[Congressional Record Volume 162, Number 142 (Tuesday, September 20, 2016)]
[House]
[Pages H5648-H5650]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       SPECIAL NEEDS TRUST FAIRNESS AND MEDICAID IMPROVEMENT ACT

  Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 670) to amend title XIX of the Social Security Act to extend 
the Medicaid rules regarding supplemental needs trusts for Medicaid 
beneficiaries to trusts established by those beneficiaries, and for 
other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 670

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Special 
     Needs Trust Fairness and Medicaid Improvement Act''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Fairness in Medicaid supplemental needs trusts.
Sec. 3. Medicaid coverage of tobacco cessation services for mothers of 
              newborns.
Sec. 4. Eliminating Federal financial participation with respect to 
              expenditures under Medicaid for agents used for cosmetic 
              purposes or hair growth.
Sec. 5. Medicaid Improvement Fund.

     SEC. 2. FAIRNESS IN MEDICAID SUPPLEMENTAL NEEDS TRUSTS.

       (a) In General.--Section 1917(d)(4)(A) of the Social 
     Security Act (42 U.S.C. 1396p(d)(4)(A)) is amended by 
     inserting ``the individual,'' after ``for the benefit of such 
     individual by''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to trusts established on or after the date of the 
     enactment of this Act.

     SEC. 3. MEDICAID COVERAGE OF TOBACCO CESSATION SERVICES FOR 
                   MOTHERS OF NEWBORNS.

       (a) In General.--Section 1905(bb) of the Social Security 
     Act (42 U.S.C. 1396d(bb)) is amended by adding at the end the 
     following new paragraph:
       ``(4) A woman shall continue to be treated as described in 
     this subsection as a pregnant woman through the end of the 1-
     year period beginning on the date of the birth of a child of 
     the woman.''.
       (b) Conforming Amendments.--
       (1) Subsections (a)(2)(B) and (b)(2)(B) of section 1916 of 
     the Social Security Act (42 U.S.C. 1396o) are each amended by 
     inserting ``(and women described in section 1905(bb) as 
     pregnant women pursuant to paragraph (4) of such section)'' 
     after ``tobacco cessation by pregnant women''.
       (2) Section 1927(d)(2)(F) of the Social Security Act (42 
     U.S.C. 1396r-8(d)(2)(F)) is amended by inserting ``(and women 
     described in section 1905(bb) as pregnant women pursuant to 
     paragraph (4) of such section)'' after ``pregnant women''.
       (c) Effective Date.--
       (1) In general.--Subject to paragraph (2), the amendments 
     made by this section shall apply with respect to items and 
     services furnished on or after the date that is two years 
     after the date of the enactment of this Act.
       (2) Exception for state legislation.--In the case of a 
     State plan under title XIX of the Social Security Act, which 
     the Secretary of Health and Human Services determines 
     requires State legislation in order for the plan to meet any 
     requirement imposed by amendments made by this section, the 
     plan shall not be regarded as

[[Page H5649]]

     failing to comply with the requirements of such title solely 
     on the basis of its failure to meet such an additional 
     requirement before the first day of the first calendar 
     quarter beginning after the close of the first regular 
     session of the State legislature that begins after the 
     effective date specified in paragraph (1). For purposes of 
     the previous sentence, in the case of a State that has a 2-
     year legislative session, each year of the session shall be 
     considered to be a separate regular session of the State 
     legislature.
       (d) Report.--Not later than two years after the date of the 
     enactment of this Act, the Inspector General of the 
     Department of Health and Human Services shall submit to 
     Congress a report that assesses the use of the tobacco 
     cessation service benefit under the Medicaid program. Such 
     report shall include an assessment of--
       (1) the extent that States are encouraging the use of such 
     benefit, such as through promotion of beneficiary and 
     provider awareness of such benefit; and
       (2) gaps in the delivery of such benefit.

     SEC. 4. ELIMINATING FEDERAL FINANCIAL PARTICIPATION WITH 
                   RESPECT TO EXPENDITURES UNDER MEDICAID FOR 
                   AGENTS USED FOR COSMETIC PURPOSES OR HAIR 
                   GROWTH.

       (a) In General.--Section 1903(i)(21) of the Social Security 
     Act (42 U.S.C. 1396b(i)(21)) is amended by inserting 
     ``section 1927(d)(2)(C) (relating to drugs when used for 
     cosmetic purposes or hair growth), except where medically 
     necessary, and'' after ``drugs described in''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply with respect to calendar quarters beginning on or 
     after the date of the enactment of this Act.

     SEC. 5. MEDICAID IMPROVEMENT FUND.

       Section 1941(b) of the Social Security Act (42 U.S.C. 
     1396w-1(b)) is amended--
       (1) in paragraph (2)--
       (A) by striking ``under paragraph (1)'' and inserting 
     ``under this subsection''; and
       (B) by redesignating such paragraph as paragraph (3); and
       (2) by inserting after paragraph (1) the following new 
     paragraph:
       ``(2) Additional funding.--In addition to any funds 
     otherwise made available to the Fund, there shall be 
     available to the Fund, for expenditures from the Fund--
       ``(A) for fiscal year 2021, $10,000,000, to remain 
     available until expended; and
       ``(B) for fiscal year 2022, $14,000,000, to remain 
     available until expended.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Kentucky (Mr. Guthrie) and the gentleman from New Jersey (Mr. Pallone) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Kentucky.


                             General Leave

  Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Kentucky?
  There was no objection.
  Mr. GUTHRIE. Mr. Speaker, I yield 5 minutes to the gentleman from 
Pennsylvania (Mr. Thompson).
  Mr. THOMPSON of Pennsylvania. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker, I rise today in strong support of H.R. 670, the Special 
Needs Trust Fairness and Medicaid Improvement Act, a bipartisan measure 
that will remove arbitrary legal barriers for individuals with 
disabilities to independently create their own special needs trust.
  Special needs trusts are valuable tools that enable assets to be 
saved on behalf of individuals with disabilities, while protecting 
their eligibility for means-tested benefits. Under current law, 
individuals who are or become disabled must have a parent, a guardian, 
or a court-appointed special needs trust regardless of the individual's 
capacity to do so on their own.
  Mr. Speaker, not only does this requirement place an undue burden on 
individuals who seek a better financial future and want to live with 
dignity, it runs counter to the precedent set by Congress with the 
creation of pooled trust accounts in 1993 and the passage of the ABLE 
Act in 2014. Both provide disabled individuals and their families 
unencumbered access to mechanisms for savings.
  My drive to correct this legal inequity stems from my experience as a 
certified recreational therapist, a hospital manager, a rehabilitation 
services manager, and a licensed nursing home administrator. In these 
roles, I worked with many people who set out on challenging journeys 
towards rehabilitation and future independence. As a result, I found it 
difficult to ignore the fact that current law is working to further 
complicate anyone's path to becoming more self-reliant and independent.
  Mr. Speaker, I would like to take this time to share the personal 
narrative of Rana McMurray Arnold, cofounder and director of the Sight-
Loss Support Group of Central Pennsylvania and a constituent of mine. 
As an individual who is living with blindness, Rana helped form a 
remarkable nonprofit to assist others with sight loss by providing peer 
counseling, vision rehabilitation referral services, and direct 
accessibility support for local events. Despite challenges she has been 
faced with, Rana has led a very fulfilling and successful life, running 
a successful service organization for 30 years and raising a family. 
However, under the current law, Rana would be deemed unfit to establish 
her own special needs trust.
  It is on Rana's behalf and on behalf of the millions of Americans 
living with disabilities that I introduced H.R. 670, and I am grateful 
for its consideration this afternoon on the House floor.
  I would also like to thank another constituent of mine, Amos Goodall, 
who has worked as an elder law attorney in State College, Pennsylvania. 
Mr. Goodall originally brought this issue to my attention and has been 
a tireless advocate for this bill. I would also like to thank Katie 
Brown of my staff, whose work on this bill has gotten us to this point 
today.
  Mr. Speaker, I urge my colleagues to join me in seizing this 
opportunity to correct a legal inequity and safeguard the rights of 
Americans living with disabilities to secure their own future financial 
stability.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I strongly support this bipartisan legislation, H.R. 
670, the Special Needs Trust Fairness and Medicaid Improvement Act. 
This legislation, which I have championed for multiple Congresses with 
my Republican colleague, Representative Glenn Thompson, would allow 
individuals with disabilities to set up special needs trusts for 
themselves without a court petition.
  I thank Representative Thompson of Pennsylvania for his continued 
leadership on this issue.
  A special needs trust is a special kind of trust that is designed to 
provide support for certain expenses for disabled individuals to 
supplement Medicaid benefits. Currently, these types of trusts 
generally must be established by parents, grandparents, legal 
guardians, or a court on behalf of the disabled individual. People can 
only set up a special needs trust for themselves after petitioning a 
court. Oftentimes, this process can take several months and can incur 
significant legal fees during the process.
  This is just not right. Individuals with disabilities can and should 
have the ability to set up a special needs trust for themselves, and 
this legislation fixes that basic inequity. This is a commonsense but 
very meaningful fix in the lives of those living with a disability.
  I would like to also note that H.R. 670 was amended in the Energy and 
Commerce Committee by adding an additional provision to require States 
to extend tobacco cessation coverage to pregnant women through the 
first year postpartum. This is also good policy. Tobacco cessation is 
absolutely critical to both saving dollars and saving lives, and 
particularly so for pregnant and postpartum women.
  When we invest in helping people to quit smoking, the benefit is not 
only clear to the health of our communities, but also to our economy. 
My own home State of New Jersey is currently piloting a project in our 
Medicaid program specifically aimed at cutting costs and improving 
birth outcomes through targeted, evidence-based efforts to help 
pregnant women to quit smoking.
  In addition, these policies are fully offset by clarifying that the 
Federal match for hair growth and cosmetic products is available when 
those products are medically necessary, which is the current policy of 
most States already. The remaining savings are put in a Medicaid 
improvement fund as a downpayment on more positive improvements to the 
Medicaid program in the future.
  So I am very proud, Mr. Speaker, that we were able to work together 
on these policies. This is an example of the type of work that we 
should do

[[Page H5650]]

more often in the Medicaid program: working together to pass policies 
that remove barriers for beneficiaries, strengthen benefits, and 
support the long-term health of the program overall.
  Mr. Speaker, I urge my colleagues to support H.R. 670. I hope that 
the Senate will consider this new version so it can swiftly become law.
  Mr. Speaker, I yield back the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I just want to commend my friend from 
Pennsylvania who has spent so much effort on this. We had testimony in 
the Energy and Commerce Committee, families coming before us who were 
in situations that are difficult and gives them the opportunity to 
provide for their loved one, the original intent of the bill. This one 
allows the individual himself or herself to set up and provide. I think 
that is the right thing to do. I encourage my colleagues to vote for 
this bill.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules 
and pass the bill, H.R. 670, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. HUELSKAMP. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________