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<dc:title>118 HR 629 IH: Medicaid Improvement and State Flexibility Act of 2023</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2023-01-30</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">118th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 629</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20230130">January 30, 2023</action-date><action-desc><sponsor name-id="G000590">Mr. Green of Tennessee</sponsor> (for himself and <cosponsor name-id="B001317">Mr. Brecheen</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend title XI of the Social Security Act to provide for State approval and implementation of specified waivers under the Medicaid program.</official-title></form><legis-body id="H2AB9AC297F7D4644A28DD6AD820436FE" style="OLC"> 
<section id="H55F37BC6F8314D5383BD857AF855DA08" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Medicaid Improvement and State Flexibility Act of 2023</short-title></quote>.</text></section> <section id="H6E2FFAE91A784F92BE4B98F364D52296"><enum>2.</enum><header>Providing for State approval and implementation of specified waivers under the Medicaid program</header><text display-inline="no-display-inline">Section 1115 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1315">42 U.S.C. 1315</external-xref>) is amended—</text>
<paragraph id="H130E5B6FEF1541D2A91FE2CED0DF72F6"><enum>(1)</enum><text>in subsection (d)—</text> <subparagraph id="HC5AE00FC64E44EB88FC42E8012F346FE"><enum>(A)</enum><text>in paragraph (1), by striking <quote>An application</quote> and inserting <quote>Subject to paragraph (4), an application</quote>; and</text></subparagraph>
<subparagraph id="H0AEB453A7A5E442C84DA2CEB783DE058"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block display-inline="no-display-inline" id="H38E396048A6B45DE99235DBE4608E797" style="OLC"> <paragraph id="HB04C056188BB443CBAFDF6BE61E0B987" indent="up1"><enum>(4)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="H0C0C6250EA4648FA8020BBE96039DE4C"><enum>(A)</enum><text>An experimental, pilot, or demonstration project undertaken under subsection (a) may be approved or renewed by a State if such project is described in subparagraph (B).</text></subparagraph>
<subparagraph id="H201557E2B5D04D6CA6DC6059639C5972" indent="up1"><enum>(B)</enum><text>An experimental, pilot, or demonstration project is described in this subparagraph if such project provides for a waiver of requirements with respect to a State plan (or a waiver of such plan) under title XIX such that—</text> <clause id="H8899A6E8E9BD489CBB7626FB77CE5190"><enum>(i)</enum><text>individuals enrolled under such plan (or such waiver) may elect to participate in such project with respect to a year;</text></clause>
<clause id="H2BDB1882246E4CCE9D1BA72EB84E62EF"><enum>(ii)</enum><text>such individuals who elect to so participate—</text> <subclause id="H66646D82427E4FAE90856752EE4178CD"><enum>(I)</enum><text>are furnished with an electronic benefits transfer card in an amount determined appropriate by the State for purposes of purchasing primary care services and medications during such year;</text></subclause>
<subclause id="H2E81D657245D4BF6A123D4A9C4E27D25"><enum>(II)</enum><text>are furnished a cash payment by the State equal to the amount of funds remaining on the individual’s electronic benefits transfer card at the end of such year; and</text></subclause> <subclause id="HF886D7AF08B547CB9E25FFD0552D1744"><enum>(III)</enum><text>are enrolled in a catastrophic insurance program determined appropriate by the State for purposes of covering services not described in subclause (I) and covering services that are described in such subclause if such individual exceeds the amount of funds provided to such individual on such card for such year; and</text></subclause></clause>
<clause id="HA64F0C75A2FD4F0BBE8E2A84B45545DE"><enum>(iii)</enum><text>Federal expenditures under such title for the period during which such project is in effect are equal to or lesser than what such expenditures would have been during such period if such project were not in effect.</text></clause></subparagraph> <subparagraph id="H18D9F06008274EE6893D00DF00E88CAE" indent="up1"><enum>(C)</enum> <clause commented="no" display-inline="yes-display-inline" id="H3C1C0A5FED464F7FA40515C56377C0FE"><enum>(i)</enum><text>In no case may a project described in subparagraph (B) result in an expenditure to pay for any abortion or to assist in the purchase, in whole or in part, of health benefit coverage that includes coverage of abortion.</text></clause>
<clause id="H2165649EDD6B4CA6AA7A6CE42DA5F948" indent="up1"><enum>(ii)</enum><text>Clause (i) shall not apply to an abortion only if necessary to save the life of the mother or if the pregnancy is the result of an act of rape or incest.</text></clause></subparagraph> <subparagraph id="HBAD38D7EB17D4E8AB9C99A65E0836614" indent="up1"><enum>(D)</enum><text>For purposes of a State’s approval or renewal of an experimental, pilot, or demonstration project under subparagraph (A), each reference to <quote>the Secretary</quote> in subsection (a) shall be deemed to be a reference to <quote>the State</quote>.</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H86C1B17FA30A45698B5ABA5359EDB36E"><enum>(2)</enum><text>in subsection (e), by inserting <quote>(other than such a project that is described in paragraph (4)(B))</quote> before the period at the end.</text></paragraph></section> </legis-body></bill>

