[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 259 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 259
To extend the Medicaid Money Follows the Person Rebalancing
demonstration, to extend protection for Medicaid recipients of home and
community-based services against spousal impoverishment, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 4, 2019
Mr. Pallone (for himself and Mr. Walden) introduced the following bill;
which was referred to the Committee on Energy and Commerce, and in
addition to the Committee on the Budget, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To extend the Medicaid Money Follows the Person Rebalancing
demonstration, to extend protection for Medicaid recipients of home and
community-based services against spousal impoverishment, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicaid Extenders Act of 2019''.
SEC. 2. EXTENSION OF MONEY FOLLOWS THE PERSON REBALANCING
DEMONSTRATION.
(a) General Funding.--Section 6071(h) of the Deficit Reduction Act
of 2005 (42 U.S.C. 1396a note) is amended--
(1) in paragraph (1)--
(A) in subparagraph (D), by striking ``and'' after
the semicolon;
(B) in subparagraph (E), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following:
``(F) subject to paragraph (3), $112,000,000 for
fiscal year 2019.'';
(2) in paragraph (2)--
(A) by striking ``Amounts made'' and inserting
``Subject to paragraph (3), amounts made''; and
(B) by striking ``September 30, 2016'' and
inserting ``September 30, 2021''; and
(3) by adding at the end the following new paragraph:
``(3) Special rule for fy 2019.--Funds appropriated under
paragraph (1)(F) shall be made available for grants to States
only if such States have an approved MFP demonstration project
under this section as of December 31, 2018.''.
(b) Funding for Quality Assurance and Improvement; Technical
Assistance; Oversight.--Section 6071(f) of the Deficit Reduction Act of
2005 (42 U.S.C. 1396a note) is amended by striking paragraph (2) and
inserting the following:
``(2) Funding.--From the amounts appropriated under
subsection (h)(1)(F) for fiscal year 2019, $500,000 shall be
available to the Secretary for such fiscal year to carry out
this subsection.''.
(c) Technical Amendment.--Section 6071(b) of the Deficit Reduction
Act of 2005 (42 U.S.C. 1396a note) is amended by adding at the end the
following:
``(10) Secretary.--The term `Secretary' means the Secretary
of Health and Human Services.''.
SEC. 3. EXTENSION OF PROTECTION FOR MEDICAID RECIPIENTS OF HOME AND
COMMUNITY-BASED SERVICES AGAINST SPOUSAL IMPOVERISHMENT.
(a) In General.--Section 2404 of Public Law 111-148 (42 U.S.C.
1396r-5 note) is amended by striking ``the 5-year period that begins on
January 1, 2014,'' and inserting ``the period beginning on January 1,
2014, and ending on March 31, 2019,''.
(b) Rule of Construction.--
(1) Protecting state spousal income and asset disregard
flexibility under waivers and plan amendments.--Nothing in
section 2404 of Public Law 111-148 (42 U.S.C. 1396r-5 note) or
section 1924 of the Social Security Act (42 U.S.C. 1396r-5)
shall be construed as prohibiting a State from disregarding an
individual's spousal income and assets under a State waiver or
plan amendment described in paragraph (2) for purposes of
making determinations of eligibility for home and community-
based services or home and community-based attendant services
and supports under such waiver or plan amendment.
(2) State waiver or plan amendment described.--A State
waiver or plan amendment described in this paragraph is any of
the following:
(A) A waiver or plan amendment to provide medical
assistance for home and community-based services under
a waiver or plan amendment under subsection (c), (d),
or (i) of section 1915 of the Social Security Act (42
U.S.C. 1396n) or under section 1115 of such Act (42
U.S.C. 1315).
(B) A plan amendment to provide medical assistance
for home and community-based services for individuals
by reason of being determined eligible under section
1902(a)(10)(C) of such Act (42 U.S.C. 1396a(a)(10)(C))
or by reason of section 1902(f) of such Act (42 U.S.C.
1396a(f)) or otherwise on the basis of a reduction of
income based on costs incurred for medical or other
remedial care under which the State disregarded the
income and assets of the individual's spouse in
determining the initial and ongoing financial
eligibility of an individual for such services in place
of the spousal impoverishment provisions applied under
section 1924 of such Act (42 U.S.C. 1396r-5).
(C) A plan amendment to provide medical assistance
for home and community-based attendant services and
supports under section 1915(k) of such Act (42 U.S.C.
1396n(k)).
SEC. 4. REDUCTION IN FMAP AFTER 2020 FOR STATES WITHOUT ASSET
VERIFICATION PROGRAM.
Section 1940 of the Social Security Act (42 U.S.C. 1396w) is
amended by adding at the end the following new subsection:
``(k) Reduction in FMAP After 2020 for Non-Compliant States.--
``(1) In general.--With respect to a calendar quarter
beginning on or after January 1, 2021, the Federal medical
assistance percentage otherwise determined under section
1905(b) for a non-compliant State shall be reduced--
``(A) for calendar quarters in 2021 and 2022, by
0.12 percentage points;
``(B) for calendar quarters in 2023, by 0.25
percentage points;
``(C) for calendar quarters in 2024, by 0.35
percentage points; and
``(D) for calendar quarters in 2025 and each year
thereafter, by 0.5 percentage points.
``(2) Non-compliant state defined.--For purposes of this
subsection, the term `non-compliant State' means a State--
``(A) that is one of the 50 States or the District
of Columbia;
``(B) with respect to which the Secretary has not
approved a State plan amendment submitted under
subsection (a)(2); and
``(C) that is not operating, on an ongoing basis,
an asset verification program in accordance with this
section.''.
SEC. 5. MEDICAID IMPROVEMENT FUND.
Section 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w-
1(b)(1)) is amended by striking ``$31,000,000'' and inserting
``$6,000,000''.
SEC. 6. BUDGETARY EFFECTS.
(a) Statutory PAYGO Scorecards.--The budgetary effects of this Act
shall not be entered on either PAYGO scorecard maintained pursuant to
section 4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C.
933(d)).
(b) Senate PAYGO Scorecards.--The budgetary effects of this Act
shall not be entered on any PAYGO scorecard maintained for purposes of
section 4106 of H. Con. Res. 71 (115th Congress).
(c) Classification of Budgetary Effects.--Notwithstanding Rule 3 of
the Budget Scorekeeping Guidelines set forth in the joint explanatory
statement of the committee of conference accompanying Conference Report
105-217 and section 250(c)(8) of the Balanced Budget and Emergency
Deficit Control Act of 1985, the budgetary effects of this Act shall
not be estimated--
(1) for purposes of section 251 of the Balanced Budget and
Emergency Deficit Control Act of 1985; and
(2) for purposes of paragraph (4)(C) of section 3 of the
Statutory Pay-As-You-Go Act of 2010 as being included in an
appropriation Act.
(d) PAYGO Annual Report.--For the purposes of the annual report
issued pursuant to section 5 of the Statutory Pay-As-You-Go Act of 2010
(2 U.S.C. 934) after adjournment of the second session of the 115th
Congress, and for determining whether a sequestration order is
necessary under such section, the debit for the budget year on the 5-
year scorecard, if any, and the 10-year scorecard, if any, shall be
deducted from such scorecard in 2019 and added to such scorecard in
2020.
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