To amend title XXI of the Social Security Act to permit the use of unexpended allotments under the State children's health care program for an additional fiscal year, and for other purposes.

January 29, 2003

Ms. DUNN (for herself, Mrs. WILSON of New Mexico, Mr. NETHERCUTT, Mr. DICKS, Mr. HASTINGS of Washington, Mr. BAIRD, Mr. MCDERMOTT, and Mr. INSLEE) introduced the following bill; which was referred to the Committee on Energy and Commerce

To amend title XXI of the Social Security Act to permit the use of unexpended allotments under the State children's health care program for an additional fiscal year, and for other purposes.

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 `Children First SCHIP Improvement Act of 2003'.

SEC. 2. PERMITTING USE OF RETAINED FISCAL YEARS 1998, 1999, AND 2000 SCHIP ALLOTMENTS THROUGH FISCAL YEAR 2004.

(a) RETAINED AND REDISTRIBUTED ALLOTMENTS FOR FISCAL YEARS 1998 AND 1999- Paragraphs (1)(B)(ii), (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'.

(b) FISCAL YEAR 2000- Section 2104(g)(2) of such Act (42 U.S.C. 1397dd(g)(2)) is amended--

(1) in the heading, by striking `AND 1999' and inserting `THROUGH 2000';

(2) by adding at the end of subparagraph (A) the following:

`(iii) FISCAL YEAR 2000 ALLOTMENT-

`(I) IN GENERAL- Except as provided in subclause (II) with respect to high unemployment States, 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, the amount specified in subparagraph (B) for fiscal year 2000 for such State shall remain available for expenditure by the State through the end of fiscal year 2004.

`(II) SPECIAL RULE FOR HIGH UNEMPLOYMENT STATES- With respect only to high unemployment States (as defined in subparagraph (D)), of the amounts allotted to such a State pursuant to this section for fiscal year 2000 that were not expended by the State by the end of fiscal year 2002, all such amounts for fiscal year 2000 for such State shall remain available for expenditure by the State through the end of fiscal year 2004.'; and

(3) by adding at the end the following new subparagraph:

`(D) HIGH UNEMPLOYMENT STATE DEFINED- For purposes of subparagraph (A)(iii), the term `high unemployment State' means a State that is any of the 50 States or the District of Columbia and that had an unemployment rate (seasonally adjusted) of at least 6 percent in each of two consecutive months in 2002.'.

(c) USE OF UNUSED FISCAL YEAR 1998 THROUGH 2000 FUNDS- Section 2104(g) of such Act (42 U.S.C. 1397dd(g)), as amended by subsection (b), is further amended by adding at the end the following new paragraph:

`(5) USE OF UNEXPENDED FISCAL YEARS 1998 THROUGH 2000 ALLOTMENTS- Notwithstanding any waiver granted under section 1115 or otherwise for the use of funds under title XIX or this title that is approved as of December 31, 2002, amounts made available for expenditure under this subsection to provide child health assistance under this title shall be expended in accordance with the following priority:

`(A) First to children who are eligible for child health assistance under this title.

`(B) Second to children who are eligible for medical assistance under title XIX.'.

(d) EFFECTIVE DATE- The amendments made by this section shall be effective as if this section had been enacted on December 31, 2002, and amounts under title XXI of the Social Security Act (42 U.S.C. 1397 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 section as if this section had been enacted on December 31, 2002.

SEC. 3. SCHIP COVERAGE OF CHILDREN ABOVE THE MEDICAID MANDATORY LEVEL FOR CERTAIN STATES MEETING ADDITIONAL REQUIREMENTS.

Section 2110(b) of the Social Security Act (42 U.S.C. 1397jj(b)) is amended--

(1) in paragraph (1)(B)(ii)--

(A) by striking `or' at the end of subclause (II);

(B) by by striking `and' at the end of subclause (III) and inserting `or'; and

(C) by adding at the end the following new subclause:

`(IV) who is residing in an eligible State (as defined in paragraph (5))) and whose family income (as determined under the State child health plan) exceeds 133 percent of the poverty line but does not exceed 50 percentage points above the medicaid applicable income level; and';

(2) in paragraph (1)(C), by striking `who is not found to be eligible for medical assistance under title XIX or' and inserting `who (i) is not found to be eligible for medical assistance under title XIX or is so eligible but is described in subparagraph (B)(ii)(IV), and (ii) is not found to be'; and

(3) by adding at the end the following new paragraph:

`(5) ELIGIBLE STATE- For purposes of paragraph (1)(B)(ii)(IV), an eligible State is a State that, with respect to the fiscal year involved, meets all of the following conditions:

`(A) EXPANDED ELIGIBILITY OF CHILDREN UNDER MEDICAID- The State's plan for medical assistance under title XIX provides, in effect as of March 31, 1997, for eligibility for medical assistance of children who are under 19 years of age and whose family income equals or exceeds 185 percent of the poverty line.

`(B) HIGHEST SCHIP INCOME ELIGIBILITY- The State child health plan (whether implemented under this title or under title XIX)--

`(i) has the highest income eligibility standard permitted under this title as of January 1, 2001;

`(ii) does not impose any waiting list, numerical limitation, or similar limitation on the eligibility of children for child health assistance; and

`(iii) provides benefits to all children in the State who apply for and meet eligibility standards.

`(C) NO LOSS OF MEDICAID OR SCHIP COVERAGE DUE TO INABILITY TO PAYMENT PREMIUMS AND COST-SHARING- The State's plan for medical assistance under title XIX and the State child health plan do not deny an eligible child coverage or needed care because of an inability to pay premiums or cost-sharing otherwise imposed under the respective plan.

`(D) 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 this title and also under title XIX.

`(E) NO ASSET TEST- The State does not impose an asset test for eligibility under this title or under section 1902(l) with respect to children.

`(F) 12-MONTH CONTINUOUS ENROLLMENT- The State has elected the option of continuing eligibility under section 1902(e)(12) and has elected a 12-month period under subparagraph (A) of such section and provides for a similar period of continuous eligibility under the State child health plan.

`(G) COORDINATED ENROLLMENT PROCESS- The State's enrollment process under this title is coordinated with such process under title XIX so that--

`(i) a family need only interact with a single agency in order to determine whether a child is eligible for benefits under this title or title XIX; and

`(ii) transfers of enrollment, without a gap in coverage, automatically occur for a child in a family the income of which changes so that the child is no longer eligible for benefits under one such title but becomes eligible for benefits under the other title.

`(H) 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 policies respecting 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 this title and title XIX.'.

END