I 

111TH CONGRESS 

1ST SESSION H. R. 465 

To amend titles XIX and XXI of the Social Security Act to permit States 

to ensure coverage without a 5-year delay of certain children and pregnant women under the Medicaid program and SCHIP. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 13, 2009 

Mr. GENE GREEN of Texas (for himself, Mr. LINCOLN DIAZ-BALART of Florida, and Mr. WAXMAN) introduced the following bill; which was referred 

to the Committee on Energy and Commerce 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

to permit States to ensure coverage without a 5-year 

delay of certain children and pregnant women under 

the Medicaid program and SCHIP. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. PERMITTING STATES TO ENSURE COVERAGE 

4 WITHOUT A 5-YEAR DELAY OF CERTAIN CHIL5 DREN AND PREGNANT WOMEN UNDER THE 

6 MEDICAID PROGRAM AND SCHIP. 

7 (a) PURPOSE.—In order to promote the health of 

8 needy children and pregnant women residing lawfully in 


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1 the United States, States should be permitted to waive 

2 certain restrictions which result in a 5-year delay for cov3 erage of necessary health services for such children and 

4 women under the Medicaid program and SCHIP. 

5 (b) MEDICAID PROGRAM.—Section 1903(v) of the 

6 Social Security Act (42 U.S.C. 1396b(v)) is amended— 

7 (1) in paragraph (1), by striking ‘‘paragraph 

8 (2)’’ and inserting ‘‘paragraphs (2) and (4)’’; and 

9 (2) by adding at the end the following new 

10 paragraph: 

11 ‘‘(4)(A) A State may elect (in a plan amendment 

12 under this title) to provide, notwithstanding sections 

13 401(a), 402(b), 403, and 421 of Public Law 104–193, 

14 medical assistance under a State plan under this title to 

15 children and pregnant women who are lawfully residing 

16 in the United States (including battered individuals de17 scribed in section 431(c) of such Act) and are otherwise 

18 eligible for such assistance. 

19 ‘‘(B) Such election may be made only with respect 

20 to either or both of the following categories of individuals: 

21 ‘‘(i) Children. 

22 ‘‘(ii) Pregnant women. 

23 ‘‘(C) In this paragraph: 

24 ‘‘(i) The term ‘pregnant women’ means 

25 women during pregnancy (and during the 60- 


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1 day period beginning on the last day of the 

2 pregnancy). 

3 ‘‘(ii) The term ‘children’ means individuals 

4 under age 19 (or such higher age as the State 

5 has elected under section 1902(l)(1)(D)), in6 cluding optional targeted low-income children 

7 described in section 1905(u)(2)(B).’’. 

8 (c) CHIP.—Section 2107(e)(1) of such Act (42 

9 U.S.C. 1397gg(e)(1)) is amended by redesignating sub10 paragraphs (C) and (D) as subparagraphs (D) and (E), 

11 respectively, and by inserting after subparagraph (B) the 

12 following new subparagraph: 

13 ‘‘(C) Paragraph (4) of section 1903(v), in14 sofar as it relates to the category of children or 

15 pregnant women (as such terms are defined in 

16 such paragraph), but only if the State has elect17 ed to apply such paragraph with respect to such 

18 category of children or pregnant women under 

19 title XIX and only if, in the case of pregnant 

20 women, the State has elected the option under 

21 section 2111 to provide assistance for pregnant 

22 women under this title.’’. 

23 (d) CONFORMING AMENDMENT.—Section 423(d)(1) 

24 of Public Law 104–193 is amended by inserting before 

25 the period the following: ‘‘and medical or child health asVerDate Nov 24 2008 23:47 Jan 14, 2009 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H465.IH H465

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1 sistance furnished under section 1903(v)(4) or 

2 2107(e)(1)(E), respectively, of the Social Security Act’’. 

3 (e) EFFECTIVE DATE.—The amendments made by 

4 this section take effect on the date of the enactment of 

5 this Act. 

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