Health Care for America's Children Act of 1998

Summary: Health Care for America's Children Act of 1998 - Amends title XIX (Medicaid) of the Social Security Act to direct the Secretary of Health and Human Services to pay a children's enrollment performance bonus to each State that:  (1) demonstrates its commitment to reach and enroll Medicaid-eligible children in its State Medicaid plan through implementation of various specified outreach activities; and (2) reports annually to the Secretary on the number of full year equivalent Medicaid-eligible children who enrolled under the State Medicaid plan as a result of having been provided presumptive eligibility and having applied for Medicaid assistance through an outstationed eligibility worker and by mail or telephone.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care for America's Children 
Act of 1998''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Over 10,000,000 children in the United States, 1 in 7, 
        lack health insurance coverage.
            (2) Nearly half of those children (4,700,000) are eligible 
        for health benefits coverage through the medicaid program but 
        are not enrolled in that program.
            (3) Children without health insurance coverage are 4 times 
        more likely to go without needed medical or surgical care.
            (4) One out of 5 children who are uninsured for a year or 
        longer are missing all of their current immunizations.
            (5) Children without health insurance are less likely to 
        have a family doctor, less likely to receive timely preventive 
        care, and less likely to receive treatment, even for serious 
        illnesses.
            (6) Uninsured children are more likely to need emergency 
        room care at twice the cost of office-based care.
            (7) A recent report by the Agency for Health Care Policy 
        and Research (AHCPR) stressed the need for States to engage in 
        outreach activities to increase the enrollment of medicaid-
        eligible children.
            (8) Outreach activities like shortened and simplified 
        applications, presumptive and continuous eligibility, and 
        outstationing of eligibility workers in schools and day care 
        centers have been found to be effective in getting medicaid-
        eligible children enrolled in the medicaid program.

SEC. 3. MEDICAID CHILDREN'S ENROLLMENT PERFORMANCE BONUS.

    Section 1903 of the Social Security Act (42 U.S.C. 1396b) is 
amended by adding at the end the following:
    ``(x)(1) In General.--Beginning with fiscal year 1999 and each 
fiscal year thereafter, in addition to any other payment under this 
title, the Secretary shall pay to each State that satisfies the 
requirements of paragraphs (2) and (3) a children's enrollment 
performance bonus under this subsection for such fiscal year in such 
amount as the Secretary shall determine.
    ``(2) Demonstration of Implementation of Outreach Strategies.--A 
State shall demonstrate to the satisfaction of the Secretary that the 
State has a commitment to reach and enroll children who are eligible 
for medical assistance under, but not enrolled in, the State plan under 
this title through effective implementation of each of the following 
outreach activities:
            ``(A) Streamlined eligibility procedures.--
                    ``(i) In general.--The State uses streamlined 
                procedures described in clause (ii) for determining the 
                eligibility for medical assistance under, and 
                enrollment in, the State plan under this title of--
                            ``(I) children in families with incomes 
                        that do not exceed the effective income level 
                        (expressed as a percent of the poverty line) 
                        that has been specified under such State plan 
                        (including under a waiver authorized by the 
                        Secretary or under section 1902(r)(2) for the 
                        child to be eligible for medical assistance 
                        under section 1902(l)(2) or 1905(n)(2) (as 
                        selected by a State)) for the age of such 
                        child; and
                            ``(II) children determined eligible for 
                        such assistance, and enrolled in the State plan 
                        under this title in accordance with the 
                        requirements of paragraphs (1) and (2) of 
                        section 1931(b).
                    ``(ii) Procedures described.--The streamlined 
                procedures described in this clause include--
                            ``(I) using shortened and simplified 
                        applications for the children described in 
                        clause (i);
                            ``(II) eliminating the assets test for 
                        determining the eligibility of such children; 
                        and
                            ``(III) allowing applications for such 
                        children to be submitted by mail or telephone.
            ``(B) Continuous eligibility for children.--The State 
        provides (or demonstrates to the satisfaction of the Secretary 
        that, not later than fiscal year 2001, the State shall provide) 
        for 12-months of continuous eligibility for children in 
        accordance with section 1902(e)(12).
            ``(C) Presumptive eligibility for children.--The State 
        provides (or demonstrates to the satisfaction of the Secretary 
        that, not later than fiscal year 2001, the State shall provide) 
        for making medical assistance available to children during a 
        presumptive eligibility period in accordance with section 
        1920A.
            ``(D) Outstationing and alternative applications.--The 
        State complies with the requirements of section 1902(a)(55) 
        (relating to outstationing of eligibility workers for the 
        receipt and initial processing of applications for medical 
        assistance and the use of alternative application forms).
            ``(E) Simplified verification of eligibility 
        requirements.--The State demonstrates to the satisfaction of 
        the Secretary that the State uses only the minimum level of 
        verification requirements as are necessary for the State to 
        ensure accurate eligibility determinations under the State plan 
        under this title.
    ``(3) Report on Number of Enrollments Resulting From Outreach.--A 
State shall annually report to the Secretary on the number of full year 
equivalent children that are determined to be eligible for medical 
assistance under the State plan under this title and are enrolled under 
the plan as a result of--
            ``(A) having been provided presumptive eligibility in 
        accordance with section 1920A;
            ``(B) having submitted an application for such assistance 
        through an outstationed eligibility worker; and
            ``(C) having submitted an application for such assistance 
        by mail or telephone.
    ``(4) No Substitution of Spending.--Amounts paid to a State under 
this subsection shall be used to supplement and not supplant other 
Federal, State, or local funds provided to the State under this title 
or title XXI. Amounts provided to the State under any other provisions 
of this title shall not be reduced solely as a result of the State's 
eligibility for a performance bonus under this subsection.''.