II 110th CONGRESS 2d Session S. 2586 IN THE SENATE OF THE UNITED STATES January 31, 2008 Mr. Rockefeller introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To provide States with fiscal relief through a temporary increase in the Federal medical assistance percentage and direct payments to States.

1.

Short title

This Act may be cited as the State Fiscal Relief Act of 2008.

2.

Temporary State fiscal relief

(a)

Temporary increase of the Medicaid FMAP

(1)

Permitting maintenance of fiscal year 2007 FMAP for last 3 calendar quarters of fiscal year 2008

Subject to paragraph (5), if the FMAP determined without regard to this subsection for a State for fiscal year 2008 is less than the FMAP as so determined for fiscal year 2007, the FMAP for the State for fiscal year 2007 shall be substituted for the State’s FMAP for the second, third, and fourth calendar quarters of fiscal year 2008, before the application of this subsection. (2)

Permitting maintenance of fiscal year 2008 FMAP for first 2 quarters of fiscal year 2009

Subject to paragraph (5), if the FMAP determined without regard to this subsection for a State for fiscal year 2009 is less than the FMAP as so determined for fiscal year 2008, the FMAP for the State for fiscal year 2008 shall be substituted for the State’s FMAP for the first and second calendar quarters of fiscal year 2009, before the application of this subsection. (3)

General 1.225 percentage points increase for last 3 calendar quarters of fiscal year 2008 and first 2 calendar quarters of fiscal year 2009

Subject to paragraphs (5), (6), and (7), for each State for the second, third, and fourth calendar quarters of fiscal year 2008 and for the first and second calendar quarters of fiscal year 2009, the FMAP (taking into account the application of paragraphs (1) and (2)) shall be increased by 1.225 percentage points. (4)

Increase in cap on medicaid payments to territories

Subject to paragraphs (6) and (7), with respect to the second, third, and fourth calendar quarters of fiscal year 2008 and the first and second calendar quarters of fiscal year 2009, the amounts otherwise determined for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa under subsections (f) and (g) of section 1108 of the Social Security Act (42 U.S.C. 1308) shall each be increased by an amount equal to 2.45 percent of such amounts. (5)

Scope of application

The increases in the FMAP for a State under this subsection shall apply only for purposes of title XIX of the Social Security Act and shall not apply with respect to— (A)disproportionate share hospital payments described in section 1923 of such Act (42 U.S.C. 1396r–4); (B)payments under title IV or XXI of such Act (42 U.S.C. 601 et seq. and 1397aa et seq.); or (C)any payments under XIX of such Act that are based on the enhanced FMAP described in section 2105(b) of such Act (42 U.S.C. 1397ee(b)). (6)

State eligibility

(A)

In general

Subject to subparagraph (B), a State is eligible for an increase in its FMAP under paragraph (3) or an increase in a cap amount under paragraph (4) only if the eligibility under its State plan under title XIX of the Social Security Act (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)) is no more restrictive than the eligibility under such plan (or waiver) as in effect on December 31, 2007. (B)

State reinstatement of eligibility permitted

A State that has restricted eligibility under its State plan under title XIX of the Social Security Act (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)) after December 31, 2007 is eligible for an increase in its FMAP under paragraph (3) or an increase in a cap amount under paragraph (4) in the first calendar quarter (and subsequent calendar quarters) in which the State has reinstated eligibility that is no more restrictive than the eligibility under such plan (or waiver) as in effect on December 31, 2007. (C)

Rule of construction

Nothing in subparagraph (A) or (B) shall be construed as affecting a State’s flexibility with respect to benefits offered under the State medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)). (7)

Requirement for certain States

In the case of a State that requires political subdivisions within the State to contribute toward the non-Federal share of expenditures under the State medicaid plan required under section 1902(a)(2) of the Social Security Act (42 U.S.C. 1396a(a)(2)), the State shall not require that such political subdivisions pay a greater percentage of the non-Federal share of such expenditures for the second, third, and fourth calendar quarters of fiscal year 2008 and the first and second calendar quarters of fiscal year 2009, than the percentage that was required by the State under such plan on December 31, 2007, prior to application of this subsection. (8)

Definitions

In this subsection: (A)

FMAP

The term FMAP means the Federal medical assistance percentage, as defined in section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)). (B)

State

The term State has the meaning given such term for purposes of title XIX of the Social Security Act (42 U.S.C. 1396 et seq.). (9)

Repeal

Effective as of October 1, 2009, this subsection is repealed. (b)

Payments to States for Assistance With Providing Government Services

The Social Security Act (42 U.S.C. 301 et seq.) is amended by inserting after title V the following: .