1.Short title; table of
contents
(a)This Act may be cited
as the More Children, More Choices Act
of 2009
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—SCHIP Reauthorization
Sec. 101. Requiring outreach and coverage before expansion of
eligibility.
Sec. 102. Application of citizenship documentation
requirements; increased Federal matching rate for citizenship documentation
enforcement under Medicaid and SCHIP.
Sec. 103. Limitations on eligibility based on substantial net
assets.
Sec. 104. Clarification of State authorities.
Sec. 105. Easing administrative barriers to State cooperation
with employer-sponsored insurance coverage.
Sec. 106. Improving beneficiary choice in SCHIP.
Sec. 107. Allotment distribution formula.
Sec. 108. Five-year reauthorization.
Sec. 109. Enhancing the programmatic focus on children and
pregnant women.
Sec. 110. Grants for outreach and enrollment.
TITLE II—Child health insurance coverage through tax
fairness
Sec. 201. Expansion of child health care insurance coverage
through tax fairness.
TITLE III—State health reform projects
Sec. 301. State health reform projects.
TITLE IV—Sense of the House of Representatives
Sec. 401. Medicare and Medicaid reform and savings.
<enum>I</enum><header>SCHIP
Reauthorization</header>
<section id="H0378788C388145C0A48297229D117047"><enum>101.</enum><header>Requiring
outreach and coverage before expansion of eligibility</header>
<subsection id="H5AD6CB3D33E445588181D58D4DEC801D"><enum>(a)</enum><header>State plan
required To specify how it will achieve coverage for 90 percent of targeted
low-income children</header>
<paragraph id="HFC68F70D6BE840B6934C07E442D4C2A3"><enum>(1)</enum><header>In
general</header><text>Section 2102(a) of the Social Security Act (42 U.S.C.
1397bb(a)) is amended—</text>
<subparagraph id="H25C23B48FE4E46EB92333F874BA9AE39"><enum>(A)</enum><text>in paragraph (6),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HB94AA01505CD4EA78F14408617D4CACB"><enum>(B)</enum><text>in paragraph (7),
by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="H26C715DE85454FFFA6856EF04207D60"><enum>(C)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H247E05B272BC4B8BAC7F8C5D9293EA6C" style="OLC">
<paragraph id="HAEA6F298591846EFAD1E8D54B8CEE670"><enum>(8)</enum><text display-inline="yes-display-inline">how the eligibility and benefits provided
for under the plan for each fiscal year (beginning with fiscal year 2010) will
allow for the State's annual funding allotment to cover at least 90 percent of
the eligible targeted low-income children in the
State.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HAAD50DD82F5B46D5B98918C3A0D933FF"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by paragraph (1) shall apply to State
child health plans for fiscal years beginning with fiscal year 2010.</text>
</paragraph></subsection><subsection id="H167B9758DBA74137A7AEE0DE00FBCB9E"><enum>(b)</enum><header>Limitation on
program expansions until lowest income eligible individuals
enrolled</header><text>Section 2105(c) of such Act (42 U.S.C. 1397dd(c)) is
amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H28430BC297A6430C977F8495E7D6D319" style="OLC">
<paragraph id="H6668462D0602445E91FAD0F8BDBC7BAE"><enum>(8)</enum><header>Limitation on
increased coverage of higher income children</header><text>For child health
assistance furnished in a fiscal year beginning with fiscal year 2010:</text>
<subparagraph id="H2CD83487A963437E92D400DAC1B66ED"><enum>(A)</enum><header>No payment for
children with family income above 250 percent of poverty line</header><text display-inline="yes-display-inline">Payment shall not be made under this
section for child health assistance for a targeted low-income child in a family
the income of which exceeds 250 percent of the poverty line applicable to a
family of the size involved.</text>
</subparagraph><subparagraph id="HCCD110834D1743B5A1531D92EE9DA916"><enum>(B)</enum><header>Special rules
for payment for children with family income above 200 percent of poverty
line</header><text display-inline="yes-display-inline">In the case of child
health assistance for a targeted low-income child in a family the income of
which exceeds 200 percent (but does not exceed 250 percent) of the poverty line
applicable to a family of the size involved no payment shall be made under this
section for such assistance unless the State demonstrates to the satisfaction
of the Secretary that—</text>
<clause id="H18453327F5B14A6A838431842EDA79AB"><enum>(i)</enum><text>the State has met
the 90 percent retrospective coverage test specified in subparagraph (C)(i) for
the previous fiscal year; and</text>
</clause><clause id="H5E2F5E2DB5DD4F2DB94738BE9DA516A7"><enum>(ii)</enum><text>the State will
meet the 90 percent prospective coverage test specified in subparagraph (C)(ii)
for the fiscal year.</text>
</clause></subparagraph><subparagraph id="HE5AF0CF6C93C41B3A160518551589424"><enum>(C)</enum><header>90 percent
coverage tests</header>
<clause id="HE7283E77651144C691BB5D4BB7DB5E2"><enum>(i)</enum><header>Retrospective
test</header><text>The 90 percent retrospective coverage test specified in this
clause is, for a State for a fiscal year, that on average during the fiscal
year, the State has enrolled under this title or title XIX at least 90 percent
of the individuals residing in the State who—</text>
<subclause id="H71B527390806474DB9E98D2147A7547D"><enum>(I)</enum><text>are children under
19 years of age (or are pregnant women) and are eligible for medical assistance
under title XIX; or</text>
</subclause><subclause id="HABAC95D953434EF48DB6C98475960935"><enum>(II)</enum><text>are targeted
low-income children whose family income does not exceed 200 percent of the
poverty line and who are eligible for child health assistance under this
title.</text>
</subclause></clause><clause id="H604E91B65046433AB0406EFA791838F4"><enum>(ii)</enum><header>Prospective
test</header><text>The 90 percent prospective test specified in this clause is,
for a State for a fiscal year, that on average during the fiscal year, the
State will enroll under this title or title XIX at least 90 percent of the
individuals residing in the State who—</text>
<subclause id="HD310D4A6E1CE44A0A6ACECA657A4EADB"><enum>(I)</enum><text>are children under
19 years of age (or are pregnant women) and are eligible for medical assistance
under title XIX; or</text>
</subclause><subclause id="HD681D380651041BCB1F6700699D8A5E1"><enum>(II)</enum><text display-inline="yes-display-inline">are targeted low-income children whose
family income does not exceed such percent of the poverty line (in excess of
200 percent) as the State elects consistent with this paragraph and who are
eligible for child health assistance under this title.</text>
</subclause></clause></subparagraph><subparagraph id="H633C363169D14528B40741BFFA143591"><enum>(D)</enum><header>Grandfather</header><text>Subparagraphs
(A) and (B) shall not apply to the provision of child health assistance—</text>
<clause id="HE2B773E459E6415A98BE9610CF6370D9"><enum>(i)</enum><text>to
a targeted low-income child who is enrolled for child health assistance under
this title as of September 30, 2007;</text>
</clause><clause id="HB9D9D85AEFCF49299B57F4BD91637458"><enum>(ii)</enum><text>to a pregnant
woman who is enrolled for assistance under this title as of September 30, 2008,
through the completion of the post-partum period following completion of her
pregnancy; and</text>
</clause><clause id="H6D04F75969904238BEA662A81F7CBA36"><enum>(iii)</enum><text>for items and
services furnished before October 1, 2009, to an individual who is not a
targeted low-income child and who is enrolled for assistance under this title
as of September 30, 2008.</text>
</clause></subparagraph><subparagraph id="H569F6B9FCF7040BB8C8F0303B0A4179"><enum>(E)</enum><header>Treatment of
pregnant women</header><text display-inline="yes-display-inline">In this
paragraph and sections 2102(a)(8) and 2104(a)(2), the term <term>targeted
low-income child</term> includes an individual under age 19, including the
period from conception to birth, who is eligible for child health assistance
under this title by virtue of the definition of the term <term>child</term>
under section 457.10 of title 42, Code of Federal
Regulations.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HEC5BC21A8DB345C39B8944C1546DFD51"><enum>(c)</enum><header>Standardization
of income determinations</header>
<paragraph id="H1E8437EADAD543F18B481E4CC1A590EE"><enum>(1)</enum><header>In
general</header><text>Section 2110(d) of such Act (42 U.S.C. 1397jj) is amended
by adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H74BC182F5ED54C9EA02F2215B4CBA27" style="OLC">
<subsection id="H6C4165CDCBC6495BBAA033F899B9BD1F"><enum>(d)</enum><header>Standardization
of income determinations</header><text>In determining family income under this
title (including in the case of a State child health plan that provides health
benefits coverage in the manner described in section 2101(a)(2)), a State shall
base such determination on gross income (including amounts that would be
included in gross income if they were not exempt from income taxation) and may
only take into consideration such income disregards as the Secretary shall
develop.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H3DC2C5F181BB46568CD30CB9DC0D2BF"><enum>(2)</enum><header>Effective
date</header><subparagraph commented="no" display-inline="yes-display-inline" id="HBA73EB649D9F453682063FF547AE6B8"><enum>(A)</enum><text>Subject to subparagraph
(B), the amendment made by paragraph (1) shall apply to determinations (and
redeterminations) of income made on or after April 1, 2009.</text>
</subparagraph><subparagraph id="HC67B36F8B8254A939B632D325D40FC06" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">In
the case of a State child health plan under title XXI of the Social Security
Act which the Secretary of Health and Human Services determines requires State
legislation (other than legislation appropriating funds) in order for the plan
to meet the additional requirement imposed by the amendment made by paragraph
(1), the State child health plan shall not be regarded as failing to comply
with the requirements of such title solely on the basis of its failure to meet
this additional requirement before the first day of the first calendar quarter
beginning after the close of the first regular session of the State legislature
that begins after the date of the enactment of this Act. For purposes of the
previous sentence, in the case of a State that has a 2-year legislative
session, each year of such session shall be deemed to be a separate regular
session of the State legislature.</text>
</subparagraph></paragraph></subsection></section><section id="H96B97C984CF64E168063F9FC55510157"><enum>102.</enum><header>Application of
citizenship documentation requirements; increased Federal matching rate for
citizenship documentation enforcement under Medicaid and SCHIP</header>
<subsection id="H174A607A6E214776902C3D1B88D2DCE7"><enum>(a)</enum><header>Application of
requirements</header>
<paragraph id="HF1A7AD829DB9457094D0DC296EDCBEB8"><enum>(1)</enum><header>In
general</header><text>Section 2105(c) of the Social Security Act (42 U.S.C.
1397dd(c)), as amended by section 101(b), is amended by adding at the end the
following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H69ACA0938ED3495AAB8DE000E2B92CE6" style="OLC">
<paragraph id="H4FCC27923D6443B19804BC6F75B3930"><enum>(9)</enum><header>Application of
citizenship documentation requirements</header>
<subparagraph id="H1BF71A47ED4747DB973B2DD46822FAB6"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">Subject to
subparagraph (B), no payment may be made under this section to a State with
respect to amounts expended for child health assistance for an individual who
declares under section 1137(d)(1)(A) to be a citizen or national of the United
States for purposes of establishing eligibility for benefits under this title,
unless the requirement of section 1903(x) is met.</text>
</subparagraph><subparagraph id="H460AFB68C17A4D648C2B2FBB9CBA4F65"><enum>(B)</enum><header>Treatment of
pregnant women</header><text display-inline="yes-display-inline">For purposes
of applying subparagraph (A) in the case of a pregnant woman who qualifies for
child health assistance by virtue of the application of section 457.10 of title
42, Code of Federal Regulations, the requirement of such section shall be
deemed to be satisfied by the presentation of documentation of personal
identity described in section 274A(b)(1)(D) of the Immigration and Nationality
Act or any other documentation of personal identity of such other type as the
Secretary finds, by regulation, provides a reliable means of
identification.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H73BEE4D308254E6B9F3B1FA3873508D4"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply to
eligibility determinations and redeterminations made on or after April 1,
2009.</text>
</paragraph></subsection><subsection id="H33E07715D8304303B3B79C565CBFE0A4"><enum>(b)</enum><header>Temporary
increase in Federal matching rate for administrative costs under Medicaid and
SCHIP</header><text>—</text>
<paragraph id="HC5AAFA6652234969815C746BAD847506"><enum>(1)</enum><header>Medicaid</header>
<subparagraph id="H9E19AA32D4A04537A574B18E005E7560"><enum>(A)</enum><header>In
general</header><text>With respect to administrative costs incurred on or after
July 1, 2006, and before October 1, 2009, in implementing the amendments made
by section 6036 of the Deficit Reduction Act of 2005 (Public Law 109–171), 75
percent shall be substituted for 50 per centum in section 1903(a)(7) of the
Social Security Act (42 U.S.C. 1396b(a)(7)).</text>
</subparagraph><subparagraph id="HA5E7102E431E4E9E81958385B997C84"><enum>(B)</enum><header>Retroactive
adjustment</header><text>The Secretary of Health and Human Services shall take
such steps as may be necessary to provide for the adjustment of payments under
section 1903(a) of the Social Security Act (42 U.S.C. 1396b(a)) to take into
account the application of subparagraph (A) for periods before the date of the
enactment of this Act.</text>
</subparagraph></paragraph><paragraph id="H8FF991361B7D48F0B5FF55B136906547"><enum>(2)</enum><header>SCHIP</header><text>With
respect to administrative costs incurred on or after April 1, 2009, and before
October 1, 2009, in implementing the amendment made by subsection (a)(1), the
enhanced FMAP applied under section 2105(a)(1)(D)(iv) of the Social Security
Act (42 U.S.C. 1397d(a)(1)(D)(iv)) shall not be less than 75 percent.</text>
</paragraph></subsection></section><section id="H19625B02099942DB9274D35D2F393DFD"><enum>103.</enum><header>Limitations on
eligibility based on substantial net assets</header>
<subsection id="HD1BB6F19F868453185142BCB5ED99C5"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2110(b) of
the Social Security Act (42 U.S.C. 1397jj(b)) is amended—</text>
<paragraph id="H372CD44B04DF4FA6B9B98B00F1EB6D95"><enum>(1)</enum><text>in paragraph (1),
by striking <quote>paragraph (2)</quote> and inserting <quote>paragraphs (2)
and (5)</quote>; and</text>
</paragraph><paragraph id="H6D64E5C0577947E481CAA38700EFC331"><enum>(2)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H0762631BB9814C49B17D761F00D7F4C4" style="OLC">
<paragraph id="H80C6E9E8E84C4E92A685CDA47D899436"><enum>(5)</enum><header>Disqualification
for individuals in families with substantial net assets</header><text display-inline="yes-display-inline">An individual in a family is not eligible
for child health assistance under this title if the individual’s family has net
assets (including the equity interest in any home) that exceeds $500,000 or
unless there is provided a document (in such a form and manner as the Secretary
shall specify) signed under penalty of perjury by an applicant for child health
assistance on behalf of the individual that the net assets of the individual’s
family (including the equity interest in the any home) does not exceed
$500,000. The Secretary may increase the dollar amount specified in the
previous sentence from year to year beginning with 2014 based on the percentage
increase in the consumer price index for all urban consumers (all items; United
States city average), rounded to the nearest
$1,000.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H8889EFDD2B7E40EABB7848B6AE313E97"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by subsection (a) shall apply to
eligibility determinations and redeterminations made on or after April 1,
2009.</text>
</subsection></section><section id="H210DDBC8CF7D4529B299600924FC8E8F"><enum>104.</enum><header>Clarification
of State authorities</header><text display-inline="no-display-inline">Section
2102 of the Social Security Act (42 U.S.C. 1397bb) is amended by adding at the
end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H9B35BA5CFA524F53BBCC4C4EC6A9B179" style="OLC">
<subsection id="H13EBCD85C8404E969F00AACB85491100"><enum>(d)</enum><header>Clarification of
State authorities</header><text>Nothing in this title shall be construed as
preventing a State, under its child health plan, from doing any of the
following:</text>
<paragraph display-inline="no-display-inline" id="HB913930862214A40911EBC2CFF48F854"><enum>(1)</enum><header>Use of waiting
periods to prevent crowd out</header><text display-inline="yes-display-inline">From using waiting periods and other tools
to prevent crowding out private sector insurance coverage.</text>
</paragraph><paragraph id="H0664864FDADB44FCB288355823F398E4"><enum>(2)</enum><header>Use of private
providers and plans</header><text display-inline="yes-display-inline">From
cooperating or contracting with private sector providers and plans in order to
provide care to targeted low-income children.</text>
</paragraph><paragraph id="HEC577FDD634840ABA1D4EFCDCDE9A5"><enum>(3)</enum><header>Use of state funds
for ineligible individuals</header><text display-inline="yes-display-inline">From providing medical benefits for
individuals who are not targeted low-income children with State
funds.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H45126182D251478B914604B06F68954C"><enum>105.</enum><header>Easing
administrative barriers to State cooperation with employer-sponsored insurance
coverage</header>
<subsection id="H7E29C574C6B042DEBFA2A04143FEDDEF"><enum>(a)</enum><header>Requiring some
coverage for employer-sponsored insurance</header>
<paragraph id="HDFBAF05D9E714AAEB6E1F7688BCA77F7"><enum>(1)</enum><header>In
general</header><text>Section 2102(a) of the Social Security Act (42 U.S.C.
1397b(a)), as amended by section 101(a), is amended—</text>
<subparagraph id="H178A8474DF694582BC2406515556DB04"><enum>(A)</enum><text>in paragraph (7),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="H5076D65B110F48C195A817A2B900B74B"><enum>(B)</enum><text>in paragraph (8),
by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="H060722AA4234406189F06801F8B3CBB8"><enum>(C)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H7F639756A73A4A8AAD63AF7859E265AC" style="OLC">
<paragraph id="HD6BF553DEC8749D8B22E00AD00CDEE91"><enum>(9)</enum><text display-inline="yes-display-inline">effective for plan years beginning on or
after October 1, 2009, how the plan will provide for child health assistance
with respect to targeted low-income children covered under a group health
plan.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H182EE0B5CBFC4CFE8843B037935DAD4F"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply beginning
with fiscal year 2010.</text>
</paragraph></subsection><subsection id="H201FCB9A6AB141699C33E8C14942CCF9"><enum>(b)</enum><header>Federal
financial participation for employer-sponsored insurance</header><text display-inline="yes-display-inline">Section 2105 of such Act (42 U.S.C. 1397d)
is amended—</text>
<paragraph id="H518D809EDDEC46779E3039335D598FE6"><enum>(1)</enum><text>in subsection
(a)(1)(C), by inserting before the semicolon at the end the following:
<quote>and, subject to paragraph (3)(C), in the form of payment of the premiums
for coverage under a group health plan that includes coverage of targeted
low-income children and benefits supplemental to such coverage</quote>;
and</text>
</paragraph><paragraph id="H03ED23D0774F4CBE908619A165B1F885"><enum>(2)</enum><text>paragraph (3) of
subsection (c) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HE99E0958C5414727B66823FC2F7DF63E" style="OLC">
<paragraph id="HCFD3484BB32044468F00DC031DE208E3"><enum>(3)</enum><header>Purchase of
employer-sponsored insurance</header>
<subparagraph id="H97F9DA3121A64927AB590748002B5100"><enum>(A)</enum><header>In
general</header><text>Payment may be made to a State under subsection
(a)(1)(C), subject to the provisions of this paragraph, for the purchase of
family coverage under a group health plan that includes coverage of targeted
low-income children unless such coverage would otherwise substitute for
coverage that would be provided to such children but for the purchase of family
coverage.</text>
</subparagraph><subparagraph id="HF945ECC7D5BB47629610BC60EC5D54EE"><enum>(B)</enum><header>Waiver of
certain provisions</header><text display-inline="yes-display-inline">With
respect to coverage described in subparagraph (A)—</text>
<clause id="H2007DC407C2D48A8845107922B1E1B00"><enum>(i)</enum><text>notwithstanding
section 2102, no minimum benefits requirement (other than those otherwise
applicable with respect to services referred to in section 2102(a)(7)) under
this title shall apply; and</text>
</clause><clause id="H22D06AABF6F947A5B570C628E48FCDE0"><enum>(ii)</enum><text>no limitation on
beneficiary cost-sharing otherwise applicable under this title or title XIX
shall apply.</text>
</clause></subparagraph><subparagraph id="H0EEAB5317D4141218228119B53203C05"><enum>(C)</enum><header>Required
provision of supplemental benefits</header><text>If the coverage described in
subparagraph (A) does not provide coverage for the services referred to in
section 2102(a)(7), the State child health plan shall provide coverage of such
services as supplemental benefits.</text>
</subparagraph><subparagraph id="H68BE855229BB4ED6871D343C89636DEC"><enum>(D)</enum><header>Limitation on
FFP</header><text>The amount of the payment under paragraph (1)(C) for coverage
described in subparagraph (A) (and supplemental benefits under subparagraph (C)
for individuals so covered) during a fiscal year may not exceed the product
of—</text>
<clause id="HC95ECABD902E4A41B4554696C74BDFDC"><enum>(i)</enum><text>the national per
capita expenditure under this title (taking into account both Federal and State
expenditures) for the previous fiscal year (as determined by the Secretary
using the best available data);</text>
</clause><clause id="H78E3EAE2DA7543988EC768A611D4F7B"><enum>(ii)</enum><text>the enhanced FMAP
for the State and fiscal year involved; and</text>
</clause><clause id="HCA36C5D0ABA74ECBA5AC7488B7063112"><enum>(iii)</enum><text>the number of
targeted low-income children for whom such coverage is provided.</text>
</clause></subparagraph><subparagraph id="H1CDCB44EBF544FDB839FB8405F915EA0"><enum>(E)</enum><header>Voluntary
enrollment</header><text>A State child health plan—</text>
<clause id="HE755338C9BDA4B618166023137F92D81"><enum>(i)</enum><text>may not require a
targeted low-income child to enroll in coverage described in subparagraph (A)
in order to obtain child health assistance under this title;</text>
</clause><clause id="HD077BDEF66B8433190195F404FDB807E"><enum>(ii)</enum><text display-inline="yes-display-inline">before providing such child health
assistance for such coverage of a child, shall make available (which may be
through an Internet website or other means) to the parent or guardian of the
child information on the coverage available under this title, including
benefits and cost-sharing; and</text>
</clause><clause id="H1288824E5C3742D584F76082045FCBD5"><enum>(iii)</enum><text>shall provide at
least one opportunity per fiscal year for beneficiaries to switch coverage
under this title from coverage described in subparagraph (A) to the coverage
that is otherwise made available under this title.</text>
</clause></subparagraph><subparagraph id="H32782862FA6046138628ECD1EF8521AC"><enum>(F)</enum><header>Information on
coverage options</header><text>A State child health plan shall—</text>
<clause id="H9687BE6504224517AA33960000747C37"><enum>(i)</enum><text display-inline="yes-display-inline">describe how the State will notify
potential beneficiaries of coverage described in subparagraph (A);</text>
</clause><clause id="H1A2923A753334E6A8C983631EA41537B"><enum>(ii)</enum><text>provide such
notification in writing at least during the initial application for enrollment
under this title and during redeterminations of eligibility if the individual
was enrolled before October 1, 2009; and</text>
</clause><clause id="HA7718CCC42FE400FB34D1FD708727FE6"><enum>(iii)</enum><text>post a
description of these coverage options on any official website that may be
established by the State in connection with the plan.</text>
</clause></subparagraph><subparagraph id="H190F3F9231894194004EBE2CA9C7B183"><enum>(G)</enum><header>Semiannual
verification of coverage</header><text>If coverage described in subparagraph
(A) is provided under a group health plan with respect to a targeted low-income
child, the State child health plan shall provide for the collection, at least
once every six months, of proof from the plan that the child is enrolled in
such coverage.</text>
</subparagraph><subparagraph display-inline="no-display-inline" id="H2BEFED5F24F14231A787C4EC054C3579"><enum>(H)</enum><header>Rule of
construction</header><text display-inline="yes-display-inline">Nothing in this
section is to be construed to prohibit a State from—</text>
<clause id="HB1CBDB3DDD7C47F796A5B4E3DDF5A992"><enum>(i)</enum><text display-inline="yes-display-inline">offering wrap around benefits in order for
a group health plan to meet any State-established minimum benefit
requirements;</text>
</clause><clause id="H59D44680D4D54173BC5E8C16B24C9E6B"><enum>(ii)</enum><text display-inline="yes-display-inline">establishing a cost-effectiveness test to
qualify for coverage under such a plan;</text>
</clause><clause id="H98A97B3F997941FBAFF56D361509D86E"><enum>(iii)</enum><text display-inline="yes-display-inline">establishing limits on beneficiary
cost-sharing under such a plan;</text>
</clause><clause id="H7C4632B353C149B1B1C1B65345F904F9"><enum>(iv)</enum><text display-inline="yes-display-inline">paying all or part of a beneficiary’s
cost-sharing requirements under such a plan;</text>
</clause><clause id="H846BD20AF5C648848E12E729C7ADC474"><enum>(v)</enum><text display-inline="yes-display-inline">paying less than the full cost of the
employee’s share of the premium under such a plan, including prorating the cost
of the premium to pay for only what the State determines is the portion of the
premium that covers targeted low-income children;</text>
</clause><clause id="H446D9471609F4A0D9BD03FFF3545B989"><enum>(vi)</enum><text display-inline="yes-display-inline">using State funds to pay for benefits above
the Federal upper limit established under subparagraph (C);</text>
</clause><clause id="H54D1F36BFAC64E7CAAAFF3201BA662B8"><enum>(vii)</enum><text display-inline="yes-display-inline">allowing beneficiaries enrolled in group
health plans from changing plans to another coverage option available under
this title at any time; or</text>
</clause><clause id="HF86537109B734848866300E9197FEC43"><enum>(viii)</enum><text display-inline="yes-display-inline">providing any guidance or information it
deems appropriate in order to help beneficiaries make an informed decision
regarding the option to enroll in coverage described in subparagraph
(A).</text>
</clause></subparagraph><subparagraph id="HF124BCF1E5434AB18F983F01B2145977"><enum>(I)</enum><header>Group health
plan defined</header><text>In this paragraph, the term <term>group health
plan</term> has the meaning given such term in section 2791(a)(1) of the Public
Health Service Act (42 U.S.C.
300gg–91(a)(1)).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H663C22DE2F174E1FA03E312BE24CB0AB"><enum>106.</enum><header>Improving
beneficiary choice in SCHIP</header>
<subsection id="H71F50981B2044897A1096F600066BA9E"><enum>(a)</enum><header>Requiring
offering of alternative coverage options</header><text>Section 2102 of the
Social Security Act (42 U.S.C. 1397b), as amended by sections 101(a), 104, and
105(a), is amended—</text>
<paragraph id="H68BC824DF1F34A46A991298FE3D405EE"><enum>(1)</enum><text>in subsection
(a)—</text>
<subparagraph id="HC84C927D819B4C0180867044F8784998"><enum>(A)</enum><text>in paragraph (8),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="H963EC0A982504B109E616200E146AD32"><enum>(B)</enum><text>in paragraph (9),
by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="H029E4682B5CC4D1FB24E53B73387581D"><enum>(C)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HA50161B6A0BD4B4DAAA600C6BBA57511" style="OLC">
<paragraph id="H5E1CFF74CBB34AAC80DAD7782BA32962"><enum>(10)</enum><text display-inline="yes-display-inline">effective for plan years beginning on or
after October 1, 2009, how the plan will provide for child health assistance
with respect to targeted low-income children through alternative coverage
options in accordance with subsection
(e).</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HA920DE7A82B449F081F6EC00643624DB"><enum>(2)</enum><text>by adding at the
end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="HCE0959A37014434FA23F7B35509F2402" style="OLC">
<subsection id="HD410AA60FFB843BCA6E1E9F102851F84"><enum>(e)</enum><header>Alternative
coverage options</header>
<paragraph id="HEDBA481577584B52B7B7EA8C5D965979"><enum>(1)</enum><header>In
general</header><text>Effective October 1, 2009, a State child health plan
shall provide for the offering of any qualified alternative coverage that a
qualified entity seeks to offer to targeted low-income children through the
plan in the State.</text>
</paragraph><paragraph id="H1A0E001D21F04068AAED2568377258F1"><enum>(2)</enum><header>Application of
uniform financial limitation for all alternative coverage
options</header><text>With respect to all qualified alternative coverage
offered in a State, the State child health plan shall establish a uniform
dollar limitation on the per capita monthly amount that will be paid by the
State to the qualified entity with respect to such coverage provided to a
targeted low-income child. Such limitation may not be less than 90 percent of
the per capita monthly payment made for coverage offered under the State child
health plan that is not in the form of an alternative coverage option. Nothing
in this paragraph shall be construed—</text>
<subparagraph id="HD61B895B2EC049058685F3992E003781"><enum>(A)</enum><text>as requiring a
State to provide for the full payment of premiums for qualified alternative
coverage;</text>
</subparagraph><subparagraph id="H4AAA169955B84CDBA69D5395F645F788"><enum>(B)</enum><text>as preventing a
State from charging additional premiums to cover the difference between the
cost of qualified alternative coverage and the amount of such payment
limitation;</text>
</subparagraph><subparagraph id="HD559C57922F7457AAE9D91C219CDAF4D"><enum>(C)</enum><text>as preventing a
State from using its own funds to provide a dollar limitation that exceeds the
Federal financial participation as limited under section 2105(c)(10).</text>
</subparagraph></paragraph><paragraph id="HF91B968789B541C2AD09E8E7CAFE8F33"><enum>(3)</enum><header>Qualified
alternative coverage defined</header><text>In this section, the term
<term>qualified alternative coverage</term> means health insurance coverage
that—</text>
<subparagraph id="H22FF68F15C3543DC854BF99EA07B21C9"><enum>(A)</enum><text>meets the coverage
requirements of section 2103 (other than cost-sharing requirements of such
section); and</text>
</subparagraph><subparagraph id="H92E89C5C49EE4DEC871F65E81E7CF284"><enum>(B)</enum><text>is offered by a
qualified insurer, and not directly by the State.</text>
</subparagraph></paragraph><paragraph id="H7C7AC979492B44AEABCA00CA705D056F"><enum>(4)</enum><header>Qualified
insurer defined</header><text>In this section, the term <term>qualified
insurer</term> means, with respect to a State, an entity that is licensed to
offer health insurance coverage in the
State.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HF4C30B6BE853413B9937B8B0764EE8A9"><enum>(b)</enum><header>Federal
financial participation for qualified alternative coverage</header><text display-inline="yes-display-inline">Section 2105 of such Act (42 U.S.C. 1397d)
is amended—</text>
<paragraph id="HC54A55EA515F4B28AC54BAA7C0086D75"><enum>(1)</enum><text>in subsection
(a)(1)(C), as amended by section 105(b), by inserting before the semicolon at
the end the following: <quote>and, subject to paragraph (8)(C), in the form of
payment of the premiums for coverage for qualified alternative
coverage</quote>; and</text>
</paragraph><paragraph id="H41B04AED0A9C4F83A12F002485BC70D"><enum>(2)</enum><text>in
subsection (c), as amended by sections 101(b) and 102(a)(1), by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H02597C2A424D48A8B7C7F81C88E1F909" style="OLC">
<paragraph id="HC48EC350E9E94A889727D171D02B0088"><enum>(10)</enum><header>Purchase of
qualified alternative coverage</header>
<subparagraph id="HE6D174F70B414475A8B8083800875D6E"><enum>(A)</enum><header>In
general</header><text>Payment may be made to a State under subsection
(a)(1)(C), subject to the provisions of this paragraph, for the purchase of
qualified alternative coverage.</text>
</subparagraph><subparagraph id="H19CD79C8CA2543EE862F0231C3D80095"><enum>(B)</enum><header>Waiver of
certain provisions</header><text display-inline="yes-display-inline">With
respect to coverage described in subparagraph (A), no limitation on beneficiary
cost-sharing otherwise applicable under this title or title XIX shall
apply.</text>
</subparagraph><subparagraph id="HE24833D8DEF947E195B7E3FBFE19CD7"><enum>(C)</enum><header>Limitation on
FFP</header><text>The amount of the payment under paragraph (1)(C) for coverage
described in subparagraph (A) during a fiscal year in the aggregate for all
such coverage in the State may not exceed the product of—</text>
<clause id="H936C9EA05D0140DE8946447305AAFD71"><enum>(i)</enum><text>the national per
capita expenditure under this title (taking into account both Federal and State
expenditures) for the previous fiscal year (as determined by the Secretary
using the best available data);</text>
</clause><clause id="HEA52D09EA8DB46DBB4312F140006C7BC"><enum>(ii)</enum><text>the enhanced FMAP
for the State and fiscal year involved; and</text>
</clause><clause id="HEE454F809FEB46F0B686B2FCF529E772"><enum>(iii)</enum><text>the number of
targeted low-income children for whom such coverage is provided.</text>
</clause></subparagraph><subparagraph id="H153F0201AC7B421A00E7FB2F52ED617F"><enum>(D)</enum><header>Voluntary
enrollment</header><text>A State child health plan—</text>
<clause id="HABBF24B45FBA4D659062771E5C573677"><enum>(i)</enum><text>may not require a
targeted low-income child to enroll in coverage described in subparagraph (A)
in order to obtain child health assistance under this title;</text>
</clause><clause id="H3CDA430880A74035AF00AD2B85E01D40"><enum>(ii)</enum><text display-inline="yes-display-inline">before providing such child health
assistance for such coverage of a child, shall make available (which may be
through an Internet website or other means) to the parent or guardian of the
child information on the coverage available under this title, including
benefits and cost-sharing; and</text>
</clause><clause id="H47F39A68B0364ACDB9008411C56DB55"><enum>(iii)</enum><text>shall provide at
least one opportunity per fiscal year for beneficiaries to switch coverage
under this title from coverage described in subparagraph (A) to the coverage
that is otherwise made available under this title.</text>
</clause></subparagraph><subparagraph id="H1CBA8D7C94B1465F00E7FEFF17FB6011"><enum>(E)</enum><header>Information on
coverage options</header><text>A State child health plan shall—</text>
<clause id="H9FE3AC0F0D054E9DB7EE475EC200E187"><enum>(i)</enum><text display-inline="yes-display-inline">describe how the State will notify
potential beneficiaries of coverage described in subparagraph (A);</text>
</clause><clause id="HE63EDB3B4F294DD6AA667DB5BB772C7D"><enum>(ii)</enum><text>provide such
notification in writing at least during the initial application for enrollment
under this title and during redeterminations of eligibility if the individual
was enrolled before October 1, 2009; and</text>
</clause><clause id="HBC90098D5DCC469D93A21CFE2C4746A5"><enum>(iii)</enum><text>post a
description of these coverage options on any official website that may be
established by the State in connection with the plan.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="HEBF0DD4025AF4D5787000040A3AF6527"><enum>(F)</enum><header>Rule of
construction</header><text display-inline="yes-display-inline">Nothing in this
section is to be construed to prohibit a State from—</text>
<clause id="HE2CD09D88B0E4D2EBD165991F8FE41B1"><enum>(i)</enum><text display-inline="yes-display-inline">establishing limits on beneficiary
cost-sharing under such alternative coverage;</text>
</clause><clause id="H8D44D960B22446B091FEE3DEAF61E797"><enum>(ii)</enum><text display-inline="yes-display-inline">paying all or part of a beneficiary’s
cost-sharing requirements under such coverage;</text>
</clause><clause id="H46CC5D30E2F2419CB23D368DCD093205"><enum>(iii)</enum><text display-inline="yes-display-inline">paying less than the full cost of a child’s
share of the premium under such coverage, insofar as the premium for such
coverage exceeds the limitation established by the State under subparagraph
(C);</text>
</clause><clause id="H7B8518F2A77B4B88BAE283D132265408"><enum>(iv)</enum><text display-inline="yes-display-inline">using State funds to pay for benefits above
the Federal upper limit established under subparagraph (C); or</text>
</clause><clause id="H82D561DB73344A2C83D8D9BEC3FF4381"><enum>(v)</enum><text display-inline="yes-display-inline">providing any guidance or information it
deems appropriate in order to help beneficiaries make an informed decision
regarding the option to enroll in coverage described in subparagraph
(A).</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H42D79A999E3B4D469F99A562C84B7F52"><enum>107.</enum><header>Allotment
distribution formula</header>
<subsection id="H074651414DF344898C76CF9CAA131C06"><enum>(a)</enum><header>Allotments to 50
States and the District of Columbia</header>
<paragraph id="H6CC0C2A9366F4484008F92C9C34CC352"><enum>(1)</enum><header>In
general</header><text>Section 2104(b) of the Social Security Act (42 U.S.C.
1397dd(b)) is amended—</text>
<subparagraph id="HCEBB0181C6C049B28EBB90811B88251C"><enum>(A)</enum><text>in paragraph (1),
by striking <quote>the same proportion</quote> and all that follows and
inserting <quote>the product of the number of SCHIP targeted children, as
determined under paragraph (2) for the second preceding fiscal year, the State
and Federal per capita SCHIP expenditures for the second preceding fiscal year,
as determined under such paragraph, and the enhanced FMAP for the State for the
second preceding fiscal year.</quote>;</text>
</subparagraph><subparagraph id="HEF692AC5CAE341EA9741646D23B7334D"><enum>(B)</enum><text>by amending
paragraph (2) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H77AF813872574325BFBE4ECE9B4A704" style="OLC">
<paragraph id="H2EF9869A86A24E36AD3387DBDEE51FB9"><enum>(2)</enum><header>Number of SCHIP
targeted children and pregnant women and national per capita SCHIP
expenditures</header>
<subparagraph id="H6DF89E3702D6493DA6D3A1493309C1E3"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">By not later than
September 30 of each year (beginning with 2009), the Secretary (in consultation
with the Director of the Bureau of the Census and using the best available data
for the fiscal year ending in the previous year) shall determine and publish in
the Federal Register—</text>
<clause id="HC36035F24A8645A18D92A287B0024765"><enum>(i)</enum><text>the average number
of low-income targeted children (described in subparagraph (B)) for any month
during such preceding fiscal year; and</text>
</clause><clause id="HD6253209BDBE43ECAA9100FA9C99BCC7"><enum>(ii)</enum><text>the combined
State and Federal per capita SCHIP expenditures (described in subparagraph (C))
for such preceding fiscal year.</text>
</clause></subparagraph><subparagraph id="H12A1860136B04546A0564716ED725E5D"><enum>(B)</enum><header>Low-income SCHIP
targeted children</header><text display-inline="yes-display-inline">Low-income
targeted children described in this subparagraph with respect to a subsection
(b) State are children (including pregnant women described in section
2105(c)(8)(E)) residing in the State who are not covered under a group health
plan or health insurance coverage (as defined for purposes of section
2110(b)(1)(C)) and whose family income—</text>
<clause id="HB38A8B884C7A469B9CF3FE81B3ACD3C1"><enum>(i)</enum><text>exceeds the lesser
of—</text>
<subclause id="H2985AAD2DA9C4117A8AE6B5CF700E6B0"><enum>(I)</enum><text>the Medicaid
applicable income level (as defined in section 2110(b)(4)); or</text>
</subclause><subclause id="H6E14E9A726C94C98BC2E7DD3287BDCFD"><enum>(II)</enum><text>150 percent of
the poverty line; but</text>
</subclause></clause><clause id="H444B80B7A21B41DCB979696C5035AF8F"><enum>(ii)</enum><text>does not exceed
200 percent of the poverty line.</text>
</clause></subparagraph><subparagraph id="HBD32DB20B7674AFF8706470007ED8C6D"><enum>(C)</enum><header>State and
Federal per capita SCHIP expenditures</header><text>The State and Federal per
capita SCHIP expenditures for a fiscal year is equal to—</text>
<clause id="HCBC616BD99524FF0B9E900689970E35F"><enum>(i)</enum><text>the aggregate
Federal and State expenditures made that are attributable to allotments under
this title for subsection (b) States for the fiscal year; divided by</text>
</clause><clause id="HA45771CC5AAA40EBB186B9C1D09BB0F1"><enum>(ii)</enum><text>the average total
number of targeted low-income children (including pregnant women described in
section 2105(c)(8)(E)) for whom health assistance was made available from such
allotments for such fiscal year.</text>
</clause></subparagraph></paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H17891DDF2BF74066B995D5AF71ADD56C"><enum>(C)</enum><text>by striking
paragraphs (3) and (4) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HFB59017F88B542B7AFBCED2397009889" style="OLC">
<paragraph id="HA8CBBD27EE7D46FCB3E085247FCB85C8"><enum>(3)</enum><header>Subsection
<enum-in-header>(b)</enum-in-header> State defined</header><text>In this
subsection, the term <term>subsection (b) State</term> means one of the 50
States or the District of Columbia.</text>
</paragraph><paragraph id="HC43700FA8F3649E081192330AD50DE00"><enum>(4)</enum><header>Proportional
reduction if total allotments exceed amount available</header><text>If the
Secretary estimates that the total of the allotments under this subsection for
a fiscal year (in combination with allotments made under subsection (c)) will
exceed the aggregate amount available for allotments for such fiscal year under
subsection (a), the Secretary shall reduce the amount of each allotment under
this subsection in a pro-rata manner so that such total does not exceed the
aggregate amount available for
allotments.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HA8669FE781904195A589EA047462A836"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply to
allotments for fiscal years beginning with fiscal year 2010.</text>
</paragraph></subsection><subsection id="H3244B7E4D218481194FC52EB573164BE"><enum>(b)</enum><header>No
redistribution of unused allotments</header>
<paragraph id="H18ACA62AF1774B25009FD7D5E5FE949C"><enum>(1)</enum><header>In
general</header><text>Section 2104(f) of such Act (42 U.S.C. 1397dd) is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H85301864EE724E0C87739B14E38F3640" style="OLC">
<subsection id="H6057D312CDAA4B66A5B2F1C1028EFE7E"><enum>(f)</enum><header>No
redistribution of unused allotments</header><text>There shall be no
redistribution of allotments from States that are not expended within the
period of availability under subsection
(e).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HD34B436841F74752806671813CF20022"><enum>(2)</enum><header>Effective
date</header><text>The amendment made by paragraph (1) shall apply to
allotments for fiscal years beginning with fiscal year 2007.</text>
</paragraph></subsection></section><section id="H60E9920FBE374EA7958415FDFB5FA8B"><enum>108.</enum><header>Five-year
reauthorization</header>
<subsection id="H1FFD8BAAB1104901BCCBC32D501FFC02"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2104(a) of
the Social Security Act (42 U.S.C. 1397dd(a)) is amended—</text>
<paragraph id="HACA977F140AC4C16B5B55300458CC221"><enum>(1)</enum><text>by striking
<quote>and</quote> at the end of paragraph (10);</text>
</paragraph><paragraph id="HFD6296798852464FB920AF3277301428"><enum>(2)</enum><text>by striking the
period at the end of paragraph (11) and inserting a semicolon; and</text>
</paragraph><paragraph id="H130A57F8F41044F9BB88C83D5E9126B5"><enum>(3)</enum><text>by adding at the
end the following new paragraphs:</text>
<quoted-block display-inline="no-display-inline" id="HF93B0403E8F44D15B44EEA7189818412" style="OLC">
<paragraph id="H73599D6A1F6A4442AAB5D35E90D746B5"><enum>(12)</enum><text>for fiscal year
2010, $7,000,000,000;</text>
</paragraph><paragraph id="H1A2C5AABB1234053BBB9E6B5BA00F176"><enum>(13)</enum><text display-inline="yes-display-inline">for fiscal year 2011,
$7,000,000,000;</text>
</paragraph><paragraph id="H0B994A45E2F64697A399876094B51E5E"><enum>(14)</enum><text display-inline="yes-display-inline">for fiscal year 2012,
$7,000,000,000;</text>
</paragraph><paragraph id="HCA3C237BB81248FB94B7F26D0292C162"><enum>(15)</enum><text display-inline="yes-display-inline">for fiscal year 2013, $7,500,000,000;
and</text>
</paragraph><paragraph id="HCA8774DD6B61461EA36E01E17DF1BEFD"><enum>(16)</enum><text display-inline="yes-display-inline">for fiscal year 2014,
$8,000,000,000.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H85ABAFEEEAC342F39779FC6260690283"><enum>(b)</enum><header>Continuation of
additional allotments to territories</header><text>Section 2104(c)(4)(B) of the
Social Security Act (42 U.S.C. 1397dd(c)(4)(B)) is amended by striking
<quote>2009</quote> and inserting <quote>2014</quote>.</text>
</subsection><subsection id="HD17A18251EE940FF0078793619A997E1"><enum>(c)</enum><header>Application to
other SCHIP funding for fiscal year 2010</header><text>Notwithstanding any
other provision of law, if funds are appropriated under any law (other than
this Act) to provide allotments to States under title XXI of the Social
Security Act for all (or any portion) of fiscal year 2010—</text>
<paragraph id="HA8AE8161D6EA43198C93E91383E16C69"><enum>(1)</enum><text>any amounts that
are so appropriated that are not so allotted and obligated before the date of
the enactment of this Act are rescinded; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HFCF3C77F051347589740B37BB58C344E"><enum>(2)</enum><text>any amount
provided for such title XXI allotments to a State under this Act (and the
amendments made by this Act) for such fiscal year shall be reduced by the
amount of such appropriations so allotted and obligated before such
date.</text>
</paragraph></subsection></section><section id="HDB14BD12AE2043F398422ED372143D27"><enum>109.</enum><header>Enhancing the
programmatic focus on children and pregnant women</header>
<subsection id="HEDC187A45F644CAEB8ADDB51C9009CB0"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2107(f) of
the Social Security Act (42 U.S.C. 1397gg(f)) is amended by striking
<quote>childless</quote>.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H03E7BB0C4CD441338FC567F465E9A65"><enum>(b)</enum><header>Effective
date</header><text display-inline="yes-display-inline">The amendment made by
subsection (a) shall take effect on the date of the enactment of this Act but
shall not apply to projects, including extensions, amendments, or renewals to
such projects, that are in effect or have been approved on the date of the
enactment of this Act.</text>
</subsection></section><section id="HF60E5A84CD5149FF9D2D37EA3F5636C6"><enum>110.</enum><header>Grants for
outreach and enrollment</header>
<subsection id="H3AADDF7ABA0840F5A4E59E6E57D570FD"><enum>(a)</enum><header>Grants</header><text>Title
XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) is amended by adding
at the end the following:</text>
<quoted-block act-name="Social Security Act" id="H976064E5141749289E8DFC883B62B048" style="OLC">
<section id="H666C59CF9CFE48D1AA05E866885303D1"><enum>2111.</enum><header>Grants to
improve outreach and enrollment</header>
<subsection id="H89286CE01C754B57AF14B7B2E53FDBCD"><enum>(a)</enum><header>Outreach and
enrollment grants; national campaign</header>
<paragraph id="H711178D1B93B4E2DBBC74DF852289472"><enum>(1)</enum><header>In
general</header><text>From the amounts appropriated for a fiscal year under
subsection (f), subject to paragraph (2), the Secretary shall award grants to
eligible entities to conduct outreach and enrollment efforts that are designed
to increase the enrollment and participation of eligible children under this
title and title XIX.</text>
</paragraph><paragraph commented="no" id="H28C09F21372D418590814C54262868D8"><enum>(2)</enum><header>10 percent set
aside for national enrollment campaign</header><text>An amount equal to 10
percent of such amounts for the fiscal year shall be used by the Secretary for
expenditures during the fiscal year to carry out a national enrollment campaign
in accordance with subsection (g).</text>
</paragraph></subsection><subsection commented="no" id="H4315453363D040E79C7F9F674E67A600"><enum>(b)</enum><header>Award of
grants</header>
<paragraph id="H27844706FDB04A4A9FC1A6601F3E3294"><enum>(1)</enum><header>Priority for
Awarding</header>
<subparagraph id="H15F3136E6DDA492C8C657495B0BA4D1C"><enum>(A)</enum><header>In
general</header><text>In awarding grants under subsection (a), the Secretary
shall give priority to eligible entities that—</text>
<clause id="H22BA5CFF12F245BEBAE058056DA2DC7"><enum>(i)</enum><text>propose to target
geographic areas with high rates of—</text>
<subclause id="H414C96D1625B477D91DCD9F2C832E2CD"><enum>(I)</enum><text>eligible but
unenrolled children, including such children who reside in rural areas;
or</text>
</subclause><subclause id="H7550ED8492B94FA9953BE8E67EFCD211"><enum>(II)</enum><text>racial and ethnic
minorities and health disparity populations, including those proposals that
address cultural and linguistic barriers to enrollment; and</text>
</subclause></clause><clause id="H7D473B5CDE1B489CB47D5465D71C4E35"><enum>(ii)</enum><text>submit the most
demonstrable evidence required under paragraphs (1) and (2) of subsection
(c).</text>
</clause></subparagraph><subparagraph id="HA3C6BC00BD1F4DEC945194482CCD5E1C"><enum>(B)</enum><header>10 percent set
aside for outreach to indian children</header><text>An amount equal to 10
percent of the funds appropriated under subsection (f) for a fiscal year shall
be used by the Secretary to award grants to Indian Health Service providers and
urban Indian organizations receiving funds under title V of the
<act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
(25 U.S.C. 1651 et seq.) for outreach to, and enrollment of, children who are
Indians.</text>
</subparagraph></paragraph><paragraph id="H43E541290BF346FB8E056643C23B357E"><enum>(2)</enum><header>2-year
availability</header><text>A grant awarded under this section for a fiscal year
shall remain available for expenditure through the end of the succeeding fiscal
year.</text>
</paragraph></subsection><subsection id="HFA1E26484CD3437A9DBC3D5B53694EDE"><enum>(c)</enum><header>Application</header><text>An
eligible entity that desires to receive a grant under subsection (a) shall
submit an application to the Secretary in such form and manner, and containing
such information, as the Secretary may decide. Such application shall
include—</text>
<paragraph id="HFEC9A4F2B17A44CFB9DF3EBBB85C0040"><enum>(1)</enum><text>evidence
demonstrating that the entity includes members who have access to, and
credibility with, ethnic or low-income populations in the communities in which
activities funded under the grant are to be conducted;</text>
</paragraph><paragraph id="H805D28FD92C649B78D1045E814056FF9"><enum>(2)</enum><text>evidence
demonstrating that the entity has the ability to address barriers to
enrollment, such as lack of awareness of eligibility, stigma concerns and
punitive fears associated with receipt of benefits, and other cultural barriers
to applying for and receiving child health assistance or medical
assistance;</text>
</paragraph><paragraph id="HEB4FADC45B6D44DDBC00B5077B3C1C34"><enum>(3)</enum><text>specific quality
or outcomes performance measures to evaluate the effectiveness of activities
funded by a grant awarded under this section; and</text>
</paragraph><paragraph id="HC8DCF73D10874F7BAA251CCB70DB4CC"><enum>(4)</enum><text>an assurance that
the eligible entity shall—</text>
<subparagraph id="H6A99F7B4036E48D18086F8F341CB04B"><enum>(A)</enum><text>conduct an
assessment of the effectiveness of such activities against the performance
measures;</text>
</subparagraph><subparagraph id="H587C7DFE726E4AD99707B70013811F58"><enum>(B)</enum><text>cooperate with the
collection and reporting of enrollment data and other information in order for
the Secretary to conduct such assessments; and</text>
</subparagraph><subparagraph id="HE5A739EECC8C4DAD804320D7FDC951D"><enum>(C)</enum><text>in the case of an
eligible entity that is not the State, provide the State with enrollment data
and other information as necessary for the State to make necessary projections
of eligible children and pregnant women.</text>
</subparagraph></paragraph></subsection><subsection id="H176476B084624577A56CA9A34BCCE6CD"><enum>(d)</enum><header>Supplement, Not
Supplant</header><text>Federal funds awarded under this section shall be used
to supplement, not supplant, non-Federal funds that are otherwise available for
activities funded under this section.</text>
</subsection><subsection id="H06A13E6251CB4541B3FD78DBAD3B581F"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H0C74E46D23B34518BF7FADE6ADEF2E00"><enum>(1)</enum><header>Eligible
entity</header><text>The term <term>eligible entity</term> means any of the
following:</text>
<subparagraph id="HA6E6D37EA1B14CD18E2FA4914F54BB89"><enum>(A)</enum><text>A State with an
approved child health plan under this title.</text>
</subparagraph><subparagraph id="H7772B4A901F44A79889CD5144D6489D9"><enum>(B)</enum><text>A local
government.</text>
</subparagraph><subparagraph id="H6D07214751174A06B176E8814868C9C6"><enum>(C)</enum><text>An Indian tribe or
tribal consortium, a tribal organization, an urban Indian organization
receiving funds under title V of the <act-name parsable-cite="IHCIA">Indian
Health Care Improvement Act</act-name> (25 U.S.C. 1651 et seq.), or an Indian
Health Service provider.</text>
</subparagraph><subparagraph id="HAC8F3304303345C8ADB1B4989BF4FF47"><enum>(D)</enum><text>A Federal health
safety net organization.</text>
</subparagraph><subparagraph id="H853490AAD6DD4812AD5FD4EDB98FEC2"><enum>(E)</enum><text>A State, national,
local, or community-based public or nonprofit private organization.</text>
</subparagraph><subparagraph id="H14BB62366D6340AFB710E7C83727F5C7"><enum>(F)</enum><text>A faith-based
organization or consortia, to the extent that a grant awarded to such an entity
is consistent with the requirements of section 1955 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
300x–65) relating to a grant award to non-governmental entities.</text>
</subparagraph><subparagraph id="H5A21102F008548CB8492A17641758D6E"><enum>(G)</enum><text>An elementary or
secondary school.</text>
</subparagraph><subparagraph id="H6421C2D5AEF94268A6E9B5E2A6FE9A5"><enum>(H)</enum><text>A national, local,
or community-based public or nonprofit private organization, including
organizations that use community health workers or community-based doula
programs.</text>
</subparagraph></paragraph><paragraph id="H699872C06F3A4F199B19A9180FD446F"><enum>(2)</enum><header>Federal health
safety net organization</header><text>The term <term>Federal health safety net
organization</term> means—</text>
<subparagraph id="H10D67EEAC32E4AB49C745B06F3CEDC98"><enum>(A)</enum><text>a federally
qualified health center (as defined in section 1905(l)(2)(B));</text>
</subparagraph><subparagraph id="H8AE10A12129E444B80EA76C0D813F909"><enum>(B)</enum><text>a hospital defined
as a disproportionate share hospital for purposes of section 1923;</text>
</subparagraph><subparagraph id="H3B34EAF1184D48C9B312CC7703C9008E"><enum>(C)</enum><text>a covered entity
described in section 340B(a)(4) of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name> (42 U.S.C. 256b(a)(4)); and</text>
</subparagraph><subparagraph id="H457D95127D9A4E6AA2DB5E36378704F2"><enum>(D)</enum><text>any other entity
or consortium that serves children under a federally funded program, including
the special supplemental nutrition program for women, infants, and children
(WIC) established under section 17 of the <act-name parsable-cite="CNA66">Child
Nutrition Act of 1966</act-name> (42 U.S.C. 1786), the head start and early
head start programs under the <act-name parsable-cite="HSA">Head Start
Act</act-name> (42 U.S.C. 9801 et seq.), the school lunch program established
under the Richard B. Russell <act-name parsable-cite="NSLA">National School
Lunch Act</act-name>, and an elementary or secondary school.</text>
</subparagraph></paragraph><paragraph id="HF17F5CB32AFC4FAD9FB22C0377885C53"><enum>(3)</enum><header>Indians; indian
tribe; tribal organization; urban indian organization</header><text>The terms
<term>Indian</term>, <term>Indian tribe</term>, <term>tribal
organization</term>, and <term>urban Indian organization</term> have the
meanings given such terms in section 4 of the <act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name> (25 U.S.C.
1603).</text>
</paragraph><paragraph id="H69BD7C46DCDC4C098490F59257A5D0E6"><enum>(4)</enum><header>Community health
worker</header><text>The term <term>community health worker</term> means an
individual who promotes health or nutrition within the community in which the
individual resides—</text>
<subparagraph id="HF2AD33203BB54A0FB9C9E629796D4766"><enum>(A)</enum><text>by serving as a
liaison between communities and health care agencies;</text>
</subparagraph><subparagraph id="H40F68C4ED04C4AACA8EC00D500AEF69F"><enum>(B)</enum><text>by providing
guidance and social assistance to community residents;</text>
</subparagraph><subparagraph id="HC16799772C914B928700C56500E1ABC6"><enum>(C)</enum><text>by enhancing
community residents’ ability to effectively communicate with health care
providers;</text>
</subparagraph><subparagraph id="HB029F9ECD5044F52865D6BE59EF412F6"><enum>(D)</enum><text>by providing
culturally and linguistically appropriate health or nutrition education;</text>
</subparagraph><subparagraph id="H5F5AEC8E52264BE5AAA2CD7D84D40D3"><enum>(E)</enum><text>by advocating for
individual and community health or nutrition needs; and</text>
</subparagraph><subparagraph id="H6879840A45AD4A4F974595D7AD39AD12"><enum>(F)</enum><text>by providing
referral and followup services.</text>
</subparagraph></paragraph></subsection><subsection id="H5746D36014FE434EA5CE9638463BED70"><enum>(f)</enum><header>Appropriation</header>
<paragraph id="H28F1BEB21EE049C3A022DB00F3907298"><enum>(1)</enum><header>In
general</header><text>There is appropriated, out of any money in the Treasury
not otherwise appropriated, for the purpose of awarding grants under this
section $100,000,000 for each of fiscal years 2010 through 2014.</text>
</paragraph><paragraph id="H2F2CEADC839546EB968607481B669037"><enum>(2)</enum><header>Grants in
addition to other amounts paid</header><text>Amounts appropriated and paid
under the authority of this section shall be in addition to amounts
appropriated under section 2104 and paid to States in accordance with section
2105, including with respect to expenditures for outreach activities in
accordance with subsections (a)(1)(D)(iii) and (c)(2)(C) of that
section.</text>
</paragraph></subsection><subsection commented="no" id="H00EB8C26740C4A9688B98DF5E2912FAB"><enum>(g)</enum><header>National
Enrollment Campaign</header><text>From the amounts made available under
subsection (a)(2) for a fiscal year, the Secretary shall develop and implement
a national enrollment campaign to improve the enrollment of underserved child
populations in the programs established under this title and title XIX. Such
campaign may include—</text>
<paragraph commented="no" id="H1A5E6CF1607D4FF19120B3F8844394D4"><enum>(1)</enum><text>the establishment
of partnerships with the Secretary of Education and the Secretary of
Agriculture to develop national campaigns to link the eligibility and
enrollment systems for the assistance programs each Secretary administers that
often serve the same children;</text>
</paragraph><paragraph commented="no" id="H79FD75FC66804D56A3C1E600B1EF4899"><enum>(2)</enum><text>the integration of
information about the programs established under this title and title XIX in
public health awareness campaigns administered by the Secretary;</text>
</paragraph><paragraph commented="no" id="HEDDB9AB633FC408CA1702351165075F0"><enum>(3)</enum><text>increased
financial and technical support for enrollment hotlines maintained by the
Secretary to ensure that all States participate in such hotlines;</text>
</paragraph><paragraph commented="no" id="H052FFC373F274B71840479EA53A94A1"><enum>(4)</enum><text>the establishment
of joint public awareness outreach initiatives with the Secretary of Education
and the Secretary of Labor regarding the importance of health insurance to
building strong communities and the economy;</text>
</paragraph><paragraph commented="no" id="H54F289405CF44415BDAE5105A5D8D926"><enum>(5)</enum><text>the development of
special outreach materials for Native Americans or for individuals with limited
English proficiency; and</text>
</paragraph><paragraph commented="no" id="HEBF0942959224B62AF994D00EC8B67EF"><enum>(6)</enum><text>such other
outreach initiatives as the Secretary determines would increase public
awareness of the programs under this title and title
XIX.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H9D8AA56F12CF4AC48C7D18C8E6BBBA00"><enum>(b)</enum><header>Nonapplication
of administrative expenditures cap</header><text>Section 2105(c)(2) of the
Social Security Act (42 U.S.C. 1397ee(c)(2)) is amended by adding at the end
the following:</text>
<quoted-block display-inline="no-display-inline" id="H36AE2A5284214A329E20A642B55489B4" style="OLC">
<subparagraph id="HAC5EFC9EA1ED477383578282D6009B71"><enum>(C)</enum><header>Nonapplication
to expenditures for outreach and enrollment</header><text>The limitation under
subparagraph (A) shall not apply with respect to expenditures for outreach
activities under section 2102(c)(1), or for enrollment activities, for children
eligible for child health assistance under the State child health plan or
medical assistance under the State plan under title
XIX.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><enum>II</enum><header>Child health
insurance coverage through tax fairness</header>
<section id="H790E9D5D970F43BDB8F3211B6B86DB24"><enum>201.</enum><header>Expansion of
child health care insurance coverage through tax fairness</header>
<subsection id="H62BD0321EAEF4D4481D8CD79C261EA36"><enum>(a)</enum><header>In
general</header><text>Subpart C of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to refundable credits) is amended by
redesignating section 37 as section 38 and by inserting after section 36 the
following new section:</text>
<quoted-block id="HB4BAB5F59C9643C8B7CF0E2062CC815">
<section id="H2B08E77AA8E5496C8CE1965F5B548C84"><enum>37.</enum><header>Child health
insurance costs</header>
<subsection id="H115741BB8E3D4BAA92FC746118B36749"><enum>(a)</enum><header>In
general</header><text>In the case of an eligible taxpayer, there shall be
allowed as a credit against the tax imposed by this subtitle an amount equal to
the amount paid by the taxpayer during the taxable year for qualified health
insurance for any dependent child of such taxpayer.</text>
</subsection><subsection id="HF319B3CAAE064B3181A6A14BC1496407"><enum>(b)</enum><header>Limitations</header>
<paragraph id="H893B944196EB4FA4BFFC4BB8E2EA1C"><enum>(1)</enum><header>In
general</header><text>The amount allowed as a credit under subsection (a) to an
eligible taxpayer for the taxable year shall not exceed the sum of the monthly
limitations for coverage months during such taxable year for the individual
referred to in subsection (a) for whom such taxpayer paid during the taxable
year any amount for coverage under qualified health insurance.</text>
</paragraph><paragraph id="H1512C6D9F38D4A7A9230B57EF005E2E"><enum>(2)</enum><header>Monthly
limitation</header><text>The monthly limitation for an individual for each
coverage month of such individual during the taxable year is the amount equal
to <fraction>1/12</fraction> of $1,400.</text>
</paragraph><paragraph id="HAF05D30FCC114E0A902B31603B909DEA"><enum>(3)</enum><header>Coverage
month</header><text>For purposes of this subsection—</text>
<subparagraph id="H3FB668FC203A4FB2A764027B936FC5B"><enum>(A)</enum><header>In
general</header><text>The term <term>coverage month</term> means, with respect
to an individual, any month if—</text>
<clause id="HD615457C883C4F929FC62076A6177891"><enum>(i)</enum><text>as
of the first day of such month such individual is covered by qualified health
insurance, and</text>
</clause><clause id="H73E2E9F542F046BEB0383247599BD9C9"><enum>(ii)</enum><text>the premium for
coverage under such insurance for such month is paid by an eligible
taxpayer.</text>
</clause></subparagraph><subparagraph id="HE860B77C382B4865B6E72B1000FA0052"><enum>(B)</enum><header>Medicare and
medicaid</header><text>Such term shall not include any month with respect to an
individual if, as of the first day of such month, such individual—</text>
<clause id="H9059C3C8484E4B01843305917782198B"><enum>(i)</enum><text>is
entitled to any benefits under title XVIII of the <act-name parsable-cite="SSA">Social Security Act</act-name>, or</text>
</clause><clause id="HCFB71245D7A64062B71697139835E2C0"><enum>(ii)</enum><text>is a participant
in the program under title XIX or XXI of such Act.</text>
</clause></subparagraph><subparagraph id="H60994029FC954C668374591540AED2A0"><enum>(C)</enum><header>Certain other
coverage</header><text>Such term shall not include any month during a taxable
year with respect to an individual if, at any time during such year, any
benefit is provided to such individual under chapter 89 of title 5, United
States Code.</text>
</subparagraph><subparagraph id="H67A6DADEFBD5403E9997D0F7FCE19CF0"><enum>(D)</enum><header>Insufficient
presence in United States</header><text>Such term shall not include any month
during a taxable year with respect to an individual if such individual is
present in the United States on fewer than 183 days during such year
(determined in accordance with section 7701(b)(7)).</text>
</subparagraph></paragraph><paragraph id="HA16341B1E44746F4B8AF08AD753ED2E"><enum>(4)</enum><header>Indexing</header><text>For
each taxable year beginning after December 31, 2009, the dollar amount in
paragraph (2) (as adjusted for the preceding taxable year by reason of this
paragraph) shall be increased or decreased by the percentage change in the
average cost of private health insurance for family coverage for such taxable
year as compared to such preceding taxable year as computed by the Office of
the Actuary of the Centers for Medicare and Medicaid Services, rounded to the
nearest whole dollar amount.</text>
</paragraph></subsection><subsection id="H7DB70DB268964993BF44A2B62803881F"><enum>(c)</enum><header>Qualified health
insurance</header><text>For purposes of this section—</text>
<paragraph id="HCD5369870DD94347BFFB24C16D68C8C"><enum>(1)</enum><header>In
general</header><text>The term <term>qualified health insurance</term> means
insurance which constitutes medical care as defined in section 213(d) without
regard to—</text>
<subparagraph id="H8A3135443D184331BA757B69002BF988"><enum>(A)</enum><text>paragraph (1)(C)
thereof, and</text>
</subparagraph><subparagraph id="H38946FB51EDE45618D1740F6007D962B"><enum>(B)</enum><text>so much of
paragraph (1)(D) thereof as relates to qualified long-term care insurance
contracts.</text>
</subparagraph></paragraph><paragraph id="HFB17862F4CDA4DBDB549E1CC046F38F2"><enum>(2)</enum><header>Exclusion of
certain other contracts</header><text>Such term shall not include insurance if
a substantial portion of its benefits are excepted benefits (as defined in
section 9832(c)).</text>
</paragraph></subsection><subsection id="H9F00794FD06847AA8CDC3C68BD200074"><enum>(d)</enum><header>Eligible
taxpayer; dependent; child</header><text>For purposes of this section—</text>
<paragraph id="HD74AD67393834590B4C39EC9E3DE55B2"><enum>(1)</enum><header>Eligible
taxpayer</header><text>The term <term>eligible taxpayer</term> means any
taxpayer whose income exceeds 200 percent but not 300 percent of the poverty
level applicable to a family of the size involved, as determined in accordance
with criteria established by the Director of the Office of Management and
Budget.</text>
</paragraph><paragraph commented="no" id="H98D52744F5EB4B5EA327C005E52963FA"><enum>(2)</enum><header>Dependent</header><text display-inline="yes-display-inline">The term <term>dependent</term> has the
meaning given such term by section 152. An individual to whom section 152(e)
applies shall be treated as a dependent of the custodial parent for a coverage
month unless the custodial and noncustodial parent provide otherwise.</text>
</paragraph><paragraph id="H4CE899FC2A96454486C4BF436FDC3BDB"><enum>(3)</enum><header>Child</header><text display-inline="yes-display-inline">The term <term>child</term> means a
qualifying child (as defined in section 152(c).</text>
</paragraph></subsection><subsection id="HFBBDF59E8AD848FF9745D580E443844B"><enum>(e)</enum><header>Special
rules</header>
<paragraph id="H22B6AFFA1B9140DAAD89379D36D5E3D3"><enum>(1)</enum><header>Coordination
with medical deduction, etc</header><text>Any amount paid by an eligible
taxpayer for insurance to which subsection (a) applies shall not be taken into
account in computing the amount allowable to such taxpayer as a credit under
section 35, as a deduction under section 213(a) or 162(l), or as an exclusion
from gross income under section 106 or 125.</text>
</paragraph><paragraph id="H19C54D18AE63436EA8423C66D2752F78"><enum>(2)</enum><header>Denial of credit
to dependents</header><text>No credit shall be allowed under this section to
any individual with respect to whom a deduction under section 151 is allowable
to another taxpayer for a taxable year beginning in the calendar year in which
such individual’s taxable year begins.</text>
</paragraph><paragraph id="H0DFE48575F0A4219B53FB14928FFD100"><enum>(3)</enum><header>Married couples
must file joint return</header>
<subparagraph id="H8137162262FA479A892289B218D2F911"><enum>(A)</enum><header>In
general</header><text>If an eligible taxpayer is married at the close of the
taxable year, the credit shall be allowed under subsection (a) only if the
taxpayer and his spouse file a joint return for the taxable year.</text>
</subparagraph><subparagraph id="H343C0EF81CF844208D109B6C515D07F9"><enum>(B)</enum><header>Marital status;
certain married individuals living apart</header><text>Rules similar to the
rules of paragraphs (3) and (4) of section 21(e) shall apply for purposes of
this paragraph.</text>
</subparagraph></paragraph><paragraph id="H95D5FCFCCF5A4A719130641B79D2D43D"><enum>(4)</enum><header>Verification of
coverage, etc</header><text>No credit shall be allowed under this section with
respect to any individual unless such individual’s coverage (and such related
information as the Secretary may require) is verified in such manner as the
Secretary may prescribe.</text>
</paragraph><paragraph id="H159B9AAB8DB04CD7B3137CACEB5F4FE8"><enum>(5)</enum><header>Insurance which
covers other individuals; treatment of payments</header><text>Rules similar to
the rules of paragraphs (7) and (8) of section 35(g) shall apply for purposes
of this section.</text>
</paragraph><paragraph id="HD7F71963539045AAAE94BA22D6EBA054"><enum>(6)</enum><header>Election not to
claim credit</header><text>This section shall not apply to an eligible taxpayer
for any taxable year if such taxpayer elects to have this section not apply for
such taxable year.</text>
</paragraph></subsection><subsection id="H2E725E8AAEE147DB0036EFB9F4C4C00"><enum>(f)</enum><header>Coordination with
advance payments</header><text>With respect to any taxable year, the amount
which would (but for this subsection) be allowed as a credit to an eligible
taxpayer under subsection (a) shall be reduced (but not below zero) by the
aggregate amount paid on behalf of such taxpayer under section 7527A for months
beginning in such taxable
year.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H4726C811C01B4FF2958946326E003997"><enum>(b)</enum><header>Information
reporting</header>
<paragraph id="HA5705BB175FD43C7B7C178F5AAEF264C"><enum>(1)</enum><header>In
general</header><text>Subpart B of part III of subchapter A of chapter 61 of
the Internal Revenue Code of 1986 (relating to information concerning
transactions with other persons) is amended by inserting after section 6050W
the following new section:</text>
<quoted-block id="H664B6D2788694A5193BEB0DF30DA1324">
<section id="HB004CD1B0A7140918D58B746BB006500"><enum>6050X.</enum><header>Returns
relating to payments for qualified health insurance</header>
<subsection id="H122C7719D7F74955AC4C416CC683444C"><enum>(a)</enum><header>In
general</header><text>Any person who, in connection with a trade or business
conducted by such person, receives payments during any calendar year from any
individual for coverage of such individual or any other individual under
qualified health insurance (as defined in section 37(c)), shall make the return
described in subsection (b) (at such time as the Secretary may by regulations
prescribe) with respect to each individual from whom such payments were
received.</text>
</subsection><subsection id="H722460944D87467D8DCFF145A87D78CF"><enum>(b)</enum><header>Form and manner
of returns</header><text>A return is described in this subsection if such
return—</text>
<paragraph id="H4E0A6067EFD942258CE2AA9D8F3337ED"><enum>(1)</enum><text>is in such form as
the Secretary may prescribe, and</text>
</paragraph><paragraph id="H7794D8548F9343768C4BD79B2597FCAD"><enum>(2)</enum><text>contains—</text>
<subparagraph id="HEE799E30467B45A09C40F734DF78FC13"><enum>(A)</enum><text>the name, address,
and TIN of the individual from whom payments described in subsection (a) were
received,</text>
</subparagraph><subparagraph id="H0009EC7E524D4B4199F38087C6312B7"><enum>(B)</enum><text>the name, address,
and TIN of each individual who was provided by such person with coverage under
qualified health insurance (as so defined) by reason of such payments and the
period of such coverage, and</text>
</subparagraph><subparagraph id="H0380DCF8A80E4086A8E2C1B0B44C8F07"><enum>(C)</enum><text>such other
information as the Secretary may reasonably prescribe.</text>
</subparagraph></paragraph></subsection><subsection id="H2634C63A5C8A446B941699006731B666"><enum>(c)</enum><header>Statements To be
furnished to individuals with respect to whom information is
required</header><text>Every person required to make a return under subsection
(a) shall furnish to each individual whose name is required under subsection
(b)(2)(A) to be set forth in such return a written statement showing—</text>
<paragraph id="H7F7BA12BB86B41DABE3055E193CEFD8F"><enum>(1)</enum><text>the name and
address of the person required to make such return and the phone number of the
information contact for such person,</text>
</paragraph><paragraph id="HD22A76C74FC6464AA1303D7D5E7327C9"><enum>(2)</enum><text>the aggregate
amount of payments described in subsection (a) received by the person required
to make such return from the individual to whom the statement is required to be
furnished, and</text>
</paragraph><paragraph id="HB4F95522B5BE45BCA4CE3FA6D45BEF04"><enum>(3)</enum><text>the information
required under subsection (b)(2)(B) with respect to such payments.</text>
</paragraph><continuation-text continuation-text-level="subsection">The
written statement required under the preceding sentence shall be furnished on
or before January 31 of the year following the calendar year for which the
return under subsection (a) is required to be made.</continuation-text></subsection><subsection id="H2E0A24D6893E477585099200666F6300"><enum>(d)</enum><header>Returns which
would be required To be made by 2 or more persons</header><text>Except to the
extent provided in regulations prescribed by the Secretary, in the case of any
amount received by any person on behalf of another person, only the person
first receiving such amount shall be required to make the return under
subsection
(a).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H63C90B2E1CBA404CA316004F012346DB"><enum>(2)</enum><header>Assessable
penalties</header>
<subparagraph id="H3DECC74FA858438883DA093E3815DB4"><enum>(A)</enum><text>Subparagraph (B) of
section 6724(d)(1) of such Code (relating to definitions) is amended by
redesignating clauses (xxi) through (xxii) as clauses (xxii) through (xxv),
respectively, and by inserting after clause (xxi) the following new
clause:</text>
<quoted-block id="H9B7B12B16761492093C82E92D1DC40B">
<clause id="HA33DF9992B1C4A968D764B3C39DE7EC9"><enum>(xxii)</enum><text>section 6050X
(relating to returns relating to payments for qualified health
insurance),</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H13C484C684104E98B4A370052CD8CE00"><enum>(B)</enum><text>Paragraph (2) of
section 6724(d) of such Code is amended by redesignating subparagraphs (EE) and
(FF) as subparagraphs (FF) and (GG), respectively, and by inserting after
subparagraph (DD) the following new subparagraph:</text>
<quoted-block id="H740F2C9B47CF4ECDBA3ECFCF4E8CB16">
<subclause id="HF1EA22D2F1C14245B4F02F95BB23F74C" indent="up2"><enum>(EE)</enum><text>section 6050X(c) (relating to
returns relating to payments for qualified health
insurance).</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HE132702DF2454960BA8B249CE3321DE"><enum>(3)</enum><header>Clerical
amendment</header><text>The table of sections for subpart B of part III of
subchapter A of chapter 61 of such Code is amended by inserting after the item
relating to section 6050W the following new item:</text>
<quoted-block id="H1DF42DDDD192441FB190A3900E2F5E0" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 6050X. Returns relating to payments
for qualified health
insurance.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HBC476D5359084E6C98C6D9EE47F079CC"><enum>(c)</enum><header>Advance payment
of credit for purchasers of qualified health insurance</header>
<paragraph id="HC16B738FA3714FF796EF99DBDCE20079"><enum>(1)</enum><header>In
general</header><text>Chapter 77 of the Internal Revenue Code of 1986 (relating
to miscellaneous provisions) is amended by adding at the end the following new
section:</text>
<quoted-block id="H473E90F34DCA448CA7E91794D44C2657">
<section id="HDDF8C9F99F144265A01EB4413EFF1DC3"><enum>7529.</enum><header>Advance
payment of health insurance credit for purchasers of qualified health
insurance</header>
<subsection id="H12F9F591BAE9494B9C75D300FF105810"><enum>(a)</enum><header>General
rule</header><text>In the case of an eligible individual, the Secretary shall
make payments to the provider of such individual’s qualified health insurance
equal to such individual’s qualified health insurance credit advance amount
with respect to such provider.</text>
</subsection><subsection id="HF7202A52922D489CBD1D048F8271C124"><enum>(b)</enum><header>Eligible
individual</header><text>For purposes of this section, the term <term>eligible
individual</term> means any individual—</text>
<paragraph id="H76FDC8867A6544798CD41416FC1ED7C9"><enum>(1)</enum><text>who purchases
qualified health insurance (as defined in section 37(c)), and</text>
</paragraph><paragraph id="H521CAECBD42447828F4DF9CA76FC9E5C"><enum>(2)</enum><text>for whom a
qualified health insurance credit eligibility certificate is in effect.</text>
</paragraph></subsection><subsection id="H5392D03BF1AF43B6AB65EAB4DE86669C"><enum>(c)</enum><header>Qualified health
insurance credit eligibility certificate</header><text>For purposes of this
section, a qualified health insurance credit eligibility certificate is a
statement furnished by an individual to the Secretary which—</text>
<paragraph id="H8E4B40A777AD45E6804EA45D1D40B63C"><enum>(1)</enum><text>certifies that the
individual will be eligible to receive the credit provided by section 37 for
the taxable year,</text>
</paragraph><paragraph id="HBF4FE052216D4F2ABBBB3CCEFE69FFA4"><enum>(2)</enum><text>estimates the
amount of such credit for such taxable year, and</text>
</paragraph><paragraph id="HA3AB43415B0A48D6B8DD11ED2CD9FAA9"><enum>(3)</enum><text>provides such
other information as the Secretary may require for purposes of this
section.</text>
</paragraph></subsection><subsection id="HF32B50F8DB53417E97CCFBAF252DDAB"><enum>(d)</enum><header>Qualified health
insurance credit advance amount</header><text>For purposes of this section, the
term <term>qualified health insurance credit advance amount</term> means, with
respect to any provider of qualified health insurance, the Secretary’s estimate
of the amount of credit allowable under section 37 to the individual for the
taxable year which is attributable to the insurance provided to the individual
by such provider.</text>
</subsection><subsection id="H85454DBE8CDC48EBB33DE166A3DE645D"><enum>(e)</enum><header>Regulations</header><text>The
Secretary shall prescribe such regulations as may be necessary to carry out the
purposes of this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HC99FD6D9FD3F43409FDC3C3A901B958"><enum>(2)</enum><header>Clerical
amendment</header><text>The table of sections for chapter 77 of such Code is
amended by adding at the end the following new item:</text>
<quoted-block id="H410BE5ADA7604ADA90A4B9DC3D42F14B" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 7529. Advance payment of health
insurance credit for purchasers of qualified health
insurance.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H40C0CBA638FB4912A5D85231203FB9D2"><enum>(d)</enum><header>Conforming
amendments</header>
<paragraph id="H24B79DFBC99044D0A429C5484B34DB22"><enum>(1)</enum><text>Paragraph (2) of
section 1324(b) of title 31, United States Code, is amended by inserting before
the period <quote>, or from section 37 of such Code</quote>.</text>
</paragraph><paragraph id="H37FD1ADBFD034C81A4B0BAFD4BE7C936"><enum>(2)</enum><text>The table of
sections for subpart C of part IV of subchapter A of chapter 1 of the Internal
Revenue Code of 1986 is amended by striking the last item and inserting the
following new items:</text>
<quoted-block id="H982DFB20452D4CC0987E7622BB24644" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 37. Health insurance
costs.</toc-entry>
<toc-entry level="section">Sec. 38. Overpayments of
tax.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H84AFD2678DFD4033AF4CDF75424480A"><enum>(e)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2008.</text>
</subsection></section><enum>III</enum><header>State health
reform projects</header>
<section id="HF79AFF5E91084113834D5306E2A11754"><enum>301.</enum><header>State health
reform projects</header>
<subsection id="H3F600769621D48D091E5F06B60AE6520"><enum>(a)</enum><header>Purposes;
Establishment of State Health Care Expansion and Improvement Program</header>
<paragraph id="HB43D5B6D72354BA09FF5C5D5F8635B00"><enum>(1)</enum><header>Purposes</header><text>The
purposes of the programs approved under this section shall include, but not be
limited to—</text>
<subparagraph id="H15B00E8572824AE70059B2AE6FA25BD9"><enum>(A)</enum><text>achieving the
goals of increased health coverage and access; and</text>
</subparagraph><subparagraph id="H6137C8FA64554C40BED8C7E36F3CC2A8"><enum>(B)</enum><text>testing
alternative reforms, such as building on the public or private health systems,
or creating new systems, to achieve the objectives of this Act.</text>
</subparagraph></paragraph><paragraph id="H7FF4F2F2CBFC4FE8A8841E32E038A5B1"><enum>(2)</enum><header>Intent of
Congress</header><text display-inline="yes-display-inline">It is the intent of
Congress that—</text>
<subparagraph id="H797E9458B1474562AF8492E98383868B"><enum>(A)</enum><text>the programs
approved under this section each comprise significant coverage
expansions;</text>
</subparagraph><subparagraph id="H0E35E2CAFAC74535AD9D9545BA00EE05"><enum>(B)</enum><text>taken as a whole,
such programs should be diverse and balanced in their approaches to covering
the uninsured; and</text>
</subparagraph><subparagraph id="HE6BAE6B89C054226B234ACAA205C21AA"><enum>(C)</enum><text>each such program
should be rigorously and objectively evaluated, so that the State programs
developed pursuant to this section may guide the development of future State
and national policy.</text>
</subparagraph></paragraph></subsection><subsection id="HADFE28DBE01F4B43919F3F19052945FF"><enum>(b)</enum><header>Applications by
States and Local Governments</header>
<paragraph id="H780724A0D1C243A98249DFB000D89F22"><enum>(1)</enum><header>Entities that
may apply</header>
<subparagraph id="HA7469B3F690A4E0FAE006EB44F283638"><enum>(A)</enum><header>In
general</header><text>A State may apply for a State health care expansion and
improvement program for the entire State (or for regions of the State) under
paragraph (2).</text>
</subparagraph><subparagraph id="H68E2901AFFCB4DF500EFDDF0E6896BAF"><enum>(B)</enum><header>Regional and
sub-state groups</header><text>A regional entity consisting of more than one
State or one or more local governments within a State may apply for a
multi-State or a sub-State health care expansion and improvement program for
the region or area involved.</text>
</subparagraph><subparagraph id="H8F1918B77A904B79BA05306F23E62CF3"><enum>(C)</enum><header>Definition</header><text>In
this section, the term <term>State</term> means the 50 States, the District of
Columbia, and the Commonwealth of Puerto Rico. Such term shall include a
regional entity described in subparagraph (B).</text>
</subparagraph></paragraph><paragraph id="H2C5CE31F96434F78887259C6CC000623"><enum>(2)</enum><header>Submission of
application</header><text>In accordance with this section, each State or
regional entity desiring to implement a State health care expansion and
improvement program may submit an application to the State Health Coverage
Innovation Commission under subsection (c) (referred to in this section as the
<quote>Commission</quote>) for approval.</text>
</paragraph><paragraph id="H2B29709816D14B02BA8752D7CA96383"><enum>(3)</enum><header>Local government
applications</header><text>Where a State fails to submit an application under
this section, a unit of local government of such State, or a consortium of such
units of local governments, may submit an application directly to the
Commission for programs or projects under this subsection. Such an application
shall be subject to the requirements of this section.</text>
</paragraph></subsection><subsection id="HF17A3F5E3C3446E196D347481C056BB9"><enum>(c)</enum><header>State Health
Coverage Innovation Commission</header>
<paragraph id="H455EAABC9AA848FCA564A4A0012FB6E3"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Within 90 days after
the date of the enactment of this Act, the Secretary of Health and Human
Services (in this section referred to as the <quote>Secretary</quote>) shall
establish a State Health Coverage Innovation Commission that—</text>
<subparagraph id="H0E36405F957640EBAD3049154F9200E1"><enum>(A)</enum><text>shall be comprised
of—</text>
<clause id="HE47A1BD53D9D4353B835C1B2D8626101"><enum>(i)</enum><text>the
Secretary;</text>
</clause><clause id="H86D48EDE616E407EA7E269C8C61440FC"><enum>(ii)</enum><text>four State
governors to be appointed by the National Governors Association on a bipartisan
basis;</text>
</clause><clause id="H09598FA5A1D642D2BEFBEE23FAC4387D"><enum>(iii)</enum><text display-inline="yes-display-inline">two members of a State legislature to be
appointed, on a joint and bipartisan basis, by the National Conference of State
Legislators and the American Legislative Exchange Council;</text>
</clause><clause id="H808D1116B4D5477888736979CFD14295"><enum>(iv)</enum><text>two
county officials to be appointed by the National Association of Counties on a
bipartisan basis;</text>
</clause><clause id="HA77A5060AB894A56B462AB5B4FEBE83"><enum>(v)</enum><text display-inline="yes-display-inline">two mayors to be appointed, on a joint and
bipartisan basis, by the National League of Cities and by the United States
Conference of Mayors;</text>
</clause><clause id="H63EE65EF25B942DF9895E67D08445C1E"><enum>(vi)</enum><text>two
individuals to be appointed by the Speaker of the House of
Representatives;</text>
</clause><clause id="HD3D8A9BDF68B4D4BA2825FA63D139508"><enum>(vii)</enum><text>two individuals
to be appointed by the minority leader of the House of Representatives;</text>
</clause><clause id="H24947D084EC9498BBFCDB4DEC58B27D9"><enum>(viii)</enum><text>two individuals
to be appointed by the majority leader of the Senate; and</text>
</clause><clause id="H91AC1C1D912A489380D26433C450C885"><enum>(ix)</enum><text>two
individuals to be appointed by the minority leader of the Senate;</text>
</clause></subparagraph><subparagraph id="H36D1F3C9DB014EACA7402417E95FACC2"><enum>(B)</enum><text display-inline="yes-display-inline">shall request States to submit proposals,
which may include a variety of reform options such as tax credit approaches,
expansions of public programs such as Medicaid and the State Children’s Health
Insurance Program, the creation of purchasing pooling arrangements similar to
the Federal Employees Health Benefits Program, individual market purchasing
options, single risk pool or single payer systems, health savings accounts, a
combination of the options described in this subparagraph, or other
alternatives determined appropriate by the Commission, including options
suggested by States or the public, and nothing in this subparagraph shall be
construed to prevent the Commission from approving a reform proposal not
included in this subparagraph;</text>
</subparagraph><subparagraph id="HFDC7B6E5652F430EA6F56C3853BF6600"><enum>(C)</enum><text>shall conduct a
thorough review of the grant application from a State and carry on a dialogue
with all State applicants concerning possible modifications and
adjustments;</text>
</subparagraph><subparagraph id="HC3E92A604FC749D9B0570842CC57CB23"><enum>(D)</enum><text>shall submit the
recommendations and legislative proposal described in subsection
(d)(4)(C);</text>
</subparagraph><subparagraph id="HB180A0EB98AD46F091DCF380B475DDB"><enum>(E)</enum><text display-inline="yes-display-inline">shall be responsible for receiving
information to determine the status and progress achieved under program or
projects granted under this section;</text>
</subparagraph><subparagraph id="H9C5D51FCEED14F348C6000AF945F5F77"><enum>(F)</enum><text>shall report to
the public concerning progress made by States with respect to the performance
measures and goals established under this section, the periodic progress of the
State relative to its State performance measures and goals, and the State
program application procedures, by region and State jurisdiction;</text>
</subparagraph><subparagraph id="HB496C5E0F171428FA13DC72535609E4"><enum>(G)</enum><text>shall promote
information exchange between States and the Federal Government;</text>
</subparagraph><subparagraph id="H952AC965DDE74E7B9413E523709D3457"><enum>(H)</enum><text>shall be
responsible for making recommendations to the Secretary and the Congress, using
equivalency or minimum standards, for minimizing the negative effect of State
program on national employer groups, provider organizations, and insurers
because of differing State requirements under the programs; and</text>
</subparagraph><subparagraph id="H99514A58BAE44DB9AE79BE1BCFD0ECB2"><enum>(I)</enum><text display-inline="yes-display-inline">may require States to submit additional
information or reports concerning the status and progress achieved under health
care expansion and improvement programs granted under this section, as
needed.</text>
</subparagraph></paragraph><paragraph id="HC6928C785DB442B9B336DA8010E8A832"><enum>(2)</enum><header>Period of
appointment; representation requirements; vacancies</header><text>Members shall
be appointed for a term of 5 years. In appointing such members under paragraph
(1)(A), the designated appointing individuals shall ensure the representation
of urban and rural areas and an appropriate geographic distribution of such
members. Any vacancy in the Commission shall not affect its powers, but shall
be filled in the same manner as the original appointment.</text>
</paragraph><paragraph id="H2F29AE4FBA954769A71EBDEC614F0003"><enum>(3)</enum><header>Chairperson,
meetings</header>
<subparagraph id="HAF0AEF5B27B344E3864E528287B1763E"><enum>(A)</enum><header>Chairperson</header><text>The
Commission shall select a Chairperson from among its members.</text>
</subparagraph><subparagraph id="H44BAD13DF2544F8FA5B7EF458F6B91BA"><enum>(B)</enum><header>Quorum</header><text display-inline="yes-display-inline">Two-thirds of the members of the Commission
shall constitute a quorum, but a lesser number of members may hold
hearings.</text>
</subparagraph><subparagraph id="H2A15857339C14CEC9103E24DAD1899A2"><enum>(C)</enum><header>Meetings</header><text>Not
later than 30 days after the date on which all members of the Commission have
been appointed, the Commission shall hold its first meeting. The Commission
shall meet at the call of the Chairperson.</text>
</subparagraph></paragraph><paragraph id="H9617A0C669C14D0FB4171D12611BB7C0"><enum>(4)</enum><header>Powers of the
commission</header>
<subparagraph id="HBCBC2B9157C74727A0E9F8A5228BAF91"><enum>(A)</enum><header>Negotiations
with states</header><text>The Commission may conduct detailed discussions and
negotiations with States submitting applications under this section, either
individually or in groups, to facilitate a final set of recommendations for
purposes of subsection (d)(4)(C).</text>
</subparagraph><subparagraph id="H1A234EC49EDA4A49B5FBCCF069F67F25"><enum>(B)</enum><header>Hearings</header><text>The
Commission may hold such hearings, sit and act at such times and places, take
such testimony, and receive such evidence as the Commission considers advisable
to carry out the purposes of this subsection.</text>
</subparagraph><subparagraph id="H3E861167A0B144F59B6821A3871257A1"><enum>(C)</enum><header>Meetings</header><text>In
addition to other meetings the Commission may hold, the Commission shall hold
an annual meeting with the participating States under this section for the
purpose of having States report progress toward the purposes in subsection (a)
and for an exchange of information.</text>
</subparagraph><subparagraph id="H44E216BD99CF4EFBA4DCB766FA727402"><enum>(D)</enum><header>Information</header><text>The
Commission may secure directly from any Federal department or agency such
information as the Commission considers necessary to carry out the provisions
of this subsection. Upon request of the Chairperson of the Commission, the head
of such department or agency shall furnish such information to the Commission
if the head of the department or agency involved determines it
appropriate.</text>
</subparagraph><subparagraph id="H7AD6489E69844429B2E599FEA619B751"><enum>(E)</enum><header>Postal
services</header><text>The Commission may use the United States mails in the
same manner and under the same conditions as other departments and agencies of
the Federal Government.</text>
</subparagraph></paragraph><paragraph id="H0829E9B24280472A9200C5BF662CE2F1"><enum>(5)</enum><header>Personnel
matters</header>
<subparagraph id="HE498FAB4DA8E4521A36C9C2949E3B994"><enum>(A)</enum><header>Compensation</header><text>Each
member of the Commission who is not an officer or employee of the Federal
Government or of a State or local government shall be compensated at a rate
equal to the daily equivalent of the annual rate of basic pay prescribed for
level IV of the Executive Schedule under section 5315 of title 5, United States
Code, for each day (including travel time) during which such member is engaged
in the performance of the duties of the Commission. All members of the
Commission who are officers or employees of the United States shall serve
without compensation in addition to that received for their services as
officers or employees of the United States.</text>
</subparagraph><subparagraph id="HC9F57155168E4DFD9653324EBAB88C08"><enum>(B)</enum><header>Travel
expenses</header><text>The members of the Commission shall be allowed travel
expenses, including per diem in lieu of subsistence, at rates authorized for
employees of agencies under subchapter I of chapter 57 of title 5, United
States Code, while away from their homes or regular places of business in the
performance of services for the Commission.</text>
</subparagraph><subparagraph id="H52F57BED55E44C3700BF25294C14FD8C"><enum>(C)</enum><header>Staff</header><text>The
Chairperson of the Commission may, without regard to the civil service laws and
regulations, appoint and terminate an executive director and such other
additional personnel as may be necessary to enable the Commission to perform
its duties. The employment of an executive director shall be subject to
confirmation by the Commission.</text>
</subparagraph><subparagraph id="H66FAC26BD4B94BAC8FEC426EAF00AB79"><enum>(D)</enum><header>Detail of
government employees</header><text>Any Federal Government employee may be
detailed to the Commission without reimbursement, and such detail shall be
without interruption or loss of civil service status or privilege.</text>
</subparagraph><subparagraph id="H22E2AC4C5D5F4344BF82C778DBCB82F"><enum>(E)</enum><header>Temporary and
intermittent services</header><text>The Chairperson of the Commission may
procure temporary and intermittent services under section 3109(b) of title 5,
United States Code, at rates for individuals which do not exceed the daily
equivalent of the annual rate of basic pay prescribed for level V of the
Executive Schedule under section 5316 of such title.</text>
</subparagraph></paragraph><paragraph id="HD2F8CEAA4D1D44359CAE6DDE887DA59C"><enum>(6)</enum><header>Funding</header><text>For
the purpose of carrying out this subsection, there are authorized to be
appropriated $3,000,000 for fiscal year 2008 and each fiscal year
thereafter.</text>
</paragraph></subsection><subsection id="H259F9D0902CE4F01A2305DD72B36D5AC"><enum>(d)</enum><header>Requirements for
Programs</header>
<paragraph id="HA94798C038684D3C00FFBEF2DDA3C524"><enum>(1)</enum><header>State
plan</header><text display-inline="yes-display-inline">A State that seeks to
operate a program under this section shall prepare and submit to the
Commission, as part of the application under subsection (b), a State health
care plan that shall have as its goal increased coverage, and in service of
that goal such additional goals as improvements in quality, efficiency,
cost-effectiveness, and the appropriate use of information technology. To
achieve such goal, the State plan shall comply with the following:</text>
<subparagraph id="H6797E8FA8E6E47859476C500AD5E762D"><enum>(A)</enum><header>Coverage</header>
<clause id="H05BA60999EB1486C8CE0B4C32EAC1AF"><enum>(i)</enum><header>In
general</header><text>With respect to coverage, the State plan shall—</text>
<subclause id="H6812EF2F6E9E4377ADCBF7AFC1D5E4E6"><enum>(I)</enum><text>provide and
describe the manner in which the State will ensure that an increased number of
individuals residing within the State will have expanded access to health care
coverage with a specific 5-year target for reduction in the number or
proportion of uninsured individuals through either private or public program
expansion, or both, in accordance with or in addition to the options
established by the Commission;</text>
</subclause><subclause id="H4389EC46431B406E9E5493301F00EBAC"><enum>(II)</enum><text>describe the
number and percentage of current uninsured individuals who will achieve
coverage under a State health program;</text>
</subclause><subclause id="HB5C68A721F0746CD86B200189F744D34"><enum>(III)</enum><text>describe the
coverage that will be provided to beneficiaries under a State health
program;</text>
</subclause><subclause id="H8141AB9645944C168D7460525BD89E1"><enum>(IV)</enum><text>identify Federal,
State, or local and private programs that currently provide health care
services in the State and describe how such programs could be coordinated with
a State health program, to the extent practicable; and</text>
</subclause><subclause id="H804B72E1554A439181C2F839E2B4696F"><enum>(V)</enum><text>provide for
improvements in the availability of appropriate health care coverage that will
increase access to care in urban, suburban, rural, and frontier areas of the
State with medically underserved populations or where there may be an
inadequate supply of health care providers.</text>
</subclause></clause><clause id="H0E5E56FFE8C64B4600114CCFD541B0A7"><enum>(ii)</enum><header>Coverage
options</header><text>The coverage under the State plan may be—</text>
<subclause id="HA2025817637345CE985EAA5DA8AE18F8"><enum>(I)</enum><text display-inline="yes-display-inline">health insurance coverage that meets the
aggregate actuarial value requirement of section 2103(a)(2)(B) of the Social
Security Act (42 U.S.C. 1397cc(a)(2)(B));</text>
</subclause><subclause id="H6469DD4B857A460BA39D89B29E01EC71"><enum>(II)</enum><text display-inline="yes-display-inline">a combination of health insurance coverage
and a consumer-directed health care spending account, if the actuarial value of
such coverage plus the amount of annual deposits into such account from sources
other than the beneficiary is not less than the actuarial value amount
described in subclause (I); or</text>
</subclause><subclause id="H6ACF386E2D534832B78F55365DAFF4D7"><enum>(III)</enum><text display-inline="yes-display-inline">health care access not less on average than
that provided through coverage described in subclause (I).</text>
</subclause></clause><clause id="H99D0492F89334CE5925F5700CC3971B"><enum>(iii)</enum><header>Construction</header><text display-inline="yes-display-inline">Nothing in this clause shall be construed
to limit in any way the authority of the Secretary of Health and Human Services
to issue waivers under section 1115 of the Social Security Act.</text>
</clause></subparagraph><subparagraph id="H593B925F974049269FD0A0A83E5C500"><enum>(B)</enum><header>Quality</header><text display-inline="yes-display-inline">With respect to quality, the State plan may
describe efforts to improve health care quality in the State, including an
explanation of how such efforts would change (if at all) under the State
plan.</text>
</subparagraph><subparagraph id="H339B78B6BB61490BB7695E3684239BF5"><enum>(C)</enum><header>Costs</header><text>With
respect to costs, the State plan shall—</text>
<clause id="H017EF60C1A95472994005613F985B48C"><enum>(i)</enum><text display-inline="yes-display-inline">describe such steps as the State may
undertake to improve the efficiency of health care;</text>
</clause><clause id="HE237A34BA26C43BD8FA8C58F5F8C2F3E"><enum>(ii)</enum><text>describe the
public and private sector financing to be provided for the State health
program;</text>
</clause><clause id="HF5994A17F98644D4BAA97F4FD7EAAFD7"><enum>(iii)</enum><text>estimate the
amount of Federal, State, and local expenditures, as well as, the costs to
business and individuals under the State health program; and</text>
</clause><clause id="H70E4B95AF48240C1A9F21FABA8792597"><enum>(iv)</enum><text>describe how the
State plan will ensure the financial solvency of the State health
program.</text>
</clause></subparagraph><subparagraph id="H7CD9BF77643F45D58FF6BCAE11C04735"><enum>(D)</enum><header>Health
information technology</header><text display-inline="yes-display-inline">With
respect to health information technology, the State plan may describe efforts
to improve the appropriate use of health information technology, including an
explanation of how such efforts would change (if at all) under the State
plan.</text>
</subparagraph><subparagraph id="HA3441597055E4045BE9B1C8E898CB888"><enum>(E)</enum><header>Exceptions to
Federal policies</header><text display-inline="yes-display-inline">The State
plan shall describe the exceptions to otherwise applicable Federal statutes,
regulations, and policies that would apply within the geographic area and time
period governed by the plan.</text>
</subparagraph></paragraph><paragraph id="H2E2BCD6D33BA4480ACDE4BC9FC9DBD8"><enum>(2)</enum><header>Technical
assistance</header><text>The Secretary shall, if requested, provide technical
assistance to States to assist such States in developing applications and plans
under this section, including technical assistance by private sector entities
if determined appropriate by the Commission.</text>
</paragraph><paragraph id="H52C383CB9B264383ABB1B7B4FE5956D9"><enum>(3)</enum><header>Initial
review</header><text>With respect to a State application under subsection (b),
the Secretary and the Commission shall complete an initial review of such State
application within 60 days of the receipt of such application, analyze the
scope of the proposal, and determine whether additional information is needed
from the State. The Commission shall advise the State within such period of the
need to submit additional information.</text>
</paragraph><paragraph id="H23175A659D624C48939B12EB328C2DE0"><enum>(4)</enum><header>Final
determination</header>
<subparagraph id="HA704CF26AB0841FEB856265FF01F59E6"><enum>(A)</enum><header>In
general</header><text>In a timely manner consistent with subparagraph (C), the
Commission shall determine whether to submit a State proposal to Congress for
approval.</text>
</subparagraph><subparagraph id="HDC78C4C949574978B212602FC32F2D60"><enum>(B)</enum><header>Voting</header>
<clause id="HA6D86A9FBC144EDABF31964C847DFFC0"><enum>(i)</enum><header>In
general</header><text display-inline="yes-display-inline">The determination to
submit a State proposal to Congress under subparagraph (A) shall be approved by
<fraction>2/3</fraction> of the members of the Commission who are present and
eligible to vote and a majority of the entire Commission.</text>
</clause><clause id="H7FC74B95D23B414C8405A9971E76D26"><enum>(ii)</enum><header>Eligibility</header><text>A
member of the Commission shall not participate in a determination under
subparagraph (A) if—</text>
<subclause id="HA54A6A7750B8435CAFBE1700886C34C5"><enum>(I)</enum><text>in the case of a
member who is a Governor, such determination relates to the State of which the
member is the Governor; or</text>
</subclause><subclause id="HB0364CD96A99487CA85D8CD0C94D284C"><enum>(II)</enum><text>in the case of
member not described in subclause (I), such determination relates to the
geographic area of a State of which such member serves as a State or local
official or as a Member of Congress.</text>
</subclause></clause></subparagraph><subparagraph id="HF475DABF2CB64A51836C4EBE5C670007"><enum>(C)</enum><header>Submission</header><text>Not
later than 90 days prior to October 1 of each fiscal year, the Commission may
submit to Congress a list, in the form of a legislative proposal, of the State
applications that the Commission recommends for approval under this
section.</text>
</subparagraph></paragraph><paragraph id="H2CAA07E4913A48BAA2FCF9F019A00068"><enum>(5)</enum><header>Program or
project period</header><text>A State program or project may be approved for a
period of 5 years and may be extended for a subsequent period of time upon
approval by the Commission, based upon achievement of targets.</text>
</paragraph></subsection><subsection id="HF0A9B0C1FC3F44020000E75043F1C9F2"><enum>(e)</enum><header>Expedited
Congressional Consideration</header>
<paragraph id="HBB0347E5F8AA45368758DDD2C94B16A0"><enum>(1)</enum><header>Introduction and
expedited consideration in the House of Representatives</header>
<subparagraph id="HD78D7A9B470C45C4B1E610A5ECEF48D9"><enum>(A)</enum><header>Introduction in
House of Representatives</header><text>The legislative proposal submitted
pursuant to subsection (d)(4)(C) shall be in the form of a joint resolution (in
this subsection referred to as the <quote>resolution</quote>). Such resolution
shall be introduced in the House of Representatives by the Speaker immediately
upon receipt of the language and shall be referred non-sequentially to the
appropriate committee (or committees) of House of Representatives. If the
resolution is not introduced in accordance with the preceding sentence, the
resolution may be introduced by any member of the House of
Representatives.</text>
</subparagraph><subparagraph id="HB72DF45623C04644AF9E53E7C1015C20"><enum>(B)</enum><header>Committee
consideration</header><text>Not later than 15 calendar days after the
introduction of the resolution described in subparagraph (A), each committee of
House of Representatives to which the resolution was referred shall report the
resolution. The report may include, at the committee’s discretion, a
recommendation for action by the House. If a committee has not reported such
resolution (or an identical resolution) at the end of 15 calendar days after
its introduction or at the end of the first day after there has been reported
to the House a resolution, whichever is earlier, such committee shall be deemed
to be discharged from further consideration of such resolution and such
resolution shall be placed on the appropriate calendar of the House of
Representatives.</text>
</subparagraph><subparagraph id="HFBF392C5ED1945B3852F005EDC531C1D"><enum>(C)</enum><header>Expedited
procedure in House</header><text display-inline="yes-display-inline">Not later
than 5 legislative days after the date on which all committees have been
discharged from consideration of a resolution, the Speaker of the House of
Representatives, or the Speaker’s designee, shall move to proceed to the
consideration of the resolution. It shall also be in order for any member of
the House of Representatives to move to proceed to the consideration of the
resolution at any time after the conclusion of such 5-day period. All points of
order against the resolution (and against consideration of the resolution) are
waived. A motion to proceed to the consideration of the resolution is highly
privileged in the House of Representatives and is not debatable. The motion is
not subject to amendment, to a motion to postpone consideration of the
resolution, or to a motion to proceed to the consideration of other business. A
motion to reconsider the vote by which the motion to proceed is agreed to or
not agreed to shall not be in order. If the motion to proceed is agreed to, the
House of Representatives shall immediately proceed to consideration of the
resolution without intervening motion, order, or other business, and the
resolution shall remain the unfinished business of the House of Representatives
until disposed of. A motion to recommit the resolution shall not be in order.
Upon its passage in the House, the clerk of the House shall provide for its
immediate transmittal to the Senate.</text>
</subparagraph></paragraph><paragraph id="HCC47F236ADE54F59BF2ED1B14A3946D"><enum>(2)</enum><header>Expedited
consideration in the Senate</header>
<subparagraph id="H09C90089FB954FDDB2C113C388BC377F"><enum>(A)</enum><header>Referral to
committee</header><text display-inline="yes-display-inline">If the resolution
is agreed to by the House of Representatives, upon its receipt in the Senate
the majority leader of the Senate, or the leader’s designee, the resolution
shall be referred to the appropriate committee of Senate.</text>
</subparagraph><subparagraph id="HFC72F50E320B49229417D8ADF7F81C3E"><enum>(B)</enum><header>Committee
consideration</header><text>Not later than 15 calendar days after the referral
of the resolution under subparagraph (A), the committee of the Senate to which
the resolution was referred shall report the resolution. The report may
include, at the committee’s discretion, a recommendation for action by the
Senate. If a committee has not reported such resolution (or an identical
resolution) at the end of 15 calendar days after its referral or at the end of
the first day after there has been reported to the Senate a resolution,
whichever is earlier, such committee shall be deemed to be discharged from
further consideration of such resolution and such resolution shall be placed on
the appropriate calendar of the Senate.</text>
</subparagraph><subparagraph id="H649E86C2E7364EFC83B463A88D039157"><enum>(C)</enum><header>Expedited floor
consideration</header><text>Not later than 5 legislative days after the date on
which all committees have been discharged from consideration of a resolution,
the majority leader of the Senate, or the majority leader’s designee, shall
move to proceed to the consideration of the resolution. It shall also be in
order for any member of the Senate to move to proceed to the consideration of
the resolution at any time after the conclusion of such 5-day period. All
points of order against the resolution (and against consideration of the
resolution) are waived. A motion to proceed to the consideration of the
resolution in the Senate is privileged and is not debatable. The motion is not
subject to amendment, to a motion to postpone consideration of the resolution,
or to a motion to proceed to the consideration of other business. A motion to
reconsider the vote by which the motion to proceed is agreed to or not agreed
to shall not be in order. If the motion to proceed is agreed to, the Senate
shall immediately proceed to consideration of the resolution without
intervening motion, order, or other business, and the resolution shall remain
the unfinished business of the Senate until disposed of.</text>
</subparagraph></paragraph><paragraph id="HB0EFE32071DF49E2B2D1FECF1B480002"><enum>(3)</enum><header>Rules of the
Senate and House of Representatives</header><text>This subsection is enacted by
Congress—</text>
<subparagraph id="HC916DFD09B71417FB37F72D9CCE37E58"><enum>(A)</enum><text>as an exercise of
the rulemaking power of the Senate and House of Representatives, respectively,
and is deemed to be part of the rules of each House, respectively, but
applicable only with respect to the procedure to be followed in that House in
the case of a resolution under this subsection, and it supersedes other rules
only to the extent that it is inconsistent with such rules; and</text>
</subparagraph><subparagraph id="H2D4CBA503A044C1CA800918582F9C204"><enum>(B)</enum><text>with full
recognition of the constitutional right of either House to change the rules (so
far as they relate to the procedure of that House) at any time, in the same
manner, and to the same extent as in the case of any other rule of that
House.</text>
</subparagraph></paragraph><paragraph id="H1F9756DC67264BE6A14F8409B4F29FDC"><enum>(4)</enum><header>Federal budget
neutrality</header><text display-inline="yes-display-inline">Except insofar as
it allots appropriations made pursuant to subsection (k), the legislative
proposal submitted pursuant to subsection (d)(4)(C) may not increase the
cumulative, net Federal budget deficit during the multi-year operation of all
the State applications contained therein, taking into account such
applications’ impact on Federal mandatory and discretionary spending, Federal
revenue, and Federal tax expenditures.</text>
</paragraph></subsection><subsection id="HB6DCD4EB0E7041BCA78406E914006042"><enum>(f)</enum><header>Funding</header>
<paragraph id="HD8A03CA702994439AA2750CC3862684"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary shall
provide a grant to a State that has an application approved under subsection
(e) to enable such State to carry out an innovative State health program in the
State, to the extent that such a grant is included in the recommendation of the
Commission.</text>
</paragraph><paragraph id="H8067DA86A1714104BAC310198FA86140"><enum>(2)</enum><header>Amount of
grant</header><text>The amount of a grant provided to a State under paragraph
(1) shall be determined based upon the recommendations of the Commission,
subject to the amount appropriated under subsection (k).</text>
</paragraph><paragraph id="H8DA1C78722884886BFADC500536FE959"><enum>(3)</enum><header>Performance-based
funding allocation</header><text display-inline="yes-display-inline">In
awarding grants under paragraph (1), the Commission shall direct the Secretary
to—</text>
<subparagraph id="HD1842818ABA546298CB230A511367955"><enum>(A)</enum><text>fund a balanced
diversity of approaches as provided for by the Commission in subsection
(c)(1)(B); and</text>
</subparagraph><subparagraph id="HC75C0150FBD24CDC8FFA6228E949BDC0"><enum>(B)</enum><text>link allocations
to the State to the meeting of the goals and performance measures relating to
health care coverage and health care costs established under this section
through the State project application process.</text>
</subparagraph></paragraph><paragraph id="H00404308FB5748F2BE47118BFBD54017"><enum>(4)</enum><header>Report</header><text>One
year prior to the end of the 5-year period beginning on the date on which the
first State begins to implement a plan approved under subsection (e), the
Commission shall prepare and submit to the appropriate committees of Congress,
a report on the progress made by States in meeting the goals of expanded
coverage and cost containment through performance measures established during
the 5-year period of the State plan. Such report may contain the recommendation
of the Commission concerning any future action that Congress should take
concerning health care reform, including whether or not to extend the program
established under this subsection.</text>
</paragraph></subsection><subsection id="HB73CDB8178E045DDB9E62791E8556E60"><enum>(g)</enum><header>Monitoring and
Evaluation</header>
<paragraph id="HCCD02811BD944CE7AA006E7051CB32D1"><enum>(1)</enum><header>Annual reports
and participation by states</header><text>Each State that has received a
program approval shall—</text>
<subparagraph id="HD2C4D817ADF148CB944870F6E843DC6E"><enum>(A)</enum><text>submit to the
Commission an annual report based on the period representing the respective
State’s fiscal year, detailing compliance with the requirements established by
the Commission and the Secretary in the approval and in this section;
and</text>
</subparagraph><subparagraph id="H929FBD2FD6DC4C2FB537B541AEA06C2"><enum>(B)</enum><text>participate in the
annual meeting under subsection (c)(4)(C).</text>
</subparagraph></paragraph><paragraph id="HA25C8BA66F6E45009B81E8DA27CFBCFE"><enum>(2)</enum><header>Evaluations by
commission</header><text>The Commission shall prepare and submit to the
Congress annual reports that shall contain—</text>
<subparagraph id="HF72D02090AF9498C9366B42E46431E78"><enum>(A)</enum><text>a description of
the effects of the reforms undertaken in States receiving approvals under this
section;</text>
</subparagraph><subparagraph id="HBD19BAB47F3B4114B4EB43905C00EB28"><enum>(B)</enum><text>a description of
the recommendations of the Commission and actions taken based on these
recommendations;</text>
</subparagraph><subparagraph id="H9AF8EF70A21B430595A4609C89EB8494"><enum>(C)</enum><text>an independent
evaluation of the effectiveness of such reforms in—</text>
<clause id="HC7FFD5F48C344068AB4D5BC7739FCF96"><enum>(i)</enum><text>expanding health
care coverage for State residents; and</text>
</clause><clause id="HB557364D5AA64E83A77EDE6422CEB276"><enum>(ii)</enum><text>reducing or
containing health care costs in the States,</text>
</clause><continuation-text continuation-text-level="subparagraph">as well
as other relevant or significant findings;</continuation-text></subparagraph><subparagraph id="H51F14D94C1B44E41916EA7CED42E1BF5"><enum>(D)</enum><text>recommendations
regarding the advisability of increasing Federal financial assistance for State
ongoing or future health program initiatives, including the amount and source
of such assistance; and</text>
</subparagraph><subparagraph id="H459FA8A75FE34E30B803B8F3C16DC0E7"><enum>(E)</enum><text>as required by the
Commission or the Secretary under this section, a periodic, independent
evaluation of the program.</text>
</subparagraph></paragraph></subsection><subsection id="H8D25DF6864674838AAF1C70905CCC500"><enum>(h)</enum><header>Noncompliance</header>
<paragraph id="H7EF16F2B98994D27A04400DD67F08B8C"><enum>(1)</enum><header>Corrective
action plans</header><text display-inline="yes-display-inline">If a State is
not in compliance with a requirement of this section, the Commission, on
recommendation of the Secretary, shall develop a corrective action plan for
such State.</text>
</paragraph><paragraph id="H2F7B2CD948B34791B100609FBEE4E531"><enum>(2)</enum><header>Termination</header><text display-inline="yes-display-inline">The Commission, on recommendation of the
Secretary, may revoke any program granted under this section. Such decisions
shall be subject to a petition for reconsideration and appeal pursuant to
regulations established by the Secretary.</text>
</paragraph></subsection><subsection id="H99225279317B4AD892122100E5BF09AE"><enum>(i)</enum><header>Relationship to
Federal Programs</header>
<paragraph id="H6BF19058F77D4E8A9C065C4F28ED9671"><enum>(1)</enum><header>In
general</header><text>Nothing in this section, or in section 1115 of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1315)
shall be construed as authorizing the Secretary, the Commission, a State, or
any other person or entity to alter or affect in any way the provisions of
title XIX of such Act (42 U.S.C. 1396 et seq.) or the regulations implementing
such title.</text>
</paragraph><paragraph id="H78590237D1354CED8E6DAC4F3486D0C"><enum>(2)</enum><header>Maintenance of
effort</header><text>No payment may be made under subsection (f)(1) if the
State adopts criteria for benefits or criteria for standards and methodologies
for purposes of determining an individual’s eligibility for medical assistance
under the State plan under title XIX that are more restrictive than those
required under Federal law and applied as of the date of enactment of this
Act.</text>
</paragraph></subsection><subsection id="H6334641F10584C7DA801CE8C006EA127"><enum>(j)</enum><header>Miscellaneous
Provisions</header>
<paragraph id="H00728DC0B11548019500009F3D4BB080"><enum>(1)</enum><header>Application of
certain requirements</header>
<subparagraph id="H3820C55C024A4BFB81101064983D6997"><enum>(A)</enum><header>Restriction on
application of preexisting condition exclusions</header>
<clause id="HCF2BECAED36B4132ACA45077F7B11CF6"><enum>(i)</enum><header>In
general</header><text>Subject to subparagraph (B), a State shall not permit the
imposition of any preexisting condition exclusion for covered benefits under a
program or project under this section.</text>
</clause><clause id="H203F024249504AF09E5CC4A2B7D0FB92"><enum>(ii)</enum><header>Group health
plans and group health insurance coverage</header><text>If the State program or
project provides for benefits through payment for, or a contract with, a group
health plan or group health insurance coverage, the program or project may
permit the imposition of a preexisting condition exclusion but only insofar and
to the extent that such exclusion is permitted under the applicable provisions
of part 7 of subtitle B of title I of the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name> and title XXVII of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name>.</text>
</clause></subparagraph><subparagraph id="HCA2FCC526ABD446F81FD4EE88599E4A2"><enum>(B)</enum><header>Compliance with
other requirements</header><text>Coverage offered under the program or project
shall comply with the requirements of subpart 2 of part A of title XXVII of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> insofar as
such requirements apply with respect to a health insurance issuer that offers
group health insurance coverage.</text>
</subparagraph></paragraph><paragraph id="HF89A7291C07E448A8C510013E360E4F"><enum>(2)</enum><header>Prevention of
duplicative payments</header>
<subparagraph id="HE006F2467A464D16B7E761072476B7E"><enum>(A)</enum><header>Other health
plans</header><text display-inline="yes-display-inline">No payment shall be
made to a State under subsection (f)(1) for expenditures for health assistance
provided for an individual to the extent that a private insurer (as defined by
the Secretary by regulation and including a group health plan (as defined in
section 607(1) of the <act-name parsable-cite="ERISA">Employee Retirement
Income Security Act of 1974</act-name>), a service benefit plan, and a health
maintenance organization) would have been obligated to provide such assistance
but for a provision of its insurance contract which has the effect of limiting
or excluding such obligation because the individual is eligible for or is
provided health assistance under the plan.</text>
</subparagraph><subparagraph id="H481B5C07DA2B44C7A5ACFF14A8FC00CF"><enum>(B)</enum><header>Other federal
governmental programs</header><text>Except as provided in any other provision
of law, no payment shall be made to a State under subsection (f)(1) for
expenditures for health assistance provided for an individual to the extent
that payment has been made or can reasonably be expected to be made promptly
(as determined in accordance with regulations) under any other federally
operated or financed health care insurance program. For purposes of this
paragraph, rules similar to the rules for overpayments under section 1903(d)(2)
of the <act-name parsable-cite="SSA">Social Security Act</act-name> shall
apply.</text>
</subparagraph></paragraph><paragraph id="H0DEAB3F379C54B08A51B9E7828008E47"><enum>(3)</enum><header>Application of
certain general provisions</header><text display-inline="yes-display-inline">The following provisions of the
<act-name parsable-cite="SSA">Social Security Act</act-name> shall apply to
States under subsection (f)(1) in the same manner as they apply to a State
under such title XIX:</text>
<subparagraph id="H17BE080829984EFC86D79DA7CFBA0916"><enum>(A)</enum><header>Title xix
provisions</header>
<clause id="H13A8BE4142A045D4885C3D9FCF048C7B"><enum>(i)</enum><text>Section
1902(a)(4)(C) (relating to conflict of interest standards).</text>
</clause><clause id="HED2F7F9C1F5B4624ADF3CCF3C1BD2E5"><enum>(ii)</enum><text>Paragraphs (2),
(16), and (17) of section 1903(i) (relating to limitations on payment).</text>
</clause><clause id="H6D58F47628B74747AE8690189027C3F2"><enum>(iii)</enum><text>Section 1903(w)
(relating to limitations on provider taxes and donations).</text>
</clause><clause id="H548434A5E6344F0BA65FF3526CF1534"><enum>(iv)</enum><text>Section 1920A
(relating to presumptive eligibility for children).</text>
</clause></subparagraph><subparagraph id="H442B8C25037E4A36AD1FF2B09097FE10"><enum>(B)</enum><header>Title xi
provisions</header>
<clause id="H2A42465B4BEC421B92B7503FAE09BE5E"><enum>(i)</enum><text>Section 1116
(relating to administrative and judicial review), but only insofar as
consistent with this title.</text>
</clause><clause id="H97EE137F80B2443E003BCDF1E971D5BE"><enum>(ii)</enum><text>Section 1124
(relating to disclosure of ownership and related information).</text>
</clause><clause id="H6EEE8C5091EE49B79FC98722FD9C9394"><enum>(iii)</enum><text>Section 1126
(relating to disclosure of information about certain convicted
individuals).</text>
</clause><clause id="HE3CEE418DA5047048C331F1E00EF05E2"><enum>(iv)</enum><text>Section 1128A
(relating to civil monetary penalties).</text>
</clause><clause id="H8778788850D74D06A9BA7854F91400BD"><enum>(v)</enum><text>Section 1128B(d)
(relating to criminal penalties for certain additional charges).</text>
</clause><clause id="H61E444DA66B144819EC3FDC4FB487E13"><enum>(vi)</enum><text>Section 1132
(relating to periods within which claims must be filed).</text>
</clause></subparagraph></paragraph><paragraph id="H775AB9B60FBB481BAE324C87921CC9D1"><enum>(4)</enum><header>Relation to
HIPAA</header><text>Health benefits coverage provided under a State program or
project under this section shall be treated as creditable coverage for purposes
of part 7 of subtitle B of title I of the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name>, title XXVII of the <act-name parsable-cite="PHSA">Public
Health Service Act</act-name>, and subtitle K of the Internal Revenue Code of
1986.</text>
</paragraph></subsection><subsection id="HB057089E6AD84F3C00D694A2F89CF18B"><enum>(k)</enum><header>Authorization of
Appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary in each fiscal year. Amounts
appropriated for a fiscal year under this subsection and not expended may be
used in subsequent fiscal years to carry out this section.</text>
</subsection></section><enum>IV</enum><header>Sense of the
House of Representatives</header>
<section id="H8276EBBF492F4B6AB31D34FE7C36F9DF"><enum>401.</enum><header>Medicare and
Medicaid reform and savings</header>
<subsection id="HF789A900E1234DBABD41BA6252E25E38"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall
implement administrative reforms with respect to—</text>
<paragraph id="H103EC30C9A7C444EAC97F0A3DF242699"><enum>(1)</enum><text>the Medicare
program under title XVIII of the Social Security Act in—</text>
<subparagraph id="H853A01D466FA4F48BED93EFE3DF8DAD7"><enum>(A)</enum><text>the reduction of
fraud and abuse in the program,</text>
</subparagraph><subparagraph id="HCB1CB64919474DE5BFC6BCDE358F1D4"><enum>(B)</enum><text>health information
technology,</text>
</subparagraph><subparagraph id="H6551D00F2493497BB474EEFDF46BDA65"><enum>(C)</enum><text>comparative
effectiveness, and</text>
</subparagraph><subparagraph id="H314D436EF3F14B0591ABAC699600E0CF"><enum>(D)</enum><text>chronic disease
management; and</text>
</subparagraph></paragraph><paragraph id="HE6B71F00CF90427491651E8D1710BB54"><enum>(2)</enum><text>the Medicaid
program under title XIX of the Social Security Act, including changes in the
Medicaid matching rate and changes in the payments for Medicaid administrative
costs to prevent duplication of such payments under the temporary assistance
for needy families program under title IV of the Social Security Act;</text>
</paragraph><continuation-text continuation-text-level="subsection">that are
sufficient to result in projected reductions in the Medicare and Medicaid
Federal budget baselines for fiscal years 2010 through 2015 that exceed the
projected revenue loss for the same period attributable to the refundable
portion of the tax credit under section 37 of the Internal Revenue Code of 1986
(as added by title II of this Act) and the increase in the Federal budget
baseline for the State children's health insurance program under title XXI of
the Social Security Act from the provisions of and amendments made by title I
of this Act.</continuation-text></subsection><subsection id="HB2765820113E40BD92A7975CDF56A400"><enum>(b)</enum><header>Consultation and
consideration</header><text>In developing the necessary program changes under
subsection (a), the Secretary of Health and Human Services shall consult with
the Government Accountability Office and the Medicare Payment Advisory
Commission and shall also consider any significant proposals for program
changes in the specified areas that have been issued by private organizations
within the last 3 years.</text>
</subsection></section>