To give States the flexibility to reduce bureaucracy by streamlining enrollment processes for the medicaid and State children's health insurance programs through better linkages with programs providing nutrition and related assistance to low-income families.

May 20, 2003

Mr. LUGAR (for himself and Mr. BINGAMAN) introduced the following bill; which was read twice and referred to the Committee on Finance

To give States the flexibility to reduce bureaucracy by streamlining enrollment processes for the medicaid and State children's health insurance programs through better linkages with programs providing nutrition and related assistance to low-income families.

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's Express Lane to Health Coverage Act of 2003'.

SEC. 2. FINDINGS; PURPOSE.

(a) FINDINGS- Congress finds the following:

(1) Despite gains made in recent years, 8,900,000 children in the United States are uninsured. Of those, 6,900,000 are eligible for public health insurance coverage.

(2) Most low-income uninsured children are enrolled in nutrition and related programs that operate under income guidelines similar to those of the medicaid program. In fact, 63 percent, or 4,300,000, low-income uninsured children are in families that receive benefits through the food stamps program, the National school lunch program, or the special supplemental nutrition program for women, infants and children (commonly referred to as `WIC').

(3) The public would be well served if Federal means-tested public programs were able to improve administrative efficiency and coordination as well as reduce unnecessary bureaucracy.

(4) Uninsured children would be well served if their enrollment in a nutrition-based or other means-tested program could serve as a gateway to health coverage.

(5) Existing law already allows children to be found income eligible for WIC based on their enrollment in the medicaid program. Current law does not, however, give States adequate flexibility to make an income determination for eligibility for the medicaid or State children's health insurance program based on an uninsured child's enrollment in WIC or another public program.

(b) PURPOSE- The purpose of this Act is to give States the flexibility to find children income eligible for the medicaid program or State children's health insurance program based on the fact that the children are eligible for nutrition assistance or similar public programs with comparable income standards and methodologies.

SEC. 3. STATE OPTION TO PROVIDE FOR SIMPLIFIED DETERMINATIONS OF A CHILD'S FINANCIAL ELIGIBILITY FOR MEDICAL ASSISTANCE UNDER MEDICAID OR CHILD HEALTH ASSISTANCE UNDER SCHIP.

(a) MEDICAID- Section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) is amended by adding at the end the following:

`(13)(A) At the option of the State, the plan may provide that financial eligibility requirements for medical assistance are met for an individual who is under an age specified by the State (not to exceed 21 years of age) by using a determination (made within a reasonable period, as found by the State, before its use for this purpose) of the individual's family or household income or resources, notwithstanding any differences in budget unit, disregard, deeming, or other methodology, by a Federal or State agency (or a public or private entity making such determination on behalf of such agency) specified by the plan, including but not limited to the agencies administering the Food Stamp Act of 1977, the Richard B. Russell National School Lunch Act, and the Child Nutrition Act of 1966, provided that such agency has fiscal liabilities or responsibilities affected or potentially affected by such determinations and provided that all information furnished by such agency pursuant to this subparagraph is used solely for purposes of determining eligibility for medical assistance under the State plan approved under this title or for child health assistance under a State plan approved under title XXI.

`(B) Nothing in subparagraph (A) shall be construed--

`(i) to authorize the denial of medical assistance under a State plan approved under this title or of child health assistance under a State plan approved under title XXI to an individual who, without the application of this paragraph or an option exercised thereunder, would qualify for such assistance;

`(ii) to relieve a State of the obligation under subsection (a)(8) to furnish assistance with reasonable promptness after the submission of an initial application that is evaluated or for which evaluation is requested pursuant to this paragraph; or

`(iii) to relieve a State of the obligation to determine eligibility on other grounds for an individual found to be ineligible under this paragraph.

`(C) At the option of a State, the financial eligibility process described in subparagraph (A) may apply to an individual who is older than age 21 if such individual's eligibility for medical assistance is based on pregnancy or if such individual is a parent, guardian, or other caretaker relative of an individual found eligible under subparagraph (A).'.

(b) SCHIP- Section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended by adding at the end the following:

`(E) Section 1902(e)(13) (relating to the State option to base a child's eligibility for assistance on financial determinations made by a program providing nutrition or other public assistance).'.

(c) EFFECTIVE DATE- The amendments made by this section take effect on October 1, 2003.

END