To temporarily increase the Federal medical assistance percentage for the medicaid program.

January 9, 2003

Mr. ROCKEFELLER (for himself, Ms. COLLINS, Mr. NELSON of Nebraska, Mr. SMITH, Mrs. CLINTON, Mrs. HUTCHISON, and Mr. GRAHAM of Florida) introduced the following bill; which was read twice and referred to the Committee on Finance

To temporarily increase the Federal medical assistance percentage for the medicaid program.

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

SECTION 1. TEMPORARY STATE FISCAL RELIEF.

(a) TEMPORARY INCREASE OF MEDICAID FMAP-

(1) PERMITTING MAINTENANCE OF FISCAL YEAR 2002 FMAP FOR LAST 2 CALENDAR QUARTERS OF FISCAL YEAR 2003- Notwithstanding any other provision of law, but subject to paragraph (5), if the FMAP determined without regard to this subsection for a State for fiscal year 2003 is less than the FMAP as so determined for fiscal year 2002, the FMAP for the State for fiscal year 2002 shall be substituted for the State's FMAP for the third and fourth calendar quarters of fiscal year 2003, before the application of this subsection.

(2) PERMITTING MAINTENANCE OF FISCAL YEAR 2003 FMAP FOR FISCAL YEAR 2004- Notwithstanding any other provision of law, but subject to paragraph (5), if the FMAP determined without regard to this subsection for a State for fiscal year 2004 is less than the FMAP as so determined for fiscal year 2003, the FMAP for the State for fiscal year 2003 shall be substituted for the State's FMAP for each calendar quarter of fiscal year 2004, before the application of this subsection.

(3) GENERAL 2.45 PERCENTAGE POINTS INCREASE FOR LAST 2 CALENDAR QUARTERS OF FISCAL YEAR 2003 AND FISCAL YEAR 2004- Notwithstanding any other provision of law, but subject to paragraphs (5) and (6), for each State for the third and fourth calendar quarters of fiscal year 2003 and each calendar quarter of fiscal year 2004, the FMAP (taking into account the application of paragraphs (1) and (2)) shall be increased by 2.45 percentage points.

(4) INCREASE IN CAP ON MEDICAID PAYMENTS TO TERRITORIES- Notwithstanding any other provision of law, but subject to paragraph (6), with respect to the third and fourth calendar quarters of fiscal year 2003 and each calendar quarter of fiscal year 2004, the amounts otherwise determined for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa under subsections (f) and (g) of section 1108 of the Social Security Act (42 U.S.C. 1308) shall each be increased by an amount equal to 4.90 percent of such amounts.

(5) SCOPE OF APPLICATION- The increases in the FMAP for a State under this subsection shall apply only for purposes of title XIX of the Social Security Act and shall not apply with respect to--

(A) disproportionate share hospital payments described in section 1923 of such Act (42 U.S.C. 1396r-4); or

(B) payments under title IV or XXI of such Act (42 U.S.C. 601 et seq. and 1397aa et seq.).

(6) STATE ELIGIBILITY-

(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) 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)) 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)) after September 2, 2003, but prior to the date of enactment of this Act is eligible for an increase in its FMAP under paragraph (3) or an increase in a cap amount under paragraph (4) in the first calendar quarter (and subsequent calendar quarters) 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.

(C) RULE OF CONSTRUCTION- Nothing in subparagraph (A) or (B) shall be construed as affecting a State's flexibility with respect to benefits offered under the State medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)).

(7) DEFINITIONS- In this subsection:

(A) FMAP- The term `FMAP' means the Federal medical assistance percentage, as defined in section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)).

(B) STATE- The term `State' has the meaning given such term for purposes of title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).

(8) REPEAL- Effective as of October 1, 2004, this subsection is repealed.

(b) ADDITIONAL TEMPORARY STATE FISCAL RELIEF-

(1) IN GENERAL- Title XX of the Social Security Act (42 U.S.C. 1397-1397f) is amended by adding at the end the following:

`SEC. 2008. ADDITIONAL TEMPORARY GRANTS FOR STATE FISCAL RELIEF.

`(a) IN GENERAL- For the purpose of providing State fiscal relief allotments to States under this section, there are hereby appropriated, out of any funds in the Treasury not otherwise appropriated, $10,000,000,000. Such funds shall be available for obligation by the State through June 30, 2005, and for expenditure by the State through September 30, 2005. This section constitutes budget authority in advance of appropriations Acts and represents the obligation of the Federal Government to provide for the payment to States of amounts provided under this section.

`(b) ALLOTMENT- Funds appropriated under subsection (a) shall be allotted by the Secretary among the States in accordance with the following table:

----------------------------------------------

`State                Allotment (in dollars)  

----------------------------------------------

 Alabama               $113,960,092           

 Alaska                $28,050,916            

 Amer. Samoa           $276,005               

 Arizona               $174,176,300           

 Arkansas              $88,932,482            

 California            $1,055,900,700         

 Colorado              $95,353,555            

 Connecticut           $138,136,104           

 Delaware              $25,691,623            

 District of Columbia  $43,356,542            

 Florida               $416,437,302           

 Georgia               $245,721,379           

 Guam                  $446,563               

 Hawaii                $30,891,959            

 Idaho                 $32,439,936            

 Illinois              $362,420,855           

 Indiana               $181,086,404           

 Iowa                  $86,873,236            

 Kansas                $62,913,352            

 Kentucky              $141,415,311           

 Louisiana             $159,884,723           

 Maine                 $61,854,394            

 Maryland              $157,333,510           

 Massachusetts         $315,177,172           

 Michigan              $290,300,805           

 Minnesota             $201,619,700           

 Mississippi           $117,970,775           

 Missouri              $201,689,388           

 Montana               $24,291,445            

 Nebraska              $53,033,542            

 Nevada                $34,887,749            

 New Hampshire         $36,067,567            

 New Jersey            $274,636,614           

 New Mexico            $75,233,465            

 New York              $1,588,884,965         

 North Carolina        $293,161,659           

 North Dakota          $18,169,187            

 N. Mariana Islands    $155,920               

 Ohio                  $410,965,675           

 Oklahoma              $97,493,874            

 Oregon                $111,334,973           

 Pennsylvania          $497,241,778           

 Puerto Rico           $12,610,820            

 Rhode Island          $53,399,083            

 South Carolina        $122,811,620           

 South Dakota          $20,201,430            

 Tennessee             $233,515,925           

 Texas                 $543,148,021           

 Utah                  $42,281,420            

 Vermont               $27,033,142            

 Virgin Islands        $416,332               

 Virginia              $143,436,753           

 Washington            $199,131,541           

 West Virginia         $63,879,139            

 Wisconsin             $180,600,752           

 Wyoming               $11,664,525            

 Total          $10,000,000,000 

----------------------------------------------

`(c) USE OF FUNDS- Funds appropriated under this section may be used by a State for services directed at the goals set forth in section 2001, subject to the requirements of this title.

`(d) PAYMENT TO STATES- Not later than 30 days after amounts are appropriated under subsection (a), in addition to any payment made under section 2002 or 2007, the Secretary shall make a lump sum payment to a State of the total amount of the allotment for the State as specified in subsection (b).

`(e) DEFINITION- For purposes of this section, the term `State' means the 50 States, the District of Columbia, and the territories contained in the list under subsection (b).'.

(2) REPEAL- Effective as of October 1, 2005, section 2008 of the Social Security Act, as added by paragraph (1), is repealed.

(c) GAO STUDY AND REPORT-

(1) STUDY- The Comptroller General of the United States shall conduct a study to determine the most appropriate data and methodology to use to determine the Federal medical assistance percentage for purposes of programs authorized under the Social Security Act.

(2) REPORT- Not later than 180 days after the date of enactment of this Act, the Comptroller General of the United States shall submit a report to Congress on the study conducted under paragraph (1).

END