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[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 1423 Introduced in Senate (IS)]

103d CONGRESS
  1st Session
                                S. 1423

To amend the Social Security Act to improve access to medicaid benefits 
 and to reduce State administrative burdens under the medicaid program.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

               August 6 (legislative day, June 30), 1993

Mr. Chafee (for himself and Mr. Bradley) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL

 
To amend the Social Security Act to improve access to medicaid benefits 
 and to reduce State administrative burdens 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; REFERENCE TO SOCIAL SECURITY ACT.

    (a) Short Title.--This Act may be cited as the ``Medicaid 
Eligibility Simplification Act.''
    (b) Reference to Social Security Act.--Except as otherwise 
specifically provided, whenever in this Act an amendment is expressed 
in terms of an amendment to or repeal of a section or other provision, 
the reference shall be considered to be made to that section or other 
provision of the Social Security Act.

SEC. 2. COVERAGE OF PREGNANCY RELATED SERVICES FOR ALIEN WOMEN DURING 
              PREGNANCY.

    (a) In General.--Section 1903(v) (42 U.S.C. 1396b(v)) is amended--
            (1) in paragraph (1) by striking ``paragraph (2)'' and 
        inserting ``paragraphs (2) and (3)'';
            (2) in paragraph (2) by striking ``only'';
            (3) by redesignating paragraph (3) as paragraph (4); and
            (4) by inserting after paragraph (2) the following new 
        paragraph:
    ``(3) Payment shall be made under this section for care and 
services that are furnished, at the option of the State, to an alien 
woman described in paragraph (1) during pregnancy if--
            ``(A) such care and services would be available to a woman 
        described in section 1902(l)(1)(A), and
            ``(B) such alien woman otherwise meets the eligibility 
        requirements for medical assistance under the State plan 
        approved under this title (other than the requirement of the 
        receipt of aid or assistance under title IV, supplemental 
        security income benefits under title XVI, or a State 
        supplementary payment).''.
    (b) Effective Date.--The amendments made by this section shall 
apply to payments under title XIX of the Social Security Act for 
calendar quarters beginning on or after October 1, 1993.

SEC. 3. SIMPLIFICATION OF APPLICATION PROCESS FOR ALIENS.

    (a) In General.--Section 1902 (42 U.S.C. 1396a) is amended by 
adding at the end the following new subsection:
    ``(z) Notwithstanding any other provision of law, in order to meet 
the requirements of subsection (a)(46) and section 1137 a State may 
provide that the signature of an adult representative of each household 
that is applying for medical assistance under this title is sufficient 
to comply with any provisions of Federal law requiring household 
members to sign the application or statements in connection with the 
application process for such medical assistance, but only if such 
representative certifies in writing, under penalty of perjury, that the 
information contained in the application for medical assistance is true 
and that all members of the household applying for such medical 
assistance are either citizens or nationals of the United States or are 
eligible to receive such assistance under this title.''.
    (b) Conforming Amendment.--Section 1902(a)(46) (42 U.S.C. 
1936a(a)(46)) is amended by inserting ``except as provided in 
subsection (z),'' after ``(46)''.
    (c) Effective Date.--The amendments made by this section shall 
apply to applications for medical assistance under title XIX of the 
Social Security Act beginning on or after October 1, 1993.

SEC. 4. ELIGIBILITY DETERMINATIONS FOR CERTAIN MONTHS IN THE CASE OF 
              INDIVIDUALS WITH WEEKLY OR BIWEEKLY INCOME.

    (a) In General.--Section 1611(c) (42 U.S.C. 1382(c)) is amended--
            (1) in paragraph (1), by inserting ``(subject to paragraph 
        (8))'' after ``An individual's eligibility for a benefit under 
        this title for a month''; and
            (2) by adding at the end the following new paragraph:
    ``(8)(A) If an individual is paid or otherwise receives income in 
any month on a regular weekly or biweekly basis (or is deemed under 
section 1614(f) to have income so paid or received), the determination 
under paragraph (1) of an individual's eligibility for benefits under 
this title for such month shall be made by treating such amounts as 
having been paid or received on a monthly basis at the same annual rate 
if such treatment would result in the individual becoming eligible for 
such benefits.
    ``(B) For purposes of subparagraph (A)--
            ``(i) the annual rate of income being paid to or received 
        by an individual on a weekly basis in any month is 52 times the 
        amount of the weekly income during such month (or of the 
        average weekly income, if there is a change in the actual 
        weekly rate during such month), and the annual rate of income 
        being paid to or received by an individual on a biweekly basis 
        in any month is 26 times the amount of the biweekly income 
        during such month (or of the average biweekly income, if there 
        is a change in the actual biweekly rate during such month); and
            ``(ii) the amount of such income to be considered as being 
        paid to or received by an individual on a regular monthly basis 
        at the `same annual rate' (in such month) is \1/12\ of the 
        annual rate determined under clause (i) with respect to the 
        weekly or biweekly income involved.''.
    (b) Effective Date.--The amendments made by this section shall 
become effective with respect to determinations of eligibility 
beginning on or after October 1, 1993.

SEC. 5. OPTIONAL REPORTING REQUIREMENTS UNDER MEDICAID TRANSITIONAL 
              MEDICAL ASSISTANCE.

    (a) In General.--Section 1925(b)(2)(B) (42 U.S.C. 1396r-6(b)(2)(B)) 
is amended--
            (1) in clause (i), by striking ``Each State shall'' and 
        inserting ``A State may''; and
            (2) in clause (ii), by striking ``Each State shall'' and 
        inserting ``A State may''.
    (b) Conforming Amendments.--Section 1925 (42 U.S.C. 1396r-6) is 
amended--
            (1) in subsection (a)(2)(A), by inserting ``, if any,'' 
        after ``subsection (b)(2)(B)(i)'';
            (2) in subsection (b)(1), by inserting ``, if any,'' after 
        ``paragraph (2)(B)(i)'';
            (3) in subsection (b)(2)(A)(i), by inserting ``if any,'' 
        after ``subparagraph (B)(i),'' and ``subparagraph (B)(ii),'';
            (4) in subsection (b)(2)(A)(ii), by inserting ``, if any,'' 
        after ``subparagraph (B)(ii)'';
            (5) in subsection (b)(3)(A)(iii), by inserting ``the State 
        does not require the reporting of such information, or'' after 
        ``unless''; and
            (6) the last sentence of subsection (b)(3)(A), is amended 
        to read as follows: ``If a State requires a family to report 
        information under paragraph (2)(B)(ii), the State shall make 
        determinations under clause (iii)(III) for a family each time 
        such a report is received.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to eligibility determinations for calendar quarters beginning on 
or after October 1, 1993.

SEC. 6. PRESUMPTIVE ELIGIBILITY FOR PREGNANT WOMEN.

    (a) Qualified Provider.--Section 1920 (42 U.S.C. 1396r-1) is 
amended in subsection (b)(2) by inserting ``any individual who is 
employed by the State and who is determined by the State agency to be 
capable of making determinations of the type described in paragraph 
(1)(A) or'' after ``the term `qualified provider' means''.
    (b) Effective Date.--The amendments made by this section shall 
apply to payments under title XIX of the Social Security Act for 
calendar quarters beginning on or after October 1, 1993.

SEC. 7. MODIFICATION TO INCOME REQUIREMENTS FOR PREGNANT WOMEN AND 
              COVERAGE FOR REPRODUCTIVE HEALTH SERVICES.

    (a) Coverage for Reproductive Health Services.--Section 1902(e)(6) 
(42 U.S.C. 1396a(e)(6)) is amended--
            (1) by striking ``(6) In the case'' and inserting ``(6)(A) 
        In the case'';
            (2) by inserting ``and, with respect to reproductive health 
        services (as defined in subparagraph (B)), such woman shall be 
        deemed to continue to be an individual described in subsection 
        (a)(10)(A)(i)(IV) and subsection (l)(1)(A) without regard to 
        such change of income through the last day of the month in 
        which the 18-month period (beginning with the month following 
        the month in which occurs the last day of her pregnancy) ends'' 
        after ``her pregnancy) ends''; and
            (3) by adding at the end the following new subparagraph:
    ``(B) For purposes of this paragraph, the term ``reproductive 
health services'' means--
            ``(i) services related to contraception (including 
        contraceptive supplies), voluntary sterilization, screening for 
        sexually transmitted diseases and cancer of the reproductive 
        system, preconceptional risk assessment and care, maternity 
        care (including prenatal, delivery, and postnatal care), and
            ``(ii) services providing information and education 
        necessary to the effectiveness of the services described in 
        clause (i).
    (b) Effective Date.--The amendments made by this section shall 
apply to payments under title XIX of the Social Security Act for 
calendar quarters beginning on or after October 1, 1993.

SEC. 8. MEDICARE PREMIUMS AND COST-SHARING FOR MEDICALLY NEEDY 
              INDIVIDUALS.

    (a) In General.--Section 1905(p)(1)(B) (42 U.S.C. 1396d(p)(1)(B)) 
is amended by inserting ``or, at the option of the State, who is 
eligible under section 1902(a)(10)(C)'' after ``paragraph (2)''.
    (b) Effective Date.--The amendments made by this section shall 
apply to payments under title XIX of the Social Security Act for 
calendar quarters beginning on or after October 1, 1993.

SEC. 9. CLARIFICATION OF INCOME METHODOLOGY USED IN DETERMINING 
              ELIGIBILITY OF CERTAIN MEDICALLY NEEDY INDIVIDUALS FOR 
              MEDICAID BENEFITS.

    (a) In General.--Section 1903(f) (42 U.S.C. 1396b(f)) is amended--
            (1) by redesignating paragraph (4) as paragraph (5); and
            (2) by inserting after paragraph (3) the following new 
        paragraph:
            ``(4) With respect to the methodology to be used in 
        determining income and resource eligibility for individuals 
        under section 1902(a)(10)(C)(i)(III), the applicable income 
        limitation described in paragraph (1)(B) shall be compared to 
        the adjusted income of such individuals after the State income 
        methodology has been applied, including methodology allowed 
        under section 1902(r)(2).''.
    (b) Conforming Amendment.--Section 1903(f)(1)(A) (42 U.S.C. 
1396b(f)(1)(A)) is amended by striking ``(4)'' and inserting ``(5)''.

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