II 

109TH CONGRESS 

1ST SESSION S. 1298 

To amend titles XIX and XXI of the Social Security Act to permit States 

to cover low-income youth up to age 23. 

IN THE SENATE OF THE UNITED STATES 

JUNE 23, 2005 

Mrs. LINCOLN (for herself, Mr. BINGAMAN, and Mr. PRYOR) introduced the 

following bill; which was read twice and referred to the Committee on Finance 

A BILL

To amend titles XIX and XXI of the Social Security Act 

to permit States to cover low-income youth up to age 23.

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 ‘‘Health Care for Young 

5 Adults Act of 2005’’. 

6 SEC. 2. PROVIDING STATE OPTION FOR SCHIP AND MED7 ICAID COVERAGE OF YOUNG ADULTS UP TO 

8 AGE 23. 

9 (a) IN GENERAL.— 
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1 (1) MEDICAID.—(A) Section 1902(l)(1)(D) of 

2 the Social Security Act (42 U.S.C. 1396a(l)(1)(D)) 

3 is amended by inserting ‘‘(or, at the option of the 

4 State, who have not attained 20, 21, or 22 years of 

5 age, as the State may elect)’’ after ‘‘have not at6 tained 19 years of age’’. 

7 (B) Clause (i) of section 1905(a) of the Social 

8 Security Act (42 U.S.C. 1396d(a)) is amended by 

9 striking ‘‘under the age of 21, or, at the option of 

10 the State, under the age of 20, 19, or 18 as the 

11 State may choose’’ and inserting ‘‘under the age of 

12 23, or, at the option of the State, under the age of 

13 22, 21, 20, 19, or 18 as the State may elect’’. 

14 (2) SCHIP.—Section 2110(c)(1) of such Act 

15 (42 U.S.C. 1397jj(c)(1)) is amended by inserting 

16 after ‘‘19 years of age’’ the following: ‘‘(or, at the 

17 option of the State and subject to the availability of 

18 additional allotments under section 2104(d), 20, 21, 

19 22, or 23 years of age)’’. 

20 (b) ADDITIONAL SCHIP ALLOTMENTS FOR PRO21 VIDING COVERAGE OF OPTIONAL YOUNG ADULTS.— 

22 (1) IN GENERAL.—Section 2104 of such Act 

23 (42 U.S.C. 1397dd) is amended by inserting after 

24 subsection (c) the following: 
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1 ‘‘(d) ADDITIONAL ALLOTMENTS FOR THE PROVISION

2 OF COVERAGE TO OPTIONAL YOUNG ADULTS.— 

3 ‘‘(1) APPROPRIATION; TOTAL ALLOTMENT.—

4 For the purpose of providing additional allotments 

5 to States under this title, there is appropriated, out 

6 of any money in the Treasury not otherwise appro7 priated, for each of fiscal years 2006 through 2009, 

8 $500,000,000. 

9 ‘‘(2) STATE AND TERRITORIAL ALLOTMENTS.—

10 In addition to the allotments provided under sub11 sections (b) and (c), subject to paragraph (3), of the 

12 amount available for the additional allotments under 

13 paragraph (1) for a fiscal year, the Secretary shall 

14 allot to each State with a State child health plan ap15 proved under this title— 

16 ‘‘(A) in the case of such a State other than 

17 a commonwealth or territory described in sub18 paragraph (B), the same proportion as the pro19 portion of the State’s allotment under sub20 section (b) (determined without regard to sub21 section (f)) to the total amount of the allot22 ments under subsection (b) for such States eli23 gible for an allotment under this paragraph for 

24 such fiscal year; and 
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1 ‘‘(B) in the case of a commonwealth or ter2 ritory described in subsection (c)(3), the same 

3 proportion as the proportion of the common4 wealth’s or territory’s allotment under sub5 section (c) (determined without regard to sub6 section (f)) to the total amount of the allot7 ments under subsection (c) for commonwealths 

8 and territories eligible for an allotment under 

9 this paragraph for such fiscal year. 

10 ‘‘(3) USE OF ADDITIONAL ALLOTMENT.—Addi11 tional allotments provided under this subsection are 

12 not available for amounts expended before October 

13 1, 2005. Such amounts are available for amounts ex14 pended on or after such date only for— 

15 ‘‘(A) expenditures described in section 

16 1905(u)(4)(A); and 

17 ‘‘(B) child health assistance for individuals 

18 who are targeted low-income children and over 

19 18 years of age and who are low-income chil20 dren only because of an election by the State 

21 under section 2110(c)(1).’’. 

22 (2) CONFORMING AMENDMENTS.—Section 2104 

23 of such Act (42 U.S.C. 1397dd) is amended— 
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1 (A) in subsection (a), in the matter pre2 ceding paragraph (1), by inserting ‘‘subject to 

3 subsection (d),’’ after ‘‘under this section,’’; 

4 (B) in subsection (b)(1), by inserting ‘‘and 

5 subsection (d)’’ after ‘‘Subject to paragraph 

6 (4)’’; and 

7 (C) in subsection (c)(1), by inserting ‘‘sub8 ject to subsection (d),’’ after ‘‘for a fiscal 

9 year,’’. 

10 (c) MODIFICATION OF MEDICAID CAPS FOR TERRI11 TORIES.—Section 1108 of such Act (42 U.S.C. 1308) is 

12 amended— 

13 (1) in subsection (f), by striking ‘‘subsection 

14 (g)’’ and inserting ‘‘subsections (g) and (h)’’; and 

15 (2) by adding at the end the following new sub16 section: 

17 ‘‘(h) The Secretary shall provide for such increase in 

18 the limitations under subsections (f) and (g) with respect 

19 to each of the territories as may be necessary for each 

20 such territory to provide for an expansion of medicaid cov21 erage to young adults described in section 

22 1902(l)(1)(D).’’. 

23 (d) EFFECTIVE DATE.—The amendments made by 

24 this section apply to items and services furnished on or 

25 after October 1, 2005, without regard to whether regula-
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1 tions implementing such amendments have been promul2 gated. 

3 SEC. 3. GRANTS TO IMPLEMENT MEDICAID AND SCHIP EX4 PANSIONS. 

5 (a) IN GENERAL.—The Secretary of Health and 

6 Human Services shall provide for grants to States (as de7 fined for purposes of titles XIX and XXI of the Social 

8 Security Act) in order to enable such States to implement 

9 expansions of eligibility for children and young adults 

10 their State medicaid plans under title XIX of the Social 

11 Security Act and State child health plans under title XXI 

12 of such Act. Such grants shall be available for planning, 

13 implementation, and outreach with respect to such ex14 panded eligibility populations. 

15 (b) TERMS AND CONDITIONS.—Grants under this 

16 section shall be made available under such terms and con17 ditions, including the approval of a grant application, as 

18 the Secretary shall specify. 

19 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

20 are authorized to be appropriated such sums as may be 

21 necessary to provide for grants under this section.

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