I 

117TH CONGRESS 

1ST SESSION H. R. 1784 

To amend title XIX of the Social Security Act to enhance reporting 

requirements for nonexpansion States, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 11, 2021 

Mr. DOGGETT (for himself, Mr. CASTRO of Texas, Mr. COOPER, Mr. CRIST, 

Mr. CUELLAR, Mr. DEUTCH, Ms. ESCOBAR, Mrs. FLETCHER, Mr. GREEN

of Texas, Mr. HASTINGS, Ms. JACKSON LEE, Ms. JOHNSON of Texas, 

Ms. SEWELL, Ms. WILLIAMS of Georgia, Ms. GARCIA of Texas, Mr. 

THOMPSON of Mississippi, Mr. DAVID SCOTT of Georgia, Ms. 

WASSERMAN SCHULTZ, Mr. BUTTERFIELD, Mr. COHEN, Ms. MOORE of 

Wisconsin, Mr. JOHNSON of Georgia, Mr. VICENTE GONZALEZ of Texas, 

and Mr. VELA) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to enhance 

reporting requirements for nonexpansion States, 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 ‘‘Medicaid Report on 

5 Expansion of Access to Coverage for Health Act’’ or the 

6 ‘‘Medicaid REACH Act’’. 


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1 SEC. 2. ENHANCED REPORTING REQUIREMENTS FOR NON2 EXPANSION STATES. 

3 Section 1903 of the Social Security Act (42 U.S.C. 

4 1396b) is amended— 

5 (1) in subsection (a)(7), by inserting ‘‘sub6 section (cc) and’’ before ‘‘section 1919(g)(3)(B)’’; 

7 and 

8 (2) by adding at the end the following new sub9 section: 

10 ‘‘(cc) REDUCTION OF FEDERAL PAYMENTS FOR CER11 TAIN ADMINISTRATIVE COSTS OF NONEXPANSION STATES

12 THAT DO NOT SATISFY REPORTING REQUIREMENTS.— 

13 ‘‘(1) IN GENERAL.— 

14 ‘‘(A) REDUCTION.—In the case of a non15 expansion State, with respect to a fiscal year 

16 (beginning with fiscal year 2022) that does not 

17 satisfy the reporting requirement under para18 graph (2) for such fiscal year, the percentage 

19 specified in subsection (a)(7) for amounts de20 scribed in such subsection expended by such 

21 State during a calendar quarter described in 

22 paragraph (4) with respect to such fiscal year, 

23 subject to subparagraph (B), shall be reduced 

24 by the number of percentage points specified in 

25 paragraph (4) for the respective calendar quar26 ter. 


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1 ‘‘(B) EXCEPTION.—In the case of a non2 expansion State that is subject to a reduction 

3 under subparagraph (A) for the calendar quar4 ter described in paragraph (4)(A) with respect 

5 to a fiscal year, if the State satisfies the criteria 

6 described in subparagraphs (A), (B), and (C) of 

7 paragraph (2) (without regard to the dates 

8 specified in such subparagraph (A) and (C)) be9 fore the beginning of a subsequent calendar 

10 quarter described in paragraph (4) with respect 

11 to such fiscal year, then such State shall not be 

12 subject to a reduction under subparagraph (A) 

13 for such subsequent calendar quarter. 

14 ‘‘(2) REPORTING REQUIREMENT.—For pur15 poses of paragraph (1), a nonexpansion State satis16 fies the reporting requirement under this paragraph 

17 for a fiscal year, if the nonexpansion State— 

18 ‘‘(A) by not later than January 1 of such 

19 year, posts on the public website of the State 

20 agency administering the State plan, the infor21 mation described in paragraph (3) with respect 

22 to such State for the previous year; 

23 ‘‘(B) provides for at least a 30-day period 

24 for notice and comment on such information; 

25 and 


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1 ‘‘(C) by not later than March 1 of such 

2 year, submits to the Secretary a complete re3 port including such information, comments sub4 mitted pursuant to subparagraph (B), and a re5 sponse by the State to each such comment. 

6 ‘‘(3) INFORMATION DESCRIBED.—The informa7 tion described in this paragraph, with respect to a 

8 State and year, is the following: 

9 ‘‘(A) The estimated number of individuals 

10 who were uninsured for at least 6 months 

11 (disaggregated by race, ethnicity, gender, and 

12 age-groups of 0 to 18 years of age and of 19 

13 years of age to 64 years of age), as well as a 

14 detailed description of the basis for the esti15 mates. 

16 ‘‘(B) The estimated number of the individ17 uals estimated under subparagraph (A) in the 

18 State who would be eligible for medical assist19 ance under the State plan if the State were to 

20 make medical assistance under the State plan 

21 available in accordance with section 1902(k)(1) 

22 to all individuals described in section 

23 1902(a)(10)(i)(VIII), and a detailed description 

24 of the basis for the estimates. 


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1 ‘‘(C) A comprehensive listing of State in2 come eligibility criteria for all mandatory and 

3 optional Medicaid eligibility groups for which 

4 the State plan provides medical assistance 

5 (other than with respect to individuals described 

6 in clause (i)(II), (ii)(VI), or (ii)(XXII) of sec7 tion 1902(a)(10)(A)). 

8 ‘‘(D) The total amount of hospital uncom9 pensated-care costs and a breakdown of the 

10 source of such costs, as well as a breakdown for 

11 rural and non-rural hospitals. 

12 ‘‘(E) The total amount received through an 

13 uncompensated care pool (as defined by the 

14 Secretary). 

15 ‘‘(4) PERCENTAGE DESCRIBED.—For purposes 

16 of paragraph (1), a calendar quarter described in 

17 this paragraph, with respect to a fiscal year, and the 

18 percentage points described in this paragraph for 

19 such quarter, with respect to a State, are— 

20 ‘‘(A) for the calendar quarter beginning on 

21 the April 1 occurring during such fiscal year, 

22 0.5 percentage points; 

23 ‘‘(B) for the calendar quarter beginning on 

24 the July 1 occurring during such fiscal year, 

25 1.0 percentage point; and 


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1 ‘‘(C) for the calendar quarter beginning on 

2 the October 1 occurring during the subsequent 

3 fiscal year, 1.5 percentage points. 

4 ‘‘(5) PAYMENT IN CASE OF REPORTING

5 STATE.—The expenses incurred by a non-expansion 

6 State, with respect to any calendar quarter with re7 spect to a fiscal year (beginning with 2021), for car8 rying out subparagraphs (A) through (C) of para9 graph (2) shall, for purposes of section 1903(a)(7), 

10 be considered to be expenses necessary for the prop11 er and efficient administration of the State plan 

12 under this title. 

13 ‘‘(6) NONEXPANION STATE DEFINED.—For 

14 purposes of this subsection, the term ‘nonexpansion 

15 State’ means, with respect to a fiscal year, a State 

16 that as of the first quarter of such fiscal year does 

17 not provide under the State plan of such State (or 

18 waiver of such plan) for making medical assistance 

19 available in accordance with section 1902(k)(1) to 

20 all individuals described in section 

21 1902(a)(10)(i)(VIII).’’. 

Æ 


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