I 

109TH CONGRESS 

1ST SESSION H. R. 2948

To give States the flexibility to reduce bureaucracy by streamlining enrollment 

processes for the Medicaid and State children’s health insurance programs through better linkages with programs providing nutrition and 

related assistance to low-income families. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 16, 2005

Ms. MILLENDER-MCDONALD (for herself, Mr. OWENS, Mr. MOORE of Kansas, 

Mr. JEFFERSON, Mr. WEXLER, and Ms. WOOLSEY) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL

To give States the flexibility to reduce bureaucracy by 

streamlining enrollment processes for the Medicaid and 

State children’s health insurance programs through better linkages with programs providing nutrition and related assistance to low-income families.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Children’s Express 

5 Lane to Health Coverage Act of 2005’’. 
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1 SEC. 2. FINDINGS; PURPOSE. 

2 (a) FINDINGS.—Congress finds the following: 

3 (1) Despite gains made in recent years, 

4 8,900,000 children in the United States are unin5 sured. Of those, 6,900,000 are eligible for public 

6 health insurance coverage. 

7 (2) Most low-income uninsured children are en8 rolled in nutrition and related programs that operate 

9 under income guidelines similar to those of the med10 icaid program. In fact, 63 percent, or 4,300,000, 

11 low-income uninsured children are in families that 

12 receive benefits through the food stamps program, 

13 the National school lunch program, or the special 

14 supplemental nutrition program for women, infants 

15 and children (commonly referred to as ‘‘WIC’’). 

16 (3) The public would be well served if Federal 

17 means-tested public programs were able to improve 

18 administrative efficiency and coordination as well as 

19 reduce unnecessary bureaucracy. 

20 (4) Uninsured children would be well served if 

21 their enrollment in a nutrition-based or other means22 tested program could serve as a gateway to health 

23 coverage. 

24 (5) Existing law already allows children to be 

25 found income eligible for WIC based on their enroll26 ment in the medicaid program. Current law does 
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1 not, however, give States adequate flexibility to 

2 make an income determination for eligibility for the 

3 medicaid or State children’s health insurance pro4 gram based on an uninsured child’s enrollment in 

5 WIC or another public program. 

6 (b) PURPOSE.—The purpose of this Act is to give 

7 States the flexibility to find children income eligible for 

8 the medicaid program or State children’s health insurance 

9 program based on the fact that the children are eligible 

10 for nutrition assistance or similar public programs with 

11 comparable income standards and methodologies. 

12 SEC. 3. STATE OPTION TO PROVIDE FOR SIMPLIFIED DE13 TERMINATIONS OF A CHILD’S FINANCIAL ELI14 GIBILITY FOR MEDICAL ASSISTANCE UNDER 

15 MEDICAID OR CHILD HEALTH ASSISTANCE 

16 UNDER SCHIP. 

17 (a) MEDICAID.— Section 1902(e) of the Social Secu18 rity Act (42 U.S.C. 1396a(e)) is amended by adding at 

19 the end the following: 

20 ‘‘(13)(A) At the option of the State, the plan may 

21 provide that financial eligibility requirements for medical 

22 assistance are met for an individual who is under an age 

23 specified by the State (except as provided in subparagraph 

24 (C), not to exceed 21 years of age) by using a determina25 tion made within a reasonable period (as determined by 
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1 the State) before its use for this purpose, of the individ2 ual’s family or household income, or if applicable for pur3 poses of determining eligibility under this title or title 

4 XXI, assets or resources, by a Federal or State agency, 

5 or a public or private entity making such determination 

6 on behalf of such agency, specified by the plan, including 

7 (but not limited to) an agency administering the Food 

8 Stamp Act of 1977, the Richard B. Russell National 

9 School Lunch Act, or the Child Nutrition Act of 1966, 

10 notwithstanding any differences in budget unit, disregard, 

11 deeming, or other methodology, but only if—

12 ‘‘(i) the agency has fiscal liabilities or respon13 sibilities affected or potentially affected by such de14 termination; and 

15 ‘‘(ii) any information furnished by the agency 

16 pursuant to this subparagraph is used solely for pur17 poses of determining eligibility for medical assistance 

18 under this title or for child health assistance under 

19 title XXI. 

20 ‘‘(B) Nothing in subparagraph (A) shall be con21 strued—

22 ‘‘(i) to authorize the denial of medical assist23 ance under this title or of child health assistance 

24 under title XXI to an individual who, without the 
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1 application of this paragraph, would qualify for such 

2 assistance; 

3 ‘‘(ii) to relieve a State of the obligation under 

4 subsection (a)(8) to furnish medical assistance with 

5 reasonable promptness after the submission of an 

6 initial application that is evaluated or for which eval7 uation is requested pursuant to this paragraph; or 

8 ‘‘(iii) to relieve a State of the obligation to de9 termine eligibility for medical assistance under this 

10 title or for child health assistance under title XXI on 

11 a basis other than family or household income (or, 

12 if applicable, assets or resources) if an individual is 

13 determined ineligible for such assistance on the basis 

14 of information furnished pursuant to this paragraph. 

15 ‘‘(C) At the option of a State, the financial eligibility 

16 process described in subparagraph (A) may apply to an 

17 individual who is older than age 21 if the individual’s eligi18 bility for medical assistance under this title is based on 

19 pregnancy or if the individual is a parent, guardian, or 

20 other caretaker relative of an individual found eligible 

21 under subparagraph (A).’’. 

22 (b) SCHIP.— Section 2107(e)(1) of the Social Secu23 rity Act (42 U.S.C. 1397gg(e)(1)) is amended by adding 

24 at the end the following: 
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1 ‘‘(E) Section 1902(e)(13) (relating to the 

2 State option to base an individual’s eligibility 

3 for assistance on financial determinations made 

4 by a program providing nutrition or other pub5 lic assistance (except that the State option 

6 under subparagraph (C) of such section shall 

7 apply under this title only if an individual is 

8 pregnant)).’’. 

9 (c) EFFECTIVE DATE.—The amendments made by 

10 this section take effect on October 1, 2005.

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