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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8327 Introduced in House (IH)]

<DOC>

118th CONGRESS
  2d Session
                                H. R. 8327

    To amend title XI of the Social Security Act to provide for the 
  redistribution of unused territorial cap amounts under the Medicaid 
                                program.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                              May 8, 2024

Mr. Sablan (for himself, Mr. Moylan, and Mrs. Radewagen) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL

 
    To amend title XI of the Social Security Act to provide for the 
  redistribution of unused territorial cap amounts under the Medicaid 
                                program.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Medicaid Continuity for the 
Insular Areas Act of 2024''.

SEC. 2. PROVIDING FOR THE REDISTRIBUTION OF UNUSED TERRITORIAL CAP 
              AMOUNTS UNDER THE MEDICAID PROGRAM.

    Section 1108(g) of the Social Security Act (42 U.S.C. 1308(g)) is 
amended by adding at the end the following new paragraph:
            ``(14) Procedure for redistribution of unused amounts.--
                    ``(A) In general.--For each fiscal year (beginning 
                with fiscal year 2022), in the case that there is at 
                least 1 specified territory (as defined in subparagraph 
                (D)) with unused amounts (as so defined) with respect 
                to such fiscal year, the Secretary shall determine an 
                appropriate procedure, with respect to each territory 
                that is a shortfall territory (as so defined) for such 
                fiscal year, to increase the limit otherwise determined 
                under this subsection on the amount certified by the 
                Secretary under title XIX for payment to such territory 
                by the amount specified in subparagraph (B).
                    ``(B) Amount specified.--
                            ``(i) In general.--For purposes of 
                        subsection (A), the amount specified in this 
                        subparagraph is, with respect to a shortfall 
                        territory and a fiscal year--
                                    ``(I) in the case the aggregate 
                                unused amounts for such fiscal year for 
                                all specified territories are greater 
                                than the aggregate shortfall amounts 
                                for such fiscal year for all such 
                                territories, the difference between the 
                                amount that would have been certified 
                                by the Secretary under title XIX for 
                                payment to such shortfall territory for 
                                such fiscal year without application of 
                                this paragraph and the amount of 
                                payment that such territory would have 
                                received under title XIX had this 
                                section not applied; and
                                    ``(II) in the case the aggregate 
                                unused amounts for such fiscal year for 
                                all specified territories are less than 
                                the aggregate shortfall amounts for 
                                such fiscal year for all such 
                                territories, an amount that bears the 
                                same ratio to such aggregate unused 
                                amounts as such shortfall territory's 
                                shortfall amount bears to such 
                                aggregate shortfall amounts.
                            ``(ii) Retrospective adjustment.--The 
                        Secretary may adjust any increases made under 
                        this paragraph for a fiscal year as necessary 
                        on the basis of information reported by 
                        specified territories not later than November 
                        30 of the succeeding fiscal year, as determined 
                        appropriate by the Secretary.
                    ``(C) Nonapplication of increase to future fiscal 
                years.--Any increase in the limit described in 
                subparagraph (A) of a specified territory for a fiscal 
                year shall not be taken into account in determining 
                such limit for such territory in the succeeding fiscal 
                year.
                    ``(D) Definitions.--In this paragraph:
                            ``(i) Shortfall amount.--The term 
                        `shortfall amount' means, with respect to a 
                        specified territory that, but for the limit on 
                        the amount certified by the Secretary under 
                        title XIX for payment to such territories for a 
                        fiscal year established under this section, 
                        would have received payment under title XIX for 
                        such fiscal year in an amount exceeding such 
                        limit, the amount of such excess.
                            ``(ii) Shortfall territory.--The term 
                        `shortfall territory' means, with respect to a 
                        fiscal year, a specified territory with respect 
                        to which the amount that would be payable to 
                        such territory under title XIX for such year, 
                        without application of this section, exceeds 
                        the limit on the amount certified by the 
                        Secretary under title XIX for payment to such 
                        territory for such year established under this 
                        section (without application of this 
                        paragraph).
                            ``(iii) Specified territory.--The term 
                        `specified territory' means the Virgin Islands, 
                        Guam, the Northern Mariana Islands, and 
                        American Samoa.
                            ``(iv) Unused amount.--The term `unused 
                        amount' means, with respect to a specified 
                        territory that was subject to a limit on the 
                        amount certified by the Secretary under title 
                        XIX for payment to such territory for a fiscal 
                        year established under this section but for 
                        which the Secretary so certified an amount for 
                        such fiscal year that was lower than such 
                        limit, the difference between such amount and 
                        such limit.''.
                                 <all>
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