I 

113TH CONGRESS 

1ST SESSION H. R. 3596 

To amend title XIX of the Social Security Act to provide medical assistance 

to uninsured newborns under the Medicaid program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 21, 2013 

Ms. DEGETTE 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 provide 

medical assistance to uninsured newborns under the 

Medicaid 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Start Healthy Act of 

5 2013’’. 

6 SEC. 2. MEDICAID ASSISTANCE FOR UNINSURED 

7 NEWBORNS. 

8 (a) MANDATORY COVERAGE OF CERTAIN

9 NEWBORNS.—Section 1902(a)(10)(A)(i) of the Social Se10 curity Act (42 U.S.C. 1396a(a)(10)(A)(i)) is amended— 


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

2 (VIII); 

3 (2) by adding ‘‘or’’ at the end of subclause 

4 (IX); and 

5 (3) by adding at the end the following: 

6 ‘‘(X) who are qualified newborns 

7 (as defined in subsection 

8 (e)(16)(A));’’. 

9 (b) DEEMED ELIGIBILITY FOR NEWBORNS.—Section 

10 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) 

11 is amended by adding at the end the following: 

12 ‘‘(16) DEEMED ELIGIBILITY FOR QUALIFIED

13 NEWBORNS.— 

14 ‘‘(A) QUALIFIED NEWBORN DEFINED.— 

15 For purposes of this section, the term ‘qualified 

16 newborn’ means a child who— 

17 ‘‘(i) is born in the United States on or 

18 after the date that is 6 months after the 

19 date of the enactment of this paragraph; 

20 ‘‘(ii) is under 1 year of age; 

21 ‘‘(iii) is not a child who is deemed eli22 gible under paragraph (4); and 

23 ‘‘(iv) is not eligible for minimum es24 sential coverage, as defined in section 

25 5000A(f)(1) of the Internal Revenue Code 


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1 of 1986, but applied without regard to cov2 erage provided under subsection 

3 (a)(10)(A)(i)(X). 

4 ‘‘(B) DEEMED ELIGIBILITY.—Subject to 

5 subparagraph (C), a child that a State reason6 ably believes is a qualified newborn (and thus 

7 eligible for medical assistance under subsection 

8 (a)(10)(A)(i)(X)) on the date of such child’s 

9 birth shall be deemed to have applied for med10 ical assistance and to have been found eligible 

11 for such assistance under such plan on the date 

12 of such birth and to remain eligible for such as13 sistance until such child is one year of age, un14 less a State determines that a child is not eligi15 ble for such medical assistance through a rede16 termination under subparagraph (D). 

17 ‘‘(C) EXCEPTION FOR OTHER COV18 ERAGE.— 

19 ‘‘(i) IN GENERAL.—If, during the pe20 riod of eligibility under subparagraph (A), 

21 the State determines that the child is en22 rolled in a type of coverage described in 

23 subparagraph (A)(iv), the State may ter24 minate medical assistance for such child 

25 under subsection (a)(10)(A)(i)(X). 


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1 ‘‘(ii) LIMITATION.—A State that de2 termines that a child is eligible for such 

3 coverage, but not enrolled in such cov4 erage, may not terminate such medical as5 sistance for such child until such child is 

6 enrolled in such coverage. 

7 ‘‘(D) REDETERMINATIONS OF ELIGI8 BILITY.— 

9 ‘‘(i) IN GENERAL.—Subject to clause 

10 (ii) and subparagraph (C)(ii), the State 

11 shall redetermine a child’s eligibility for 

12 medical assistance under subsection 

13 (a)(10)(A)(i)(X) not later than 180 days 

14 after the date of the child’s birth. 

15 ‘‘(ii) LIMITATION.—If an application 

16 is required for a redetermination under 

17 clause (i), and such application is not re18 ceived by the State, and the State reason19 ably believes that the child for which such 

20 application was required continues to be a 

21 qualified newborn, the State may not dis22 continue such child’s eligibility for medical 

23 assistance under subsection 

24 (a)(10)(A)(i)(X) on the basis of such miss25 ing application. 


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1 ‘‘(iii) REDUCED FMAP FOR FAILURE

2 TO DO TIMELY DETERMINATION.—The in3 creased Federal medical assistance per4 centage provided under the third sentence 

5 of section 1905(b) with respect to individ6 uals eligible for medical assistance under 

7 section 1902(a)(10)(A)(i)(X) shall not 

8 apply with respect to a child, beginning 

9 180 days after the date of the child’s birth, 

10 for whom a determination is not made on 

11 a timely basis under clause (i), unless the 

12 limitation under clause (ii) applies to such 

13 child.’’. 

14 (c) 100 PERCENT MATCHING RATE FOR TEMPORARY

15 COVERAGE OF CERTAIN NEWBORNS.— 

16 (1) IN GENERAL.—The third sentence of sec17 tion 1905(b) of the Social Security Act (42 U.S.C. 

18 1396d(b)) is amended by inserting before the period 

19 at the end the following: ‘‘and, subject to section 

20 1902(e)(16)(D)(iii), for medical assistance for indi21 viduals in one of the 50 States or the District of Co22 lumbia eligible for such assistance under section 

23 1902(a)(10)(A)(i)(X)’’. 


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1 (2) APPLICATION TO TERRITORIES.—Section 

2 1108(g)(4) of the Social Security Act (42 U.S.C. 

3 1308(g)(4)) is amended— 

4 (A) by striking ‘‘and (4)’’ and inserting 

5 ‘‘and (5)’’; and 

6 (B) by adding at the end the following: 

7 ‘‘Payment for medical assistance for an indi8 vidual eligible for assistance under section 

9 1902(a)(10)(A)(i)(X) shall not be taken into ac10 count in applying subsection (f) (as increased in 

11 accordance with paragraphs (1), (2), (3), and 

12 (5) of this subsection).’’ 

13 (d) CONFORMING AMENDMENT.—Section 1903(f)(4) 

14 of the Social Security Act (42 U.S.C. 1396b(f)(4)) is 

15 amended by inserting ‘‘1902(a)(10)(A)(i)(X),’’ after 

16 ‘‘1902(a)(10)(A)(i)(VIII),’’. 

17 (e) TECHNICAL AMENDMENTS.—Section 1902(e) of 

18 the Social Security Act (42 U.S.C. 1396a(e)) is amended 

19 by redesignating the paragraph (14) relating to exclusion 

20 of compensation for participation in a clinical trial for 

21 testing of treatments for a rare disease or condition, as 

22 added by section 3 of the Improving Access to Clinical 

23 Trials Act of 2009 (Public Law 111–255), as paragraph 

24 (15). Such redesignation shall not be construed to affect 


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1 the application of section 3(e) of the Improving Access to 

2 Clinical Trials Act of 2009 to such paragraph. 

3 (f) DELAY IN IMPLEMENTATION PERMITTED FOR

4 STATE PLAN AMENDMENT.—In the case of a State plan 

5 for medical assistance under title XIX of the Social Secu6 rity Act which the Secretary of Health and Human Serv7 ices determines requires State legislation (other than legis8 lation appropriating funds) in order for the plan to meet 

9 the additional requirements imposed by the amendments 

10 made by this section, the State plan shall not be regarded 

11 as failing to comply with the requirements of such title 

12 solely on the basis of its failure to meet these additional 

13 requirements before the first day of the first calendar 

14 quarter beginning after the close of the first regular ses15 sion of the State legislature that begins after the date of 

16 enactment of this Act. For purposes of the previous sen17 tence, in the case of a State that has a 2-year legislative 

18 session, each year of such session shall be deemed to be 

19 a separate regular session of the State legislature. 

Æ 


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