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.

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)).