To amend title XXI of the Social Security Act to extend the availability of allotments to States for fiscal years 1998 through 2000, and for other purposes.

January 30, 2003

Ms. CANTWELL (for herself and Mrs. MURRAY) introduced the following bill; which was read twice and referred to the Committee on Finance

To amend title XXI of the Social Security Act to extend the availability of allotments to States for fiscal years 1998 through 2000, 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's Health Protection and Eligibility Act of 2003'.

SEC. 2. RETENTION AND REDISTRIBUTION OF SCHIP ALLOTMENTS FOR FISCAL YEARS 1998 THROUGH 2000.

(a) EXTENSION OF AVAILABILITY OF FISCAL YEARS 1998 AND 1999 ALLOTMENTS- Section 2104(g) of the Social Security Act (42 U.S.C. 1397dd(g)) is amended--

(1) in paragraph (1)(B)(ii), by striking `2002' and inserting `2004';

(2) in paragraph (2)(A)(i), by striking `2002' and inserting `2004'; and

(3) in paragraph (2)(A)(ii), by striking `2002' and inserting `2004'.

(b) APPLICATION AND MODIFICATION OF BIPA RULE FOR REDISTRIBUTION AND EXTENDED AVAILABILITY TO ALLOTMENTS FOR FISCAL YEAR 2000- Section 2104(g) of the Social Security Act (42 U.S.C. 1397dd(g)), as amended by subsection (a), is amended--

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

(2) in paragraph (1)--

(A) in subparagraph (A)--

(i) in the matter preceding clause (i)--

(I) by inserting `or for fiscal year 2000 by the end of fiscal year 2002,' after `2001,'; and

(II) by striking `1998 or 1999' and inserting `1998, 1999, or 2000';

(ii) in clause (i)--

(I) in subclause (I), by striking `or' at the end;

(II) in subclause (II), by striking the period and inserting `; or'; and

(III) by adding at the end the following:

`(III) the fiscal year 2000 allotment, 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) in clause (ii), by striking `1998 or 1999' and inserting `1998, 1999, or 2000'; and

(B) in subparagraph (B), in the matter preceding clause (i), by striking `1998 or 1999' and inserting `1998, 1999, or 2000';

(3) in paragraph (2)--

(A) in the paragraph heading, by striking `1998 AND 1999' and inserting `1998, 1999, AND 2000'; and

(B) in subparagraph (A), by adding at the end the following:

`(iii) FISCAL YEAR 2000 ALLOTMENT-

`(I) IN GENERAL- Except as provided in subclause (II), 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) STATES WITH HIGH UNEMPLOYMENT- In the case of a State for which the average rate of unemployment in the State for any consecutive 2 months of 2002 or 2003 exceeds 6 percent, as determined by the Secretary of Labor, the total amount allotted to the State pursuant to this section for fiscal year 2000 that was not expended by

the State by the end of fiscal year 2002 shall remain available for expenditure by the State through the end of fiscal year 2004 and shall not be subject to redistribution under paragraph (1).'; and

(4) in paragraph (3)--

(A) by striking `or fiscal year 1999' and inserting `, fiscal year 1999, or fiscal year 2000'; and

(B) by striking `or November 30, 2001,' and inserting `, November 30, 2001, or November 30, 2002,'.

(c) EFFECTIVE DATE- The amendments made by this section shall take effect as if included in the enactment of section 801 of Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (114 Stat. 2763A-578), as enacted into law by section 1(a)(6) of Public Law 106-554.

SEC. 3. AUTHORITY FOR QUALIFYING STATES TO USE SCHIP FUNDS FOR MEDICAID EXPENDITURES.

(a) 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, with respect to fiscal year 2003, a qualifying State (as defined in paragraph (2)) may elect to use any or all of the aggregate amount of funds available to the State under this title from allotments made to the State (or redistributed to the State) for fiscal years 1998 through 2000, plus an amount equal to 10 percent of allotments made to the State for each of fiscal years 2001 through 2003, for payments for such fiscal years under title XIX in accordance with subparagraph (B).

`(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 total amount of funds described with respect to the State in subparagraph (A), 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 for expenditures of the State for the fiscal year 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)) of such expenditures.

`(ii) EXPENDITURES DESCRIBED- For purposes of clause (i), the expenditures described in this clause are expenditures for the fiscal year for providing medical assistance under title XIX to individuals who have not attained age 19 or who are pregnant women.

`(C) ADDITIONAL PAYMENTS PERMITTED FOR CERTAIN STATES-

`(i) IN GENERAL- With respect to fiscal year 2004 and each fiscal year thereafter, a qualifying State that also has a State child health plan that (whether implemented under title XIX or this title) has the highest income eligibility standard permitted under this title as of January 1, 2001, may elect to have the Secretary pay the State from the allotment for the State for such fiscal year under subsection (b) or (c) of section 2104, an amount each quarter equal to the additional amount that would have been paid to the State under title XIX for expenditures of the State for the fiscal year 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)) of such expenditures.

`(ii) EXPENDITURES DESCRIBED- For purposes of clause (i), the expenditures described in this clause are expenditures for the fiscal year for providing medical assistance under title XIX to individuals who have not attained age 19 and whose family income exceeds the minimum income eligibility level the State is required to establish under section 1902(l) but does not exceed 200 percent of the poverty line.

`(2) QUALIFYING STATE- In this subsection, the term `qualifying State' means a State that satisfies the following:

`(A) NO REDUCTION IN MEDICAID OR SCHIP INCOME ELIGIBILITY- Since January 1, 2001, the State has not reduced the income, assets, or resource requirements for eligibility for medical assistance under title XIX or for child health assistance under this title.

`(B) NO WAITING LIST IMPOSED- The State does not impose any numerical limitation, waiting list, or similar limitation on the eligibility of children for medical assistance under title XIX or child health assistance under this title and does not limit the acceptance of applications for such assistance.

`(C) PROVIDES ASSISTANCE TO ALL CHILDREN WHO APPLY AND QUALIFY- The State provides medical assistance under title XIX or child health assistance under this title to all children in the State who apply for and meet the eligibility standards for such assistance.

`(D) PROTECTION AGAINST INABILITY TO PAY PREMIUMS OR COPAYMENTS- The State ensures that no child loses coverage under title XIX or this title, or is denied needed care, as a result of the child's parents' inability to pay any premiums or cost-sharing required under such title.

`(E) ADDITIONAL REQUIREMENTS- The State has implemented at least 3 of the following policies and procedures (relating to coverage of children under title XIX and this title):

`(i) SIMPLIFIED APPLICATION FORM- With respect to children who are eligible for medical assistance under title XIX, the State uses the same simplified application form (including, if applicable, permitting application other than in person) for purposes of establishing eligibility for assistance under title XIX and this title.

`(ii) ELIMINATION OF ASSET TEST- The State does not apply any asset test for eligibility under title XIX or this title with respect to children.

`(iii) ADOPTION OF 12-MONTH CONTINUOUS ENROLLMENT- The State provides that eligibility shall not be regularly redetermined more often than once every year under this title or for children eligible for medical assistance under title XIX.

`(iv) 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 with respect to 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 title XIX and this title.

`(v) OUTSTATIONING ENROLLMENT STAFF- The State provides for the receipt and initial processing of applications for benefits under this title and for children under title XIX at facilities defined as disproportionate share hospitals under section 1923(a)(1)(A) and Federally-qualified health centers described in section 1905(l)(2)(B) consistent with section 1902(a)(55).'.

(b) EFFECTIVE DATE- The amendment made by this section shall take effect as if enacted on October 1, 2002.

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