[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 895 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                 S. 895

 To amend titles XIX and XXI of the Social Security Act to ensure that 
  every child in the United States has access to affordable, quality 
           health insurance coverage, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 15, 2007

 Mrs. Clinton introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend titles XIX and XXI of the Social Security Act to ensure that 
  every child in the United States has access to affordable, quality 
           health insurance coverage, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; AMENDMENTS TO SOCIAL SECURITY ACT; TABLE OF 
              CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Children's Health 
First Act''.
    (b) Amendments to Social Security Act.--Except as otherwise 
specifically provided, whenever in this Act an amendment is expressed 
in terms of an amendment to or repeal of a section or other provision, 
the reference shall be considered to be made to that section or other 
provision of the Social Security Act.
    (c) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; amendments to Social Security Act; table of 
                            contents.
       TITLE I--OPTIONS FOR AFFORDABLE COVERAGE FOR ALL CHILDREN

   Subtitle A--Expanded Coverage of Children Under SCHIP and Through 
                      Employer-Sponsored Coverage

Sec. 101. State option to expand coverage of children under SCHIP.
Sec. 102. Authority for States to offer purchase of coverage for 
                            uncovered children under SCHIP.
Sec. 103. Support for employment-based coverage of children eligible 
                            for SCHIP or Medicaid.
Sec. 104. Modification of prohibition on coverage of children of State 
                            employees.
       Subtitle B--Ensuring Dependable Coverage for All Children

Sec. 111. Improving benchmark coverage options.
Sec. 112. Requiring coverage of EPSDT services, including dental 
                            services, and federally-qualified health 
                            services and improving coverage of 
                            additional categories of services.
Sec. 113. Clarification of requirement to provide EPSDT services for 
                            all children in benchmark benefit packages 
                            under Medicaid.
Sec. 114. Medicaid-SCHIP Payment Advisory Commission.
                Subtitle C--Ensuring a Fair Partnership

Sec. 121. Increase in FMAP for medical assistance for children for 
                            States that expand coverage of children.
      Subtitle D--State Options for Additional Coverage Expansions

Sec. 131. Optional coverage of older children under Medicaid and SCHIP.
Sec. 132. Optional coverage of legal immigrants under the Medicaid 
                            program and SCHIP.
Sec. 133. State option to expand or add coverage of certain pregnant 
                            women under SCHIP.
            TITLE II--REMOVAL OF OTHER BARRIERS TO COVERAGE

Sec. 201. Establishment of new base SCHIP allotments that are 
                            responsive to increases in health care 
                            costs and enrollment expansions.
Sec. 202. 2-year initial availability of SCHIP allotments.
Sec. 203. Redistribution of unused allotments to address State funding 
                            shortfalls.
Sec. 204. Incentives for school-based outreach and enrollment.
Sec. 205. Medicaid citizenship documentation requirements.
Sec. 206. State option to provide for ``express lane'' and simplified 
                            determinations of a child's financial 
                            eligibility for medical assistance under 
                            Medicaid or child health assistance under 
                            SCHIP.
Sec. 207. Information technology connections to improve health coverage 
                            determinations.
Sec. 208. Encouraging culturally appropriate enrollment practices.
Sec. 209. Model of Interstate coordinated enrollment and coverage 
                            process.
Sec. 210. Elimination of counting medicaid child presumptive 
                            eligibility costs against title XXI 
                            allotment.
Sec. 211. Authority for qualifying States to use portion of SCHIP 
                            allotment for any fiscal year for certain 
                            medicaid expenditures.
Sec. 212. Application of Medicaid outreach procedures to all pregnant 
                            women and children.
                       TITLE III--EFFECTIVE DATE

Sec. 301. Effective date.

       TITLE I--OPTIONS FOR AFFORDABLE COVERAGE FOR ALL CHILDREN

   Subtitle A--Expanded Coverage of Children Under SCHIP and Through 
                      Employer-Sponsored Coverage

SEC. 101. STATE OPTION TO EXPAND COVERAGE OF CHILDREN UNDER SCHIP.

    (a) Option for Coverage of Children up to 400 Percent of Poverty 
Line.--Section 2110(c)(4) (42 U.S.C. 1397jj(c)(4)) is amended by 
inserting ``(or, at the option of the State, any percentage up to 400 
percent)'' after ``200 percent''.
    (b) Ensuring Funding for State Eligibility Expansion.--
            (1) In general.--Section 2105 (42 U.S.C. 1397dd) is amended 
        by adding at the end the following new subsection:
    ``(i) Funding for Child Health Assistance for Coverage Expansion 
States.--
            ``(1) In general.--Notwithstanding section 2104, in the 
        case of a State that has elected the option under section 
        2110(c)(4) to apply for a calendar quarter in a fiscal year a 
        percentage that is 400 percent and that meets the requirement 
        of paragraph (2) (relating to no limitation on enrollment), the 
        allotment determined for the State for such fiscal year under 
        section 2104 shall be increased by such sums as are necessary 
        for making payments to the State for expenditures described in 
        subsection (a)(1).
            ``(2) No limitation on enrollment.--The requirement of this 
        paragraph with respect to a State for a calendar quarter is 
        that the State does not impose, with respect to the enrollment 
        under the State child health plan of targeted low-income 
        children during the quarter, any enrollment cap or other 
        numerical limitation on enrollment, any waiting list, any 
        procedures designed to delay the consideration of applications 
        for enrollment, or similar limitation with respect to 
        enrollment.
            ``(3) Appropriation.--There is appropriated, out of any 
        money in the Treasury not otherwise appropriated, such sums as 
        may be necessary for the purpose of paying a State described in 
        paragraph (1) for each calendar quarter described in such 
        paragraph, an amount equal to the enhanced FMAP of expenditures 
        described in such paragraph and incurred during such 
        quarter.''.
            (2) Conforming amendments.--Section 2104 (42 U.S.C. 1397dd) 
        is amended--
                    (A) in subsection (a), by striking ``subsection 
                (d)'' and inserting `` subsections (d) and (h) and 
                section 2105(i)'';
                    (B) in subsection (b)(1), by striking ``subsection 
                (d)'' and inserting `` subsections (d) and (h) and 
                section 2105(i)''; and
                    (C) in subsection (c)(1), by striking ``subsection 
                (d)'' and inserting `` subsections (d) and (h) and 
                section 2105(i)''.

SEC. 102. AUTHORITY FOR STATES TO OFFER PURCHASE OF COVERAGE FOR 
              UNCOVERED CHILDREN UNDER SCHIP.

    (a) In General.--Title XXI (42 U.S.C. 1397aa et seq.) is amended by 
adding at the end the following new section:

``SEC. 2111. AUTHORITY FOR STATES TO OFFER PURCHASE OF COVERAGE FOR 
              UNCOVERED CHILDREN WHO ARE NOT OTHERWISE ELIGIBLE FOR 
              ASSISTANCE UNDER SCHIP OR MEDICAID.

    ``(a) Authority To Offer Purchase of Coverage.--
            ``(1) Option for states with income eligibility level of at 
        least 200, but not 400, percent.--Subject to the succeeding 
        provisions of this section, in the case of a State that meets 
        the requirement of section 2105(i)(2) for a calendar quarter 
        and that has elected to apply an income eligibility level under 
        section 2110(c)(4) that is at least 200 percent, but not 400 
        percent, of the poverty line for the calendar quarter, the 
        State may permit during the calendar quarter the purchase of 
        coverage under this title by families, employers, or others 
        (under the same terms of the plan that apply to targeted low-
        income children) for an uncovered child who would be eligible 
        to be a targeted low-income child but whose family income 
        exceeds such level.
            ``(2) Requirement for states with 400 percent income 
        eligibility level.--In the case of a State that meets the 
        requirement of section 2105(i)(2) for a calendar quarter and 
        that has elected to apply an income eligibility level under 
        section 2110(c)(4) that is 400 percent of the poverty line for 
        the calendar quarter, the State shall permit during the quarter 
        the purchase of coverage described in paragraph (1).
    ``(b) Community-Rated, Actuarially Based Premium.--The premium 
imposed for coverage of a child pursuant to subsection (a) shall not 
exceed a community-rated premium that reflects the actuarial average 
cost of providing coverage under the State child health plan to 
enrollees who are children.
    ``(c) State Option Regarding Limitation on Cost-Sharing.--
            ``(1) In general.--In the case of children covered under 
        the plan by reason of purchasing such coverage pursuant to 
        subsection (a), the State may elect in applying the limitation 
        on cost-sharing described in section 2103(e)(3)(B) (including 
        to children who are provided benefits in the manner described 
        in section 2103(e)(4)) not to apply such limitation with 
        respect to some or all of the premiums imposed for the purchase 
        of such coverage.
            ``(2) Rule of construction.--Nothing in paragraph (1) shall 
        be construed as prohibiting an employer from providing an 
        employee with financial benefits to offset the cost of premiums 
        and cost-sharing imposed with respect to the purchase of 
        coverage of a child pursuant to subsection (a).
    ``(d) No Federal Matching Payment Available.--No payments shall be 
made under section 2105(a) (other than under clauses (iii) and (iv) of 
paragraph (1)(D)) with respect to child health assistance provided 
under the State child health plan to children covered under the plan by 
reason of purchasing such coverage pursuant to this section.''.
    (b) Conforming Amendments.--
            (1) Section 2110(b)(1)(B) (42 U.S.C. 1397jj(b)(1)(B)) is 
        amended--
                    (A) in clause (i), by striking ``or'' at the end;
                    (B) in clause (ii), in the matter before subclause 
                (I), by inserting ``who'' before ``is'';
                    (C) in clause (ii)(III), by striking ``and'' and 
                inserting ``or''; and
                    (D) by adding at the end the following new clause:
                    ``(iii) who is a child with respect to whom 
                coverage is purchased under section 2111(a); and''.
            (2) Section 2103(e) (42 U.S.C. 1397cc) is amended--
                    (A) in paragraph (3)(B), by striking ``and (2)'' 
                and inserting ``, (2), and section 2111(d)''; and
                    (B) in paragraph (4), by striking ``Nothing'' and 
                inserting ``Subject to 2111(d)(2), nothing''.

SEC. 103. SUPPORT FOR EMPLOYMENT-BASED COVERAGE OF CHILDREN ELIGIBLE 
              FOR SCHIP OR MEDICAID.

    (a) Subsidies for Employment-Based Coverage.--
            (1) Under schip.--Section 2105 (42 U.S.C. 1397ee) is 
        amended--
                    (A) in subsection (a)(1)(D)--
                            (i) by striking ``and'' at the end of 
                        clause (iii);
                            (ii) by redesignating clause (iv) as clause 
                        (v); and
                            (iii) by inserting after clause (iii) the 
                        following new clause:
                            ``(iv) payments for employment-based 
                        coverage under subsection (c)(2)(C); and'';
                    (B) in subsection (c)(2)(A), by inserting ``(other 
                than under clause (iv) of such paragraph)'' after ``of 
                such subsection''; and
                    (C) in subsection (c)(2), by adding at the end the 
                following new subparagraph:
                    ``(C) Subsidies for employment-based coverage.--
                            ``(i) In general.--In the case of a State 
                        that has elected the option under section 
                        2110(c)(4) to apply for a calendar quarter a 
                        percentage that is 400 percent and that meets 
                        the requirement of subsection (i)(2) for the 
                        calendar quarter, subject to clause (ii), the 
                        limitation under subparagraph (A) on 
                        expenditures shall not apply to a payment for 
                        the provision of health benefits coverage 
                        during the calendar quarter under a group 
                        health plan for an employer premium assistance 
                        eligible child (and to supplemental benefits 
                        described in subclause (II)) if the State 
                        demonstrates to the satisfaction of the 
                        Secretary that--
                                    ``(I) the actuarial value of the 
                                health benefits coverage (as determined 
                                pursuant to section 2103(c)(4)) is at 
                                least equal to the actuarial value of 
                                the child health assistance provided 
                                under the State child health plan for 
                                children with the same (or comparable) 
                                family income and the group health plan 
                                does not discriminate in its coverage 
                                of employer premium assistance eligible 
                                children on the basis of health status; 
                                and
                                    ``(II) the State will provide 
                                supplemental benefits for employer 
                                premium assistance eligible children 
                                under the State child health plan in 
                                accordance with section 2110(b)(5) in 
                                order that such supplemental benefits, 
                                in combination with such coverage, 
                                provides the same benefits as would be 
                                available under the child health plan 
                                to the child if section 2110(b)(1)(C) 
                                did not apply to the child.
                            ``(ii) Limitation on federal matching 
                        payments.--No payment shall be made under 
                        subsection (a) with respect to a payment 
                        described in clause (i) for coverage of a child 
                        insofar as the payment exceeds 50 percent of 
                        the amount of expenditures that the State would 
                        have otherwise incurred for providing child 
                        health assistance for such child if the child 
                        were a targeted low-income child.
                            ``(iii) Employer premium assistance 
                        eligible child defined.--For purposes of clause 
                        (i), the term `employer premium assistance 
                        eligible child' means a child who is covered 
                        under a group health plan, who is not eligible 
                        for medical assistance under the State plan 
                        under title XIX, and who would satisfy the 
                        requirements for being a targeted low-income 
                        child under the State child health plan if the 
                        condition described in subparagraph (C) of 
                        section 2110(b)(1) did not apply.''.
            (2) Reference to existing medicaid authority.--For 
        provisions relating to authority of State Medicaid plan to 
        provide payment to employers for enrollment of Medicaid-
        eligible children in a group health plan, and requiring the 
        continued provision of medical assistance to supplement 
        coverage under such plan, see section 1906 of the Social 
        Security Act (42 U.S.C. 1396e).
    (b) State Provision of Supplemental SCHIP Benefits in Case of 
Children Covered Under Group Health Plans.--
            (1) In general.--Section 2110(b) (42 U.S.C. 1397jj(b)) is 
        amended--
                    (A) in paragraph (1)(C), by inserting ``, subject 
                to paragraph (5),'' after ``under title XIX or''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(5) State provision of supplemental benefits in case of 
        children covered under group health plans.--
                    ``(A) Requirement for children enrolled under 
                subsidized employment-based coverage.--In the case of a 
                State that provides payment under section 2105(c)(2)(C) 
                for health benefits coverage for a child enrolled in a 
                group health plan, the requirement of paragraph (1)(C) 
                shall not apply to such child, but the child health 
                assistance under this title shall be limited to--
                            ``(i) benefits for items or services that 
                        are not covered, or are only partially covered, 
                        under such plan; and
                            ``(ii) protection against incurring out-of-
                        pocket costs (including premiums) in excess of 
                        the limitations otherwise applicable to a 
                        targeted low-income child with the same family 
                        income.
                    ``(B) Option for other children.--For children not 
                described in subparagraph (A), a State may waive the 
                requirement of paragraph (1)(C), with respect to 
                children within one or more classes or categories of 
                children specified by the State, in the case of a child 
                covered under a group health plan in order to provide 
                child health assistance--
                            ``(i) for items or services that are not 
                        covered, or are only partially covered, under 
                        such plan; or
                            ``(ii) to protect against incurred out-of-
                        pocket costs (including premiums) exceeding the 
                        limitations otherwise applicable to a targeted 
                        low-income child with the same family income.
                    ``(C) Eligibility.--In applying subparagraph (B), a 
                State may limit the application of the waiver under 
                such subparagraph to children whose family income does 
                not exceed a level specified by the State, which may 
                not exceed the maximum income level otherwise 
                established for other children under the State child 
                health plan.
                    ``(D) Continued application of duty to prevent 
                substitution of existing coverage.--Nothing in this 
                paragraph shall be construed as modifying the 
                application of section 2102(b)(3)(C) to a State.''.
            (2) Application of enhanced match under medicaid.--Section 
        1905 (42 U.S.C. 1396d) is amended--
                    (A) in subsection (b), in the fourth sentence, by 
                striking ``subsection (u)(3)'' and inserting ``(u)(3), 
                or (u)(4)''; and
                    (B) in subsection (u), by redesignating paragraph 
                (4) as paragraph (5) and by inserting after paragraph 
                (3) the following new paragraph:
    ``(4) For purposes of subsection (b), the expenditures described in 
this paragraph are expenditures for items and services for children 
described in section 2110(b)(5).''.
            (3) Application of secondary payor provisions.--Section 
        2107(e)(1) (42 U.S.C. 1397gg(e)(1)) is amended--
                    (A) by redesignating subparagraphs (B) through (D) 
                as subparagraphs (C) through (E), respectively; and
                    (B) by inserting after subparagraph (A) the 
                following new subparagraph:
                    ``(B) Section 1902(a)(25) (relating to coordination 
                of benefits and secondary payor provisions) with 
                respect to benefits provided under section 
                2110(b)(5).''.

SEC. 104. MODIFICATION OF PROHIBITION ON COVERAGE OF CHILDREN OF STATE 
              EMPLOYEES.

    Section 2110(b)(2)(B) (42 U.S.C. 1397jj(b)(2)) is amended--
            (1) by striking ``is eligible'' and inserting ``would be 
        eligible''; and
            (2) by inserting ``(as in effect on March 1, 2007)'' after 
        ``plan''.

       Subtitle B--Ensuring Dependable Coverage for All Children

SEC. 111. IMPROVING BENCHMARK COVERAGE OPTIONS.

    (a) Limitation on Use of Secretary-Approved Coverage.--Section 
2103(a)(4) (42 U.S.C. 1397cc(a)(4)) is amended by striking the period 
at the end and inserting ``, but only if such determination was made 
before March 1, 2007.''.
    (b) Requirement for Most Popular Family Coverage for State Employee 
Coverage Benchmark.--Section 2103(b)(2) (42 U.S.C. 1397(b)(2)) is 
amended--
            (1) by striking ``A health benefits coverage plan'' and 
        inserting ``The health benefits coverage plan''; and
            (2) by inserting ``and that has been selected the most, by 
        employees seeking dependent coverage, among such plans that 
        provide such dependent coverage, in either of the previous 2 
        plan years'' before the period.

SEC. 112. REQUIRING COVERAGE OF EPSDT SERVICES, INCLUDING DENTAL 
              SERVICES, AND FEDERALLY-QUALIFIED HEALTH SERVICES AND 
              IMPROVING COVERAGE OF ADDITIONAL CATEGORIES OF SERVICES.

    (a) Additional Required Services.--
            (1) Required coverage of epsdt services, including dental 
        services.--Section 2103(c) (42 U.S.C. 1397cc(c)) is amended--
                    (A) by redesignating paragraph (5) as paragraph 
                (6); and
                    (B) by inserting after paragraph (4), the 
                following:
            ``(5) Other required services.--The child health assistance 
        provided to a targeted low-income child shall include coverage 
        of the following:
                    ``(A) EPSDT services, including dental services.--
                Early and periodic screening, diagnostic, and treatment 
                services described in subsections (a)(4)(B) and (r) of 
                section 1905 and provided in accordance with section 
                1903(a)(43) (including dental services that are 
                necessary to prevent disease and promote oral health, 
                restore oral structures to health and function, and 
                treat emergency conditions).''.
            (2) Required coverage of fqhc and rhc services.--Section 
        2103(c)(5) (42 U.S.C. 1397cc(c)(5)) (as added by subsection 
        (a)), is amended by adding at the end the following:
                    ``(B) FQHC and rhc services.--Federally-qualified 
                health center services (as defined in section 
                1905(l)(2)) and rural health clinic services (as 
                defined in section 1905(l)(1)).''.
            (3) Assuring access to care.--
                    (A) State child health plan requirement.--Section 
                2102(a)(7)(B) (42 U.S.C. 1397bb(c)(2)) is amended by 
                inserting ``and services described in section 
                2103(c)(5)'' after ``emergency services''.
                    (B) Annual report.--Section 2108(a)(1) (42 U.S.C. 
                1397hh(a)(1)) is amended--
                            (i) by striking ``including the progress'' 
                        and inserting ``including--
                    ``(A) the progress''; and
                            (ii) by adding at the end the following:
                    ``(B) the extent to which the operation of such 
                plan ensures access, comparable to access under 
                employer-sponsored or other private health insurance 
                coverage (or in the case of federally-qualified health 
                center services (as defined in section 1905(l) (2)) and 
                rural health clinic services (as defined in section 
                1905(l)(1)), access comparable to the access to such 
                services under title XIX), for child health assistance 
                to targeted low-income children consistent with the 
                provisions of this title; and''.
            (4) Conforming amendment.--Section 2103(a) (42 U.S.C. 
        1397cc(a)) is amended, in the matter preceding paragraph (1), 
        by striking ``subsection (c)(5)'' and inserting ``paragraphs 
        (5) and (6) of subsection (c)''.
    (b) 100 Percent Actuarial Value for Additional Services Included in 
Benchmark Package.--Section 2103(a)(2)(C) (42 U.S.C. 1397cc(a)(2)(C)) 
is amended by striking ``75 percent'' and inserting ``100 percent''.

SEC. 113. CLARIFICATION OF REQUIREMENT TO PROVIDE EPSDT SERVICES FOR 
              ALL CHILDREN IN BENCHMARK BENEFIT PACKAGES UNDER 
              MEDICAID.

    (a) In General.--Section 1937(a)(1), as inserted by section 6044(a) 
of the Deficit Reduction Act of 2005, is amended--
            (1) in subparagraph (A)--
                    (A) in the matter before clause (i), by inserting 
                ``subject to subparagraph (E),'' after 
                ``Notwithstanding any other provision of this title''; 
                and
                    (B) by striking ``enrollment in coverage that 
                provides'' and all that follows and inserting 
                ``benchmark coverage described in subsection (b)(1) or 
                benchmark equivalent coverage described in subsection 
                (b)(2).'';
            (2) by striking subparagraph (C) and inserting the 
        following new subparagraph:
                    ``(C) State option to provide additional 
                benefits.--A State, at its option, may provide such 
                additional benefits to benchmark coverage described in 
                subsection (b)(1) or benchmark equivalent coverage 
                described in subsection (b)(2) as the State may 
                specify.''; and
            (3) by adding at the end the following new subparagraph:
                    ``(E) Requiring coverage of epsdt services.--
                Nothing in this paragraph shall be construed as 
                affecting a child's entitlement to care and services 
                described in subsections (a)(4)(B) and (r) of section 
                1905 and provided in accordance with section 
                1903(a)(43) whether provided through benchmark 
                coverage, benchmark equivalent coverage, or 
                otherwise.''.
    (b) Effective Date.--The amendments made by this subsection shall 
take effect as if included in the amendment made by section 6044(a) of 
the Deficit Reduction Act of 2005.

SEC. 114. MEDICAID-SCHIP PAYMENT ADVISORY COMMISSION.

    Title XIX (42 U.S.C. 1396 et seq.) is amended by inserting before 
section 1901 the following new section:

              ``medicaid-schip payment advisory commission

    ``Sec. 1900.  (a) Establishment.--There is hereby established the 
Medicaid-SCHIP Payment Advisory Commission (in this section referred to 
as the `Commission').
    ``(b) Duties.--
            ``(1) Review of payment policies and annual reports.--The 
        Commission shall--
                    ``(A) review payment policies of the Medicaid 
                program established under this title (in this section 
                referred to as `Medicaid') and the State Children's 
                Health Insurance Program established under title XXI 
                (in this section referred to as `SCHIP'), including 
                topics described in paragraph (2);
                    ``(B) make recommendations to Congress concerning 
                such payment policies;
                    ``(C) by not later than March 1 of each year, 
                submit a report to Congress containing the results of 
                such reviews and its recommendations concerning such 
                policies; and
                    ``(D) by not later than June 1 of each year, submit 
                a report to Congress containing an examination of 
                issues affecting Medicaid and SCHIP, including the 
                implications of changes in health care delivery in the 
                United States and in the market for health care 
                services on such programs.
            ``(2) Specific topics to be reviewed.--Specifically, the 
        Commission shall review the following:
                    ``(A) The factors affecting expenditures for 
                services in different sectors (such as physician, 
                hospital and other sectors), payment methodologies, and 
                their relationship to access and quality of care for 
                Medicaid and SCHIP beneficiaries.
                    ``(B) The affects of Medicaid and SCHIP payment 
                policies on access to services for children and other 
                Medicaid and SCHIP populations.
            ``(3) Comments on certain secretarial reports.--If the 
        Secretary submits to Congress (or a committee of Congress) a 
        report that is required by law and that relates to payment 
        policies under Medicaid or SCHIP, the Secretary shall transmit 
        a copy of the report to the Commission. The Commission shall 
        review the report and, not later than 6 months after the date 
        of submittal of the Secretary's report to Congress, shall 
        submit to the appropriate committees of Congress written 
        comments on such report. Such comments may include such 
        recommendations as the Commission deems appropriate.
            ``(4) Agenda and additional reviews.--The Commission shall 
        consult periodically with the Chairmen and Ranking Minority 
        Members of the appropriate committees of Congress regarding the 
        Commission's agenda and progress towards achieving the agenda. 
        The Commission may conduct additional reviews, and submit 
        additional reports to the appropriate committees of Congress, 
        from time to time on such topics relating to the program under 
        this title or title XXI as may be requested by such Chairmen 
        and Members and as the Commission deems appropriate.
            ``(5) Availability of reports.--The Commission shall 
        transmit to the Secretary a copy of each report submitted under 
        this subsection and shall make such reports available to the 
        public.
            ``(6) Appropriate committee of congress.--For purposes of 
        this section, the term `appropriate committees of Congress' 
        means the Committees on Energy and Commerce of the House of 
        Representatives and the Committee on Finance of the Senate.
            ``(7) Voting and reporting requirements.--With respect to 
        each recommendation contained in a report submitted under 
        paragraph (1), each member of the Commission shall vote on the 
        recommendation, and the Commission shall include, by member, 
        the results of that vote in the report containing the 
        recommendation.
            ``(8) Examination of budget consequences.--Before making 
        any recommendations, the Commission shall examine the budget 
        consequences of such recommendations, directly or through 
        consultation with appropriate expert entities.
    ``(c) Application of Provisions.--The following provisions of 
section 1805 shall apply to the Commission in the same manner as they 
apply to the Medicare Payment Advisory Commission:
            ``(1) Subsection (c) (relating to membership).
            ``(2) Subsection (d) (relating to staff and consultants).
            ``(3) Subsection (e) (relating to powers).
    ``(d) Authorization of Appropriations.--
            ``(1) Request for appropriations.--The Commission shall 
        submit requests for appropriations in the same manner as the 
        Comptroller General submits requests for appropriations, but 
        amounts appropriated for the Commission shall be separate from 
        amounts appropriated for the Comptroller General.
            ``(2) Authorization.--There are authorized to be 
        appropriated such sums as may be necessary to carry out the 
        provisions of this section.''.

                Subtitle C--Ensuring a Fair Partnership

SEC. 121. INCREASE IN FMAP FOR MEDICAL ASSISTANCE FOR CHILDREN FOR 
              STATES THAT EXPAND COVERAGE OF CHILDREN.

    Section 1905 (42 U.S.C. 1396d) is amended--
            (1) in subsection (b), in the first sentence--
                    (A) by striking ``and (4)'' and inserting ``(4)''; 
                and
                    (B) by inserting ``, and (5) in the case of a State 
                that is described in subsection (y)(1) and section 
                2105(i)(1) for a calendar quarter, notwithstanding the 
                previous clauses of this sentence, the Federal medical 
                assistance percentage with respect to medical 
                assistance provided to children shall be increased by 
                the number of percentage points determined under 
                subsection (y)(4)'' before the period; and
            (2) by adding at the end the following new subsection:
    ``(y) Determination of Increase in FMAP for Medical Assistance for 
Children for States That Expand Coverage of Children.--
            ``(1) State described.--For purposes of clause (5) of the 
        first sentence of subsection (b), a State described in this 
        paragraph is a State that--
                    ``(A) meets the continuous eligibility requirement 
                of paragraph (2); and
                    ``(B) has implemented model outreach and enrollment 
                practices in accordance with at least 3 subparagraphs 
                of paragraph (3) (relating to coverage of children 
                under this title and title XXI).
            ``(2) Continuous eligibility requirement.--The requirement 
        of this paragraph is that the State has elected the option of 
        continuous eligibility for a full 12 months for children 
        described in section 1902(e)(12) under this title, as well as 
        applying such policy under its State child health plan under 
        title XXI.
            ``(3) Model outreach and enrollment practices.--
                    ``(A) Application outreach process.--The State 
                makes available to parents and caretaker relatives of 
                children, in English and other languages that shall be 
                required by the Secretary to comply with title VI of 
                the Civil Rights Act of 1964, information regarding 
                applying, and upon request, an application, for medical 
                assistance for children under this title and for child 
                health assistance under title XXI consistent with the 
                following:
                            ``(i) Posting of availability of 
                        information.--An announcement concerning the 
                        availability of such information and 
                        applications is posted in a conspicuous manner 
                        at a location that is easily accessible to the 
                        public--
                                    ``(I) in each hospital in the State 
                                that is a participating provider under 
                                the State child health plan under title 
                                XXI or under the State plan under this 
                                title;
                                    ``(II) in each public elementary 
                                and secondary school in the State; and
                                    ``(III) in the facility of each 
                                public health care provider in the 
                                State, including federally-qualified 
                                health centers and rural health 
                                centers, participating under such State 
                                child health plan or under this title.
                            ``(ii) Year-round availability of 
                        applications.--Such applications are made 
                        available in such locations on an on-going 
                        basis.
                            ``(iii) Annual enrollment campaign in 
                        schools.--An outreach and enrollment campaign 
                        is conducted at least annually in such public 
                        elementary and secondary schools, during which 
                        information concerning enrollment of children 
                        is sent to the homes of children.
                            ``(iv) Outstationing or training of staff 
                        for initial processing.--Providing for the 
                        receipt and initial processing of any such 
                        application at each facility specified in 
                        section 1902(a)(55) and at each school 
                        described in clause (i)(II) in which not less 
                        than 30 percent of the students are eligible 
                        for free or reduced lunch under the Richard D. 
                        Russell National School Lunch Act, through--
                                    ``(I) the stationing at such 
                                facility or school of State or local 
                                agency personnel to determine 
                                eligibility for such assistance; or
                                    ``(II) upon request of the facility 
                                or school, the training and 
                                certification of personnel of such 
                                facility or school (and access to 
                                necessary automated data systems) to 
                                make such initial eligibility 
                                determinations.
                    ``(B) One-step application process.--
                            ``(i) In general.--The State provides for 
                        either or both of the following:
                                    ``(I) The one-step enrollment 
                                process described in clause (ii).
                                    ``(II) The express lane process 
                                described in clause (iii).
                            ``(ii) One-step application process (single 
                        application for multiple public assistance 
                        programs).--The State treats an application for 
                        assistance for or on behalf of a child (who has 
                        not otherwise been determined eligible for 
                        assistance under this title or title XXI) under 
                        any public assistance program administered by 
                        another Federal or State agency, including the 
                        agencies administering the Food Stamp Act of 
                        1977, the Richard B. Russell National School 
                        Lunch Act, and the Child Nutrition Act of 1966, 
                        notwithstanding any differences in budget unit, 
                        disregard, deeming, or other methodology, as an 
                        application for medical assistance under this 
                        title for the child, or for child health 
                        assistance under title XXI, but only if--
                                    ``(I) such agency has fiscal 
                                liabilities under such program that are 
                                affected or potentially affected by 
                                such determinations; and
                                    ``(II) any information furnished by 
                                such agency pursuant to this clause is 
                                kept confidential (except from the 
                                applicant and the applicant's parent or 
                                caretaker relative) and is used solely 
                                for purposes of determining eligibility 
                                for medical assistance under this title 
                                or for child health assistance under 
                                title XXI.
                            ``(iii) Express lane process (acceptance of 
                        income-related determinations for other 
                        assistance programs).--The State is 
                        implementing the option provided under section 
                        1902(e)(13) under title XIX, as well as under 
                        this title pursuant to section 2107(e)(1)(C).
                    ``(C) Administrative verification of income.--The 
                State permits a parent or caretaker relative of a child 
                applying for medical assistance under this title or 
                child health assistance under title XXI to declare and 
                certify by signature under penalty of perjury 
                information relating to family income, assets, 
                expenses, and other financial information for purposes 
                of determining and redetermining financial eligibility 
                and not to routinely require an in-person interview, 
                except in cases justified by individual circumstances. 
                Nothing in this subparagraph shall be construed as 
                preventing a State from taking steps to verify 
                information provided or to seek further information and 
                documentation from applicants in individual cases in 
                the case of discrepancies or where otherwise justified.
                    ``(D) Simplified, consistent application form and 
                process.--The State uses an application form and 
                process consistent with the following:
                            ``(i) The application forms and materials 
                        are in such languages in addition to English as 
                        shall be required by the Secretary to comply 
                        with title VI of the Civil Rights Act of 1964.
                            ``(ii) The application form and 
                        supplemental forms (if any) and information 
                        verification process is the same for purposes 
                        of establishing and renewing eligibility for 
                        children for medical assistance under this 
                        title and child health assistance under title 
                        XXI.
                            ``(iii) The process does not require an 
                        application to be made in person or a face-to-
                        face interview, unless there are discrepancies 
                        or individual circumstances justifying an in-
                        person application or face-to-face interview.
                    ``(E) Use of administrative renewal.--
                            ``(i) In general.--The State provides, in 
                        the case of renewal of a child's eligibility 
                        for medical assistance under this title or 
                        child health assistance under title XXI, that 
                        notice is provided to the parent or caretaker 
                        relative of the child that eligibility of the 
                        child will be renewed and continued based on 
                        the information available to the State unless 
                        the State is provided other information.
                            ``(ii) Satisfaction through demonstrated 
                        use of ex parte process.--A State shall be 
                        treated as satisfying the requirement of clause 
                        (i) if renewal of eligibility of children under 
                        this title or title XXI is determined on an ex 
                        parte basis, without any requirement for an in-
                        person interview, unless sufficient information 
                        is not in the State's possession and cannot be 
                        acquired from other sources (including other 
                        State agencies) without the participation of 
                        the applicant or the applicant's parent or 
                        caretaker relative.
                    ``(F) Application of presumptive eligibility.--The 
                State has implemented the option, for purposes of both 
                this title and title XXI, of applying presumptive 
                eligibility provisions under sections 1920, 1920A, and 
                2107(e)(1)(G).
            ``(4) Determination of increase.--
                    ``(A) In general.--For purposes of clause (5) of 
                the first sentence of subsection (b), in the case of a 
                State described in such clause, the number of 
                percentage points determined under this paragraph is 
                equal to the product of the phase-in percentage for the 
                State (specified under subparagraph (B)) multiplied by 
                the number of percentage points by which the Federal 
                medical assistance percentage determined for the State 
                under subsection (b) (without regard to clause (5) of 
                such subsection) is less than the enhanced FMAP 
                described in section 2105(b).
                    ``(B) Phase-in percentage.--For purposes of 
                subparagraph (A), the phase-in percentage specified in 
                this subparagraph for a State for a fiscal year is 
                equal to--
                            ``(i) the number of percentage points by 
                        which--
                                    ``(I) the income level established 
                                by the State under the most recent plan 
                                amendment of such State referred to in 
                                section 1905(b)(5), expressed in terms 
                                of a number of percentage points of the 
                                official poverty line; exceeds
                                    ``(II) the applicable income level 
                                established by the State as of January 
                                1, 2007, expressed in terms of a number 
                                of percentage points of the official 
                                poverty line, in order to be a targeted 
                                low-income child under the State plan 
                                under title XXI; divided by
                            ``(ii) the number of percentage points by 
                        which 400 exceeds the applicable income level 
                        (expressed in percentage points) described in 
                        clause (i)(II).
            ``(5) Increase in cap on payments to territories.--If 
        Puerto Rico, the Virgin Islands, Guam, the Northern Mariana 
        Islands, or American Samoa qualify for an increase under 
        subsection (b)(5) for a calendar quarter for a fiscal year, the 
        additional Federal financial participation under this title 
        that results from enrollment of additional children under this 
        title for such fiscal year because of the exercise of such 
        option shall not be counted towards the limitation on 
        expenditures under this title for such commonwealth or 
        territory otherwise determined under subsections (f) and (g) of 
        section 1108.
            ``(6) Scope of application.--The increase in the Federal 
        medical assistance percentage under subsection (b)(5) shall 
        only apply for purposes of payments under section 1903 with 
        respect to medical assistance provided to children and shall 
        not apply with respect to--
                    ``(A) disproportionate share hospital payments 
                described in section 1923;
                    ``(B) payments under title IV or XXI; or
                    ``(C) any payments under this title that are based 
                on the enhanced FMAP described in section 2105(b).
            ``(7) Rule of construction.--Nothing in this subsection 
        shall be construed as preventing a State from implementing any 
        of the model outreach and enrollment practices described in 
        paragraph (3), notwithstanding that the State may not qualify 
        for an increase in the Federal medical assistance percentage 
        under subsection (b)(5).''.

      Subtitle D--State Options for Additional Coverage Expansions

SEC. 131. OPTIONAL COVERAGE OF OLDER CHILDREN UNDER MEDICAID AND SCHIP.

    (a) Medicaid.--
            (1) In general.--Section 1902(l)(1)(D) (42 U.S.C. 
        1396a(l)(1)(D)) is amended by inserting ``(or, at the election 
        of a State, 20, 21, 22, 23, 24, or 25 years of age)'' after 
        ``19 years of age''.
            (2) Conforming amendments.--
                    (A) Section 1902(e)(3)(A) (42 U.S.C. 
                1396a(e)(3)(A)) is amended by inserting ``(or 1 year 
                less than the age the State has elected under 
                subsection (l)(1)(D))'' after ``18 years of age''.
                    (B) Section 1902(e)(12) (42 U.S.C. 1396a(e)(12)) is 
                amended by inserting ``or such higher age as the State 
                has elected under subsection (l)(1)(D)'' after ``19 
                years of age''.
                    (C) Section 1920A(b)(1) (42 U.S.C. 1396r-1a(b)(1)) 
                is amended by inserting ``or such higher age as the 
                State has elected under section 1902(l)(1)(D)'' after 
                ``19 years of age''.
                    (D) Section 1928(h)(1) (42 U.S.C. 1396s(h)(1)) is 
                amended by inserting ``or 1 year less than the age the 
                State has elected under section 1902(l)(1)(D)'' before 
                the period at the end.
                    (E) Section 1932(a)(2)(A) (42 U.S.C. 1396u-
                2(a)(2)(A)) is amended by inserting ``(or such higher 
                age as the State has elected under section 
                1902(l)(1)(D))'' after ``19 years of age''.
    (b) Title XXI.--Section 2110(c)(1) (42 U.S.C. 1397jj(c)(1)) is 
amended by inserting ``(or such higher age as the State has elected 
under section 1902(l)(1)(D))''.

SEC. 132. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS UNDER THE MEDICAID 
              PROGRAM AND SCHIP.

    (a) Medicaid Program.--Section 1903(v) (42 U.S.C. 1396b(v)) is 
amended--
            (1) in paragraph (1), by striking ``paragraph (2)'' and 
        inserting ``paragraphs (2) and (4)''; and
            (2) by adding at the end the following new paragraph:
    ``(4)(A) A State may elect (in a plan amendment under this title) 
to provide medical assistance under this title, notwithstanding 
sections 401(a), 402(b), 403, and 421 of the Personal Responsibility 
and Work Opportunity Reconciliation Act of 1996, for aliens who are 
lawfully residing in the United States (including battered aliens 
described in section 431(c) of such Act) and who are otherwise eligible 
for such assistance, within either or both of the following eligibility 
categories:
            ``(i) Pregnant women.--Women during pregnancy (and during 
        the 60-day period beginning on the last day of the pregnancy).
            ``(ii) Children.--Individuals under 21 years of age, 
        including optional targeted low-income children described in 
        section 1905(u)(2)(B).
    ``(B) In the case of a State that has elected to provide medical 
assistance to a category of aliens under subparagraph (A), no debt 
shall accrue under an affidavit of support against any sponsor of such 
an alien on the basis of provision of assistance to such category and 
the cost of such assistance shall not be considered as an unreimbursed 
cost.''.
    (b) SCHIP.--Section 2107(e)(1) (42 U.S.C. 1397gg(e)(1)), as amended 
by section 103(b)(3), is amended by redesignating subparagraphs (D) and 
(E) as subparagraph (E) and (F), respectively, and by inserting after 
subparagraph (C) the following new subparagraph:
                    ``(D) Section 1903(v)(4)(A)(ii) (relating to 
                optional coverage of categories of lawfully residing 
                immigrant children), but only if the State has elected 
                to apply such section to the category of children under 
                title XIX.''.

SEC. 133. STATE OPTION TO EXPAND OR ADD COVERAGE OF CERTAIN PREGNANT 
              WOMEN UNDER SCHIP.

    (a) SCHIP.--
            (1) Coverage.--Title XXI (42 U.S.C. 1397aa et seq.), as 
        amended by section 102, is amended by adding at the end the 
        following new section:

``SEC. 2112. OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN.

    ``(a) Optional Coverage.--Notwithstanding any other provision of 
this title, a State may provide for coverage, through an amendment to 
its State child health plan under section 2102, of pregnancy-related 
assistance for targeted low-income pregnant women in accordance with 
this section, but only if--
            ``(1) the State has established an income eligibility 
        level--
                    ``(A) for pregnant women under subsection 
                (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902 that is 
                at least 185 percent of the poverty line; and
                    ``(B) for children under this title that is at 
                least 200 percent of the poverty line; and
            ``(2) the State meets the requirement of section 2105(i)(2) 
        (relating to no waiting list for children).
    ``(b) Definitions.--For purposes of this title:
            ``(1) Pregnancy-related assistance.--The term `pregnancy-
        related assistance' has the meaning given the term child health 
        assistance in section 2110(a) as if any reference to targeted 
        low-income children were a reference to targeted low-income 
        pregnant women.
            ``(2) Targeted low-income pregnant woman.--The term 
        `targeted low-income pregnant woman' means a woman--
                    ``(A) during pregnancy and through the end of the 
                month in which the 60-day period (beginning on the last 
                day of her pregnancy) ends;
                    ``(B) whose family income exceeds 185 percent of 
                the poverty level applicable to a family of the size 
                involved, but does not exceed the income eligibility 
                level established under the State child health plan 
                under this title for a targeted low-income child; and
                    ``(C) who satisfies the requirements of paragraphs 
                (1)(A), (1)(C), (2), and (3) of section 2110(b).
    ``(c) References to Terms and Special Rules.--In the case of, and 
with respect to, a State providing for coverage of pregnancy-related 
assistance to targeted low-income pregnant women under subsection (a), 
the following special rules apply:
            ``(1) Any reference in this title (other than in subsection 
        (b)) to a targeted low-income child is deemed to include a 
        reference to a targeted low-income pregnant woman.
            ``(2) Any such reference to child health assistance with 
        respect to such women is deemed a reference to pregnancy-
        related assistance.
            ``(3) Any such reference to a child is deemed a reference 
        to a woman during pregnancy and the period described in 
        subsection (b)(2)(A).
            ``(4) In applying section 2102(b)(3)(B), any reference to 
        children found through screening to be eligible for medical 
        assistance under the State medicaid plan under title XIX is 
        deemed a reference to pregnant women.
            ``(5) There shall be no exclusion of benefits for services 
        described in subsection (b)(1) based on any preexisting 
        condition and no waiting period (including any waiting period 
        imposed to carry out section 2102(b)(3)(C)) shall apply.
            ``(6) In applying section 2103(e)(3)(B) in the case of a 
        pregnant woman provided coverage under this section, the 
        limitation on total annual aggregate cost-sharing shall be 
        applied to such pregnant woman.
            ``(7) In applying section 2104(i)--
                    ``(A) in the case of State which did not provide 
                for coverage for pregnant women under this title (under 
                a waiver or otherwise) during fiscal year 2007, the 
                allotment amount otherwise computed for the first 
                fiscal year in which the State elects to provide 
                coverage under this section shall be increased by an 
                amount (determined by the Secretary) equal to the 
                enhanced FMAP of the expenditures under this title for 
                such coverage, based upon projected enrollment and per 
                capita costs of such enrollment; and
                    ``(B) in the case of a State which provided for 
                coverage of pregnant women under this title for the 
                previous fiscal year--
                            ``(i) in applying paragraph (1)(B)(ii) of 
                        such section, there shall also be taken into 
                        account (in an appropriate proportion) the 
                        percentage increase in births in the United 
                        States for the relevant period; and
                            ``(ii) in applying paragraph (1)(C), 
                        pregnant women (and per capita expenditures for 
                        such women) shall be accounted for separately 
                        from children, but shall be included in the 
                        total amount of any allotment adjustment under 
                        such paragraph.
    ``(d) Automatic Enrollment for Children Born to Women Receiving 
Pregnancy-Related Assistance.--If a child is born to a targeted low-
income pregnant woman who was receiving pregnancy-related assistance 
under this section on the date of the child's birth, the child shall be 
deemed to have applied for child health assistance under the State 
child health plan and to have been found eligible for such assistance 
under such plan or to have applied for medical assistance under title 
XIX and to have been found eligible for such assistance under such 
title, as appropriate, on the date of such birth and to remain eligible 
for such assistance until the child attains 1 year of age. During the 
period in which a child is deemed under the preceding sentence to be 
eligible for child health or medical assistance, the child health or 
medical assistance eligibility identification number of the mother 
shall also serve as the identification number of the child, and all 
claims shall be submitted and paid under such number (unless the State 
issues a separate identification number for the child before such 
period expires).''.
            (2) No cost-sharing for pregnancy-related benefits.--
        Section 2103(e)(2) (42 U.S.C. 1397cc(e)(2)) is amended--
                    (A) in the heading, by inserting ``or pregnancy-
                related services'' after ``preventive services''; and
                    (B) by inserting before the period at the end the 
                following: ``or for pregnancy-related services''.
            (3) Additional amendment.--Section 2107(e)(1)(G) (42 U.S.C. 
        1397gg(e)(1)(G)), as redesignated by sections 103(b), 132(b), 
        and 207, is amended to read as follows:
                    ``(G) Sections 1920 and 1920A (relating to 
                presumptive eligibility for pregnant women and 
                children).''.
    (b) Amendments to Medicaid.--
            (1) Eligibility of a newborn.--Section 1902(e)(4) (42 
        U.S.C. 1396a(e)(4)) is amended in the first sentence by 
        striking ``so long as the child is a member of the woman's 
        household and the woman remains (or would remain if pregnant) 
        eligible for such assistance''.
            (2) Application of qualified entities to presumptive 
        eligibility for pregnant women under medicaid.--Section 1920(b) 
        (42 U.S.C. 1396r-1(b)) is amended by adding after paragraph (2) 
        the following flush sentence:
``The term `qualified provider' includes a qualified entity, as defined 
in section 1920A(b)(3).''.

            TITLE II--REMOVAL OF OTHER BARRIERS TO COVERAGE

SEC. 201. ESTABLISHMENT OF NEW BASE SCHIP ALLOTMENTS THAT ARE 
              RESPONSIVE TO INCREASES IN HEALTH CARE COSTS AND 
              ENROLLMENT EXPANSIONS.

    Section 2104 (42 U.S.C. 1397dd), as amended by section 101(b), is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (9), by striking ``and'' at the 
                end;
                    (B) in paragraph (10), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following new 
                paragraph:
            ``(11) for fiscal year 2008 and each succeeding fiscal 
        year, the sum of the State allotments provided under subsection 
        (i) for such fiscal year.'';
            (2) in subsection (b)(1), by striking ``and (h)'' and 
        inserting ``(h), and (i)''; and
            (3) in subsection (c)(1), by striking ``and (h)'' and 
        inserting ``(h), and (i)''.
            (4) by adding at the end the following new subsection:
    ``(i) Allotments for States and Territories Beginning With Fiscal 
Year 2008.--
            ``(1) General allotment computation.--
                    ``(A) In general.--Subject to the succeeding 
                provisions of this subsection, the Secretary shall 
                compute a State allotment for each State for each 
                fiscal year as follows:
                            ``(i) Rebasing in fiscal year 2008 and each 
                        second succeeding fiscal year.--For fiscal year 
                        2008 and each second succeeding fiscal year, 
                        the allotment of a State is equal to the 
                        Federal payments to the State that are 
                        attributable to (and countable towards) the 
                        allotment under this section for the State for 
                        the previous fiscal year multiplied by the 
                        allotment increase factor under subparagraph 
                        (B) for the fiscal year involved.
                            ``(ii) Using projections for fiscal year 
                        2009 and each second succeeding fiscal year.--
                        For fiscal year 2009 and each second succeeding 
                        fiscal year, the allotment of a State is equal 
                        to the amount of the State allotment under this 
                        subparagraph for the previous fiscal year 
                        multiplied by the allotment increase factor 
                        under subparagraph (B) for the fiscal year 
                        involved.
                    ``(B) Allotment increase factor.--The allotment 
                increase factor under this subparagraph for a fiscal 
                year is equal to the product of the following:
                            ``(i) Per capita health care growth 
                        factor.--One plus the percentage increase in 
                        the projected per capita amount of National 
                        Health Expenditures from the second previous 
                        fiscal year to the previous fiscal year, as 
                        most recently published by the Secretary before 
                        the beginning of the fiscal year involved.
                            ``(ii) Child population growth factor.--One 
                        plus the percentage increase in the population 
                        of children under 20 years of age in the State 
                        from July 1 in such second previous fiscal year 
                        to July 1 in the previous fiscal year, as 
                        determined by the Secretary based on the most 
                        recent published estimates of the Bureau of the 
                        Census before the beginning of the fiscal year 
                        involved.
                    ``(C) Outreach adjustment.--
                            ``(i) In general.--If a State's 
                        expenditures under this title in a fiscal year 
                        (beginning with fiscal year 2008) exceeds the 
                        allotment provided under this section 
                        (determined without regard to any reallotment 
                        it receives that is available for expenditure 
                        during such fiscal year) and if the average 
                        number of enrollees in the State under this 
                        title for such fiscal year exceeds its target 
                        number of enrollees for that year, for the 
                        subsequent fiscal year the allotment under this 
                        section for the State shall be increased by the 
                        amount by which--
                                    ``(I) the product of--
                                            ``(aa) such additional 
                                        number of enrollees; and
                                            ``(bb) the projected per 
                                        capita Federal expenditures 
                                        under the State child health 
                                        plan (as determined under 
                                        clause (iii) for such 
                                        subsequent fiscal year); 
                                        reduced by
                                    ``(II) the amount of any allotment 
                                redistributed to the State under this 
                                section for such subsequent fiscal 
                                year.
                            ``(ii) Target number of enrollees.--In this 
                        subsection, the target number of enrollees for 
                        a State for a fiscal year is equal to the 
                        average number of enrollees enrolled in the 
                        State child health plan under this title during 
                        fiscal year 2007 increased (for each subsequent 
                        fiscal year through the fiscal year involved) 
                        by the population growth for children in that 
                        State for the year ending on June 30 before the 
                        beginning of the fiscal year (as estimated by 
                        the Bureau of the Census).
                            ``(iii) Projected per capita federal 
                        expenditures.--For purposes of subparagraph 
                        (A)(i)(II), the projected per capita Federal 
                        expenditures under a State child health plan 
                        for a fiscal year is equal to the average per 
                        capita Federal expenditures under such plan for 
                        fiscal year 2007, increased (for each 
                        subsequent fiscal year up to and including the 
                        fiscal year involved) by the annual percentage 
                        increase in per capita amount of National 
                        Health Expenditures (as estimated by the 
                        Secretary) for the respective subsequent fiscal 
                        year.
                            ``(iv) Availability.--Notwithstanding 
                        subsection (e), an increase in allotment under 
                        this paragraph shall only be available for 
                        expenditure during the fiscal year in which it 
                        is provided.
                            ``(v) Interaction with other provisions.--
                                    ``(I) Coverage expansion states.--
                                In the case of a State that has an 
                                increased allotment under section 
                                2105(i)--
                                            ``(aa) there shall be no 
                                        increased allotment under 
                                        paragraph (2); and
                                            ``(bb) the allotment under 
                                        this subsection shall not be 
                                        subject to reallotment or 
                                        redistribution to other States.
                                    ``(II) No reallotment of outreach 
                                adjustment.--In no case shall any 
                                increase in allotment under paragraph 
                                (2) for a State be subject to 
                                reallotment or redistribution to other 
                                States.''.

SEC. 202. 2-YEAR INITIAL AVAILABILITY OF SCHIP ALLOTMENTS.

    Section 2104(e) (42 U.S.C. 1397dd(e)) is amended to read as 
follows:
    ``(e) Availability of Amounts Allotted.--
            ``(1) In general.--Except as provided in paragraph (2), 
        amounts allotted to a State pursuant to this section--
                    ``(A) for each of fiscal years 1998 through 2007, 
                shall remain available for expenditure by the State 
                through the end of the second succeeding fiscal year; 
                and
                    ``(B) for fiscal year 2008 and each fiscal year 
                thereafter, shall remain available for expenditure by 
                the State through the end of the succeeding fiscal 
                year.
            ``(2) Availability of amounts reallotted.--Amounts 
        reallotted to a State under subsection (f) shall be available 
        for expenditure by the State through the end of the fiscal year 
        in which they are reallotted.''.

SEC. 203. REDISTRIBUTION OF UNUSED ALLOTMENTS TO ADDRESS STATE FUNDING 
              SHORTFALLS.

    Section 2104(f) (42 U.S.C. 1397dd(f)) is amended--
            (1) by striking ``The Secretary'' and inserting the 
        following:
            ``(1) In general.--The Secretary'';
            (2) by striking ``States that have fully expended the 
        amount of their allotments under this section'' and inserting 
        ``States that the Secretary determines with respect to the 
        fiscal year for which unused allotments are available for 
        redistribution under this subsection, are shortfall States 
        described in paragraph (2) for such fiscal year''; and
            (3) by adding at the end the following new paragraph:
            ``(2) Shortfall states described.--
                    ``(A) In general.--For purposes of paragraph (1), 
                with respect to a fiscal year, a shortfall State 
                described in this subparagraph is a State with a State 
                child health plan approved under this title for which 
                the Secretary estimates on the basis of the most recent 
                data available to the Secretary, that the projected 
                expenditures under such plan for the State for the 
                fiscal year will exceed the sum of--
                            ``(i) the amount of the State's allotments 
                        for any preceding fiscal years that remain 
                        available for expenditure and that will not be 
                        expended by the end of the immediately 
                        preceding fiscal year; and
                            ``(ii) the amount of the State's allotment 
                        for the fiscal year.
                    ``(B) Proration rule.--If the amounts available for 
                redistribution under paragraph (1) for a fiscal year 
                are less than the total amounts of the estimated 
                shortfalls determined for the year under subparagraph 
                (A), the amount to be reallotted under such paragraph 
                for each shortfall State shall be reduced 
                proportionally.
                    ``(C) Retrospective adjustment.--The Secretary may 
                adjust the estimates and determinations made under 
                paragraph (1) and this paragraph with respect to a 
                fiscal year as necessary on the basis of the amounts 
                reported by States not later than November 30 of the 
                succeeding fiscal year, as approved by the 
                Secretary.''.

SEC. 204. INCENTIVES FOR SCHOOL-BASED OUTREACH AND ENROLLMENT.

    Section 2105(a) (42 U.S.C. 1397ee(a)) is amended by adding at the 
end the following new paragraph:
            ``(3) Special rule for school-based outreach and enrollment 
        activities.--With respect to expenditures in a quarter for 
        school-based outreach and enrollment activities--
                    ``(A) the `enhanced FMAP' for purposes of paragraph 
                (1) is equal to 90 percent; and
                    ``(B) the limitation under subsection (c)(2)(A) 
                shall not apply to such expenditures.''.

SEC. 205. MEDICAID CITIZENSHIP DOCUMENTATION REQUIREMENTS.

    (a) State Option To Require Certain Individuals To Present 
Satisfactory Documentary Evidence of Proof of Citizenship or 
Nationality for Purposes of Eligibility for Medicaid.--
            (1) In general.--Section 1902(a)(46) (42 U.S.C. 
        1396a(a)(46)) is amended--
                    (A) by inserting ``(A)'' after ``(46)'';
                    (B) by adding ``and'' after the semicolon; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(B) at the option of the State and subject to section 
        1903(x), require that, with respect to an individual (other 
        than an individual described in section 1903(x)(1)) who 
        declares to be a citizen or national of the United States for 
        purposes of establishing initial eligibility for medical 
        assistance under this title (or, at State option, for purposes 
        of renewing or redetermining such eligibility to the extent 
        that such satisfactory documentary evidence of citizenship or 
        nationality has not yet been presented), there is presented 
        satisfactory documentary evidence of citizenship or nationality 
        of the individual (using criteria determined by the State, 
        which shall be no more restrictive than the criteria used by 
        the Social Security Administration to determine citizenship, 
        and which shall accept as such evidence a document issued by a 
        federally-recognized Indian tribe evidencing membership or 
        enrollment in, or affiliation with, such tribe (such as a 
        tribal enrollment card or certificate of degree of Indian 
        blood, and, with respect to those federally-recognized Indian 
        tribes located within States having an international border 
        whose membership includes individuals who are not citizens of 
        the United States, such other forms of documentation (including 
        tribal documentation, if appropriate) that the Secretary, after 
        consulting with such tribes, determines to be satisfactory 
        documentary evidence of citizenship or nationality for purposes 
        of satisfying the requirement of this subparagraph));''.
            (2) Limitation on waiver authority.--Notwithstanding any 
        provision of section 1115 of the Social Security Act (42 U.S.C. 
        1315), or any other provision of law, the Secretary of Health 
        and Human Services may not waive the requirements of section 
        1902(a)(46)(B) of such Act (42 U.S.C. 1396a(a)(46)(B)) with 
        respect to a State.
            (3) Conforming amendments.--Section 1903 (42 U.S.C. 1396b) 
        is amended--
                    (A) in subsection (i)--
                            (i) in paragraph (20), by adding ``or'' 
                        after the semicolon;
                            (ii) in paragraph (21), by striking ``; 
                        or'' and inserting a period; and
                            (iii) by striking paragraph (22); and
                    (B) in subsection (x) (as amended by section 
                405(c)(1)(A) of division B of the Tax Relief and Health 
                Care Act of 2006 (Public Law 109-432))--
                            (i) by striking paragraphs (1) and (3);
                            (ii) by redesignating paragraph (2) as 
                        paragraph (1);
                            (iii) in paragraph (1), as so redesignated, 
                        by striking ``paragraph (1)'' and inserting 
                        ``section 1902(a)(46)(B)''; and
                            (iv) by adding at the end the following new 
                        paragraph:
    ``(2) In the case of an individual declaring to be a citizen or 
national of the United States with respect to whom a State requires the 
presentation of satisfactory documentary evidence of citizenship or 
nationality under section 1902(a)(46)(B), the individual shall be 
provided at least the reasonable opportunity to present satisfactory 
documentary evidence of citizenship or nationality under this 
subsection as is provided under clauses (i) and (ii) of section 
1137(d)(4)(A) to an individual for the submittal to the State of 
evidence indicating a satisfactory immigration status.''.
    (b) Clarification of Rules for Children Born in the United States 
to Mothers Eligible for Medicaid.--Section 1903(x) (42 U.S.C. 
1396b(x)), as amended by subsection (a)(3)(B), is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (C), by striking ``or'' at the 
                end;
                    (B) by redesignating subparagraph (D) as 
                subparagraph (E); and
                    (C) by inserting after subparagraph (C) the 
                following new subparagraph:
            ``(D) pursuant to the application of section 1902(e)(4) 
        (and, in the case of an individual who is eligible for medical 
        assistance on such basis, the individual shall be deemed to 
        have provided satisfactory documentary evidence of citizenship 
        or nationality and shall not be required to provide further 
        documentary evidence on any date that occurs during or after 
        the period in which the individual is eligible for medical 
        assistance on such basis); or''; and
            (2) by adding at the end the following new paragraph:
    ``(3) Nothing in subparagraph (A) or (B) of section 1902(a)(46), 
the preceding paragraphs of this subsection, or the Deficit Reduction 
Act of 2005, including section 6036 of such Act, shall be construed as 
changing the requirement of section 1902(e)(4) that a child born in the 
United States to an alien mother for whom medical assistance for the 
delivery of such child is available as treatment of an emergency 
medical condition pursuant to subsection (v) shall be deemed eligible 
for medical assistance during the first year of such child's life.''.
    (c) Effective Date.--
            (1) Retroactive application.--The amendments made by this 
        section shall take effect as if included in the enactment of 
        the Deficit Reduction Act of 2005 (Public Law 109-171; 120 
        Stat. 4).
            (2) Restoration of eligibility.--In the case of an 
        individual who, during the period that began on July 1, 2006, 
        and ends on the date of enactment of this Act, was determined 
        to be ineligible for medical assistance under a State Medicaid 
        program solely as a result of the application of subsections 
        (i)(22) and (x) of section 1903 of the Social Security Act (as 
        in effect during such period), but who would have been 
        determined eligible for such assistance if such subsections, as 
        amended by subsections (a) and (b), had applied to the 
        individual, a State may deem the individual to be eligible for 
        such assistance as of the date that the individual was 
        determined to be ineligible for such medical assistance on such 
        basis.

SEC. 206. STATE OPTION TO PROVIDE FOR ``EXPRESS LANE'' AND SIMPLIFIED 
              DETERMINATIONS OF A CHILD'S FINANCIAL ELIGIBILITY FOR 
              MEDICAL ASSISTANCE UNDER MEDICAID OR CHILD HEALTH 
              ASSISTANCE UNDER SCHIP.

    (a) Medicaid.--Section 1902(e) (42 U.S.C. 1396a(e)) is amended by 
adding at the end the following:
    ``(13)(A) At the option of the State, the plan may provide that 
eligibility requirements (including such requirements applicable to 
redeterminations or renewals of eligibility) for medical assistance 
relating to income, assets (or resources), or citizenship status are 
met for a child who is under an age specified by the State (not to 
exceed 21 years of age) by using a determination made within a 
reasonable period (as determined by the State) before its use for this 
purpose, of the child's family or household income, or if applicable 
for purposes of determining eligibility under this title or title XXI, 
assets or resources, or citizenship status, respectively, 
(notwithstanding any other provision of law, including sections 
1902(a)(46)(B), 1903(x), and 1137(d)), by a Federal or State agency, or 
a public or private entity making such determination on behalf of such 
agency, specified by the plan, including an agency administering the 
State program funded under part A of title IV, the Food Stamp Act of 
1977, the Richard B. Russell National School Lunch Act, or the Child 
Nutrition Act of 1966, notwithstanding any differences in budget unit, 
disregard, deeming, or other methodology, but only if--
            ``(i) the agency has fiscal liabilities or responsibilities 
        affected by such determination; and
            ``(ii) the agency or entity notifies the child's family--
                    ``(I) of the information which shall be disclosed 
                in accordance with this subparagraph;
                    ``(II) that the information disclosed will be used 
                solely for purposes of determining eligibility for 
                medical assistance under this title or for child health 
                assistance under title XXI; and
                    ``(III) that interagency agreements limit the use 
                of such information to that purpose; and
            ``(iii) the requirements of section 1939 are satisfied.
    ``(B) Nothing in this paragraph shall be construed to relieve a 
State of the obligation to determine, on another basis, eligibility for 
medical assistance under this title or for child health assistance 
under title XXI if a child is determined ineligible for such assistance 
on the basis of information furnished pursuant to this paragraph.
    ``(C) If a State applies the eligibility process described in 
subparagraph (A) to individuals eligible under this title and to 
individuals eligible under title XXI, the State may, at its option, 
implement its duties under subparagraphs (A) and (B) of section 
2102(b)(3) using either or both of the following approaches:
            ``(i) The State may--
                    ``(I) establish a threshold percentage of the 
                Federal poverty level (that shall exceed the income 
                eligibility level applicable for a population of 
                individuals under this title by 30 percentage points 
                (as a fraction of the Federal poverty level) or such 
                other higher number of percentage points as the State 
                determines reflects the typical application of income 
                methodologies by the non-health program and the State 
                plan under this title); and
                    ``(II) provide that, with respect to any individual 
                within such population whom a non-health agency 
                determines has income that does not exceed such 
                threshold percentage for such population, such 
                individual is eligible for medical assistance under 
                this title (regardless of whether such individual would 
                otherwise be determined to be eligible to receive such 
                assistance).
        In exercising the approach under this clause, a State shall 
        inform families whose children are enrolled in a State child 
        health plan under title XXI based on having family income above 
        the threshold described in subclause (I) that they may qualify 
        for medical assistance under this title and, at their option, 
        can seek a regular eligibility determination for such 
        assistance for their child.
            ``(ii) Regardless of whether a State otherwise provides for 
        presumptive eligibility under section 1920A, a State may 
        provide presumptive eligibility under this title, consistent 
        with subsection (e) of section 1920A, to a child who, based on 
        a determination by a non-health agency, would qualify for child 
        health assistance under a State child health plan under title 
        XXI. During such presumptive eligibility period, the State may 
        determine the child's eligibility for medical assistance under 
        this title, pursuant to subparagraph (A) of section 2102(b)(3), 
        based on telephone contact with family members, access to data 
        available in electronic or paper form, and other means of 
        gathering information that are less burdensome to the family 
        than completing an application form on behalf of the child. The 
        procedures described in the previous sentence may be used 
        regardless of whether the State uses similar procedures under 
        other circumstances for purposes of determining eligibility for 
        medical assistance under this title.
    ``(D) At the option of a State, the eligibility process described 
in subparagraph (A) may apply to an individual who is not a child.
    ``(E)(i) At the option of a State, an individual determined to be 
eligible for medical assistance or child health assistance pursuant to 
subparagraph (A), (C), or (D) or other procedures through which 
eligibility is determined based on data obtained from sources other 
than the individual may receive medical assistance under this title if 
such individual (or, in the case of an individual under age 19 (or if 
the State elects the option under subparagraph (A), age 20 or 21) who 
is not authorized to consent to medical care, the individual's parent, 
guardian, or other caretaker relative) has acknowledged notice of such 
determination and has consented to such eligibility determination. The 
State (at its option) may waive any otherwise applicable requirements 
for signatures by or on behalf of an individual who has so consented.
    ``(ii) In the case of an individual enrolled pursuant to clause 
(i), the State shall inform the individual (or, in the case of an 
individual under age 19 (or if the State elects the option under 
subparagraph (A), age 20 or 21), the individual's parent, guardian, or 
other caretaker relative) about the significance of such enrollment, 
including appropriate methods to access covered services.
    ``(F) For purposes of this paragraph--
            ``(i) the term `non-health agency' means an agency or 
        entity described in subparagraph (A); and
            ``(ii) the term `non-health benefits' means the benefits or 
        assistance provided by a non-health agency.''.
    (b) SCHIP.--Section 2107(e)(1) (42 U.S.C. 1397gg(e)(1)), as amended 
by sections 103(b) and 132(b), is amended by redesignating 
subparagraphs (C) through (F) as subparagraphs (D) through (G) and by 
inserting after subparagraph (B) the following new subparagraph:
                    ``(C) Section 1902(e)(13) (relating to the State 
                option to base a determination of a child's eligibility 
                for assistance on determinations made by a program 
                providing nutrition or other public assistance (except 
                that the State option under subparagraph (D) of such 
                section shall apply under this title only if an 
                individual is pregnant)).''.
    (c) Presumptive Eligibility.--Section 1920A (42 U.S.C. 1396r-1a) is 
amended--
            (1) in subsection (b)(3)(A)(i), is amended by striking ``or 
        (IV)'' and inserting ``(IV) is an agency or entity described in 
        section 1902(e)(13)(A), or (V)''; and
            (2) by adding at the end the following:
    ``(e) In the case of a State with a child health plan under title 
XXI that provides for presumptive eligibility under such plan for 
children, the State shall make a reasonable effort to place each 
presumptively eligible child in the program under this title or title 
XXI for which the child appears most likely to qualify. During the 
child's period of presumptive eligibility, the State shall receive 
Federal matching funds under section 1903 or section 2105, depending on 
the program in which the child has been placed. If at the conclusion of 
such period, the child is found to qualify for, and is enrolled in, the 
program established under this title or title XXI when the child was 
enrolled in the program under the other such title during such period, 
the State's receipt of Federal matching funds shall be adjusted both 
retroactively and prospectively so that Federal matching funds are 
provided, both during and following such period of presumptive 
eligibility, based on the program in which the child is enrolled.''.
    (d) Signature Requirements.--Section 1902(a) (42 U.S.C. 1396a(a)) 
is amended by adding at the end the following: ``Notwithstanding any 
other provision of law, a signature under penalty of perjury shall not 
be required on an application form for medical assistance as to any 
element of eligibility for which eligibility is based on information 
received from a source other than applicant, rather than on 
representations from the applicant. Notwithstanding any other provision 
of law, any signature requirement for an application for medical 
assistance may be satisfied through an electronic signature, as defined 
in section 1710(1) of the Government Paperwork Elimination Act (44 
U.S.C. 3504 note).''.

SEC. 207. INFORMATION TECHNOLOGY CONNECTIONS TO IMPROVE HEALTH COVERAGE 
              DETERMINATIONS.

    (a) Enhanced Federal Funding for Improvements Related to 
Implementation of Certain Model Outreach and Enrollment Practices.--
            (1) In general.--Section 1903(a)(3)(A) (42 U.S.C. 
        1396b(a)(3)(A)) is amended--
                    (A) by striking ``and'' at the end of clause (i); 
                and
                    (B) by adding at the end the following new clause:
                    ``(iii) 75 percent of so much of the sums expended 
                during such quarter as are attributable to the design, 
                development, or installation of such mechanized claims 
                processing and information retrieval systems and the 
                implementation of administrative systems and processes 
                (including modification of eligibility computer systems 
                to permit the exchange of electronic information with 
                other Federal or State programs) as the Secretary 
                determines are directly related to the implementation 
                of a model outreach and enrollment practice described 
                in subparagraph (B), (C), (D), (E), or (F) of section 
                1905(y)(3), and''.
            (2) Conforming amendment to ensure availability for 
        territories.--Section 1108(g) (42 U.S.C. 1308(g)) is amended by 
        adding at the end the following new paragraph:
            ``(4) Additional increase for certain expenditures.--With 
        respect to fiscal year 2008 and each fiscal year thereafter, if 
        Puerto Rico, the Virgin Islands, Guam, the Northern Mariana 
        Islands, or American Samoa qualify for a payment under section 
        1903(a)(3)(A)(iii) for a calendar quarter of such fiscal year, 
        the additional Federal financial participation under such 
        section shall not be counted towards the limitation on 
        expenditures under title XIX for such commonwealth or territory 
        otherwise determined under subsection (f) and this subsection 
        for such fiscal year.''.
    (b) Authorization of Information Disclosure.--
            (1) In general.--Title XIX (42 U.S.C. 1396 et seq.) is 
        amended--
                    (A) by redesignating section 1939 as section 1940; 
                and
                    (B) by inserting after section 1938 the following:

            ``authorization to receive pertinent information

    ``Sec. 1939.  (a) In General.--Notwithstanding any other provision 
of law, a Federal or State agency or private entity in possession of 
the sources of data potentially pertinent to eligibility determinations 
under this title or title XXI (including eligibility files maintained 
by programs described in section 1902(e)(13)(A), information described 
in paragraph (2) or (3) of section 1137(a), vital records information 
about births in any State, and information described in sections 453(i) 
and 1902(a)(25)(I)) is authorized to convey such data or information to 
a State agency administering a State plan under this title or title 
XXI, if--
            ``(1) such data or information are used only to establish 
        or verify eligibility or provide coverage under this title or 
        title XXI; and
            ``(2) an interagency or other agreement, consistent with 
        standards developed by the Secretary, prevents the unauthorized 
        use, disclosure, or modification of such data and otherwise 
        meets applicable Federal requirements safeguarding privacy and 
        data security.
    ``(b) Requirements for Conveyance.--Data or information may be 
conveyed pursuant to this section only if the following requirements 
are met:
            ``(1) The individual whose circumstances are described in 
        the data or information (or such individual's parent, guardian, 
        caretaker relative, or authorized representative) has either 
        provided advance consent to disclosure or has not objected to 
        disclosure after receiving advance notice of disclosure and a 
        reasonable opportunity to object.
            ``(2) Such data or information are used solely for the 
        purposes of--
                    ``(A) identifying individuals who are eligible or 
                potentially eligible for assistance under this title or 
                title XXI and enrolling such individuals in the State 
                plans established under such titles; and
                    ``(B) verifying the eligibility of individuals for 
                assistance under the State plans established under this 
                title or title XXI.
            ``(3) An interagency or other agreement, consistent with 
        standards developed by the Secretary--
                    ``(A) prevents the unauthorized use, disclosure, or 
                modification of such data and otherwise meets 
                applicable Federal requirements safeguarding privacy 
                and data security; and
                    ``(B) requires the State agencies administering the 
                State plans established under this title and title XXI 
                to use the data and information obtained under this 
                section to seek to enroll individuals in such plans.
    ``(c) Criminal Penalty.--A person described in the subsection (a) 
who publishes, divulges, discloses, or makes known in any manner, or to 
any extent not authorized by Federal law, any information obtained 
under this section shall be fined not more than $1,000 or imprisoned 
not more than 1 year, or both for each such unauthorized activity.
    ``(d) Rule of Construction.--The limitations and requirements that 
apply to disclosure pursuant to this section shall not be construed to 
prohibit the conveyance or disclosure of data or information otherwise 
permitted under Federal law (without regard to this section).''.
            (2) Conforming amendment to assure access to national new 
        hires database.--Section 453(i)(1) (42 U.S.C. 653(i)(1)) is 
        amended by striking ``and programs funded under part A'' and 
        inserting ``, programs funded under part A, and State plans 
        approved under title XIX or XXI''.
            (3) Conforming amendment to provide schip programs with 
        access to national income data.--Section 6103(l)(7)(D)(ii) of 
        the Internal Revenue Code of 1986 is amended by inserting ``or 
        title XXI'' after ``title XIX''.
            (4) Conforming amendment to provide access to data about 
        enrollment in insurance for purposes of evaluating applications 
        and for schip.--Section 1902(a)(25)(I)(i) (42 U.S.C. 
        1396a(a)(25)(I)(i)) is amended--
                    (A) by inserting ``(and, at State option, 
                individuals who are potentially eligible or who 
                apply)'' after ``with respect to individuals who are 
                eligible''; and
                    (B) by inserting ``under this title (and, at State 
                option, child health assistance under title XXI)'' 
                after ``the State plan''.

SEC. 208. ENCOURAGING CULTURALLY APPROPRIATE ENROLLMENT PRACTICES.

    Section 1903(a)(2) (42 U.S.C. 1396b(a)(2)) is amended by adding at 
the end the following new subparagraph:
            ``(E) an amount equal to 75 percent of so much of the sums 
        expended during such quarter (as found necessary by the 
        Secretary for the proper and efficient administration of the 
        State plan) as are attributable to translation or 
        interpretation services in connection with the enrollment under 
        this title of children of families for whom English is not 
        their primary language; plus''.

SEC. 209. MODEL OF INTERSTATE COORDINATED ENROLLMENT AND COVERAGE 
              PROCESS.

    In order to assure continuity of coverage of low-income children 
under the Medicaid program and the State Children's Health Insurance 
Program (SCHIP), the Secretary of Health and Human Services, in 
consultation with State Medicaid and SCHIP directors, shall develop and 
disseminate a model process for the coordination of the enrollment and 
coverage under such programs of children who, because of migration of 
families, emergency evacuations, educational needs, or otherwise, 
frequently change their State of residency or otherwise are temporarily 
present outside of the State of their residency.

SEC. 210. ELIMINATION OF COUNTING MEDICAID CHILD PRESUMPTIVE 
              ELIGIBILITY COSTS AGAINST TITLE XXI ALLOTMENT.

    Section 2105(a)(1) (42 U.S.C. 1397ee(a)(1)) is amended--
            (1) in the matter preceding subparagraph (A), by striking 
        ``(or, in the case of expenditures described in subparagraph 
        (B), the Federal medical assistance percentage (as defined in 
        the first sentence of section 1905(b)))''; and
            (2) by amending subparagraph (B) to read as follows:
                    ``(B) [reserved]''.

SEC. 211. AUTHORITY FOR QUALIFYING STATES TO USE PORTION OF SCHIP 
              ALLOTMENT FOR ANY FISCAL YEAR FOR CERTAIN MEDICAID 
              EXPENDITURES.

    Section 2105(g)(1)(A) (42 U.S.C. 1397ee(g)(1)(A)), as amended by 
section 201(b) of the National Institutes of Health Reform Act of 2006 
(Public Law 109-482) is amended by striking ``fiscal year 1998, 1999, 
2000, 2001, 2004, 2005, 2006, or 2007'' and inserting ``a fiscal 
year''.

SEC. 212. APPLICATION OF MEDICAID OUTREACH PROCEDURES TO ALL PREGNANT 
              WOMEN AND CHILDREN.

    (a) In General.--Section 1902(a)(55) (42 U.S.C. 1396a(a)(55)) is 
amended by striking ``individuals for medical assistance under 
subsection (a)(10)(A)(i)(IV), (a)(10)(A)(i)(VI), (a)(10)(A)(i)(VII), or 
(a)(10)(A)(ii)(IX)'' and inserting ``child and pregnant women for 
medical assistance (including under clauses (i)(IV), (i)(VI), (i)(VII), 
and (ii)(IX) of paragraph (10)(A))''.
    (b) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendment made by subsection (a) takes effect on January 1, 
        2008.
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act, which 
        the Secretary of Health and Human Services determines requires 
        State legislation in order for the plan to meet the additional 
        requirements imposed by the amendment made by subsection (a), 
        the State plan shall not be regarded as failing to comply with 
        the requirements of such Act solely on the basis of its failure 
        to meet these additional requirements 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 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 the session shall be 
        considered to be a separate regular session of the State 
        legislature.

                       TITLE III--EFFECTIVE DATE

SEC. 301. EFFECTIVE DATE.

    Unless otherwise provided, the amendments made by this Act shall 
take effect on October 1, 2007, and shall apply to child health 
assistance and medical assistance provided on or after that date 
without regard to whether or not final regulations to carry out such 
amendments have been promulgated by such date.
                                 <all>