I 

114TH CONGRESS 

2D SESSION H. R. 5100 

To amend title XIX of the Social Security Act to protect at-risk youth 

against termination of Medicaid eligibility while an inmate of a public 

institution. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 28, 2016 

Mr. CA ́RDENAS (for himself and Mr. GRIFFITH) 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 protect 

at-risk youth against termination of Medicaid eligibility 

while an inmate of a public institution. 

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 ‘‘At-Risk Youth Med5 icaid Protection Act of 2016’’. 

6 SEC. 2. AT-RISK YOUTH MEDICAID PROTECTION. 

7 (a) IN GENERAL.—Section 1902 of the Social Secu8 rity Act (42 U.S.C. 1396a) is amended— 

9 (1) in subsection (a)— 


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1 (A) by striking ‘‘and’’ at the end of para2 graph (80); 

3 (B) by striking the period at the end of 

4 paragraph (81) and inserting ‘‘; and’’; and 

5 (C) by inserting after paragraph (81) the 

6 following new paragraph: 

7 ‘‘(82) provide that— 

8 ‘‘(A) the State shall not terminate eligi9 bility for medical assistance under a State plan 

10 for an individual who is an eligible juvenile (as 

11 defined in subsection (ll)(2)) because the juve12 nile is an inmate of a public institution (as de13 fined in subsection (ll)(3)), but may suspend 

14 coverage during the period the juvenile is such 

15 an inmate; 

16 ‘‘(B) the State shall restore coverage for 

17 such medical assistance to such an individual 

18 upon the individual’s release from any such 

19 public institution, without requiring a new ap20 plication from the individual, unless (and until 

21 such date as) there is a determination that the 

22 individual no longer meets the eligibility re23 quirements for such medical assistance; and 

24 ‘‘(C) the State shall process any applica25 tion for medical assistance submitted by, or on 


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1 behalf of, a juvenile who is an inmate of a pub2 lic institution notwithstanding that the juvenile 

3 is such an inmate.’’; and 

4 (2) by adding at the end the following new sub5 section: 

6 ‘‘(ll) JUVENILE; ELIGIBLE JUVENILE; PUBLIC INSTI7 TUTION.—For purposes of subsection (a)(82) and this 

8 subsection: 

9 ‘‘(1) JUVENILE.—The term ‘juvenile’ means an 

10 individual who is— 

11 ‘‘(A) under 21 years of age; or 

12 ‘‘(B) is described in subsection 

13 (a)(10)(A)(i)(IX). 

14 ‘‘(2) ELIGIBLE JUVENILE.—The term ‘eligible 

15 juvenile’ means a juvenile who is an inmate of a 

16 public institution and was eligible for medical assist17 ance under the State plan immediately before be18 coming an inmate of such a public institution or who 

19 becomes eligible for such medical assistance while an 

20 inmate of a public institution. 

21 ‘‘(3) INMATE OF A PUBLIC INSTITUTION.—The 

22 term ‘inmate of a public institution’ has the meaning 

23 given such term for purposes of applying the sub24 division (A) following paragraph (29) of section 


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1 1905(a), taking into account the exception in such 

2 subdivision for a patient of a medical institution.’’. 

3 (b) NO CHANGE IN EXCLUSION FROM MEDICAL AS4 SISTANCE FOR INMATES OF PUBLIC INSTITUTIONS.— 

5 Nothing in this section shall be construed as changing the 

6 exclusion from medical assistance under the subdivision 

7 (A) following paragraph (29) of section 1905(a) of the So8 cial Security Act (42 U.S.C. 1396d(a)), including any ap9 plicable restrictions on a State submitting claims for Fed10 eral financial participation under title XIX of such Act 

11 for such assistance. 

12 (c) NO CHANGE IN CONTINUITY OF ELIGIBILITY BE13 FORE ADJUDICATION OR SENTENCING.—Nothing in this 

14 section shall be construed to mandate, encourage, or sug15 gest that a State suspend or terminate coverage for indi16 viduals before they have been adjudicated or sentenced. 

17 (d) EFFECTIVE DATE.— 

18 (1) IN GENERAL.—Except as provided in para19 graph (2), the amendments made by subsection (a) 

20 shall apply to eligibility of juveniles who become in21 mates of public institutions on or after the date that 

22 is 1 year after the date of the enactment of this Act. 

23 (2) RULE FOR CHANGES REQUIRING STATE

24 LEGISLATION.—In the case of a State plan for med25 ical assistance under title XIX of the Social Security 


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1 Act which the Secretary of Health and Human Serv2 ices determines requires State legislation (other than 

3 legislation appropriating funds) in order for the plan 

4 to meet the additional requirements imposed by the 

5 amendments made by subsection (a), the State plan 

6 shall not be regarded as failing to comply with the 

7 requirements of such title solely on the basis of its 

8 failure to meet these additional requirements before 

9 the first day of the first calendar quarter beginning 

10 after the close of the first regular session of the 

11 State legislature that begins after the date of the en12 actment of this Act. For purposes of the previous 

13 sentence, in the case of a State that has a 2-year 

14 legislative session, each year of such session shall be 

15 deemed to be a separate regular session of the State 

16 legislature. 

Æ 


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