[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4996 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 428
116th CONGRESS
  2d Session
                                H. R. 4996

                          [Report No. 116-527]

 To amend title XIX of the Social Security Act to provide for a State 
option under the Medicaid program to provide for and extend continuous 
       coverage for certain individuals, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 8, 2019

 Ms. Kelly of Illinois (for herself, Mr. Burgess, Ms. Underwood, Mrs. 
    Rodgers of Washington, Ms. Pressley, and Mr. Carter of Georgia) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

                           September 21, 2020

 Additional sponsors: Ms. Herrera Beutler, Mr. Walden, Mr. Engel, Mrs. 
Hayes, Mr. Trone, Mr. Crenshaw, Mr. Guthrie, Mr. Ruiz, Ms. Schakowsky, 
Mr. Fitzpatrick, Mr. Cunningham, Ms. Norton, Mr. Larsen of Washington, 
Mr. Clay, Mr. McGovern, Ms. Kendra S. Horn of Oklahoma, Ms. Finkenauer, 
Mrs. Axne, Ms. Shalala, Mr. Walberg, Mr. McEachin, Mrs. Fletcher, Mrs. 
 Bustos, Mr. Van Drew, Ms. Jackson Lee, Ms. Dean, Mr. Lamb, Mrs. Davis 
      of California, Ms. Porter, Mrs. Napolitano, and Ms. Houlahan

                           September 21, 2020

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
    [For text of introduced bill, see copy of bill as introduced on 
                           November 8, 2019]

_______________________________________________________________________

                                 A BILL


 
 To amend title XIX of the Social Security Act to provide for a State 
option under the Medicaid program to provide for and extend continuous 
       coverage for certain individuals, 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 ``Helping Medicaid Offer Maternity 
Services Act of 2019'' or the ``Helping MOMS Act of 2019''.

SEC. 2. STATE OPTION UNDER MEDICAID PROGRAM TO PROVIDE FOR AND EXTEND 
              CONTINUOUS COVERAGE FOR CERTAIN INDIVIDUALS.

    (a) State Option To Extend Continuous Coverage for Pregnant and 
Postpartum Individuals.--Title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) is amended--
            (1) in section 1902(e)(5), by inserting after ``60-day 
        period'' the following: ``or, at the option of the State, 1-
        year period'';
            (2) in section 1902(e)(6), by inserting after ``60-day 
        period'' the following: ``or, at the option of the State, 1-
        year period'';
            (3) in section 1902(l)(1)(A), by inserting after ``60-day 
        period'' the following: ``, or, at the option of the State, 1-
        year period,'';
            (4) in section 1903(v)(4)(A)(i), by inserting after ``60-
        day period'' the following: ``, or, at the option of the State, 
        1-year period,''; and
            (5) in section 1905(a), in the fourth sentence in the 
        matter following paragraph (30), by inserting after ``60-day 
        period'' the following: ``, or, at the option of the State, 1-
        year period,''.
    (b) State Option To Provide Continuous Coverage for Full Benefits 
for Individuals Who Are or Become Pregnant.--Section 1902(e)(6) of the 
Social Security Act (42 U.S.C. 1396a(e)(6)), as amended by subsection 
(a), is further amended--
            (1) by striking ``(6) In the case of a pregnant woman'' and 
        inserting
    ``(6)(A) In the case of a pregnant woman''; and
            (2) by adding at the end the following:
    ``(B)(i) At the option of the State, the State plan may provide 
that an individual who is eligible for medical assistance under the 
State plan (or a waiver of such plan) or for child health assistance 
under title XXI and who is, or who while so eligible becomes, pregnant 
shall continue to be eligible for such medical assistance or child 
health assistance, respectively, through the end of the month in which 
the 1-year period (beginning on the last day of such pregnancy) ends, 
regardless of the basis for the individual's eligibility for such 
medical assistance.''.
    (c) Increase of FMAP.--Section 1905 of the Social Security Act (42 
U.S.C. 1396d) is amended--
            (1) in subsection (b), in the first sentence, by striking 
        ``and (ff)'' and inserting ``(ff), and (gg)''; and
            (2) by adding at the end the following new subsection:
    ``(gg) Specified Coverage Extension States.--
            ``(1) In general.--Notwithstanding subsection (b), 
        beginning January 1, 2020, in the case of a specified coverage 
        extension State, for the initial extension calendar quarters 
        with respect to such State, the Federal medical assistance 
        percentage that would otherwise apply to the State without 
        application of this subsection, shall be increased by 5 
        percentage points.
            ``(2) Specified coverage extension state.--For purposes of 
        this subsection, the term `specified coverage extension State' 
        means a State, the State plan of which has in effect the 
        application of the 1-year period of continuous medical 
        assistance pursuant to each of paragraphs (5) and (6) of 
        section 1902(e).
            ``(3) Initial extension calendar quarter.--For purposes of 
        this subsection, the term `initial extension calendar quarter' 
        means, with respect to a State, each calendar quarter occurring 
        in the first fiscal year that the State is a specified coverage 
        extension State.''.
    (d) Application to CHIP Optional Coverage of Targeted Low-Income 
Pregnant Women.--Section 2112 of the Social Security Act (42 U.S.C. 
1397ll) is amended--
            (1) in subsection (d)(2)(A), by inserting after ``60-day 
        period'' the following: ``, or, at the option of the State, 1-
        year period''; and
            (2) in subsection (f)(2), by inserting after ``60-day 
        period'' the following: ``, or, at the option of the State, 1-
        year period''.
    (e) Effective Date.--The amendments made by this section shall 
apply with respect to eligibility determinations for items and services 
under State plans under title XIX of the Social Security Act (or a 
waiver of such a plan) (42 U.S.C. 1396 et seq.) and under State child 
health plans under title XXI (or waiver of such a plan) made on or 
after January 1, 2020.

SEC. 3. MACPAC REPORT.

    (a) In General.--Not later than 1 year after the date of the 
enactment of this Act, the Medicaid and CHIP Payment and Access 
Commission (referred to in this section as ``MACPAC'') shall publish a 
report on the coverage of doula services under State Medicaid programs, 
which shall at a minimum include the following:
            (1) Information about coverage for doula services under 
        State Medicaid programs that currently provide coverage for 
        such services, including the type of doula services offered 
        (such as prenatal, labor and delivery, postpartum support, and 
        also community-based and traditional doula services).
            (2) An analysis of barriers to covering doula services 
        under State Medicaid programs.
            (3) An identification of effective strategies to increase 
        the use of doula services in order to provide better care and 
        achieve better maternal and infant health outcomes, including 
        strategies that States may use to recruit, train, and certify a 
        diverse doula workforce, particularly from underserved 
        communities, communities of color, and communities facing 
        linguistic or cultural barriers.
            (4) Recommendations for legislative and administrative 
        actions to increase access to doula services in State Medicaid 
        programs, including actions that ensure doulas may earn a 
        living wage that accounts for their time and costs associated 
        with providing care.
    (b) Stakeholder Consultation.--In developing the report required 
under subsection (a), MACPAC shall consult with relevant stakeholders, 
including--
            (1) States;
            (2) organizations representing consumers, including those 
        that are disproportionately impacted by poor maternal health 
        outcomes;
            (3) organizations and individuals representing doula 
        services providers, including community-based doula programs 
        and those who serve underserved communities, including 
        communities of color, and communities facing linguistic or 
        cultural barriers; and
            (4) organizations representing health care providers.

SEC. 4. GAO REPORT.

    (a) In General.--Not later than 2 years after the date of the 
enactment of this Act and every five years thereafter, the Comptroller 
General of the United States shall submit to Congress a report on the 
State adoption, under the Medicaid program under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.) and the Children's Health 
Insurance Program under title XXI of such Act, of extending coverage to 
365 days postpartum pursuant to the provisions of (and amendments made 
by this Act). Such report shall include the information and 
recommendations described in subsection (b) and shall also identify 
ongoing gaps in coverage for--
            (1) pregnant women under the Medicaid program and the 
        Children's Health Insurance Program; and
            (2) postpartum women under the Medicaid program and the 
        Children's Health Insurance Program who received assistance 
        under either such program during their pregnancy.
    (b) Content of Report.--The report under subsection (a) shall 
include the following:
            (1) Information regarding the extent to which States have 
        elected to extend coverage to 365 days postpartum pursuant to 
        the provisions of (and amendments made by this Act), including 
        which States make the election and when, impacts on perinatal 
        insurance churn in those States compared to States that did not 
        make such election, other health impacts of such election 
        including regarding maternal mortality and morbidity rates, and 
        impacts on State and Federal Medicaid spending.
            (2) Information about the abilities, successes, and 
        challenges of State Medicaid agencies in--
                    (A) transitioning their eligibility systems to 
                incorporate such an election by a State and in 
                determining whether pregnant and postpartum women are 
                eligible under another insurance affordability program; 
                and
                    (B) transitioning any such women who are so 
                eligible to coverage under such a program, pursuant to 
                section 1943(b)(3) of the Social Security Act (42 U.S.C 
                1396w-3(b)(3)).
            (3) Information on factors contributing to ongoing gaps in 
        coverage resulting from women transitioning from coverage under 
        the Medicaid program or Children's Health Insurance Program 
        that disproportionately impact underserved populations, 
        including low-income women, women of color, women who reside in 
        a health professional shortage area (as defined in section 
        332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 
        254e(a)(1)(A))), or who are members of a medically underserved 
        population (as defined by section 330(b)(3) of such Act (42 
        U.S.C. 254b(b)(3)(A))).
            (4) Recommendations for addressing and reducing such gaps 
        in coverage.
            (5) Such other information as the Comptroller General 
        determines appropriate.

SEC. 5. REPORT ON MEDICAID BUNDLED PAYMENTS FOR PREGNANCY-RELATED 
              SERVICES.

    Not later than 2 years after the date of the enactment of this Act, 
the Medicaid and CHIP Payment Advisory Commission shall submit to 
Congress a report containing an analysis of the use of bundled payments 
for reimbursing health care providers with respect to pregnancy-related 
services furnished under State plans (or waivers of such plans) under 
title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).
                                                 Union Calendar No. 428

116th CONGRESS

  2d Session

                               H. R. 4996

                          [Report No. 116-527]

_______________________________________________________________________

                                 A BILL

 To amend title XIX of the Social Security Act to provide for a State 
option under the Medicaid program to provide for and extend continuous 
       coverage for certain individuals, and for other purposes.

_______________________________________________________________________

                           September 21, 2020

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed