II 110th CONGRESS 1st Session S. 142 IN THE SENATE OF THE UNITED STATES January 4, 2007 Ms. Cantwell (for herself, Mrs. Murray, and Ms. Mikulski) 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 allow qualifying States to use all or any portion of their allotments under the State Children's Health Insurance Program for certain Medicaid expenditures.

1.

Authority for qualifying States to use all or any portion of their SCHIP allotments for certain Medicaid expenditures

(a)

In general

Section 2105(g)(1)(A) of the Social Security Act (42 U.S.C. 1397ee(g)(1)(A)), as amended by section 201(b) of the National Institutes of Health Reform Act of 2006, is amended by striking not more than 20 percent of any allotment under section 2104 for fiscal year 1998, 1999, 2000, 2001, 2004, 2005, 2006, or 2007 and inserting all or any portion of any allotment made to the State under section 2104 for a fiscal year. (b)

Additional requirements

Section 2105(g)(2) of such Act (42 U.S.C. 1397ee(g)(2)) is amended— (1)by striking a State, that, on and inserting a State that is described in subparagraph (A) and satisfies all of the requirements of subparagraph (B).(A)

State described

A State described in this subparagraph is a State that, on ; and (2)by adding at the end the following: (B)

Requirements

The requirements of this subparagraph are the following: (i)

No reduction in medicaid or SCHIP income eligibility

Since January 1, 2001, the State has not reduced the income, assets, or resource requirements for eligibility for medical assistance under title XIX or for child health assistance under this title. (ii)

No waiting list imposed

The State does not impose any numerical limitation, waiting list, or similar limitation on the eligibility of children for medical assistance under title XIX or child health assistance under this title and does not limit the acceptance of applications for such assistance. (iii)

Provides assistance to all children who apply and qualify

The State provides medical assistance under title XIX or child health assistance under this title to all children in the State who apply for and meet the eligibility standards for such assistance. (iv)

Protection against inability to pay premiums or copayments

The State ensures that no child loses coverage under title XIX or this title, or is denied needed care, as a result of the child’s parents’ inability to pay any premiums or cost-sharing required under such title. (v)

Additional requirements

The State has implemented at least 3 of the following policies and procedures (relating to coverage of children under title XIX and this title): (I)

Simplified application form

With respect to children who are eligible for medical assistance under title XIX, the State uses the same simplified application form (including, if applicable, permitting application other than in person) for purposes of establishing eligibility for assistance under title XIX and this title. (II)

Elimination of asset test

The State does not apply any asset test for eligibility under title XIX or this title with respect to children. (III)

Adoption of 12-month continuous enrollment

The State provides that eligibility shall not be regularly redetermined more often than once every year under this title or for children eligible for medical assistance under title XIX. (IV)

Same verification and redetermination policies; automatic reassessment of eligibility

With respect to children who are eligible for medical assistance under section 1902(a)(10)(A), the State provides for initial eligibility determinations and redeterminations of eligibility using the same verification policies (including with respect to face-to-face interviews), forms, and frequency as the State uses for such purposes under this title, and, as part of such redeterminations, provides for the automatic reassessment of the eligibility of such children for assistance under title XIX and this title. (V)

Outstationing enrollment staff

The State provides for the receipt and initial processing of applications for benefits under this title and for children under title XIX at facilities defined as disproportionate share hospitals under section 1923(a)(1)(A) and Federally-qualified health centers described in section 1905(l)(2)(B) consistent with section 1902(a)(55). . (c)

Effective date

The amendments made by this section shall take effect on October 1, 2007, and shall apply to expenditures described in section 2105(g)(1)(B)(ii) of the Social Security Act (42 U.S.C. 1397ee(g)(1)(B)(ii)) that are made after that date.