II

106TH CONGRESS

1ST SESSION S. 737

To amend title XIX of the Social Security Act to provide States with options

for providing family planning services and supplies to women eligible

for medical assistance under the Medicaid Program.

IN THE SENATE OF THE UNITED STATES

MARCH 25, 1999

Mr. CHAFEE (for himself and Mrs. FEINSTEIN) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

To amend title XIX of the Social Security Act to provide

States with options for providing family planning services

and supplies to women eligible for medical assistance

under the Medicaid Program.

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 ‘‘Family Planning State

5 Flexibility Act of 1999’’.
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1 SEC. 2. STATE OPTION TO PROVIDE FAMILY PLANNING

2 SERVICES AND SUPPLIES TO WOMEN WITH

3 INCOMES THAT DO NOT EXCEED A STATE’S

4 INCOME ELIGIBILITY LEVEL FOR MEDICAL

5 ASSISTANCE.

6 (a) IN GENERAL.—Title XIX of the Social Security

7 Act (42 U.S.C. 1396 et seq.) is amended—

8 (1) by redesignating section 1935 as section

9 1936; and

10 (2) by inserting after section 1934 the fol11 lowing:

12 ‘‘STATE OPTION TO PROVIDE FAMILY PLANNING

13 SERVICES AND SUPPLIES TO CERTAIN WOMEN

14 ‘‘SEC. 1935. (a) IN GENERAL.—Subject to sub15 sections (b) and (c), a State may elect (through a State

16 plan amendment) to make medical assistance described in

17 section 1905(a)(4)(C) available to any woman whose fam18 ily income does not exceed the greater of—

19 ‘‘(1) 185 percent of the income official poverty

20 line (as defined by the Office of Management and

21 Budget, and revised annually in accordance with sec22 tion 673(2) of the Omnibus Budget Reconciliation

23 Act of 1981) applicable to a family of the size in24 volved; or

25 ‘‘(2) the eligibility income level (expressed as a

26 percent of such poverty line) that has been specified
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1 under a waiver authorized by the Secretary or under

2 section 1902(r)(2)), as of October 1, 1999, for a

3 woman to be eligible for medical assistance under

4 the State plan.

5 ‘‘(b) COMPARABILITY.—Medical assistance described

6 in section 1905(a)(4)(C) that is made available under a

7 State plan amendment under subsection (a) shall not be

8 less in amount, duration, or scope than the medical assist9 ance described in that section that is made available to

10 any other individual under the State plan.

11 ‘‘(c) MAINTENANCE OF EFFORT.—No payment shall

12 be made under section 1903(a)(5) for medical assistance

13 made available under a State plan amendment under sub14 section (a) unless the State demonstrates to the satisfac15 tion of the Secretary that, with respect to a fiscal year,

16 the State share of funds expended for such fiscal year for

17 all Federally funded programs under which the State pro18 vides or makes available family planning services is not

19 less than the level of the State share expended for such

20 programs during fiscal year 2000.

21 ‘‘(d) OPTION TO EXTEND COVERAGE DURING A

22 POST-ELIGIBILITY PERIOD.—

23 ‘‘(1) INITIAL PERIOD.—A State plan amend24 ment made under subsection (a) may provide that

25 any woman who was receiving medical assistance de-
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1 scribed in section 1905(a)(4)(C) as a result of such

2 amendment, and who becomes ineligible for such as3 sistance because of hours of, or income from, em4 ployment, may remain eligible for such medical as5 sistance through the end of the 6-month period that

6 begins on the first day she becomes so ineligible.

7 ‘‘(2) ADDITIONAL EXTENSION.—A State plan

8 amendment made under subsection (a) may provide

9 that any women who has received medical assistance

10 described in section 1905(a)(4)(C) during the entire

11 6-month period described in paragraph (1) may be

12 extended coverage for such assistance for a suc13 ceeding 6-month period.’’.

14 (b) EFFECTIVE DATE.—The amendments made by

15 subsection (a) apply to medical assistance provided on and

16 after October 1, 1999.

17 SEC. 3. STATE OPTION TO EXTEND THE POSTPARTUM PE18 RIOD FOR PROVISION OF FAMILY PLANNING

19 SERVICES AND SUPPLIES.

20 (a) IN GENERAL.—Section 1902(e)(5) of the Social

21 Security Act (42 U.S.C. 1396a(e)(5)) is amended—

22 (1) by striking ‘‘eligible under the plan, as

23 though’’ and inserting ‘‘eligible under the plan—

24 ‘‘(A) as though’’;
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1 (2) by striking the period and inserting ‘‘;

2 and’’; and

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

4 ‘‘(B) for medical assistance described in section

5 1905(a)(4)(C) for so long as the family income of

6 such woman does not exceed the maximum income

7 level established by the State for the woman to be

8 eligible for medical assistance under the State plan

9 (as a result of pregnancy or otherwise).’’.

10 (b) EFFECTIVE DATE.—The amendments made by

11 subsection (a) apply to medical assistance provided on and

12 after October 1, 1999.

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