II

103D CONGRESS

2D SESSION S. 1891

To shift financial responsibility for providing welfare assistance to the States

and shift financial responsibility for providing medical assistance under

title XIX of the Social Security Act to the Federal Government, and

for other purposes.

IN THE SENATE OF THE UNITED STATES

MARCH 7 (legislative day, FEBRUARY 22), 1994

Mrs. KASSEBAUM (for herself, Mr. BENNETT, Mr. BROWN, Mr. CRAIG, and

Mr. DANFORTH) introduced the following bill; which was read twice and

referred to the Committee on Finance

A BILL

To shift financial responsibility for providing welfare assistance to the States and shift financial responsibility for

providing medical assistance under title XIX of the Social Security Act to the Federal Government, 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 ‘‘Welfare and Medicaid

5 Responsibility Exchange Act of 1994’’.
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•S 1891 IS

1 SEC. 2. EXCHANGE OF FINANCIAL RESPONSIBILITIES FOR

2 CERTAIN WELFARE PROGRAMS AND THE

3 MEDICAID PROGRAM.

4 (a) IN GENERAL.—In exchange for the Federal funds

5 received by a State under section 3 for fiscal years 1996,

6 1997, 1998, 1999, and 2000 such State shall provide cash

7 and non-cash assistance to low income individuals in ac8 cordance with subsection (b).

9 (b) REQUIREMENT TO PROVIDE A CERTAIN LEVEL

10 OF LOW INCOME ASSISTANCE.—

11 (1) IN GENERAL.—The amount of cash and

12 non-cash assistance provided to low income individ13 uals by a State for any quarter during fiscal years

14 1996, 1997, 1998, 1999, and 2000 shall not be less

15 than the sum of—

16 (A) the amount determined under para17 graph (2); and

18 (B) the amount determined under para19 graph (3).

20 (2) MAINTENANCE OF EFFORT WITH RESPECT

21 TO FEDERAL PROGRAMS TERMINATED.—

22 (A) QUARTER BEGINNING OCTOBER 1,

23 1995.—The amount determined under this para24 graph for the quarter beginning October 1,

25 1995, is an amount equal to the sum of—
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1 (i) one-quarter of the base expendi2 tures determined under subparagraph (C)

3 for the State,

4 (ii) the product of the amount deter5 mined under clause (i) and the estimated

6 increase in the consumer price index (for

7 all urban consumers, United States city av8 erage) for the preceding quarter, and

9 (iii) the amount that the Federal Gov10 ernment and the State would have ex11 pended in the State in the quarter under

12 the programs terminated under section 4

13 solely by reason of the increase in recipi14 ents which the Secretary of Health and

15 Human Services and the Secretary of Agri16 culture estimate would have occurred if

17 such programs had not been terminated.

18 (B) SUCCEEDING QUARTERS.—The

19 amount determined under this paragraph for

20 any quarter beginning on or after January 1,

21 1996, is an amount equal to the sum of—

22 (i) the amount expended by the State

23 under subsection (a) in the preceding quar24 ter,
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1 (ii) the product of the amount deter2 mined under clause (i) and the estimated

3 increase in the consumer price index (for

4 all urban consumers, United States city av5 erage) for the preceding quarter, and

6 (iii) the amount that the Federal Gov7 ernment and the State would have ex8 pended in the State in the quarter under

9 the programs terminated under section 4

10 solely by reason of the increase in recipi11 ents which the Secretary of Health and

12 Human Services and the Secretary of Agri13 culture estimate would have occurred if

14 such programs had not been terminated.

15 (C) DETERMINATION OF BASE AMOUNT.—

16 The Secretary of Health and Human Services,

17 in cooperation with the Secretary of Agri18 culture, shall calculate for each State an

19 amount equal to the total Federal and State ex20 penditures for administering and providing—

21 (i) aid to families with dependent chil22 dren under a State plan under title IV of

23 the Social Security Act (42 U.S.C. 601 et

24 seq.),
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1 (ii) benefits under the food stamp pro2 gram under the Food Stamp Act of 1977

3 (7 U.S.C. 2011 et seq.), including benefits

4 provided under section 19 of such Act (7

5 U.S.C. 2028), and

6 (iii) benefits under the special supple7 mental program for women, infants, and

8 children established under section 17 of

9 the Child Nutrition Act of 1966 (42

10 U.S.C. 1786),

11 for the State during the 12-month period begin12 ning on July 1, 1994.

13 (3) MAINTENANCE OF EFFORT WITH RESPECT

14 TO STATE PROGRAMS.—The amount determined

15 under this paragraph for a quarter is the amount of

16 State expenditures for such quarter required to

17 maintain State programs providing cash and non18 cash assistance to low income individuals as such

19 programs were in effect during the 12-month period

20 beginning on July 1, 1994.

21 SEC. 3. PAYMENTS TO STATES.

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

23 Human Services shall make quarterly payments to each

24 State during fiscal years 1996, 1997, 1998, 1999, and

25 2000 in an amount equal to one-quarter of the amount
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1 determined under subsection (b) for the applicable fiscal

2 year and such amount shall be used for the purposes de3 scribed in subsection (c).

4 (b) PAYMENT EQUIVALENT TO FEDERAL WELFARE

5 SAVINGS.—

6 (1) IN GENERAL.—The amount available to be

7 paid to a State for a fiscal year shall be an amount

8 equal to the amount calculated under paragraph (2)

9 for the State.

10 (2) AMOUNTS AVAILABLE.—

11 (A) FISCAL YEAR 1996.—In fiscal year

12 1996, the amount available under this sub13 section for a State is equal to the sum of—

14 (i) the base amount determined under

15 paragraph (3) for the State,

16 (ii) the product of the amount deter17 mined under clause (i) and the increase in

18 the consumer price index (for all urban

19 consumers, United States city average) for

20 the 12-month period described in para21 graph (3), and

22 (iii) the amount that the Federal Gov23 ernment and the State would have ex24 pended in the State in fiscal year 1996

25 under the programs terminated under sec-
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1 tion 4 solely by reason of the increase in

2 recipients which the Secretary of Health

3 and Human Services and the Secretary of

4 Agriculture estimate would have occurred

5 if such programs had not been terminated.

6 (B) SUCCEEDING FISCAL YEARS.—In any

7 succeeding fiscal year, the amount available

8 under this subsection for a State is equal to the

9 sum of—

10 (i) the amount determined under this

11 paragraph for the State in the previous fis12 cal year,

13 (ii) the product of the amount deter14 mined under clause (i) and the estimated

15 increase in the consumer price index (for

16 all urban consumers, United States city av17 erage) during the previous fiscal year, and

18 (iii) the amount that the Federal Gov19 ernment and the State would have ex20 pended in the State in the fiscal year

21 under the programs terminated under sec22 tion 4 solely by reason of the increase in

23 recipients which the Secretary of Health

24 and Human Services and the Secretary of
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1 Agriculture estimate would have occurred

2 if such programs had not been terminated.

3 (3) DETERMINATION OF BASE AMOUNT.—The

4 Secretary of Health and Human Services, in co5 operation with the Secretary of Agriculture, shall

6 calculate the amount that the Federal Government

7 expended for administering and providing—

8 (A) aid to families with dependent children

9 under a State plan under title IV of the Social

10 Security Act (42 U.S.C. 601 et seq.),

11 (B) benefits under the food stamp program

12 under the Food Stamp Act of 1977 (7 U.S.C.

13 2011 et seq.), including benefits provided under

14 section 19 of such Act (7 U.S.C. 2028), and

15 (C) benefits under the special supplemental

16 program for women, infants, and children es17 tablished under section 17 of the Child Nutri18 tion Act of 1966 (42 U.S.C. 1786),

19 in each State during the 12-month period beginning

20 on July 1, 1994.

21 (c) PURPOSES FOR WHICH AMOUNTS MAY BE EX22 PENDED.—

23 (1) MEDICAID PROGRAM.—
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1 (A) IN GENERAL.—Notwithstanding any

2 other provision of law, during fiscal years 1996,

3 1997, 1998, 1999, and 2000 a State shall—

4 (i) except as provided in subparagraph

5 (B), provide medical assistance under title

6 XIX of the Social Security Act in accord7 ance with the terms of the State’s plan in

8 effect on January 1, 1994, and

9 (ii) use the funds it receives under

10 this section toward the State’s financial

11 participation for expenditures made under

12 the plan.

13 (B) CHANGES IN ELIGIBILITY DURING FIS14 CAL YEARS 1998, 1999, AND 2000.—During fiscal

15 years 1998, 1999, and 2000, a State may

16 change State plan requirements relating to eli17 gibility for medical assistance under title XIX

18 of the Social Security Act if the aggregate ex19 penditures under such State plan for the fiscal

20 year do not exceed the amount that would have

21 been spent if a State plan described in subpara22 graph (A)(i) had been in effect during such fis23 cal year.

24 (C) WAIVER OF REQUIREMENTS.—The

25 Secretary of Health and Human Services may
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1 grant a waiver of the requirements under sub2 paragraphs (A)(i) and (B) if a State makes an

3 adequate showing of need in a waiver applica4 tion submitted in such manner as the Secretary

5 determines appropriate.

6 (2) EXCESS.—A State that receives funds

7 under this section that are in excess of the State’s

8 financial participation for expenditures made under

9 the State plan for medical assistance under title

10 XIX of the Social Security Act shall use such excess

11 funds to provide cash and non-cash assistance for

12 low income families.

13 (d) DENIAL OF PAYMENTS FOR FAILURE TO MAIN14 TAIN EFFORT.—No payment shall be made under sub15 section (a) for a quarter if a State fails to comply with

16 the requirements of section 2(b) for the preceding quarter.

17 (e) ENTITLEMENT.—This section constitutes budget

18 authority in advance of appropriations Acts, and rep19 resents the obligation of the Federal Government to pro20 vide the payments described in subsection (a).

21 SEC. 4. TERMINATION OF CERTAIN FEDERAL WELFARE

22 PROGRAMS.

23 (a) TERMINATION.—
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1 (1) AFDC.—Part A of title IV of the Social Se2 curity Act (42 U.S.C. 601 et seq.) is amended by

3 adding at the end the following new section:

4 ‘‘TERMINATION OF AUTHORITY

5 ‘‘SEC. 418. The authority provided by this part shall

6 terminate on October 1, 1995.’’.

7 (2) JOBS.—Part F of title IV of the Social Se8 curity Act (42 U.S.C. 681 et seq.) is amended by

9 adding at the end the following new section:

10 ‘‘TERMINATION OF AUTHORITY

11 ‘‘SEC. 488. The authority provided by this part shall

12 terminate on October 1, 1995.’’.

13 (3) SPECIAL SUPPLEMENTAL FOOD PROGRAM

14 FOR WOMEN, INFANTS, AND CHILDREN (WIC).—

15 Section 17 of the Child Nutrition Act of 1966 (42

16 U.S.C. 1786) is amended by adding at the end the

17 following new subsection:

18 ‘‘(q) The authority provided by this section shall ter19 minate on October 1, 1995.’’.

20 (4) FOOD STAMP PROGRAM.—The Food Stamp

21 Act of 1977 (7 U.S.C. 2011 et seq.) is amended by

22 adding at the end the following new section:

23 ‘‘SEC. 24. TERMINATION OF AUTHORITY.

24 ‘‘The authority provided by this Act shall terminate

25 on October 1, 1995.’’.

26 (b) REFERENCES IN OTHER LAWS.—
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1 (1) IN GENERAL.—Any reference in any law,

2 regulation, document, paper, or other record of the

3 United States to any provision that has been termi4 nated by reason of the amendments made in sub5 section (a) shall, unless the context otherwise re6 quires, be considered to be a reference to such provi7 sion, as in effect immediately before the date of the

8 enactment of this Act.

9 (2) STATE PLANS.—Any reference in any law,

10 regulation, document, paper, or other record of the

11 United States to a State plan that has been termi12 nated by reason of the amendments made in sub13 section (a), shall, unless the context otherwise re14 quires, be considered to be a reference to such plan

15 as in effect immediately before the date of the enact16 ment of this Act.

17 SEC. 5. FEDERALIZATION OF THE MEDICAID PROGRAM.

18 Beginning on October 1, 2000—

19 (1) each State with a State plan approved

20 under title XIX of the Social Security Act shall be

21 relieved of administrative or financial responsibility

22 for the medicaid program under such title of such

23 Act,

24 (2) the Secretary of Health and Human Serv25 ices shall assume such responsibilities and continue
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1 to conduct such program in a State in any manner

2 determined appropriate by the Secretary that is in

3 accordance with the provisions of title XIX of the

4 Social Security Act, and

5 (3) all expenditures for the program as con6 ducted by the Secretary shall be paid by Federal

7 funds.

8 SEC. 6. SECRETARIAL SUBMISSION OF LEGISLATIVE PRO9 POSAL FOR TECHNICAL AND CONFORMING

10 AMENDMENTS.

11 The Secretary of Health and Human Services shall,

12 within 90 days after the date of enactment of this Act,

13 submit to the appropriate committees of Congress, a legis14 lative proposal providing for such technical and conform15 ing amendments in the law as are required by the provi16 sions of this Act.

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