110 HR 3872 IH: Children Come First Act of 2007 U.S. House of Representatives 2007-10-17 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
I 110th CONGRESS 1st Session H. R. 3872 IN THE HOUSE OF REPRESENTATIVES October 17, 2007 Mr. Fortenberry introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XXI of the Social Security Act to impose requirements on coverage of children in higher income families under the State Children’s Health Insurance Program (SCHIP).
1.
Short title
This Act may be cited as the Children Come First Act of 2007.
2.
Limitation on payments for States covering children in families with income between 200 and 300 percent of the poverty line; option of premium assistance for children of higher income families
(a)
In general
Section 2105(c) of the Social Security Act (42 U.S.C. 1397ee(c)) is amended by adding at the end the following new paragraph: (8)
Limitation on payments for States covering children of higher income families
(A)
In general
No payment shall be made under this section for child health assistance provided for a child of a higher income family (as defined in subparagraph (B)) under the State child health plan unless— (i)the family demonstrates that health insurance coverage for the child is— (I)unattainable, in accordance with subparagraph (C); or (II)unaffordable, in accordance with subparagraph (D); and (ii)the plan permits the family to be provided child health assistance through the form of premium assistance described in subparagraph (E) rather than through Medicaid or otherwise. (B)
Higher income family
For purposes of this paragraph, the term higher income family means a family the income of which exceeds 200 percent, but does not exceed 300 percent, of the poverty line. (C)
Unattainability
For purposes of this paragraph, health insurance coverage shall be treated as unattainable with respect to the child of a higher income family if the family can demonstrate an inability to obtain health insurance coverage for the child (as determined in accordance with standards established by the Secretary). (D)
Unaffordability
(i)
In general
For purposes of this paragraph, health insurance coverage shall be treated as unaffordable with respect to the child of a higher income family if the premium for such coverage exceeds the percentage (as determined by the Secretary under clause (ii)) of the adjusted gross income of the family. In applying the previous sentence to family coverage, there shall only be taken into account the portion of such premium that is actuarially attributable to children (as computed for purposes of subparagraph (E)(iii)). (ii)
Percentage determined
The Secretary shall determine a percentage under this clause based on factors such as family size, the average premium for health insurance coverage in the private sector for children, and such other factors as the Secretary deems appropriate. (E)
Premium assistance option
(i)
In general
The premium assistance option under this subparagraph shall be in the form of payment of premium for a policy that provides health insurance benefits to the child of a higher income family involved. Except as otherwise specifically provided, the State child health plan shall establish standards for such benefits and premium contributions. (ii)
Treatment
Payment of premium assistance under this subparagraph shall be treated as child health assistance for purposes of obtaining Federal financial participation under section 2105. (iii)
Application to family coverage
In the case of premium assistance under this subparagraph applied to coverage of one or more children under family coverage that covers a parent of such a child or other individuals who are not children, the amount of the premium payment under the option under this subparagraph shall be adjusted to take into account only the portion of the health insurance benefits that are actuarially attributable to such children. (F)
Exception for currently covered individuals
Subparagraph (A) shall not apply until October 1, 2011, to children who are enrolled under this part as targeted low-income children as of October 1, 2008.. (b)
Effective date
The amendment made by subsection (a) shall apply to State child health plans for payment for items and services furnished on or after October 1, 2008.