[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4031 Introduced in House (IH)]






108th CONGRESS
  2d Session
                                H. R. 4031

 To give States the flexibility to reduce bureaucracy by streamlining 
   enrollment processes for the Medicaid and State children's health 
  insurance programs through better linkages with programs providing 
        nutrition and related assistance to low-income families.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 25, 2004

    Ms. Carson of Indiana (for herself, Mr. Fattah, Mr. Wexler, Mr. 
Emanuel, Ms. Millender-McDonald, Mr. Owens, Mr. Filner, Mr. Frost, and 
  Ms. Eddie Bernice Johnson of Texas) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To give States the flexibility to reduce bureaucracy by streamlining 
   enrollment processes for the Medicaid and State children's health 
  insurance programs through better linkages with programs providing 
        nutrition and related assistance to low-income families.

    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 Express Lane to Health 
Coverage Act of 2004''.

SEC. 2. FINDINGS; PURPOSE.

    (a) Findings.--Congress finds the following:
            (1) Despite gains made in recent years, 8,900,000 children 
        in the United States are uninsured. Of those, 6,900,000 are 
        eligible for public health insurance coverage.
            (2) Most low-income uninsured children are enrolled in 
        nutrition and related programs that operate under income 
        guidelines similar to those of the medicaid program. In fact, 
        63 percent, or 4,300,000, low-income uninsured children are in 
        families that receive benefits through the food stamps program, 
        the National school lunch program, or the special supplemental 
        nutrition program for women, infants and children (commonly 
        referred to as ``WIC'').
            (3) The public would be well served if Federal means-tested 
        public programs were able to improve administrative efficiency 
        and coordination as well as reduce unnecessary bureaucracy.
            (4) Uninsured children would be well served if their 
        enrollment in a nutrition-based or other means-tested program 
        could serve as a gateway to health coverage.
            (5) Existing law already allows children to be found income 
        eligible for WIC based on their enrollment in the medicaid 
        program. Current law does not, however, give States adequate 
        flexibility to make an income determination for eligibility for 
        the medicaid or State children's health insurance program based 
        on an uninsured child's enrollment in WIC or another public 
        program.
    (b) Purpose.--The purpose of this Act is to give States the 
flexibility to find children income eligible for the medicaid program 
or State children's health insurance program based on the fact that the 
children are eligible for nutrition assistance or similar public 
programs with comparable income standards and methodologies.

SEC. 3. STATE OPTION TO PROVIDE FOR SIMPLIFIED DETERMINATIONS OF A 
              CHILD'S FINANCIAL ELIGIBILITY FOR MEDICAL ASSISTANCE 
              UNDER MEDICAID OR CHILD HEALTH ASSISTANCE UNDER SCHIP.

    (a) Medicaid.--Section 1902(e) of the Social Security Act (42 
U.S.C. 1396a(e)) is amended by adding at the end the following:
            ``(13)(A) At the option of the State, the plan may provide 
        that financial eligibility requirements for medical assistance 
        are met for an individual who is under an age specified by the 
        State (not to exceed 21 years of age) by using a determination 
        (made within a reasonable period, as found by the State, before 
        its use for this purpose) of the individual's family or 
        household income or resources, notwithstanding any differences 
        in budget unit, disregard, deeming, or other methodology, by a 
        Federal or State agency (or a public or private entity making 
        such determination on behalf of such agency) specified by the 
        plan, including but not limited to the agencies administering 
        the Food Stamp Act of 1977, the Richard B. Russell National 
        School Lunch Act, and the Child Nutrition Act of 1966, provided 
        that such agency has fiscal liabilities or responsibilities 
        affected or potentially affected by such determinations and 
        provided that all information furnished by such agency pursuant 
        to this subparagraph is used solely for purposes of determining 
        eligibility for medical assistance under the State plan 
        approved under this title or for child health assistance under 
        a State plan approved under title XXI.
            ``(B) Nothing in subparagraph (A) shall be construed--
                    ``(i) to authorize the denial of medical assistance 
                under a State plan approved under this title or of 
                child health assistance under a State plan approved 
                under title XXI to an individual who, without the 
                application of this paragraph or an option exercised 
                thereunder, would qualify for such assistance;
                    ``(ii) to relieve a State of the obligation under 
                subsection (a)(8) to furnish assistance with reasonable 
                promptness after the submission of an initial 
                application that is evaluated or for which evaluation 
                is requested pursuant to this paragraph; or
                    ``(iii) to relieve a State of the obligation to 
                determine eligibility on other grounds for an 
                individual found to be ineligible under this paragraph.
            ``(C) At the option of a State, the financial eligibility 
        process described in subparagraph (A) may apply to an 
        individual who is older than age 21 if such individual's 
        eligibility for medical assistance is based on pregnancy or if 
        such individual is a parent, guardian, or other caretaker 
        relative of an individual found eligible under subparagraph 
        (A).''.
    (b) SCHIP.--Section 2107(e)(1) of the Social Security Act (42 
U.S.C. 1397gg(e)(1)) is amended by adding at the end the following:
                    ``(E) Section 1902(e)(13) (relating to the State 
                option to base a child's eligibility for assistance on 
                financial determinations made by a program providing 
                nutrition or other public assistance).''.
    (c) Effective Date.--The amendments made by this section take 
effect on October 1, 2003.
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