georgia, Mr. Frost, Mr.
Moran of Virginia, Mr. Dicks, Mr. Boswell, Mr. Lampson, Ms. Solis, Ms.
McCarthy of Missouri, Ms. Berkley, Mr. Etheridge, Mr. Israel, Mr.
Sandlin, and Mr. Carson of Oklahoma) introduced the following bill;
which was referred to the Committee on Ways and Means, and in addition
to the Committees on Energy and Commerce, and Education and the
Workforce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To expand coverage options for unemployed workers to receive and pay
for COBRA health insurance benefits, and to provide for a program of
enhanced unemployment coverage.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; ETC.
(a) Short Title.--This Act may be cited as the ``Work Opportunity
and Relief Compensation Act''.
(b) Table of Contents.--
Sec. 1. Short title; etc.
TITLE I--HEALTH INSURANCE
Subtitle A--Health Insurance Coverage Options for Recently Unemployed
Individuals and Their Families
Sec. 101. Premium assistance for COBRA continuation coverage for
individuals and their families.
Sec. 102. State option to provide temporary medicaid coverage for
certain uninsured individuals.
Sec. 103. State option to provide temporary coverage under medicaid for
the unsubsidized portion of COBRA
continuation premiums.
Sec. 104. Temporary increases of medicaid FMAP for fiscal year 2002.
Sec. 105. Definitions.
Subtitle B--Other Provisions
Sec. 111. Inclusion of Indian women with breast or cervical cancer in
optional medicaid eligibility category.
Sec. 112. Increase in floor for treatment as an extremely low DSH State
to 3 percent in fiscal year 2002.
Sec. 113. Moratorium on changes to certain upper payment limits under
medicaid.
Sec. 114. Revision and simplification of the Transitional Medical
Assistance Program (TMA).
TITLE II--TEMPORARY ENHANCED UNEMPLOYMENT BENEFITS
Sec. 201. Short title.
Sec. 202. Federal-State agreements.
Sec. 203. Temporary supplemental unemployment compensation account.
Sec. 204. Payments to States having agreements under this title.
Sec. 205. Financing provisions.
Sec. 206. Fraud and overpayments.
Sec. 207. Definitions.
Sec. 208. Applicability.
TITLE I--HEALTH INSURANCE
Subtitle A--Health Insurance Coverage Options for Recently Unemployed
Individuals and Their Families
SEC. 101. PREMIUM ASSISTANCE FOR COBRA CONTINUATION COVERAGE FOR
INDIVIDUALS AND THEIR FAMILIES.
(a) Establishment.--
(1) In general.--Not later than 30 days after the date of
enactment of this Act, the Secretary of the Treasury, in
consultation with the Secretary of Labor, shall establish a
program under which 75 percent of the premium for COBRA
continuation coverage shall be provided for an individual who--
(A) at any time during the period that begins on
September 11, 2001, and ends on December 31, 2002, is
separated from employment; and
(B) is eligible for, and has elected coverage
under, COBRA continuation coverage.
(2) Inclusion of certain individuals.--For purposes of
paragraph (1), the spouse, child, or other individual who was
an insured under health insurance coverage of an individual who
was killed as a result of the terrorist-related aircraft
crashes on September 11, 2001, or as a result of any other
terrorist-related event occurring during the period described
in that paragraph, and who is eligible for, and has elected
coverage under, COBRA continuation coverage shall be eligible
for premium assistance under the program established under this
section.
(3) State option to elect administration of program.--
(A) In general.--A State may elect to administer
the premium assistance program established under this
section if the State submits to the Secretary of the
Treasury, not later than January 1, 2002, a plan that
describes how the State will administer such program on
behalf of the individuals described in paragraph (1) or
(2) who reside in the State beginning on that date.
(B) State entitlement.--In the case of a State that
submits a plan under subparagraph (A), the Secretary of
the Treasury shall pay to each such State an amount for
each quarter equal to the total amount of
premium subsidies provided in that quarter on behalf of such
individuals.
(4) Immediate implementation.--The program established
under this section shall be implemented without regard to
whether or not final regulations to carry out such program have
been promulgated by the date described in paragraph (1).
(b) Limitation of Period of Premium Assistance.--
(1) In general.--Premium assistance provided in accordance
with this section shall end with respect to an individual on
the earlier of--
(A) the date the individual is no longer covered
under COBRA continuation coverage; or
(B) 12 months after the date the individual is
first enrolled in the premium assistance program
established under this section.
(2) No assistance after december 31, 2002.--No premium
assistance (including payment for such assistance) may be
provided under this section after December 31, 2002.
(c) Payment Arrangements; Crediting of Assistance.--
(1) Provision of assistance.--
(A) In general.--Premium assistance shall be
provided under the program established under this
section through direct payment arrangements with a
group health plan (including a multiemployer plan), an
issuer of health insurance coverage, an administrator,
or an employer as appropriate with respect to the
individual provided such assistance.
(B) Additional option for state-run program.--In
the case of a State that elects to administer the
program established under this section, such assistance
may be provided through the State public employment
office or other agency responsible for administering
the State unemployment compensation program.
(2) Premiums payable by individual reduced by amount of
assistance.--Premium assistance provided under this section
shall be credited by the group health plan, issuer of health
insurance coverage, or an administrator against the premium
otherwise owed by the individual involved for COBRA
continuation coverage.
(d) Program Requirements.--Premium assistance shall be provided
under the program established under this section consistent with the
following:
(1) All qualifying individuals may apply.--All individuals
described in paragraph (1) or (2) of subsection (a) may apply
for such assistance at any time during the period described in
subsection (a)(1)(A).
(2) Selection on first-come, first-served basis.--Such
assistance shall be provided to such individuals who apply for
the assistance in the order in which they apply.
(e) Limitation on Entitlement.--Nothing in this section shall be
construed as establishing any entitlement of individuals described in
paragraph (1) or (2) of subsection (a) to premium assistance under this
section.
(f) Disregard of Subsidies for Purposes of Federal and State
Programs.--Notwithstanding any other provision of law, any premium
assistance provided to, or on behalf of, an individual under this
section, shall not be considered income or resources in determining
eligibility for, or the amount of assistance or benefits provided
under, any other Federal public benefit or State or local public
benefit.
(g) Change in COBRA Notice.--
(1) General notice.--
(A) In general.--In the case of notices provided
under section 4980B(f)(6) of the Internal Revenue Code
of 1986, section 2206 of the Public Health Service Act
(42 U.S.C. 300bb-6), section 606 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C.
1166), or section 8905a(f)(2)(A) of title 5, United
States Code, with respect to individuals who, during
the period described in subsection (a)(1)(A), become
entitled to elect COBRA continuation coverage, such
notices shall include an additional notification to the
recipient of the availability of premium assistance for
such coverage under this section and for temporary
medicaid assistance under section 103 for the remaining
portion of COBRA continuation premiums.
(B) Alternative notice.--In the case of COBRA
continuation coverage to which the notice provision
under such sections does not apply, the Secretary of
the Treasury, in consultation with the Secretary of
Labor, shall, in coordination with administrators of
the group health plans (or other entities) that provide
or administer the COBRA continuation coverage involved,
assure the provision of such notice.
(C) Form.--The requirement of the additional
notification under this paragraph may be met by
amendment of existing notice forms or by inclusion of a
separate document with the notice otherwise required.
(2) Specific requirements.--Each additional notification
under paragraph (1) shall include--
(A) the forms necessary for establishing
eligibility and enrollment in the premium assistance
program established under this section in connection
with the coverage with respect to each covered employee
or other qualified beneficiary;
(B) the name, address, and telephone number
necessary to contact the administrator and any other
person maintaining relevant information in connection
with the premium assistance; and
(C) the following statement displayed in a
prominent manner:
``You may be eligible to receive assistance with payment of 75
percent of your COBRA continuation coverage premiums and with temporary
medicaid coverage for the remaining premium portion for a duration of
not to exceed 12 months.''.
(3) Notice relating to retroactive coverage.--In the case
of such notices previously transmitted before the date of
enactment of this Act in the case of an individual described in
paragraph (1) who has elected (or is still eligible to elect)
COBRA continuation coverage as of the date of enactment of this
Act, the administrator of the group health plan (or other
entity) involved or the Secretary of the Treasury, in
consultation with the Secretary of Labor, (in the case
described in the paragraph (1)(B)) shall provide (within 60
days after the date of enactment of this Act) for the
additional notification required to be provided under paragraph
(1).
(4) Model notices.--Not later than 30 days after the date
of enactment of this Act, the Secretary of the Treasury shall
prescribe models for the additional notification required under
this subsection.
(h) Reports.--Beginning on January 1, 2002, and every 3 months
thereafter until January 1, 2003, the Secretary of the Treasury shall
submit a report to Congress regarding the premium assistance program
established under this section that includes the following:
(1) The status of the implementation of the program.
(2) The number of individuals provided assistance under the
program as of the date of the report.
(3) The average dollar amount (monthly and annually) of the
premium assistance provided under the program.
(4) The number and identification of the States that have
elected to administer the program.
(5) The total amount of expenditures incurred (with
administrative expenditures noted separately) under the program
as of the date of the report.
(i) Appropriation.--
(1) In general.--Out of any funds in the Treasury not
otherwise appropriated, there is appropriated to carry out this
section, such sums as are necessary for each of fiscal years
2002 and 2003.
(2) Obligation of funds.--This section constitutes budget
authority in advance of appropriations Acts and represents the
obligation of the Federal Government to provide for the payment
of premium assistance under this section.
(j) Sunset.--No premium assistance (including payment for such
assistance) may be provided under this section after December 31, 2002.
SEC. 102. STATE OPTION TO PROVIDE TEMPORARY MEDICAID COVERAGE FOR
CERTAIN UNINSURED INDIVIDUALS.
(a) State Option.--Notwithstanding any other provision of law, a
State may elect to provide under its medicaid program under title XIX
of the Social Security Act medical assistance in the case of an
individual--
(1) who at any time during the period that begins on
September 11, 2001, and ends on December 31, 2002, is separated
from employment;
(2) who is not eligible for COBRA continuation coverage;
(3) who is uninsured; and
(4) whose assets, resources, and earned or unearned income
(or both) do not exceed such limitations (if any) as the State
may establish.
(b) Limitation of Period of Coverage.--Medical assistance provided
in accordance with this section shall end with respect to an individual
on the earlier of--
(1) the date the individual is no longer uninsured; or
(2) subject to subsection (c)(4), 12 months after the date
the individual first receives such assistance.
(c) Special Rules.--In the case of medical assistance provided
under this section--
(1) the Federal medical assistance percentage under section
1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) shall
be the enhanced FMAP (as defined in section 2105(b) of such Act
(42 U.S.C. 1397ee(b)));
(2) a State may elect to apply any income, asset, or
resource limitation permitted under the State medicaid plan or
under title XIX of such Act;
(3) the provisions of section 1916(g) of the Social
Security Act (42 U.S.C. 1396o) shall apply to the provision of
such assistance in the same manner as the provisions of such
section apply with respect to individuals provided medical
assistance only under subclause (XV) or (XVI) of section
1902(a)(10)(A)(ii) of such Act (42 U.S.C. 1396a(a)(10)(A)(ii));
(4) a State may elect to provide such assistance in
accordance with section 1902(a)(34) of the Social Security Act
(42 U.S.C. 1396a(a)(34)) and any assistance provided with
respect to a month described in that section shall not be
included in the determination of the 12-month period under
subsection (b)(2);
(5) a State may elect to make eligible for such medical
assistance a dependent spouse or children of an individual
eligible for medical assistance under subsection (a), if such spouse or
children are uninsured;
(6) individuals eligible for medical assistance under this
section shall be deemed to be described in the list of
individuals described in the matter preceding paragraph (1) of
section 1905(a) of such Act (42 U.S.C. 1396d(a));
(7) a State may elect to provide such medical assistance
without regard to any limitation under sections 401(a), 402(b),
403, and 421 of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 (8 U.S.C. 1611(a),
1612(b), 1613, and 1631) and no debt shall accrue under an
affidavit of support against any sponsor of an individual who
is an alien who is provided such assistance, and the cost of
such assistance shall not be considered as an unreimbursed
cost; and
(8) the Secretary of Health and Human Services shall not
count, for purposes of section 1108(f) of the Social Security
Act (42 U.S.C. 1308(f)), such amount of payments under this
section as bears a reasonable relationship to the average
national proportion of payments made under this section for the
50 States and the District of Columbia to the payments
otherwise made under title XIX for such States and District.
(d) Sunset.--No medical assistance may be provided under this
section after December 31, 2002.
SEC. 103. STATE OPTION TO PROVIDE TEMPORARY COVERAGE UNDER MEDICAID FOR
THE UNSUBSIDIZED PORTION OF COBRA CONTINUATION PREMIUMS.
(a) State Option.--
(1) In general.--Notwithstanding any other provision of
law, a State may elect to provide under its medicaid program
under title XIX of the Social Security Act medical assistance
in the form of payment for the portion of the premium for COBRA
continuation coverage for which an individual does not receive
a subsidy under the premium assistance program established
under section 101 in the case of an individual--
(A) who at any time during the period that begins
on September 11, 2001, and ends on December 31, 2002,
is separated from employment;
(B) who is eligible for, and has elected coverage
under, COBRA continuation coverage;
(C) who is receiving premium assistance under the
program established under section 101; and
(D) whose family income does not exceed 200 percent
of the poverty line.
(2) Inclusion of certain individuals.--For purposes of
paragraph (1), the spouse, child, or other individual who was
an insured under health insurance coverage of an individual who
was killed as a result of the terrorist-related aircraft
crashes on September 11, 2001, or as a result of any other
terrorist-related event occurring during the period described
in that paragraph, and who satisfies the requirements of
subparagraphs (B), (C), and (D) of paragraph (1) shall be
eligible for medical assistance under this section.
(b) Limitation of Period of Coverage.--Medical assistance provided
in accordance with this section shall end with respect to an individual
on the earlier of--
(1) the date the individual is no longer covered under
COBRA continuation coverage; or
(2) 12 months after the date the individual first receives
such assistance under this section.
(c) Special Rules.--In the case of medical assistance provided
under this section--
(1) such assistance may be provided without regard to--
(A) whether the State otherwise has elected to make
medical assistance available for COBRA premiums under
section 1902(a)(10)(F) of the Social Security Act (42
U.S.C. 1396a(a)(10)(F)); or
(B) the conditions otherwise imposed for the
provision of medical assistance for such COBRA premiums
under clause (XII) of the matter following section
1902(a)(10)(G) of the Social Security Act (42 U.S.C.
1396a(a)(10)(G)), or paragraphs (1)(B), (1)(C), (1)(D),
and (4) of section 1902(u) of such Act (42 U.S.C.
1396a(u)); and
(2) paragraphs (1), (2), (4), (5), (7), and (8) of
subsection (c) of section 102 apply to such assistance in the
same manner as such paragraphs apply to the provision of
medical assistance under that section.
(d) Sunset.--No medical assistance may be provided under this
section after December 31, 2002.
SEC. 104. TEMPORARY INCREASES OF MEDICAID FMAP FOR FISCAL YEAR 2002.
(a) Permitting Maintenance of Fiscal Year 2001 FMAP.--
Notwithstanding any other provision of law, but subject to subsection
(d), if the FMAP determined without regard to this section for a State
for fiscal year 2002 is less than the FMAP as so determined for fiscal
year 2001, the FMAP for the State for fiscal year 2001 shall be
substituted for the State's FMAP for fiscal year 2002, before the
application of this section.
(b) General 1.50 Percentage Points Increase.--Notwithstanding any
other provision of law, but subject to subsections (d) and (e), for
each State for each calendar quarter in fiscal year 2002, the FMAP
(taking into account the application of subsection (a)) shall be
increased by 1.50 percentage points.
(c) Further Increase for States With High Unemployment Rates.--
(1) In general.--Notwithstanding any other provision of
law, but subject to subsections (d) and (e), the FMAP for a
high unemployment State for a calendar quarter in fiscal year
2002 (and any subsequent calendar quarter in such fiscal year
regardless of whether the State continues to be a high
unemployment State for a calendar quarter in such fiscal year)
shall be increased (after the application of subsections (a)
and (b)) by 1.50 percentage points.
(2) High unemployment state.--For purposes of this
subsection, a State is a high unemployment State for a calendar
quarter if, for any 3 consecutive months beginning on or after
June 2001 and ending with the second month before the beginning
of the calendar quarter, the State has an unemployment rate
that exceeds the national average unemployment rate. Such
unemployment rates for such months shall be determined based on
publications of the Bureau of Labor Statistics of the
Department of Labor.
(d) 1-Year Increase in Cap on Medicaid Payments to Territories.--
Notwithstanding any other provision of law, with respect to fiscal year
2002, the amounts otherwise determined for Puerto Rico, the Virgin
Islands, Guam, the Northern Mariana Islands, and American Samoa under
section 1108 of the Social Security Act (42 U.S.C. 1308) shall each be
increased by an amount equal to 3.093 percentage points of such
amounts.
(e) Scope of Application.--The increases in the FMAP for a State
under this section shall apply only for purposes of title XIX of the
Social Security Act and shall not apply with respect to--
(1) disproportionate share hospital payments described in
section 1923 of such Act (42 U.S.C. 1396r-4); and
(2) payments under titles IV and XXI of such Act (42 U.S.C.
601 et seq. and 1397aa et seq.).
(f) State Eligibility.--A State is eligible for an increase in its
FMAP under subsection (b) or (c) only if the eligibility under its
State plan under title XIX of the Social Security Act (including any
waiver under such title or under section 1115 of such Act (42 U.S.C.
1315)) is no more restrictive than the eligibility under such plan (or
waiver) as in effect on October 1, 2001.
SEC. 105. DEFINITIONS.
In this subtitle:
(1) Administrator.--The term ``administrator'' has the
meaning given that term in section 3(16)(A) of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1002(16)(A)).
(2) COBRA continuation coverage.--
(A) In general.--The term ``COBRA continuation
coverage'' means coverage under a group health plan
provided by an employer pursuant to title XXII of the
Public Health Service Act, section 4980B of the
Internal Revenue Code of 1986, part 6 of subtitle B of
title I of the Employee Retirement Income Security Act
of 1974, or section 8905a of title 5, United States
Code.
(B) Application to employers in states requiring
such coverage.--Such term includes such coverage
provided by an employer in a State that has enacted a
law that requires the employer to provide such coverage
even though the employer would not otherwise be
required to provide such coverage under the provisions
of law referred to in subparagraph (A).
(3) Covered employee.--The term ``covered employee'' has
the meaning given that term in section 607(2) of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1167(2)).
(4) Federal public benefit.--The term ``Federal public
benefit'' has the meaning given that term in section 401(c) of
the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (8 U.S.C. 1611(c)).
(5) FMAP.--The term ``FMAP'' means the Federal medical
assistance percentage, as defined in section 1905(b) of the
Social Security Act (42 U.S.C. 1396d(b)).
(6) Group health plan.--The term ``group health plan'' has
the meaning given that term in section 2791(a) of the Public
Health Service Act (42 U.S.C. 300gg-91(a)) and in section
607(1) of the Employee Retirement Income Security Act of 1974
(29 U.S.C. 1167(1)).
(7) Health insurance coverage.--The term ``health insurance
coverage'' has the meaning given that term in section
2791(b)(1) of the Public Health Service Act (42 U.S.C. 300gg-
91(b)(1)).
(8) Multiemployer plan.--The term ``multiemployer plan''
has the meaning given that term in section 3(37) of the
Employee Retirement Income Security Act of 1974 (29 U.S.C.
1002(37)).
(9) Poverty line.--The term ``poverty line'' has the
meaning given that term in section 2110(c)(5) of the Social
Security Act (42 U.S.C. 1397jj(c)(5)).
(10) Qualified beneficiary.--The term ``qualified
beneficiary'' has the meaning given that term in section 607(3)
of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1167(3)).
(11) State.--The term ``State'' has the meaning given such
term for purposes of title XIX of the Social Security Act (42
U.S.C. 1396 et seq.).
(12) State or local public benefit.--The term ``State or
local public benefit'' has the meaning given that term in
section 411(c) of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 (8 U.S.C. 1621(c)).
(13) Uninsured.--
(A) In general.--The term ``uninsured'' means, with
respect to an individual, that the individual is not
covered under--
(i) a group health plan;
(ii) health insurance coverage; or
(iii) a program under title XVIII, XIX, or
XXI of the Social Security Act (other than
under such title XIX pursuant to section 102).
(B) Exclusion.--Such coverage under clause (i) or
(ii) shall not include coverage consisting solely of
coverage of excepted benefits (as defined in section
2791(c) of the Public Health Service Act (42 U.S.C.
300gg-91(c)).
Subtitle B--Other Provisions
SEC. 111. INCLUSION OF INDIAN WOMEN WITH BREAST OR CERVICAL CANCER IN
OPTIONAL MEDICAID ELIGIBILITY CATEGORY.
(a) In General.--Notwithstanding any other provision of law, during
fiscal year 2002, the subsection (aa) of section 1902 of the Social
Security Act (42 U.S.C. 1396a) added by section 2(a)(2) of the Breast
and Cervical Cancer Prevention and Treatment Act of 2000 (Public Law
106-354; 114 Stat. 1381) shall be applied as if ``, but applied without
regard to paragraph (1)(F) of such section'' were inserted before the
period in paragraph (4).
(b) Technical Amendments.--
(1) Section 1902 of the Social Security Act (42 U.S.C.
1396a), as amended by section 702(b) of the Medicare, Medicaid,
and SCHIP Benefits Improvement and Protection Act of 2000 (as
enacted into law by section 1(a)(6) of Public Law 106-554) (114
Stat. 2763A-572), is amended by redesignating the subsection
(aa) added by such section as subsection (bb).
(2) Section 1902(a)(15) of the Social Security Act (42
U.S.C. 1396a(a)(15)), as added by section 702(a)(2) of the
Medicare, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 (as so enacted into law) (114 Stat.
2763A-572), is amended by striking ``subsection (aa)'' and
inserting ``subsection (bb)''.
(3) Section 1915(b) of the Social Security Act (42 U.S.C.
1396n(b)), as amended by section 702(c)(2) of the Medicare,
Medicaid, and SCHIP Benefits Improvement and Protection Act of
2000 (as so enacted into law) (114 Stat. 2763A-574), is amended
by striking ``1902(aa)'' and inserting ``1902(bb)''.
(4) The amendments made this subsection shall take effect
as if included in the enactment of section 702 of the Medicare,
Medicaid, and SCHIP Benefits Improvement and Protection Act of
2000 (as enacted into law by section 1(a)(6) of Public Law 106-
554) (114 Stat. 2763A-572).
SEC. 112. INCREASE IN FLOOR FOR TREATMENT AS AN EXTREMELY LOW DSH STATE
TO 3 PERCENT IN FISCAL YEAR 2002.
Section 1923(f)(5) of the Social Security Act (42 U.S.C. 1396r-
4(f)(5)) is amended--
(1) by striking ``In the case of'' and inserting the
following:
``(A) In general.--In the case of''; and
(2) by adding at the end the following new subparagraph:
``(B) Fiscal year 2002.--With respect to fiscal
year 2002, subparagraph (A) shall be applied--
``(i) as if `fiscal year 2000' were
substituted for `fiscal year 1999';
``(ii) as if `August 31, 2001' were
substituted for `August 31, 2000';
``(iii) as if `3 percent' were substituted
for `1 percent' each place it appears;
``(iv) as if `fiscal year 2002' were
substituted for `fiscal year 2001'; and
``(v) without regard to the second sentence
of that subparagraph.''.
SEC. 113. MORATORIUM ON CHANGES TO CERTAIN UPPER PAYMENT LIMITS UNDER
MEDICAID.
(a) In General.--Except as provided in subsection (b), during the
period that begins on October 1, 2001, and ends on March 31, 2002, the
Secretary of Health and Human Services (in this section referred to as
the ``Secretary'') may not implement any modification to the upper
payment limit requirements under title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.) for services furnished by non-State
government-owned or operated hospitals.
(b) Exception.--The Secretary may implement any changes to such
limits that were published in the Federal Register as a final rule
before October 1, 2001.
SEC. 114. REVISION AND SIMPLIFICATION OF THE TRANSITIONAL MEDICAL
ASSISTANCE PROGRAM (TMA).
(a) Option of Continuous Eligibility for 12 Months; Option of
Continuing Coverage for Up To an Additional Year.--
(1) Option of continuous eligibility for 12 months by
making reporting requirements optional.--Section 1925(b) of the
Social Security Act (42 U.S.C. 1396r-6(b)) is amended--
(A) in paragraph (1), by inserting ``, at the
option of a State,'' after ``and which'';
(B) in paragraph (2)(A), by inserting ``Subject to
subparagraph (C)--'' after ``(A) Notices.--'';
(C) in paragraph (2)(B), by inserting ``Subject to
subparagraph (C)--'' after ``(B) Reporting
requirements.--'';
(D) by adding at the end the following new
subparagraph:
``(C) State option to waive notice and reporting
requirements.--A State may waive some or all of the
reporting requirements under clauses (i) and (ii) of
subparagraph (B). Insofar as it waives such a reporting
requirement, the State need not provide for a notice
under subparagraph (A) relating to such requirement.'';
and
(E) in paragraph (3)(A)(iii), by inserting ``the
State has not waived under paragraph (2)(C) the
reporting requirement with respect to such month under
paragraph (2)(B) and if'' after ``6-month period if''.
(2) State option to extend eligibility for low-income
individuals for up to 12 additional months.--Section 1925 of
such Act (42 U.S.C. 1396r-6) is further amended--
(A) by redesignating subsections (c) through (f) as
subsections (d) through (g); and
(B) by inserting after subsection (b) the following
new subsection:
``(c) State Option of Up To 12 Months of Additional Eligibility.--
``(1) In general.--Notwithstanding any other provision of
this title, each State plan approved under this title may
provide, at the option of the State, that the State shall offer
to each family which received assistance during the entire 6-
month period under subsection (b) and which meets the
applicable requirement of paragraph (2), in the last month of
the period the option of extending coverage under this
subsection for the succeeding period not to exceed 12 months.
``(2) Income restriction.--The option under paragraph (1)
shall not be made available to a family for a succeeding period
unless the State determines that the family's average gross
monthly earnings (less such costs for such child care as is
necessary for the employment of the caretaker relative) as of
the end of the 6-month period under subsection (b) does not
exceed 185 percent of the 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) applicable to a family of the size
involved.
``(3) Application of extension rules.--The provisions of
paragraphs (2), (3), (4), and (5) of subsection (b) shall apply
to the extension provided under this subsection in the same
manner as they apply to the extension provided under subsection
(b)(1), except that for purposes of this subsection--
``(A) any reference to a 6-month period under
subsection (b)(1) is deemed a reference to the
extension period provided under paragraph (1) and any
deadlines for any notices or reporting and the premium
payment periods shall be modified to correspond to the
appropriate calendar quarters of coverage provided
under this subsection; and
``(B) any reference to a provision of subsection
(a) or (b) is deemed a reference to the corresponding
provision of subsection (b) or of this subsection,
respectively.''.
(b) State Option To Waive Receipt of Medicaid for 3 of Previous 6
Months To Qualify for TMA.--Section 1925(a)(1) of such Act (42 U.S.C.
1396r-6(a)(1)) is amended by adding at the end the following: ``A State
may, at its option, also apply the previous sentence in the case of a
family that was receiving such aid for fewer than 3 months, or that had
applied for and was eligible for such aid for fewer than 3 months,
during the 6 immediately preceding months described in such
sentence.''.
(c) CMS Report on Enrollment and Participation Rates Under TMA.--
Section 1925 of such Act (42 U.S.C. 1396r-6), as amended by subsection
(a)(2)(A), is amended--
(1) by further redesignating subsection (g) as subsection
(i); and
(2) by inserting after subsection (f) the following new
subsection:
``(g) Additional Provisions.--
``(1) Collection and reporting of participation
information.--
``(A) In general.--Each State shall--
``(i) collect and submit to the Secretary,
in a format specified by the Secretary,
information on average monthly enrollment and
average monthly participation rates for adults
and children under this section; and
``(ii) make such information publicly
available.
``(B) Timing of submission.--Information required
to be submitted under subparagraph (A)(i) shall be
submitted under that subparagraph at the same time and
frequency in which other enrollment information under
this title is submitted to the Secretary.
``(C) Annual report to congress.--The Secretary
shall submit to Congress annual reports concerning such
rates using the information required to be submitted
under subparagraph (A)(i).''.
(d) Coordination of Work.--Section 1925(g) of such Act (42 U.S.C.
1396r-6), as added by subsection (c), is amended by adding at the end
the following new paragraph:
``(2) Coordination with administration for children and
families.--The Administrator of the Centers for Medicare &
Medicaid Services, in carrying out this section, shall work
with the Assistant Secretary for the Administration for
Children and Families to develop guidance or other technical
assistance for States regarding best practices in guaranteeing
access to transitional medical assistance under this
section.''.
(e) Elimination of TMA Requirement for States That Extend Coverage
to Children and Parents Through 185 Percent of Poverty.--
(1) In general.--Section 1925 of such Act (42 U.S.C. 1396r-
6), as amended by subsection (c), is further amended by
inserting after subsection (g) the following new subsection:
``(h) Provisions Optional for States That Extend Coverage to
Children and Parents Through 185 Percent of Poverty.--A State may (but
is not required to) meet the requirements of subsections (a) and (b) if
it provides for medical assistance under this title (whether under
section 1931, through a waiver under section 1115, or otherwise) to
families (including both children and caretaker relatives) the average
gross monthly earning of which (less such costs for such child care as
is necessary for the employment of a caretaker relative) is at or below
a level that is at least 185 percent of the 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) applicable to a family of the size involved.''.
(2) Conforming amendments.--Section 1925 of such Act (42
U.S.C. 1396r-6) is further amended, in subsections (a)(1) and
(b)(1), by inserting ``, but subject to subsection (h),'' after
``Notwithstanding any other provision of this title,'' each
place it appears.
(f) Requirement of Notice for All Families Losing TANF.--Subsection
(a)(2) of section 1925 of such Act (42 U.S.C. 1396r-6) is amended by
adding after and below subparagraph (B), the following:
``Each State shall provide, to families whose aid or assistance
under part A or E of title IV has terminated but whose
eligibility for medical assistance under this title continues,
written notice of their ongoing eligibility for such medical
assistance. If a State makes a determination that any member of
a family whose aid or assistance under part A or E of title IV
is being terminated is also no longer eligible for medical
assistance under this title, the notice of such determination
shall be supplemented by a 1-page notification form describing
the different ways in which individuals and families may
qualify for such medical assistance and explaining that
individuals and families do not have to be receiving aid or
assistance under part A or E of title IV in order to qualify
for such medical assistance.''.
(g) Extending Use of Outstationed Workers To Accept Applications
for Transitional Medical Assistance.--Section 1902(a)(55) of the Social
Security Act (42 U.S.C. 1396a(a)(55)) is amended by inserting ``and
under section 1931'' after ``(a)(10)(A)(ii)(IX)''.
(h) Effective Dates.--
(1) In general.--Except as provided in paragraphs (2) and
(3), the amendments made by this section shall apply to
calendar quarters beginning on or after October 1, 2001,
without regard to whether final regulations to carry out such
amendments have been promulgated by such date.
(2) Notice requirement.--The amendment made by subsection
(f) shall take effect on the date that is 6 months after the
date of enactment of this Act.
(3) Extension of effective dates for state law amendment.--
In the case of a State plan for medical assistance under title
XIX of the Social Security Act which the Secretary of Health
and Human Services determines requires State legislation (other
than legislation appropriating funds) in order for the plan to
meet the additional requirements imposed by the amendments made
by this section, the State plan shall not be regarded as
failing to comply with the requirements of such title solely on
the basis of its failure to meet these additional requirements
before the first day of the first calendar quarter beginning
after the close of the first regular session of the State
legislature that begins after the date of the enactment of this
Act. For purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year of such
session shall be deemed to be a separate regular session of the
State legislature.
TITLE II--TEMPORARY ENHANCED UNEMPLOYMENT BENEFITS
SEC. 201. SHORT TITLE.
This title may be cited as the ``Temporary Unemployment
Compensation Act of 2001''.
SEC. 202. FEDERAL-STATE AGREEMENTS.
(a) In General.--Any State which desires to do so may enter into
and participate in an agreement under this title with the Secretary of
Labor (in this title referred to as the ``Secretary''). Any State which
is a party to an agreement under this title may, upon providing 30
days' written notice to the Secretary, terminate such agreement.
(b) Provisions of Agreement.--
(1) In general.--Any agreement under subsection (a) shall
provide that the State agency of the State will make--
(A) payments of regular compensation to individuals
in amounts and to the extent that such payments would
be determined if the State law were applied with the
modifications described in paragraph (2); and
(B) payments of temporary supplemental unemployment
compensation to individuals who--
(i) have exhausted all rights to regular
compensation under the State law;
(ii) do not, with respect to a week, have
any rights to compensation (excluding extended
compensation) under the State law of any other
State (whether one that has entered into an
agreement under this title or otherwise) nor
compensation under any other Federal law (other
than under the Federal-State Extended
Unemployment Compensation Act of 1970 (26
U.S.C. 3304 note)), and are not paid or
entitled to be paid any additional compensation
under any Federal or State law; and
(iii) are not receiving compensation with
respect to such week under the unemployment
compensation law of Canada.
(2) Modifications described.--The modifications described
in this paragraph are as follows:
(A) Alternative base period.--An individual shall
be eligible for regular compensation if the individual
would be so eligible, determined by applying--
(i) the base period that would otherwise
apply under the State law if this title had not
been enacted; or
(ii) a base period ending at the close of
the calendar quarter most recently completed
before the date of the individual's application
for benefits, provided that wage data for that
quarter has been reported to the State;
whichever results in the greater amount.
(B) Part-time employment.--An individual shall not
be denied regular compensation under the State law's
provisions relating to availability for work, active
search for work, or refusal to accept work, solely by
virtue of the fact that such individual is seeking, or
is available for, only part-time (and not full-time)
work, if--
(i) the individual's employment on which
eligibility for the regular compensation is
based was part-time employment; or
(ii) the individual can show good cause for
seeking, or being available for, only part-time
(and not full-time) work.
(C) Increased benefits.--
(i) In general.--The amount of regular
compensation (including dependents' allowances)
payable for any week shall be equal to the
amount determined under the State law (before
the application of this subparagraph), plus an
amount equal to the greater of--
(I) 15 percent of the amount so
determined; or
(II) $25.
(ii) Rounding.--For purposes of determining
the amount under clause (i)(I), such amount
shall be rounded to the dollar amount specified
under State law.
(c) Nonreduction Rule.--Under the agreement, subsection (b)(2)(C)
shall not apply (or shall cease to apply) with respect to a State upon
a determination by the Secretary that the method governing the
computation of regular compensation under the State law of that State
has been modified in a way such that--
(1) the average weekly amount of regular compensation which
will be payable during the period of the agreement (determined
disregarding the modifications described in subsection (b)(2))
will be less than
(2) the average weekly amount of regular compensation which
would otherwise have been payable during such period under the
State law, as in effect on September 11, 2001.
(d) Coordination Rules.--
(1) Regular compensation payable under a federal law.--The
modifications described in subsection (b)(2) shall also apply
in determining the amount of benefits payable under any Federal
law to the extent that those benefits are determined by
reference to regular compensation payable under the State law
of the State involved.
(2) TSUC to serve as second-tier benefits.--Notwithstanding
any other provision of law, extended benefits shall not be
payable to any individual for any week for which temporary
supplemental unemployment compensation is payable to such
individual.
(e) Exhaustion of Benefits.--For purposes of subsection
(b)(1)(B)(i), an individual shall be considered to have exhausted such
individual's rights to regular compensation under a State law when--
(1) no payments of regular compensation can be made under
such law because such individual has received all regular
compensation available to such individual based on employment
or wages during such individual's base period; or
(2) such individual's rights to such compensation have been
terminated by reason of the expiration of the benefit year with
respect to which such rights existed.
(f) Weekly Benefit Amount, Terms and Conditions, etc. Relating to
TSUC.--For purposes of any agreement under this title--
(1) the amount of temporary supplemental unemployment
compensation which shall be payable to an individual for any
week of total unemployment shall be equal to the amount of
regular compensation (including dependents' allowances) payable
to such individual under the State law for a week for total
unemployment during such individual's benefit year;
(2) the terms and conditions of the State law which apply
to claims for regular compensation and to the payment thereof
shall apply to claims for temporary supplemental unemployment
compensation and the payment thereof, except where inconsistent
with the provisions of this title or with the regulations or
operating instructions of the Secretary promulgated to carry
out this title; and
(3) the maximum amount of temporary supplemental
unemployment compensation payable to any individual for whom a
temporary supplemental unemployment compensation account is
established under section 203 shall not exceed the amount
established in such account for such individual.
SEC. 203. TEMPORARY SUPPLEMENTAL UNEMPLOYMENT COMPENSATION ACCOUNT.
(a) In General.--Any agreement under this title shall provide that
the State will establish, for each eligible individual who files an
application for temporary supplemental unemployment compensation, a
temporary supplemental unemployment compensation account.
(b) Amount in Account.--
(1) In general.--The amount established in an account under
subsection (a) shall be equal to the lesser of--
(A) 50 percent of the total amount of regular
compensation (including dependents' allowances) payable
to the individual during the individual's benefit year
under such law; or
(B) 13 times the individual's weekly benefit
amount.
(2) Weekly benefit amount.--For purposes of this
subsection, an individual's weekly benefit amount for any week
is the amount of regular compensation (including dependents'
allowances) under the State law payable to such individual for
such week for total unemployment.
(3) Rule of construction.--For purposes of any computation
under paragraph (1) (and any determination of amount under
section 202(f)(1)), the modification described in section
202(b)(2)(C) (relating to increased benefits) shall be deemed
to have been in effect with respect to the entirety of the
benefit year involved.
SEC. 204. PAYMENTS TO STATES HAVING AGREEMENTS UNDER THIS TITLE.
(a) General Rule.--There shall be paid to each State which has
entered into an agreement under this title an amount equal to--
(1) 100 percent of any regular compensation made payable to
individuals by such State by virtue of the modifications which
are described in section 202(b)(2) and deemed to be in effect
with respect to such State pursuant to section 202(b)(1)(A);
(2) 100 percent of any regular compensation--
(A) which is paid to individuals by such State by
reason of the fact that its State law contains
provisions comparable to the modifications described in
subparagraphs (A) and (B) of section 202(b)(2); but
only
(B) to the extent that those amounts would, if such
amounts were instead payable by virtue of the State
law's being deemed to be so modified pursuant to
section 202(b)(1)(A), have been reimbursable under
paragraph (1); and
(3) 100 percent of the temporary supplemental unemployment
compensation paid to individuals by the State pursuant to such
agreement.
(b) Determination of Amount.--Sums under subsection (a) payable to
any State by reason of such State having an agreement under this title
shall be payable, either in advance or by way of reimbursement (as may
be determined by the Secretary), in such amounts as the Secretary
estimates the State will be entitled to receive under this title for
each calendar month, reduced or increased, as the case may be, by any
amount by which the Secretary finds that the Secretary's estimates for
any prior calendar month were greater or less than the amounts which
should have been paid to the State. Such estimates may be made on the
basis of such statistical, sampling, or other method as may be agreed
upon by the Secretary and the State agency of the State involved.
(c) Administrative Expenses, etc.--There is hereby appropriated out
of the employment security administration account of the Unemployment
Trust Fund (as established by section 901(a) of the Social Security Act
(42 U.S.C. 1101(a))) $500,000,000 to reimburse States for the costs of
the administration of agreements under this title (including any
improvements in technology in connection therewith) and to provide
reemployment services to unemployment compensation claimants in States
having agreements under this title. Each State's share of the amount
appropriated by the preceding sentence shall be determined by the
Secretary according to the factors described in section 302(a) of the
Social Security Act (42 U.S.C. 501(a)) and certified by the Secretary
to the Secretary of the Treasury.
SEC. 205. FINANCING PROVISIONS.
(a) In General.--Funds in the extended unemployment compensation
account (as established by section 905(a) of the Social Security Act
(42 U.S.C. 1105(a))), and the Federal unemployment account (as
established by section 904(g) of such Act (42 U.S.C. 1104(g))), of the
Unemployment Trust Fund (as established by section 904(a) of such Act
(42 U.S.C. 1104(a))) shall be used, in accordance with subsection (b),
for the making of payments (described in section 204(a)) to States
having agreements entered into under this title.
(b) Certification.--The Secretary shall from time to time certify
to the Secretary of the Treasury for payment to each State the sums
described in section 204(a) which are payable to such State under this
title. The Secretary of the Treasury, prior to audit or settlement by
the General Accounting Office, shall make payments to the State in
accordance with such certification by transfers from the extended
unemployment compensation account, as so established (or, to the extent
that there are insufficient funds in that account, from the Federal
unemployment account, as so established) to the account of such State
in the Unemployment Trust Fund (as so established).
SEC. 206. FRAUD AND OVERPAYMENTS.
(a) In General.--If an individual knowingly has made, or caused to
be made by another, a false statement or representation of a material
fact, or knowingly has failed, or caused another to fail, to disclose a
material fact, and as a result of such false statement or
representation or of such nondisclosure such individual has received
any regular compensation or temporary supplemental unemployment
compensation under this title to which he was not entitled, such
individual--
(1) shall be ineligible for any further benefits under this
title in accordance with the provisions of the applicable State
unemployment compensation law relating to fraud in connection
with a claim for unemployment compensation; and
(2) shall be subject to prosecution under section 1001 of
title 18, United States Code.
(b) Repayment.--In the case of individuals who have received any
regular compensation or temporary supplemental unemployment
compensation under this title to which such individuals were not
entitled, the State shall require such individuals to repay those
benefits to the State agency, except that the State agency may waive
such repayment if it determines that--
(1) the payment of such benefits was without fault on the
part of any such individual; and
(2) such repayment would be contrary to equity and good
conscience.
(c) Recovery by State Agency.--
(1) In general.--The State agency may recover the amount to
be repaid, or any part thereof, by deductions from any regular
compensation or temporary supplemental unemployment
compensation payable to such individual under this title or
from any unemployment compensation payable to such individual
under any Federal unemployment compensation law administered by
the State agency or under any other Federal law administered by
the State agency which provides for the payment of any
assistance or allowance with respect to any week of
unemployment, during the 3-year period after the date such
individuals received the payment of the regular compensation or
temporary supplemental unemployment compensation to which such
individuals were not entitled, except that no single deduction
may exceed 50 percent of the weekly benefit amount from which
such deduction is made.
(2) Opportunity for hearing.--No repayment shall be
required, and no deduction shall be made, until a determination
has been made, notice thereof and an opportunity for a fair
hearing has been given to the individual, and the determination
has become final.
(d) Review.--Any determination by a State agency under this section
shall be subject to review in the same manner and to the same extent as
determinations under the State unemployment compensation law, and only
in that manner and to that extent.
SEC. 207. DEFINITIONS.
For purposes of this title:
(1) In general.--The terms ``compensation'', ``regular
compensation'', ``extended compensation'', ``additional
compensation'', ``benefit year'', ``base period'', ``State'',
``State agency'', ``State law'', and ``week'' have the
respective meanings given such terms under section 205 of the
Federal-State Extended Unemployment Compensation Act of 1970,
subject to paragraph (2).
(2) State law and regular compensation.--In the case of a
State entering into an agreement under this title--
(A) ``State law'' shall be considered to refer to
the State law of such State, applied in conformance
with the modifications described in section 202(b)(2),
subject to section 202(c); and
(B) ``regular compensation'' shall be considered to
refer to such compensation, determined under its State
law (applied in the manner described in subparagraph
(A));
except as otherwise provided or where the context clearly
indicates otherwise.
SEC. 208. APPLICABILITY.
(a) In General.--An agreement entered into under this title shall
apply to weeks of unemployment--
(1) beginning after the date on which such agreement is
entered into; and
(2) ending before January 1, 2003.
(b) Specific Rules.--
(1) In general.--Under such an agreement, the following
rules shall apply:
(A) Alternative base periods.--The modification
described in section 202(b)(2)(A) (relating to
alternative base periods) shall not apply except in the
case of initial claims filed on or after the first day
of the week that includes September 11, 2001.
(B) Part-time employment and increased benefits.--
The modifications described in subparagraphs (B) and
(C) of section 202(b)(2) (relating to part-time
employment and increased benefits, respectively) shall
apply to weeks of unemployment described in subsection
(a), regardless of the date on which an individual's
initial claim for benefits is filed.
(C) Eligibility for tsuc.--The payments described
in section 202(b)(1)(B) (relating to temporary
supplemental unemployment compensation) shall not apply
except in the case of individuals exhausting their
rights to regular compensation (as described in clause
(i) of such section) on or after the first day of the
week that includes September 11, 2001.
(2) Reapplication process.--
(A) Alternative base periods.--In the case of an
individual who filed an initial claim for regular
compensation on or after the first day of the week that
includes September 11, 2001, and before the date that
the State entered into an agreement under subsection
(a)(1) that was denied as a result of the application
of the base period that applied under the State law
prior to the date on which the State entered into the
such agreement, such individual--
(i) may refile a claim for regular
compensation based on the modification
described in section 202(b)(2)(A) (relating to
alternative base periods) on or after the date
on which the State enters into such agreement
and before the date on which such agreement
terminates; and
(ii) if eligible, shall be entitled to such
compensation only for weeks of unemployment
described in subsection (a) beginning on or
after the date on which the individual files
such claim.
(B) Part-time employment.--In the case of an
individual who before the date that the State entered
into an agreement under subsection (a)(1) was denied
regular compensation under the State law's provisions
relating to availability for work, active search for
work, or refusal to accept work, solely by virtue of
the fact that such individual is seeking, or available
for, only part-time (and not full-time) work, such
individual--
(i) may refile a claim for regular compensation
based on the modification described in section
202(b)(2)(B) (relating to part-time employment) on or
after the date on which the State enters into the
agreement under subsection (a)(1) and before the date
on which such agreement terminates; and
(ii) if eligible, shall be entitled to such
compensation only for weeks of unemployment described
in subsection (a) beginning on or after the date on
which the individual files such claim.
(3) No retroactive payments for weeks prior to agreement.--
No amounts shall be payable to an individual under an agreement
entered into under this title for any week of unemployment
prior to the week beginning after the date on which such
agreement is entered into.
<all>