To amend title XIX of the Social Security Act to permit States to expand Medicaid eligibility to uninsured, poor adults.

Summary: Keep America Healthy Act of 2005 - Amends title XIX (Medicaid) of the Social Security Act (SSA) to make a new optional Medicaid eligibility group for individuals between ages 21 and 65 whose family income does not exceed a State-specified percentage up to 200 percent of the applicable poverty line. Authorizes the State also to require the individual's resources not to exceed whatever level the State may establish, so long as it is not more restrictive than the requirements of SSA title XVI (Supplemental Security Income). Provides for the application to such new group of the enhanced Federal medical assistance percentage dtermined under SSA title XXI (State Children's Health Insurance Program) (SCHIP).

Amends SSA title XI to provide for an increase in the Medicaid payment limit for territories to accommodate expanded coverage for residents of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Keep America Healthy Act of 2005''.

SEC. 2. OPTIONAL MEDICAID COVERAGE OF UNINSURED, POOR ADULTS.

    (a) Availability of Medicaid Coverage for Uninsured, Poor Adults.--
            (1) Addition of optional coverage group.--Section 
        1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 
        1396a(a)(10)(A)(ii)) is amended--
                    (A) by striking ``or'' at the end of subclause 
                (XVII);
                    (B) by striking the semicolon at the end of 
                subclause (XVIII) and inserting ``, or''; and
                    (C) by adding at the end the following new 
                subclause:
                                    ``(XIX) described in subsection 
                                (cc);''.
            (2) Eligibility standards for new eligibility group.--
        Section 1902 of such Act is further amended by adding at the 
        end the following new subsection:
    ``(cc) Coverage of Uninsured, Poor Adults.--For purposes of 
subsection (a)(10)(A)(ii)(XIX), individuals described in this 
subsection are individuals who meet the following requirements:
            ``(1) Age.--The individual is at least 21 years of age but 
        is under 65 years of age.
            ``(2) Income.--The income of the individual's family does 
        not exceed a percentage (not to exceed 200 percent) specified 
        by the State of the poverty line (as defined in section 
        2110(c)(5)) applicable to a family of the size involved and, at 
        the option of a State, the individual's resources do not exceed 
        such resource level as the State may establish, so long as such 
        resource level is not more restrictive than the resources an 
        individual may have and obtain benefits under the supplemental 
        security income program under title XVI.''.
    (b) Provision of Enhanced Federal Medical Assistance as Incentive 
for States to Increase Coverage.--
            (1) Application of enhanced federal medical assistance 
        percentage.--Section 1905(b)(4) of such Act (42 U.S.C. 
        1396d(b)(4)) is amended by inserting ``or section 
        1902(a)(10)(A)(ii)(XIX)'' after ``section 
        1902(a)(10)(A)(ii)(XVIII)''.
            (2) Increase in medicaid payment limit for territories to 
        accommodate expanded coverage for residents of puerto rico, the 
        virgin islands, guam, american samoa, and the northern mariana 
        islands.--Section 1108 of such Act (42 U.S.C. 1308) is 
        amended--
                    (A) in subsection (f), by striking ``subsection 
                (g)'' and inserting ``subsections (g) and (h)''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(h) Increase in Medicaid Payment Limit to Accommodate Expanded 
Coverage Under the Keep America Healthy Act.--
            ``(1) Fiscal year 2006 and thereafter.--With respect to 
        fiscal year 2006 and each succeeding fiscal year, if Puerto 
        Rico, the Virgin Islands, Guam, the Northern Mariana Islands, 
        or American Samoa provides for coverage of individuals under 
        section 1902(a)(10)(A)(ii)(XIX) in a fiscal year, the amounts 
        otherwise determined for the respective territory under 
        subsections (f) and (g) for such fiscal year shall be increased 
        by a percentage (estimated by the Secretary) equal to 120 
        percent of the State average Keep America Healthy percentage, 
        estimated by the Secretary under paragraph (2) for the fiscal 
        year involved.
            ``(2) Annual estimation of state average keep america 
        healthy percentage.--For each such fiscal year the Secretary 
        shall estimate a State average Keep America Healthy percentage 
        equal to (A) the total Federal payments under title XIX for the 
        fiscal year for the 50 States and the District of Columbia that 
        are attributable to individuals made eligible for benefits 
        under section 1902(a)(10)(A)(ii)(XIX), divided by (B) the total 
        Federal payments under such title the fiscal year for such 
        States and District.''.
    (c) Conforming and Technical Amendments.--(1) Section 1903(f)(4) of 
such Act (42 U.S.C. 1396b(f)(4)) is amended by inserting 
``1902(a)(10)(A)(ii)(XIX),'' after ``1902(a)(10)(A)(ii)(XVIII),''.
    (2) Section 1905(a) of such Act (42 U.S.C. 1396d(a)) is amended, in 
the matter before paragraph (1)--
            (A) by striking ``or'' at the end of clause (xii);
            (B) by adding ``or'' at the end of clause (xiii); and
            (C) by inserting after clause (xiii) the following new 
        clause:
                    ``(xiv) individuals described in section 
                1902(cc),''.
    (3) Section 1905(u)(4) of such Act (42 U.S.C. 1396d(u)(4)) is 
amended by inserting before the period at the end the following: ``for 
individuals not covered under section 1902(a)(10)(A)(ii)(XIX)''.
    (d) Effective Date.--The amendments made by this section shall take 
effect on October 1, 2005.