1.Short
title; table of contents
(a)This Act may be cited
as the More Children, More Choices Act
of 2007
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of
contents.
TITLE I—SCHIP Reauthorization
Sec. 101. Requiring outreach and coverage before expansion of
eligibility.
Sec. 102. Application of citizenship documentation
requirements; increased Federal matching rate for citizenship documentation
enforcement under Medicaid and SCHIP.
Sec. 103. Limitations on eligibility based on substantial net
assets.
Sec. 104. Clarification of State authorities.
Sec. 105. Easing administrative barriers to State cooperation
with employer-sponsored insurance coverage.
Sec. 106. Improving beneficiary choice in SCHIP.
Sec. 107. Allotment distribution formula.
Sec. 108. Five-year reauthorization.
Sec. 109. Enhancing the programmatic focus on children and
pregnant women.
Sec. 110. Grants for outreach and enrollment.
TITLE II—Child health insurance coverage through tax
fairness
Sec. 201. Expansion of child health care insurance coverage
through tax fairness.
TITLE III—State health reform projects
Sec. 301. State health reform projects.
TITLE IV—Sense of the Senate
Sec. 401. Sense of the Senate.
<enum>I</enum><header>SCHIP
Reauthorization</header>
<section id="H565AA506DEAB4565BA429E46F2CA566C"><enum>101.</enum><header>Requiring
outreach and coverage before expansion of eligibility</header>
<subsection id="H80DA6F1610F74070980063C187E55F15"><enum>(a)</enum><header>State plan
required To specify how it will achieve coverage for 90 percent of targeted
low-income children</header>
<paragraph id="HEEDA3E52B907470DBB2EF000F5ED2CA7"><enum>(1)</enum><header>In
general</header><text>Section 2102(a) of the Social Security Act (42 U.S.C.
1397bb(a)) is amended—</text>
<subparagraph id="HBC32635BCFBE47E0B1EFFC6FF0091C2"><enum>(A)</enum><text>in paragraph (6),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HB2A58AFE96E44C6697A3DE0000C82D25"><enum>(B)</enum><text>in paragraph (7),
by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="H97A68D0E7F3946E4A716135508CC6277"><enum>(C)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H5B8C1B62F944438CBC19BAEC3B326BEF" style="OLC">
<paragraph id="H920149F4E38A4120872015706DE7A927"><enum>(8)</enum><text display-inline="yes-display-inline">how the eligibility and benefits provided
for under the plan for each fiscal year (beginning with fiscal year 2009) will
allow for the State's annual funding allotment to cover at least 90 percent of
the eligible targeted low-income children in the
State.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H758DF3D8B1D2400A9EC1CD569E7695F5"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by paragraph (1) shall apply to State
child health plans for fiscal years beginning with fiscal year 2009.</text>
</paragraph></subsection><subsection id="H234E8C5D52E24C2BA0849BB627C61F48"><enum>(b)</enum><header>Limitation on
program expansions until lowest income eligible individuals
enrolled</header><text>Section 2105(c) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C.
1397dd(c)</external-xref>) is amended by adding at the end the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HECE909E6967E44B7899E6220A7AAF712" style="OLC">
<paragraph id="H05972A3C55F84FDC9F4E00C91F410984"><enum>(8)</enum><header>Limitation on
increased coverage of higher income children</header><text>For child health
assistance furnished in a fiscal year beginning with fiscal year 2008:</text>
<subparagraph id="HA4E4260251CF4D07A016C244005F915B"><enum>(A)</enum><header>No payment for
children with family income above 250 percent of poverty line</header><text display-inline="yes-display-inline">Payment shall not be made under this
section for child health assistance for a targeted low-income child in a family
the income of which exceeds 250 percent of the poverty line applicable to a
family of the size involved.</text>
</subparagraph><subparagraph id="H8BBB67E35D05480B93AA9FE5F1ED22F"><enum>(B)</enum><header>Special rules for
payment for children with family income above 200 percent of poverty
line</header><text display-inline="yes-display-inline">In the case of child
health assistance for a targeted low-income child in a family the income of
which exceeds 200 percent (but does not exceed 250 percent) of the poverty line
applicable to a family of the size involved no payment shall be made under this
section for such assistance unless the State demonstrates to the satisfaction
of the Secretary that—</text>
<clause id="HD9D077E088A74F638E6483B49C5B32FC"><enum>(i)</enum><text>the State has met
the 90 percent retrospective coverage test specified in subparagraph (C)(i) for
the previous fiscal year; and</text>
</clause><clause id="H89EC1D1AC48347AB9F69C63E647188ED"><enum>(ii)</enum><text>the State will
meet the 90 percent prospective coverage test specified in subparagraph (C)(ii)
for the fiscal year.</text>
</clause></subparagraph><subparagraph id="HB9A5C9E44E2B45E2A019F092AEEEE031"><enum>(C)</enum><header>90 percent
coverage tests</header>
<clause id="H54BAE6E0A086470399C3BBAEC7B360D3"><enum>(i)</enum><header>Retrospective
test</header><text>The 90 percent retrospective coverage test specified in this
clause is, for a State for a fiscal year, that on average during the fiscal
year, the State has enrolled under this title or title XIX at least 90 percent
of the individuals residing in the State who—</text>
<subclause id="HA831A3A276874DAEAE7E8D2CB5619D20"><enum>(I)</enum><text>are children under
19 years of age (or are pregnant women) and are eligible for medical assistance
under title XIX; or</text>
</subclause><subclause id="HD5CB120980824B32A66C7B31AD459EE8"><enum>(II)</enum><text>are targeted
low-income children whose family income does not exceed 200 percent of the
poverty line and who are eligible for child health assistance under this
title.</text>
</subclause></clause><clause id="HFDD42A4432604E51A051A8BEF41832A6"><enum>(ii)</enum><header>Prospective
test</header><text>The 90 percent prospective test specified in this clause is,
for a State for a fiscal year, that on average during the fiscal year, the
State will enroll under this title or title XIX at least 90 percent of the
individuals residing in the State who—</text>
<subclause id="HCF68B74917EB45DE88E75381CA109C49"><enum>(I)</enum><text>are children under
19 years of age (or are pregnant women) and are eligible for medical assistance
under title XIX; or</text>
</subclause><subclause id="HE0214D5536024DAEA4D6CAC400E8D2E7"><enum>(II)</enum><text display-inline="yes-display-inline">are targeted low-income children whose
family income does not exceed such percent of the poverty line (in excess of
200 percent) as the State elects consistent with this paragraph and who are
eligible for child health assistance under this title.</text>
</subclause></clause></subparagraph><subparagraph id="H2FFDCE1E1BC145928DF1609C585C39EC"><enum>(D)</enum><header>Grandfather</header><text>Subparagraphs
(A) and (B) shall not apply to the provision of child health assistance—</text>
<clause id="H33CA3FA1CF62436B9CD0D521F5511100"><enum>(i)</enum><text>to
a targeted low-income child who is enrolled for child health assistance under
this title as of September 30, 2007;</text>
</clause><clause id="H821CBF65AB444934A6FF0054DE8F3CD1"><enum>(ii)</enum><text>to a pregnant
woman who is enrolled for assistance under this title as of September 30, 2007,
through the completion of the post-partum period following completion of her
pregnancy; and</text>
</clause><clause id="H29EE3D2E612E45FA8ED3D310BE85D90"><enum>(iii)</enum><text>for items and
services furnished before October 1, 2008, to an individual who is not a
targeted low-income child and who is enrolled for assistance under this title
as of September 30, 2007.</text>
</clause></subparagraph><subparagraph id="H8AD2D1C397524BD59655334ED9005827"><enum>(E)</enum><header>Treatment of
pregnant women</header><text display-inline="yes-display-inline">In this
paragraph and sections 2102(a)(8) and 2104(a)(2), the term <term>targeted
low-income child</term> includes an individual under age 19, including the
period from conception to birth, who is eligible for child health assistance
under this title by virtue of the definition of the term <term>child</term>
under <external-xref legal-doc="usc" parsable-cite="usc/42/457">section
457.10</external-xref> of title 42, Code of Federal
Regulations.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HC9A4FA97CDE6429EA5D16E0656B8F98F"><enum>(c)</enum><header>Standardization
of income determinations</header>
<paragraph id="H81B1F2663EF54FC1A8FE32C2FE4E45BF"><enum>(1)</enum><header>In
general</header><text>Section 2110(d) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397jj">42 U.S.C. 1397jj</external-xref>)
is amended by adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H29CEBF09F2FD4E7BA7008EC3B67595FA" style="OLC">
<subsection id="HCB8B7002179C4DF28E09CC5C64190091"><enum>(d)</enum><header>Standardization
of income determinations</header><text>In determining family income under this
title (including in the case of a State child health plan that provides health
benefits coverage in the manner described in section 2101(a)(2)), a State shall
base such determination on gross income (including amounts that would be
included in gross income if they were not exempt from income taxation) and may
only take into consideration such income disregards as the Secretary shall
develop.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H5A4051AEDE3743A3AD9DD6ECCE2D3E0"><enum>(2)</enum><header>Effective
date</header><subparagraph commented="no" display-inline="yes-display-inline" id="HBE6A10DC7102481095ACE5F1D7E424E5"><enum>(A)</enum><text>Subject to subparagraph
(B), the amendment made by paragraph (1) shall apply to determinations (and
redeterminations) of income made on or after April 1, 2008.</text>
</subparagraph><subparagraph id="HEBC40BE6D8444371838C66E5EAC51B6F" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">In
the case of a State child health plan under title XXI of the Social Security
Act which the Secretary of Health and Human Services determines requires State
legislation (other than legislation appropriating funds) in order for the plan
to meet the additional requirement imposed by the amendment made by paragraph
(1), the State child health plan shall not be regarded as failing to comply
with the requirements of such title solely on the basis of its failure to meet
this additional requirement before the first day of the first calendar quarter
beginning after the close of the first regular session of the State legislature
that begins after the date of the enactment of this Act. For purposes of the
previous sentence, in the case of a State that has a 2-year legislative
session, each year of such session shall be deemed to be a separate regular
session of the State legislature.</text>
</subparagraph></paragraph></subsection></section><section id="H0DFB0283EFD54D479FE29EBB9E8CA94"><enum>102.</enum><header>Application of
citizenship documentation requirements; increased Federal matching rate for
citizenship documentation enforcement under Medicaid and SCHIP</header>
<subsection id="H0D91C171B4FC4B1FB150FFEC351E8629"><enum>(a)</enum><header>Application of
requirements</header>
<paragraph id="H019BA285348D4CBD8BD065EC3617886C"><enum>(1)</enum><header>In
general</header><text>Section 2105(c) of the Social Security Act (42 U.S.C.
1397dd(c)), as amended by section 101(b), is amended by adding at the end the
following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H4FD1B3A8C8F745F98F1CD200D0265FFA" style="OLC">
<paragraph id="H239DFC8D958C46708B1735F5FC5700D6"><enum>(9)</enum><header>Application of
citizenship documentation requirements</header>
<subparagraph id="H25CF120E79D24089AD4F1E95EDA5ED47"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">Subject to
subparagraph (B), no payment may be made under this section to a State with
respect to amounts expended for child health assistance for an individual who
declares under section 1137(d)(1)(A) to be a citizen or national of the United
States for purposes of establishing eligibility for benefits under this title,
unless the requirement of section 1903(x) is met.</text>
</subparagraph><subparagraph id="HEF1E4C23EA834FF9AAEDD5D33E18E92"><enum>(B)</enum><header>Treatment of
pregnant women</header><text display-inline="yes-display-inline">For purposes
of applying subparagraph (A) in the case of a pregnant woman who qualifies for
child health assistance by virtue of the application of section 457.10 of title
42, Code of Federal Regulations, the requirement of such section shall be
deemed to be satisfied by the presentation of documentation of personal
identity described in section 274A(b)(1)(D) of the Immigration and Nationality
Act or any other documentation of personal identity of such other type as the
Secretary finds, by regulation, provides a reliable means of
identification.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HE44E23D00A044F21AED89E9E46025337"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply to
eligibility determinations and redeterminations made on or after April 1,
2008.</text>
</paragraph></subsection><subsection id="H1D8F07101CD4421DA08920A1EF1E93A8"><enum>(b)</enum><header>Temporary
increase in Federal matching rate for administrative costs under Medicaid and
SCHIP</header><text>—</text>
<paragraph id="H6AA2AF194506499DB081656BF07F82B"><enum>(1)</enum><header>Medicaid</header>
<subparagraph id="HBC384FB98B1A46D2AEDB1100369846F6"><enum>(A)</enum><header>In
general</header><text>With respect to administrative costs incurred on or after
July 1, 2006, and before October 1, 2008, in implementing the amendments made
by section 6036 of the Deficit Reduction Act of 2005 (<external-xref legal-doc="public-law" parsable-cite="pl/109/171">Public Law
109–171</external-xref>), 75 percent shall be substituted for 50 per centum in
section 1903(a)(7) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(a)(7)</external-xref>).</text>
</subparagraph><subparagraph id="H296406AB909D42759FA00103CDCA31B"><enum>(B)</enum><header>Retroactive
adjustment</header><text>The Secretary of Health and Human Services shall take
such steps as may be necessary to provide for the adjustment of payments under
section 1903(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(a)</external-xref>) to take into
account the application of subparagraph (A) for periods before the date of the
enactment of this Act.</text>
</subparagraph></paragraph><paragraph id="H09A2F96795A7486000AD6F3692052D88"><enum>(2)</enum><header>SCHIP</header><text>With
respect to administrative costs incurred on or after April 1, 2008, and before
October 1, 2008 in implementing the amendment made by subsection (a)(1), the
enhanced FMAP applied under section 2105(a)(1)(D)(iv) of the Social Security
Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397d">42 U.S.C.
1397d(a)(1)(D)(iv)</external-xref>) shall not be less than 75 percent.</text>
</paragraph></subsection></section><section id="H878E07564C774648B9A1D2009C3EE40"><enum>103.</enum><header>Limitations on
eligibility based on substantial net assets</header>
<subsection id="H15B8C6786BBE43EA9E6510E97C36BF82"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2110(b) of
the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397jj">42 U.S.C. 1397jj(b)</external-xref>) is
amended—</text>
<paragraph id="HE817AB56D45A4C69A6F6D78D3BBE8800"><enum>(1)</enum><text>in paragraph (1),
by striking <quote>paragraph (2)</quote> and inserting <quote>paragraphs (2)
and (5)</quote>; and</text>
</paragraph><paragraph id="H7CE7AF9FC31C4FEE8557360036FCA9BF"><enum>(2)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H91B19087733346DA86D19CA76FE4296E" style="OLC">
<paragraph id="HF12C824E9B18436DB1451E72D35B1B94"><enum>(5)</enum><header>Disqualification
for individuals in families with substantial net assets</header><text display-inline="yes-display-inline">An individual in a family is not eligible
for child health assistance under this title if the individual’s family has net
assets (including the equity interest in any home) that exceeds $500,000 or
unless there is provided a document (in such a form and manner as the Secretary
shall specify) signed under penalty of perjury by an applicant for child health
assistance on behalf of the individual that the net assets of the individual’s
family (including the equity interest in the any home) does not exceed
$500,000. The Secretary may increase the dollar amount specified in the
previous sentence from year to year beginning with 2013 based on the percentage
increase in the consumer price index for all urban consumers (all items; United
States city average), rounded to the nearest
$1,000.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H4AE6B14042354F5CA6C7B1DAB306E72D"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by subsection (a) shall apply to
eligibility determinations and redeterminations made on or after April 1,
2008.</text>
</subsection></section><section id="HC0717E6A246647289BECF6689FD5A568"><enum>104.</enum><header>Clarification
of State authorities</header><text display-inline="no-display-inline">Section
2102 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397bb">42 U.S.C. 1397bb</external-xref>) is amended by
adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H73D791A0ED3049C0A19D8D313FDAB0C0" style="OLC">
<subsection id="H79A5ECB841BF43EEA271885BD5EA5FF9"><enum>(d)</enum><header>Clarification of
State authorities</header><text>Nothing in this title shall be construed as
preventing a State, under its child health plan, from doing any of the
following:</text>
<paragraph display-inline="no-display-inline" id="HE09761736EA74DAD98232C97CA72564D"><enum>(1)</enum><header>Use of waiting
periods to prevent crowd out</header><text display-inline="yes-display-inline">From using waiting periods and other tools
to prevent crowding out private-sector insurance coverage.</text>
</paragraph><paragraph id="HAE0DC3E1BF3F47C28190417026405DDA"><enum>(2)</enum><header>Use of private
providers and plans</header><text display-inline="yes-display-inline">From
cooperating or contracting with private sector providers and plans in order to
provide care to targeted low-income children.</text>
</paragraph><paragraph id="HEBFA22A0CEBC4CE9A7E2E0E6A98B48AD"><enum>(3)</enum><header>Use of state
funds for ineligible individuals</header><text display-inline="yes-display-inline">From providing medical benefits for
individuals who are not targeted low-income children with State
funds.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HF4A2DE626706410081BBBE878300B95E"><enum>105.</enum><header>Easing
administrative barriers to State cooperation with employer-sponsored insurance
coverage</header>
<subsection id="HD068365DBC3A41D1B5B0E45C9864953D"><enum>(a)</enum><header>Requiring some
coverage for employer-sponsored insurance</header>
<paragraph id="H033D98B26B334E6781390088A8C9323F"><enum>(1)</enum><header>In
general</header><text>Section 2102(a) of the Social Security Act (42 U.S.C.
1397b(a)), as amended by section 101(a), is amended—</text>
<subparagraph id="H3AA0158537844ECB9F4728E68C6773F0"><enum>(A)</enum><text>in paragraph (7),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="H9F1F74706DA0436B90C4918CBA30D707"><enum>(B)</enum><text>in paragraph (8),
by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="HDB30CDCE1D504B65BEB8EFCB00A5A950"><enum>(C)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HCD97A0A80FBE46CE80B44FFD245100F1" style="OLC">
<paragraph id="HE2FAA8AFE08148AC8FFE10C5A65FD801"><enum>(9)</enum><text display-inline="yes-display-inline">effective for plan years beginning on or
after October 1, 2008, how the plan will provide for child health assistance
with respect to targeted low-income children covered under a group health
plan.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H31EFFC911ACB404B9BB9BC6E7D3502A4"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply beginning
with fiscal year 2009.</text>
</paragraph></subsection><subsection id="H7B6AC4716B034E419638CEBDE836DF98"><enum>(b)</enum><header>Federal
financial participation for employer-sponsored insurance</header><text display-inline="yes-display-inline">Section 2105 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397d">42 U.S.C. 1397d</external-xref>)
is amended—</text>
<paragraph id="H79978AF997854E1C92CCD1ABFEB55CAA"><enum>(1)</enum><text>in subsection
(a)(1)(C), by inserting before the semicolon at the end the following:
<quote>and, subject to paragraph (3)(C), in the form of payment of the premiums
for coverage under a group health plan that includes coverage of targeted
low-income children and benefits supplemental to such coverage</quote>;
and</text>
</paragraph><paragraph id="H4FFE369259AD469C804CE520CD33CD29"><enum>(2)</enum><text>paragraph (3) of
subsection (c) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HC0E7B89AF9C44562A907E2DA8C554CA7" style="OLC">
<paragraph id="HF50C7B3683414A64A5D5E3A616DAC04"><enum>(3)</enum><header>Purchase of
employer-sponsored insurance</header>
<subparagraph id="H27C57D877DEA45EB9950807795507C42"><enum>(A)</enum><header>In
general</header><text>Payment may be made to a State under subsection
(a)(1)(C), subject to the provisions of this paragraph, for the purchase of
family coverage under a group health plan that includes coverage of targeted
low-income children unless such coverage would otherwise substitute for
coverage that would be provided to such children but for the purchase of family
coverage.</text>
</subparagraph><subparagraph id="H57DA4938743245AFBFA8A9056115EDC2"><enum>(B)</enum><header>Waiver of
certain provisions</header><text display-inline="yes-display-inline">With
respect to coverage described in subparagraph (A)—</text>
<clause id="HEF6FFBC1C70E402AB682B75133E2A688"><enum>(i)</enum><text>notwithstanding
section 2102, no minimum benefits requirement (other than those otherwise
applicable with respect to services referred to in section 2102(a)(7)) under
this title shall apply; and</text>
</clause><clause id="HB21A163FE5FD43319654D439024B34"><enum>(ii)</enum><text>no
limitation on beneficiary cost-sharing otherwise applicable under this title or
title XIX shall apply.</text>
</clause></subparagraph><subparagraph id="H1DE9D07D22DE4ECFA85E76345B82918E"><enum>(C)</enum><header>Required
provision of supplemental benefits</header><text>If the coverage described in
subparagraph (A) does not provide coverage for the services referred to in
section 2102(a)(7), the State child health plan shall provide coverage of such
services as supplemental benefits.</text>
</subparagraph><subparagraph id="H7B33EFE6AC094AFE86A93FC063F681E5"><enum>(D)</enum><header>Limitation on
FFP</header><text>The amount of the payment under paragraph (1)(C) for coverage
described in subparagraph (A) (and supplemental benefits under subparagraph (C)
for individuals so covered) during a fiscal year may not exceed the product
of—</text>
<clause id="H80585C080C184E0BA5AFD727BBFDE267"><enum>(i)</enum><text>the national per
capita expenditure under this title (taking into account both Federal and State
expenditures) for the previous fiscal year (as determined by the Secretary
using the best available data);</text>
</clause><clause id="H8E2D1B32F83B4D2ABAC4C50493ECDC50"><enum>(ii)</enum><text>the enhanced FMAP
for the State and fiscal year involved; and</text>
</clause><clause id="H5CFFE70BF54C42CAA9C7302435BB1DF9"><enum>(iii)</enum><text>the number of
targeted low-income children for whom such coverage is provided.</text>
</clause></subparagraph><subparagraph id="HB565A0E4894A49628710E8996722037B"><enum>(E)</enum><header>Voluntary
enrollment</header><text>A State child health plan—</text>
<clause id="H34A34DEE450E4D8BA0DA738F9F48C2A8"><enum>(i)</enum><text>may not require a
targeted low-income child to enroll in coverage described in subparagraph (A)
in order to obtain child health assistance under this title;</text>
</clause><clause id="H92003BA6E48A40FE809FBC9FDD771191"><enum>(ii)</enum><text display-inline="yes-display-inline">before providing such child health
assistance for such coverage of a child, shall make available (which may be
through an Internet website or other means) to the parent or guardian of the
child information on the coverage available under this title, including
benefits and cost-sharing; and</text>
</clause><clause id="H0994286635CA4AA3A4E71C938F9EB985"><enum>(iii)</enum><text>shall provide at
least one opportunity per fiscal year for beneficiaries to switch coverage
under this title from coverage described in subparagraph (A) to the coverage
that is otherwise made available under this title.</text>
</clause></subparagraph><subparagraph id="HF58B70457A424975A576D393D1003FBF"><enum>(F)</enum><header>Information on
coverage options</header><text>A State child health plan shall—</text>
<clause id="HA84E2950504C49BA8318C036CE7C6D4F"><enum>(i)</enum><text display-inline="yes-display-inline">describe how the State will notify
potential beneficiaries of coverage described in subparagraph (A);</text>
</clause><clause id="H9DC46A578E2F470D80EDFFF9FC9C1802"><enum>(ii)</enum><text>provide such
notification in writing at least during the initial application for enrollment
under this title and during redeterminations of eligibility if the individual
was enrolled before October 1, 2008; and</text>
</clause><clause id="H37A4A284E2C843B69B8492802FCE022B"><enum>(iii)</enum><text>post a
description of these coverage options on any official website that may be
established by the State in connection with the plan.</text>
</clause></subparagraph><subparagraph id="HD480589047204FB3B9AECDEBEEB30616"><enum>(G)</enum><header>Semiannual
verification of coverage</header><text>If coverage described in subparagraph
(A) is provided under a group health plan with respect to a targeted low-income
child, the State child health plan shall provide for the collection, at least
once every six months, of proof from the plan that the child is enrolled in
such coverage.</text>
</subparagraph><subparagraph display-inline="no-display-inline" id="H248D0BEA27C54F7B0023F6EFEE4D1B5"><enum>(H)</enum><header>Rule of
construction</header><text display-inline="yes-display-inline">Nothing in this
section is to be construed to prohibit a State from—</text>
<clause id="H24673FA2A618468AB522FA67874F67F0"><enum>(i)</enum><text display-inline="yes-display-inline">offering wrap around benefits in order for
a group health plan to meet any State-established minimum benefit
requirements;</text>
</clause><clause id="H0A4B60D15ADD465DB92E091F70009BC8"><enum>(ii)</enum><text display-inline="yes-display-inline">establishing a cost-effectiveness test to
qualify for coverage under such a plan;</text>
</clause><clause id="HCD9D16665CFE4401A5EB9D3DDBF38EE3"><enum>(iii)</enum><text display-inline="yes-display-inline">establishing limits on beneficiary
cost-sharing under such a plan;</text>
</clause><clause id="H7C2BD8A34A5241F2A193000700F33EB4"><enum>(iv)</enum><text display-inline="yes-display-inline">paying all or part of a beneficiary’s
cost-sharing requirements under such a plan;</text>
</clause><clause id="HEB59BE8E97514D9A996269BF00360013"><enum>(v)</enum><text display-inline="yes-display-inline">paying less than the full cost of the
employee’s share of the premium under such a plan, including prorating the cost
of the premium to pay for only what the State determines is the portion of the
premium that covers targeted low-income children;</text>
</clause><clause id="H82B2D092329941878BA5008D4D902F20"><enum>(vi)</enum><text display-inline="yes-display-inline">using State funds to pay for benefits above
the Federal upper limit established under subparagraph (C);</text>
</clause><clause id="H5659702D04924FF5B910C05AAD82B72"><enum>(vii)</enum><text display-inline="yes-display-inline">allowing beneficiaries enrolled in group
health plans from changing plans to another coverage option available under
this title at any time; or</text>
</clause><clause id="H3EE0B89B14A64F238CD43B2370120065"><enum>(viii)</enum><text display-inline="yes-display-inline">providing any guidance or information it
deems appropriate in order to help beneficiaries make an informed decision
regarding the option to enroll in coverage described in subparagraph
(A).</text>
</clause></subparagraph><subparagraph id="HEFC0FA59C83A4A348550DB02F0F97B00"><enum>(I)</enum><header>Group health
plan defined</header><text>In this paragraph, the term <term>group health
plan</term> has the meaning given such term in section 2791(a)(1) of the Public
Health Service Act (42 U.S.C.
300gg–91(a)(1)).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="HC35F845E122E4E1696ACE150D3165EA9"><enum>106.</enum><header>Improving
beneficiary choice in SCHIP</header>
<subsection id="HEDD712F712F946CCB59B97A63FAC5555"><enum>(a)</enum><header>Requiring
offering of alternative coverage options</header><text>Section 2102 of the
Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397b">42 U.S.C. 1397b</external-xref>), as amended by
sections 101(a), 104, and 105(a), is amended—</text>
<paragraph id="H86D00031C71B48A7A5DC5D12DE1EDFD8"><enum>(1)</enum><text>in subsection
(a)—</text>
<subparagraph id="H13481CE9DF1647DF81340042EAF70000"><enum>(A)</enum><text>in paragraph (8),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HAF6DC324F6424FE7B7C7C600BE91D9FC"><enum>(B)</enum><text>in paragraph (9),
by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="HFA6B952FE2BE49A4B2FCED6CE47F407F"><enum>(C)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HBF1A0B5BB1704813BA00BCF4735FCEBE" style="OLC">
<paragraph id="H2E6BB528855544679D90B30094A1488C"><enum>(10)</enum><text display-inline="yes-display-inline">effective for plan years beginning on or
after October 1, 2008, how the plan will provide for child health assistance
with respect to targeted low-income children through alternative coverage
options in accordance with subsection
(e).</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H565A557CF08F4D1BB38F62DE3EC1613C"><enum>(2)</enum><text>by adding at the
end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H342DA36D9538462BA3E51F5F8555A16B" style="OLC">
<subsection id="HE38E011B2EC14C50AC237F1F54B5CD4B"><enum>(e)</enum><header>Alternative
coverage options</header>
<paragraph id="H50BB21177F7043E4BFD9671D89D4F087"><enum>(1)</enum><header>In
general</header><text>Effective October 1, 2008, a State child health plan
shall provide for the offering of any qualified alternative coverage that a
qualified entity seeks to offer to targeted low-income children through the
plan in the State.</text>
</paragraph><paragraph id="HEA28B016EB6C4E778F00C068D6B0B199"><enum>(2)</enum><header>Application of
uniform financial limitation for all alternative coverage
options</header><text>With respect to all qualified alternative coverage
offered in a State, the State child health plan shall establish a uniform
dollar limitation on the per capita monthly amount that will be paid by the
State to the qualified entity with respect to such coverage provided to a
targeted low-income child. Such limitation may not be less than 90 percent of
the per capita monthly payment made for coverage offered under the State child
health plan that is not in the form of an alternative coverage option. Nothing
in this paragraph shall be construed—</text>
<subparagraph id="HF19B6AC079D8429F946C4E02E7E549EE"><enum>(A)</enum><text>as requiring a
State to provide for the full payment of premiums for qualified alternative
coverage;</text>
</subparagraph><subparagraph id="HF4FEB1ABE12A41DC92E3D2A8E5B0F095"><enum>(B)</enum><text>as preventing a
State from charging additional premiums to cover the difference between the
cost of qualified alternative coverage and the amount of such payment
limitation;</text>
</subparagraph><subparagraph id="HD759CD56C38A4649A63CF27DA3E6487"><enum>(C)</enum><text>as preventing a
State from using its own funds to provide a dollar limitation that exceeds the
Federal financial participation as limited under section 2105(c)(10).</text>
</subparagraph></paragraph><paragraph id="H539AE4C589AD48F5A487AE8C5FC8511E"><enum>(3)</enum><header>Qualified
alternative coverage defined</header><text>In this section, the term
<term>qualified alternative coverage</term> means health insurance coverage
that—</text>
<subparagraph id="H9886DAD28F7E4535874652FCD57977AE"><enum>(A)</enum><text>meets the coverage
requirements of section 2103 (other than cost-sharing requirements of such
section); and</text>
</subparagraph><subparagraph id="HE00777C2F1094F669E41A2BAC27EC9ED"><enum>(B)</enum><text>is offered by a
qualified insurer, and not directly by the State.</text>
</subparagraph></paragraph><paragraph id="H3B28F318BEA14453A1AA4DCC7F07EDC9"><enum>(4)</enum><header>Qualified
insurer defined</header><text>In this section, the term <term>qualified
insurer</term> means, with respect to a State, an entity that is licensed to
offer health insurance coverage in the
State.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HBEDD5650B93040698DC851CA0863D0BA"><enum>(b)</enum><header>Federal
financial participation for qualified alternative coverage</header><text display-inline="yes-display-inline">Section 2105 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397d">42 U.S.C. 1397d</external-xref>)
is amended—</text>
<paragraph id="HCEB889D4F78546C481DCB1AB93AA9809"><enum>(1)</enum><text>in subsection
(a)(1)(C), as amended by section 105(b), by inserting before the semicolon at
the end the following: <quote>and, subject to paragraph (8)(C), in the form of
payment of the premiums for coverage for qualified alternative
coverage</quote>; and</text>
</paragraph><paragraph id="H5292A70BC3CD4FC48E029912FDE4F8DE"><enum>(2)</enum><text>in subsection (c),
as amended by sections 101(b) and 102(a)(1), by adding at the end the following
new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H541F9034027A4A5AA84900CC73CC51B6" style="OLC">
<paragraph id="HFF7ED92A2D404C5184364997023D8223"><enum>(10)</enum><header>Purchase of
qualified alternative coverage</header>
<subparagraph id="H5FDFEE5131714197A46600B2B656A122"><enum>(A)</enum><header>In
general</header><text>Payment may be made to a State under subsection
(a)(1)(C), subject to the provisions of this paragraph, for the purchase of
qualified alternative coverage.</text>
</subparagraph><subparagraph id="HEF4C79A7981A4BB0004D82250441F582"><enum>(B)</enum><header>Waiver of
certain provisions</header><text display-inline="yes-display-inline">With
respect to coverage described in subparagraph (A), no limitation on beneficiary
cost-sharing otherwise applicable under this title or title XIX shall
apply.</text>
</subparagraph><subparagraph id="H00F0F0F31DBD44B7888E99FD2733EED"><enum>(C)</enum><header>Limitation on
FFP</header><text>The amount of the payment under paragraph (1)(C) for coverage
described in subparagraph (A) during a fiscal year in the aggregate for all
such coverage in the State may not exceed the product of—</text>
<clause id="H3EE6AE88574842D190207CAE49FCCF96"><enum>(i)</enum><text>the national per
capita expenditure under this title (taking into account both Federal and State
expenditures) for the previous fiscal year (as determined by the Secretary
using the best available data);</text>
</clause><clause id="H93076E3FE35646129FE0E517E4FD8D9E"><enum>(ii)</enum><text>the enhanced FMAP
for the State and fiscal year involved; and</text>
</clause><clause id="H47CE0A75B3184632B2AA25381452E09B"><enum>(iii)</enum><text>the number of
targeted low-income children for whom such coverage is provided.</text>
</clause></subparagraph><subparagraph id="HE44C4402BAE342FB8B8B5DD73987BF88"><enum>(D)</enum><header>Voluntary
enrollment</header><text>A State child health plan—</text>
<clause id="HBC51D85C772F4B20A7ADC787B189A753"><enum>(i)</enum><text>may not require a
targeted low-income child to enroll in coverage described in subparagraph (A)
in order to obtain child health assistance under this title;</text>
</clause><clause id="HC68114D48B7849DDAE1FF24F7D2F1661"><enum>(ii)</enum><text display-inline="yes-display-inline">before providing such child health
assistance for such coverage of a child, shall make available (which may be
through an Internet website or other means) to the parent or guardian of the
child information on the coverage available under this title, including
benefits and cost-sharing; and</text>
</clause><clause id="H2A748CE1B24B442FAE06838E3204F400"><enum>(iii)</enum><text>shall provide at
least one opportunity per fiscal year for beneficiaries to switch coverage
under this title from coverage described in subparagraph (A) to the coverage
that is otherwise made available under this title.</text>
</clause></subparagraph><subparagraph id="H73F41A9F9FFE4E32A5CAC226BDCD1B97"><enum>(E)</enum><header>Information on
coverage options</header><text>A State child health plan shall—</text>
<clause id="H94DB1BB11450472393032D81D200A722"><enum>(i)</enum><text display-inline="yes-display-inline">describe how the State will notify
potential beneficiaries of coverage described in subparagraph (A);</text>
</clause><clause id="HC741E3513F3049F88962FFF01CD283DA"><enum>(ii)</enum><text>provide such
notification in writing at least during the initial application for enrollment
under this title and during redeterminations of eligibility if the individual
was enrolled before October 1, 2008; and</text>
</clause><clause id="H90D12CF1015245BD8822F33BDD2E3264"><enum>(iii)</enum><text>post a
description of these coverage options on any official website that may be
established by the State in connection with the plan.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="H0AF126BB893846419F38586B8224A272"><enum>(F)</enum><header>Rule of
construction</header><text display-inline="yes-display-inline">Nothing in this
section is to be construed to prohibit a State from—</text>
<clause id="H60F134EE0A9C48608D1BFEBF15BCAA57"><enum>(i)</enum><text display-inline="yes-display-inline">establishing limits on beneficiary
cost-sharing under such alternative coverage;</text>
</clause><clause id="H006502FB93054DB7B2ED7D499903FBC6"><enum>(ii)</enum><text display-inline="yes-display-inline">paying all or part of a beneficiary’s
cost-sharing requirements under such coverage;</text>
</clause><clause id="HF330E4FE716F46608B720099ABEB7F1"><enum>(iii)</enum><text display-inline="yes-display-inline">paying less than the full cost of a child’s
share of the premium under such coverage, insofar as the premium for such
coverage exceeds the limitation established by the State under subparagraph
(C);</text>
</clause><clause id="H45806ABB3FB643EEA627D90018F5CED0"><enum>(iv)</enum><text display-inline="yes-display-inline">using State funds to pay for benefits above
the Federal upper limit established under subparagraph (C); or</text>
</clause><clause id="HA5461C9236CC4D6080795034D2E0350"><enum>(v)</enum><text display-inline="yes-display-inline">providing any guidance or information it
deems appropriate in order to help beneficiaries make an informed decision
regarding the option to enroll in coverage described in subparagraph
(A).</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="HE4FD8B2BF33243C9AC00FB8289FEFEED"><enum>107.</enum><header>Allotment
distribution formula</header>
<subsection id="HD09C28A36D5044CCA0E1A21CD4E917FC"><enum>(a)</enum><header>Allotments to 50
States and the District of Columbia</header>
<paragraph id="HE89BBCA16A604FAE806CC4020006C6FD"><enum>(1)</enum><header>In
general</header><text>Section 2104(b) of the Social Security Act (42 U.S.C.
1397dd(b)) is amended—</text>
<subparagraph id="id1A965DC7AF29460E860EB338984DEE40"><enum>(A)</enum><text>in paragraph (1),
by striking <quote>the same proportion</quote> and all that follows and
inserting <quote>the product of the number of SCHIP targeted children, as
determined under paragraph (2) for the second preceding fiscal year, the State
and Federal per capita SCHIP expenditures for the second preceding fiscal year,
as determined under such paragraph, and the enhanced FMAP for the State for the
second preceding fiscal year.</quote>;</text>
</subparagraph><subparagraph id="id2B203F4CBC0B4F8EA097091276E15CF2"><enum>(B)</enum><text>by amending
paragraph (2) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H85F8EF4729F74E8BA1D1607CD3626460" style="OLC">
<paragraph id="H30BE69579AC14EF183644E3CE4D5F425"><enum>(2)</enum><header>Number of SCHIP
targeted children and pregnant women and national per capita SCHIP
expenditures</header>
<subparagraph id="HAF837F3AA2074F31AF6B308DCE8B1DE9"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">By not later than
September 30 of each year (beginning with 2007), the Secretary (in consultation
with the Director of the Bureau of the Census and using the best available data
for the fiscal year ending in the previous year) shall determine and publish in
the Federal Register—</text>
<clause id="HC282468693F440AB82C2065866DCD5FD"><enum>(i)</enum><text>the average number
of low-income targeted children (described in subparagraph (B)) for any month
during such preceding fiscal year; and</text>
</clause><clause id="HD2B25A156B0C48DBB2E4D70625C44636"><enum>(ii)</enum><text>the combined
State and Federal per capita SCHIP expenditures (described in subparagraph (C))
for such preceding fiscal year.</text>
</clause></subparagraph><subparagraph id="HF3A8CF0EDB8341B5B3379F4B8E622ED5"><enum>(B)</enum><header>Low-income SCHIP
targeted children</header><text display-inline="yes-display-inline">Low-income
targeted children described in this subparagraph with respect to a subsection
(b) State are children (including pregnant women described in section
2105(c)(8)(E)) residing in the State who are not covered under a group health
plan or health insurance coverage (as defined for purposes of section
2110(b)(1)(C)) and whose family income—</text>
<clause id="H662BE691B9E840729E0000F1953B84A0"><enum>(i)</enum><text>exceeds the lesser
of—</text>
<subclause id="idA7E9CB7489FB46AB9C0C90727D02BE74"><enum>(I)</enum><text>the Medicaid
applicable income level (as defined in section 2110(b)(4)); or</text>
</subclause><subclause id="idBEDA0057F36843EAB52C7DDE2D953601"><enum>(II)</enum><text>150 percent of
the poverty line; but</text>
</subclause></clause><clause id="H2E0D35D456E941BF9F1893345862A82B"><enum>(ii)</enum><text>does not 200
percent of the poverty line.</text>
</clause></subparagraph><subparagraph id="HDA52229C448241FD8E5B00ED2E113303"><enum>(C)</enum><header>State and
Federal per capita SCHIP expenditures</header><text>The State and Federal per
capita SCHIP expenditures for a fiscal year is equal to—</text>
<clause id="HF91CBE87224748AD8F2DA576469073AC"><enum>(i)</enum><text>the aggregate
Federal and State expenditures made that are attributable to allotments under
this title for subsection (b) States for the fiscal year; divided by</text>
</clause><clause id="HB3051421BB1E4CCDA9EFC1E66EBF247C"><enum>(ii)</enum><text>the average total
number of targeted low-income children (including pregnant women described in
section 2105(c)(8)(E)) for whom health assistance was made available from such
allotments for such fiscal year.</text>
</clause></subparagraph></paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="id52F9E0331198496D84FC5102F905FD37"><enum>(C)</enum><text>by striking
paragraphs (3) and (4) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HCD714FED2C41407CA69CF42038A8717E" style="OLC">
<paragraph id="HA132440D33284A46861412C383A55CB7"><enum>(3)</enum><header>Subsection (b)
State defined</header><text>In this subsection, the term <term>subsection (b)
State</term> means one of the 50 States or the District of Columbia.</text>
</paragraph><paragraph id="H765DF8FB64D84692ABAF1882F9A1B400"><enum>(4)</enum><header>Proportional
reduction if total allotments exceed amount available</header><text>If the
Secretary estimates that the total of the allotments under this subsection for
a fiscal year (in combination with allotments made under subsection (c)) will
exceed the aggregate amount available for allotments for such fiscal year under
subsection (a), the Secretary shall reduce the amount of each allotment under
this subsection in a pro-rata manner so that such total does not exceed the
aggregate amount available for
allotments.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="id6067ADD7AF2A461B83E3EE4A044D0759"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply to
allotments for fiscal years beginning with fiscal year 2008.</text>
</paragraph></subsection><subsection id="H871373DDD44C45EDB100072163AFB904"><enum>(b)</enum><header>No
redistribution of unused allotments</header>
<paragraph id="HD0D45E77DD52459583007BB5E1A3E135"><enum>(1)</enum><header>In
general</header><text>Section 2104(f) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd</external-xref>)
is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HDD573F8BEDBE4FB38780C9FF6FD5156E" style="OLC">
<subsection id="HF818FD773AF94F68AD85F3C8B353D1A5"><enum>(f)</enum><header>No
redistribution of unused allotments</header><text>There shall be no
redistribution of allotments from States that are not expended within the
period of availability under subsection
(e).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HA485F70197EC4FD594897EFF3E88432B"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply to
allotments for fiscal years beginning with fiscal year 2005.</text>
</paragraph></subsection></section><section id="H45D7E9D152E247D2979EEE7F57122CF6"><enum>108.</enum><header>Five-year
reauthorization</header>
<subsection id="id4AF9CDA582334B8AB35E14F6BFF9BD23"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2104(a) of
the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(a)</external-xref>) is
amended—</text>
<paragraph id="H153FC1733CD844C7A2421FDFB283007"><enum>(1)</enum><text>by
striking <quote>and</quote> at the end of paragraph (9);</text>
</paragraph><paragraph id="HD7676BF08EC843D999CC321C27B6DD9"><enum>(2)</enum><text>by
striking the period at the end of paragraph (10) and inserting a semicolon;
and</text>
</paragraph><paragraph id="H11E9EC2D5C824EB595A78C98A2148314"><enum>(3)</enum><text>by adding at the
end the following new paragraphs:</text>
<quoted-block display-inline="no-display-inline" id="H443D40255C81439687D182F0A938E794" style="OLC">
<paragraph id="H01C56CFDE00C4DFBBAAF9E00166FCA90"><enum>(11)</enum><text>for fiscal year
2008, $7,000,000,000;</text>
</paragraph><paragraph id="H209BCDE24C544BE89F207363EF7B3438"><enum>(12)</enum><text display-inline="yes-display-inline">for fiscal year 2009,
$7,000,000,000;</text>
</paragraph><paragraph id="H34D3C2E77FE9414CAA1E0633648DB28B"><enum>(13)</enum><text display-inline="yes-display-inline">for fiscal year 2010,
$7,000,000,000;</text>
</paragraph><paragraph id="HEE014733F15D48FAB1E0916804357F2"><enum>(14)</enum><text display-inline="yes-display-inline">for fiscal year 2011, $7,500,000,000;
and</text>
</paragraph><paragraph id="H2ABF6C11E3D6449A9CDFB738C8C2BDFF"><enum>(15)</enum><text display-inline="yes-display-inline">for fiscal year 2012,
$8,000,000,000.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idEACC35F7F6D34CD2AD4C9F1E48119F2E"><enum>(b)</enum><header>Continuation of
additional allotments to territories</header><text>Section 2104(c)(4)(B) of the
Social Security Act (42 U.S.C. 1397dd(c)(4)(B)) is amended by striking
<quote>fiscal year 2007</quote> and inserting <quote>each of fiscal years 2007
through 2012</quote>.</text>
</subsection><subsection id="HD1C026BC12BA42698C00AE09F25782CE"><enum>(c)</enum><header>Application to
other SCHIP funding for fiscal year 2008</header><text>Notwithstanding any
other provision of law, if funds are appropriated under any law (other than
this Act) to provide allotments to States under title XXI of the Social
Security Act for all (or any portion) of fiscal year 2008—</text>
<paragraph id="HF52F1917EB8343A489C4CDDD0473AA61"><enum>(1)</enum><text>any amounts that
are so appropriated that are not so allotted and obligated before the date of
the enactment of this Act are rescinded; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H88BE68098C3F4965BFB45D714838FB"><enum>(2)</enum><text>any amount provided
for such title XXI allotments to a State under this Act (and the amendments
made by this Act) for such fiscal year shall be reduced by the amount of such
appropriations so allotted and obligated before such date.</text>
</paragraph></subsection></section><section id="HB70DDE7B7BCD427A887767108FCD61D0"><enum>109.</enum><header>Enhancing the
programmatic focus on children and pregnant women</header>
<subsection id="HE748396F92BE4B64A7B71F04A5408E28"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2107(f) of
the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397gg">42 U.S.C. 1397gg(f)</external-xref>) is amended
by striking <quote>childless</quote>.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HB4CE70680C6B462A990087A339BE971C"><enum>(b)</enum><header>Effective
date</header><text display-inline="yes-display-inline">The amendment made by
subsection (a) shall take effect on the date of the enactment of this Act but
shall not apply to projects, including extensions, amendments, or renewals to
such projects, that are in effect or have been approved on the date of the
enactment of this Act.</text>
</subsection></section><section id="id6F7836C5C34B42AF9FD218C730D5864D"><enum>110.</enum><header>Grants for
outreach and enrollment</header>
<subsection id="id248ED27589F9401C9895D6EE2C76BB4F"><enum>(a)</enum><header>Grants</header><text>Title
XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) is amended by adding
at the end the following:</text>
<quoted-block act-name="Social Security Act" id="IDAFEDF086D88441D687EC648AE624E951" style="OLC">
<section id="ID9B8762DFDBCE434D834292D0476B26A8"><enum>2111.</enum><header>Grants to
improve outreach and enrollment</header>
<subsection id="ID74E6740521D04EE3A08143CBDF440682"><enum>(a)</enum><header>Outreach and
enrollment grants; national campaign</header>
<paragraph id="id0B06C0CEF99844DBA8249CA4CAC54B1E"><enum>(1)</enum><header>In
general</header><text>From the amounts appropriated for a fiscal year under
subsection (f), subject to paragraph (2), the Secretary shall award grants to
eligible entities to conduct outreach and enrollment efforts that are designed
to increase the enrollment and participation of eligible children under this
title and title XIX.</text>
</paragraph><paragraph commented="no" id="IDD95F96AFCF194191ABD22B68BC9D7629"><enum>(2)</enum><header>10 percent set
aside for national enrollment campaign</header><text>An amount equal to 10
percent of such amounts for the fiscal year shall be used by the Secretary for
expenditures during the fiscal year to carry out a national enrollment campaign
in accordance with subsection (g).</text>
</paragraph></subsection><subsection commented="no" id="id64F50B5652D84596B0A5EC66DC8DC536"><enum>(b)</enum><header>Award of
grants</header>
<paragraph id="ID500754BA2E4141558DBE3DA2AC9C5EA4"><enum>(1)</enum><header>Priority for
Awarding</header>
<subparagraph id="ID5E7658359EA54D5E8CA14296E12CFEED"><enum>(A)</enum><header>In
general</header><text>In awarding grants under subsection (a), the Secretary
shall give priority to eligible entities that—</text>
<clause id="idAD69168CE51E4468898A514AE498A4FB"><enum>(i)</enum><text>propose to target
geographic areas with high rates of—</text>
<subclause id="IDC6F18D5CA27440A583198F4EF3C0B90B"><enum>(I)</enum><text>eligible but
unenrolled children, including such children who reside in rural areas;
or</text>
</subclause><subclause id="ID689651E029F14D579E846597C7ECC992"><enum>(II)</enum><text>racial and
ethnic minorities and health disparity populations, including those proposals
that address cultural and linguistic barriers to enrollment; and</text>
</subclause></clause><clause id="id5EBB5079478143299A6077955CD5B799"><enum>(ii)</enum><text>submit the most
demonstrable evidence required under paragraphs (1) and (2) of subsection
(c).</text>
</clause></subparagraph><subparagraph id="ID013F71F54AC14F88ACDCC674E2DFB063"><enum>(B)</enum><header>10 percent set
aside for outreach to indian children</header><text>An amount equal to 10
percent of the funds appropriated under subsection (f) for a fiscal year shall
be used by the Secretary to award grants to Indian Health Service providers and
urban Indian organizations receiving funds under title V of the
<act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
(25 U.S.C. 1651 et seq.) for outreach to, and enrollment of, children who are
Indians.</text>
</subparagraph></paragraph><paragraph id="id94100B1E838C4EA8A93F87A0E92DD863"><enum>(2)</enum><header>2-year
availability</header><text>A grant awarded under this section for a fiscal year
shall remain available for expenditure through the end of the succeeding fiscal
year.</text>
</paragraph></subsection><subsection id="idBF2C68438263404EB5B05F323B4FD756"><enum>(c)</enum><header>Application</header><text>An
eligible entity that desires to receive a grant under subsection (a) shall
submit an application to the Secretary in such form and manner, and containing
such information, as the Secretary may decide. Such application shall
include—</text>
<paragraph id="id58F1D383F4034AFB90CB45D2ADDAE73B"><enum>(1)</enum><text>evidence
demonstrating that the entity includes members who have access to, and
credibility with, ethnic or low-income populations in the communities in which
activities funded under the grant are to be conducted;</text>
</paragraph><paragraph id="idC2FB1C8BF4C940B9A11015FBFC60EFA9"><enum>(2)</enum><text>evidence
demonstrating that the entity has the ability to address barriers to
enrollment, such as lack of awareness of eligibility, stigma concerns and
punitive fears associated with receipt of benefits, and other cultural barriers
to applying for and receiving child health assistance or medical
assistance;</text>
</paragraph><paragraph id="id208274F2AE9840EC84403392676DA962"><enum>(3)</enum><text>specific quality
or outcomes performance measures to evaluate the effectiveness of activities
funded by a grant awarded under this section; and</text>
</paragraph><paragraph id="id3D2BB28B72844FC08F82D3A78E8D49DC"><enum>(4)</enum><text>an assurance that
the eligible entity shall—</text>
<subparagraph id="idED6DEDA4091A416DAABE819857801BFB"><enum>(A)</enum><text>conduct an
assessment of the effectiveness of such activities against the performance
measures;</text>
</subparagraph><subparagraph id="idE7C73FB4F0F64CCBB73BECD86840B32E"><enum>(B)</enum><text>cooperate with
the collection and reporting of enrollment data and other information in order
for the Secretary to conduct such assessments; and</text>
</subparagraph><subparagraph id="idA2CB6BABFD7D46A3AEE601E26D7D5A67"><enum>(C)</enum><text>in the case of an
eligible entity that is not the State, provide the State with enrollment data
and other information as necessary for the State to make necessary projections
of eligible children and pregnant women.</text>
</subparagraph></paragraph></subsection><subsection id="id0DA78BB1342A42DC8AB852AA8A2BB296"><enum>(d)</enum><header>Supplement, Not
Supplant</header><text>Federal funds awarded under this section shall be used
to supplement, not supplant, non-Federal funds that are otherwise available for
activities funded under this section.</text>
</subsection><subsection id="idC49F6B61C4DE451DB278F0FAC5167E37"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="id3BFF774C4F704493BAA22EDEC26DE59C"><enum>(1)</enum><header>Eligible
entity</header><text>The term <term>eligible entity</term> means any of the
following:</text>
<subparagraph id="idF9A27209698041A293756BE10DF4CE69"><enum>(A)</enum><text>A State with an
approved child health plan under this title.</text>
</subparagraph><subparagraph id="idF55E440439894F4FBD3788DACA33F7B9"><enum>(B)</enum><text>A local
government.</text>
</subparagraph><subparagraph id="idAE90581CDB904CE1B7941C173153D690"><enum>(C)</enum><text>An Indian tribe
or tribal consortium, a tribal organization, an urban Indian organization
receiving funds under title V of the <act-name parsable-cite="IHCIA">Indian
Health Care Improvement Act</act-name> (25 U.S.C. 1651 et seq.), or an Indian
Health Service provider.</text>
</subparagraph><subparagraph id="idFAE44AA9C34A49FF95BD24E76256841D"><enum>(D)</enum><text>A Federal health
safety net organization.</text>
</subparagraph><subparagraph id="idC3454C0686C14BE3B96B69C5148BFE60"><enum>(E)</enum><text>A State,
national, local, or community-based public or nonprofit private
organization.</text>
</subparagraph><subparagraph id="id2F4E990CEAC04F9F8F22FD0C88B19973"><enum>(F)</enum><text>A faith-based
organization or consortia, to the extent that a grant awarded to such an entity
is consistent with the requirements of section 1955 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
300x–65) relating to a grant award to non-governmental entities.</text>
</subparagraph><subparagraph id="idE3F5688E385642339B9D2B5F1539E2A2"><enum>(G)</enum><text>An elementary or
secondary school.</text>
</subparagraph><subparagraph id="H1B068A44ABA1471DB043C4C39C7EAA20"><enum>(H)</enum><text>A national, local,
or community-based public or nonprofit private organization, including
organizations that use community health workers or community-based doula
programs.</text>
</subparagraph></paragraph><paragraph id="id10EF62CD88B647AFBC3BD4093D1525A3"><enum>(2)</enum><header>Federal health
safety net organization</header><text>The term <term>Federal health safety net
organization</term> means—</text>
<subparagraph id="idC8884EC67A7D489B85C6E7512B0F4886"><enum>(A)</enum><text>a
Federally-qualified health center (as defined in section 1905(l)(2)(B));</text>
</subparagraph><subparagraph id="id852F6BEE19DC42BBAFB8D088356E8846"><enum>(B)</enum><text>a hospital
defined as a disproportionate share hospital for purposes of section
1923;</text>
</subparagraph><subparagraph id="idB6D27CE5D3204541AD0972683F718BB4"><enum>(C)</enum><text>a covered entity
described in section 340B(a)(4) of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name> (42 U.S.C. 256b(a)(4)); and</text>
</subparagraph><subparagraph id="idAACD56DCE29D400C938E5A1A78E8D516"><enum>(D)</enum><text>any other entity
or consortium that serves children under a federally-funded program, including
the special supplemental nutrition program for women, infants, and children
(WIC) established under section 17 of the <act-name parsable-cite="CNA66">Child
Nutrition Act of 1966</act-name> (42 U.S.C. 1786), the head start and early
head start programs under the <act-name parsable-cite="HSA">Head Start
Act</act-name> (42 U.S.C. 9801 et seq.), the school lunch program established
under the Richard B. Russell <act-name parsable-cite="NSLA">National School
Lunch Act</act-name>, and an elementary or secondary school.</text>
</subparagraph></paragraph><paragraph id="idFDBB3CFBB2B9442982EA1D2418D9EDC8"><enum>(3)</enum><header>Indians; indian
tribe; tribal organization; urban indian organization</header><text>The terms
<term>Indian</term>, <term>Indian tribe</term>, <term>tribal
organization</term>, and <term>urban Indian organization</term> have the
meanings given such terms in section 4 of the <act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name> (25 U.S.C.
1603).</text>
</paragraph><paragraph id="idF95BC21A585E46F1955749DCAEE96C68"><enum>(4)</enum><header>Community
health worker</header><text>The term <term>community health worker</term> means
an individual who promotes health or nutrition within the community in which
the individual resides—</text>
<subparagraph id="ID1713875CD4AD458EA66CCD420B02AE57"><enum>(A)</enum><text>by serving as a
liaison between communities and health care agencies;</text>
</subparagraph><subparagraph id="ID59C265546AB8461E9C6F5D5CBC221E6F"><enum>(B)</enum><text>by providing
guidance and social assistance to community residents;</text>
</subparagraph><subparagraph id="IDF7832A9BEAD2494AAA1EB41423460AEE"><enum>(C)</enum><text>by enhancing
community residents’ ability to effectively communicate with health care
providers;</text>
</subparagraph><subparagraph id="ID82965F09BBD140469CBEF0FEA4C1E7BF"><enum>(D)</enum><text>by providing
culturally and linguistically appropriate health or nutrition education;</text>
</subparagraph><subparagraph id="ID379DF57E5E964B57B75339A92D710CD5"><enum>(E)</enum><text>by advocating for
individual and community health or nutrition needs; and</text>
</subparagraph><subparagraph id="IDA425067F10564454B831B04C791F8D2A"><enum>(F)</enum><text>by providing
referral and followup services.</text>
</subparagraph></paragraph></subsection><subsection id="IDF2678CBB138B406B9B78F628E54D0EA7"><enum>(f)</enum><header>Appropriation</header>
<paragraph id="idFAD6FBA4D02E4C7BA2749967D7A251BE"><enum>(1)</enum><header>In
general</header><text>There is appropriated, out of any money in the Treasury
not otherwise appropriated, for the purpose of awarding grants under this
section $100,000,000 for each of fiscal years 2008 through 2012.</text>
</paragraph><paragraph id="id3C0BE3C07C094E20B0378C28B84D946F"><enum>(2)</enum><header>Grants in
addition to other amounts paid</header><text>Amounts appropriated and paid
under the authority of this section shall be in addition to amounts
appropriated under section 2104 and paid to States in accordance with section
2105, including with respect to expenditures for outreach activities in
accordance with subsections (a)(1)(D)(iii) and (c)(2)(C) of that
section.</text>
</paragraph></subsection><subsection commented="no" id="IDFC3C25AFC4D44483867C7EEB5837BD6D"><enum>(g)</enum><header>National
Enrollment Campaign</header><text>From the amounts made available under
subsection (a)(2) for a fiscal year, the Secretary shall develop and implement
a national enrollment campaign to improve the enrollment of underserved child
populations in the programs established under this title and title XIX. Such
campaign may include—</text>
<paragraph commented="no" id="IDB4853B34BC5946CBA2DBF8FB5BE6B78B"><enum>(1)</enum><text>the establishment
of partnerships with the Secretary of Education and the Secretary of
Agriculture to develop national campaigns to link the eligibility and
enrollment systems for the assistance programs each Secretary administers that
often serve the same children;</text>
</paragraph><paragraph commented="no" id="IDF40B75B529544213B1B75B8A95EAB3DD"><enum>(2)</enum><text>the integration
of information about the programs established under this title and title XIX in
public health awareness campaigns administered by the Secretary;</text>
</paragraph><paragraph commented="no" id="ID1A601FFDD636458E949F0E5B5B311698"><enum>(3)</enum><text>increased
financial and technical support for enrollment hotlines maintained by the
Secretary to ensure that all States participate in such hotlines;</text>
</paragraph><paragraph commented="no" id="ID1E7C953E3FDD4F7F80768AE39BB05380"><enum>(4)</enum><text>the establishment
of joint public awareness outreach initiatives with the Secretary of Education
and the Secretary of Labor regarding the importance of health insurance to
building strong communities and the economy;</text>
</paragraph><paragraph commented="no" id="IDE52EDDF903924B47B1F25B0C9E38CB2B"><enum>(5)</enum><text>the development
of special outreach materials for Native Americans or for individuals with
limited English proficiency; and</text>
</paragraph><paragraph commented="no" id="ID80D6BECF6737415B9C9E2EDF6AD96CD8"><enum>(6)</enum><text>such other
outreach initiatives as the Secretary determines would increase public
awareness of the programs under this title and title
XIX.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id8EE2DDEFDD1A4E1B8B400971E56ED9D6"><enum>(b)</enum><header>Nonapplication
of administrative expenditures cap</header><text>Section 2105(c)(2) of the
Social Security Act (42 U.S.C. 1397ee(c)(2)) is amended by adding at the end
the following:</text>
<quoted-block display-inline="no-display-inline" id="id602D81BA2ADB4C5C907B78343364EF4D" style="OLC">
<subparagraph id="id2A6921FC83384A0B95BA4D51C5E903ED"><enum>(C)</enum><header>Nonapplication
to expenditures for outreach and enrollment</header><text>The limitation under
subparagraph (A) shall not apply with respect to expenditures for outreach
activities under section 2102(c)(1), or for enrollment activities, for children
eligible for child health assistance under the State child health plan or
medical assistance under the State plan under title
XIX.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><enum>II</enum><header>Child health
insurance coverage through tax fairness</header>
<section id="id377633F9D40C4E8D8BFBC3F49FFFC5F3"><enum>201.</enum><header>Expansion of
child health care insurance coverage through tax fairness</header>
<subsection id="ID4587D0D7887C493FA0C27F5C6A499831"><enum>(a)</enum><header>In
general</header><text>Subpart C of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to refundable credits) is amended by
redesignating section 36 as section 37 and by inserting after section 35 the
following new section:</text>
<quoted-block id="IDD6DFB095C2984D32B71C3A19AC35BE8F">
<section id="IDF1D6A321D11442BAA8DCEAEE6F0914A2"><enum>36.</enum><header>Child health
insurance costs</header>
<subsection id="ID6DADB95D2CD140AB8210D21D11DACD22"><enum>(a)</enum><header>In
general</header><text>In the case of an eligible taxpayer, there shall be
allowed as a credit against the tax imposed by this subtitle an amount equal to
the amount paid by the taxpayer during the taxable year for qualified health
insurance for any dependent child of such taxpayer.</text>
</subsection><subsection id="ID715120D9C121434091EF0C56B9232F1C"><enum>(b)</enum><header>Limitations</header>
<paragraph id="IDE587D2B926D942D5BE3E3099413325A4"><enum>(1)</enum><header>In
general</header><text>The amount allowed as a credit under subsection (a) to an
eligible taxpayer for the taxable year shall not exceed the sum of the monthly
limitations for coverage months during such taxable year for the individual
referred to in subsection (a) for whom such taxpayer paid during the taxable
year any amount for coverage under qualified health insurance.</text>
</paragraph><paragraph id="IDF847802D3F3F4E85A208AC5C61A53E50"><enum>(2)</enum><header>Monthly
limitation</header><text>The monthly limitation for an individual for each
coverage month of such individual during the taxable year is the amount equal
to <fraction>1/12</fraction>th of $1,400.</text>
</paragraph><paragraph id="IDAEB0CBFC57F243DDA9887C875A1E4EC3"><enum>(3)</enum><header>Coverage
month</header><text>For purposes of this subsection—</text>
<subparagraph id="ID38E20120B75C4164864FB2803A83DDE7"><enum>(A)</enum><header>In
general</header><text>The term <term>coverage month</term> means, with respect
to an individual, any month if—</text>
<clause id="IDCADC88D67EF44CD48D314A9B09DD0384"><enum>(i)</enum><text>as of the first
day of such month such individual is covered by qualified health insurance,
and</text>
</clause><clause id="ID8DC7EBDA63AD4E73A9762B1012C028E0"><enum>(ii)</enum><text>the premium for
coverage under such insurance for such month is paid by an eligible
taxpayer.</text>
</clause></subparagraph><subparagraph id="IDFDF94FAE5CE04BC4B59F119084B27383"><enum>(B)</enum><header>Medicare and
medicaid</header><text>Such term shall not include any month with respect to an
individual if, as of the first day of such month, such individual—</text>
<clause id="ID2FDB891AD447478290FC3652412055FA"><enum>(i)</enum><text>is entitled to
any benefits under title XVIII of the <act-name parsable-cite="SSA">Social
Security Act</act-name>, or</text>
</clause><clause id="IDD622A7B7551840F29C94FF10142DD09E"><enum>(ii)</enum><text>is a participant
in the program under title XIX or XXI of such Act.</text>
</clause></subparagraph><subparagraph id="ID0A6D09F6D5D2427DBAF7C5F99AA4C981"><enum>(C)</enum><header>Certain other
coverage</header><text>Such term shall not include any month during a taxable
year with respect to an individual if, at any time during such year, any
benefit is provided to such individual under chapter 89 of title 5, United
States Code.</text>
</subparagraph><subparagraph id="IDFDD5DF82E21E440E983E19C5629F12B7"><enum>(D)</enum><header>Insufficient
presence in United States</header><text>Such term shall not include any month
during a taxable year with respect to an individual if such individual is
present in the United States on fewer than 183 days during such year
(determined in accordance with section 7701(b)(7)).</text>
</subparagraph></paragraph><paragraph id="ID2eb042f10a5e402191cb41562d917d06"><enum>(4)</enum><header>Indexing</header><text>For
each taxable year beginning after December 31, 2008, the dollar amount in
paragraph (2) (as adjusted for the preceding taxable year by reason of this
paragraph) shall be increased or decreased by the percentage change in the
average cost of private health insurance for family coverage for such taxable
year as compared to such preceding taxable year as computed by the Office of
the Actuary of the Centers for Medicare and Medicaid Services, rounded to the
nearest whole dollar amount.</text>
</paragraph></subsection><subsection id="IDBCA52B5625394D10BB142A9F050C8082"><enum>(c)</enum><header>Qualified
health insurance</header><text>For purposes of this section—</text>
<paragraph id="ID59D749A36D024C66B2A736A104728D00"><enum>(1)</enum><header>In
general</header><text>The term <term>qualified health insurance</term> means
insurance which constitutes medical care as defined in section 213(d) without
regard to—</text>
<subparagraph id="IDA2014D4F729A416380674691BF5D3698"><enum>(A)</enum><text>paragraph (1)(C)
thereof, and</text>
</subparagraph><subparagraph id="IDDD28A496CECE44A29384FB1748E85184"><enum>(B)</enum><text>so much of
paragraph (1)(D) thereof as relates to qualified long-term care insurance
contracts.</text>
</subparagraph></paragraph><paragraph id="IDC129DCC05D2D44DDAC82BC66B04FC8D7"><enum>(2)</enum><header>Exclusion of
certain other contracts</header><text>Such term shall not include insurance if
a substantial portion of its benefits are excepted benefits (as defined in
section 9832(c)).</text>
</paragraph></subsection><subsection id="HFAF346A600EF41909E1C00C0B4008129"><enum>(d)</enum><header>Eligible
taxpayer; dependent; child</header><text>For purposes of this section—</text>
<paragraph id="idD9FE0CAC0D9546DC9A8790A72CC890D5"><enum>(1)</enum><header>Eligible
taxpayer</header><text>The term <term>eligible taxpayer</term> means any
taxpayer whose income exceeds 200 percent but not 300 percent of the poverty
level applicable to a family of the size involved, as determined in accordance
with criteria established by the Director of the Office of Management and
Budget.</text>
</paragraph><paragraph commented="no" id="HC7D3630AAB5A4A069486A8D56EF69F94"><enum>(2)</enum><header>Dependent</header><text display-inline="yes-display-inline">The term <term>dependent</term> has the
meaning given such term by section 152. An individual to whom section 152(e)
applies shall be treated as a dependent of the custodial parent for a coverage
month unless the custodial and noncustodial parent provide otherwise.</text>
</paragraph><paragraph id="H949519B06A5E4C10B1DE15CF2999AE08"><enum>(3)</enum><header>Child</header><text display-inline="yes-display-inline">The term <term>child</term> means a
qualifying child (as defined in section 152(c).</text>
</paragraph></subsection><subsection id="HBF29794C54F64658855E2B926DEC71EF"><enum>(e)</enum><header>Special
rules</header>
<paragraph id="H8E7DE35B3A83488F911DA045C5FA1387"><enum>(1)</enum><header>Coordination
with medical deduction, etc</header><text>Any amount paid by an eligible
taxpayer for insurance to which subsection (a) applies shall not be taken into
account in computing the amount allowable to such taxpayer as a credit under
section 35, as a deduction under section 213(a) or 162(l), or as an exclusion
from gross income under section 106 or 125.</text>
</paragraph><paragraph id="H852CD577D01746C8B4E8170697A334C4"><enum>(2)</enum><header>Denial of credit
to dependents</header><text>No credit shall be allowed under this section to
any individual with respect to whom a deduction under section 151 is allowable
to another taxpayer for a taxable year beginning in the calendar year in which
such individual’s taxable year begins.</text>
</paragraph><paragraph id="H7A92F39D69DE44EE8EA17B8700C73B6E"><enum>(3)</enum><header>Married couples
must file joint return</header>
<subparagraph id="H21FC1551FD144EC59334DFA0AB2EEA1E"><enum>(A)</enum><header>In
general</header><text>If an eligible taxpayer is married at the close of the
taxable year, the credit shall be allowed under subsection (a) only if the
taxpayer and his spouse file a joint return for the taxable year.</text>
</subparagraph><subparagraph id="H9CBF24352D824F179000F98E30CFC09F"><enum>(B)</enum><header>Marital status;
certain married individuals living apart</header><text>Rules similar to the
rules of paragraphs (3) and (4) of section 21(e) shall apply for purposes of
this paragraph.</text>
</subparagraph></paragraph><paragraph id="H8542BE7FD3C944A486009F6683A29B02"><enum>(4)</enum><header>Verification of
coverage, etc</header><text>No credit shall be allowed under this section with
respect to any individual unless such individual’s coverage (and such related
information as the Secretary may require) is verified in such manner as the
Secretary may prescribe.</text>
</paragraph><paragraph id="HC6959014AB1F4D75A0FCF1008760D015"><enum>(5)</enum><header>Insurance which
covers other individuals; treatment of payments</header><text>Rules similar to
the rules of paragraphs (7) and (8) of section 35(g) shall apply for purposes
of this section.</text>
</paragraph><paragraph id="IDB16CA2B1EC024231BE210CA808B6BAA6"><enum>(6)</enum><header>Election not to
claim credit</header><text>This section shall not apply to an eligible taxpayer
for any taxable year if such taxpayer elects to have this section not apply for
such taxable year.</text>
</paragraph></subsection><subsection id="HBB3D4FF4A7B64831BD982878C12E1F1B"><enum>(f)</enum><header>Coordination
with advance payments</header><text>With respect to any taxable year, the
amount which would (but for this subsection) be allowed as a credit to an
eligible taxpayer under subsection (a) shall be reduced (but not below zero) by
the aggregate amount paid on behalf of such taxpayer under section 7527A for
months beginning in such taxable
year.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDB8902E0387D341C18BA32C7E4521018F"><enum>(b)</enum><header>Information
reporting</header>
<paragraph id="ID05E1FF8189194BF69575DC136EABD3F7"><enum>(1)</enum><header>In
general</header><text>Subpart B of part III of subchapter A of chapter 61 of
the Internal Revenue Code of 1986 (relating to information concerning
transactions with other persons) is amended by inserting after section 6050V
the following new section:</text>
<quoted-block id="ID9D84A472D82246DCA5A9B7E8F1206BE9">
<section id="ID5921B5B9BF7D444AAC10321537CFB568"><enum>6050W.</enum><header>Returns
relating to payments for qualified health insurance</header>
<subsection id="ID2D07BC6CFBEE486090D76B59BF5180F5"><enum>(a)</enum><header>In
general</header><text>Any person who, in connection with a trade or business
conducted by such person, receives payments during any calendar year from any
individual for coverage of such individual or any other individual under
qualified health insurance (as defined in section 36(c)), shall make the return
described in subsection (b) (at such time as the Secretary may by regulations
prescribe) with respect to each individual from whom such payments were
received.</text>
</subsection><subsection id="IDD561474FD78F47FFBF0BB06C52C879C2"><enum>(b)</enum><header>Form and manner
of returns</header><text>A return is described in this subsection if such
return—</text>
<paragraph id="ID41753015D8F0403CBDACC76A7F99D2D9"><enum>(1)</enum><text>is in such form
as the Secretary may prescribe, and</text>
</paragraph><paragraph id="ID6E43F36132F04C209E4F2F51A90FC726"><enum>(2)</enum><text>contains—</text>
<subparagraph id="IDA988843A861549FF95E3B6B93822082A"><enum>(A)</enum><text>the name,
address, and TIN of the individual from whom payments described in subsection
(a) were received,</text>
</subparagraph><subparagraph id="IDFB62DC8DDA9245FE8DB5D7681C88AFAB"><enum>(B)</enum><text>the name,
address, and TIN of each individual who was provided by such person with
coverage under qualified health insurance (as so defined) by reason of such
payments and the period of such coverage, and</text>
</subparagraph><subparagraph id="IDD49AC329481F4C2B9E5809D6D41C24E9"><enum>(C)</enum><text>such other
information as the Secretary may reasonably prescribe.</text>
</subparagraph></paragraph></subsection><subsection id="IDE974AE234A34434CB4F2612A05F3C0EB"><enum>(c)</enum><header>Statements To
be furnished to individuals with respect to whom information is
required</header><text>Every person required to make a return under subsection
(a) shall furnish to each individual whose name is required under subsection
(b)(2)(A) to be set forth in such return a written statement showing—</text>
<paragraph id="ID45D3D6E28DE64DB788A47C71E4A5C524"><enum>(1)</enum><text>the name and
address of the person required to make such return and the phone number of the
information contact for such person,</text>
</paragraph><paragraph id="ID809D60AEA9BE468AA0D43C8678E60950"><enum>(2)</enum><text>the aggregate
amount of payments described in subsection (a) received by the person required
to make such return from the individual to whom the statement is required to be
furnished, and</text>
</paragraph><paragraph id="ID8009C0CBC3EF4693B1D08A4F42162E3B"><enum>(3)</enum><text>the information
required under subsection (b)(2)(B) with respect to such payments.</text>
</paragraph><continuation-text continuation-text-level="subsection">The
written statement required under the preceding sentence shall be furnished on
or before January 31 of the year following the calendar year for which the
return under subsection (a) is required to be made.</continuation-text></subsection><subsection id="ID78E3F601255B4C81971352F8624D2D11"><enum>(d)</enum><header>Returns which
would be required To be made by 2 or more persons</header><text>Except to the
extent provided in regulations prescribed by the Secretary, in the case of any
amount received by any person on behalf of another person, only the person
first receiving such amount shall be required to make the return under
subsection
(a).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="idC17D31ED6F654F868403F097422DEF8B"><enum>(2)</enum><header>Assessable
penalties</header>
<subparagraph id="id08393A45C90E4DC29068B54306D9808B"><enum>(A)</enum><text>Subparagraph (B)
of section 6724(d)(1) of such Code (relating to definitions) is amended by
redesignating clauses (xv) through (xx) as clauses (xvi) through (xxi),
respectively, and by inserting after clause (xi) the following new
clause:</text>
<quoted-block id="idDA4A218D5F754ED78B5E8A369E5F57B5">
<clause id="idEB175B66A5BE4BD7AAA667C76799FB6B"><enum>(xv)</enum><text>section 6050W
(relating to returns relating to payments for qualified health
insurance),</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="idF0DFDA85F4F3419CB83ED1019B36D084"><enum>(B)</enum><text>Paragraph (2) of
section 6724(d) of such Code is amended by striking the period at the end of
subparagraph (CC) and inserting <quote>, or</quote> and by adding at the end
the following new subparagraph:</text>
<quoted-block id="id10CDF5CCDA31419C95240ED1830E907F">
<subclause id="id9755EBFBF4924E47801A1DE824BC6914" indent="up2"><enum>(DD)</enum><text>section 6050W(c) (relating to
returns relating to payments for qualified health
insurance).</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="IDBDF451AB0B6E44799F6524BC776D8053"><enum>(3)</enum><header>Clerical
amendment</header><text>The table of sections for subpart B of part III of
subchapter A of chapter 61 of such Code is amended by inserting after the item
relating to section 6050V the following new item:</text>
<quoted-block id="ID3B8FC5CB69E14A2282BF2583D2B8ADFA" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 6050W. Returns relating to payments
for qualified health
insurance.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="ID9F49CDF479984070BA2200953D096E93"><enum>(c)</enum><header>Advance payment
of credit for purchasers of qualified health insurance</header>
<paragraph id="ID3B3AB38419484970AAFBC7177C17C521"><enum>(1)</enum><header>In
general</header><text>Chapter 77 of the Internal Revenue Code of 1986 (relating
to miscellaneous provisions) is amended by adding at the end the following new
section:</text>
<quoted-block id="ID723F9D5A8BA441279E914D01326DB14B">
<section id="ID4520C89972D942759C9C5C2B1EFFE6D2"><enum>7529.</enum><header>Advance
payment of health insurance credit for purchasers of qualified health
insurance</header>
<subsection id="IDEE1F8121B47B474C9E6FEF58FBAFFF76"><enum>(a)</enum><header>General
rule</header><text>In the case of an eligible individual, the Secretary shall
make payments to the provider of such individual’s qualified health insurance
equal to such individual’s qualified health insurance credit advance amount
with respect to such provider.</text>
</subsection><subsection id="ID280FD48558C6492C9394332AF20AD461"><enum>(b)</enum><header>Eligible
individual</header><text>For purposes of this section, the term <term>eligible
individual</term> means any individual—</text>
<paragraph id="IDE0981BC09E8E45878B7EDC46A2EEB327"><enum>(1)</enum><text>who purchases
qualified health insurance (as defined in section 36(c)), and</text>
</paragraph><paragraph id="ID1C2EC623BAA3426F82B3B3B05D82FCA6"><enum>(2)</enum><text>for whom a
qualified health insurance credit eligibility certificate is in effect.</text>
</paragraph></subsection><subsection id="ID5CDA4408FFFF41728AA97871F3FB9FB8"><enum>(c)</enum><header>Qualified
health insurance credit eligibility certificate</header><text>For purposes of
this section, a qualified health insurance credit eligibility certificate is a
statement furnished by an individual to the Secretary which—</text>
<paragraph id="ID58F34F6125CC4536A1BCF359C08CBBB6"><enum>(1)</enum><text>certifies that
the individual will be eligible to receive the credit provided by section 36
for the taxable year,</text>
</paragraph><paragraph id="IDF812393E060742179A4D60B508F0A608"><enum>(2)</enum><text>estimates the
amount of such credit for such taxable year, and</text>
</paragraph><paragraph id="ID8AEEDFDF1BB2435A942DE7CAC3DCECB8"><enum>(3)</enum><text>provides such
other information as the Secretary may require for purposes of this
section.</text>
</paragraph></subsection><subsection id="IDB391774EFB6E49C6956D672D0BFA8871"><enum>(d)</enum><header>Qualified
health insurance credit advance amount</header><text>For purposes of this
section, the term <term>qualified health insurance credit advance amount</term>
means, with respect to any provider of qualified health insurance, the
Secretary’s estimate of the amount of credit allowable under section 36 to the
individual for the taxable year which is attributable to the insurance provided
to the individual by such provider.</text>
</subsection><subsection id="IDEACAFE97DD9E46EFB24902D8CAC728FF"><enum>(e)</enum><header>Regulations</header><text>The
Secretary shall prescribe such regulations as may be necessary to carry out the
purposes of this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="ID8A173A5E69A04F4897E27963AC661CBE"><enum>(2)</enum><header>Clerical
amendment</header><text>The table of sections for chapter 77 of such Code is
amended by adding at the end the following new item:</text>
<quoted-block id="ID002B4A98C6F3473BA930EBE31440029F" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 7529. Advance payment of health
insurance credit for purchasers of qualified health
insurance.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="ID80C09AFED960496D8399E84DA0521FAC"><enum>(d)</enum><header>Conforming
amendments</header>
<paragraph id="ID1461DC399F6B45C296D2B33AE8F29E0C"><enum>(1)</enum><text>Paragraph (2) of
section 1324(b) of title 31, United States Code, is amended by inserting before
the period <quote>, or from section 36 of such Code</quote>.</text>
</paragraph><paragraph id="ID4FC1BF91F00B48CDA345AEEFACF2C4C5"><enum>(2)</enum><text>The table of
sections for subpart C of part IV of subchapter A of chapter 1 of the Internal
Revenue Code of 1986 is amended by striking the last item and inserting the
following new items:</text>
<quoted-block id="ID5959B8B215EC4E408F6F85FF47572176" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 36. Health insurance
costs.</toc-entry>
<toc-entry level="section">Sec. 37. Overpayments of
tax.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="ID60FBC70F4450483C842446ADF822DCED"><enum>(e)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2007.</text>
</subsection></section><enum>III</enum><header>State health
reform projects</header>
<section commented="no" display-inline="no-display-inline" id="ID4C635770EFD84B4587191EAD5A68B002" section-type="subsequent-section"><enum>301.</enum><header display-inline="yes-display-inline">State health reform projects</header>
<subsection commented="no" display-inline="no-display-inline" id="ID732604427D724F9F8EE9D5949B46C828"><enum>(a)</enum><header display-inline="yes-display-inline">Purpose; Establishment of State Health Care
Expansion and Improvement Program</header><text display-inline="yes-display-inline">The purposes of the programs approved under
this section shall include, but not be limited to—</text>
<paragraph commented="no" display-inline="no-display-inline" id="IDB62DA5005DC44E29B008F5E7DD22FDB0"><enum>(1)</enum><text display-inline="yes-display-inline">achieving the goals of increased health
coverage and access;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID2D3BDCF4BC434CA1A4908B6D4B00829F"><enum>(2)</enum><text display-inline="yes-display-inline">ensuring that patients receive
high-quality, appropriate health care;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDB0F9B5AB00B240C388100DF5749545EE"><enum>(3)</enum><text display-inline="yes-display-inline">improving the efficiency of health care
spending; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID36DCA097B56A48B9935B960892D3FD7E"><enum>(4)</enum><text display-inline="yes-display-inline">testing alternative reforms, such as
building on the public or private health systems, or creating new systems, to
achieve the objectives of this Act.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="IDBEA5221A17C04D39841065DE057172E1"><enum>(b)</enum><header display-inline="yes-display-inline">Applications by States, Local Governments,
and Tribes</header>
<paragraph commented="no" display-inline="no-display-inline" id="ID36BC85839DBD40C1A4F2F8F0A3809D15"><enum>(1)</enum><header display-inline="yes-display-inline">Entities that may apply</header>
<subparagraph commented="no" display-inline="no-display-inline" id="IDB0871A345B0B45E89603D6E7C2E074D4"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">A State, in consultation with local
governments, Indian tribes, and Indian organizations involved in the provision
of health care, may apply for a State health care expansion and improvement
program for the entire State (or for regions of the State) under paragraph
(2).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDFEA7AB6864DF4AAF8DA38C1A6CD414C4"><enum>(B)</enum><header display-inline="yes-display-inline">Regional groups</header><text display-inline="yes-display-inline">A regional entity consisting of more than
one State may apply for a multi-State health care expansion and improvement
program for the entire region involved under paragraph (2).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID7E49E2ABE7EC41DDBFD28BE00EB2781B"><enum>(C)</enum><header display-inline="yes-display-inline">Definition</header><text display-inline="yes-display-inline">In this Act, the term <term>State</term>
means the 50 States, the District of Columbia, and the Commonwealth of Puerto
Rico. Such term shall include a regional entity described in subparagraph
(B).</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID576066E57B584F5C84630B7C2097145B"><enum>(2)</enum><header display-inline="yes-display-inline">Submission of application</header><text display-inline="yes-display-inline">In accordance with this section, each State
desiring to implement a State health care expansion and improvement program may
submit an application to the State Health Innovation Commission under
subsection (c) (referred to in this section as the <quote>Commission</quote>)
for approval.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID397BA5BF43314793B141E9A1C252F102"><enum>(3)</enum><header display-inline="yes-display-inline">Local government applications</header>
<subparagraph commented="no" display-inline="no-display-inline" id="ID30FD344759D24954ACA4ED3058156581"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Where a State declines to submit an
application under this section, a unit of local government of such State, or a
consortium of such units of local governments, may submit an application
directly to the Commission for programs or projects under this subsection. Such
an application shall be subject to the requirements of this section.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID18FEBB89707940D9882BC968D0A3986A"><enum>(B)</enum><header display-inline="yes-display-inline">Other applications</header><text display-inline="yes-display-inline">Subject to such additional guidelines as
the Secretary may prescribe, a unit of local government, Indian tribe, or
Indian health organization may submit an application under this section,
whether or not the State submits such an application, if such unit of local
government can demonstrate unique demographic needs or a significant population
size that warrants a substate program under this subsection.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="IDEC301319D66D4638A1901C7756E96043"><enum>(c)</enum><header display-inline="yes-display-inline">State Health Innovation Commission</header>
<paragraph commented="no" display-inline="no-display-inline" id="IDBAAF49B4BC70473EA2152D0932C4642E"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Within 90 days after the date of the
enactment of this Act, the Secretary shall establish a State Health Innovation
Commission that shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="ID5041181EDCD44AA992C8B291033ECA07"><enum>(A)</enum><text display-inline="yes-display-inline">be comprised of—</text>
<clause commented="no" display-inline="no-display-inline" id="IDA156F43C7591437186DBEBE606AA63ED"><enum>(i)</enum><text display-inline="yes-display-inline">the Secretary;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID5A7CB7EC96284717B1EFBC44DB825E5A"><enum>(ii)</enum><text display-inline="yes-display-inline">four State governors to be appointed by the
National Governors Association on a bipartisan basis;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID9F391677709E4B558ADF3A836822E00A"><enum>(iii)</enum><text display-inline="yes-display-inline">two members of a State legislature to be
appointed by the National Conference of State Legislators on a bipartisan
basis;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID7280BB873B8048C99455D314CBCDE831"><enum>(iv)</enum><text display-inline="yes-display-inline">two county officials to be appointed by the
National Association of Counties on a bipartisan basis;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDD9E71BB7A2C5487399B40B0A8F992123"><enum>(v)</enum><text display-inline="yes-display-inline">two mayors to be appointed by the United
States Conference of Mayors and the National League of Cities on a joint and
bipartisan basis;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDD975522E7656410BA95E162F4FCC2FD9"><enum>(vi)</enum><text display-inline="yes-display-inline">two individuals to be appointed by the
Speaker of the House of Representatives;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID2D0DDD81CF0545E2875F2179C11C9175"><enum>(vii)</enum><text display-inline="yes-display-inline">two individuals to be appointed by the
minority leader of the House of Representatives;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDEBEBC3C9611A4592ACB00644B4FA5ED5"><enum>(viii)</enum><text display-inline="yes-display-inline">two individuals to be appointed by the
majority leader of the Senate;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID8D0707A61E7E4796B2C9704D4DBA0CE7"><enum>(ix)</enum><text display-inline="yes-display-inline">two individuals to be appointed by the
minority leader of the Senate; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID0A1B639CF7DD4C7CA894217F501BDDBF"><enum>(x)</enum><text display-inline="yes-display-inline">two individuals who are members of
federally-recognized Indian tribes to be appointed on a bipartisan basis by the
National Congress of American Indians;</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDFFEA1543033E4ED9B42AF2A40900A224"><enum>(B)</enum><text display-inline="yes-display-inline">upon approval of <fraction>2/3</fraction>
of the members of the Commission, provide the States with a variety of reform
options for their applications, such as tax credit approaches, expansions of
public programs such as medicaid and the State Children’s Health Insurance
Program, the creation of purchasing pooling arrangements similar to the Federal
Employees Health Benefits Program, individual market purchasing options, single
risk pool or single payer systems, health savings accounts, a combination of
the options described in this clause, or other alternatives determined
appropriate by the Commission, including options suggested by States, Indian
tribes, or the public;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID482E3A72219B4F75946DD6CBEC8BDE20"><enum>(C)</enum><text display-inline="yes-display-inline">establish, in collaboration with a
qualified and independent organization such as the Institute of Medicine,
minimum performance measures and goals with respect to coverage, quality, and
cost of State programs, as described under subsection (d)(1);</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID1C23E3B074FA4B23BD634890407B3E4C"><enum>(D)</enum><text display-inline="yes-display-inline">conduct a thorough review of the grant
application from a State and carry on a dialogue with all State applicants
concerning possible modifications and adjustments;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDBC930B9844FF42DAB7F1D26A0BD23925"><enum>(E)</enum><text display-inline="yes-display-inline">submit the recommendations and legislative
proposal described in subsection (d)(4)(B);</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDB95B4788B9084995BC893B9304306AB3"><enum>(F)</enum><text display-inline="yes-display-inline">be responsible for monitoring the status
and progress achieved under program or projects granted under this
section;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID3B5BAC2CC7E44AD1A99424E0E5B808C0"><enum>(G)</enum><text display-inline="yes-display-inline">report to the public concerning progress
made by States with respect to the performance measures and goals established
under this Act, the periodic progress of the State relative to its State
performance measures and goals, and the State program application procedures,
by region and State jurisdiction;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDD015AFA9C5734E82864CC076B33A8CBB"><enum>(H)</enum><text display-inline="yes-display-inline">promote information exchange between States
and the Federal Government; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID09A1B823C2D14824BC22F0D4F6756D8D"><enum>(I)</enum><text display-inline="yes-display-inline">be responsible for making recommendations
to the Secretary and the Congress, using equivalency or minimum standards, for
minimizing the negative effect of State program on national employer groups,
provider organizations, and insurers because of differing State requirements
under the programs.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID8456EB8D0EA34A0FA2EA4FD0CCA04EA5"><enum>(2)</enum><header display-inline="yes-display-inline">Period of appointment; representation
requirements; vacancies</header><text display-inline="yes-display-inline">Members shall be appointed for a term of 5
years. In appointing such members under paragraph (1)(A), the designated
appointing individuals shall ensure the representation of urban and rural areas
and an appropriate geographic distribution of such members. Any vacancy in the
Commission shall not affect its powers, but shall be filled in the same manner
as the original appointment.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDDDFC8AFA4A7E48E4BEDAF9E619946B7A"><enum>(3)</enum><header display-inline="yes-display-inline">Chairperson, meetings</header>
<subparagraph commented="no" display-inline="no-display-inline" id="ID0FF4A0EE566649F399E4B568D1467E49"><enum>(A)</enum><header display-inline="yes-display-inline">Chairperson</header><text display-inline="yes-display-inline">The Commission shall select a Chairperson
from among its members.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID5E734743375949148F44C04541134E3C"><enum>(B)</enum><header display-inline="yes-display-inline">Quorum</header><text display-inline="yes-display-inline">A majority of the members of the Commission
shall constitute a quorum, but a lesser number of members may hold
hearings.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID0762F0A6A759456DBF859BA6235399C3"><enum>(C)</enum><header display-inline="yes-display-inline">Meetings</header><text display-inline="yes-display-inline">Not later than 30 days after the date on
which all members of the Commission have been appointed, the Commission shall
hold its first meeting. The Commission shall meet at the call of the
Chairperson.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDF5F9F7A714204178AA83CE0E5D910B5E"><enum>(4)</enum><header display-inline="yes-display-inline">Powers of the commission</header>
<subparagraph commented="no" display-inline="no-display-inline" id="ID5FE62EBD017F43D8862C19DE1DA84BD0"><enum>(A)</enum><header display-inline="yes-display-inline">Negotiations with states</header><text display-inline="yes-display-inline">The Commission may conduct detailed
discussions and negotiations with States submitting applications under this
section, either individually or in groups, to facilitate a final set of
recommendations for purposes of subsection (d)(4)(B). Such negotiations shall
include consultations with Indian tribes, and be conducted in a public
forum.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDE5F4315AE6AB48D3BC118EDA80F9EF4E"><enum>(B)</enum><header display-inline="yes-display-inline">Hearings</header><text display-inline="yes-display-inline">The Commission may hold such hearings, sit
and act at such times and places, take such testimony, and receive such
evidence as the Commission considers advisable to carry out the purposes of
this subsection.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID2E103E45F0A943E5BC66369A781EDE4E"><enum>(C)</enum><header display-inline="yes-display-inline">Meetings</header><text display-inline="yes-display-inline">In addition to other meetings the
Commission may hold, the Commission shall hold an annual meeting with the
participating States under this section for the purpose of having States report
progress toward the purposes in subsection (a)(1) and for an exchange of
information.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDF4C128B28B9B457F8DFF0DBAACF4BF4D"><enum>(D)</enum><header display-inline="yes-display-inline">Information</header><text display-inline="yes-display-inline">The Commission may secure directly from any
Federal department or agency such information as the Commission considers
necessary to carry out the provisions of this subsection. Upon request of the
Chairperson of the Commission, the head of such department or agency shall
furnish such information to the Commission if the head of the department or
agency involved determines it appropriate.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID46F1DB7ADA2D482DA326A2D9806ECA0A"><enum>(E)</enum><header display-inline="yes-display-inline">Postal services</header><text display-inline="yes-display-inline">The Commission may use the United States
mails in the same manner and under the same conditions as other departments and
agencies of the Federal Government.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDBBF3265AE8034D13928D62BB1E1AA5EA"><enum>(5)</enum><header display-inline="yes-display-inline">Personnel matters</header>
<subparagraph commented="no" display-inline="no-display-inline" id="ID83A165F85418493AA9FA531CBD030F59"><enum>(A)</enum><header display-inline="yes-display-inline">Compensation</header><text display-inline="yes-display-inline">Each member of the Commission who is not an
officer or employee of the Federal Government or of a State or local government
shall be compensated at a rate equal to the daily equivalent of the annual rate
of basic pay prescribed for level IV of the Executive Schedule under section
5315 of title 5, United States Code, for each day (including travel time)
during which such member is engaged in the performance of the duties of the
Commission. All members of the Commission who are officers or employees of the
United States shall serve without compensation in addition to that received for
their services as officers or employees of the United States.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID2F50C14FEE054E77991CA9A59BF561EE"><enum>(B)</enum><header display-inline="yes-display-inline">Travel expenses</header><text display-inline="yes-display-inline">The members of the Commission shall be
allowed travel expenses, including per diem in lieu of subsistence, at rates
authorized for employees of agencies under subchapter I of chapter 57 of title
5, United States Code, while away from their homes or regular places of
business in the performance of services for the Commission.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID93AFC9CEADD3406B92C1B2B0000C9577"><enum>(C)</enum><header display-inline="yes-display-inline">Staff</header><text display-inline="yes-display-inline">The Chairperson of the Commission may,
without regard to the civil service laws and regulations, appoint and terminate
an executive director and such other additional personnel as may be necessary
to enable the Commission to perform its duties. The employment of an executive
director shall be subject to confirmation by the Commission.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID27A2EFB9919F4DFEAB897350A1A7326E"><enum>(D)</enum><header display-inline="yes-display-inline">Detail of government
employees</header><text display-inline="yes-display-inline">Any Federal
Government employee may be detailed to the Commission without reimbursement,
and such detail shall be without interruption or loss of civil service status
or privilege.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDEA1BA34054E44FBA8C233C7B7217F7CA"><enum>(E)</enum><header display-inline="yes-display-inline">Temporary and intermittent
services</header><text display-inline="yes-display-inline">The Chairperson of
the Commission may procure temporary and intermittent services under section
3109(b) of title 5, United States Code, at rates for individuals which do not
exceed the daily equivalent of the annual rate of basic pay prescribed for
level V of the Executive Schedule under section 5316 of such title.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID9714DA0F274D4D90808AA2C69FB2CFC9"><enum>(6)</enum><header display-inline="yes-display-inline">Funding</header><text display-inline="yes-display-inline">For the purpose of carrying out this
subsection, there are authorized to be appropriated $3,000,000 for fiscal year
2007 and each fiscal year thereafter.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ID573035B3C1C84F1F82ECD1DC459AB5B1"><enum>(d)</enum><header display-inline="yes-display-inline">Requirements for Programs</header>
<paragraph commented="no" display-inline="no-display-inline" id="IDD9051D1B9E7844409098E72F834815B6"><enum>(1)</enum><header display-inline="yes-display-inline">State plan</header><text display-inline="yes-display-inline">A State that seeks to receive a grant under
subsection (f) to operate a program under this section shall prepare and submit
to the Commission, as part of the application under subsection (b), a State
health care plan that shall have as its goal improvements in coverage, quality
and costs. To achieve such goal, the State plan shall comply with the
following:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="ID48B6CBE5B3B349F2B7A8F6D8CF4504AA"><enum>(A)</enum><header display-inline="yes-display-inline">Coverage</header><text display-inline="yes-display-inline">With respect to coverage, the State plan
shall—</text>
<clause commented="no" display-inline="no-display-inline" id="IDA39F6CD4248C49A68C1CDD7BC5CF4105"><enum>(i)</enum><text display-inline="yes-display-inline">provide and describe the manner in which
the State will ensure that an increased number of individuals residing within
the State will have expanded access to health care coverage with a specific
5-year target for reduction in the number of uninsured individuals through
either private or public program expansion, or both, in accordance with the
options established by the Commission;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID514ABF2E23C2425DA5D9FA01601DEC28"><enum>(ii)</enum><text display-inline="yes-display-inline">describe the number and percentage of
current uninsured individuals who will achieve coverage under the State health
program;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID76DE8B97358742C5869BC28224D7CFC1"><enum>(iii)</enum><text display-inline="yes-display-inline">describe the minimum benefits package that
will be provided to all classes of beneficiaries under the State health
program;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID8E23AD6F46DE4417986EB294147827DD"><enum>(iv)</enum><text display-inline="yes-display-inline">identify Federal, State, or local and
private programs that currently provide health care services in the State and
describe how such programs could be coordinated with the State health program,
to the extent practicable; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDB86A2D59C8F64F0098C6FA76004A9789"><enum>(v)</enum><text display-inline="yes-display-inline">provide for improvements in the
availability of appropriate health care services that will increase access to
care in urban, rural, and frontier areas of the State with medically
underserved populations or where there is an inadequate supply of health care
providers.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID718316B43F504B0081190C9B616A2D1F"><enum>(B)</enum><header display-inline="yes-display-inline">Quality</header><text display-inline="yes-display-inline">With respect to quality, the State plan
shall—</text>
<clause commented="no" display-inline="no-display-inline" id="ID328DBF325F4846D0B4EA78693EF82C8F"><enum>(i)</enum><text display-inline="yes-display-inline">provide a plan to improve health care
quality in the State, including increasing effectiveness, efficiency,
timeliness, patient focused, equity while reducing health disparities, and
medical errors; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDAB5EDED1DE6246DCBAC59C5F25F8D85E"><enum>(ii)</enum><text display-inline="yes-display-inline">contain appropriate results-based quality
indicators established by the Commission that will be addressed by the State as
well as State-specific quality indicators.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID733EE4C5B8AB4A4392BDDE08D12B399A"><enum>(C)</enum><header display-inline="yes-display-inline">Costs</header><text display-inline="yes-display-inline">With respect to costs, the State plan
shall—</text>
<clause commented="no" display-inline="no-display-inline" id="ID30691340EDF0427C9A3E4F27F15CF92D"><enum>(i)</enum><text display-inline="yes-display-inline">provide that the State will develop and
implement systems to improve the efficiency of health care, including a
specific 5-year target for reducing administrative costs (including paperwork
burdens);</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID1E40823C535941D1B4E8A84030061604"><enum>(ii)</enum><text display-inline="yes-display-inline">describe the public and private sector
financing to be provided for the State health program;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID209FDE894ABB47D5979D4E427C47EB35"><enum>(iii)</enum><text display-inline="yes-display-inline">estimate the amount of Federal, State, and
local expenditures, as well as, the costs to business and individuals under the
State health program;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID44F4519B0CE34BBC95C0605F38B3D9EC"><enum>(iv)</enum><text display-inline="yes-display-inline">describe how the State plan will ensure the
financial solvency of the State health program; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID1481AF93C6AC4392A1140850E5CF6F15"><enum>(v)</enum><text display-inline="yes-display-inline">provide that the State will prepare and
submit to the Secretary and the Commission such reports as the Secretary or
Commission may require to carry out program evaluations.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID688090639B264CA4B10A76A797072C6B"><enum>(D)</enum><header display-inline="yes-display-inline">Health information technology</header><text display-inline="yes-display-inline">With respect to health information
technology, the State plan shall provide methodology for the appropriate use of
health information technology to improve infrastructure, such as improving the
availability of evidence-based medical and outcomes data to providers and
patients, as well as other health information (such as electronic health
records, electronic billing, and electronic prescribing).</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID849629FC4F404DE1B3BD7EBA8B062921"><enum>(2)</enum><header display-inline="yes-display-inline">Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall, if requested, provide
technical assistance to States to assist such States in developing applications
and plans under this section, including technical assistance by private sector
entities if determined appropriate by the Commission.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID71AC9A8C9F774831AD578D66F1856784"><enum>(3)</enum><header display-inline="yes-display-inline">Initial
review</header><text display-inline="yes-display-inline">With respect to a
State application for a grant under subsection (b), the Secretary and the
Commission shall complete an initial review of such State application within 60
days of the receipt of such application, analyze the scope of the proposal, and
determine whether additional information is needed from the State. The
Commission shall advise the State within such period of the need to submit
additional information.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID559DD3B69BE140C2AA32EBC9C42FEE69"><enum>(4)</enum><header display-inline="yes-display-inline">Final determination</header>
<subparagraph commented="no" display-inline="no-display-inline" id="IDBF83E006650B4FF8AE626F593AD49834"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Not later than 90 days after completion of
the initial review under paragraph (3), the Commission shall determine whether
to submit a State proposal to Congress for approval.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID1DFF6F13CAF64E58A2552081FDFAFB47"><enum>(B)</enum><header display-inline="yes-display-inline">Voting</header>
<clause commented="no" display-inline="no-display-inline" id="IDDA57BCC8FA254214893A143B54CE929D"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The determination to submit a State
proposal to Congress under subparagraph (A) shall be approved by
<fraction>2/3</fraction> of the members of the Commission who are eligible to
participate in such determination subject to clause (ii).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID3B421D6D702A44D4A15F3C6C4775A011"><enum>(ii)</enum><header display-inline="yes-display-inline">Eligibility</header><text display-inline="yes-display-inline">A member of the Commission shall not
participate in a determination under subparagraph (A) if—</text>
<subclause commented="no" display-inline="no-display-inline" id="ID389B9721CC66457CB95E98864374362F"><enum>(I)</enum><text display-inline="yes-display-inline">in the case of a member who is a Governor,
such determination relates to the State of which the member is the Governor;
or</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="IDF68043602F4F468DA338B5F541739A54"><enum>(II)</enum><text display-inline="yes-display-inline">in the case of member not described in
subclause (I), such determination relates to the geographic area of a State of
which such member serves as a State or local official.</text>
</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDA7F72352B77D40A29A8635BF1C8738F9"><enum>(C)</enum><header display-inline="yes-display-inline">Submission</header><text display-inline="yes-display-inline">Not later than 90 days prior to October 1
of each fiscal year, the Commission shall submit to Congress a list, in the
form of a legislative proposal, of the State applications that the Commission
recommends for approval under this section.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDD370FC5476DC4F249A7FB14BBAC2E675"><enum>(D)</enum><header display-inline="yes-display-inline">Approval</header><text display-inline="yes-display-inline">With respect to a fiscal year, a State
proposal that has been recommended under subparagraph (B) shall be deemed to be
approved, and subject to the availability of appropriations, Federal funds
shall be provided to such program, unless a joint resolution has been enacted
disapproving such proposal as provided for in subsection (e). Nothing in the
preceding sentence shall be construed to include the approval of State
proposals that involve waivers or modifications in applicable Federal
law.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDCE08796B4AF04EAF901B82AC2CE1E2D3"><enum>(5)</enum><header display-inline="yes-display-inline">Program or project period</header><text display-inline="yes-display-inline">A State program or project may be approved
for a period of 5 years and may be extended for subsequent 5-year periods upon
approval by the Commission and the Secretary, based upon achievement of
targets, except that a shorter period may be requested by a State and granted
by the Secretary.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ID81B2631C02E34D39BC469CA755D0ACCD"><enum>(e)</enum><header display-inline="yes-display-inline">Expedited Congressional
Consideration</header>
<paragraph commented="no" display-inline="no-display-inline" id="IDC9810F4467194EA194F94D7499C7D31E"><enum>(1)</enum><header display-inline="yes-display-inline">Introduction and Committee
Consideration</header>
<subparagraph commented="no" display-inline="no-display-inline" id="IDA13CD16D1A804772BF829AB2F86E1252"><enum>(A)</enum><header display-inline="yes-display-inline">Introduction</header><text display-inline="yes-display-inline">The legislative proposal submitted pursuant
to subsection (d)(4)(B) shall be in the form of a joint resolution (in this
subsection referred to as the <quote>resolution</quote>). Such resolution shall
be introduced in the House of Representatives by the Speaker, and in the
Senate, by the majority leader, immediately upon receipt of the language and
shall be referred to the appropriate committee of Congress. If the resolution
is not introduced in accordance with the preceding sentence, the resolution may
be introduced in either House of Congress by any member thereof.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDCC6F8BE212E5465DAC86A1D79107773A"><enum>(B)</enum><header display-inline="yes-display-inline">Committee consideration</header><text display-inline="yes-display-inline">A resolution introduced in the House of
Representatives shall be referred to the Committee on Ways and Means of the
House of Representatives. A resolution introduced in the Senate shall be
referred to the Committee on Finance of the Senate. Not later than 15 calendar
days after the introduction of the resolution, the committee of Congress to
which the resolution was referred shall report the resolution or a committee
amendment thereto. If the committee has not reported such resolution (or an
identical resolution) at the end of 15 calendar days after its introduction or
at the end of the first day after there has been reported to the House involved
a resolution, whichever is earlier, such committee shall be deemed to be
discharged from further consideration of such reform bill and such reform bill
shall be placed on the appropriate calendar of the House involved.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID15AA53F46D5844C8AE8B97D7382981EE"><enum>(2)</enum><header display-inline="yes-display-inline">Expedited Procedure</header>
<subparagraph commented="no" display-inline="no-display-inline" id="ID22A17797FD614500BA11EC9D6F214F8E"><enum>(A)</enum><header display-inline="yes-display-inline">Consideration</header><text display-inline="yes-display-inline">Not later than 5 days after the date on
which a committee has been discharged from consideration of a resolution, the
Speaker of the House of Representatives, or the Speaker’s designee, or the
majority leader of the Senate, or the leader’s designee, shall move to proceed
to the consideration of the committee amendment to the resolution, and if there
is no such amendment, to the resolution. It shall also be in order for any
member of the House of Representatives or the Senate, respectively, to move to
proceed to the consideration of the resolution at any time after the conclusion
of such 5-day period. All points of order against the resolution (and against
consideration of the resolution) are waived. A motion to proceed to the
consideration of the resolution is highly privileged in the House of
Representatives and is privileged in the Senate and is not debatable. The
motion is not subject to amendment, to a motion to postpone consideration of
the resolution, or to a motion to proceed to the consideration of other
business. A motion to reconsider the vote by which the motion to proceed is
agreed to or not agreed to shall not be in order. If the motion to proceed is
agreed to, the House of Representatives or the Senate, as the case may be,
shall immediately proceed to consideration of the resolution without
intervening motion, order, or other business, and the resolution shall remain
the unfinished business of the House of Representatives or the Senate, as the
case may be, until disposed of.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDD6867AFC3C6C4A6BB1C07F678C4EEBF8"><enum>(B)</enum><header display-inline="yes-display-inline">Consideration by other house</header><text display-inline="yes-display-inline">If, before the passage by one House of the
resolution that was introduced in such House, such House receives from the
other House a resolution as passed by such other House—</text>
<clause commented="no" display-inline="no-display-inline" id="ID1AC37923D97F4C81B12B14CABF7BBD46"><enum>(i)</enum><text display-inline="yes-display-inline">the resolution of the other House shall not
be referred to a committee and may only be considered for final passage in the
House that receives it under clause (iii);</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID75747E4CF84B4F4A93CA27E3A11F5BD9"><enum>(ii)</enum><text display-inline="yes-display-inline">the procedure in the House in receipt of
the resolution of the other House, with respect to the resolution that was
introduced in the House in receipt of the resolution of the other House, shall
be the same as if no resolution had been received from the other House;
and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDCA321422C48D4E5DAA8AE368C94A55D6"><enum>(iii)</enum><text display-inline="yes-display-inline">notwithstanding clause (ii), the vote on
final passage shall be on the reform bill of the other House.</text>
</clause><continuation-text commented="no" continuation-text-level="subparagraph">Upon disposition of a resolution
that is received by one House from the other House, it shall no longer be in
order to consider the resolution bill that was introduced in the receiving
House.</continuation-text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID8720CB0DB5954561A9DC2C24FEFC7CD0"><enum>(C)</enum><header display-inline="yes-display-inline">Consideration in conference</header><text display-inline="yes-display-inline">Immediately upon a final passage of the
resolution that results in a disagreement between the two Houses of Congress
with respect to the resolution, conferees shall be appointed and a conference
convened. Not later than 10 days after the date on which conferees are
appointed, the conferees shall file a report with the House of Representatives
and the Senate resolving the differences between the Houses on the resolution.
Notwithstanding any other rule of the House of Representatives or the Senate,
it shall be in order to immediately consider a report of a committee of
conference on the resolution filed in accordance with this subclause. Debate in
the House of Representatives and the Senate on the conference report shall be
limited to 10 hours, equally divided and controlled by the Speaker of the House
of Representatives and the minority leader of the House of Representatives or
their designees and the majority and minority leaders of the Senate or their
designees. A vote on final passage of the conference report shall occur
immediately at the conclusion or yielding back of all time for debate on the
conference report.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID0E7E684AB6A545C587F6F93427DDBFD3"><enum>(3)</enum><header display-inline="yes-display-inline">Rules of the senate and house of
representatives</header><text display-inline="yes-display-inline">This
subsection is enacted by Congress—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="ID5554A183426244799068BA756AB2DF88"><enum>(A)</enum><text display-inline="yes-display-inline">as an exercise of the rulemaking power of
the Senate and House of Representatives, respectively, and is deemed to be part
of the rules of each House, respectively, but applicable only with respect to
the procedure to be followed in that House in the case of a resolution, and it
supersedes other rules only to the extent that it is inconsistent with such
rules; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID0311B773E1344510AF50C1064CE1724F"><enum>(B)</enum><text display-inline="yes-display-inline">with full recognition of the constitutional
right of either House to change the rules (so far as they relate to the
procedure of that House) at any time, in the same manner, and to the same
extent as in the case of any other rule of that House.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID65040FF03D2A4BF7992FD7ED4C542B93"><enum>(4)</enum><header display-inline="yes-display-inline">Limitation</header><text display-inline="yes-display-inline">The amount of Federal funds provided with
respect to any State proposal that is deemed approved under subsection (d)(3)
shall not exceed the cost provided for such proposals within the concurrent
resolution on the budget as enacted by Congress for the fiscal year
involved.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="IDD0F93B098EE845E381B89498CD9BE36C"><enum>(f)</enum><header display-inline="yes-display-inline">Funding</header>
<paragraph commented="no" display-inline="no-display-inline" id="ID2E817F6179904ECBB40A4FAC303DC545"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary shall provide a grant to a
State that has an application approved under subsection (b) to enable such
State to carry out an innovative State health program in the State.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDBA58044A080F4CD98CA0EF1CDB4B149D"><enum>(2)</enum><header display-inline="yes-display-inline">Amount of grant</header><text display-inline="yes-display-inline">The amount of a grant provided to a State
under paragraph (1) shall be determined based upon the recommendations of the
Commission, subject to the amount appropriated under subsection (k).</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDC905D4EA547C46169D285432E5CF017E"><enum>(3)</enum><header display-inline="yes-display-inline">Performance-based funding allocation and
prioritization</header><text display-inline="yes-display-inline">In awarding
grants under paragraph (1), the Secretary shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="IDEA2F73A5F3234250AAF819DED0937B04"><enum>(A)</enum><text display-inline="yes-display-inline">fund a diversity of approaches as provided
for by the Commission in subsection (c)(1)(B);</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDB377266D6010437EABD7F73C2C283B26"><enum>(B)</enum><text display-inline="yes-display-inline">give priority to those State programs that
the Commission determines have the greatest opportunity to succeed in providing
expanded health insurance coverage and in providing children, youth, and other
vulnerable populations with improved access to health care items and services;
and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID36FBEE73FDE740BE90AB597ADB5D35D8"><enum>(C)</enum><text display-inline="yes-display-inline">link allocations to the State to the
meeting of the goals and performance measures relating to health care coverage,
quality, and health care costs established under this Act through the State
project application process.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDB27275E1BAD24E57B7CA968FF1673EC9"><enum>(4)</enum><header display-inline="yes-display-inline">Maintenance of effort</header><text display-inline="yes-display-inline">A State, in utilizing the proceeds of a
grant received under paragraph (1), shall maintain the expenditures of the
State for health care coverage purposes for the support of direct health care
delivery at a level equal to not less than the level of such expenditures
maintained by the State for the fiscal year preceding the fiscal year for which
the grant is received.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID9107D310900A44D78BA023B693F61F2A"><enum>(5)</enum><header display-inline="yes-display-inline">Report</header><text display-inline="yes-display-inline">At the end of the 5-year period beginning
on the date on which the Secretary awards the first grant under paragraph (1),
the State Health Innovation Advisory Commission established under subsection
(c) shall prepare and submit to the appropriate committees of Congress, a
report on the progress made by States receiving grants under paragraph (1) in
meeting the goals of expanded coverage, improved quality, and cost containment
through performance measures established during the 5-year period of the grant.
Such report shall contain the recommendation of the Commission concerning any
future action that Congress should take concerning health care reform,
including whether or not to extend the program established under this
subsection.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ID434A4F7BB68E4203B2750D32BECBC6AC"><enum>(g)</enum><header display-inline="yes-display-inline">Monitoring and Evaluation</header>
<paragraph commented="no" display-inline="no-display-inline" id="IDCAB63F7366D84A51AFA4EE3722853FDF"><enum>(1)</enum><header display-inline="yes-display-inline">Annual reports and participation by
states</header><text display-inline="yes-display-inline">Each State that has
received a program approval shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="ID2E7219CBBDE44E2580A25D1E863A896C"><enum>(A)</enum><text display-inline="yes-display-inline">submit to the Commission an annual report
based on the period representing the respective State’s fiscal year, detailing
compliance with the requirements established by the Commission and the
Secretary in the approval and in this section; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID73BCA474B61547159470F9F1936F8F0C"><enum>(B)</enum><text display-inline="yes-display-inline">participate in the annual meeting under
subsection (c)(4)(B).</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDEA87CDD3ED084EBF847D09685C56D53E"><enum>(2)</enum><header display-inline="yes-display-inline">Evaluations by commission</header><text display-inline="yes-display-inline">The Commission, in consultation with a
qualified and independent organization such as the Institute of Medicine, shall
prepare and submit to the Committee on Finance and the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee on Energy and
Commerce, the Committee on Education and Labor, and the Committee on Ways and
Means of the House of Representatives annual reports that shall contain—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="IDBDD55794FD87434BBB3C6D5E949123CA"><enum>(A)</enum><text display-inline="yes-display-inline">a description of the effects of the reforms
undertaken in States receiving approvals under this section;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID1BF18077EBE6449698980EE5D2EE1AC1"><enum>(B)</enum><text display-inline="yes-display-inline">a description of the recommendations of the
Commission and actions taken based on these recommendations;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDFF7042A4DEF247CAA1FAA829DA73D52E"><enum>(C)</enum><text display-inline="yes-display-inline">an evaluation of the effectiveness of such
reforms in—</text>
<clause commented="no" display-inline="no-display-inline" id="ID34FCE4931F0C40DDA21CCE692A057417"><enum>(i)</enum><text display-inline="yes-display-inline">expanding health care coverage for State
residents;</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID9568B868574E4A14B3278A8A05FD4E44"><enum>(ii)</enum><text display-inline="yes-display-inline">improving the quality of health care
provided in the States; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID9B1BF8511A294FDE884DEE4A32F65766"><enum>(iii)</enum><text display-inline="yes-display-inline">reducing or containing health care costs in
the States;</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID20177B3406B14186BF0567B99B95EA11"><enum>(D)</enum><text display-inline="yes-display-inline">recommendations regarding the advisability
of increasing Federal financial assistance for State ongoing or future health
program initiatives, including the amount and source of such assistance;
and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID9826DC9DC08D48A1AE8FAFDB4157B0B1"><enum>(E)</enum><text display-inline="yes-display-inline">as required by the Commission or the
Secretary under subsection (f)(5), a periodic, independent evaluation of the
program.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="IDCD52D1DC2194445BB9D906909053BCC0"><enum>(h)</enum><header display-inline="yes-display-inline">Noncompliance</header>
<paragraph commented="no" display-inline="no-display-inline" id="IDF58469D87BF74BB9A4E51FB3D7BDD315"><enum>(1)</enum><header display-inline="yes-display-inline">Corrective action plans</header><text display-inline="yes-display-inline">If a State is not in compliance with a
requirement of this section, the Secretary shall develop a corrective action
plan for such State.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDA101F9D4B7A14D9D9C898F12BDEBBBFB"><enum>(2)</enum><header display-inline="yes-display-inline">Termination</header><text display-inline="yes-display-inline">For good cause and in consultation with the
Commission, the Secretary may revoke any program granted under this section.
Such decisions shall be subject to a petition for reconsideration and appeal
pursuant to regulations established by the Secretary.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ID941BDB94388A4130AF03DF91E9555355"><enum>(i)</enum><header display-inline="yes-display-inline">Relationship to Federal Programs</header>
<paragraph commented="no" display-inline="no-display-inline" id="ID610C735866074D7DAED4C4F0FE7584A8"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Nothing in this Act, or in section 1115 of
the <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1315) shall be construed as authorizing the Secretary, the Commission, a State,
or any other person or entity to alter or affect in any way the provisions of
title XIX of such Act (42 U.S.C. 1396 et seq.) or the regulations implementing
such title.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID593F1AB03D244D2E97B4F831B5E131DD"><enum>(2)</enum><header display-inline="yes-display-inline">Maintenance of effort</header><text display-inline="yes-display-inline">No payment may be made under this section
if the State adopts criteria for benefits, income, and resource standards and
methodologies for purposes of determining an individual’s eligibility for
medical assistance under the State plan under title XIX that are more
restrictive than those applied as of the date of enactment of this Act.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="IDD9015B7A0A964305B5162AD4EE70DA91"><enum>(j)</enum><header display-inline="yes-display-inline">Miscellaneous Provisions</header>
<paragraph commented="no" display-inline="no-display-inline" id="ID95B3DA65F303473FA263990E4E9AAFCB"><enum>(1)</enum><header display-inline="yes-display-inline">Application of certain
requirements</header>
<subparagraph commented="no" display-inline="no-display-inline" id="ID3CF7A678753B46658E805B7C07544E44"><enum>(A)</enum><header display-inline="yes-display-inline">Restriction on application of preexisting
condition exclusions</header>
<clause commented="no" display-inline="no-display-inline" id="IDBB33BF1A10A34B7BB3BF9D6895C06A02"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to subparagraph (B), a State shall
not permit the imposition of any preexisting condition exclusion for covered
benefits under a program or project under this section.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDD18F223F23B740E29B993D28296D8292"><enum>(ii)</enum><header display-inline="yes-display-inline">Group health plans and group health
insurance coverage</header><text display-inline="yes-display-inline">If the
State program or project provides for benefits through payment for, or a
contract with, a group health plan or group health insurance coverage, the
program or project may permit the imposition of a preexisting condition
exclusion but only insofar and to the extent that such exclusion is permitted
under the applicable provisions of part 7 of subtitle B of title I of the
<act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name> and title XXVII of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name>.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID34560762361E4BFDA2C499C86454FC5D"><enum>(B)</enum><header display-inline="yes-display-inline">Compliance with other
requirements</header><text display-inline="yes-display-inline">Coverage offered
under the program or project shall comply with the requirements of subpart 2 of
part A of title XXVII of the <act-name parsable-cite="PHSA">Public Health
Service Act</act-name> insofar as such requirements apply with respect to a
health insurance issuer that offers group health insurance coverage.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDF83BD46963CF43478C2FBC57B5B34EC9"><enum>(2)</enum><header display-inline="yes-display-inline">Prevention of duplicative payments</header>
<subparagraph commented="no" display-inline="no-display-inline" id="ID695D3D0B0B0246B7A085410449832AF5"><enum>(A)</enum><header display-inline="yes-display-inline">Other health plans</header><text display-inline="yes-display-inline">No payment shall be made to a State under
this section for expenditures for health assistance provided for an individual
to the extent that a private insurer (as defined by the Secretary by regulation
and including a group health plan (as defined in section 607(1) of the
<act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name>), a service benefit plan, and a health maintenance
organization) would have been obligated to provide such assistance but for a
provision of its insurance contract which has the effect of limiting or
excluding such obligation because the individual is eligible for or is provided
health assistance under the plan.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID077CC462BBA243559E6F0DAFE5501575"><enum>(B)</enum><header display-inline="yes-display-inline">Other federal governmental
programs</header><text display-inline="yes-display-inline">Except as provided
in any other provision of law, no payment shall be made to a State under this
section for expenditures for health assistance provided for an individual to
the extent that payment has been made or can reasonably be expected to be made
promptly (as determined in accordance with regulations) under any other
federally operated or financed health care insurance program, other than an
insurance program operated or financed by the Indian Health Service, as
identified by the Secretary. For purposes of this paragraph, rules similar to
the rules for overpayments under section 1903(d)(2) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> shall
apply.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID756E8A6A885A485E992A6DA399C5B413"><enum>(3)</enum><header display-inline="yes-display-inline">Application of certain general
provisions</header><text display-inline="yes-display-inline">The following
sections of the <act-name parsable-cite="SSA">Social Security Act</act-name>
shall apply to States under this section in the same manner as they apply to a
State under such title XIX:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="ID2694A5EF24954E91B2649D640143EF51"><enum>(A)</enum><header display-inline="yes-display-inline">Title <enum-in-header>XIX</enum-in-header>
provisions</header>
<clause commented="no" display-inline="no-display-inline" id="IDED1714FA0A6A43AD94CA617A5A4A8BAA"><enum>(i)</enum><text display-inline="yes-display-inline">Section 1902(a)(4)(C) (relating to conflict
of interest standards).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID6982D2391E154AA19249CC604DEE1E46"><enum>(ii)</enum><text display-inline="yes-display-inline">Paragraphs (2), (16), and (17) of section
1903(i) (relating to limitations on payment).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID3B0BF1D02F8448D199BAFEE7E6C23E07"><enum>(iii)</enum><text display-inline="yes-display-inline">Section 1903(w) (relating to limitations on
provider taxes and donations).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID80D996D4C33A4F2E84ED8846BF3AC264"><enum>(iv)</enum><text display-inline="yes-display-inline">Section 1920A (relating to presumptive
eligibility for children).</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDD130292CC711461193C56C335CDD75F4"><enum>(B)</enum><header display-inline="yes-display-inline">Title <enum-in-header>XI</enum-in-header>
provisions</header>
<clause commented="no" display-inline="no-display-inline" id="ID92A963DDB69740189137B4B69E87FD2F"><enum>(i)</enum><text display-inline="yes-display-inline">Section 1116 (relating to administrative
and judicial review), but only insofar as consistent with this title.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDC3B145AFA47548139B63545419018D42"><enum>(ii)</enum><text display-inline="yes-display-inline">Section 1124 (relating to disclosure of
ownership and related information).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID25645E422A254E1DAF7A64A9E290B7E4"><enum>(iii)</enum><text display-inline="yes-display-inline">Section 1126 (relating to disclosure of
information about certain convicted individuals).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID9BD40E36992F46F2A440B229E53001B3"><enum>(iv)</enum><text display-inline="yes-display-inline">Section 1128A (relating to civil monetary
penalties).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="IDF51E1E977BFB42AFAC5E92DF42600D7F"><enum>(v)</enum><text display-inline="yes-display-inline">Section 1128B(d) (relating to criminal
penalties for certain additional charges).</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID88F6A46A750F465AABAC327AF1F7325F"><enum>(vi)</enum><text display-inline="yes-display-inline">Section 1132 (relating to periods within
which claims must be filed).</text>
</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ID675A35E27C8440F8AB623A498F4A7896"><enum>(4)</enum><header display-inline="yes-display-inline">Relation to other laws</header>
<subparagraph commented="no" display-inline="no-display-inline" id="IDB201E7E818F84EE8A0E9CB89FC96EFA5"><enum>(A)</enum><header display-inline="yes-display-inline">HIPAA</header><text display-inline="yes-display-inline">Health benefits coverage provided under a
State program or project under this section shall be treated as creditable
coverage for purposes of part 7 of subtitle B of title I of the
<act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name>, title XXVII of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name>, and subtitle K of the Internal Revenue Code of
1986.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID38930DC49DEE4124BAE2DE61A110A0E1"><enum>(B)</enum><header display-inline="yes-display-inline">ERISA</header><text display-inline="yes-display-inline">Nothing in this section shall be construed
as affecting or modifying section 514 of the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name> (29 U.S.C. 1144) with respect to a group health plan (as
defined in section 2791(a)(1) of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name> (42 U.S.C. 300gg–91(a)(1))).</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ID560F5A6B3CF848FC833D1FC040FB2736"><enum>(k)</enum><header display-inline="yes-display-inline">Authorization of
Appropriations</header><text display-inline="yes-display-inline">There is
authorized to be appropriated to carry out this section, such sums as may be
necessary in each fiscal year. Amounts appropriated for a fiscal year under
this subsection and not expended may be used in subsequent fiscal years to
carry out this section.</text>
</subsection></section><enum>IV</enum><header>Sense of the
Senate</header>
<section id="id85FD5562F348495A97C6C6C503DA2123"><enum>401.</enum><header>Sense of the
Senate</header><text display-inline="no-display-inline">It is the sense of the
Senate that any increases in Federal budget outlays resulting from this Act be
fully offset by reductions in Federal budget outlays, and that any reductions
in Federal revenues resulting from this Act be fully offset.</text>
</section>