[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 747 Introduced in Senate (IS)]







109th CONGRESS
  1st Session
                                 S. 747

 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 SENATE OF THE UNITED STATES

                             April 11, 2005

   Mr. Lugar (for himself, Mr. Bingaman, Mr. Cochran, Mr. Kerry, Mr. 
 Durbin, and Mrs. Feinstein) introduced the following bill; which was 
          read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 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 2005''.

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 (except as provided in subparagraph (C), not to exceed 21 
        years of age) by using a determination made within a reasonable 
        period (as determined by the State) before its use for this 
        purpose, of the individual's family or household income, or if 
        applicable for purposes of determining eligibility under this 
        title or title XXI, assets or resources, 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) an agency administering the Food Stamp Act of 
        1977, the Richard B. Russell National School Lunch Act, or the 
        Child Nutrition Act of 1966, notwithstanding any differences in 
        budget unit, disregard, deeming, or other methodology, but only 
        if--
                    ``(i) the agency has fiscal liabilities or 
                responsibilities affected or potentially affected by 
                such determination; and
                    ``(ii) any information furnished by the agency 
                pursuant to this subparagraph is used solely for 
                purposes of determining eligibility for medical 
                assistance under this title or for child health 
                assistance under title XXI.
            ``(B) Nothing in subparagraph (A) shall be construed--
                    ``(i) to authorize the denial of medical assistance 
                under this title or of child health assistance under 
                title XXI to an individual who, without the application 
                of this paragraph, would qualify for such assistance;
                    ``(ii) to relieve a State of the obligation under 
                subsection (a)(8) to furnish medical 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 for medical assistance under this 
                title or for child health assistance under title XXI on 
                a basis other than family or household income (or, if 
                applicable, assets or resources) if an individual is 
                determined ineligible for such assistance on the basis 
                of information furnished pursuant to 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 the individual's 
        eligibility for medical assistance under this title is based on 
        pregnancy or if the 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 an individual's eligibility for 
                assistance on financial determinations made by a 
                program providing nutrition or other public assistance 
                (except that the State option under subparagraph (C) of 
                such section shall apply under this title only if an 
                individual is pregnant)).''.
    (c) Effective Date.--The amendments made by this section take 
effect on October 1, 2005.
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