II

106TH CONGRESS

1ST SESSION S. 1717

To amend title XXI of the Social Security Act to provide for coverage

of pregnancy-related assistance for targeted low-income pregnant women.

IN THE SENATE OF THE UNITED STATES

OCTOBER 12, 1999

Mr. BOND (for himself, Mr. BREAUX, Mr. MCCAIN, Mr. BAUCUS, and Mrs.

LINCOLN) introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To amend title XXI of the Social Security Act to provide

for coverage of pregnancy-related assistance for targeted

low-income pregnant women.

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 ‘‘Mothers and Newborns

5 Health Insurance Act of 1999’’.
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1 SEC. 2. OPTIONAL COVERAGE OF LOW-INCOME, UNIN2 SURED PREGNANT WOMEN UNDER A STATE

3 CHILD HEALTH PLAN.

4 (a) IN GENERAL.—Title XXI of the Social Security

5 Act (42 U.S.C. 1397aa et seq.) is amended by adding at

6 the end the following:

7 ‘‘SEC. 2111. OPTIONAL COVERAGE OF LOW-INCOME, UNIN8 SURED PREGNANT WOMEN.

9 ‘‘(a) OPTIONAL COVERAGE.—Notwithstanding any

10 other provision of this title, a State child health plan may

11 provide for coverage of pregnancy-related assistance for

12 targeted low-income pregnant women in accordance with

13 this section.

14 ‘‘(b) DEFINITIONS.—For purposes of this section:

15 ‘‘(1) PREGNANCY-RELATED ASSISTANCE.—The

16 term ‘pregnancy-related assistance’ has the meaning

17 given the term ‘child health assistance’ in section

18 2110(a) as if any reference to targeted low-income

19 children were a reference to targeted low-income

20 pregnant women, except that the assistance shall be

21 limited to services related to pregnancy (which in22 clude prenatal, delivery, and postpartum services)

23 and to other conditions that may complicate preg24 nancy and shall not include pre-pregnancy services

25 and supplies.
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1 ‘‘(2) TARGETED LOW-INCOME PREGNANT

2 WOMAN.—The term ‘targeted low-income pregnant

3 woman’ has the meaning given the term ‘targeted

4 low-income child’ in section 2110(b) as if any ref5 erence to a child were deemed a reference to a

6 woman during pregnancy and through the end of the

7 month in which the 60-day period (beginning on the

8 last day of her pregnancy) ends.

9 ‘‘(c) REFERENCES TO TERMS AND SPECIAL

10 RULES.—In the case of, and with respect to, a State pro11 viding for coverage of pregnancy-related assistance to tar12 geted low-income pregnant women under subsection (a),

13 the following special rules apply:

14 ‘‘(1) Any reference in this title (other than sub15 section (b)) to a targeted low-income child is deemed

16 to include a reference to a targeted low-income preg17 nant woman.

18 ‘‘(2) Any such reference to child health assist19 ance with respect to such women is deemed a ref20 erence to pregnancy-related assistance.

21 ‘‘(3) Any such reference to a child is deemed a

22 reference to a woman during pregnancy and the pe23 riod described in subsection (b)(2).
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1 ‘‘(4) The medicaid applicable income level is

2 deemed a reference to the income level established

3 under section 1902(l)(2)(A).

4 ‘‘(5) Subsection (a) of section 2103 (relating to

5 required scope of health insurance coverage) shall

6 not apply insofar as a State limits coverage to serv7 ices described in subsection (b)(1) and the reference

8 to such section in section 2105(a)(1) is deemed not

9 to require, in such case, compliance with the require10 ments of section 2103(a).

11 ‘‘(6) There shall be no exclusion of benefits for

12 services described in subsection (b)(1) based on any

13 pre-existing condition, and no waiting period (includ14 ing a waiting period to carry out section

15 2102(b)(3)(C)) shall apply.

16 ‘‘(d) NO IMPACT ON ALLOTMENTS.—Nothing in this

17 section shall be construed as affecting the amount of any

18 initial allotment provided to a State under section

19 2104(b).

20 ‘‘(e) APPLICATION OF FUNDING RESTRICTIONS.—

21 The coverage under this section (and the funding of such

22 coverage) is subject to the restrictions of section

23 2105(c).’’.
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1 (b) CONFORMING AMENDMENT.—Section

2 2102(b)(1)(B) of the Social Security Act (42 U.S.C.

3 1397bb(b)(1)(B)) is amended—

4 (1) by striking ‘‘and’’ at the end of clause (i);

5 (2) by striking the period at the end of clause

6 (ii) and inserting ‘‘, and’’; and

7 (3) by adding at the end the following:

8 ‘‘(iii) may not apply a waiting period

9 (including a waiting period to carry out

10 paragraph (3)(C)) in the case of a targeted

11 low-income child who is pregnant.’’.

12 (c) EFFECTIVE DATE.—The amendments made by

13 subsections (a) and (b) shall take effect on the date of

14 the enactment of this Act and shall apply to allotments

15 under title XXI of the Social Security Act (42 U.S.C.

16 1397aa et seq.) for all fiscal years.

17 SEC. 3. AUTOMATIC ENROLLMENT FOR CHILDREN BORN

18 TO WOMEN RECEIVING PREGNANCY-RE19 LATED ASSISTANCE.

20 (a) IN GENERAL.—Section 2111 of the Social Secu21 rity Act, as added by section 2, is amended by adding at

22 the end the following:

23 ‘‘(f) AUTOMATIC ENROLLMENT FOR CHILDREN

24 BORN TO WOMEN RECEIVING PREGNANCY-RELATED AS25 SISTANCE.—Notwithstanding any other provision of this
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1 title, if a child is born to a targeted low-income pregnant

2 woman who was receiving pregnancy-related assistance

3 under this section on the date of the child’s birth, the child

4 shall be deemed to have applied for child health assistance

5 under the State child health plan on the date of such birth,

6 to have been found eligible for such assistance on such

7 date, and to remain eligible for such assistance until the

8 child attains 1 year of age.’’.

9 (b) EFFECTIVE DATE.—The amendment made by

10 subsection (a) shall take effect on the date of the enact11 ment of this Act and shall apply to allotments under title

12 XXI of the Social Security Act (42 U.S.C. 1397aa et seq.)

13 for all fiscal years.

14 SEC. 4. EXPANDED AVAILABILITY OF FUNDING FOR ADMIN15 ISTRATIVE COSTS RELATED TO OUTREACH

16 AND ELIGIBILITY DETERMINATIONS.

17 Section 1931(h) of the Social Security Act (42 U.S.C.

18 1396u–1(h)) is amended—

19 (1) by striking the subsection heading and in20 serting ‘‘INCREASED FEDERAL MATCHING RATE

21 FOR ADMINISTRATIVE COSTS RELATED TO OUT22 REACH AND ELIGIBILITY DETERMINATIONS’’;

23 (2) in paragraph (2), by striking ‘‘eligibility de24 terminations’’ and all that follows and inserting ‘‘de25 terminations of the eligibility of children and preg-
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1 nant women for benefits under the State plan under

2 this title or title XXI, outreach to children and preg3 nant women likely to be eligible for such benefits,

4 and such other outreach- and eligibility-related ac5 tivities as the Secretary may approve.’’;

6 (3) in paragraph (3), by striking ‘‘and ending

7 with fiscal year 2000’’; and

8 (4) by striking paragraph (4) and inserting the

9 following:

10 ‘‘(4) ENCOURAGING USE OF LOCAL AND COM11 MUNITY-BASED ORGANIZATIONS IN OUTREACH AND

12 ENROLLMENT ACTIVITIES.—The Secretary shall es13 tablish a procedure under which, if a State does not

14 otherwise obligate the amounts made available under

15 this subsection, local and community-based public or

16 nonprofit private organizations (including local and

17 county governments, public health departments,

18 community health centers, children’s hospitals, and

19 disproportionate share hospitals) may seek to have

20 administrative costs relating to outreach and enroll21 ment of children and pregnant women under this

22 title and title XXI treated as administrative costs of

23 a State described in section 1903(a)(7), if such or24 ganizations have the permission of the State in25 volved. A State may require such an organization to
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1 provide payment of such amounts as the State would

2 otherwise be responsible for in order to obtain pay3 ment under this paragraph.’’.

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