I 111th CONGRESS 1st Session H. R. 2680 IN THE HOUSE OF REPRESENTATIVES June 3, 2009 Ms. Bordallo (for herself, Mr. Serrano, Mr. Faleomavaega, Mrs. Christensen, Mr. Pierluisi, and Mr. Sablan) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Social Security Act to provide for payment parity for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa under the Medicaid Program, and for other purposes.

1.

Short title

This Act may be cited as the Territorial Health Parity Act of 2009.

2.

Medicaid payment parity for the territories

(a)

Elimination of funding limitations for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa

(1)

In general

Section 1108 of the Social Security Act (42 U.S.C. 1308) is amended— (A)in subsection (f), in the matter before paragraph (1), by striking subsection (g) and inserting subsections (g) and (h); (B)in subsection (g)(2), in the matter before subparagraph (A), by inserting and subsection (h) after paragraph (3); and (C)by adding at the end the following new subsection: (h)

Sunset of funding limitations for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa

Subsections (f) and (g) shall not apply to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa for any fiscal year after fiscal year 2009. . (2)

Conforming amendment

Section 1903(u) of such Act (42 U.S.C. 1396c(u)) is amended by striking paragraph (4). (3)

Effective date

The amendments made by this subsection shall apply beginning with fiscal year 2010. (b)

Parity in FMAP

(1)

In general

Section 1905(b)(2) of such Act (42 U.S.C. 1396d(b)(2)) is amended by inserting after 50 per centum the following: (except that, beginning with fiscal year 2012, the Federal medical assistance percentage for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa shall be the Federal medical assistance percentage determined by the Secretary in consultation (for the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa) with the Secretary of the Interior). (2)

2-fiscal-year transition

Notwithstanding any other provision of law, during fiscal years 2010 and 2011, the Federal medical assistance percentage established under section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa shall be the highest such Federal medical assistance percentage applicable to any of the 50 States or the District of Columbia for the fiscal year involved, taking into account the application of subsections (a) and (b)(1) of 5001 of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111–5) to such States and District for calendar quarters during such fiscal years for which such subsections apply respectively. (3)

Per capita income data

(A)

Report to Congress

Not later than October 1, 2010, the Secretary of Health and Human Services shall submit to Congress a report that describes the per capita income data used to promulgate the Federal medical assistance percentage in the territories and how such data differ from the per capita income data used to promulgate Federal medical assistance percentages for the 50 States and the District of Columbia. The report should include recommendations on how the Federal medical assistance percentages can be calculated for the territories to ensure parity with the 50 States and the District of Columbia. (B)

Application

Section 1101(a)(8)(B) of the Social Security Act (42 U.S.C. 1308(a)(8)(B)) is amended— (i)by striking (other than Puerto Rico, the Virgin Islands, and Guam) and inserting (including Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa); and (ii)by inserting (or, if such satisfactory data are not available in the case of the Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, satisfactory data available from the Department of the Interior for the same period, or if such satisfactory data are not available in the case of Puerto Rico, satisfactory data available from the Government of the Commonwealth of Puerto Rico for the same period) after Department of Commerce. (4)

Relation to American Recovery and Reinvestment Act of 2009

For any period and territory in which the provisions of this subsection apply to a territory, the provisions of section 5001(b)(2) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111–5) shall not apply (except as otherwise specifically provided in paragraph (2)).

3.

Clarification of Medicaid coverage for citizens of Freely Associated States

(a)

In general

Section 402(b)(2) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1612(b)(2)) is amended by adding at the end the following: (G)

Medicaid exception for citizens of Freely Associated States

With respect to eligibility for benefits for the program defined in paragraph (3)(C) (relating to the Medicaid program), paragraph (1) shall not apply to any individual who lawfully resides in the United States (including territories and possessions of the United States) in accordance with the Compacts of Free Association between the Government of the United States and the Governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. . (b)

Conforming definition of qualified alien

Section 431(b) of such Act (8 U.S.C. 1641(b)) is amended— (1)in paragraph (6), by striking or at the end; (2)in paragraph (7), by striking the period at the end and inserting ; or; and (3)by adding at the end the following: (8)an individual who lawfully resides in the United States (including territories and possessions of the United States) in accordance with a Compact of Free Association referred to in section 402(b)(2)(G), but only with respect to the program defined in section 402(b)(3)(C) (relating to the Medicaid program). . (c)

Setting FMAP at 100 percent

The third sentence of section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is amended by inserting before the period at the end the following: and as medical assistance for individuals described in section 402(b)(2)(G) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. (d)

Effective date

The amendments made by this Act take effect on October 1, 2009, Act and apply to benefits and assistance provided on or after that date.