[Congressional Record Volume 149, Number 27 (Thursday, February 13, 2003)]
[Senate]
[Pages S2491-S2492]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KYL (for himself, Mr. McCain, Mr. Domenici, Mrs. 
        Feinstein, Mr. Cornyn, and Mr. Schumer):
  S. 412. A bill to amend the Balanced Budget Act of 1997 to extend and 
modify the reimbursement of State and local funds expended for 
emergency health services furnished to undocumented aliens; to the 
Committee on Finance.
  Mr. KYL. Mr. President, I ask unanimous consent that the text of the 
bill be printed in the Record.

[[Page S2492]]

  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 412

       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 ``Local Emergency Health 
     Services Reimbursement Act of 2003''.

     SEC. 2. FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH SERVICES 
                   FURNISHED TO UNDOCUMENTED ALIENS.

       Section 4723 of the Balanced Budget Act of 1997 (8 U.S.C. 
     1611 note) is amended to read as follows:

     ``SEC. 4723. FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH 
                   SERVICES FURNISHED TO UNDOCUMENTED ALIENS.

       ``(a) Total Amount Available for Allotment.--There is 
     appropriated, out of any funds in the Treasury not otherwise 
     appropriated, $1,450,000,000 for each of fiscal years 2004 
     through 2008, for the purpose of making allotments under this 
     section to States described in paragraph (1) or (2) of 
     subsection (b). Funds appropriated under the preceding 
     sentence shall remain available until expended.
       ``(b) State Allotments.--
       ``(1) Based on percentage of undocumented aliens.--
       ``(A) In general.--Out of the amount appropriated under 
     subsection (a) for each fiscal year, the Secretary shall use 
     $957,000,000 of such amount to make allotments for each such 
     fiscal year in accordance with subparagraph (B).
       ``(B) Formula.--The amount of the allotment for each State 
     for a fiscal year shall be equal to the product of--
       ``(i) the total amount available for allotments under this 
     paragraph for the fiscal year; and
       ``(ii) the percentage of undocumented aliens residing in 
     the State with respect to the total number of such aliens 
     residing in all States, as determined by the Statistics 
     Division of the Immigration and Naturalization Service, as of 
     January 2003, based on the 2000 decennial census.
       ``(2) Based on number of undocumented alien apprehension 
     states.--
       ``(A) In general.--Out of the amount appropriated under 
     subsection (a) for a fiscal year, the Secretary shall use 
     $493,000,000 of such amount to make allotments for each such 
     fiscal year for each of the 6 States with the highest number 
     of undocumented alien apprehensions for such fiscal year.
       ``(B) Determination of allotments.--The amount of the 
     allotment for each State described in subparagraph (A) for a 
     fiscal year shall bear the same ratio to the total amount 
     available for allotments under this paragraph for the fiscal 
     year as the ratio of the number of undocumented alien 
     apprehensions in the State in the fiscal year bears to the 
     total of such numbers for all such States for such fiscal 
     year.
       ``(C) Data.--For purposes of this paragraph, the highest 
     number of undocumented alien apprehensions for a fiscal year 
     shall be based on the 4 most recent quarterly apprehension 
     rates for undocumented aliens in such States, as reported by 
     the Immigration and Naturalization Service.
       ``(3) Rule of construction.--Nothing in this section shall 
     be construed as prohibiting a State that is described in both 
     of paragraphs (1) and (2) from receiving an allotment under 
     both paragraphs for a fiscal year.
       ``(c) Use of Funds.--
       ``(1) Authority to make payments.--From the allotments made 
     for a State under subsection (b) for a fiscal year, the 
     Secretary shall pay directly to local governments, hospitals, 
     or other providers located in the State (including providers 
     of services received through an Indian Health Service 
     facility whether operated by the Indian Health Service or by 
     an Indian tribe or tribal organization) that provide 
     uncompensated emergency health services furnished to 
     undocumented aliens during that fiscal year, and to the 
     State, such amounts (subject to the total amount available 
     from such allotments) as the local governments, hospitals, 
     providers, or State demonstrate were incurred for the 
     provision of such services during that fiscal year.
       ``(2) Limitation on state use of funds.--Funds paid to a 
     State from allotments made under subsection (b) for a fiscal 
     year may only be used for making payments to local 
     governments, hospitals, or other providers for costs incurred 
     in providing emergency health services to undocumented aliens 
     or for State costs incurred with respect to the provision of 
     emergency health services to such aliens.
       ``(3) Inclusion of costs incurred with respect to certain 
     aliens.--Uncompensated emergency health services furnished to 
     aliens who have been allowed to enter the United States for 
     the sole purpose of receiving emergency health services may 
     be included in the determination of costs incurred by a 
     State, local government, hospital, or other provider with 
     respect to the provision of such services.
       ``(d) Applications; Advance Payments; Reallotment of Unused 
     Funds.--
       ``(1) Deadline for establishment of application process.--
       ``(A) In general.--Not later than July 31, 2003, the 
     Secretary shall establish a process under which States, local 
     governments, hospitals, or other providers located in the 
     State may apply for payments from allotments made under 
     subsection (b) for a fiscal year for uncompensated emergency 
     health services furnished to undocumented aliens during that 
     fiscal year.
       ``(B) Inclusion of measures to combat fraud.--The Secretary 
     shall include in the process established under subparagraph 
     (A) measures to ensure that fraudulent payments are not made 
     from the allotments determined under subsection (b) or from 
     amounts reallotted under paragraph (3).
       ``(2) Advance payment; Retrospective adjustment.--The 
     process established under paragraph (1) shall allow for 
     making payments under this section for each quarter of a 
     fiscal year on the basis of advance estimates of expenditures 
     submitted by applicants for such payments and such other 
     investigation as the Secretary may find necessary, and for 
     making reductions or increases in the payments as necessary 
     to adjust for any overpayment or underpayment for prior 
     quarters.
       ``(3) Reallotment of Unused Funds.--
       ``(A) In general.--With respect to allotments made under 
     subsection (b) for a fiscal year, the amount of any allotment 
     to a State for a fiscal year that the Secretary determines 
     will not be expended during that fiscal year or the 
     succeeding fiscal year shall be available for reallotment 
     during the second succeeding fiscal year, on such date as the 
     Secretary may determine, to other States with allotments 
     under that subsection that the Secretary determines will use 
     such excess amounts during that second succeeding fiscal 
     year.
       ``(B) Determination of reallotments.--Reallotments under 
     subparagraph (A) shall be made in the same manner as 
     allotments are determined under paragraphs (1) and (2) of 
     subsection (b) but only with respect to those States that the 
     Secretary determines qualify for a reallotment for a fiscal 
     year under that subparagraph.
       ``(C) Treatment.--Any amount reallotted under subparagraph 
     (A) to a State is deemed to be part of its allotment under 
     subsection (b) for the fiscal year in which the reallotment 
     occurs.
       ``(e) Definitions.--In this section:
       ``(1) Hospital.--The term `hospital' has the meaning given 
     such term in section 1861(e) of the Social Security Act (42 
     U.S.C. 1395x(e)).
       ``(2) Indian tribe; tribal organization.--The terms `Indian 
     tribe' and `tribal organization' have the meanings given such 
     terms in section 4 of the Indian Health Care Improvement Act.
       ``(3) Provider.--The term `provider' includes a physician, 
     any other health care professional licensed under State law, 
     and any other entity that furnishes emergency health 
     services, including ambulance services.
       ``(4) Secretary.--The term `Secretary' means the Secretary 
     of Health and Human Services.
       ``(5) State.--The term `State' means the 50 States and the 
     District of Columbia.
       ``(f) Entitlement.--This section constitutes budget 
     authority in advance of appropriations Acts and represents 
     the obligation of the Federal Government to provide for the 
     payment of amounts provided under this section.''.
                                 ______