[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 2137 Introduced in Senate (IS)]








109th CONGRESS
  1st Session
                                S. 2137

  To amend title XXI of the Social Security Act to make all uninsured 
children eligible for the State children's health insurance program, to 
  encourage States to increase the number of children enrolled in the 
medicaid and State children's health insurance programs by simplifying 
the enrollment and renewal procedures for those programs, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           December 16, 2005

  Mr. Durbin 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 make all uninsured 
children eligible for the State children's health insurance program, to 
  encourage States to increase the number of children enrolled in the 
medicaid and State children's health insurance programs by simplifying 
the enrollment and renewal procedures for those programs, 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 ``All Kids Health Insurance Coverage 
Act of 2005''.

SEC. 2. FINDINGS.

    The Senate finds the following:
            (1) There are more than 9,000,000 children in the United 
        States with no health insurance coverage.
            (2) Uninsured children, when compared to privately insured 
        children, are--
                    (A) 3.5 times more likely to have gone without 
                needed medical, dental, or other health care;
                    (B) 4 times more likely to have delayed seeking 
                medical care;
                    (C) 5 times more likely to go without needed 
                prescription drugs; and
                    (D) 6.5 times less likely to have a regular source 
                of care.
            (3) Children without health insurance coverage are at a 
        disadvantage in the classroom, as shown by the following 
        studies:
                    (A) The Florida Healthy Kids Annual Report 
                published in 1997, found that children who do not have 
                health care coverage are 25 percent more likely to miss 
                school.
                    (B) A study of the California Health Families 
                program found that children enrolled in public health 
                coverage experienced a 68 percent improvement in school 
                performance and school attendance.
                    (C) A 2002 Building Bridges to Healthy Kids and 
                Better Students study conducted by the Council of Chief 
                State School Officers in Vermont concluded that 
                children who started out without health insurance saw 
                their reading scores more than double after obtaining 
                health care coverage.
            (4) More than half of uninsured children in the United 
        States are eligible for coverage under either the State 
        Children's Health Insurance Program (SCHIP) or Medicaid, but 
        are not enrolled in those safety net programs.
            (5) Some States, seeing that the Federal Government is not 
        providing assistance to middle class families who are unable to 
        afford health insurance, are trying to extend health care 
        coverage to some or all children in the State.
            (6) State efforts to cover all children may not be 
        successful without financial assistance from the Federal 
        Government.

SEC. 3. ELIGIBILITY OF ALL UNINSURED CHILDREN FOR SCHIP.

    (a) In General.--Section 2110(b) of the Social Security Act (42 
U.S.C. 1397jj(b)) is amended--
            (1) in paragraph (1)--
                    (A) by striking subparagraph (B); and
                    (B) by redesignating subparagraph (C) as 
                subparagraph (B);
            (2) in paragraph (2)--
                    (A) by striking ``include'' and all that follows 
                through ``a child who is an'' and inserting ``include a 
                child who is an''; and
                    (B) by striking the semicolon and all that follows 
                through the period and inserting a period; and
            (3) by striking paragraph (4).
    (b) No Exclusion of Children With Access to High-Cost Coverage.--
Section 2110(b)(3) of the Social Security Act (42 U.S.C. 1397jj(b)(3)) 
is amended--
            (1) in the paragraph heading, by striking ``rule'' and 
        inserting ``rules'';
            (2) by striking ``A child shall not be considered to be 
        described in paragraph (1)(C)'' and inserting the following:
                    ``(A) Certain non federally funded coverage.--A 
                child shall not be considered to be described in 
                paragraph (1)(C)''; and
            (3) by adding at the end the following:
                    ``(B) No exclusion of children with access to high-
                cost coverage.--A State may include a child as a 
                targeted vulnerable child if the child has access to 
                coverage under a group health plan or health insurance 
                coverage and the total annual aggregate cost for 
                premiums, deductibles, cost sharing, and similar 
                charges imposed under the group health plan or health 
                insurance coverage with respect to all targeted 
                vulnerable children in the child's family exceeds 5 
                percent of such family's income for the year 
                involved.''.
    (c) Conforming Amendments.--
            (1) Titles XIX and XXI of the Social Security Act (42 
        U.S.C. 1396 et seq.; 1397aa et. seq.) are amended by striking 
        ``targeted low-income'' each place it appears and inserting 
        ``targeted vulnerable''.
            (2) Section 2101(a) of such Act (42 U.S.C. 1397aa(a)) is 
        amended by striking ``uninsured, low-income'' and inserting 
        ``low-income''.
            (3) Section 2102(b)(3)(C) of such Act (42 U.S.C. 
        1397bb(b)(3)(C)) is amended by inserting ``, particularly with 
        respect to children whose family income exceeds 200 percent of 
        the poverty line'' before the semicolon.
            (4) Section 2102(b)(3)(E), section 2105(a)(1)(D)(ii), 
        paragraphs (1)(C) and (2) of section 2107, and subsections 
        (a)(1) and (d)(1)(B) of section 2108 of such Act (42 U.S.C. 
        1397bb(b)(3)(E); 1397ee(a)(1)(D)(ii); 1397gg; 1397hh) are 
        amended by striking ``low-income'' each place it appears.
            (5) Section 2110(a)(27) of such Act (42 U.S.C. 
        1397jj(a)(27)) is amended by striking ``eligible low-income 
        individuals'' and inserting ``targeted vulnerable 
        individuals''.
    (d) Effective Date.--The amendments made by this section take 
effect on October 1, 2006.

SEC. 4. INCREASE IN FEDERAL FINANCIAL PARTICIPATION UNDER SCHIP AND 
              MEDICAID FOR STATES WITH SIMPLIFIED ENROLLMENT AND 
              RENEWAL PROCEDURES FOR CHILDREN.

    (a) SCHIP.--Section 2105(c)(2) of the Social Security Act (42 
U.S.C. 1397ee(c)(2)) is amended by adding at the end the following:
                    ``(C) Nonapplication of limitation and increase in 
                federal payment for states with simplified enrollment 
                and renewal procedures.--
                            ``(i) In general.--Notwithstanding 
                        subsection (a)(1) and subparagraph (A)--
                                    ``(I) the limitation under 
                                subparagraph (A) on expenditures for 
                                items described in subsection (a)(1)(D) 
                                shall not apply with respect to 
                                expenditures incurred to carry out any 
                                of the outreach strategies described in 
                                clause (ii), but only if the State 
                                carries out the same outreach 
                                strategies for children under title 
                                XIX; and
                                    ``(II) the enhanced FMAP for a 
                                State for a fiscal year otherwise 
                                determined under subsection (b) shall 
                                be increased by 5 percentage points 
                                (without regard to the application of 
                                the 85 percent limitation under that 
                                subsection) with respect to such 
                                expenditures.
                            ``(ii) Outreach strategies described.--For 
                        purposes of clause (i), the outreach strategies 
                        described in this clause are the following:
                                    ``(I) Presumptive eligibility.--The 
                                State provides for presumptive 
                                eligibility for children under this 
                                title and under title XIX.
                                    ``(II) Adoption of 12-month 
                                continuous eligibility.--The State 
                                provides that eligibility for children 
                                shall not be redetermined more often 
                                than once every year under this title 
                                or under title XIX.
                                    ``(III) Elimination of asset 
                                test.--The State does not apply any 
                                asset test for eligibility under this 
                                title or title XIX with respect to 
                                children.
                                    ``(IV) Passive renewal.--The State 
                                provides for the automatic renewal of 
                                the eligibility of children for 
                                assistance under this title and under 
                                title XIX if the family of which such a 
                                child is a member does not report any 
                                changes to family income or other 
                                relevant circumstances, subject to 
                                verification of information from State 
                                databases.''.
    (b) Medicaid.--
            (1) In general.--Section 1902(l) of the Social Security Act 
        (42 U.S.C. 1396a(l)) is amended--
                    (A) in paragraph (3), by inserting ``subject to 
                paragraph (5)'', after ``Notwithstanding subsection 
                (a)(17),''; and
                    (B) by adding at the end the following:
    ``(5)(A) Notwithstanding the first sentence of section 1905(b), 
with respect to expenditures incurred to carry out any of the outreach 
strategies described in subparagraph (B) for individuals under 19 years 
of age who are eligible for medical assistance under subsection 
(a)(10)(A), the Federal medical assistance percentage is equal to the 
enhanced FMAP described in section 2105(b) and increased under section 
2105(c)(2)(C)(i)(II), but only if the State carries out the same 
outreach strategies for children under title XXI.
    ``(B) For purposes of subparagraph (A), the outreach strategies 
described in this subparagraph are the following:
            ``(i) Presumptive eligibility.--The State provides for 
        presumptive eligibility for such individuals under this title 
        and title XXI.
            ``(ii) Adoption of 12-month continuous eligibility.--The 
        State provides that eligibility for such individuals shall not 
        be redetermined more often than once every year under this 
        title or under title XXI.
            ``(iii) Elimination of asset test.--The State does not 
        apply any asset test for eligibility under this title or title 
        XXI with respect to such individuals.
            ``(iv) Passive renewal.--The State provides for the 
        automatic renewal of the eligibility of such individuals for 
        assistance under this title and under title XXI if the family 
        of which such an individual is a member does not report any 
        changes to family income or other relevant circumstances, 
        subject to verification of information from State databases.''.
            (2) Conforming amendment.--The first sentence of section 
        1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is 
        amended by striking ``section 1933(d)'' and inserting 
        ``sections 1902(l)(5) and 1933(d)''.
    (c) Effective Date.--The amendments made by this section take 
effect on October 1, 2006.

SEC. 5. LIMITATION ON PAYMENTS TO STATES THAT HAVE AN ENROLLMENT CAP 
              BUT HAVE NOT EXHAUSTED THE STATE'S AVAILABLE ALLOTMENTS.

    (a) In General.--Section 2105 of the Social Security Act (42 U.S.C. 
1397ee) is amended by adding at the end the following:
    ``(h) Limitation on Payments to States That Have an Enrollment Cap 
but Have Not Exhausted the State's Available Allotments.--
            ``(1) In general.--Notwithstanding any other provision of 
        this section, payment shall not be made to a State under this 
        section if the State has an enrollment freeze, enrollment cap, 
        procedures to delay consideration of, or not to consider, 
        submitted applications for child health assistance, or a 
        waiting list for the submission or consideration of such 
        applications or for such assistance, and the State has not 
        fully expended the amount of all allotments available with 
        respect to a fiscal year for expenditure by the State, 
        including allotments for prior fiscal years that remain 
        available for expenditure during the fiscal year under 
        subsection (c) or (g) of section 2104 or that were 
        redistributed to the State under subsection (f) or (g) of 
        section 2104.
            ``(2) Rule of construction.--Paragraph (1) shall not be 
        construed as prohibiting a State from establishing regular open 
        enrollment periods for the submission of applications for child 
        health assistance.''.
    (b) Effective Date.--The amendments made by this section take 
effect on October 1, 2006.

SEC. 6. ADDITIONAL ENHANCEMENT TO FMAP TO PROMOTE EXPANSION OF COVERAGE 
              TO ALL UNINSURED CHILDREN UNDER MEDICAID AND SCHIP.

    (a) In General.--Title XXI (42 U.S.C. 1397aa et seq.) is amended by 
adding at the end the following:

``SEC. 2111. ADDITIONAL ENHANCEMENT TO FMAP TO PROMOTE EXPANSION OF 
              COVERAGE TO ALL UNINSURED CHILDREN UNDER MEDICAID AND 
              SCHIP.

    ``(a) In General.--Notwithstanding subsection (b) of section 2105 
(and without regard to the application of the 85 percent limitation 
under that subsection), the enhanced FMAP with respect to expenditures 
in a quarter for providing child health assistance to uninsured 
children whose family income exceeds 200 percent of the poverty line, 
shall be increased by 5 percentage points.
    ``(b) Uninsured Child Defined.--
            ``(1) In general.--For purposes of subsection (a), subject 
        to paragraph (2), the term `uninsured child' means an uncovered 
        child who has been without creditable coverage for a period 
        determined by the Secretary, except that such period shall not 
        be less than 6 months.
            ``(2) Special rule for newborn children.--In the case of a 
        child 12 months old or younger, the period determined under 
        paragraph (1) shall be 0 months and such child shall be 
        considered uninsured upon birth.
            ``(3) Special rule for children losing medicaid or schip 
        coverage due to increased family income.--In the case of a 
        child who, due to an increase in family income, becomes 
        ineligible for coverage under title XIX or this title during 
        the period beginning on the date that is 12 months prior to the 
        date of enactment of the All Kids Health Insurance Coverage Act 
        of 2005 and ending on the date of enactment of such Act, the 
        period determined under paragraph (1) shall be 0 months and 
        such child shall be considered uninsured upon the date of 
        enactment of the All Kids Health Insurance Coverage Act of 
        2005.
            ``(4) Monitoring and adjustment of period required to be 
        uninsured.--The Secretary shall--
                    ``(A) monitor the availability and retention of 
                employer-sponsored health insurance coverage of 
                dependent children; and
                    ``(B) adjust the period determined under paragraph 
                (1) as needed for the purpose of promoting the 
                retention of private or employer-sponsored health 
                insurance coverage of dependent children and timely 
                access to health care services for such children.''.
    (b) Cost-Sharing for Children in Families With High Family 
Income.--Section 2103(e)(3) of the Social Security Act (42 U.S.C. 
1397cc(e)(3)) is amended by adding at the end the following new 
subparagraph:
                    ``(C) Children in families with high family 
                income.--
                            ``(i) In general.--For children not 
                        described in subparagraph (A) whose family 
                        income exceeds 400 percent of the poverty line 
                        for a family of the size involved, subject to 
                        paragraphs (1)(B) and (2), the State shall 
                        impose a premium that is not less than the cost 
                        of providing child health assistance to 
                        children in such families, and deductibles, 
                        cost sharing, or similar charges shall be 
                        imposed under the State child health plan 
                        (without regard to a sliding scale based on 
                        income), except that the total annual aggregate 
                        cost-sharing with respect to all such children 
                        in a family under this title may not exceed 5 
                        percent of such family's income for the year 
                        involved.
                            ``(ii) Inflation adjustment.--The dollar 
                        amount specified in clause (i) shall be 
                        increased, beginning with fiscal year 2008, 
                        from year to year based on the percentage 
                        increase in the consumer price index for all 
                        urban consumers (all items; United States city 
                        average). Any dollar amount established under 
                        this clause that is not a multiple of $100 
                        shall be rounded to the nearest multiple of 
                        $100.''.
    (c) Additional Allotments for States Providing Coverage to All 
Uninsured Children in the State.--
            (1) In general.--Section 2104 of the Social Security Act 
        (42 U.S.C. 1397dd) is amended by inserting after subsection (c) 
        the following:
    ``(d) Additional Allotments for States Providing Coverage to All 
Uninsured Children in the State.--
            ``(1) Appropriation; total allotment.--For the purpose of 
        providing additional allotments to States to provide coverage 
        of all uninsured children (as defined in section 2111(b)) in 
        the State under the State child health plan, there is 
        appropriated, out of any money in the Treasury not otherwise 
        appropriated--
                    ``(A) for fiscal years 2007, 2008, and 2009, 
                $3,000,000,000;
                    ``(B) for fiscal year 2010, $5,000,000,000; and
                    ``(C) for fiscal year 2011, $7,000,000,000.
            ``(2) State and territorial allotments.--
                    ``(A) In general.--In addition to the allotments 
                provided under subsections (b) and (c), subject to 
                subparagraph (B) and paragraphs (3) and (4), of the 
                amount available for the additional allotments under 
                paragraph (1) for a fiscal year, the Secretary shall 
                allot to each State with a State child health plan that 
                provides coverage of all uninsured children (as so 
                defined) in the State approved under this title--
                            ``(i) in the case of such a State other 
                        than a commonwealth or territory described in 
                        subsection (ii), the same proportion as the 
                        proportion of the State's allotment under 
                        subsection (b) (determined without regard to 
                        subsection (f)) to 98.95 percent of the total 
                        amount of the allotments under such section for 
                        such States eligible for an allotment under 
                        this subparagraph for such fiscal year; and
                            ``(ii) in the case of a commonwealth or 
                        territory described in subsection (c)(3), the 
                        same proportion as the proportion of the 
                        commonwealth's or territory's allotment under 
                        subsection (c) (determined without regard to 
                        subsection (f)) to 1.05 percent of the total 
                        amount of the allotments under such section for 
                        commonwealths and territories eligible for an 
                        allotment under this subparagraph for such 
                        fiscal year.
                    ``(B) Minimum allotment.--
                            ``(i) In general.--No allotment to a State 
                        for a fiscal year under this subsection shall 
                        be less than 50 percent of the amount of the 
                        allotment to the State determined under 
                        subsections (b) and (c) for the preceding 
                        fiscal year.
                            ``(ii) Pro rata reductions.--The Secretary 
                        shall make such pro rata reductions to the 
                        allotments determined under this subsection as 
                        are necessary to comply with the requirements 
                        of clause (i).
                    ``(C) Availability and redistribution of unused 
                allotments.--In applying subsections (e) and (f) with 
                respect to additional allotments made available under 
                this subsection, the procedures established under such 
                subsections shall ensure such additional allotments are 
                only made available to States which have elected to 
                provide coverage under section 2111.
            ``(3) Use of additional allotment.--Additional allotments 
        provided under this subsection are not available for amounts 
        expended before October 1, 2005. Such amounts are available for 
        amounts expended on or after such date for child health 
        assistance for uninsured children (as defined in section 
        2111(b)).
            ``(4) Requiring election to provide coverage.--No payments 
        may be made to a State under this title from an allotment 
        provided under this subsection unless the State has made an 
        election to provide child health assistance for all uninsured 
        children (as so defined) in the State, including such children 
        whose family income exceeds 200 percent of the poverty line.''.
            (2) Conforming amendments.--Section 2104 of the Social 
        Security Act (42 U.S.C. 1397dd) is amended--
                    (A) in subsection (a), by inserting ``subject to 
                subsection (d),'' after ``under this section,'';
                    (B) in subsection (b)(1), by inserting ``and 
                subsection (d)'' after ``Subject to paragraph (4)''; 
                and
                    (C) in subsection (c)(1), by inserting ``subject to 
                subsection (d),'' after ``for a fiscal year,''.
    (d) Effective Date.--The amendments made by this section take 
effect on October 1, 2006.

SEC. 7. REPEAL OF THE SCHEDULED PHASEOUT OF THE LIMITATIONS ON PERSONAL 
              EXEMPTIONS AND ITEMIZED DEDUCTIONS.

    (a) In General.--The Internal Revenue Code of 1986 is amended--
            (1) by striking subparagraphs (E) and (F) of section 
        151(d)(3), and
            (2) by striking subsections (f) and (g) of section 68.
    (b) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2005.
    (c) Application of EGTRRA Sunset.--The amendments made by this 
section shall be subject to title IX of the Economic Growth and Tax 
Relief Reconciliation Act of 2001 to the same extent and in the same 
manner as the provision of such Act to which such amendment relates.
                                 <all>