    [United States Statutes at Large, Volume 117, 108th Congress, 1st Session]
    [From the U.S. Government Publishing Office, www.gpo.gov]

    117 STAT. 892

    Public Law 108-74
    108th Congress

    An Act

    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, and for other
    purposes. [NOTE: Aug. 15, 2003 -  [H.R. 2854]]

    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:

    [[Page 893]]

    117 STAT. 893

    ``(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'';
    (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 [NOTE: 42 USC
    1397dd.] 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

    [[Page 894]]

    117 STAT. 894

    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 [NOTE: 42
    USC 1397dd.] (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--

    [[Page 895]]

    117 STAT. 895

    (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 [NOTE: 42 USC 1397dd note.] 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, a qualifying State (as defined in
    paragraph (2)) may elect to use not more than 20 percent
    of any allotment under section 2104 for fiscal year
    1998, 1999, 2000, or 2001 (insofar as it is available
    under subsections (e) and (g) of such section) for
    payments under title XIX in accordance with subparagraph
    (B), instead of for expenditures under this title.
    ``(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 availability of
    funds under such subparagraph with respect to the
    State, 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
    with respect to expenditures 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)).
    ``(ii) Expenditures described.--For purposes
    of this subparagraph, the expenditures described
    in this clause are expenditures, made after the
    date of the enactment of this subsection and
    during the period in which funds are available to
    the qualifying State for use under subparagraph
    (A), for 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

    [[Page 896]]

    117 STAT. 896

    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, on and after April 15,
    1997, has an income eligibility standard that is at least 185
    percent of the poverty line 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, in the case
    of a State that has a statewide waiver in effect under section
    1115 with respect to title XIX that was first implemented on
    July 1, 1995, has an income eligibility standard under such
    waiver for children that is at least 185 percent of the poverty
    line, or, in the case of a State that has a statewide waiver in
    effect under section 1115 with respect to title XIX that was
    first implemented on January 1, 1994, has an income eligibility
    standard under such waiver for children who lack health
    insurance that is at least 185 percent of the poverty line.
    ``(3) Construction.--Nothing in paragraphs (1) and (2) shall
    be construed as modifying the requirements applicable to States
    implementing State child health plans under this title.''.

    SEC. 2. TECHNICAL CORRECTION.

    (a) Temporary Increase of the Medicaid FMAP.--Subparagraphs (A) and
    (B) of section 401(a)(6) of the Jobs and Growth Tax Relief
    Reconciliation Act of 2003 (Public Law 108-27) [NOTE: Ante, p. 765.]
    are amended to read as follows:
    ``(A) In general.--Subject to subparagraph (B), a
    State is eligible for an increase in its FMAP under
    paragraph (3) or an increase in a cap amount under
    paragraph (4) for any date after September 2, 2003, only
    if the eligibility under its State plan under title XIX
    of the Social Security Act (including any waiver under
    such title or under section 1115 of such Act (42 U.S.C.
    1315)) applied as of such date is no more restrictive
    than the eligibility under such plan (or waiver) as in
    effect on September 2, 2003.
    ``(B) State reinstatement of eligibility
    permitted.--A State that has restricted eligibility
    under its State plan under title XIX of the Social
    Security Act (including any waiver under such title or
    under section 1115 of such Act (42 U.S.C. 1315)) for any
    date after September 2, 2003, is eligible for an
    increase in its FMAP under paragraph (3) or an increase
    in a cap amount under paragraph (4) for subsequent dates
    in which the State has reinstated eligibility that is no
    more restrictive than the eligibility under such plan
    (or waiver) as in effect on September 2, 2003.''.

    (b) Retroactive [NOTE: 42 USC 1396d note.] Effective Date.--The
    amendment made by subsection (a) shall take effect as if included in the
    enactment

    [[Page 897]]

    117 STAT. 897

    of section 401 of the Jobs and Growth Tax Relief Reconciliation Act of
    2003 (Public Law 108-27).

    Approved August 15, 2003.

    LEGISLATIVE HISTORY--H.R. 2854 (S. 312):
    ---------------------------------------------------------------------------

    SENATE REPORTS: No. 108-78 accompanying S. 312 (Comm. on Finance).
    CONGRESSIONAL RECORD, Vol. 149 (2003):
    July 25, considered and passed House.
    July 31, considered and passed Senate.