To extend State Medicaid fiscal relief.

Summary: Medicaid Act of 2004 - Amends the Jobs and Growth Tax Relief Reconciliation Act of 2003 to extend the temporary freeze of the Federal medical assistance percentage (FMAP) under title XIX (Medicaid) of the Social Security Act (SSA) for certain States (continuing the FY 2003 FMAP through each calendar quarter of FY 2004, and the FY 2004 FMAP for each calendar quarter of FY 2005 if the FY 2005 FMAP would otherwise be less than the FY 2004 FMAP).

Amends the Jobs and Growth Tax Relief Reconciliation Act of 2003 to increase the FMAP: (1) by 2.95 percentage points for the last two calendar quarters of FY 2003 and the first three calendar quarters of FY 2004; and (2) by 1.60 percentage points for the last calendar quarter of FY 2004 and each calendar quarter of FY 2005.

Increases by 5.9 percent the ceiling on Medicaid payments to specified territories for the last two calendar quarters of FY 2003 and the first three calendar quarters of FY 2004. Increases such ceiling by 2.52 percent for the last calendar quarter of FY 2004 and each calendar quarter of FY 2005.

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SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Act of 2004''.

SEC. 2. EXTENSION OF MEDICAID STATE FISCAL RELIEF.

    (a) Extension of Temporary Freeze of Medicaid FMAP for Certain 
States.--Section 401(a) of the Jobs and Growth Tax Relief 
Reconciliation Act of 2003 (42 U.S.C. 1396d note) is amended--
            (1) in the subsection heading, by striking 
        ``$10,000,000,000 for a'';
            (2) in paragraph (2)--
                    (A) in the paragraph heading, by striking ``first 3 
                quarters of''; and
                    (B) by striking ``the first, second, and third 
                calendar quarters'' and inserting ``each calendar 
                quarter'';
            (3) by redesignating paragraphs (3) through (9) as 
        paragraphs (4) through (10), respectively; and
            (4) by inserting after paragraph (2), the following:
            ``(3) Permitting maintenance of fiscal year 2004 fmap for 
        fiscal year 2005.--Subject to paragraph (6), if the FMAP 
        determined without regard to this subsection for a State for 
        fiscal year 2005 is less than the FMAP as so determined for 
        fiscal year 2004, the FMAP for the State for fiscal year 2004 
        shall be substituted for the State's FMAP for each calendar 
        quarter of fiscal year 2005, before the application of this 
        subsection.''.
    (b) Temporary Increase in Medicaid FMAP for All States.--Section 
401(a) of the Jobs and Growth Tax Relief Reconciliation Act of 2003 (42 
U.S.C. 1396d note), as amended by subsection (a), is amended by 
striking paragraphs (4) and (5) (as redesignated by subsection (a)(3)) 
and inserting the following:
            ``(4) Temporary increase in medicaid fmap.--
                    ``(A) General 2.95 percentage points increase for 
                last 2 calendar quarters of fiscal year 2003 and first 
                3 calendar quarters of fiscal year 2004.--Subject to 
                paragraphs (6), (7), and (8), for each State for the 
                third and fourth calendar quarters of fiscal year 2003 
                and for the first, second, and third calendar quarters 
                of fiscal year 2004, the FMAP (taking into account the 
                application of paragraphs (1), (2), and (3)) shall be 
                increased by 2.95 percentage points.
                    ``(B) General 1.60 percentage points increase for 
                last calendar quarter of fiscal year 2004 and each 
                calendar quarter of fiscal year 2005.--Subject to 
                paragraphs (6), (7), and (8), for each State for the 
                fourth calendar quarter of fiscal year 2004 and each 
                calendar quarter of fiscal year 2005, the FMAP (taking 
                into account the application of paragraphs (1), (2), 
                and (3) but without regard to the application of 
                subparagraph (A)) shall be increased by 1.60 percentage 
                points.
            ``(5) Increase in cap on medicaid payments to 
        territories.--
                    ``(A) Last 2 calendar quarters of fiscal year 2003 
                and first 3 calendar quarters of fiscal year 2004.--
                Subject to paragraphs (7) and (8), with respect to the 
                third and fourth calendar quarters of fiscal year 2003 
                and the first, second, and third calendar quarters of 
                fiscal year 2004, the amounts otherwise determined for 
                Puerto Rico, the Virgin Islands, Guam, the Northern 
                Mariana Islands, and American Samoa under subsections 
                (f) and (g) of section 1108 of the Social Security Act 
                (42 U.S.C. 1308) shall each be increased by an amount 
                equal to 5.90 percent of such amounts.
                    ``(B) Last calendar quarter of fiscal year 2004 and 
                each calendar quarter of fiscal year 2005.--Subject to 
                paragraphs (7) and (8), with respect to the fourth 
                calendar quarter of fiscal year 2004 and each calendar 
                quarter of fiscal year 2005, the amounts otherwise 
                determined for Puerto Rico, the Virgin Islands, Guam, 
                the Northern Mariana Islands, and American Samoa under 
                subsections (f) and (g) of section 1108 of the Social 
                Security Act (42 U.S.C. 1308) shall each be increased 
                by an amount equal to 2.52 percent of such amounts.''.
    (c) Conforming Amendments.--Section 401(a) of the Jobs and Growth 
Tax Relief Reconciliation Act of 2003 (42 U.S.C. 1396d note), as 
amended by subsections (a) and (b), is amended--
            (1) in paragraph (1), by striking ``paragraph (5)'' and 
        inserting ``paragraph (6)'';
            (2) in paragraph (2), by striking ``paragraph (5)'' and 
        inserting ``paragraph (6)'';
            (3) in paragraph (7) (as redesignated by subsection 
        (a)(3))--
                    (A) by striking ``paragraph (4)'' each place it 
                appears and inserting ``paragraph (5)''; and
                    (B) by striking ``paragraph (3)'' each place it 
                appears and inserting ``paragraph (4)'';
            (4) in paragraph (8) (as so redesignated), by striking 
        ``the first, second and third calendar quarters of fiscal year 
        2004'' and inserting ``each calendar quarter of fiscal year 
        2004 and fiscal year 2005''; and
            (5) in paragraph (10) (as so redesignated), by striking 
        ``October 1, 2004'' and inserting ``January 1, 2005''.