I 

110TH CONGRESS 

2D SESSION H. R. 5268 

To provide for a temporary increase of the Federal medical assistance 

percentage under the Medicaid Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 7, 2008 

Mr. PALLONE (for himself, Mr. KING of New York, Mr. DINGELL, and Mr. 

REYNOLDS) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To provide for a temporary increase of the Federal medical 

assistance percentage under the Medicaid Program, 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. TEMPORARY INCREASE OF MEDICAID FMAP. 

4 (a) PERMITTING MAINTENANCE OF FISCAL YEAR

5 2007 FMAP FOR LAST 2 CALENDAR QUARTERS OF FIS6 CAL YEAR 2008.—Subject to subsection (e), if the FMAP 

7 determined without regard to this section for a State for 

8 fiscal year 2008 is less than the FMAP as so determined 

9 for fiscal year 2007, the FMAP for the State for fiscal 


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1 year 2007 shall be substituted for the State’s FMAP for 

2 the third and fourth calendar quarters of fiscal year 2008, 

3 before the application of this section. 

4 (b) PERMITTING MAINTENANCE OF FISCAL YEAR

5 2008 FMAP FOR FIRST 3 QUARTERS OF FISCAL YEAR

6 2009.—Subject to subsection (e), if the FMAP determined 

7 without regard to this section for a State for fiscal year 

8 2009 is less than the FMAP as so determined for fiscal 

9 year 2008, the FMAP for the State for fiscal year 2008 

10 shall be substituted for the State’s FMAP for the first, 

11 second, and third calendar quarters of fiscal year 2009, 

12 before the application of this section. 

13 (c) GENERAL 2.95 PERCENTAGE POINTS INCREASE

14 FOR LAST 2 CALENDAR QUARTERS OF FISCAL YEAR 2008 

15 AND FIRST 3 CALENDAR QUARTERS OF FISCAL YEAR

16 2009.—Subject to subsections (e), (f), and (g), for each 

17 State for the third and fourth calendar quarters of fiscal 

18 year 2008 and for the first, second, and third calendar 

19 quarters of fiscal year 2009, the FMAP (taking into ac20 count the application of subsections (a) and (b)) shall be 

21 increased by 2.95 percentage points. 

22 (d) INCREASE IN CAP ON MEDICAID PAYMENTS TO

23 TERRITORIES.—Subject to subsections (f) and (g), with 

24 respect to the third and fourth calendar quarters of fiscal 

25 year 2008 and the first, second, and third calendar quarVerDate Aug 31 2005 21:15 Feb 08, 2008 Jkt 069200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5268.IH H5268

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1 ters of fiscal year 2009, the amounts otherwise determined 

2 for Puerto Rico, the Virgin Islands, Guam, the Northern 

3 Mariana Islands, and American Samoa under subsections 

4 (f) and (g) of section 1108 of the Social Security Act (42 

5 U.S.C. 1308) shall each be increased by an amount equal 

6 to 5.90 percent of such amounts. 

7 (e) SCOPE OF APPLICATION.—The increases in the 

8 FMAP for a State under this section shall apply only for 

9 purposes of title XIX of the Social Security Act and shall 

10 not apply with respect to— 

11 (1) disproportionate share hospital payments 

12 described in section 1923 of such Act (42 U.S.C. 

13 1396r–4); 

14 (2) payments under title IV or XXI of such Act 

15 (42 U.S.C. 601 et seq. and 1397aa et seq.); or 

16 (3) any payments under XIX of such Act that 

17 are based on the enhanced FMAP described in sec18 tion 2105(b) of such Act (42 U.S.C. 1397ee(b)). 

19 (f) STATE ELIGIBILITY.— 

20 (1) IN GENERAL.—Subject to paragraph (2), a 

21 State is eligible for an increase in its FMAP under 

22 subsection (c) or an increase in a cap amount under 

23 subsection (d) only if the eligibility under its State 

24 plan under title XIX of the Social Security Act (in25 cluding any waiver under such title or under section 


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1 1115 of such Act (42 U.S.C. 1315)) is no more re2 strictive than the eligibility under such plan (or 

3 waiver) as in effect on January 1, 2008. 

4 (2) STATE REINSTATEMENT OF ELIGIBILITY

5 PERMITTED.—A State that has restricted eligibility 

6 under its State plan under title XIX of the Social 

7 Security Act (including any waiver under such title 

8 or under section 1115 of such Act (42 U.S.C. 

9 1315)) after January 1, 2008, is eligible for an in10 crease in its FMAP under subsection (c) or an in11 crease in a cap amount under subsection (d) in the 

12 first calendar quarter (and subsequent calendar 

13 quarters) in which the State has reinstated eligibility 

14 that is no more restrictive than the eligibility under 

15 such plan (or waiver) as in effect on January 1, 

16 2008. 

17 (3) RULE OF CONSTRUCTION.—Nothing in 

18 paragraph (1) or (2) shall be construed as affecting 

19 a State’s flexibility with respect to benefits offered 

20 under the State medicaid program under title XIX 

21 of the Social Security Act (42 U.S.C. 1396 et seq.) 

22 (including any waiver under such title or under sec23 tion 1115 of such Act (42 U.S.C. 1315)). 

24 (g) REQUIREMENT FOR CERTAIN STATES.—In the 

25 case of a State that requires political subdivisions within 


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1 the State to contribute toward the non-Federal share of 

2 expenditures under the State medicaid plan required 

3 under section 1902(a)(2) of the Social Security Act (42 

4 U.S.C. 1396a(a)(2)), the State shall not require that such 

5 political subdivisions pay a greater percentage of the non6 Federal share of such expenditures for the third and 

7 fourth calendar quarters of fiscal year 2008 and the first, 

8 second, and third calendar quarters of fiscal year 2009, 

9 than the percentage that would have been required by the 

10 State under such plan on March 31, 2008, prior to appli11 cation of this section. 

12 (h) DEFINITIONS.—In this section: 

13 (1) FMAP.—The term ‘‘FMAP’’ means the 

14 Federal medical assistance percentage, as defined in 

15 section 1905(b) of the Social Security Act (42 

16 U.S.C. 1396d(b)). 

17 (2) STATE.—The term ‘‘State’’ has the mean18 ing given such term for purposes of title XIX of the 

19 Social Security Act (42 U.S.C. 1396 et seq.). 

20 (3) REPEAL.—Effective as of October 1, 2009, 

21 this section is repealed. 


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1 SEC. 2. ADJUSTMENT IN COMPUTATION OF MEDICAID 

2 FMAP TO DISREGARD AN EXTRAORDINARY 

3 EMPLOYER PENSION CONTRIBUTION. 

4 (a) IN GENERAL.—Only for purposes of computing 

5 the FMAP (as defined in subsection (e)) for a State for 

6 a fiscal year (beginning with fiscal year 2006) and apply7 ing the FMAP under title XIX of the Social Security Act, 

8 any significantly disproportionate employer pension or in9 surance fund contribution described in subsection (b) shall 

10 be disregarded in computing the per capita income of such 

11 State, but shall not be disregarded in computing the per 

12 capita income for the continental United States (and Alas13 ka) and Hawaii. 

14 (b) SIGNIFICANTLY DISPROPORTIONATE EMPLOYER

15 PENSION AND INSURANCE FUND CONTRIBUTION.— 

16 (1) IN GENERAL.—For purposes of this section, 

17 a significantly disproportionate employer pension 

18 and insurance fund contribution described in this 

19 subsection with respect to a State is any identifiable 

20 employer contribution towards pension or other em21 ployee insurance funds that is estimated to accrue to 

22 residents of such State for a calendar year (begin23 ning with calendar year 2003) if the increase in the 

24 amount so estimated exceeds 25 percent of the total 

25 increase in personal income in that State for the 

26 year involved. 


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1 (2) DATA TO BE USED.—For estimating and 

2 adjusting a FMAP already calculated as of the date 

3 of the enactment of this Act for a State with a sig4 nificantly disproportionate employer pension and in5 surance fund contribution, the Secretary of Health 

6 and Human Services shall use the personal income 

7 data set originally used in calculating such FMAP. 

8 (3) SPECIAL ADJUSTMENT FOR NEGATIVE

9 GROWTH.—If in any calendar year the total personal 

10 income growth in a State is negative, an employer 

11 pension and insurance fund contribution for the pur12 poses of calculating the State’s FMAP for a cal13 endar year shall not exceed 125 percent of the 

14 amount of such contribution for the previous cal15 endar year for the State. 

16 (c) HOLD HARMLESS.—No State shall have its 

17 FMAP for a fiscal year reduced as a result of the applica18 tion of this section. 

19 (d) REPORT.—Not later than May 15, 2008, the Sec20 retary of Health and Human Services shall submit to Con21 gress a report on the problems presented by the current 

22 treatment of pension and insurance fund contributions in 

23 the use of Bureau of Economic Affairs calculations for the 

24 FMAP and for Medicaid and on possible alternative meth25 odologies to mitigate such problems. 


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1 (e) FMAP DEFINED.—For purposes of this section, 

2 the term ‘‘FMAP’’ means the Federal medical assistance 

3 percentage, as defined in section 1905(b) of the Social Se4 curity Act (42 U.S.C. 1396(d)). 

Æ 


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