# Children's Health Insurance Program Reauthorization Act of 2009

The Children's Health Insurance Program Reauthorization Act of 2009 passed the Senate on January 29, 2009 by a vote of 66-32 and passed the House on February 4, 2009 by a vote of 290-135.
Note: This is the original legislation as it was initially enacted. Any subsequent amendments hosted on Wikisource may be listed using What Links Here.
An Act To amend title XXI of the Social Security Act to extend and improve the Children’s Health Insurance Program, 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; AMENDMENTS TO SOCIAL SECURITY ACT; REFERENCES; TABLE OF CONTENTS.

    (a) SHORT TITLE.—
       This Act may be cited as the ‘‘Children’s Health Insurance Program Reauthorization Act of 2009’’.
    (b) AMENDMENTS TO SOCIAL SECURITY ACT.—
       Except as otherwise specifically provided, whenever in this Act an amendment is expressed in terms of an amendment to or repeal of a section or other provision, the reference shall be considered to be made to that section or other provision of the Social Security Act.
    (c) REFERENCES TO CHIP; MEDICAID; SECRETARY.—
       In this Act:
          (1) CHIP.—
             The term ‘‘CHIP’’ means the State Children's Health Insurance Program established under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.).
          (2) MEDICAID.—
             The term ‘‘Medicaid’’ means the program for medical assistance established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).
          (3) SECRETARY.—
             The term ‘‘Secretary’’ means the Secretary of Health and Human Services.
    (d) TABLE OF CONTENTS.—
       The table of contents of this Act is as follows:
             Sec. 1. Short title; amendments to Social Security Act; references; table of contents.
             Sec. 2. Purpose.
             Sec. 3. General effective date; exception for State legislation; contingent effective date; reliance on law.
       TITLE I—FINANCING
          Subtitle A—Funding
             Sec. 101. Extension of CHIP.
             Sec. 102. Allotments for States and territories for fiscal years 2009 through 2013.
             Sec. 103. Child Enrollment Contingency Fund.
             Sec. 104. CHIP performance bonus payment to offset additional enrollment costs resulting from enrollment and retention efforts.
             Sec. 105. Two-year initial availability of CHIP allotments.
             Sec. 106. Redistribution of unused allotments.
             Sec. 107. Option for qualifying States to receive the enhanced portion of the CHIP matching rate for Medicaid coverage of certain children.
             Sec. 108. One-time appropriation.
             Sec. 109. Improving funding for the territories under CHIP and Medicaid.
          Subtitle B—Focus on Low-Income Children and Pregnant Women
             Sec. 111. State option to cover low-income pregnant women under CHIP through a State plan amendment.
             Sec. 112. Phase-out of coverage for nonpregnant childless adults under CHIP; conditions for coverage of parents.
             Sec. 113. Elimination of counting Medicaid child presumptive eligibility costs against title XXI allotment.
             Sec. 114. Limitation on matching rate for States that propose to cover children with effective family income that exceeds 300 percent of the poverty line.
             Sec. 115. State authority under Medicaid.
       TITLE II—OUTREACH AND ENROLLMENT
          Subtitle A—Outreach and Enrollment Activities
             Sec. 201. Grants and enhanced administrative funding for outreach and enrollment.
             Sec. 202. Increased outreach and enrollment of Indians.
             Sec. 203. State option to rely on findings from an Express Lane agency to conduct simplified eligibility determinations.
          Subtitle B—Reducing Barriers to Enrollment
             Sec. 211. Verification of declaration of citizenship or nationality for purposes of eligibility for Medicaid and CHIP.
             Sec. 212. Reducing administrative barriers to enrollment.
             Sec. 213. Model of Interstate coordinated enrollment and coverage process.
             Sec. 214. Permitting States to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and CHIP.
       TITLE III—REDUCING BARRIERS TO PROVIDING PREMIUM ASSISTANCE
          Subtitle A—Additional State Option for Providing Premium Assistance
             Sec. 301. Additional State option for providing premium assistance.
             Sec. 302. Outreach, education, and enrollment assistance.
          Subtitle B—Coordinating Premium Assistance With Private Coverage
             Sec. 311. Special enrollment period under group health plans in case of termination of Medicaid or CHIP coverage or eligibility for assistance in purchase of employment-based coverage; coordination of coverage.
       TITLE IV—STRENGTHENING QUALITY OF CARE AND HEALTH OUTCOMES
             Sec. 401. Child health quality improvement activities for children enrolled in Medicaid or CHIP.
             Sec. 402. Improved availability of public information regarding enrollment of children in CHIP and Medicaid.
             Sec. 403. Application of certain managed care quality safeguards to CHIP.
       TITLE V—IMPROVING ACCESS TO BENEFITS
             Sec. 501. Dental benefits.
             Sec. 502. Mental health parity in CHIP plans.
             Sec. 503. Application of prospective payment system for services provided by Federally-qualified health centers and rural health clinics.
             Sec. 504. Premium grace period.
             Sec. 505. Clarification of coverage of services provided through school-based health centers.
             Sec. 506. Medicaid and CHIP Payment and Access Commission.
       TITLE VI—PROGRAM INTEGRITY AND OTHER MISCELLANEOUS PROVISIONS
          Subtitle A—Program Integrity and Data Collection
             Sec. 601. Payment error rate measurement (‘‘PERM’’).
             Sec. 602. Improving data collection.
             Sec. 603. Updated Federal evaluation of CHIP.
             Sec. 604. Access to records for IG and GAO audits and evaluations.
             Sec. 605. No Federal funding for illegal aliens; disallowance for unauthorized expenditures.
          Subtitle B—Miscellaneous Health Provisions
             Sec. 611. Deficit Reduction Act technical corrections.
             Sec. 612. References to title XXI.
             Sec. 613. Prohibiting initiation of new health opportunity account demonstration programs.
             Sec. 614. Adjustment in computation of Medicaid FMAP to disregard an extraordinary employer pension contribution.
             Sec. 615. Clarification treatment of regional medical center.
             Sec. 616. Extension of Medicaid DSH allotments for Tennessee and Hawaii.
             Sec. 617. GAO report on Medicaid managed care payment rates.
          Subtitle C—Other Provisions
             Sec. 621. Outreach regarding health insurance options available to children.
             Sec. 622. Sense of the Senate regarding access to affordable and meaningful health insurance coverage.
       TITLE VII—REVENUE PROVISIONS
             Sec. 701. Increase in excise tax rate on tobacco products.
             Sec. 702. Administrative improvements.
             Sec. 703. Treasury study concerning magnitude of tobacco smuggling in the United States.
             Sec. 704. Time for payment of corporate estimated taxes.

### SEC. 2. PURPOSE.

    It is the purpose of this Act to provide dependable and stable funding for children’s health insurance under titles XXI and XIX of the Social Security Act in order to enroll all six million uninsured children who are eligible, but not enrolled, for coverage today through such titles.

### SEC. 3. GENERAL EFFECTIVE DATE; EXCEPTION FOR STATE LEGISLATION; CONTINGENT EFFECTIVE DATE; RELIANCE ON LAW.

    (a) GENERAL EFFECTIVE DATE.—
       Unless otherwise provided in this Act, subject to subsections (b) through (d), this Act (and the amendments made by this Act) shall take effect on April 1, 2009, and shall apply to child health assistance and medical assistance provided on or after that date.
    (b) EXCEPTION FOR STATE LEGISLATION.—
       In the case of a State plan under title XIX or State child health plan under XXI of the Social Security Act, which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet one or more additional requirements imposed by amendments made by this Act, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.
    (c) COORDINATION OF CHIP FUNDING FOR FISCAL YEAR 2009.—
       Notwithstanding any other provision of law, insofar as funds have been appropriated under section 2104(a)(11), 2104(k), or 2104(l) of the Social Security Act, as amended by section 201 of Public Law 110-173, to provide allotments to States under CHIP for fiscal year 2009—
          (1) any amounts that are so appropriated that are not so allotted and obligated before April 1, 2009, are rescinded; and
          (2) any amount provided for CHIP allotments to a State under this Act (and the amendments made by this Act) for such fiscal year shall be reduced by the amount of such appropriations so allotted and obligated before such date.
    (d) RELIANCE ON LAW.—
       With respect to amendments made by this Act (other than title VII) that become effective as of a date—
          (1) such amendments are effective as of such date whether or not regulations implementing such amendments have been issued; and
          (2) Federal financial participation for medical assistance or child health assistance furnished under title XIX or XXI, respectively, of the Social Security Act on or after such date by a State in good faith reliance on such amendments before the date of promulgation of final regulations, if any, to carry out such amendments (or before the date of guidance, if any, regarding the implementation of such amendments) shall not be denied on the basis of the State’s failure to comply with such regulations or guidance.
Approved February 4, 2009.

## Legislative History

* H.R. 2, (S. 896)
** HOUSE REPORTS:
*** No. 111-1 (Comm. on Rules)
** CONGRESSIONAL RECORD, Vol. 155 (2009):
*** Jan. 14, considered and passed House.
*** Jan. 26-29, considered and passed Senate, amended.
*** Feb. 4, House concurred in Senate amendment.
** DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 44 (2009):
*** Feb. 4, Presidential remarks.
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