I 111th CONGRESS 1st Session H. R. 563 IN THE HOUSE OF REPRESENTATIVES January 15, 2009 Mrs. Biggert (for herself, Mr. McCaul, Ms. Ginny Brown-Waite of Florida, Mr. Ehlers, Mr. Fortenberry, and Mr. Kirk) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XXI of the Social Security Act to require States to provide priority under the State Children’s Health Insurance Program (SCHIP) to children in families with gross income below 200 percent of the Federal poverty level.

1.

Short title

This Act may be cited as the SCHIP Expansion for Kids in Need Act of 2009.

2.

Requiring priority for SCHIP coverage of children in families with income under 200 percent of the Federal poverty level

(a)

Data collection requirement

Section 2108 of the Social Security Act (42 U.S.C. 1397hh) is amended by adding at the end the following new subsection: (e)

Inclusion of certain income-related data

(1)

In general

Each annual report under this section for each fiscal year (beginning with fiscal year 2010) shall include information, consistent with regulations promulgated under paragraph (2), on the success of the State in providing health insurance coverage for children at various family income levels. (2)

Regulations

In order to provide consistency in the reporting of information under paragraph (1), the Secretary shall promulgate, not later than September 30, 2009, standards for data collection and statistical methodologies that must be used in submitting such information. Such standards shall provide for family income levels to be determined based on gross income relative to percentages of the poverty line for a family of the size involved. . (b)

Plan for coverage of low income children

Section 2101 of such Act (42 U.S.C. 1397aa) is amended by adding at the end the following new subsection: (e)

Inclusion of plan for coverage of low income children

(1)

Development

No State child health plan shall be considered approved under section 2106 for a fiscal year (beginning with fiscal year 2010) unless— (A)the State has developed and submitted to the Secretary, not later than 6 months after the date of the enactment of this subsection, a plan to assure that all qualified low-income children (as defined in paragraph (3)) are covered by creditable health coverage; (B)such a plan has been approved under paragraph (2); and (C)the State implements such plan beginning with fiscal year 2010. (2)

Review and approval

The Secretary shall— (A)promptly review plans submitted under paragraph (1)(A); (B)approve such plan if the Secretary determines that the plan is reasonably designed to assure the coverage described in such paragraph, effective as for the plan year beginning in fiscal year 2010; or (C)disapprove such plan if the Secretary determines that the plan is not so reasonably designed. (3)

Opportunity for resubmittal

If the Secretary disapproves a plan under paragraph (2)(C), the Secretary shall provide the State with an opportunity to resubmit a modified plan under paragraph (1)(A) that meets the requirement of paragraph (2)(B). (4)

Notification

The Secretary shall promptly notify the State involved of the approval or disapproval of a plan submitted under paragraph (1)(A), or resubmitted under paragraph (3). (5)

Qualified low-income children

In this subsection and section 2105(c)(8), the term qualified low-income child means a child— (A)the gross income of whose family does not exceed 200 percent of the poverty line for a family of the size involved; and (B)who meets all eligibility requirements, other than those related to income, to be a targeted low-income child. . (c)

Limitation on use of SCHIP funds

Section 2105(c) of such Act (42 U.S.C. 1397ee(c)) is amended by adding at the end the following new paragraph: (8)

Limitation based on increases in income eligibility

(A)

In general

Subject to subparagraph (B), in the case of a State that increases its income eligibility level under its State child health plan above the level in effect as of the date of the enactment of this paragraph, payment shall not be made to a State under this section for any amount expended for an individual whose family income exceeds the income eligibility level under its State child health plan as of such date unless the State demonstrates to the satisfaction of the Secretary that no more than 10 percent of qualified low-income children (as defined in section 2101(e)(5)) residing in the State are not covered under creditable health coverage. (B)

Safe harbor for qualified low-income children and currently eligible children

Subparagraph (A) shall not apply to limit payment under this section for amounts expended for— (i)qualified low-income children (as so defined); or (ii)any child who meets eligibility standards under the State child health plan as in effect as of the date of the enactment of this paragraph. .