II 

108TH CONGRESS 

1ST SESSION H. R. 2854

IN THE SENATE OF THE UNITED STATES 

JULY 28 (legislative day, JULY 21), 2003

Received 

AN ACT

To amend title XXI of the Social Security Act to extend 

the availability of allotments for fiscal years 1998 

through 2001 under the State 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,
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1 SECTION 1. EXTENSION OF AVAILABILITY OF SCHIP ALLOT2 MENTS FOR FISCAL YEARS 1998 THROUGH 

3 2001. 

4 (a) EXTENDING AVAILABILITY OF SCHIP ALLOT5 MENTS FOR FISCAL YEARS 1998 THROUGH 2001.—

6 (1) RETAINED AND REDISTRIBUTED ALLOT7 MENTS FOR FISCAL YEARS 1998 AND 1999.—Para8 graphs (2)(A)(i) and (2)(A)(ii) of section 2104(g) of 

9 the Social Security Act (42 U.S.C. 1397dd(g)) are 

10 each amended by striking ‘‘fiscal year 2002’’ and in11 serting ‘‘fiscal year 2004’’. 

12 (2) EXTENSION AND REVISION OF RETAINED

13 AND REDISTRIBUTED ALLOTMENTS FOR FISCAL

14 YEAR 2000.—

15 (A) PERMITTING AND EXTENDING RETEN16 TION OF PORTION OF FISCAL YEAR 2000 ALLOT17 MENT.—Paragraph (2) of such section 2104(g) 

18 is amended—

19 (i) in the heading, by striking ‘‘AND

20 1999’’ and inserting ‘‘THROUGH 2000’’; and 

21 (ii) by adding at the end of subpara22 graph (A) the following: 

23 ‘‘(iii) FISCAL YEAR 2000 ALLOT24 MENT.—Of the amounts allotted to a State 

25 pursuant to this section for fiscal year 

26 2000 that were not expended by the State 
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1 by the end of fiscal year 2002, 50 percent 

2 of that amount shall remain available for 

3 expenditure by the State through the end 

4 of fiscal year 2004.’’. 

5 (B) REDISTRIBUTED ALLOTMENTS.—Para6 graph (1) of such section 2104(g) is amended—

7 (i) in subparagraph (A), by inserting 

8 ‘‘or for fiscal year 2000 by the end of fis9 cal year 2002,’’ after ‘‘fiscal year 2001,’’; 

10 (ii) in subparagraph (A), by striking 

11 ‘‘1998 or 1999’’ and inserting ‘‘1998, 

12 1999, or 2000’’; 

13 (iii) in subparagraph (A)(i)—

14 (I) by striking ‘‘or’’ at the end of 

15 subclause (I), 

16 (II) by striking the period at the 

17 end of subclause (II) and inserting ‘‘; 

18 or’’; and 

19 (III) by adding at the end the 

20 following new subclause: 

21 ‘‘(III) the fiscal year 2000 allot22 ment, the amount specified in sub23 paragraph (C)(i) (less the total of the 

24 amounts under clause (ii) for such fis25 cal year), multiplied by the ratio of 
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1 the amount specified in subparagraph 

2 (C)(ii) for the State to the amount 

3 specified in subparagraph (C)(iii).’’; 

4 (iv) in subparagraph (A)(ii), by strik5 ing ‘‘or 1999’’ and inserting ‘‘, 1999, or 

6 2000’’; 

7 (v) in subparagraph (B), by striking 

8 ‘‘with respect to fiscal year 1998 or 1999’’; 

9 (vi) in subparagraph (B)(ii)—

10 (I) by inserting ‘‘with respect to 

11 fiscal year 1998, 1999, or 2000,’’ 

12 after ‘‘subsection (e),’’; and 

13 (II) by striking ‘‘2002’’ and in14 serting ‘‘2004’’; and 

15 (vii) by adding at the end the fol16 lowing new subparagraph: 

17 ‘‘(C) AMOUNTS USED IN COMPUTING RE18 DISTRIBUTIONS FOR FISCAL YEAR 2000.—For 

19 purposes of subparagraph (A)(i)(III)—

20 ‘‘(i) the amount specified in this 

21 clause is the amount specified in para22 graph (2)(B)(i)(I) for fiscal year 2000, less 

23 the total amount remaining available pur24 suant to paragraph (2)(A)(iii); 
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1 ‘‘(ii) the amount specified in this 

2 clause for a State is the amount by which 

3 the State’s expenditures under this title in 

4 fiscal years 2000, 2001, and 2002 exceed 

5 the State’s allotment for fiscal year 2000 

6 under subsection (b); and 

7 ‘‘(iii) the amount specified in this 

8 clause is the sum, for all States entitled to 

9 a redistribution under subparagraph (A) 

10 from the allotments for fiscal year 2000, of 

11 the amounts specified in clause (ii).’’. 

12 (C) CONFORMING AMENDMENTS.—Such 

13 section 2104(g) is further amended—

14 (i) in its heading, by striking ‘‘AND

15 1999’’ and inserting ‘‘, 1999, AND 2000’’; 

16 and 

17 (ii) in paragraph (3)—

18 (I) by striking ‘‘or fiscal year 

19 1999’’ and inserting ‘‘, fiscal year 

20 1999, or fiscal year 2000’’; and 

21 (II) by striking ‘‘or November 

22 30, 2001’’ and inserting ‘‘November 

23 30, 2001, or November 30, 2002’’, re24 spectively. 
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1 (3) EXTENSION AND REVISION OF RETAINED

2 AND REDISTRIBUTED ALLOTMENTS FOR FISCAL

3 YEAR 2001.—

4 (A) PERMITTING AND EXTENDING RETEN5 TION OF PORTION OF FISCAL YEAR 2001 ALLOT6 MENT.—Paragraph (2) of such section 2104(g), 

7 as amended in paragraph (2)(A)(ii), is further 

8 amended—

9 (i) in the heading, by striking ‘‘2000’’ 

10 and inserting ‘‘2001’’; and 

11 (ii) by adding at the end of subpara12 graph (A) the following: 

13 ‘‘(iv) FISCAL YEAR 2001 ALLOT14 MENT.—Of the amounts allotted to a State 

15 pursuant to this section for fiscal year 

16 2001 that were not expended by the State 

17 by the end of fiscal year 2003, 50 percent 

18 of that amount shall remain available for 

19 expenditure by the State through the end 

20 of fiscal year 2005.’’. 

21 (B) REDISTRIBUTED ALLOTMENTS.—Para22 graph (1) of such section 2104(g), as amended 

23 in paragraph (2)(B), is further amended—
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1 (i) in subparagraph (A), by inserting 

2 ‘‘or for fiscal year 2001 by the end of fis3 cal year 2003,’’ after ‘‘fiscal year 2002,’’; 

4 (ii) in subparagraph (A), by striking 

5 ‘‘1999, or 2000’’ and inserting ‘‘1999, 

6 2000, or 2001’’; 

7 (iii) in subparagraph (A)(i)—

8 (I) by striking ‘‘or’’ at the end of 

9 subclause (II), 

10 (II) by striking the period at the 

11 end of subclause (III) and inserting ‘‘; 

12 or’’; and 

13 (III) by adding at the end the 

14 following new subclause: 

15 ‘‘(IV) the fiscal year 2001 allot16 ment, the amount specified in sub17 paragraph (D)(i) (less the total of the 

18 amounts under clause (ii) for such fis19 cal year), multiplied by the ratio of 

20 the amount specified in subparagraph 

21 (D)(ii) for the State to the amount 

22 specified in subparagraph (D)(iii).’’; 

23 (iv) in subparagraph (A)(ii), by strik24 ing ‘‘or 2000’’ and inserting ‘‘2000, or 

25 2001’’; 
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1 (v) in subparagraph (B)—

2 (I) by striking ‘‘and’’ at the end 

3 of clause (ii); 

4 (II) by redesignating clause (iii) 

5 as clause (iv); and 

6 (III) by inserting after clause (ii) 

7 the following new clause: 

8 ‘‘(iii) notwithstanding subsection (e), 

9 with respect to fiscal year 2001, shall re10 main available for expenditure by the State 

11 through the end of fiscal year 2005; and’’; 

12 and 

13 (vi) by adding at the end the following 

14 new subparagraph: 

15 ‘‘(D) AMOUNTS USED IN COMPUTING RE16 DISTRIBUTIONS FOR FISCAL YEAR 2001.—For 

17 purposes of subparagraph (A)(i)(IV)—

18 ‘‘(i) the amount specified in this 

19 clause is the amount specified in para20 graph (2)(B)(i)(I) for fiscal year 2001, less 

21 the total amount remaining available pur22 suant to paragraph (2)(A)(iv); 

23 ‘‘(ii) the amount specified in this 

24 clause for a State is the amount by which 

25 the State’s expenditures under this title in 
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1 fiscal years 2001, 2002, and 2003 exceed 

2 the State’s allotment for fiscal year 2001 

3 under subsection (b); and 

4 ‘‘(iii) the amount specified in this 

5 clause is the sum, for all States entitled to 

6 a redistribution under subparagraph (A) 

7 from the allotments for fiscal year 2001, of 

8 the amounts specified in clause (ii).’’. 

9 (C) CONFORMING AMENDMENTS.—Such 

10 section 2104(g) is further amended—

11 (i) in its heading, by striking ‘‘AND

12 2000’’ and inserting ‘‘2000, AND 2001’’; 

13 and 

14 (ii) in paragraph (3)—

15 (I) by striking ‘‘or fiscal year 

16 2000’’ and inserting ‘‘fiscal year 

17 2000, or fiscal year 2001’’; and 

18 (II) by striking ‘‘or November 

19 30, 2002,’’ and inserting ‘‘November 

20 30, 2002, or November 30, 2003,’’, 

21 respectively. 

22 (4) EFFECTIVE DATE.—This subsection, and 

23 the amendments made by this subsection, shall be 

24 effective as if this subsection had been enacted on 

25 September 30, 2002, and amounts under title XXI 
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1 of the Social Security Act (42 U.S.C. 1397aa et 

2 seq.) from allotments for fiscal years 1998 through 

3 2000 are available for expenditure on and after Oc4 tober 1, 2002, under the amendments made by this 

5 subsection as if this subsection had been enacted on 

6 September 30, 2002. 

7 (b) AUTHORITY FOR QUALIFYING STATES TO USE

8 PORTION OF SCHIP FUNDS FOR MEDICAID EXPENDI9 TURES.—Section 2105 of the Social Security Act (42 

10 U.S.C. 1397ee) is amended by adding at the end the fol11 lowing: 

12 ‘‘(g) AUTHORITY FOR QUALIFYING STATES TO USE

13 CERTAIN FUNDS FOR MEDICAID EXPENDITURES.—

14 ‘‘(1) STATE OPTION.—

15 ‘‘(A) IN GENERAL.—Notwithstanding any 

16 other provision of law, a qualifying State (as 

17 defined in paragraph (2)) may elect to use not 

18 more than 20 percent of any allotment under 

19 section 2104 for fiscal year 1998, 1999, 2000, 

20 or 2001 (insofar as it is available under sub21 sections (e) and (g) of such section) for pay22 ments under title XIX in accordance with sub23 paragraph (B), instead of for expenditures 

24 under this title. 

25 ‘‘(B) PAYMENTS TO STATES.—
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1 ‘‘(i) IN GENERAL.—In the case of a 

2 qualifying State that has elected the option 

3 described in subparagraph (A), subject to 

4 the availability of funds under such sub5 paragraph with respect to the State, the 

6 Secretary shall pay the State an amount 

7 each quarter equal to the additional 

8 amount that would have been paid to the 

9 State under title XIX with respect to ex10 penditures described in clause (ii) if the 

11 enhanced FMAP (as determined under 

12 subsection (b)) had been substituted for 

13 the Federal medical assistance percentage 

14 (as defined in section 1905(b)). 

15 ‘‘(ii) EXPENDITURES DESCRIBED.—

16 For purposes of this subparagraph, the ex17 penditures described in this clause are ex18 penditures, made after the date of the en19 actment of this subsection and during the 

20 period in which funds are available to the 

21 qualifying State for use under subpara22 graph (A), for medical assistance under 

23 title XIX to individuals who have not at24 tained age 19 and whose family income ex25 ceeds 150 percent of the poverty line. 
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1 ‘‘(iii) NO IMPACT ON DETERMINATION

2 OF BUDGET NEUTRALITY FOR WAIVERS.—

3 In the case of a qualifying State that uses 

4 amounts paid under this subsection for ex5 penditures described in clause (ii) that are 

6 incurred under a waiver approved for the 

7 State, any budget neutrality determina8 tions with respect to such waiver shall be 

9 determined without regard to such 

10 amounts paid. 

11 ‘‘(2) QUALIFYING STATE.—In this subsection, 

12 the term ‘qualifying State’ means a State that, on 

13 and after April 15, 1997, has an income eligibility 

14 standard that is at least 185 percent of the poverty 

15 line with respect to any 1 or more categories of chil16 dren (other than infants) who are eligible for med17 ical assistance under section 1902(a)(10)(A) or, in 

18 the case of a State that has a statewide waiver in 

19 effect under section 1115 with respect to title XIX 

20 that was first implemented on July 1, 1995, has an 

21 income eligibility standard under such waiver for 

22 children that is at least 185 percent of the poverty 

23 line, or, in the case of a State that has a statewide 

24 waiver in effect under section 1115 with respect to 

25 title XIX that was first implemented on January 1, 
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1 1994, has an income eligibility standard under such 

2 waiver for children who lack health insurance that is 

3 at least 185 percent of the poverty line. 

4 ‘‘(3) CONSTRUCTION.—Nothing in paragraphs 

5 (1) and (2) shall be construed as modifying the re6 quirements applicable to States implementing State 

7 child health plans under this title.’’. 

8 SEC. 2. TECHNICAL CORRECTION. 

9 (a) TEMPORARY INCREASE OF THE MEDICAID

10 FMAP.—Subparagraphs (A) and (B) of section 401(a)(6) 

11 of the Jobs and Growth Tax Relief Reconciliation Act of 

12 2003 (Public Law 108–27) are amended to read as fol13 lows: 

14 ‘‘(A) IN GENERAL.—Subject to subpara15 graph (B), a State is eligible for an increase in 

16 its FMAP under paragraph (3) or an increase 

17 in a cap amount under paragraph (4) for any 

18 date after September 2, 2003, only if the eligi19 bility under its State plan under title XIX of 

20 the Social Security Act (including any waiver 

21 under such title or under section 1115 of such 

22 Act (42 U.S.C. 1315)) applied as of such date 

23 is no more restrictive than the eligibility under 

24 such plan (or waiver) as in effect on September 

25 2, 2003. 
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1 ‘‘(B) STATE REINSTATEMENT OF ELIGI2 BILITY PERMITTED.—A State that has re3 stricted eligibility under its State plan under 

4 title XIX of the Social Security Act (including 

5 any waiver under such title or under section 

6 1115 of such Act (42 U.S.C. 1315)) for any 

7 date after September 2, 2003, is eligible for an 

8 increase in its FMAP under paragraph (3) or 

9 an increase in a cap amount under paragraph 

10 (4) for subsequent dates in which the State has 

11 reinstated eligibility that is no more restrictive 

12 than the eligibility under such plan (or waiver) 

13 as in effect on September 2, 2003.’’. 

14 (b) RETROACTIVE EFFECTIVE DATE.—The amend15 ment made by subsection (a) shall take effect as if in16 cluded in the enactment of section 401 of the Jobs and 

17 Growth Tax Relief Reconciliation Act of 2003 (Public Law 

18 108–27).

Passed the House of Representatives July 25, 2003. 

Attest: JEFF TRANDAHL, 

Clerk. 

By DAN STRODEL, 

Assistant to the Clerk.