H. R. 2854

One Hundred Eighth Congress

of the

United States of America

AT THE FIRST SESSION

Begun and held at the City of Washington on Tuesday,

the seventh day of January, two thousand and three

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.

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

SECTION 1. EXTENSION OF AVAILABILITY OF SCHIP ALLOTMENTS FOR

FISCAL YEARS 1998 THROUGH 2001.

(a) EXTENDING AVAILABILITY OF SCHIP ALLOTMENTS FOR

FISCAL YEARS 1998 THROUGH 2001.—

(1) RETAINED AND REDISTRIBUTED ALLOTMENTS FOR FISCAL

YEARS 1998 AND 1999.—Paragraphs (2)(A)(i) and (2)(A)(ii) of section 2104(g) of the Social Security Act (42 U.S.C. 1397dd(g))

are each amended by striking ‘‘fiscal year 2002’’ and inserting

‘‘fiscal year 2004’’.

(2) EXTENSION AND REVISION OF RETAINED AND REDISTRIB- UTED ALLOTMENTS FOR FISCAL YEAR 2000.— (A) PERMITTING AND EXTENDING RETENTION OF PORTION

OF FISCAL YEAR 2000 ALLOTMENT.—Paragraph (2) of such section 2104(g) is amended— (i) in the heading, by striking ‘‘AND 1999’’ and

inserting ‘‘THROUGH 2000’’; and

(ii) by adding at the end of subparagraph (A) the

following: ‘‘(iii) FISCAL YEAR 2000 ALLOTMENT.—Of the

amounts allotted to a State pursuant to this section

for fiscal year 2000 that were not expended by the

State by the end of fiscal year 2002, 50 percent of

that amount shall remain available for expenditure

by the State through the end of fiscal year 2004.’’.

(B) REDISTRIBUTED ALLOTMENTS.—Paragraph (1) of such section 2104(g) is amended—

(i) in subparagraph (A), by inserting ‘‘or for fiscal

year 2000 by the end of fiscal year 2002,’’ after ‘‘fiscal

year 2001,’’;

(ii) in subparagraph (A), by striking ‘‘1998 or 1999’’

and inserting ‘‘1998, 1999, or 2000’’;

(iii) in subparagraph (A)(i)—

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

(I),

(II) by striking the period at the end of subclause (II) and inserting ‘‘; or’’; and

(III) by adding at the end the following new

subclause:
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‘‘(III) the fiscal year 2000 allotment, the

amount specified in subparagraph (C)(i) (less the

total of the amounts under clause (ii) for such

fiscal year), multiplied by the ratio of the amount

specified in subparagraph (C)(ii) for the State to

the amount specified in subparagraph (C)(iii).’’;

(iv) in subparagraph (A)(ii), by striking ‘‘or 1999’’

and inserting ‘‘, 1999, or 2000’’;

(v) in subparagraph (B), by striking ‘‘with respect

to fiscal year 1998 or 1999’’;

(vi) in subparagraph (B)(ii)—

(I) by inserting ‘‘with respect to fiscal year

1998, 1999, or 2000,’’ after ‘‘subsection (e),’’; and

(II) by striking ‘‘2002’’ and inserting ‘‘2004’’;

and

(vii) by adding at the end the following new

subparagraph:

‘‘(C) AMOUNTS USED IN COMPUTING REDISTRIBUTIONS

FOR FISCAL YEAR 2000.—For purposes of subparagraph

(A)(i)(III)—

‘‘(i) the amount specified in this clause is the

amount specified in paragraph (2)(B)(i)(I) for fiscal year

2000, less the total amount remaining available pursuant to paragraph (2)(A)(iii);

‘‘(ii) the amount specified in this clause for a State

is the amount by which the State’s expenditures under

this title in fiscal years 2000, 2001, and 2002 exceed

the State’s allotment for fiscal year 2000 under subsection (b); and

‘‘(iii) the amount specified in this clause is the

sum, for all States entitled to a redistribution under

subparagraph (A) from the allotments for fiscal year

2000, of the amounts specified in clause (ii).’’.

(C) CONFORMING AMENDMENTS.—Such section 2104(g)

is further amended—

(i) in its heading, by striking ‘‘AND 1999’’ and

inserting ‘‘, 1999, AND 2000’’; and

(ii) in paragraph (3)—

(I) by striking ‘‘or fiscal year 1999’’ and

inserting ‘‘, fiscal year 1999, or fiscal year 2000’’;

and

(II) by striking ‘‘or November 30, 2001’’ and

inserting ‘‘November 30, 2001, or November 30,

2002’’, respectively.

(3) EXTENSION AND REVISION OF RETAINED AND REDISTRIBUTED ALLOTMENTS FOR FISCAL YEAR 2001.—

(A) PERMITTING AND EXTENDING RETENTION OF PORTION

OF FISCAL YEAR 2001 ALLOTMENT.—Paragraph (2) of such

section 2104(g), as amended in paragraph (2)(A)(ii), is further amended—

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

‘‘2001’’; and

(ii) by adding at the end of subparagraph (A) the

following: ‘‘(iv) FISCAL YEAR 2001 ALLOTMENT.—Of the

amounts allotted to a State pursuant to this section

for fiscal year 2001 that were not expended by the
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State by the end of fiscal year 2003, 50 percent of

that amount shall remain available for expenditure

by the State through the end of fiscal year 2005.’’.

(B) REDISTRIBUTED ALLOTMENTS.—Paragraph (1) of

such section 2104(g), as amended in paragraph (2)(B), is

further amended—

(i) in subparagraph (A), by inserting ‘‘or for fiscal

year 2001 by the end of fiscal year 2003,’’ after ‘‘fiscal

year 2002,’’;

(ii) in subparagraph (A), by striking ‘‘1999, or

2000’’ and inserting ‘‘1999, 2000, or 2001’’;

(iii) in subparagraph (A)(i)—

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

(II),

(II) by striking the period at the end of subclause (III) and inserting ‘‘; or’’; and

(III) by adding at the end the following new

subclause:

‘‘(IV) the fiscal year 2001 allotment, the

amount specified in subparagraph (D)(i) (less the

total of the amounts under clause (ii) for such

fiscal year), multiplied by the ratio of the amount

specified in subparagraph (D)(ii) for the State to

the amount specified in subparagraph (D)(iii).’’;

(iv) in subparagraph (A)(ii), by striking ‘‘or 2000’’

and inserting ‘‘2000, or 2001’’;

(v) in subparagraph (B)—

(I) by striking ‘‘and’’ at the end of clause (ii);

(II) by redesignating clause (iii) as clause (iv);

and

(III) by inserting after clause (ii) the following

new clause:

‘‘(iii) notwithstanding subsection (e), with respect

to fiscal year 2001, shall remain available for expenditure by the State through the end of fiscal year 2005;

and’’; and

(vi) by adding at the end the following new

subparagraph:

‘‘(D) AMOUNTS USED IN COMPUTING REDISTRIBUTIONS

FOR FISCAL YEAR 2001.—For purposes of subparagraph

(A)(i)(IV)—

‘‘(i) the amount specified in this clause is the

amount specified in paragraph (2)(B)(i)(I) for fiscal year

2001, less the total amount remaining available pursuant to paragraph (2)(A)(iv);

‘‘(ii) the amount specified in this clause for a State

is the amount by which the State’s expenditures under

this title in fiscal years 2001, 2002, and 2003 exceed

the State’s allotment for fiscal year 2001 under subsection (b); and

‘‘(iii) the amount specified in this clause is the

sum, for all States entitled to a redistribution under

subparagraph (A) from the allotments for fiscal year

2001, of the amounts specified in clause (ii).’’.

(C) CONFORMING AMENDMENTS.—Such section 2104(g)

is further amended—
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(i) in its heading, by striking ‘‘AND 2000’’ and

inserting ‘‘2000, AND 2001’’; and

(ii) in paragraph (3)—

(I) by striking ‘‘or fiscal year 2000’’ and

inserting ‘‘fiscal year 2000, or fiscal year 2001’’;

and

(II) by striking ‘‘or November 30, 2002,’’ and

inserting ‘‘November 30, 2002, or November 30,

2003,’’, respectively.

(4) EFFECTIVE DATE.—This subsection, and the amendments made by this subsection, shall be effective as if this

subsection had been enacted on September 30, 2002, and

amounts under title XXI of the Social Security Act (42 U.S.C.

1397aa et seq.) from allotments for fiscal years 1998 through

2000 are available for expenditure on and after October 1,

2002, under the amendments made by this subsection as if

this subsection had been enacted on September 30, 2002.

(b) AUTHORITY FOR QUALIFYING STATES TO USE PORTION OF

SCHIP FUNDS FOR MEDICAID EXPENDITURES.—Section 2105 of the

Social Security Act (42 U.S.C. 1397ee) is amended by adding at

the end the following:

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

FUNDS FOR MEDICAID EXPENDITURES.—

‘‘(1) STATE OPTION.—

‘‘(A) IN GENERAL.—Notwithstanding any other provision of law, a qualifying State (as defined in paragraph

(2)) may elect to use not more than 20 percent of any

allotment under section 2104 for fiscal year 1998, 1999,

2000, or 2001 (insofar as it is available under subsections

(e) and (g) of such section) for payments under title XIX

in accordance with subparagraph (B), instead of for

expenditures under this title.

‘‘(B) PAYMENTS TO STATES.—

‘‘(i) IN GENERAL.—In the case of a qualifying State

that has elected the option described in subparagraph

(A), subject to the availability of funds under such

subparagraph with respect to the State, the Secretary

shall pay the State an amount each quarter equal

to the additional amount that would have been paid

to the State under title XIX with respect to expenditures described in clause (ii) if the enhanced FMAP

(as determined under subsection (b)) had been substituted for the Federal medical assistance percentage

(as defined in section 1905(b)).

‘‘(ii) EXPENDITURES DESCRIBED.—For purposes of

this subparagraph, the expenditures described in this

clause are expenditures, made after the date of the

enactment of this subsection and during the period

in which funds are available to the qualifying State

for use under subparagraph (A), for medical assistance

under title XIX to individuals who have not attained

age 19 and whose family income exceeds 150 percent

of the poverty line.

‘‘(iii) NO IMPACT ON DETERMINATION OF BUDGET

NEUTRALITY FOR WAIVERS.—In the case of a qualifying

State that uses amounts paid under this subsection

for expenditures described in clause (ii) that are
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incurred under a waiver approved for the State, any

budget neutrality determinations with respect to such

waiver shall be determined without regard to such

amounts paid.

‘‘(2) QUALIFYING STATE.—In this subsection, the term ‘qualifying State’ means a State that, on and after April 15, 1997,

has an income eligibility standard that is at least 185 percent

of the poverty line with respect to any 1 or more categories

of children (other than infants) who are eligible for medical

assistance under section 1902(a)(10)(A) or, in the case of a

State that has a statewide waiver in effect under section 1115

with respect to title XIX that was first implemented on July

1, 1995, has an income eligibility standard under such waiver

for children that is at least 185 percent of the poverty line,

or, in the case of a State that has a statewide waiver in

effect under section 1115 with respect to title XIX that was

first implemented on January 1, 1994, has an income eligibility

standard under such waiver for children who lack health insurance that is at least 185 percent of the poverty line.

‘‘(3) CONSTRUCTION.—Nothing in paragraphs (1) and (2)

shall be construed as modifying the requirements applicable

to States implementing State child health plans under this

title.’’.

SEC. 2. TECHNICAL CORRECTION.

(a) TEMPORARY INCREASE OF THE MEDICAID FMAP.—Subparagraphs (A) and (B) of section 401(a)(6) of the Jobs and Growth

Tax Relief Reconciliation Act of 2003 (Public Law 108–27) are

amended to read as follows:

‘‘(A) IN GENERAL.—Subject to subparagraph (B), a State

is eligible for an increase in its FMAP under paragraph

(3) or an increase in a cap amount under paragraph (4)

for any date after September 2, 2003, only if the eligibility

under its State plan under title XIX of the Social Security

Act (including any waiver under such title or under section

1115 of such Act (42 U.S.C. 1315)) applied as of such

date is no more restrictive than the eligibility under such

plan (or waiver) as in effect on September 2, 2003.

‘‘(B) STATE REINSTATEMENT OF ELIGIBILITY PERMITTED.—A State that has restricted eligibility under its

State plan under title XIX of the Social Security Act

(including any waiver under such title or under section

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

September 2, 2003, is eligible for an increase in its FMAP

under paragraph (3) or an increase in a cap amount under

paragraph (4) for subsequent dates in which the State

has reinstated eligibility that is no more restrictive than

the eligibility under such plan (or waiver) as in effect

on September 2, 2003.’’.

(b) RETROACTIVE EFFECTIVE DATE.—The amendment made by

subsection (a) shall take effect as if included in the enactment
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of section 401 of the Jobs and Growth Tax Relief Reconciliation

Act of 2003 (Public Law 108–27).

Speaker of the House of Representatives.

Vice President of the United States and

President of the Senate.