109th CONGRESS
2d Session
H. R. 5728
To amend titles XIX and XXI of the Social Security Act to provide
States with the option to expand or add coverage of pregnant women under
the Medicaid and State children's health insurance programs, and for other
purposes.
IN THE HOUSE OF REPRESENTATIVES
June 29, 2006
Ms. DEGETTE (for herself and Mr. WALDEN of Oregon) introduced the following
bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend titles XIX and XXI of the Social Security Act to provide
States with the option to expand or add coverage of pregnant women under
the Medicaid and State children's health insurance programs, 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; TABLE OF CONTENTS.
(a) Short Title- This Act may be cited as the `Prevent Prematurity and Improve
Child Health Act of 2006'.
(b) Table of Contents- The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. State option to expand or add coverage of certain pregnant women
under medicaid and SCHIP.
Sec. 3. Promoting cessation of tobacco use under the medicaid program.
Sec. 4. Promoting cessation of tobacco use under the maternal and child
health services block grant program.
Sec. 5. State option to provide family planning services and supplies
to individuals with incomes that do not exceed a State's income eligibility
level for medical assistance.
Sec. 6. State option to extend the postpartum period for provision of
family planning services and supplies.
Sec. 7. State option to provide wrap-around SCHIP coverage to children
who have other health coverage.
SEC. 2. STATE OPTION TO EXPAND OR ADD COVERAGE OF CERTAIN PREGNANT WOMEN
UNDER MEDICAID AND SCHIP.
(1) AUTHORITY TO EXPAND COVERAGE- Section 1902(l)(2)(A)(i) of the Social
Security Act (42 U.S.C. 1396a(l)(2)(A)(i)) is amended by inserting `(or
such higher percentage as the State may elect for purposes of expenditures
for medical assistance for pregnant women described in section 1905(u)(4)(A))'
after `185 percent'.
(2) ENHANCED MATCHING FUNDS AVAILABLE IF CERTAIN CONDITIONS MET- Section
1905 of the Social Security Act (42 U.S.C. 1396d) is amended--
(A) in the fourth sentence of subsection (b), by striking `or subsection
(u)(3)' and inserting `, (u)(3), or (u)(4)'; and
(i) by redesignating paragraph (4) as paragraph (5); and
(ii) by inserting after paragraph (3) the following new paragraph:
`(4) For purposes of the fourth sentence of subsection (b) and section 2105(a),
the expenditures described in this paragraph are the following:
`(A) CERTAIN PREGNANT WOMEN- If the conditions described in subparagraph
(B) are met, expenditures for medical assistance for pregnant women described
in subsection (n) or under section 1902(l)(1)(A) in a family the income
of which exceeds 185 percent of the poverty line, but does not exceed
the income eligibility level established under title XXI for a targeted
low-income child.
`(B) CONDITIONS- The conditions described in this subparagraph are the
following:
`(i) The State plans under this title and title XXI do not provide coverage
for pregnant women described in subparagraph (A) with higher family
income without covering such pregnant women with a lower family income.
`(ii) The State does not apply an effective income level for pregnant
women that is lower than the effective income level (expressed as a
percent of the poverty line and considering applicable income disregards)
that has been specified under the State plan under subsection (a)(10)(A)(i)(III)
or (l)(2)(A) of section 1902, as of January 1, 2006, to be eligible
for medical assistance as a pregnant woman.
`(C) DEFINITION OF POVERTY LINE- In this subsection, the term `poverty
line' has the meaning given such term in section 2110(c)(5).'.
(3) PAYMENT FROM TITLE XXI ALLOTMENT FOR MEDICAID EXPANSION COSTS; ELIMINATION
OF COUNTING MEDICAID CHILD PRESUMPTIVE ELIGIBILITY COSTS AGAINST TITLE
XXI ALLOTMENT- Section 2105(a)(1) of the Social Security Act (42 U.S.C.
1397ee(a)(1)) is amended--
(A) in the matter preceding subparagraph (A), by striking `(or, in the
case of expenditures described in subparagraph (B), the Federal medical
assistance percentage (as defined in the first sentence of section 1905(b)))';
and
(B) by striking subparagraph (B) and inserting the following new subparagraph:
`(B) for the provision of medical assistance that is attributable to
expenditures described in section 1905(u)(4)(A);'.
(1) COVERAGE- Title XXI of the Social Security Act (42 U.S.C. 1397aa et
seq.) is amended by adding at the end the following new section:
`SEC. 2111. OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN.
`(a) Optional Coverage- Notwithstanding any other provision of this title,
a State may provide for coverage, through an amendment to its State child
health plan under section 2102, of pregnancy-related assistance for targeted
low-income pregnant women in accordance with this section, but only if--
`(1) the State has established an income eligibility level for pregnant
women under subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902
that is at least 185 percent of the income official poverty line; and
`(2) the State meets the conditions described in section 1905(u)(4)(B).
`(b) Definitions- For purposes of this title:
`(1) PREGNANCY-RELATED ASSISTANCE- The term `pregnancy-related assistance'
has the meaning given the term child health assistance in section 2110(a)
as if any reference to targeted low-income children were a reference to
targeted low-income pregnant women, except that the assistance shall be
limited to services related to pregnancy (which include prenatal, delivery,
and postpartum services and services described in section 1905(a)(4)(C))
and to other conditions that may complicate pregnancy.
`(2) TARGETED LOW-INCOME PREGNANT WOMAN- The term `targeted low-income
pregnant woman' means a woman--
`(A) during pregnancy and through the end of the month in which the
60-day period (beginning on the last day of her pregnancy) ends;
`(B) whose family income exceeds the effective income level (expressed
as a percent of the poverty line and considering applicable income disregards)
that has been specified under subsection (a)(10)(A)(i)(III) or (l)(2)(A)
of section 1902, as of January 1, 2006, to be eligible for medical assistance
as a pregnant woman under title XIX but does not exceed the income eligibility
level established under the State child health plan under this title
for a targeted low-income child; and
`(C) who satisfies the requirements of paragraphs (1)(A), (1)(C), (2),
and (3) of section 2110(b).
`(c) References to Terms and Special Rules- In the case of, and with respect
to, a State providing for coverage of pregnancy-related assistance to targeted
low-income pregnant women under subsection (a), the following special rules
apply:
`(1) Any reference in this title (other than in subsection (b)) to a targeted
low-income child is deemed to include a reference to a targeted low-income
pregnant woman.
`(2) Any such reference to child health assistance with respect to such
women is deemed a reference to pregnancy-related assistance.
`(3) Any such reference to a child is deemed a reference to a woman during
pregnancy and the period described in subsection (b)(2)(A).
`(4) In applying section 2102(b)(3)(B), any reference to children found
through screening to be eligible for medical assistance under the State
medicaid plan under title XIX is deemed a reference to pregnant women.
`(5) There shall be no exclusion of benefits for services described in
subsection (b)(1) based on any preexisting condition and no waiting period
(including any waiting period imposed to carry out section 2102(b)(3)(C))
shall apply.
`(6) Subsection (a) of section 2103 (relating to required scope of health
insurance coverage) shall not apply insofar as a State limits coverage
to services described in subsection (b)(1) and the reference to such section
in section 2105(a)(1)(C) is deemed not to require, in such case, compliance
with the requirements of section 2103(a).
`(7) In applying section 2103(e)(3)(B) in the case of a pregnant woman
provided coverage under this section, the limitation on total annual aggregate
cost-sharing shall be applied to such pregnant woman.
`(8) The reference in section 2107(e)(1)(D) to section 1920A (relating
to presumptive eligibility for children) is deemed a reference to section
1920 (relating to presumptive eligibility for pregnant women).
`(d) Automatic Enrollment for Children Born to Women Receiving Pregnancy-Related
Assistance- If a child is born to a targeted low-income pregnant woman who
was receiving pregnancy-related assistance under this section on the date
of the child's birth, the child shall be deemed to have applied for child
health assistance under the State child health plan and to have been found
eligible for such assistance under such plan or to have applied for medical
assistance under title XIX and to have been found eligible for such assistance
under such title, as appropriate, on the date of such birth and to remain
eligible for such assistance until the child attains 1 year of age. During
the period in which a child is deemed under the preceding sentence to be
eligible for child health or medical assistance, the child health or medical
assistance eligibility identification number of the mother shall also serve
as the identification number of the child, and all claims shall be submitted
and paid under such number (unless the State issues a separate identification
number for the child before such period expires).'.
(2) ADDITIONAL ALLOTMENTS FOR PROVIDING COVERAGE OF PREGNANT WOMEN-
(A) IN GENERAL- Section 2104 of the Social Security Act (42 U.S.C. 1397dd)
is amended by adding at the end the following new subsection:
`(h) Additional Allotments for Providing Coverage of Pregnant Women-
`(1) APPROPRIATION; TOTAL ALLOTMENT- For the purpose of providing additional
allotments to States under this title, there is appropriated, out of any
money in the Treasury not otherwise appropriated, for each of fiscal years
2007 through 2010, $200,000,000.
`(2) STATE AND TERRITORIAL ALLOTMENTS- In addition to the allotments provided
under subsections (b) and (c), subject to 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 approved under this title--
`(A) in the case of such a State other than a commonwealth or territory
described in subparagraph (B), the same proportion as the proportion
of the State's allotment under subsection (b) (determined without regard
to subsection (f)) to the total amount of the allotments under subsection
(b) for such States eligible for an allotment under this paragraph for
such fiscal year; and
`(B) 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 under subsection (c) (determined without regard
to subsection (f)) to the total amount of the allotments under subsection
(c) for commonwealths and territories eligible for an allotment under
this paragraph for such fiscal year.
`(3) USE OF ADDITIONAL ALLOTMENT- Additional allotments provided under
this subsection are not available for amounts expended before October
1, 2006. Such amounts are available for amounts expended on or after such
date for child health assistance for targeted low-income children, as
well as for pregnancy-related assistance for targeted low-income pregnant
women.
`(4) NO PAYMENTS UNLESS ELECTION TO EXPAND COVERAGE OF PREGNANT WOMEN-
No payments may be made to a State under this title from an allotment
provided under this subsection unless the State provides pregnancy-related
assistance for targeted low-income pregnant women under this title, or
provides medical assistance for pregnant women under title XIX, whose
family income exceeds the effective income level applicable under subsection
(a)(10)(A)(i)(III) or (l)(2)(A) of section 1902 to a family of the size
involved as of January 1, 2006.'.
(B) CONFORMING AMENDMENTS- Section 2104 of the Social Security Act (42
U.S.C. 1397dd) is amended--
(i) in subsection (a), in the matter preceding paragraph (1), by inserting
`subject to subsection (h),' after `under this section,';
(ii) in subsection (b)(1), by inserting `and subsection (h)' after
`Subject to paragraph (4)'; and
(iii) in subsection (c)(1), by inserting `subject to subsection (h),'
after `for a fiscal year,'.
(3) ADDITIONAL CONFORMING AMENDMENTS-
(A) NO COST-SHARING FOR PREGNANCY-RELATED BENEFITS- Section 2103(e)(2)
of the Social Security Act (42 U.S.C. 1397cc(e)(2)) is amended--
(i) in the heading, by inserting `or pregnancy-related services' after
`preventive services'; and
(ii) by inserting before the period at the end the following: `or
for pregnancy-related services'.
(B) NO WAITING PERIOD- Section 2102(b)(1)(B) (42 U.S.C. 1397bb(b)(1)(B))
is amended--
(i) in clause (i), by striking `, and' at the end and inserting a
semicolon;
(ii) in clause (ii), by striking the period at the end and inserting
`; and'; and
(iii) by adding at the end the following new clause:
`(iii) may not apply a waiting period (including a waiting period
to carry out paragraph (3)(C)) in the case of a targeted low-income
pregnant woman.'.
(c) Authority for States That Provide Medicaid or SCHIP Coverage for Pregnant
Women With Income Above 185 Percent of the Poverty Line To Use Portion of
SCHIP Funds for Medicaid Expenditures- Section 2105(g) of the Social Security
Act (42 U.S.C. 1397ee(g)) is amended--
(1) in the subsection heading, by inserting `and certain pregnancy coverage
expansion states' after `qualifying states';
(2) by adding at the end the following:
`(4) SPECIAL AUTHORITY FOR CERTAIN PREGNANCY COVERAGE EXPANSION STATES-
`(A) IN GENERAL- In the case of a State that, as of the date of enactment
of the Prevent Prematurity and Improve Child Health Act of 2006, has
an income eligibility standard under title XIX or this title (under
section 1902(a)(10)(A) or under a statewide waiver in effect under section
1115 with respect to title XIX or this title) that is at least 185 percent
of the poverty line with respect to pregnant women, the State may elect
to use not more than 20 percent of any allotment under section 2104
for any fiscal year (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.
`(i) IN GENERAL- In the case of a State described in subparagraph
(A) that has elected the option described in that subparagraph, subject
to the availability of funds under such subparagraph and, if applicable,
paragraph (1)(A), 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 paragraph and during the period
in which funds are available to the State for use under subparagraph
(A), for medical assistance under title XIX for pregnant women whose
family income is at least 185 percent of the poverty line.
`(iii) NO IMPACT ON DETERMINATION OF BUDGET NEUTRALITY FOR WAIVERS-
In the case of a State described in subparagraph (A) that uses amounts
paid under this paragraph for expenditures described in clause (ii)
that are 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.'; and
(3) in paragraph (3), by striking `and (2)' and inserting `(2), and (4)'.
(d) Other Amendments to Medicaid-
(1) ELIGIBILITY OF A NEWBORN- Section 1902(e)(4) of the Social Security
Act (42 U.S.C. 1396a(e)(4)) is amended in the first sentence by striking
`so long as the child is a member of the woman's household and the woman
remains (or would remain if pregnant) eligible for such assistance'.
(2) APPLICATION OF QUALIFIED ENTITIES TO PRESUMPTIVE ELIGIBILITY FOR PREGNANT
WOMEN UNDER MEDICAID- Section 1920(b) of the Social Security Act (42 U.S.C.
1396r-1(b)) is amended by adding after paragraph (2) the following flush
sentence:
`The term `qualified provider' includes a qualified entity as defined in
section 1920A(b)(3).'.
(e) Effective Date- The amendments made by this section apply to items and
services furnished on or after October 1, 2006, without regard to whether
regulations implementing such amendments have been promulgated.
SEC. 3. PROMOTING CESSATION OF TOBACCO USE UNDER THE MEDICAID PROGRAM.
(a) Dropping Exception From Medicaid Prescription Drug Coverage for Tobacco
Cessation Medications- Section 1927(d)(2) of the Social Security Act (42
U.S.C. 1396r-8(d)(2)) is amended--
(1) by striking subparagraph (E);
(2) by redesignating subparagraphs (F) through (J) as subparagraphs (E)
through (I), respectively; and
(3) in subparagraph (F) (as redesignated by paragraph (2)), by inserting
before the period at the end the following: `, except agents approved
by the Food and Drug Administration for purposes of promoting, and when
used to promote, tobacco cessation'.
(b) Requiring Coverage of Tobacco Cessation Counseling Services for Pregnant
Women- Section 1905 of the Social Security Act (42 U.S.C. 1396d(a)(4)) is
amended--
(1) in subsection (a)(4)--
(A) by striking `and' before `(C)'; and
(B) by inserting before the semicolon at the end the following new subparagraph:
`; and (D) counseling for cessation of tobacco use (as defined in subsection
(x)) for pregnant women'; and
(2) by adding at the end the following:
`(x)(1) For purposes of this title, the term `counseling for cessation of
tobacco use' means therapy and counseling for cessation of tobacco use for
pregnant women who use tobacco products or who are being treated for tobacco
use that is furnished--
`(A) by or under the supervision of a physician; or
`(B) by any other health care professional who--
`(i) is legally authorized to furnish such services under State law
(or the State regulatory mechanism provided by State law) of the State
in which the services are furnished; and
`(ii) is authorized to receive payment for other services under this
title or is designated by the Secretary for this purpose.
`(2) Subject to paragraph (3), such term is limited to--
`(A) therapy and counseling services recommended in `Treating Tobacco
Use and Dependence: A Clinical Practice Guideline', published by the Public
Health Service in June 2000, or any subsequent modification of such Guideline;
and
`(B) such other therapy and counseling services that the Secretary recognizes
to be effective.
`(3) Such term shall not include coverage for drugs or biologicals that
are not otherwise covered under this title.'.
(c) Removal of Cost-Sharing for Tobacco Cessation Counseling Services for
Pregnant Women- Section 1916 of the Social Security Act (42 U.S.C. 1396o)
is amended in each of subsections (a)(2)(B) and (b)(2)(B) by inserting `,
and counseling for cessation of tobacco use (as defined in section 1905(x))'
after `complicate the pregnancy'.
(d) Effective Date- The amendments made by this section shall apply to services
furnished on or after the date that is 1 year after the date of enactment
of this Act.
SEC. 4. PROMOTING CESSATION OF TOBACCO USE UNDER THE MATERNAL AND CHILD
HEALTH SERVICES BLOCK GRANT PROGRAM.
(a) Quality Maternal and Child Health Services Includes Tobacco Cessation
Counseling and Medications-
(1) IN GENERAL- Section 501 of the Social Security Act (42 U.S.C. 701)
is amended by adding at the end the following new subsection:
`(d) For purposes of this title, counseling for cessation of tobacco use
(as defined in section 1905(x)), drugs and biologicals used to promote smoking
cessation, and the inclusion of antitobacco messages in health promotion
counseling shall be considered to be part of quality maternal and child
health services.'.
(2) EFFECTIVE DATE- The amendment made by paragraph (1) shall take effect
on the date that is 1 year after the date of enactment of this Act.
(b) Evaluation of National Core Performance Measures-
(1) IN GENERAL- The Administrator of the Health Resources and Services
Administration shall assess the current national core performance measures
and national core outcome measures utilized under the Maternal and Child
Health Block Grant under title V of the Social Security Act (42 U.S.C.
701 et seq.) for purposes of expanding such measures to include some of
the known causes of low birthweight and prematurity, including the percentage
of infants born to pregnant women who smoked during pregnancy.
(2) REPORT- Not later than 1 year after the date of enactment of this
Act, the Administrator of the Health Resources and Services Administration
shall submit to the appropriate committees of Congress a report concerning
the results of the evaluation conducted under paragraph (1).
SEC. 5. STATE OPTION TO PROVIDE FAMILY PLANNING SERVICES AND SUPPLIES
TO INDIVIDUALS WITH INCOMES THAT DO NOT EXCEED A STATE'S INCOME ELIGIBILITY
LEVEL FOR MEDICAL ASSISTANCE.
(a) In General- Title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.) is amended--
(1) by redesignating section 1938 as section 1939; and
(2) by inserting after section 1937 the following new section:
`STATE OPTION TO PROVIDE FAMILY PLANNING SERVICES AND SUPPLIES
`In General
`Sec. 1938. (a) Subject to subsections (b) and (c), a State may elect (through
a State plan amendment) to make medical assistance described in section
1905(a)(4)(C) available to any individual whose family income does not exceed
the greater of--
`(1) 185 percent of the income official poverty line (as defined by the
Office of Management and Budget, and revised annually in accordance with
section 673(2) of the Omnibus Budget Reconciliation Act of 1981) applicable
to a family of the size involved; or
`(2) the eligibility income level (expressed as a percentage of such poverty
line) that has been specified under a waiver authorized by the Secretary
or under section 1902(r)(2)), as of October 1, 2006, for an individual
to be eligible for medical assistance under the State plan.
`Comparability
`(b) Medical assistance described in section 1905(a)(4)(C) that is made
available under a State plan amendment under subsection (a) shall--
`(1) not be less in amount, duration, or scope than the medical assistance
described in that section that is made available to any other individual
under the State plan; and
`(2) be provided in accordance with the restrictions on deductions, cost
sharing, or similar charges imposed under section 1916(a)(2)(D).
`Option to Extend Coverage During a Post-Eligibility Period
`(1) Initial Period- A State plan amendment made under subsection (a)
may provide that any individual who was receiving medical assistance described
in section 1905(a)(4)(C) as a result of such amendment, and who becomes
ineligible for such assistance because of hours of, or income from, employment,
may remain eligible for such medical assistance through the end of the
6-month period that begins on the first day the individual becomes so
ineligible.
`(2) Additional Extension- A State plan amendment made under subsection
(a) may provide that any individual who has received medical assistance
described in section 1905(a)(4)(C) during the entire 6-month period described
in paragraph (1) may be extended coverage for such assistance for a succeeding
6-month period.'.
(b) Effective Date- The amendments made by subsection (a) apply to medical
assistance provided on and after October 1, 2006.
SEC. 6. STATE OPTION TO EXTEND THE POSTPARTUM PERIOD FOR PROVISION OF
FAMILY PLANNING SERVICES AND SUPPLIES.
(a) In General- Section 1902(e)(5) of the Social Security Act (42 U.S.C.
1396a(e)(5)) is amended--
(1) by striking `eligible under the plan, as though' and inserting `eligible
under the plan--
(2) by striking the period and inserting `; and'; and
(3) by adding at the end the following new subparagraph:
`(B) for medical assistance described in section 1905(a)(4)(C) for so
long as the family income of such woman does not exceed the maximum income
level established by the State for the woman to be eligible for medical
assistance under the State plan (as a result of pregnancy or otherwise).'.
(b) Effective Date- The amendments made by subsection (a) apply to medical
assistance provided on and after October 1, 2006.
SEC. 7. STATE OPTION TO PROVIDE WRAP-AROUND SCHIP COVERAGE TO CHILDREN
WHO HAVE OTHER HEALTH COVERAGE.
(A) STATE OPTION TO PROVIDE WRAP-AROUND COVERAGE- Section 2110(b) of
the Social Security Act (42 U.S.C. 1397jj(b)) is amended--
(i) in paragraph (1)(C), by inserting `, subject to paragraph (5),'
after `under title XIX or'; and
(ii) by adding at the end the following:
`(5) STATE OPTION TO PROVIDE WRAP-AROUND COVERAGE- A State may waive the
requirement of paragraph (1)(C) that a targeted low-income child may not
be covered under a group health plan or under health insurance coverage,
if the State satisfies the conditions described in subsection (c)(8).
The State may waive such requirement in order to provide--
`(A) services for a child with special health care needs; or
In waiving such requirement, a State may limit the application of the
waiver to children whose family income does not exceed a level specified
by the State, so long as the level so specified does not exceed the maximum
income level otherwise established for other children under the State
child health plan .'.
(B) CONDITIONS DESCRIBED- Section 2105(c) of the Social Security Act
(42 U.S.C. 1397ee(c)) is amended by adding at the end the following:
`(8) CONDITIONS FOR PROVISION OF WRAP-AROUND COVERAGE- For purposes of
section 2110(b)(5), the conditions described in this paragraph are the
following:
`(A) INCOME ELIGIBILITY- The State child health plan (whether implemented
under title XIX or this XXI)--
`(i) has the highest income eligibility standard permitted under this
title as of January 1, 2006;
`(ii) subject to subparagraph (B), does not limit the acceptance of
applications for children; and
`(iii) provides benefits to all children in the State who apply for
and meet eligibility standards.
`(B) NO WAITING LIST IMPOSED- With respect to children whose family
income is at or below 200 percent of the poverty line, the State does
not impose any numerical limitation, waiting list, or similar limitation
on the eligibility of such children for child health assistance under
such State plan.
`(C) NO MORE FAVORABLE TREATMENT- The State child health plan may not
provide more favorable coverage of dental services to the children covered
under section 2110(b)(5) than to children otherwise covered under this
title.'.
(C) STATE OPTION TO WAIVE WAITING PERIOD- Section 2102(b)(1)(B) of the
Social Security Act (42 U.S.C. 1397bb(b)(1)(B)), as amended by section
2(b)(3)(B), is amended--
(i) in clause (ii), by striking `, and' at the end and inserting a
semicolon;
(ii) in clause (iii), by striking the period at the end and inserting
`; and'; and
(iii) by adding at the end the following new clause:
`(iv) at State option, may not apply a waiting period in the case
of a child described in section 2110(b)(5), if the State satisfies
the requirements of section 2105(c)(8).'.
(2) APPLICATION OF ENHANCED MATCH UNDER MEDICAID- Section 1905 of the
Social Security Act (42 U.S.C. 1396d), as amended by section 2(a)(2),
is amended--
(A) in subsection (b), in the fourth sentence, by striking `or (u)(4)'
and inserting `(u)(4), or (u)(5)'; and
(i) by redesignating paragraph (5) as paragraph (6); and
(ii) by inserting after paragraph (4) the following:
`(5) For purposes of subsection (b), the expenditures described in this
paragraph are expenditures for items and services for children described
in section 2110(b)(5), but only in the case of a State that satisfies
the requirements of section 2105(c)(8).'.
(3) APPLICATION OF SECONDARY PAYOR PROVISIONS- Section 2107(e)(1) of the
Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended by redesignating
subparagraphs (B) through (D) as subparagraphs (C) through (E) and by
inserting after subparagraph (A) the following new subparagraph:
`(B) Section 1902(a)(25) (relating to coordination of benefits and secondary
payor provisions) with respect to children covered under a waiver described
in section 2110(b)(5).'.
(b) Effective Date- The amendments made by subsection (a) shall take effect
on January 1, 2006, and shall apply to child health assistance and medical
assistance provided on or after that date.
END
