[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5375 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 5375

To amend titles XIX and XXI of the Social Security Act to eliminate the 
 CHIP maintenance of effort requirement and to eliminate DSH cuts for 
          States not implementing the ACA Medicaid expansion.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 27, 2016

  Mr. Mullin introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend titles XIX and XXI of the Social Security Act to eliminate the 
 CHIP maintenance of effort requirement and to eliminate DSH cuts for 
          States not implementing the ACA Medicaid expansion.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preserving Access to Medicaid for 
Americans Act of 2016''.

SEC. 2. ELIMINATION OF MOE REQUIREMENT FOR CHIP ELIGIBILITY.

    Section 2105(d)(3) of the Social Security Act (42 U.S.C. 
1397ee(d)(3)) is amended by striking ``September 30, 2019'' and 
inserting ``the date of the enactment of the Preserving Access to 
Medicaid for Americans Act of 2016''.

SEC. 3. ELIMINATION OF DSH CUTS FOR STATES NOT IMPLEMENTING ACA 
              EXPANSION.

    (a) In General.--Section 1923(f)(7) of the Social Security Act (42 
U.S.C. 1396r-4(f)(7)) is amended--
            (1) in subparagraph (A)--
                    (A) in clause (i)--
                            (i) in the matter preceding subclause (I), 
                        by striking ``each of fiscal years 2018 through 
                        2025'' and inserting ``fiscal year 2018 and 
                        each subsequent fiscal year''; and
                            (ii) in subclause (I)--
                                    (I) by striking ``the amount 
                                specified under the DSH health reform 
                                methodology under subparagraph (B)'' 
                                and inserting ``the amount of the 
                                aggregate reduction target''; and
                                    (II) by striking ``DSH allotments 
                                to States'' and inserting ``the DSH 
                                allotment to each expansion State'' 
                                each place it appears;
                    (B) in clause (ii)--
                            (i) in the matter preceding subclause (I), 
                        by striking ``The aggregate reductions'' and 
                        inserting ``In applying subparagraph (B), the 
                        aggregate reduction targets'';
                            (ii) in subclause (VII), by striking 
                        ``and'' at the end;
                            (iii) in subclause (VIII), by striking the 
                        period at the end and inserting ``; and''; and
                            (iv) by adding at the end the following new 
                        subclause:
                                    ``(IX) $8,000,000,000 for fiscal 
                                year 2026 and, subject to subparagraph 
                                (C), each subsequent fiscal year.'';
                    (C) by amending clause (iv) to read as follows:
                            ``(iv) Definitions.--For purposes of this 
                        paragraph:
                                    ``(I) The term `expansion State' 
                                means, for a fiscal year, a State that, 
                                as of the date that is 180 days before 
                                the start of such fiscal year, provides 
                                for eligibility under clause (i)(VIII) 
                                or (ii)(XX) of section 1902(a)(10)(A) 
                                for medical assistance under this title 
                                (or a waiver of the State plan approved 
                                under section 1115).
                                    ``(II) The term `non-expansion 
                                State' means, for a fiscal year, a 
                                State that is not an expansion State 
                                for such fiscal year.''; and
                    (D) in clause (v), by striking ``Distribution of 
                aggregate reductions.--The Secretary shall distribute 
                the aggregate reductions'' and inserting ``Distribution 
                of aggregate reduction targets.--The Secretary shall 
                distribute the aggregate reduction targets under clause 
                (ii) among all the States (including non-expansion 
                States)'';
            (2) in subparagraph (B), by adding at the end the following 
        new clause:
                            ``(iv) The methodology imposes reduction 
                        targets as if the reductions under subparagraph 
                        (A) were applied to all States, including non-
                        expansion States.''; and
            (3) by adding at the end the following new subparagraph:
                    ``(C) Extension of reduction for expansion states 
                to pay for elimination of reduction for non-expansion 
                states.--The aggregate amount of reductions under 
                subparagraph (A) for fiscal years after fiscal year 
                2025 shall not exceed the sum of the aggregate 
                reduction targets distributed under clause (v) to non-
                expansion States for fiscal years 2018 through 2025.''.
    (b) Conforming Amendment.--Section 1923(f)(8) of the Social 
Security Act (42 U.S.C. 1396r-4(f)(8)) is amended by striking ``fiscal 
year 2025'' and inserting ``the last fiscal year for which a reduction 
is made under paragraph (7)(A)''.
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