[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 2819 Introduced in Senate (IS)]







107th CONGRESS
  2d Session
                                S. 2819

  To amend title XXI of the Social Security Act to permit qualifying 
  States to use a portion of their unspent allotments under the State 
  children's health insurance program to expand health coverage under 
 that program or for expenditures under the medicaid program, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 30, 2002

Mr. Jeffords (for himself, Mr. Bingaman, Mrs. Lincoln, and Mrs. Murray) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XXI of the Social Security Act to permit qualifying 
  States to use a portion of their unspent allotments under the State 
  children's health insurance program to expand health coverage under 
 that program or for expenditures 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 ``State Children's Health Insurance 
Program Budget Allocation Act of 2002''.

SEC. 2. AUTHORITY FOR QUALIFYING STATES TO USE PORTION OF SCHIP FUNDS 
              FOR MEDICAID EXPENDITURES.

    (a) Authority for Qualifying States To Use Portion of SCHIP Funds 
for Medicaid Expenditures.--
            (1) In general.--Section 2105 of the Social Security Act 
        (42 U.S.C. 1397ee) is amended by adding at the end the 
        following:
    ``(g) Authority for Qualifying States To Use Certain Funds for 
Medicaid Expenditures.--
            ``(1) State option.--
                    ``(A) In general.--Notwithstanding any other 
                provision of law, with respect to fiscal years 2002 and 
                2003, a qualifying State (as defined in paragraph (3)) 
                may elect to use any or all of the funds described with 
                respect to the State in paragraph (2) (in addition for 
                expenditures under this title) for payments for such 
                fiscal years under title XIX in accordance with 
                subparagraph (B).
                    ``(B) Payments to states.--
                            ``(i) In general.--In the case of a 
                        qualifying State that has elected the option 
                        described in subparagraph (A), subject to the 
                        total amount of funds described with respect to 
                        the State in paragraph (2), the Secretary shall 
                        pay the State (in addition to payments under 
                        subsection (a)) an amount each quarter equal to 
                        the additional amount that would have been paid 
                        to the State under title XIX for expenditures 
                        of the State for fiscal years 2002 and 2003 
                        described in clause (ii) if the enhanced FMAP 
                        (as determined under subsection (b)) had been 
                        substituted for the Federal medical assistance 
                        percentage (as defined in section 1905(b)) of 
                        such expenditures.
                            ``(ii) Expenditures described.--For 
                        purposes of clause (i), the expenditures 
                        described in this clause are expenditures for 
                        such fiscal years for providing medical 
                        assistance under title XIX to individuals who 
                        have not attained age 19 or who are pregnant 
                        women.
            ``(2) Funds described.--With respect to a qualifying State, 
        the funds described in this paragraph are the following:
                    ``(A) Amounts redistributed to the state from the 
                fiscal years 1998 and 1999 allotments of other 
                states.--The amount (if any) redistributed to the State 
                from the unexpended fiscal years 1998 and 1999 
                allotments of other States under section 2104(g)(1) 
                that remain available for expenditure by the State 
                under subparagraph (B) of that section (as amended by 
                the State Children's Health Insurance Program Budget 
                Allocation Act of 2002).
                    ``(B) Amounts remaining available for expenditure 
                from the fiscal years 1998 and 1999 allotments for the 
                state.--The portion (if any) of the unexpended fiscal 
                years 1998 and 1999 allotments for the State that 
                remain available for expenditure by the State under 
                section 2104(g)(2) (as so amended).
                    ``(C) Amounts redistributed to the state from the 
                fiscal year 2000 allotments of other states.--The 
                amount (if any) redistributed to the State from the 
                unexpended fiscal year 2000 allotments of other States 
                under section 2104(h)(1) (as added by such Act).
                    ``(D) Amounts remaining available for expenditure 
                from the fiscal year 2000 allotment for the state.--The 
                portion (if any) of the unexpended fiscal year 2000 
                allotment for the State that remains available for 
                expenditure by the State under section 2104(h)(2) (as 
                so added).
            ``(3) Qualifying state.--In this subsection, the term 
        `qualifying State' means a State that meets the following 
        criteria:
                    ``(A) Maintenance of effort.--With respect to a 
                fiscal year, the State expenditures under this title 
                for the fiscal year are not less than the level of such 
                expenditures for the preceding fiscal year.
                    ``(B) Income eligibility standard.--
                            ``(i) Eligibility for all low-income 
                        children.--The State child health plan (whether 
                        implemented under this title or title XIX) has 
                        an income eligibility standard for children 
                        under 19 years of age that is at least 200 
                        percent of the poverty line.
                            ``(ii) Commitment to move toward 
                        eligibility for all low-income children.--In 
                        the case of a State that is not described in 
                        clause (i), with respect to each of fiscal 
years 2002 and 2003, the State submits a plan amendment that increases 
the income eligibility standard for children under 19 years of age over 
the income eligibility standard that applied to such children for the 
preceding fiscal year by the lesser of--
                                    ``(I) 10 percentage points; or
                                    ``(II) the difference between such 
                                income eligibility standard for such 
                                preceding fiscal year and 200 percent.
                    ``(C) No waiting list imposed.--The State does not 
                impose any numerical limitation, waiting list, or 
                similar limitation on the eligibility of--
                            ``(i) in the case of a State with a child 
                        health plan described in subparagraph (B)(i), 
                        children whose family income is at or below 200 
                        percent of the poverty line for child health 
                        assistance under the plan; and
                            ``(ii) in the case of a State that meets 
                        the requirements of subparagraph (B)(ii), 
                        children who are eligible for child health 
                        assistance under the plan with respect to each 
                        of fiscal years 2002 and 2003.
                    ``(D) Maintenance of benefits.--With respect to 
                fiscal years 2002 and 2003, the benefits provided for 
                children and, if applicable, pregnant women eligible 
                for assistance under the State child health plan 
                (whether implemented under this title or title XIX), 
                and the benefits provided for individuals eligible for 
                medical assistance under section 1902(a)(10)(A)(i), are 
                not less in amount, duration, or scope than the 
                benefits provided for such individuals for the 
                preceding fiscal year.
                    ``(E) Additional criteria for states that have not 
                expended all of their fiscal year 1998, 1999, or 2000 
                allotments.--In the case of a State that--
                            ``(i) of the amounts allotted to the State 
                        pursuant to section 2104 for fiscal year 1998, 
                        did not expend all of such amounts by the end 
                        of fiscal year 2000;
                            ``(ii) of the amounts allotted to the State 
                        pursuant to section 2104 for fiscal year 1999, 
                        did not expend all of such amounts by the end 
                        of fiscal year 2001; or
                            ``(iii) of the amounts allotted to a State 
                        pursuant to section 2104 for fiscal year 2000, 
                        did not expend all of such amounts by the end 
                        of fiscal year 2002,
                the State also satisfies the criteria described in 
                subparagraph (F).
                    ``(F) Enrollment and retention procedures.--The 
                State has implemented at least 4 of the following 
                policies and procedures (relating to coverage of 
                children under this title and title XIX):
                            ``(i) Uniform, simplified application 
                        form.--With respect to children who are 
                        eligible for medical assistance under section 
                        1902(a)(10)(A), the State uses the same 
                        uniform, simplified application form 
                        (including, if applicable, permitting 
                        application other than in person) for purposes 
                        of establishing eligibility for benefits under 
                        title XIX and this title.
                            ``(ii) Elimination of assets test.--The 
                        State does not apply any assets test for 
                        children who are eligible for medical 
                        assistance under section 1902(a)(10)(A) or for 
                        child health assistance under this title.
                            ``(iii) Adoption of 12-month continuous 
                        enrollment.--The State provides that 
                        eligibility shall not be regularly redetermined 
                        more often than once every year for children 
                        under this title or under title XIX for 
                        children eligible for medical assistance under 
                        section 1902(a)(10)(A).
                            ``(iv) Presumptive eligibility for 
                        children.--The State provides presumptive 
                        eligibility for children under sections 1920A 
                        and section 2107(e)(1)(D).
                            ``(v) Same verification and redetermination 
                        policies; automatic reassessment of 
                        eligibility.--With respect to children who are 
                        eligible for medical assistance under section 
                        1902(a)(10)(A), the State provides for initial 
                        eligibility determinations and redeterminations 
                        of eligibility using the same verification 
                        policies (including with respect to face-to-
                        face interviews), forms, and frequency as the 
                        State uses for such purposes under this title, 
                        and, as part of such redeterminations, provides 
                        for the automatic reassessment of the 
                        eligibility of such children for assistance 
                        under title XIX and this title.
                            ``(vi) Outstationing enrollment staff.--The 
                        State provides for the receipt and initial 
                        processing of applications for benefits under 
                        this title and for children under title XIX at 
                        facilities defined as disproportionate share 
                        hospitals under section 1923(a)(1)(A) and 
                        Federally-qualified health centers described in 
                        section 1905(l)(2)(B) consistent with section 
                        1902(a)(55).''.

SEC. 3. EXTENSION OF AVAILABILITY OF 1998 AND 1999 ALLOTMENTS.

    (a) Extension of Availability of Redistributed Amounts; Authority 
for Qualifying States To Use Redistributed Amounts for Medicaid 
Expenditures.--Section 2104(g)(1)(B) of the Social Security Act (42 
U.S.C. 1397dd(g)(1)(B)) is amended--
            (1) in clause (ii)--
                    (A) by inserting ``subject to clause (iv),'' after 
                ``subsection (e),''; and
                    (B) by striking ``and'' at the end;
            (2) in clause (iii), by striking the period and inserting 
        ``; and''; and
            (3) by adding at the end the following:
                            ``(iv) if the State is a qualifying State 
                        (as defined in section 2105(g)(3)), shall 
                        remain available for expenditure by the State 
                        through the end of fiscal year 2003 and may be 
                        used in accordance with section 2105(g)(1).''.
    (b) Extension of Availability of Funds Unexpended From 1998 and 
1999 Allotments.--Section 2104(g)(2)(A) of the Social Security Act (42 
U.S.C. 1397dd(g)(2)) is amended by adding at the end the following:
                            ``(iii) Special rule for fiscal years 2002 
                        and 2003 for qualifying states.--In the case of 
                        a State that is a qualifying State (as defined 
                        in section 2105(g)(3)), clauses (i) and (ii) 
                        shall each be applied by substituting `2003, in 
                        accordance with section 2105(g)(1)' for `2002'.
                            ``(iv) Extended availability of certain 
                        other funds.--The following amounts shall 
                        remain available for expenditure by the 
                        Secretary to carry out the purposes of this 
                        title through the end of fiscal year 2004:
                                    ``(I) Non-qualifying states.--In 
                                the case of a State that is not a 
                                qualifying State (as defined in section 
                                2105(g)(3)), any amounts described in 
                                paragraph (1) or clause (i) or (ii) of 
                                this subparagraph that are not expended 
                                by the State as of September 30, 2002.
                                    ``(II) Unexpended funds of 
                                qualifying states at the end of fiscal 
                                year 2003.--In the case of a State that 
                                is a qualifying State (as so defined), 
                                any amounts described in paragraph (1) 
                                (after the application of subparagraph 
                                (B)(iv) of that paragraph) and any 
                                amounts described in clause (i) or (ii) 
                                of this subparagraph (after the 
                                application of clause (iii) of this 
                                subparagraph), that are not expended by 
                                the State as of September 30, 2003.''.
    (c) Authority for Qualifying States To Use Up To 10 Percent of 1998 
and 1999 Unexpended Allotments for Outreach Activities.--Section 
2104(g)(2)(C) of the Social Security Act (42 U.S.C. 1397dd(g)(2)(C)) is 
amended--
            (1) by striking ``Notwithstanding'' and inserting the 
        following:
                            ``(i) In general.--Notwithstanding''; and
            (2) by adding at the end the following:
                            ``(ii) Special rule for fiscal years 2002 
                        and 2003 for qualifying states.--In the case of 
                        a State that is a qualifying State (as defined 
                        in section 2105(g)(3)), clause (i) shall be 
                        applied by substituting--
                                    ``(I) in the heading, `1998 and 
                                1999' for `1998'; and
                                    ``(II) `each of fiscal years 1998 
                                and 1999' for `fiscal year 1998'.''.

SEC. 4. APPLICATION OF BIPA RULE FOR REDISTRIBUTION AND EXTENDED 
              AVAILABILITY OF UNUSED ALLOTMENTS TO FISCAL YEAR 2000 
              ALLOTMENTS.

    (a) In General.--Section 2104 of the Social Security Act (42 U.S.C. 
1397dd) is amended by adding at the end the following:
    ``(h) Rule for Redistribution and Extended Availability of Fiscal 
Year 2000 Allotments.--
            ``(1) Amount redistributed.--
                    ``(A) In general.--In the case of a State that 
                expends all of its allotment under subsection (b) or 
                (c) for fiscal year 2000 by the end of fiscal year 
                2002, the Secretary shall redistribute to the State 
                under subsection (f) (from the fiscal year 2000 
                allotments of other States, as determined by the 
                application of paragraphs (2) and (3)) the following 
                amount:
                            ``(i) State.--In the case of one of the 50 
                        States or the District of Columbia, with 
                        respect to the fiscal year 2000 allotment, the 
                        amount by which the State's expenditures under 
                        this title in fiscal years 2000, 2001, and 2002 
                        exceed the State's allotment for fiscal year 
                        2000 under subsection (b).
                            ``(ii) Territory.--In the case of a 
                        commonwealth or territory described in 
                        subsection (c)(3), an amount that bears the 
                        same ratio to 1.05 percent of the total amount 
                        described in paragraph (2)(B)(i)(I) as the 
                        ratio of the commonwealth's or territory's 
                        fiscal year 2000 allotment under subsection (c) 
                        bears to the total of all such allotments for 
                        that fiscal year under such subsection.
                    ``(B) Expenditure rules.--An amount redistributed 
                to a State under this paragraph with respect to fiscal 
                year 2000--
                            ``(i) shall not be included in the 
                        determination of the State's allotment for any 
                        fiscal year under this section;
                            ``(ii) notwithstanding subsection (e), 
                        shall remain available for expenditure by the 
                        State under this title through the end of 
                        fiscal year 2003;
                            ``(iii) shall be counted as being expended 
                        with respect to a fiscal year allotment in 
                        accordance with applicable regulations of the 
                        Secretary; and
                            ``(iv) with respect to fiscal years 2002 
                        and 2003, if the State is a qualifying State 
                        (as defined in section 2105(g)(3)), may be used 
                        in accordance with section 2105(g)(1).
            ``(2) Extension of availability of portion of unexpended 
        fiscal year 2000 allotments.--
                    ``(A) In general.--Notwithstanding subsection (e):
                            ``(i) Fiscal year 2000 allotment of 
                        qualifying state.--In the case of a State that 
                        is a qualifying State (as defined in section 
                        2105(g)(3)), of the amounts allotted to a State 
                        pursuant to this section for fiscal year 2000 
                        that were not expended by the State by the end 
                        of fiscal year 2002, the amount specified in 
                        subparagraph (B) for fiscal year 2000 for the 
                        State shall remain available for expenditure by 
                        the State through the end of fiscal year 2003, 
                        in accordance with section 2105(g)(1).
                            ``(ii) Extended availability of certain 
                        other funds.--The following amounts shall 
                        remain available for expenditure by the 
                        Secretary to carry out the purposes of this 
                        title through the end of fiscal year 2004:
                                    ``(I) Non-qualifying states.--In 
                                the case of a State that is not a 
                                qualifying State (as defined in section 
                                2105(g)(3)), any amounts allotted to 
                                the State pursuant to this section for 
                                fiscal year 2000 that are not expended 
                                by the State as of September 30, 2002, 
                                and that are not redistributed under 
                                paragraph (1)(A).
                                    ``(II) Unexpended funds of 
                                qualifying states and states receiving 
                                redistributed funds at the end of 
                                fiscal year 2003.--In the case of a 
                                State that is a qualifying State (as so 
                                defined), or in the case of a State 
                                receiving a redistributed amount under 
                                paragraph (1)(A), any amounts described 
                                in paragraph (1)(A) and any amounts 
                                described in clause (i) of this 
                                subparagraph that are not expended by 
                                such a State as of September 30, 2003.
                    ``(B) Amount remaining available for expenditure.--
                The amount specified in this subparagraph for a 
                qualifying State (as so defined) for fiscal year 2000 
                is equal to--
                            ``(i) the amount by which (I) the total 
                        amount available for redistribution under 
                        subsection (f) from the allotments for that 
                        fiscal year, exceeds (II) the total amounts 
                        redistributed under paragraph (1) for that 
                        fiscal year; multiplied by
                            ``(ii) the ratio of the amount of the 
                        State's unexpended allotment for that fiscal 
                        year to the total amount described in clause 
                        (i)(I) for that fiscal year.
                    ``(C) Expenditure rules.--
                            ``(i) In general.--Any amount with respect 
                        to fiscal year 2000 that remains available for 
                        expenditure by a qualifying State (as so 
                        defined) under this paragraph--
                                    ``(I) shall not be included in the 
                                determination of the State's allotment 
                                for any fiscal year under this section; 
                                and
                                    ``(III) shall be counted as being 
                                expended with respect to a fiscal year 
                                allotment in accordance with applicable 
                                regulations of the Secretary.
                            ``(ii) Use of up to 10 percent of retained 
                        allotments for outreach activities.--
                        Notwithstanding section 2105(c)(2)(A), up to 10 
                        percent of the amount specified in subparagraph 
                        (B) with respect to a qualifying State (as so 
                        defined) for fiscal year 2000 may be used for 
                        expenditures for outreach activities approved 
                        by the Secretary.
            ``(3) Determination of amounts.--For purposes of 
        calculating the amounts described in paragraphs (1) and (2) 
        relating to the allotments for fiscal year 2000, the Secretary 
        shall use the amounts reported by the States not later than 
        November 30 of calendar year 2002 on HCFA Form 64 or HCFA Form 
        21, as approved by the Secretary.''.

SEC. 5. EVALUATION AND REPORT.

    Not later than June 30, 2003, the Secretary of Health and Human 
Services shall submit a report to Congress evaluating the impact of the 
amendments made by this Act on the medicaid and State children's health 
insurance programs under titles XIX and XXI of the Social Security Act 
(42 U.S.C. 1396 et seq., 1397aa et seq.), particularly with respect to 
the enrollment of children in such programs and Federal and State 
expenditures under the programs.
                                 <all>