Healthy Seniors Act of 1999

Summary: Directs the Secretary of Health and Human Services to reduce payments to a State for a calendar quarter in a fiscal year to the extent that the Secretary determines that certain State expenditure levels for Medicare beneficiaries related to any State- funded prescription drug program or Medicare medical assistance provided under Medicare is less than the level of such expenditures under Medicare or Medicaid during FY 1999.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Healthy Seniors Act of 1999''.

SEC. 2. PRESCRIPTION DRUG ASSISTANCE UNDER THE MEDICAID PROGRAM.

    (a) Eligibility.--Section 1902(a)(10) of the Social Security Act 
(42 U.S.C. 1396a(a)(10)) is amended--
            (1) in subparagraph (E)(iv)(II), by striking ``and'' at the 
        end;
            (2) in subparagraph (F), by adding ``and'' at the end; and
            (3) by inserting after subparagraph (F) the following:
                    ``(G) for making medical assistance described in 
                section 1905(v) available (but only for prescribed 
                drugs available under the State plan furnished during 
                fiscal year 2000 and each fiscal year thereafter), for 
                individuals who--
                            ``(i) are not otherwise eligible for 
                        medical assistance for prescribed drugs under 
                        the State plan;
                            ``(ii) are enrolled in part B of title 
                        XVIII; and
                            ``(iii) whose income does not exceed 175 
                        percent of the 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) for a family of the size involved;''.
    (b) Benefit.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended by adding at the end the following:
    ``(v)(1) For purposes of section 1902(a)(10)(G), the medical 
assistance described in this subsection is the applicable percentage 
(determined under paragraph (2)) of a low-income medicare beneficiary's 
out-of-pocket expenditures for prescribed drugs available under the 
State plan.
    ``(2) For purposes of paragraph (1), the applicable percentage is--
                    ``(A) in the case of a low-income medicare 
                beneficiary whose income does not exceed 100 percent of 
                the 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 for a family of the size 
                involved), 100 percent;
                    ``(B) in the case of a low-income medicare 
                beneficiary whose income exceeds 100 but does not 
                exceed 125 percent of such poverty line, 75 percent;
                    ``(C) in the case of a low-income medicare 
                beneficiary whose income exceeds 125 but does not 
                exceed 150 percent of such poverty line, 50 percent; 
                and
                    ``(D) in the case of a low-income medicare 
                beneficiary whose income exceeds 150 but does not 
                exceed 175 percent of such poverty line, 25 percent.
    ``(3) In this subsection, the term `low-income medicare 
beneficiary' means an individual described in section 
1902(a)(10)(G).''.
    (c) Conforming Amendment.--Section 1903(f)(4) of the Social 
Security Act (42 U.S.C. 1396b(f)(4)) is amended by striking ``or 
1905(u)'' and inserting ``1905(u), or 1902(a)(10)(G)''.
    (d) Effective Date.--The amendments made by this section shall 
apply to medical assistance provided beginning with fiscal year 2000.

SEC. 3. PAYMENTS TO STATES FOR COSTS AT A FEDERAL MATCHING RATE OF 100 
              PERCENT.

    (a) In General.--Section 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended--
            (1) in the first sentence of subsection (b), by inserting 
        ``and 1903(x)'' after ``1933(d)''; and
            (2) by adding at the end the following:
    ``(x) With respect to medical assistance described in section 
1905(v) for individuals described in section 1902(a)(10)(G), and 
amounts expended for the proper and efficient administration of such 
sections, the Federal medical assistance percentage for such medical 
assistance and amounts is equal to 100 percent.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to medical assistance provided beginning with fiscal year 2000.

SEC. 4. ON-GOING STATE MAINTENANCE OF EFFORT.

    Notwithstanding any other provision of law, the Secretary of Health 
and Human Services shall reduce payments to a State under section 
1903(a) of the Social Security Act (42 U.S.C. 1396b(a)) for a calendar 
quarter in a fiscal year to the extent that the Secretary determines 
that, for a quarter beginning on or after January 1, 2000--
            (1) the level of State expenditures for medicare 
        beneficiaries under any State-funded prescription drug program 
        for such quarter is less than the level of such expenditures 
        under such program during fiscal year 1999; or
            (2) the level of State expenditures for medical assistance 
        provided to medicare beneficiaries under title XIX of such Act 
        (42 U.S.C. 1396 et seq.) for such quarter is less than the 
        level of such expenditures under such title during fiscal year 
        1999.