[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 312 Reported in Senate (RS)]






                                                       Calendar No. 166
108th CONGRESS
  1st Session
                                 S. 312

                          [Report No. 108-78]

      To amend title XXI of the Social Security Act to extend the 
availability of allotments for fiscal years 1998 through 2001 under the 
               State Children's Health Insurance Program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            February 5, 2003

 Mr. Rockefeller (for himself, Mr. Chafee, Mr. Kennedy, Ms. Snowe, Mr. 
   Baucus, Mr. Grassley, Mr. Corzine, Mr. Warner, Mrs. Clinton, Ms. 
     Collins, Mr. Bingaman, Mr. McCain, Mr. Bayh, Mr. DeWine, Mrs. 
Hutchison, Mrs. Lincoln, Mr. Hatch, Mr. Lautenberg, , Ms. Mikulski, Mr. 
 Lugar, Mr. Sarbanes, Mrs. Feinstein, Ms. Cantwell, Mr. Jeffords, Mr. 
 Crapo, and Mr. Roberts) introduced the following bill; which was read 
             twice and referred to the Committee on Finance

                             June 24, 2003

              Reported by Mr. Grassley, without amendment

_______________________________________________________________________

                                 A BILL


 
      To amend title XXI of the Social Security Act to extend the 
availability of allotments for fiscal years 1998 through 2001 under the 
               State Children's Health Insurance Program.

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

SECTION 1. EXTENSION OF AVAILABILITY OF SCHIP ALLOTMENTS FOR FISCAL 
              YEARS 1998 THROUGH 2001.

    (a) Extending Availability of SCHIP Allotments for Fiscal Years 
1998 Through 2001.--
            (1) Retained and redistributed allotments for fiscal years 
        1998 and 1999.--Paragraphs (2)(A)(i) and (2)(A)(ii) of section 
        2104(g) of the Social Security Act (42 U.S.C. 1397dd(g)) are 
        each amended by striking ``fiscal year 2002'' and inserting 
        ``fiscal year 2004''.
            (2) Extension and revision of retained and redistributed 
        allotments for fiscal year 2000.--
                    (A) Permitting and extending retention of portion 
                of fiscal year 2000 allotment.--Paragraph (2) of such 
                section 2104(g) is amended--
                            (i) in the heading, by striking ``and 
                        1999'' and inserting ``through 2000''; and
                            (ii) by adding at the end of subparagraph 
                        (A) the following:
                            ``(iii) Fiscal year 2000 allotment.--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, 50 percent of that amount shall remain 
                        available for expenditure by the State through 
                        the end of fiscal year 2004.''.
                    (B) Redistributed allotments.--Paragraph (1) of 
                such section 2104(g) is amended--
                            (i) in subparagraph (A), by inserting ``or 
                        for fiscal year 2000 by the end of fiscal year 
                        2002,'' after ``fiscal year 2001,'';
                            (ii) in subparagraph (A), by striking 
                        ``1998 or 1999'' and inserting ``1998, 1999, or 
                        2000'';
                            (iii) in subparagraph (A)(i)--
                                    (I) by striking ``or'' at the end 
                                of subclause (I),
                                    (II) by striking the period at the 
                                end of subclause (II) and inserting ``; 
                                or''; and
                                    (III) by adding at the end the 
                                following new subclause:
                                    ``(III) the fiscal year 2000 
                                allotment, the amount specified in 
                                subparagraph (C)(i) (less the total of 
                                the amounts under clause (ii) for such 
                                fiscal year), multiplied by the ratio 
                                of the amount specified in subparagraph 
                                (C)(ii) for the State to the amount 
                                specified in subparagraph (C)(iii).'';
                            (iv) in subparagraph (A)(ii), by striking 
                        ``or 1999'' and inserting ``, 1999, or 2000'';
                            (v) in subparagraph (B), by striking ``with 
                        respect to fiscal year 1998 or 1999'';
                            (vi) in subparagraph (B)(ii)--
                                    (I) by inserting ``with respect to 
                                fiscal year 1998, 1999, or 2000,'' 
                                after ``subsection (e),''; and
                                    (II) by striking ``2002'' and 
                                inserting ``2004''; and
                            (vii) by adding at the end the following 
                        new subparagraph:
                    ``(C) Amounts used in computing redistributions for 
                fiscal year 2000.--For purposes of subparagraph 
                (A)(i)(III)--
                            ``(i) the amount specified in this clause 
                        is the amount specified in paragraph 
                        (2)(B)(i)(I) for fiscal year 2000, less the 
                        total amount remaining available pursuant to 
                        paragraph (2)(A)(iii);
                            ``(ii) the amount specified in this clause 
                        for a State is 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); and
                            ``(iii) the amount specified in this clause 
                        is the sum, for all States entitled to a 
                        redistribution under subparagraph (A) from the 
                        allotments for fiscal year 2000, of the amounts 
                        specified in clause (ii).''.
                    (C) Conforming amendments.--Such section 2104(g) is 
                further amended--
                            (i) in its heading, by striking ``and 
                        1999'' and inserting ``, 1999, and 2000''; and
                            (ii) in paragraph (3)--
                                    (I) by striking ``or fiscal year 
                                1999'' and inserting ``, fiscal year 
                                1999, or fiscal year 2000''; and
                                    (II) by striking ``or November 30, 
                                2001'' and inserting ``November 30, 
                                2001, or November 30, 2002'', 
                                respectively.
            (3) Extension and revision of retained and redistributed 
        allotments for fiscal year 2001.--
                    (A) Permitting and extending retention of portion 
                of fiscal year 2001 allotment.--Paragraph (2) of such 
                section 2104(g), as amended in paragraph (2)(A)(ii), is 
                further amended--
                            (i) in the heading, by striking ``2000'' 
                        and inserting ``2001''; and
                            (ii) by adding at the end of subparagraph 
                        (A) the following:
                            ``(iv) Fiscal year 2001 allotment.--Of the 
                        amounts allotted to a State pursuant to this 
                        section for fiscal year 2001 that were not 
                        expended by the State by the end of fiscal year 
                        2003, 50 percent of that amount shall remain 
                        available for expenditure by the State through 
                        the end of fiscal year 2005.''.
                    (B) Redistributed allotments.--Paragraph (1) of 
                such section 2104(g), as amended in paragraph (2)(B), 
                is further amended--
                            (i) in subparagraph (A), by inserting ``or 
                        for fiscal year 2001 by the end of fiscal year 
                        2003,'' after ``fiscal year 2002,'';
                            (ii) in subparagraph (A), by striking 
                        ``1999, or 2000'' and inserting ``1999, 2000, 
                        or 2001'';
                            (iii) in subparagraph (A)(i)--
                                    (I) by striking ``or'' at the end 
                                of subclause (II),
                                    (II) by striking the period at the 
                                end of subclause (III) and inserting 
                                ``; or''; and
                                    (III) by adding at the end the 
                                following new subclause:
                                    ``(IV) the fiscal year 2001 
                                allotment, the amount specified in 
                                subparagraph (D)(i) (less the total of 
                                the amounts under clause (ii) for such 
                                fiscal year), multiplied by the ratio 
                                of the amount specified in subparagraph 
                                (D)(ii) for the State to the amount 
                                specified in subparagraph (D)(iii).'';
                            (iv) in subparagraph (A)(ii), by striking 
                        ``or 2000'' and inserting ``2000, or 2001'';
                            (v) in subparagraph (B)--
                                    (I) by striking ``and'' at the end 
                                of clause (ii);
                                    (II) by redesignating clause (iii) 
                                as clause (iv); and
                                    (III) by inserting after clause 
                                (ii) the following new clause:
                            ``(iii) notwithstanding subsection (e), 
                        with respect to fiscal year 2001, shall remain 
                        available for expenditure by the State through 
                        the end of fiscal year 2005; and''; and
                            (vi) by adding at the end the following new 
                        subparagraph:
                    ``(D) Amounts used in computing redistributions for 
                fiscal year 2001.--For purposes of subparagraph 
                (A)(i)(IV)--
                            ``(i) the amount specified in this clause 
                        is the amount specified in paragraph 
                        (2)(B)(i)(I) for fiscal year 2001, less the 
                        total amount remaining available pursuant to 
                        paragraph (2)(A)(iv);
                            ``(ii) the amount specified in this clause 
                        for a State is the amount by which the State's 
                        expenditures under this title in fiscal years 
                        2001, 2002, and 2003 exceed the State's 
                        allotment for fiscal year 2001 under subsection 
                        (b); and
                            ``(iii) the amount specified in this clause 
                        is the sum, for all States entitled to a 
                        redistribution under subparagraph (A) from the 
                        allotments for fiscal year 2001, of the amounts 
                        specified in clause (ii).''.
                    (C) Conforming amendments.--Such section 2104(g) is 
                further amended--
                            (i) in its heading, by striking ``and 
                        2000'' and inserting ``2000, and 2001''; and
                            (ii) in paragraph (3)--
                                    (I) by striking ``or fiscal year 
                                2000'' and inserting ``fiscal year 
                                2000, or fiscal year 2001''; and
                                    (II) by striking ``or November 30, 
                                2002,'' and inserting ``November 30, 
                                2002, or November 30, 2003,'', 
                                respectively.
            (4) Effective date.--This subsection, and the amendments 
        made by this subsection, shall be effective as if this 
        subsection had been enacted on September 30, 2002, and amounts 
        under title XXI of the Social Security Act (42 U.S.C. 1397aa et 
        seq.) from allotments for fiscal years 1998 through 2000 are 
        available for expenditure on and after October 1, 2002, under 
        the amendments made by this subsection as if this subsection 
        had been enacted on September 30, 2002.
    (b) Authority for Qualifying States To Use Portion of SCHIP Funds 
for Medicaid Expenditures.--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 allotments for fiscal 
                years 1998, 1999, 2000, 2001, for fiscal years in which 
                such allotments are available under subsections (e) and 
                (g) of section 2104, a qualifying State (as defined in 
                paragraph (2)) may elect to use not more than 20 
                percent of such allotments (instead of for expenditures 
                under this title) for payments for such fiscal year 
                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 subparagraph (A), the Secretary 
                        shall pay the State 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 the fiscal year 
                        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 and whose family 
                        income exceeds 150 percent of the poverty line.
                            ``(iii) No impact on determination of 
                        budget neutrality for waivers.--In the case of 
                        a qualifying State that uses amounts paid under 
                        this subsection for expenditures described in 
                        clause (ii) that are incurred under a waiver 
                        approved for the State, any budget neutrality 
                        determinations with respect to such waiver 
                        shall be determined without regard to such 
                        amounts paid.
            ``(2) Qualifying state.--In this subsection, the term 
        `qualifying State' means a State that--
                    ``(A) as of April 15, 1997, has an income 
                eligibility standard with respect to any 1 or more 
                categories of children (other than infants) who are 
                eligible for medical assistance under section 
                1902(a)(10)(A) or under a waiver under section 1115 
                implemented on January 1, 1994, that is up to 185 
                percent of the poverty line or above; and
                    ``(B) satisfies the requirements described in 
                paragraph (3).
            ``(3) Requirements.--The requirements described in this 
        paragraph are the following:
                    ``(A) SCHIP income eligibility.--The State has a 
                State child health plan that (whether implemented under 
                title XIX or this title)--
                            ``(i) as of January 1, 2001, has an income 
                        eligibility standard that is at least 200 
                        percent of the poverty line or has an income 
                        eligibility standard that exceeds 200 percent 
                        of the poverty line under a waiver under 
                        section 1115 that is based on a child's lack of 
                        health insurance;
                            ``(ii) subject to subparagraph (B), does 
                        not limit the acceptance of applications for 
                        children; and
                            ``(iii) provides benefits to all children 
                        in the State who apply for and meet eligibility 
                        standards on a statewide basis.
                    ``(B) No waiting list imposed.--With respect to 
                children whose family income is at or below 200 percent 
                of the poverty line, the State does not impose any 
                numerical limitation, waiting list, or similar 
                limitation on the eligibility of such children for 
                child health assistance under such State plan.
                    ``(C) Additional requirements.--The State has 
                implemented at least 3 of the following policies and 
                procedures (relating to coverage of children under 
                title XIX and this title):
                            ``(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 asset test.--The 
                        State does not apply any asset test for 
                        eligibility under section 1902(l) or this title 
                        with respect to children.
                            ``(iii) Adoption of 12-month continuous 
                        enrollment.--The State provides that 
                        eligibility shall not be regularly redetermined 
                        more often than once every year under this 
                        title or for children described in section 
                        1902(a)(10)(A).
                            ``(iv) 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.
                            ``(v) 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).''.




                                                       Calendar No. 166

108th CONGRESS

  1st Session

                                 S. 312

                          [Report No. 108-78]

_______________________________________________________________________

                                 A BILL

      To amend title XXI of the Social Security Act to extend the 
availability of allotments for fiscal years 1998 through 2001 under the 
               State Children's Health Insurance Program.

_______________________________________________________________________

                             June 24, 2003

                       Reported without amendment