[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3917 Introduced in House (IH)]







109th CONGRESS
  1st Session
                                H. R. 3917

 To provide for payment by large employers for employees, and spouses 
and dependents of employees, who are covered under the Medicaid Program 
                               or SCHIP.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 27, 2005

 Mr. Pallone introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To provide for payment by large employers for employees, and spouses 
and dependents of employees, who are covered under the Medicaid Program 
                               or SCHIP.

    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 ``Large Employer Medicaid and SCHIP 
Responsibility Act of 2005''.

SEC. 2. LARGE EMPLOYER RESPONSIBILITY FOR MEDICAID AND SCHIP COVERAGE 
              OF EMPLOYEES AND THEIR DEPENDENTS.

    (a) In General.--Notwithstanding any other provision of law, any 
large employer that employs one or more employees who are enrolled (or 
any of whose spouses or dependent children are enrolled) under medicaid 
or SCHIP for a month in a year is liable to the Secretary of Health and 
Human Services for payment of the penalty computed under subsection 
(b)(4) with respect to each such employee, spouse, or dependent. Such 
payment shall be made on a quarterly basis for months in each quarter 
in a form and manner specified by the Secretary and shall be payable to 
States in accordance with subsection (d).
    (b) Amount of Per Capita Penalty.--
            (1) Computation of monthly average costs for adults and 
        children.--The Secretary shall compute for months in each year 
        for each State a monthly average cost of providing acute care 
        under medicaid and SCHIP for a month in the year for--
                    (A) an adult who is not disabled and is under 65 
                years of age; and
                    (B) a child.
            (2) Administrative factor for costs of program.--The 
        Secretary shall compute an estimate of the average monthly per 
        capita cost of administering this section in a year, including 
        costs relating to collection of the penalty under this section 
        and enforcement of such penalty.
            (3) Adjusted monthly average cost per covered employee or 
        spouse or child.--The Secretary shall compute an adjusted 
        monthly average cost for a month in a year for an employee, or 
        spouse of an employee, and for a dependent child in each State 
        equal to the sum of--
                    (A) 80 percent of the amount computed under 
                subparagraph (1) for an adult or child, respectively; 
                and
                    (B) the monthly per capita cost computed under 
                paragraph (2).
            (4) Penalty amount.--The amount of the per capita penalty 
        under this paragraph for an employer for a month in a year for 
        an employee (or spouse of an employee) or a dependent child is 
        equal to the adjusted monthly average cost for such employee, 
        spouse, or dependent child computed under paragraph (3).
    (c) Enforcement.--Penalties imposed under this section may be 
collected in the same manner as civil money penalties may be collected 
under section 1128A of the Social Security Act.
    (d) Payment to State Providing Medicaid or SCHIP Assistance.--The 
Secretary shall provide for the distribution of penalties paid under 
this section with respect to an employee, spouse, or child covered 
under medicaid or SCHIP in a State to such State.
    (e) Definitions.--For purposes of this section:
            (1) Employee.--The term ``employee'' means, with respect to 
        an employer, an individual who is employed by the employer for 
        an average of at least 40 hours a week and has been so employed 
        by that employer for at least 3 months.
            (2) Large employer.--The term ``large employer'' means an 
        employer that has 50 or more employees.
            (3) Medicaid.--The term ``medicaid'' means a State plan 
        under title XIX of the Social Security Act.
            (4) SCHIP.--The term ``SCHIP'' means a State child health 
        insurance program under title XXI of the Social Security Act.
            (5) Secretary.--The term ``Secretary'' means Secretary of 
        Health and Human Services.
            (6) State.--The term ``State'' has the meaning given such 
        term for purposes of title XIX of the Social Security Act.
    (f) Effective Date.--This section shall apply to employers for 
months beginning with January 2006.
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