I 

116TH CONGRESS 

1ST SESSION H. R. 2715 

To amend title XI of the Social Security Act to provide for State approval 

and implementation of specified waivers under the Medicaid program. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 14, 2019 

Mr. GREEN of Tennessee (for himself, Mr. WRIGHT, Mr. ARMSTRONG, Mr. 

NORMAN, Mr. MARSHALL, and Mr. KEVIN HERN of Oklahoma) introduced the following bill; which was referred to the Committee on Energy 

and Commerce 

A BILL 

To amend title XI of the Social Security Act to provide 

for State approval and implementation of specified waivers 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 ‘‘Medicaid Improvement 

5 and State Flexibility Act of 2019’’. 


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1 SEC. 2. PROVIDING FOR STATE APPROVAL AND IMPLEMEN2 TATION OF SPECIFIED WAIVERS UNDER THE 

3 MEDICAID PROGRAM. 

4 Section 1115 of the Social Security Act (42 U.S.C. 

5 1315) is amended— 

6 (1) in subsection (d)— 

7 (A) in paragraph (1), by striking ‘‘An ap8 plication’’ and inserting ‘‘Subject to paragraph 

9 (4), an application’’; and 

10 (B) by adding at the end the following new 

11 paragraph: 

12 ‘‘(4)(A) An experimental, pilot, or demonstration 

13 project undertaken under subsection (a) may be approved 

14 or renewed by a State if such project is described in sub15 paragraph (B). 

16 ‘‘(B) An experimental, pilot, or demonstration project 

17 is described in this subparagraph if such project provides 

18 for a waiver of requirements with respect to a State plan 

19 (or a waiver of such plan) under title XIX such that— 

20 ‘‘(i) individuals enrolled under such plan (or 

21 such waiver) may elect to participate in such project 

22 with respect to a year; 

23 ‘‘(ii) such individuals who elect to so partici24 pate— 

25 ‘‘(I) are furnished with an electronic bene26 fits transfer card in an amount determined apVerDate Sep 11 2014 05:04 May 24, 2019 Jkt 034408 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2715.IH H2715

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1 propriate by the State for purposes of pur2 chasing primary care services and medications 

3 during such year; 

4 ‘‘(II) are furnished a cash payment by the 

5 State equal to the amount of funds remaining 

6 on the individual’s electronic benefits transfer 

7 card at the end of such year; and 

8 ‘‘(III) are enrolled in a catastrophic insur9 ance program determined appropriate by the 

10 State for purposes of covering services not de11 scribed in subclause (I) and covering services 

12 that are described in such subclause if such in13 dividual exceeds the amount of funds provided 

14 to such individual on such card for such year; 

15 and 

16 ‘‘(iii) Federal expenditures under such title for 

17 the period during which such project is in effect are 

18 equal to or lesser than what such expenditures would 

19 have been during such period if such project were 

20 not in effect. 

21 ‘‘(C)(i) In no case may a project described in sub22 paragraph (B) result in an expenditure to pay for any 

23 abortion or to assist in the purchase, in whole or in part, 

24 of health benefit coverage that includes coverage of abor25 tion. 


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1 ‘‘(ii) Clause (i) shall not apply to an abortion only 

2 if necessary to save the life of the mother or if the preg3 nancy is the result of an act of rape or incest. 

4 ‘‘(D) For purposes of a State’s approval or renewal 

5 of an experimental, pilot, or demonstration project under 

6 subparagraph (A), each reference to ‘the Secretary’ in 

7 subsection (a) shall be deemed to be a reference to ‘the 

8 State’.’’; and 

9 (2) in subsection (e), by inserting ‘‘(other than 

10 such a project that is described in paragraph 

11 (4)(B))’’ before the period at the end. 

Æ 


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