[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5268 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 5268

 To provide for a temporary increase of the Federal medical assistance 
     percentage under the Medicaid Program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 7, 2008

 Mr. Pallone (for himself, Mr. King of New York, Mr. Dingell, and Mr. 
  Reynolds) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To provide for a temporary increase of the Federal medical assistance 
     percentage under the Medicaid Program, 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. TEMPORARY INCREASE OF MEDICAID FMAP.

    (a) Permitting Maintenance of Fiscal Year 2007 FMAP for Last 2 
Calendar Quarters of Fiscal Year 2008.--Subject to subsection (e), if 
the FMAP determined without regard to this section for a State for 
fiscal year 2008 is less than the FMAP as so determined for fiscal year 
2007, the FMAP for the State for fiscal year 2007 shall be substituted 
for the State's FMAP for the third and fourth calendar quarters of 
fiscal year 2008, before the application of this section.
    (b) Permitting Maintenance of Fiscal Year 2008 FMAP for First 3 
Quarters of Fiscal Year 2009.--Subject to subsection (e), if the FMAP 
determined without regard to this section for a State for fiscal year 
2009 is less than the FMAP as so determined for fiscal year 2008, the 
FMAP for the State for fiscal year 2008 shall be substituted for the 
State's FMAP for the first, second, and third calendar quarters of 
fiscal year 2009, before the application of this section.
    (c) General 2.95 Percentage Points Increase for Last 2 Calendar 
Quarters of Fiscal Year 2008 and First 3 Calendar Quarters of Fiscal 
Year 2009.--Subject to subsections (e), (f), and (g), for each State 
for the third and fourth calendar quarters of fiscal year 2008 and for 
the first, second, and third calendar quarters of fiscal year 2009, the 
FMAP (taking into account the application of subsections (a) and (b)) 
shall be increased by 2.95 percentage points.
    (d) Increase in Cap on Medicaid Payments to Territories.--Subject 
to subsections (f) and (g), with respect to the third and fourth 
calendar quarters of fiscal year 2008 and the first, second, and third 
calendar quarters of fiscal year 2009, the amounts otherwise determined 
for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana 
Islands, and American Samoa under subsections (f) and (g) of section 
1108 of the Social Security Act (42 U.S.C. 1308) shall each be 
increased by an amount equal to 5.90 percent of such amounts.
    (e) Scope of Application.--The increases in the FMAP for a State 
under this section shall apply only for purposes of title XIX of the 
Social Security Act and shall not apply with respect to--
            (1) disproportionate share hospital payments described in 
        section 1923 of such Act (42 U.S.C. 1396r-4);
            (2) payments under title IV or XXI of such Act (42 U.S.C. 
        601 et seq. and 1397aa et seq.); or
            (3) any payments under XIX of such Act that are based on 
        the enhanced FMAP described in section 2105(b) of such Act (42 
        U.S.C. 1397ee(b)).
    (f) State Eligibility.--
            (1) In general.--Subject to paragraph (2), a State is 
        eligible for an increase in its FMAP under subsection (c) or an 
        increase in a cap amount under subsection (d) only if the 
        eligibility under its State plan under title XIX of the Social 
        Security Act (including any waiver under such title or under 
        section 1115 of such Act (42 U.S.C. 1315)) is no more 
        restrictive than the eligibility under such plan (or waiver) as 
        in effect on January 1, 2008.
            (2) State reinstatement of eligibility permitted.--A State 
        that has restricted eligibility under its State plan under 
        title XIX of the Social Security Act (including any waiver 
        under such title or under section 1115 of such Act (42 U.S.C. 
        1315)) after January 1, 2008, is eligible for an increase in 
        its FMAP under subsection (c) or an increase in a cap amount 
        under subsection (d) in the first calendar quarter (and 
        subsequent calendar quarters) in which the State has reinstated 
        eligibility that is no more restrictive than the eligibility 
        under such plan (or waiver) as in effect on January 1, 2008.
            (3) Rule of construction.--Nothing in paragraph (1) or (2) 
        shall be construed as affecting a State's flexibility with 
        respect to benefits offered under the State medicaid program 
        under title XIX of the Social Security Act (42 U.S.C. 1396 et 
        seq.) (including any waiver under such title or under section 
        1115 of such Act (42 U.S.C. 1315)).
    (g) Requirement for Certain States.--In the case of a State that 
requires political subdivisions within the State to contribute toward 
the non-Federal share of expenditures under the State medicaid plan 
required under section 1902(a)(2) of the Social Security Act (42 U.S.C. 
1396a(a)(2)), the State shall not require that such political 
subdivisions pay a greater percentage of the non-Federal share of such 
expenditures for the third and fourth calendar quarters of fiscal year 
2008 and the first, second, and third calendar quarters of fiscal year 
2009, than the percentage that would have been required by the State 
under such plan on March 31, 2008, prior to application of this 
section.
    (h) Definitions.--In this section:
            (1) FMAP.--The term ``FMAP'' means the Federal medical 
        assistance percentage, as defined in section 1905(b) of the 
        Social Security Act (42 U.S.C. 1396d(b)).
            (2) State.--The term ``State'' has the meaning given such 
        term for purposes of title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.).
            (3) Repeal.--Effective as of October 1, 2009, this section 
        is repealed.

SEC. 2. ADJUSTMENT IN COMPUTATION OF MEDICAID FMAP TO DISREGARD AN 
              EXTRAORDINARY EMPLOYER PENSION CONTRIBUTION.

    (a) In General.--Only for purposes of computing the FMAP (as 
defined in subsection (e)) for a State for a fiscal year (beginning 
with fiscal year 2006) and applying the FMAP under title XIX of the 
Social Security Act, any significantly disproportionate employer 
pension or insurance fund contribution described in subsection (b) 
shall be disregarded in computing the per capita income of such State, 
but shall not be disregarded in computing the per capita income for the 
continental United States (and Alaska) and Hawaii.
    (b) Significantly Disproportionate Employer Pension and Insurance 
Fund Contribution.--
            (1) In general.--For purposes of this section, a 
        significantly disproportionate employer pension and insurance 
        fund contribution described in this subsection with respect to 
        a State is any identifiable employer contribution towards 
        pension or other employee insurance funds that is estimated to 
        accrue to residents of such State for a calendar year 
        (beginning with calendar year 2003) if the increase in the 
        amount so estimated exceeds 25 percent of the total increase in 
        personal income in that State for the year involved.
            (2) Data to be used.--For estimating and adjusting a FMAP 
        already calculated as of the date of the enactment of this Act 
        for a State with a significantly disproportionate employer 
        pension and insurance fund contribution, the Secretary of 
        Health and Human Services shall use the personal income data 
        set originally used in calculating such FMAP.
            (3) Special adjustment for negative growth.--If in any 
        calendar year the total personal income growth in a State is 
        negative, an employer pension and insurance fund contribution 
        for the purposes of calculating the State's FMAP for a calendar 
        year shall not exceed 125 percent of the amount of such 
        contribution for the previous calendar year for the State.
    (c) Hold Harmless.--No State shall have its FMAP for a fiscal year 
reduced as a result of the application of this section.
    (d) Report.--Not later than May 15, 2008, the Secretary of Health 
and Human Services shall submit to Congress a report on the problems 
presented by the current treatment of pension and insurance fund 
contributions in the use of Bureau of Economic Affairs calculations for 
the FMAP and for Medicaid and on possible alternative methodologies to 
mitigate such problems.
    (e) FMAP Defined.--For purposes of this section, the term ``FMAP'' 
means the Federal medical assistance percentage, as defined in section 
1905(b) of the Social Security Act (42 U.S.C. 1396(d)).
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