[Congressional Record Volume 151, Number 162 (Friday, December 16, 2005)]
[Senate]
[Pages S13802-S13804]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN:
  S. 2137. A bill to amend title XXI of the Social Security Act to make 
all uninsured children eligible for the State children's health 
insurance program, to encourage States to increase the number of 
children enrolled in the medicaid and State children's health insurance 
programs by simplifying the enrollment and renewal procedures for those 
programs, and for other purposes; to the Committee on Finance.
  Mr. DURBIN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2137

       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 ``All Kids Health Insurance 
     Coverage Act of 2005''.

     SEC. 2. FINDINGS.

       The Senate finds the following:
       (1) There are more than 9,000,000 children in the United 
     States with no health insurance coverage.
       (2) Uninsured children, when compared to privately insured 
     children, are --
       (A) 3.5 times more likely to have gone without needed 
     medical, dental, or other health care;
       (B) 4 times more likely to have delayed seeking medical 
     care;
       (C) 5 times more likely to go without needed prescription 
     drugs; and
       (D) 6.5 times less likely to have a regular source of care.
       (3) Children without health insurance coverage are at a 
     disadvantage in the classroom, as shown by the following 
     studies:
       (A) The Florida Healthy Kids Annual Report published in 
     1997, found that children who do not have health care 
     coverage are 25 percent more likely to miss school.
       (B) A study of the California Health Families program found 
     that children enrolled in public health coverage experienced 
     a 68 percent improvement in school performance and school 
     attendance.
       (C) A 2002 Building Bridges to Healthy Kids and Better 
     Students study conducted by the Council of Chief State School 
     Officers in Vermont concluded that children who started out 
     without health insurance saw their reading scores more than 
     double after obtaining health care coverage.
       (4) More than half of uninsured children in the United 
     States are eligible for coverage under either the State 
     Children's Health Insurance Program (SCHIP) or Medicaid, but 
     are not enrolled in those safety net programs.
       (5) Some States, seeing that the Federal Government is not 
     providing assistance to middle class families who are unable 
     to afford health insurance, are trying to extend health care 
     coverage to some or all children in the State.
       (6) State efforts to cover all children may not be 
     successful without financial assistance from the Federal 
     Government.

     SEC. 3. ELIGIBILITY OF ALL UNINSURED CHILDREN FOR SCHIP.

       (a) In General.--Section 2110(b) of the Social Security Act 
     (42 U.S.C. 1397jj(b)) is amended--
       (1) in paragraph (1)--
       (A) by striking subparagraph (B); and
       (B) by redesignating subparagraph (C) as subparagraph (B);
       (2) in paragraph (2)--
       (A) by striking ``include'' and all that follows through 
     ``a child who is an'' and inserting ``include a child who is 
     an''; and
       (B) by striking the semicolon and all that follows through 
     the period and inserting a period; and
       (3) by striking paragraph (4).
       (b) No Exclusion of Children With Access to High-Cost 
     Coverage.--Section 2110(b)(3) of the Social Security Act (42 
     U.S.C. 1397jj(b)(3)) is amended--
       (1) in the paragraph heading, by striking ``rule'' and 
     inserting ``rules'';
       (2) by striking ``A child shall not be considered to be 
     described in paragraph (1)(C)'' and inserting the following:
       ``(A) Certain non federally funded coverage.--A child shall 
     not be considered to be described in paragraph (1)(C)''; and
       (3) by adding at the end the following:
       ``(B) No exclusion of children with access to high-cost 
     coverage.--A State may include a child as a targeted 
     vulnerable child if the child has access to coverage under a 
     group health plan or health insurance coverage and the total 
     annual aggregate cost for premiums, deductibles, cost 
     sharing, and similar charges imposed under the group health 
     plan or health insurance coverage with respect to all 
     targeted vulnerable children in the child's family exceeds 5 
     percent of such family's income for the year involved.''.
       (c) Conforming Amendments.--
       (1) Titles XIX and XXI of the Social Security Act (42 
     U.S.C. 1396 et seq.; 1397aa et. seq.) are amended by striking 
     ``targeted low-income'' each place it appears and inserting 
     ``targeted vulnerable''.
       (2) Section 2101(a) of such Act (42 U.S.C. 1397aa(a)) is 
     amended by striking ``uninsured, low-income'' and inserting 
     ``low-income''.
       (3) Section 2102(b)(3)(C) of such Act (42 U.S.C. 
     1397bb(b)(3)(C)) is amended by inserting ``, particularly 
     with respect to children whose family income exceeds 200 
     percent of the poverty line'' before the semicolon.
       (4) Section 2102(b)(3)(E), section 2105(a)(1)(D)(ii), 
     paragraphs (1)(C) and (2) of section 2107, and subsections 
     (a)(1) and (d)(1)(B) of section 2108 of such Act (42 U.S.C. 
     1397bb(b)(3)(E); 1397ee(a)(1)(D)(ii); 1397gg; 1397hh) are 
     amended by striking ``low-income'' each place it appears.
       (5) Section 2110(a)(27) of such Act (42 U.S.C. 
     1397jj(a)(27)) is amended by striking ``eligible low-income 
     individuals'' and inserting ``targeted vulnerable 
     individuals''.
       (d) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.

     SEC. 4. INCREASE IN FEDERAL FINANCIAL PARTICIPATION UNDER 
                   SCHIP AND MEDICAID FOR STATES WITH SIMPLIFIED 
                   ENROLLMENT AND RENEWAL PROCEDURES FOR CHILDREN.

       (a) SCHIP.--Section 2105(c)(2) of the Social Security Act 
     (42 U.S.C. 1397ee(c)(2)) is amended by adding at the end the 
     following:
       ``(C) Nonapplication of limitation and increase in federal 
     payment for states with simplified enrollment and renewal 
     procedures.--
       ``(i) In general.--Notwithstanding subsection (a)(1) and 
     subparagraph (A)--

       ``(I) the limitation under subparagraph (A) on expenditures 
     for items described in subsection (a)(1)(D) shall not apply 
     with respect to expenditures incurred to carry out any of the 
     outreach strategies described in clause (ii), but only if the 
     State carries out the same outreach strategies for children 
     under title XIX; and

[[Page S13803]]

       ``(II) the enhanced FMAP for a State for a fiscal year 
     otherwise determined under subsection (b) shall be increased 
     by 5 percentage points (without regard to the application of 
     the 85 percent limitation under that subsection) with respect 
     to such expenditures.

       ``(ii) Outreach strategies described.--For purposes of 
     clause (i), the outreach strategies described in this clause 
     are the following:

       ``(I) Presumptive eligibility.--The State provides for 
     presumptive eligibility for children under this title and 
     under title XIX.
       ``(II) Adoption of 12-month continuous eligibility.--The 
     State provides that eligibility for children shall not be 
     redetermined more often than once every year under this title 
     or under title XIX.
       ``(III) Elimination of asset test.--The State does not 
     apply any asset test for eligibility under this title or 
     title XIX with respect to children.
       ``(IV) Passive renewal.--The State provides for the 
     automatic renewal of the eligibility of children for 
     assistance under this title and under title XIX if the family 
     of which such a child is a member does not report any changes 
     to family income or other relevant circumstances, subject to 
     verification of information from State databases.''.

       (b) Medicaid.--
       (1) In general.--Section 1902(l) of the Social Security Act 
     (42 U.S.C. 1396a(l)) is amended--
       (A) in paragraph (3), by inserting ``subject to paragraph 
     (5)'', after ``Notwithstanding subsection (a)(17),''; and
       (B) by adding at the end the following:
       ``(5)(A) Notwithstanding the first sentence of section 
     1905(b), with respect to expenditures incurred to carry out 
     any of the outreach strategies described in subparagraph (B) 
     for individuals under 19 years of age who are eligible for 
     medical assistance under subsection (a)(10)(A), the Federal 
     medical assistance percentage is equal to the enhanced FMAP 
     described in section 2105(b) and increased under section 
     2105(c)(2)(C)(i)(II), but only if the State carries out the 
     same outreach strategies for children under title XXI.
       ``(B) For purposes of subparagraph (A), the outreach 
     strategies described in this subparagraph are the following:
       ``(i) Presumptive eligibility.--The State provides for 
     presumptive eligibility for such individuals under this title 
     and title XXI.
       ``(ii) Adoption of 12-month continuous eligibility.--The 
     State provides that eligibility for such individuals shall 
     not be redetermined more often than once every year under 
     this title or under title XXI.
       ``(iii) Elimination of asset test.--The State does not 
     apply any asset test for eligibility under this title or 
     title XXI with respect to such individuals.
       ``(iv) Passive renewal.--The State provides for the 
     automatic renewal of the eligibility of such individuals for 
     assistance under this title and under title XXI if the family 
     of which such an individual is a member does not report any 
     changes to family income or other relevant circumstances, 
     subject to verification of information from State 
     databases.''.
       (2) Conforming amendment.--The first sentence of section 
     1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is 
     amended by striking ``section 1933(d)'' and inserting 
     ``sections 1902(l)(5) and 1933(d)''.
       (c) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.

     SEC. 5. LIMITATION ON PAYMENTS TO STATES THAT HAVE AN 
                   ENROLLMENT CAP BUT HAVE NOT EXHAUSTED THE 
                   STATE'S AVAILABLE ALLOTMENTS.

       (a) In General.--Section 2105 of the Social Security Act 
     (42 U.S.C. 1397ee) is amended by adding at the end the 
     following:
       ``(h) Limitation on Payments to States That Have an 
     Enrollment Cap but Have Not Exhausted the State's Available 
     Allotments.--
       ``(1) In general.--Notwithstanding any other provision of 
     this section, payment shall not be made to a State under this 
     section if the State has an enrollment freeze, enrollment 
     cap, procedures to delay consideration of, or not to 
     consider, submitted applications for child health assistance, 
     or a waiting list for the submission or consideration of such 
     applications or for such assistance, and the State has not 
     fully expended the amount of all allotments available with 
     respect to a fiscal year for expenditure by the State, 
     including allotments for prior fiscal years that remain 
     available for expenditure during the fiscal year under 
     subsection (c) or (g) of section 2104 or that were 
     redistributed to the State under subsection (f) or (g) of 
     section 2104.
       ``(2) Rule of construction.--Paragraph (1) shall not be 
     construed as prohibiting a State from establishing regular 
     open enrollment periods for the submission of applications 
     for child health assistance.''.
       (b) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.

     SEC. 6. ADDITIONAL ENHANCEMENT TO FMAP TO PROMOTE EXPANSION 
                   OF COVERAGE TO ALL UNINSURED CHILDREN UNDER 
                   MEDICAID AND SCHIP.

       (a) In General.--Title XXI (42 U.S.C. 1397aa et seq.) is 
     amended by adding at the end the following:

     ``SEC. 2111. ADDITIONAL ENHANCEMENT TO FMAP TO PROMOTE 
                   EXPANSION OF COVERAGE TO ALL UNINSURED CHILDREN 
                   UNDER MEDICAID AND SCHIP.

       ``(a) In General.--Notwithstanding subsection (b) of 
     section 2105 (and without regard to the application of the 85 
     percent limitation under that subsection), the enhanced FMAP 
     with respect to expenditures in a quarter for providing child 
     health assistance to uninsured children whose family income 
     exceeds 200 percent of the poverty line, shall be increased 
     by 5 percentage points.
       ``(b) Uninsured Child Defined.--
       ``(1) In general.--For purposes of subsection (a), subject 
     to paragraph (2), the term `uninsured child' means an 
     uncovered child who has been without creditable coverage for 
     a period determined by the Secretary, except that such period 
     shall not be less than 6 months.
       ``(2) Special rule for newborn children.--In the case of a 
     child 12 months old or younger, the period determined under 
     paragraph (1) shall be 0 months and such child shall be 
     considered uninsured upon birth.
       ``(3) Special rule for children losing medicaid or schip 
     coverage due to increased family income.--In the case of a 
     child who, due to an increase in family income, becomes 
     ineligible for coverage under title XIX or this title during 
     the period beginning on the date that is 12 months prior to 
     the date of enactment of the All Kids Health Insurance 
     Coverage Act of 2005 and ending on the date of enactment of 
     such Act, the period determined under paragraph (1) shall be 
     0 months and such child shall be considered uninsured upon 
     the date of enactment of the All Kids Health Insurance 
     Coverage Act of 2005.
       ``(4) Monitoring and adjustment of period required to be 
     uninsured.--The Secretary shall--
       ``(A) monitor the availability and retention of employer-
     sponsored health insurance coverage of dependent children; 
     and
       ``(B) adjust the period determined under paragraph (1) as 
     needed for the purpose of promoting the retention of private 
     or employer-sponsored health insurance coverage of dependent 
     children and timely access to health care services for such 
     children.''.
       (b) Cost-Sharing for Children in Families With High Family 
     Income.--Section 2103(e)(3) of the Social Security Act (42 
     U.S.C. 1397cc(e)(3)) is amended by adding at the end the 
     following new subparagraph:
       ``(C) Children in families with high family income.--
       ``(i) In general.--For children not described in 
     subparagraph (A) whose family income exceeds 400 percent of 
     the poverty line for a family of the size involved, subject 
     to paragraphs (1)(B) and (2), the State shall impose a 
     premium that is not less than the cost of providing child 
     health assistance to children in such families, and 
     deductibles, cost sharing, or similar charges shall be 
     imposed under the State child health plan (without regard to 
     a sliding scale based on income), except that the total 
     annual aggregate cost-sharing with respect to all such 
     children in a family under this title may not exceed 5 
     percent of such family's income for the year involved.
       ``(ii) Inflation adjustment.--The dollar amount specified 
     in clause (i) shall be increased, beginning with fiscal year 
     2008, from year to year based on the percentage increase in 
     the consumer price index for all urban consumers (all items; 
     United States city average). Any dollar amount established 
     under this clause that is not a multiple of $100 shall be 
     rounded to the nearest multiple of $100.''.
       (c) Additional Allotments for States Providing Coverage to 
     All Uninsured Children in the State.--
       (1) In general.--Section 2104 of the Social Security Act 
     (42 U.S.C. 1397dd) is amended by inserting after subsection 
     (c) the following:
       ``(d) Additional Allotments for States Providing Coverage 
     to All Uninsured Children in the State.--
       ``(1) Appropriation; total allotment.--For the purpose of 
     providing additional allotments to States to provide coverage 
     of all uninsured children (as defined in section 2111(b)) in 
     the State under the State child health plan, there is 
     appropriated, out of any money in the Treasury not otherwise 
     appropriated--
       ``(A) for fiscal years 2007, 2008, and 2009, 
     $3,000,000,000;
       ``(B) for fiscal year 2010, $5,000,000,000; and
       ``(C) for fiscal year 2011, $7,000,000,000.
       ``(2) State and territorial allotments.--
       ``(A) In general.--In addition to the allotments provided 
     under subsections (b) and (c), subject to subparagraph (B) 
     and paragraphs (3) and (4), of the amount available for the 
     additional allotments under paragraph (1) for a fiscal year, 
     the Secretary shall allot to each State with a State child 
     health plan that provides coverage of all uninsured children 
     (as so defined) in the State approved under this title--
       ``(i) in the case of such a State other than a commonwealth 
     or territory described in subsection (ii), the same 
     proportion as the proportion of the State's allotment under 
     subsection (b) (determined without regard to subsection (f)) 
     to 98.95 percent of the total amount of the allotments under 
     such section for such States eligible for an allotment under 
     this subparagraph for such fiscal year; and
       ``(ii) in the case of a commonwealth or territory described 
     in subsection (c)(3), the same proportion as the proportion 
     of the commonwealth's or territory's allotment

[[Page S13804]]

     under subsection (c) (determined without regard to subsection 
     (f)) to 1.05 percent of the total amount of the allotments 
     under such section for commonwealths and territories eligible 
     for an allotment under this subparagraph for such fiscal 
     year.
       ``(B) Minimum allotment.--
       ``(i) In general.--No allotment to a State for a fiscal 
     year under this subsection shall be less than 50 percent of 
     the amount of the allotment to the State determined under 
     subsections (b) and (c) for the preceding fiscal year.
       ``(ii) Pro rata reductions.--The Secretary shall make such 
     pro rata reductions to the allotments determined under this 
     subsection as are necessary to comply with the requirements 
     of clause (i).
       ``(C) Availability and redistribution of unused 
     allotments.--In applying subsections (e) and (f) with respect 
     to additional allotments made available under this 
     subsection, the procedures established under such subsections 
     shall ensure such additional allotments are only made 
     available to States which have elected to provide coverage 
     under section 2111.
       ``(3) Use of additional allotment.--Additional allotments 
     provided under this subsection are not available for amounts 
     expended before October 1, 2005. Such amounts are available 
     for amounts expended on or after such date for child health 
     assistance for uninsured children (as defined in section 
     2111(b)).
       ``(4) Requiring election to provide coverage.--No payments 
     may be made to a State under this title from an allotment 
     provided under this subsection unless the State has made an 
     election to provide child health assistance for all uninsured 
     children (as so defined) in the State, including such 
     children whose family income exceeds 200 percent of the 
     poverty line.''.
       (2) Conforming amendments.--Section 2104 of the Social 
     Security Act (42 U.S.C. 1397dd) is amended--
       (A) in subsection (a), by inserting ``subject to subsection 
     (d),'' after ``under this section,'';
       (B) in subsection (b)(1), by inserting ``and subsection 
     (d)'' after ``Subject to paragraph (4)''; and
       (C) in subsection (c)(1), by inserting ``subject to 
     subsection (d),'' after ``for a fiscal year,''.
       (d) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.

     SEC. 7. REPEAL OF THE SCHEDULED PHASEOUT OF THE LIMITATIONS 
                   ON PERSONAL EXEMPTIONS AND ITEMIZED DEDUCTIONS.

       (a) In General.--The Internal Revenue Code of 1986 is 
     amended--
       (1) by striking subparagraphs (E) and (F) of section 
     151(d)(3), and
       (2) by striking subsections (f) and (g) of section 68.
       (b) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2005.
       (c) Application of EGTRRA Sunset.--The amendments made by 
     this section shall be subject to title IX of the Economic 
     Growth and Tax Relief Reconciliation Act of 2001 to the same 
     extent and in the same manner as the provision of such Act to 
     which such amendment relates.
                                 ______