[Congressional Record Volume 149, Number 96 (Thursday, June 26, 2003)]
[Senate]
[Pages S8633-S8635]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             AMENDING TITLE XXI OF THE SOCIAL SECURITY ACT

  Mr. GRASSLEY. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of Calendar No. 166, S. 312.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (S. 312) to amend title XXI of the Social Security 
     Act to extend the availability of allotments for fiscal years 
     1998 through 2001 under the State Children's Health Insurance 
     Program.

  There being no objection, the Senate proceeded to consider the bill.
  Mr. GRASSLEY. Mr. President, I ask unanimous consent that the 
managers' amendment be agreed to; that the bill, as amended, be read a 
third time and passed; that the motion to reconsider be laid upon the 
table; and that any statements relating to the bill be printed in the 
Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 1113) was agreed to, as follows:

               (Purpose: To make a technical correction)

       At the end, add the following:

     SEC. 2. TECHNICAL CORRECTION.

       (a) Temporary Increase of the Medicaid FMAP.--Section 
     401(a)(6)(A) of the Jobs and Growth Tax Relief Reconciliation 
     Act of 2003 (Public Law 108-027) is amended by inserting 
     ``after September 2, 2003,'' after ``(42 U.S.C. 1315))''.
       (b) Retroactive Effective Date.--The amendment made by 
     subsection (a) shall take effect as if included in the 
     enactment of section 401 of the Jobs and Growth Tax Relief 
     Reconciliation Act of 2003 (Public Law 108-027).

  The bill (S. 312), as amended, was read the third time and passed, as 
follows:

                                 S. 312

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

     SECTION 1. EXTENSION OF AVAILABILITY OF SCHIP ALLOTMENTS FOR 
                   FISCAL YEARS 1998 THROUGH 2001.

       (a) Extending Availability of SCHIP Allotments for Fiscal 
     Years 1998 Through 2001.--
       (1) Retained and redistributed allotments for fiscal years 
     1998 and 1999.--Paragraphs (2)(A)(i) and (2)(A)(ii) of 
     section 2104(g) of the Social Security Act (42 U.S.C. 
     1397dd(g)) are each amended by striking ``fiscal year 2002'' 
     and inserting ``fiscal year 2004''.
       (2) Extension and revision of retained and redistributed 
     allotments for fiscal year 2000.--
       (A) Permitting and extending retention of portion of fiscal 
     year 2000 allotment.--Paragraph (2) of such section 2104(g) 
     is amended--
       (i) in the heading, by striking ``and 1999'' and inserting 
     ``through 2000''; and
       (ii) by adding at the end of subparagraph (A) the 
     following:
       ``(iii) Fiscal year 2000 allotment.--Of the amounts 
     allotted to a State pursuant to this section for fiscal year 
     2000 that were not expended by the State by the end of fiscal 
     year 2002, 50 percent of that amount shall remain available 
     for expenditure by the State through the end of fiscal year 
     2004.''.
       (B) Redistributed allotments.--Paragraph (1) of such 
     section 2104(g) is amended--
       (i) in subparagraph (A), by inserting ``or for fiscal year 
     2000 by the end of fiscal year 2002,'' after ``fiscal year 
     2001,'';
       (ii) in subparagraph (A), by striking ``1998 or 1999'' and 
     inserting ``1998, 1999, or 2000'';
       (iii) in subparagraph (A)(i)--

       (I) by striking ``or'' at the end of subclause (I),
       (II) by striking the period at the end of subclause (II) 
     and inserting ``; or''; and
       (III) by adding at the end the following new subclause:
       ``(III) the fiscal year 2000 allotment, the amount 
     specified in subparagraph (C)(i) (less the total of the 
     amounts under clause (ii) for such fiscal year), multiplied 
     by the ratio of the amount specified in subparagraph (C)(ii) 
     for the State to the amount specified in subparagraph 
     (C)(iii).'';

       (iv) in subparagraph (A)(ii), by striking ``or 1999'' and 
     inserting ``, 1999, or 2000'';
       (v) in subparagraph (B), by striking ``with respect to 
     fiscal year 1998 or 1999'';

[[Page S8634]]

       (vi) in subparagraph (B)(ii)--

       (I) by inserting ``with respect to fiscal year 1998, 1999, 
     or 2000,'' after ``subsection (e),''; and
       (II) by striking ``2002'' and inserting ``2004''; and

       (vii) by adding at the end the following new subparagraph:
       ``(C) Amounts used in computing redistributions for fiscal 
     year 2000.--For purposes of subparagraph (A)(i)(III)--
       ``(i) the amount specified in this clause is the amount 
     specified in paragraph (2)(B)(i)(I) for fiscal year 2000, 
     less the total amount remaining available pursuant to 
     paragraph (2)(A)(iii);
       ``(ii) the amount specified in this clause for a State is 
     the amount by which the State's expenditures under this title 
     in fiscal years 2000, 2001, and 2002 exceed the State's 
     allotment for fiscal year 2000 under subsection (b); and
       ``(iii) the amount specified in this clause is the sum, for 
     all States entitled to a redistribution under subparagraph 
     (A) from the allotments for fiscal year 2000, of the amounts 
     specified in clause (ii).''.
       (C) Conforming amendments.--Such section 2104(g) is further 
     amended--
       (i) in its heading, by striking ``and 1999'' and inserting 
     ``, 1999, and 2000''; and
       (ii) in paragraph (3)--

       (I) by striking ``or fiscal year 1999'' and inserting ``, 
     fiscal year 1999, or fiscal year 2000''; and
       (II) by striking ``or November 30, 2001'' and inserting 
     ``November 30, 2001, or November 30, 2002'', respectively.

       (3) Extension and revision of retained and redistributed 
     allotments for fiscal year 2001.--
       (A) Permitting and extending retention of portion of fiscal 
     year 2001 allotment.--Paragraph (2) of such section 2104(g), 
     as amended in paragraph (2)(A)(ii), is further amended--
       (i) in the heading, by striking ``2000'' and inserting 
     ``2001''; and
       (ii) by adding at the end of subparagraph (A) the 
     following:
       ``(iv) Fiscal year 2001 allotment.--Of the amounts allotted 
     to a State pursuant to this section for fiscal year 2001 that 
     were not expended by the State by the end of fiscal year 
     2003, 50 percent of that amount shall remain available for 
     expenditure by the State through the end of fiscal year 
     2005.''.
       (B) Redistributed allotments.--Paragraph (1) of such 
     section 2104(g), as amended in paragraph (2)(B), is further 
     amended--
       (i) in subparagraph (A), by inserting ``or for fiscal year 
     2001 by the end of fiscal year 2003,'' after ``fiscal year 
     2002,'';
       (ii) in subparagraph (A), by striking ``1999, or 2000'' and 
     inserting ``1999, 2000, or 2001'';
       (iii) in subparagraph (A)(i)--

       (I) by striking ``or'' at the end of subclause (II),
       (II) by striking the period at the end of subclause (III) 
     and inserting ``; or''; and
       (III) by adding at the end the following new subclause:
       ``(IV) the fiscal year 2001 allotment, the amount specified 
     in subparagraph (D)(i) (less the total of the amounts under 
     clause (ii) for such fiscal year), multiplied by the ratio of 
     the amount specified in subparagraph (D)(ii) for the State to 
     the amount specified in subparagraph (D)(iii).'';

       (iv) in subparagraph (A)(ii), by striking ``or 2000'' and 
     inserting ``2000, or 2001'';
       (v) in subparagraph (B)--

       (I) by striking ``and'' at the end of clause (ii);
       (II) by redesignating clause (iii) as clause (iv); and
       (III) by inserting after clause (ii) the following new 
     clause:

       ``(iii) notwithstanding subsection (e), with respect to 
     fiscal year 2001, shall remain available for expenditure by 
     the State through the end of fiscal year 2005; and''; and
       (vi) by adding at the end the following new subparagraph:
       ``(D) Amounts used in computing redistributions for fiscal 
     year 2001.--For purposes of subparagraph (A)(i)(IV)--
       ``(i) the amount specified in this clause is the amount 
     specified in paragraph (2)(B)(i)(I) for fiscal year 2001, 
     less the total amount remaining available pursuant to 
     paragraph (2)(A)(iv);
       ``(ii) the amount specified in this clause for a State is 
     the amount by which the State's expenditures under this title 
     in fiscal years 2001, 2002, and 2003 exceed the State's 
     allotment for fiscal year 2001 under subsection (b); and
       ``(iii) the amount specified in this clause is the sum, for 
     all States entitled to a redistribution under subparagraph 
     (A) from the allotments for fiscal year 2001, of the amounts 
     specified in clause (ii).''.
       (C) Conforming amendments.--Such section 2104(g) is further 
     amended--
       (i) in its heading, by striking ``and 2000'' and inserting 
     ``2000, and 2001''; and
       (ii) in paragraph (3)--

       (I) by striking ``or fiscal year 2000'' and inserting 
     ``fiscal year 2000, or fiscal year 2001''; and
       (II) by striking ``or November 30, 2002,'' and inserting 
     ``November 30, 2002, or November 30, 2003,'', respectively.

       (4) Effective date.--This subsection, and the amendments 
     made by this subsection, shall be effective as if this 
     subsection had been enacted on September 30, 2002, and 
     amounts under title XXI of the Social Security Act (42 U.S.C. 
     1397aa et seq.) from allotments for fiscal years 1998 through 
     2000 are available for expenditure on and after October 1, 
     2002, under the amendments made by this subsection as if this 
     subsection had been enacted on September 30, 2002.
       (b) Authority for Qualifying States To Use Portion of SCHIP 
     Funds for Medicaid Expenditures.--Section 2105 of the Social 
     Security Act (42 U.S.C. 1397ee) is amended by adding at the 
     end the following:
       ``(g) Authority for Qualifying States To Use Certain Funds 
     for Medicaid Expenditures.--
       ``(1) State option.--
       ``(A) In general.--Notwithstanding any other provision of 
     law, with respect to allotments for fiscal years 1998, 1999, 
     2000, 2001, for fiscal years in which such allotments are 
     available under subsections (e) and (g) of section 2104, a 
     qualifying State (as defined in paragraph (2)) may elect to 
     use not more than 20 percent of such allotments (instead of 
     for expenditures under this title) for payments for such 
     fiscal year under title XIX in accordance with subparagraph 
     (B).
       ``(B) Payments to states.--
       ``(i) In general.--In the case of a qualifying State that 
     has elected the option described in subparagraph (A), subject 
     to the total amount of funds described with respect to the 
     State in subparagraph (A), the Secretary shall pay the State 
     an amount each quarter equal to the additional amount that 
     would have been paid to the State under title XIX for 
     expenditures of the State for the fiscal year described in 
     clause (ii) if the enhanced FMAP (as determined under 
     subsection (b)) had been substituted for the Federal medical 
     assistance percentage (as defined in section 1905(b)) of such 
     expenditures.
       ``(ii) Expenditures described.--For purposes of clause (i), 
     the expenditures described in this clause are expenditures 
     for such fiscal years for providing medical assistance under 
     title XIX to individuals who have not attained age 19 and 
     whose family income exceeds 150 percent of the poverty line.
       ``(iii) No impact on determination of budget neutrality for 
     waivers.--In the case of a qualifying State that uses amounts 
     paid under this subsection for expenditures described in 
     clause (ii) that are incurred under a waiver approved for the 
     State, any budget neutrality determinations with respect to 
     such waiver shall be determined without regard to such 
     amounts paid.
       ``(2) Qualifying state.--In this subsection, the term 
     `qualifying State' means a State that--
       ``(A) as of April 15, 1997, has an income eligibility 
     standard with respect to any 1 or more categories of children 
     (other than infants) who are eligible for medical assistance 
     under section 1902(a)(10)(A) or under a waiver under section 
     1115 implemented on January 1, 1994, that is up to 185 
     percent of the poverty line or above; and
       ``(B) satisfies the requirements described in paragraph 
     (3).
       ``(3) Requirements.--The requirements described in this 
     paragraph are the following:
       ``(A) SCHIP income eligibility.--The State has a State 
     child health plan that (whether implemented under title XIX 
     or this title)--
       ``(i) as of January 1, 2001, has an income eligibility 
     standard that is at least 200 percent of the poverty line or 
     has an income eligibility standard that exceeds 200 percent 
     of the poverty line under a waiver under section 1115 that is 
     based on a child's lack of health insurance;
       ``(ii) subject to subparagraph (B), does not limit the 
     acceptance of applications for children; and
       ``(iii) provides benefits to all children in the State who 
     apply for and meet eligibility standards on a statewide 
     basis.
       ``(B) No waiting list imposed.--With respect to children 
     whose family income is at or below 200 percent of the poverty 
     line, the State does not impose any numerical limitation, 
     waiting list, or similar limitation on the eligibility of 
     such children for child health assistance under such State 
     plan.
       ``(C) Additional requirements.--The State has implemented 
     at least 3 of the following policies and procedures (relating 
     to coverage of children under title XIX and this title):
       ``(i) Uniform, simplified application form.--With respect 
     to children who are eligible for medical assistance under 
     section 1902(a)(10)(A), the State uses the same uniform, 
     simplified application form (including, if applicable, 
     permitting application other than in person) for purposes of 
     establishing eligibility for benefits under title XIX and 
     this title.
       ``(ii) Elimination of asset test.--The State does not apply 
     any asset test for eligibility under section 1902(l) or this 
     title with respect to children.
       ``(iii) Adoption of 12-month continuous enrollment.--The 
     State provides that eligibility shall not be regularly 
     redetermined more often than once every year under this title 
     or for children described in section 1902(a)(10)(A).
       ``(iv) Same verification and redetermination policies; 
     automatic reassessment of eligibility.--With respect to 
     children who are eligible for medical assistance under 
     section 1902(a)(10)(A), the State provides for initial 
     eligibility determinations and redeterminations of 
     eligibility using the same verification policies (including 
     with respect to face-to-face interviews), forms, and 
     frequency as the State uses for such purposes under this 
     title, and, as part of such redeterminations, provides for 
     the automatic reassessment of the eligibility of such 
     children for assistance under title XIX and this title.

[[Page S8635]]

       ``(v) Outstationing enrollment staff.--The State provides 
     for the receipt and initial processing of applications for 
     benefits under this title and for children under title XIX at 
     facilities defined as disproportionate share hospitals under 
     section 1923(a)(1)(A) and Federally-qualified health centers 
     described in section 1905(l)(2)(B) consistent with section 
     1902(a)(55).''.

     SEC. 2. TECHNICAL CORRECTION.

       (a) Temporary Increase of the Medicaid FMAP.--Section 
     401(a)(6)(A) of the Jobs and Growth Tax Relief Reconciliation 
     Act of 2003 (Public Law 108-027) is amended by inserting 
     ``after September 2, 2003,'' after ``(42 U.S.C. 1315))''.
       (b) Retroactive Effective Date.--The amendment made by 
     subsection (a) shall take effect as if included in the 
     enactment of section 401 of the Jobs and Growth Tax Relief 
     Reconciliation Act of 2003 (Public Law 108-027).

                          ____________________