I 

113TH CONGRESS 

1ST SESSION H. R. 1698 

To amend titles XIX and XXI of the Social Security Act to provide for 

12-month continuous enrollment of individuals under the Medicaid program and Children’s Health Insurance Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 24, 2013 

Mr. GENE GREEN of Texas (for himself and Mr. BARTON) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

to provide for 12-month continuous enrollment of individuals under the Medicaid program and Children’s Health 

Insurance Program, and for other purposes. 

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 ‘‘Stabilize Medicaid and 

5 CHIP Coverage Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) Every year millions of people are enrolled in 

2 Medicaid and the Children’s Health Insurance Pro3 gram (in this section referred to as ‘‘CHIP’’), but 

4 subsequently lose their coverage, despite still being 

5 eligible, because of inefficient and cumbersome pa6 perwork and logistical requirements. 

7 (2) Data show that the typical enrollee receives 

8 Medicaid coverage for about three-quarters of a 

9 year. Coverage periods are lower for non-elderly, 

10 non-disabled adults than for those with disabilities, 

11 seniors, and children. 

12 (3) Medicaid enrollees with coverage disruptions 

13 are more likely to be hospitalized for illnesses like 

14 asthma, diabetes, or cardiovascular disease that can 

15 be effectively managed through ongoing primary 

16 medical care and medication, are less likely to be 

17 screened for breast cancer, and may have poorer 

18 cancer outcomes. 

19 (4) Children enrolled in CHIP also experience 

20 disruptions in health coverage and care. For exam21 ple, during just a one-year period, over one-third of 

22 CHIP enrollees were also enrolled in a State’s Med23 icaid program. Transitions between Medicaid and 

24 CHIP can cause disruptions in care because the 


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1 health care coverage and participating providers vary 

2 between the two programs. 

3 (5) Interruptions in coverage can impair the re4 ceipt of effective primary care and lead to expensive 

5 hospitalizations or emergency room visits. Unneces6 sary enrollment, disenrollment, and reenrollment in 

7 Medicaid and CHIP result in higher administrative 

8 expenses for re-enrollment and result in more people 

9 uninsured at any given time. 

10 (6) Stable coverage under Medicaid and CHIP 

11 lowers average monthly medical costs. 

12 (7) Continuous enrollment also permits better 

13 prevention and disease management, leading to 

14 fewer serious illnesses and hospitalizations. 

15 (8) Children with stable coverage are less likely 

16 to have unmet medical needs, allowing children to 

17 receive the preventive care that is necessary to help 

18 them grow into healthy adults. 

19 SEC. 3. 12-MONTH CONTINUOUS ENROLLMENT. 

20 (a) REQUIREMENT OF 12-MONTH CONTINUOUS EN21 ROLLMENT UNDER MEDICAID.—Section 1902(e)(12) of 

22 the Social Security Act (42 U.S.C. 1396a(e)(12)) is 

23 amended to read as follows: 

24 ‘‘(12) 12-MONTH CONTINUOUS ENROLLMENT.— 

25 Notwithstanding any other provision of this title, a 


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1 State plan approved under this title (or under any 

2 waiver of such plan approved pursuant to section 

3 1115 or section 1915), shall provide that an indi4 vidual who is determined to be eligible for benefits 

5 under such plan (or waiver) shall remain eligible and 

6 enrolled for such benefits through the end of the 

7 month in which the 12-month period (beginning on 

8 the date of determination of eligibility) ends.’’. 

9 (b) REQUIREMENT OF 12-MONTH CONTINUOUS EN10 ROLLMENT UNDER CHIP.— 

11 (1) IN GENERAL.—Section 2102(b) of the So12 cial Security Act (42 U.S.C. 1397bb(b)) is amended 

13 by adding at the end the following new paragraph: 

14 ‘‘(6) REQUIREMENT FOR 12-MONTH CONTIN15 UOUS ENROLLMENT.—Notwithstanding any other 

16 provision of this title, a State child health plan that 

17 provides child health assistance under this title 

18 through a means other than described in section 

19 2101(a)(2), shall provide that an individual who is 

20 determined to be eligible for benefits under such 

21 plan shall remain eligible and enrolled for such bene22 fits through the end of the month in which the 12- 

23 month period (beginning on the date of determina24 tion of eligibility) ends.’’. 


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1 (2) CONFORMING AMENDMENT.—Section 

2 2105(a)(4)(A) of the Social Security Act (42 U.S.C. 

3 1397ee(a)(4)(A)) is amended— 

4 (A) by striking ‘‘has elected the option of’’ 

5 and inserting ‘‘is in compliance with the re6 quirement for’’; and 

7 (B) by striking ‘‘applying such policy 

8 under its State child health plan under this 

9 title’’ and inserting ‘‘in compliance with section 

10 2102(b)’’. 

11 (c) EFFECTIVE DATE.— 

12 (1) IN GENERAL.—Except as provided in para13 graph (2) or (3), the amendments made by sub14 sections (a) and (b) shall apply to determinations 

15 (and redeterminations) of eligibility made on or after 

16 the date that is 18 months after the date of the en17 actment of this Act. 

18 (2) EXTENSION OF EFFECTIVE DATE FOR

19 STATE LAW AMENDMENT.—In the case of a State 

20 plan under title XIX or State child health plan 

21 under title XXI of the Social Security Act (42 

22 U.S.C. 1396 et seq., 42 U.S.C. 1397aa et seq.) 

23 which the Secretary of Health and Human Services 

24 determines requires State legislation (other than leg25 islation appropriating funds) in order for the respecVerDate Mar 15 2010 01:50 Apr 30, 2013 Jkt 029200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1698.IH H1698

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1 tive plan to meet the additional requirement imposed 

2 by the amendment made by subsection (a) or (b), re3 spectively, the respective plan shall not be regarded 

4 as failing to comply with the requirements of such 

5 title solely on the basis of its failure to meet such 

6 applicable additional requirement before the first 

7 day of the first calendar quarter beginning after the 

8 close of the first regular session of the State legisla9 ture that begins after the date of enactment of this 

10 Act. For purposes of the previous sentence, in the 

11 case of a State that has a 2-year legislative session, 

12 each year of the session is considered to be a sepa13 rate regular session of the State legislature. 

14 (3) OPTION TO IMPLEMENT 12-MONTH CONTIN15 UOUS ELIGIBILITY PRIOR TO EFFECTIVE DATE.—A 

16 State may elect through a State plan amendment 

17 under title XIX or XXI of the Social Security Act 

18 (42 U.S.C. 1396 et seq., 42 U.S.C. 1397aa et seq.) 

19 to apply the amendment made by subsection (a) or 

20 (b), respectively, on any date prior to the 18-month 

21 date specified in paragraph (1), but not sooner than 

22 the date of the enactment of this Act. 

Æ 


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