II 

110TH CONGRESS 

1ST SESSION S. 1564 

To amend the Social Security Act to provide health insurance coverage for 

children and pregnant and post-partum women throughout the United 

States by combining the children and pregnant women health coverage 

under Medicaid and SCHIP into a new All Healthy Children Program, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 7, 2007 

Mr. SANDERS introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To amend the Social Security Act to provide health insurance 

coverage for children and pregnant and post-partum 

women throughout the United States by combining the 

children and pregnant women health coverage under 

Medicaid and SCHIP into a new All Healthy Children 

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. SHORT TITLE; TABLE OF CONTENTS; FINDINGS; 

4 PURPOSE. 

5 (a) SHORT TITLE.—This Act may be cited as the ‘‘All 

6 Healthy Children Act of 2007’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents of 

2 this Act is as follows: 

Sec. 1. Short title; table of contents; findings; purpose. 

Sec. 2. Creation of new title XXII of the Social Security Act. 

‘‘TITLE XXII—ALL HEALTHY CHILDREN PROGRAM 

‘‘Sec. 2201. All Healthy Children Program. 

‘‘Sec. 2202. General contents of State all healthy children plan; eligibility; 

enrollment. 

‘‘Sec. 2203. Benefits; premiums; cost-sharing; provider payment rates. 

‘‘Sec. 2204. Payments to States. 

‘‘Sec. 2205. Application of SCHIP, Medicaid, and related SSA provisions; 

waivers; administration. 

‘‘Sec. 2206. Definitions. 

‘‘Sec. 2207. Effective dates; transition. 

Sec. 3. Commission on Children’s Health Coverage. 

3 (c) FINDINGS.—Congress finds the following: 

4 (1) More than 9,000,000 children in the United 

5 States—one in 9—have no health insurance cov6 erage. 

7 (2) Every 46 seconds, another baby is born un8 insured in the United States. 

9 (3) Existing health care programs for low-in10 come children vary widely, with different standards 

11 for eligibility, cost sharing, and benefits in each of 

12 the 50 States and the District of Columbia. 

13 (4) The majority of uninsured children are eli14 gible for coverage under Medicaid or the State Chil15 dren’s Health Insurance Program (SCHIP), but are 

16 not enrolled in existing programs because of dif17 ferent eligibility and enrollment barriers that make 

18 it difficult to obtain or keep coverage. 


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1 (5) Millions more children are underinsured or 

2 at risk of losing coverage if their parents change 

3 jobs or more employers drop family coverage. 

4 (6) Uninsured children are almost 12 times as 

5 likely as insured children to have an untreated med6 ical need and are four times as likely as insured chil7 dren to have an unmet dental need. 

8 (7) Uninsured children are more than 5 times 

9 as likely as insured children to have gone more than 

10 2 years without a doctor visit. 

11 (8) The majority of uninsured children live in 

12 two-parent households and almost 90 percent live in 

13 families where at least 1 parent works. 

(9) An estimated 2 14 ⁄3 of children and adolescents 

15 with mental health needs are not getting the care 

16 they need and only 1 in 5 children with serious emo17 tional disturbances receives specialized treatment. 

18 (10) It costs less to provide health insurance 

19 coverage to children than to any other group of peo20 ple. 

21 (11) Increases in private health insurance costs 

22 are dramatically outpacing increases in wages. 

23 (12) The United States spending on health care 

24 per person is more than twice the average spent in 

25 industrialized countries, yet the United States ranks 


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1 near the bottom among those countries in infant 

2 mortality rates. 

3 (13) Children enrolled in a health coverage pro4 gram experienced significant improvements in health 

5 after just 1 year and significant decreases of limita6 tions in their daily activities. 

7 (14) Enrollment in health insurance has been 

8 associated with improvements in school. 

9 (15) When juvenile offenders arrested for minor 

10 offenses had access to intensive and coordinated 

mental health services, more than a 1 11 ⁄3 fewer were 

12 re-arrested the following year, compared to those 

13 who only had access to basic mental health services. 

14 (d) PURPOSE.—It is the purpose of this Act to sim15 plify and consolidate children’s health coverage under 

16 Medicaid and SCHIP into a single program that guaran17 tees children in all 50 States and the District of Columbia 

18 all medically necessary services. 

19 SEC. 2. CREATION OF NEW TITLE XXII OF THE SOCIAL SE20 CURITY ACT. 

21 (a) IN GENERAL.—The Social Security Act is amend22 ed by adding at the end the following new title: 


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1 ‘‘TITLE XXII—ALL HEALTHY 

2 CHILDREN PROGRAM 

3 ‘‘SEC. 2201. ALL HEALTHY CHILDREN PROGRAM. 

4 ‘‘(a) IN GENERAL.—There is established under this 

5 title a State-operated program receiving Federal financial 

6 assistance to provide comprehensive health coverage for 

7 children and pregnant and post-partum women in place 

8 of benefits previously provided for children and pregnant 

9 and post-partum women under the Medicaid program 

10 under title XIX and the State Children’s Health Insurance 

11 Program under title XXI. 

12 ‘‘(b) STATE ALL HEALTHY CHILDREN PLAN RE13 QUIRED.—A State is not eligible for payment under sec14 tion 2204 unless the State has submitted to the Secretary 

15 under section 2202 a plan that— 

16 ‘‘(1) sets forth how the State intends to use the 

17 funds provided under this title to provide all healthy 

18 children assistance to uninsured children and preg19 nant and post-partum women consistent with the 

20 provisions of this title, and 

21 ‘‘(2) has been approved under section 2202. 

22 ‘‘(c) STATE AND INDIVIDUAL ENTITLEMENT.—This 

23 title constitutes budget authority in advance of appropria24 tions Acts and represents the obligation of the Federal 

25 Government to provide for the payment to States of 


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1 amounts provided under section 2204. Each individual 

2 who is an all healthy children eligible individual and who 

3 qualifies for benefits under this title has an entitlement 

4 to such benefits in accordance with this title. 

5 ‘‘(d) RULE OF CONSTRUCTION.—In construing the 

6 meaning, scope, and enforceability of the legal entitlement 

7 to assistance created by this title, it is the intent of Con8 gress that existing judicial and other precedents or con9 trolling law in effect on the date of enactment of this title 

10 relating to the construction of the meaning, scope, and en11 forceability of the legal entitlement of children and other 

12 individuals entitled to medical assistance under title XIX 

13 shall apply to the construction of the meaning, scope, and 

14 enforceability of the legal entitlement of individuals to all 

15 healthy children assistance under this title. 

16 ‘‘(e) PRIVATE RIGHT OF ACTION.— 

17 ‘‘(1) IN GENERAL.—Any person aggrieved by a 

18 violation of this title or a failure of an individual or 

19 entity, including a State or Federal agency, to com20 ply with the provisions of this title, including any 

21 regulation promulgated pursuant to this title, may 

22 bring a civil action in any Federal district court, re23 gardless of amount in controversy, or State court of 

24 competent jurisdiction to enforce such person’s 

25 rights. 


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1 ‘‘(2) NO EXCLUSION OF OTHER REMEDIES.— 

2 The availability of a private right of action under 

3 this subsection shall not be construed to preclude 

4 the ability of any person aggrieved to obtain relief 

5 for a violation of this title or a failure of an indi6 vidual or entity to comply with the provision of this 

7 title, or any regulations promulgated pursuant to 

8 this title, under any other applicable statute or other 

9 basis for relief. 

10 ‘‘(3) RELIEF.—In an action under this sub11 section, the court may award all relief allowed by 

12 law, including but not limited to compensatory and 

13 exemplary damages and injunctive relief, and attor14 neys’ fees and court costs. 

15 ‘‘(4) PERSON AGGRIEVED DEFINED.—In this 

16 subsection, the term ‘person aggrieved’ includes a 

17 child or individual entitled to benefits under this 

18 title, the parent or guardian of such child, a provider 

19 of services to children or other individuals entitled to 

20 such benefits, or an association or other entity 

21 whose mission is to ensure that children or pregnant 

22 and post-partum women receive adequate health care 

23 services. 

24 ‘‘(f) EFFECTIVE DATE.—No State is eligible for pay25 ments under section 2204 for all healthy children assistVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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1 ance for coverage provided for periods beginning before 

2 October 1, 2008. 

3 ‘‘SEC. 2202. GENERAL CONTENTS OF STATE ALL HEALTHY 

4 CHILDREN PLAN; ELIGIBILITY; ENROLLMENT. 

5 ‘‘(a) GENERAL CONTENTS.—A State all healthy chil6 dren plan shall include a description, consistent with the 

7 requirements of this title, of— 

8 ‘‘(1) the all healthy children assistance provided 

9 under the plan for all healthy children eligible indi10 viduals, including the proposed methods of delivery 

11 and utilization control systems; 

12 ‘‘(2) eligibility standards consistent with sub13 section (b); 

14 ‘‘(3) enrollment and outreach activities con15 sistent with subsection (c); and 

16 ‘‘(4) methods (including monitoring) used— 

17 ‘‘(A) to assure the quality and appropriate18 ness of care, particularly with respect to pre19 natal care, well-baby care, well-child care, and 

20 immunizations provided under the plan, and 

21 ‘‘(B) to assure access to all medically nec22 essary health care services, including emergency 

23 services. 

24 ‘‘(b) ELIGIBILITY STANDARDS AND METHOD25 OLOGY.— 


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1 ‘‘(1) IN GENERAL.—The all healthy children 

2 plan for a State shall provide that all of the fol3 lowing are all healthy children eligible individuals if 

4 they are residents: 

5 ‘‘(A) FULL SUBSIDY INDIVIDUALS.— 

6 ‘‘(i) All children under age 19 whose 

7 family income does not exceed 300 percent 

8 of the poverty line (as defined in section 

9 2110(c)(5)). 

10 ‘‘(ii) All pregnant and post-partum 

11 women whose family income does not ex12 ceed 300 percent of the poverty line. 

13 ‘‘(iii) All children under age 19 and 

14 pregnant and post-partum women who 

15 would have qualified for medical assistance 

16 under title XIX (as applied in the State as 

17 of October 1, 2005). 

18 ‘‘(iv) All children who meet the re19 quirements of subparagraphs (A) and (B) 

20 of section 1905(w)(1) (relating to inde21 pendent foster care adolescents). 

22 ‘‘(B) TRANSITIONAL ASSISTANCE.—An in23 dividual who loses eligibility as an individual de24 scribed in subparagraph (A) because of an in25 crease in family income, but only during the 3- 


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1 month period beginning with the first month in 

2 which such eligibility is lost. Cost-sharing for 

3 transition coverage may not exceed the amounts 

4 the State plan charged for such individual be5 fore receiving transitional assistance. 

6 ‘‘(C) BUY-IN ELIGIBLE INDIVIDUALS.—In7 dividuals who, but for the amount of family in8 come, would be an individual described in sub9 paragraph (A) and who are not described in 

10 subparagraph (B) if they meet such terms and 

11 conditions as the Secretary determines appro12 priate. 

13 ‘‘(2) RESIDENCY REQUIREMENT.—For purposes 

14 of this title, an individual is a resident of a State if 

15 the individual is present in the State with intent to 

16 remain, and includes any individual who would be 

17 treated as such a resident under title XIX (as in ef18 fect as of January 1, 2007). 

19 ‘‘(3) POST-PARTUM WOMAN DEFINED.—In this 

20 title, the term ‘post-partum woman’ means a woman 

21 during the period beginning on the date of comple22 tion of pregnancy and ending on the last day of the 

23 first month that ends at least 60 days after such 

24 date. 


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1 ‘‘(4) INCOME METHODOLOGY.—The method2 ology for determining income under a State all 

3 healthy children plan shall not be more restrictive 

4 than the income methodology described in section 

5 1931(b)(1)(B), to the extent such methodology is 

6 consistent with the requirements of section 

7 1902(a)(17). 

8 ‘‘(5) NO ASSET TEST.—The State plan may not 

9 impose any asset or resource test for eligibility. 

10 ‘‘(6) CONSTRUCTION.—Nothing in this title 

11 shall be construed as preventing a State from cov12 ering individuals (such as individuals who are 19 or 

13 20 years of age) who are not all healthy children eli14 gible individuals under title XIX. 

15 ‘‘(7) EXCLUSION OF PUBLIC BENEFIT DEFINI16 TION.—The benefits provided under this title shall 

17 not be deemed to constitute a Federal or State pub18 lic benefit within the meaning of title IV of the Per19 sonal Responsibility and Work Opportunity Rec20 onciliation Act of 1996 (Public Law 104–193) nor 

21 shall any documentation of citizenship be required 

22 for the purpose of securing benefits under this title. 

23 ‘‘(8) SPECIAL RULES FOR TERRITORIES.—In 

24 the case of States that are not one of the 50 states 

25 or the District of Columbia, the Secretary may, by 


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1 regulation, adjust the income eligibility levels set 

2 forth in this title, taking into account factors such 

3 as average income, costs of living, and availability of 

4 health care coverage in a manner that assures equi5 table access to health coverage for children and 

6 pregnant and post-partum women residing in such 

7 States. 

8 ‘‘(c) ENROLLMENT.— 

9 ‘‘(1) STREAMLINED ENROLLMENT SYSTEM.— 

10 Each State plan shall provide for a system of 

11 streamlined enrollment that includes the following 

12 (as specified by the Secretary): 

13 ‘‘(A) A simple, short application form 

14 translated into multiple languages. 

15 ‘‘(B) Applicant self-attestation of eligi16 bility, subject to verification, random audits, or 

17 both. 

18 ‘‘(C) The option for applications to be sub19 mitted in-person, on-line, by mail, or as part of 

20 applications for other programs. 

21 ‘‘(D) Automatic enrollment, as provided 

22 under paragraph (2). 

23 ‘‘(E) 12-month continuous eligibility for 

24 children. 


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1 ‘‘(F) Presumptive eligibility during an in2 terim period of coverage for individuals who ap3 pear to qualify for assistance under this title, 

4 on the basis of preliminary information. 

5 ‘‘(G) A determination of continued eligi6 bility at the end of an individual’s eligibility pe7 riod, based on all data available to the State. If 

8 such determination cannot be made, the indi9 vidual or family shall be contacted for addi10 tional information, but only to the extent such 

11 information is not available to State officials 

12 from other sources. The family shall be notified 

13 of all determinations and findings and given an 

14 opportunity to contest and appeal them. An in15 dividual’s eligibility shall continue until the re16 determination process is complete. 

17 ‘‘(2) AUTOMATIC ENROLLMENT PROCEDURES.— 

18 ‘‘(A) IN GENERAL.—The automatic enroll19 ment procedures under this paragraph shall in20 clude enrollment of any all healthy children eli21 gible individual at the following points, unless 

22 the individual (or parent or guardian on the in23 dividual’s behalf) affirmatively declines such en24 rollment: 


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1 ‘‘(i) Unless the individual otherwise 

2 establishes enrollment in health benefits 

3 plan or coverage, at the point of a final de4 termination— 

5 ‘‘(I) of individual’s eligibility to 

6 participate in any federally-funded, 

7 means-tested program, regardless of 

8 any differences between the program’s 

9 eligibility or income methodology and 

10 those otherwise used under this title, 

11 or 

12 ‘‘(II) that, based on the income 

13 determinations made as part of such 

14 eligibility determination, the indi15 vidual is eligible to participate under 

16 this title. 

17 ‘‘(ii) Birth of a child in the United 

18 States. 

19 ‘‘(iii) Assignment of a social security 

20 account number for a child. 

21 ‘‘(iv) A visit with any health care pro22 vider eligible to participate in the program 

23 established under this title. 

24 ‘‘(v) Enrollment in any public elemen25 tary or secondary school within the State 


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1 or any other elementary or secondary 

2 school subject to mandatory immunization 

3 requirements. 

4 ‘‘(vi) Enrollment in a publicly-sub5 sidized child care program. 

6 ‘‘(vii) Upon discharge of a child from 

7 a public institution or other institution 

8 where the child has been confined. 

9 ‘‘(viii) Such other points of enrollment 

10 as the State or Secretary may establish. 

11 For purposes of this subparagraph, the term 

12 ‘federally-funded, means-tested program’ in13 cludes the National School Lunch Program 

14 under the Richard B. Russell National School 

15 Lunch Act (42 U.S.C. 1751 et seq.), the Food 

16 Stamp Program under the Food Stamp Act of 

17 1977, the special supplemental nutrition pro18 gram for women, infants, and children (WIC) 

19 under section 17 of the Child Nutrition Act of 

20 1966 (42 U.S.C. 1786), subsidized child care 

21 under the Child Care Development Block Grant 

22 Act of 1990 (42 U.S.C. 9858 et seq.), programs 

23 carried out under the Head Start Act (42 

24 U.S.C. 9831 et seq.), and other means-tested 

25 programs designated by the Secretary. 


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1 ‘‘(B) OPERATION OF AUTOMATIC ENROLL2 MENT.— 

3 ‘‘(i) IN GENERAL.—In the case of 

4 automatic enrollment under subparagraph 

5 (A)— 

6 ‘‘(I) the enrolled individual (or 

7 parents or guardians of such indi8 vidual) shall be advised of the level of 

9 premiums and cost-sharing applicable 

10 consistent with section 2203 and the 

11 fact that enrollment is conditioned 

12 upon payment of any applicable pre13 miums; and 

14 ‘‘(II) the failure to pay any ini15 tial applicable premiums shall be 

16 treated as an affirmative rejection of 

17 coverage. 

18 ‘‘(ii) NOTICE.—The State plan shall 

19 implement effective procedures, consistent 

20 with the Secretary’s guidelines, for ensur21 ing that— 

22 ‘‘(I) auto-enrolled individuals (or 

23 their parents or guardians) under24 stand their right to decline the covVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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1 erage made available through auto-en2 rollment; and 

3 ‘‘(II) after enrollment, they re4 ceive confirmation of coverage and in5 formation on benefits. 

6 ‘‘(iii) EQUAL TREATMENT.—A State 

7 plan shall implement effective procedures 

8 to ensure that individuals covered through 

9 auto-enrollment do not receive fewer serv10 ices, on average, than do similar individ11 uals enrolled through other means. 

12 ‘‘(iv) INFORMATION SHARING.—Each 

13 State shall develop the information tech14 nology infrastructure needed for automated 

15 transmission and analysis of data involving 

16 means-tested programs referred to in sub17 paragraph (A) and other sources of data 

18 pertinent to eligibility under this title, in19 cluding State and Federal income tax 

20 records and information contained in the 

21 National Directory of New Hires. Con22 sistent with standards developed by the 

23 Secretary, the State shall implement effec24 tive safeguards that protect the confiden25 tiality of such data and limit its use to the 


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1 effective administration of this title, includ2 ing an identification of potentially eligible 

3 individuals not enrolled in the State plan 

4 as well as eligibility verification. 

5 ‘‘(3) OUTREACH.—Each State plan shall pro6 vide for a system for culturally and linguistically 

7 competent outreach to families of potentially eligible 

8 individuals, which shall— 

9 ‘‘(A) be fully accessible to those whose 

10 ability to communicate is affected by disability; 

11 and 

12 ‘‘(B) incorporate proactive communication 

13 (via telephone or in-person visits) to such fami14 lies, consumer education, a preliminary or final 

15 eligibility determination, and enrollment com16 pleted within a single encounter, whenever pos17 sible, and proactive follow-up, when necessary. 

18 ‘‘(d) AVOIDING CROWD-OUT AND COORDINATION

19 WITH OTHER HEALTH COVERAGE PROGRAMS.— 

20 ‘‘(1) IN GENERAL.—The State plan shall in21 clude a description of procedures, consistent with 

22 this subsection, to be used to ensure— 

23 ‘‘(A) that benefits provided under the 

24 State all healthy children plan do not substitute 

25 for coverage under group health plans; 


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1 ‘‘(B) the provision of all healthy children 

2 assistance to all healthy children eligible indi3 viduals in the State who are Indians (as defined 

4 in section 4(c) of the Indian Health Care Im5 provement Act, 25 U.S.C. 1603(c)); and 

6 ‘‘(C) coordination with other public and 

7 private programs providing creditable coverage 

8 for low-income children and pregnant and post9 partum women. 

10 ‘‘(2) GROUP HEALTH PLAN COVERAGE PER11 MITTED.—Notwithstanding paragraph (1)(A), a 

12 State plan may not deny enrollment under this title 

13 in the case of any of the following individuals or cir14 cumstances: 

15 ‘‘(A) The individual would have qualified 

16 for medical assistance under title XIX under 

17 State law as in effect on October 1, 2005. 

18 ‘‘(B) The individual has family income that 

19 does not exceed 150 percent of the poverty line. 

20 ‘‘(C) The individual’s enrollment under a 

21 group health plan— 

22 ‘‘(i) ended more than four months be23 fore applying for enrollment under this 

24 title; or 


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1 ‘‘(ii) was involuntarily terminated be2 cause of the death of a parent, job loss, or 

3 other circumstance. 

4 ‘‘(D) Other than for the subsidies de5 scribed in section 2203(b)(2)(B) (in the case of 

6 all healthy children eligible individuals with 

7 family income that exceeds 300 percent of the 

8 poverty line), the failure of a parent or other in9 dividual (other than the enrollee) to enroll the 

10 all healthy children eligible individual in an 

11 available group health plan. 

12 ‘‘(3) SUPPLEMENTAL COVERAGE.— 

13 ‘‘(A) IN GENERAL.—In the case of an all 

14 healthy children eligible individual who is en15 rolled in a group health plan, the State plan— 

16 ‘‘(i) must provide full supplemental 

17 coverage (described in subparagraph (B)) 

18 if— 

19 ‘‘(I) the individual would have 

20 qualified for supplemental coverage 

21 under title XIX under State law as in 

22 effect on October 1, 2005; or 

23 ‘‘(II) the individual is disabled 

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1 mental security income program 

2 under title XVI); and 

3 ‘‘(ii) may provide some or all of such 

4 coverage to other all healthy children eligi5 ble individuals (or to reasonable classifica6 tions of such individuals, as specified 

7 under the State plan). 

8 ‘‘(B) FULL SUPPLEMENTAL COVERAGE DE9 SCRIBED.—Full supplemental coverage de10 scribed in this subparagraph includes the fol11 lowing: 

12 ‘‘(i) Benefits covered by the State 

13 plan that are outside the scope of benefits 

14 offered under the group health plan. 

15 ‘‘(ii) Reimbursement of families’ pre16 mium payments under the group health 

17 plan for all healthy children eligible indi18 viduals so that costs do not exceed levels 

19 otherwise permitted by the State plan. 

20 ‘‘(iii) Coverage of out-of-pocket costs 

21 incurred under the group health plan 

22 where such coverage prevents those costs 

23 from exceeding the levels otherwise per24 mitted under the State plan. 


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1 ‘‘(e) ASSISTANCE FOR CHILDREN WHO AGE OUT OF

2 ASSISTANCE.—The State plan shall provide assistance in 

3 obtaining health benefits to individuals who lose eligibility 

4 under this title because of age. 

5 ‘‘(f) EMERGENCY COVERAGE.—When an all healthy 

6 children eligible individual enrolled in a State plan in one 

7 State moves to another State because of natural disaster 

8 or other reasons, the individual shall receive immediate 

9 and automatic presumptive eligibility under this title in 

10 the State to which the individual moves. 

11 ‘‘SEC. 2203. BENEFITS; PREMIUMS; COST-SHARING; PRO12 VIDER PAYMENT RATES. 

13 ‘‘(a) BENEFITS.— 

14 ‘‘(1) IN GENERAL.—The all healthy children as15 sistance under this title shall include benefits for all 

16 medically necessary health care, including early and 

17 periodic screening, diagnostic, and treatment serv18 ices (as defined in section 1905(r)) consistent with 

19 the requirements of section 1902(a)(43). 

20 ‘‘(2) BENEFIT PROTECTIONS.—The State plan 

21 shall provide for all benefit protections for all 

22 healthy children eligible individuals that would oth23 erwise have applied under title XIX if such individ24 uals were entitled to medical assistance under such 


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1 title, including the application of no preexisting ex2 clusion. 

3 ‘‘(b) PREMIUMS.—Subject to subsection (d)— 

4 ‘‘(1) NO PREMIUM FOR LOWER-INCOME INDI5 VIDUALS.—For all healthy children eligible individ6 uals described in subparagraph (A) or (B) of section 

7 2202(b)(1), there shall be no premium imposed for 

8 coverage under this title. 

9 ‘‘(2) REQUIRED PREMIUMS FOR BUY-IN ELIGI10 BLE INDIVIDUALS.— 

11 ‘‘(A) IN GENERAL.—Except as provided in 

12 this paragraph, in the case of all healthy chil13 dren eligible individuals described in section 

14 2202(b)(1)(C), the premium for coverage under 

15 this title shall be the applicable percentage 

16 specified in subparagraph (D) of such premium 

17 (as estimated under a methodology specified by 

18 the Secretary) as is equal to the full average 

19 per capita cost of benefits for all healthy chil20 dren eligible individuals under the State all 

21 healthy children plan. 

22 ‘‘(B) AGGREGATE LIMIT.— 

23 ‘‘(i) IN GENERAL.—Subject to clause 

24 (ii), in no case shall the premium for cov25 erage under this title exceed (taking into 


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1 account any private coverage in which the 

2 all healthy children eligible individual is 

3 enrolled as well as supplemental coverage 

4 purchased under this title)— 

5 ‘‘(I) 5 percent of the family in6 come; or 

7 ‘‘(II) in the case of multiple eligi8 ble individuals within the same family, 

9 10 percent of family income. 

10 ‘‘(ii) LIMITATION.—Clause (i) shall 

11 not apply for an all healthy children eligi12 ble individual in a family if— 

13 ‘‘(I) the individual could be cov14 ered under a group health plan for 

15 which the employer (or other plan 

16 sponsor) provides for payment of at 

17 least 50 percent of the premium for 

18 coverage of such individual; and 

19 ‘‘(II) the individual is not so cov20 ered because of a rejection of such 

21 coverage option. 

22 ‘‘(C) OPTIONAL SUBSIDIES.—A State plan 

23 may reduce premiums otherwise imposed for 

24 reasonable classifications of all healthy children 

25 eligible individuals described in section 


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1 2202(b)(1)(C). Such classifications may in2 clude— 

3 ‘‘(i) all healthy children eligible indi4 viduals with family income within specific 

5 income ranges; 

6 ‘‘(ii) all healthy children eligible indi7 viduals with special health care needs; and 

8 ‘‘(iii) all healthy children eligible indi9 viduals who could have qualified for med10 ical assistance under an optional eligibility 

11 category under title XIX (as in effect as of 

12 January 1, 2007). 

13 ‘‘(D) APPLICABLE PERCENTAGE SPECI14 FIED.—For purposes of subparagraph (A)(i), 

15 with respect to all healthy children eligible indi16 viduals described in section 2202(b)(1)(C), the 

17 applicable percentage specified in this subpara18 graph is as follows: 

19 ‘‘(i) In the case of such all healthy 

20 children eligible individuals whose income 

21 exceeds 300, but does not exceed 320 per22 cent of the poverty line, 25 percent. 

23 ‘‘(ii) In the case of such all healthy 

24 children eligible individuals whose income 


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1 exceeds 320, but does not exceed 340 per2 cent of the poverty line, 35 percent. 

3 ‘‘(iii) In the case of such all healthy 

4 children eligible individuals whose income 

5 exceeds 340, but does not exceed 360 per6 cent of the poverty line, 45 percent. 

7 ‘‘(iv) In the case of such all healthy 

8 children eligible individuals whose income 

9 exceeds 360, but does not exceed 380 per10 cent of the poverty line, 55 percent. 

11 ‘‘(v) In the case of such all healthy 

12 children eligible individuals whose income 

13 exceeds 380, but does not exceed 400 per14 cent of the poverty line, 65 percent. 

15 ‘‘(vi) In the case of such all healthy 

16 children eligible individuals whose income 

17 exceeds 400, but does not exceed 425 per18 cent of the poverty line, 80 percent. 

19 ‘‘(vii) In the case of such all healthy 

20 children eligible individuals whose income 

21 exceeds 425, but does not exceed 450 per22 cent of the poverty line, 90 percent. 

23 ‘‘(viii) In the case of such all healthy 

24 children eligible individuals whose income 


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1 exceeds 450 percent of the poverty line, 

2 100 percent. 

3 ‘‘(3) PREMIUM PAYMENTS.— 

4 ‘‘(A) IN GENERAL.—The State all healthy 

5 children plan shall provide effective measures, 

6 consistent with standards established by the 

7 Secretary, to make premium payment simple 

8 and convenient to parents (or other payers) and 

9 to preserve continuity of coverage. Such meas10 ures shall include— 

11 ‘‘(i) discounts to encourage the pay12 ment of quarterly or annual premiums in 

13 advance; 

14 ‘‘(ii) options to make premium pay15 ments automatically by credit card, debit 

16 account payments, electronic fund trans17 fers, payroll withholding, or otherwise; and 

18 ‘‘(iii) payment opportunities at mul19 tiple, convenient community locations. 

20 ‘‘(B) PROMOTING CONTINUITY OF COV21 ERAGE.—In the case of all healthy children eli22 gible individuals for whom premium payments 

23 are required under the State plan, the plan 

24 shall have effective procedures to prevent pre25 mium non-payment from interrupting conVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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1 tinuity of coverage. If there is a default on pre2 mium payments, the State plan shall provide 

3 reasonable opportunities to cure such default, 

4 including at least a 60-day period, following no5 tice of default, during which overdue premium 

6 payments may be made without interrupting 

7 coverage or incurring interest charges, late fees, 

8 or other costs. 

9 ‘‘(c) COST-SHARING.— 

10 ‘‘(1) LIMITATIONS.—Subject to subsection (d), 

11 for all healthy children eligible individuals with a 

12 family income that— 

13 ‘‘(A) does not exceed 200 percent of the 

14 poverty line, there shall be no out-of-pocket 

15 cost-sharing imposed; 

16 ‘‘(B) does exceed 200 percent, but does not 

17 exceed 300 percent, of the poverty line, only 

18 nominal out-of-pocket cost-sharing may be im19 posed; or 

20 ‘‘(C) exceeds 300 percent of the poverty 

21 line, out-of-pocket cost-sharing charged may not 

22 exceed levels the Secretary finds to be con23 sistent with charges under employer-based 

24 health insurance for the majority of employees 

25 enrolled in such coverage nationally. 


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1 In no case shall an all healthy children eligible indi2 vidual described in subparagraph (A) or (B) of sec3 tion 2202(b)(1) be denied services under this title 

4 because of failure to pay out-of-pocket cost-sharing. 

5 ‘‘(2) WAIVER.—A state may elect to waive or 

6 reduce out-of-pocket cost-sharing otherwise author7 ized under this subsection. 

8 ‘‘(d) LIMITATIONS ON OUT-OF-POCKET COSTS.— 

9 ‘‘(1) CURRENT MEDICAID.—For each all 

10 healthy children eligible individual, premiums and 

11 out-of-pocket cost-sharing may not exceed the levels 

12 that would have been charged for that individual 

13 under State Medicaid and SCHIP law as of October 

14 1, 2005, updated in a manner specified by the Sec15 retary based on changes, after that date, to average 

16 earnings among families with incomes that do not 

17 exceed 200 percent of the poverty line. 

18 ‘‘(2) AFFORDABILITY.—The State plan shall 

19 provide effective measures, consistent with standards 

20 established by the Secretary, to further limit out-of21 pocket cost-sharing (taking into account all pre22 miums and cost-sharing) of all healthy children eligi23 ble individuals to affordable levels, for all individual 

24 health care services and total family costs. Such 

25 measures may include coding of each individual’s enVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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1 rollment card. Such measures may not include a re2 quirement that households track incurred costs. 

3 ‘‘(e) CHOICE OF PLANS.—To the extent feasible, a 

4 State plan must provide, insofar as the plan provides for 

5 benefits through enrollment in specific health benefits 

6 plans, for each enrollee to have a choice of at least two 

7 health plan options, consistent with the requirements of 

8 section 1932. 

9 ‘‘(f) REIMBURSEMENT RATES.—The State shall es10 tablish under the State plan, in consultation with appro11 priate child health providers and experts— 

12 ‘‘(1) payment rates for providers that are— 

13 ‘‘(A) not less than 80 percent of the aver14 age of payment rates for similar services for 

15 providers under private health insurance plans 

16 within that State; and 

17 ‘‘(B) sufficient in amount to ensure that 

18 enrolled all healthy children eligible individuals 

19 have adequate access to all services covered 

20 under this title; and 

21 ‘‘(2) payments rates to capitated plans that are 

22 actuarially sound, based on comprehensive encounter 

23 data. 


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1 ‘‘SEC. 2204. PAYMENTS TO STATES. 

2 ‘‘(a) PAYMENT.—Subject to the succeeding provisions 

3 of this section, the Secretary shall pay to each State with 

4 a plan approved under this title, an amount for each quar5 ter equal to the Federal all healthy children matching rate 

6 for the State (as determined under subsection (b)) of the 

7 total expenditures under the plan for the quarter, except 

8 that the matching rate for the development and operation 

9 of information technology shall be the same as the Federal 

10 matching percentage in effect for such technology under 

11 subparagraphs (A) and (B) of section 1903(a)(3). 

12 ‘‘(b) COMPUTATION OF FEDERAL ALL HEALTHY

13 CHILDREN MATCHING RATE.— 

14 ‘‘(1) IN GENERAL.—Subject to paragraph (3), 

15 the Federal all healthy children matching rate under 

16 this subsection for a State for a calendar quarter in 

17 a fiscal year is equal to the ratio of— 

18 ‘‘(A) the total expenditures under the 

19 State plan under this title for the quarter that 

20 are attributable to required populations and 

21 services, less the State share of basic expendi22 tures described in paragraph (2), to 

23 ‘‘(B) the total expenditures referred to in 

24 subparagraph (A). 

25 ‘‘(2) STATE SHARE FOR BASIC EXPENDI26 TURES.— 


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1 ‘‘(A) IN GENERAL.—The State share of ex2 penditures attributable to required populations 

3 and services under this title for a quarter in a 

fiscal year is equal to 1 4 ⁄4 of the product of the 

5 following: 

6 ‘‘(i) BASE AMOUNT.—The base FY 

7 2006 amount (specified in subparagraph 

8 (B) for the State). 

9 ‘‘(ii) CHILD INCREASE FACTOR.—One 

10 plus the percentage increase in the number 

11 of children residing in the State, as esti12 mated by the Secretary, from fiscal year 

13 2006 to the fiscal year involved. 

14 ‘‘(iii) COST INCREASE FACTOR.—One 

15 plus the percentage increase in the medical 

16 care component of the consumer price 

17 index for all urban consumers (U.S. city 

18 average), as estimated by the Secretary, 

19 from fiscal year 2006 to the fiscal year in20 volved. 

21 ‘‘(B) BASE FY 2006 AMOUNT.—For pur22 poses of this paragraph, the ‘base FY 2006 

23 amount’ for a State is equal to the sum of— 

24 ‘‘(i) the total amount of expenditures 

25 made by the State during calendar quarVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00032 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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1 ters in fiscal year 2006 under title XIX 

2 (including under any waiver under section 

3 1115) that are attributable to coverage of 

4 individuals who meet the requirement to be 

5 all healthy children eligible individuals, in6 cluding an appropriate portion of adminis7 trative expenses, reduced by the amount of 

8 Federal financial participation provided 

9 with respect to such expenditures; and 

10 ‘‘(ii) the total amount of expenditures 

11 made by the State during calendar quar12 ters in fiscal year 2006 under title XXI 

13 (including under any waiver under section 

14 1115), reduced by the amount of payment 

15 received by the State under such title for 

16 such quarters. 

17 ‘‘(3) COUNTER-CYCLICAL REDUCTION.—The 

18 Secretary shall establish a formula for providing, in 

19 addition to the base Federal matching amounts, 

20 automatic supplemental assistance to States that ex21 perience a sustained economic downturn, based upon 

22 State’s quarterly unemployment rate exceeding the 

23 State’s average of such rates during a period of pre24 vious calendar quarters (in such number as the Sec25 retary shall specify) and by a percentage to be deterVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00033 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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1 mined by the Secretary and in an amount calculated 

2 on the basis of the relationship between changes in 

3 unemployment and anticipated increases in providing 

4 services under this title. The supplemental assistance 

5 shall be distributed quarterly through a supplement 

6 to the State’s Federal payment and shall be for such 

7 duration as the Secretary determines appropriate. 

8 ‘‘(c) BONUS FOR MEETING ENROLLMENT TAR9 GETS.—The Secretary is authorized to establish a system 

10 for providing additional bonus payments for States that 

11 meet or exceed enrollment targets established for each 

12 State by the Secretary, taking into account the cir13 cumstances in each State. 

14 ‘‘(d) ADVANCE PAYMENT; RETROSPECTIVE ADJUST15 MENT.—The Secretary may make payments under this 

16 section for each quarter on the basis of advance estimates 

17 of expenditures submitted by the State and such other in18 vestigation as the Secretary may find necessary, and may 

19 reduce or increase the payments as necessary to adjust 

20 for any overpayment or underpayment for prior quarters. 

21 ‘‘(e) TREATMENT OF TERRITORIES.—In the case of 

22 States that are not one of the 50 States or the District 

23 of Columbia, the Secretary shall by regulation establish 

24 an equitable formula for allocating funds to provide servVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00034 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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1 ices to all healthy children eligible individuals residing in 

2 such States. 

3 ‘‘SEC. 2205. APPLICATION OF SCHIP, MEDICAID, AND RE4 LATED SSA PROVISIONS; WAIVERS; ADMINIS5 TRATION. 

6 ‘‘(a) SCHIP PROVISIONS RELATING TO PLAN SUB7 MISSION, STRATEGIC OBJECTIVES AND PERFORMANCE

8 GOALS, AND AUDITS.—Except to the extent inconsistent 

9 with the provisions of this title, sections 2106, 2107, and 

10 2108(d) shall apply with respect to State plans under this 

11 title in the same manner as they applied with respect to 

12 State plans under title XXI. 

13 ‘‘(b) MEDICAID PROVISIONS.—Except to the extent 

14 inconsistent with the provisions of this title, the provisions 

15 of title XIX (and the provisions of title XI, including sec16 tion 1115, insofar as they are applicable to title XIX) shall 

17 apply to activities under this title. 

18 ‘‘(c) LIMITATION ON WAIVERS.—No waiver shall be 

19 granted under section 1115 with respect to this title if 

20 it is likely to result in— 

21 ‘‘(1) an increase in health care or health pre22 mium costs for all healthy children eligible individ23 uals under this title; or 


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•S 1564 IS

1 ‘‘(2) a reduction in benefits, eligibility, guaran2 teed eligibility, health care access, or health care 

3 quality for such individuals under this title. 

4 ‘‘(d) ANNUAL REPORTS.—The Secretary shall 

5 present annual reports to Congress describing implemen6 tation of this title. Such reports shall include a description 

7 of— 

8 ‘‘(1) optional coverage chosen by States; and 

9 ‘‘(2) for each category of coverage and method 

10 of enrollment, nationwide and State-specific data 

11 showing the number and characteristics of all 

12 healthy children eligible individuals receiving cov13 erage, services provided, categories and amounts of 

14 expenditures. 

15 ‘‘SEC. 2206. DEFINITIONS. 

16 ‘‘(a) IN GENERAL.—For purposes of this title: 

17 ‘‘(1) ALL HEALTHY CHILDREN ELIGIBLE INDI18 VIDUAL.—The term ‘all healthy children eligible in19 dividual’ means individuals described in section 

20 2202(b)(1). 

21 ‘‘(2) ALL HEALTHY CHILDREN ASSISTANCE.— 

22 The term ‘all healthy children assistance’ means 

23 payment under this title for part or all of the cost 

24 of health benefits coverage for all healthy children 

25 eligible individual. 


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1 ‘‘(3) CHILD, GROUP HEALTH PLAN, AND POV2 ERTY LINE.—The terms ‘child’, ‘group health plan’, 

3 and ‘poverty line’ have the meanings given such 

4 terms in section 2110(c). 

5 ‘‘(4) STATE ALL HEALTHY CHILDREN PLAN; 

6 STATE PLAN.—The terms ‘State all healthy children 

7 plan’ and ‘State plan’ mean such a plan as approved 

8 under this title. 

9 ‘‘(5) STATE.—The term ‘State’ has the mean10 ing given such term for purposes of titles XIX and 

11 XXI. 

12 ‘‘SEC. 2207. EFFECTIVE DATES; TRANSITION. 

13 ‘‘(a) EFFECTIVE DATE.—Benefits and payments to 

14 States shall first be available under this title for items and 

15 services furnished on or after October 1, 2008 (in this sec16 tion referred to as the ‘All Healthy Children Program ef17 fective date’). 

18 ‘‘(b) TRANSITION PROVISIONS.— 

19 ‘‘(1) IN GENERAL.—Any child under 19 years 

20 of age, any pregnant or post-partum woman, or any 

21 independent foster care adolescent (as defined in 

22 section 1905(w)(1)) who, as of the day before the 

23 All Healthy Children Program effective date, is en24 rolled under title XIX or XXI shall, as of such effec25 tive date, automatically qualify for and be enrolled 


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•S 1564 IS

1 in the State plan under this title, with the benefits 

2 based on the family income of the individual as most 

3 recently determined for purposes of the title under 

4 which the individual was enrolled. 

5 ‘‘(2) TREATMENT OF SCHIP ADULTS.—In the 

6 case of an individual not described in paragraph (1) 

7 who, as of the day before the All Healthy Children 

8 Program effective date, was enrolled under title XXI 

9 through a program waiver, during the remainder of 

10 such program waiver period, so long as the indi11 vidual continues to meet the conditions for eligibility 

12 under such program waiver, shall be eligible for 

13 medical assistance under the State plan under title 

14 XIX and, with respect to medical assistance to such 

15 individuals, the enhanced FMAP under title XXI 

16 shall be substituted for the Federal medical assist17 ance percentage (FMAP) for purposes of section 

18 1903(a)(1). 

19 ‘‘(3) GUIDANCE.—The Secretary shall provide 

20 guidance and assistance to the States in carrying 

21 out this section. 

22 ‘‘(c) MEDICAID; SCHIP TRANSITION.—Notwith23 standing any other provision of law, as of the All Healthy 

24 Children Program effective date, any all healthy children 

25 eligible individual shall not be eligible for medical assistVerDate Aug 31 2005 22:46 Jun 08, 2007 Jkt 059196 PO 00000 Frm 00038 Fmt 6652 Sfmt 6201 E:\BILLS\S1564.IS S1564

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•S 1564 IS

1 ance under title XIX or child health assistance under title 

2 XXI and no Federal financial participation shall be avail3 able under either such title with respect to such individ4 uals.’’. 

5 SEC. 3. COMMISSION ON CHILDREN’S HEALTH COVERAGE. 

6 (a) ESTABLISHMENT.—There is hereby established a 

7 Commission on Children’s Health Coverage (in this sec8 tion referred to as the ‘‘Commission’’). 

9 (b) COMPOSITION.— 

10 (1) IN GENERAL.—The Commission shall be 

11 composed of the following: 

12 (A) Four members one each appointed by 

13 the majority and minority leaders of the House 

14 of Representatives and the majority and minor15 ity leaders of the Senate. 

16 (B) One member appointed by the Sec17 retary of Health and Human Services. 

18 (C) Two members one each appointed by 

19 the American Academy of Pediatrics and by the 

20 Institute of Medicine of the National Academies 

21 of Science. 

22 (D) One member appointed by the Sec23 retary of Health and Human Services who is a 

24 representative of parents of children with spe25 cial health care needs. 


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•S 1564 IS

1 (E) One member appointed by the Sec2 retary of Health and Human Services who is a 

3 representative of a children’s advocacy group. 

4 (F) Two non-voting advisory members ap5 pointed by the National Governors Association. 

6 Appointment of members of the Commission shall 

7 first be made not later than 60 days after the date 

8 of the enactment of this Act. 

9 (2) TERMS.—The term of each member of the 

10 Commission shall be for 2 years. A vacancy shall be 

11 filled in the same manner as the original appoint12 ment but the member so appointed shall serve for 

13 the remainder of the term of the vacating member. 

14 (3) COMPENSATION.—Members of the Commis15 sion who are not Federal officers or employees shall 

16 be entitled to compensation, including travel time, at 

17 a per diem rate equivalent of rate for level IV of Ex18 ecutive Schedule under section 5315 of title 5, 

19 United States Code, and for travel expense reim20 bursement, at rates authorized for employees of 

21 agencies under such title. 

22 (4) CHAIR.—The Secretary shall designate a 

23 member to serve as Chair of the Commission. 

24 (5) MEETINGS.—The Commission shall meet at 

25 the call of the Chair. 


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1 (6) USE OF COMMITTEES.—The Commission 

2 may establish committees if necessary to carry out 

3 its duties. 

4 (c) SUPERMAJORITY REQUIREMENT FOR ACTIONS.— 

5 Commission actions must be approved by at least six of 

6 the members described in subparagraphs (A) through (E) 

7 of subsection (b)(1). 

8 (d) ADMINISTRATION.— 

9 (1) POWERS.— 

10 (A) HEARINGS.—The Commission may 

11 hold such hearings, sit and act at such times 

12 and places, take such testimony, and receive 

13 such evidence as the Commission considers ad14 visable to carry out this section. 

15 (B) INFORMATION FROM FEDERAL AGEN16 CIES.—The Commission may secure directly 

17 from any Federal department or agency such 

18 information as the Commission considers nec19 essary to carry out this section. Upon request 

20 of the Chairperson of the Commission, the head 

21 of such department or agency shall furnish such 

22 information to the Commission. 

23 (C) POSTAL SERVICES.—The Commission 

24 may use the United States mails in the same 

25 manner and under the same conditions as other 


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•S 1564 IS

1 departments and agencies of the Federal Gov2 ernment. 

3 (D) GIFTS.—The Commission may accept, 

4 use, and dispose of gifts or donations of serv5 ices or property. 

6 (2) COMPENSATION.—While serving on the 

7 business of the Commission (including travel time), 

8 a member of the Commission who is not a Federal 

9 officer or employee shall be entitled to compensation 

10 at the per diem equivalent of the rate provided for 

11 level IV of the Executive Schedule under section 

12 5315 of title 5, United States Code, and while so 

13 serving away from home and the member’s regular 

14 place of business, any member may be allowed travel 

15 expenses, as authorized by the chairperson of the 

16 Commission. All members of the Commission who 

17 are officers or employees of the United States shall 

18 serve without compensation in addition to that re19 ceived for their services as officers or employees of 

20 the United States. 

21 (3) STAFF.— 

22 (A) IN GENERAL.—The Chair of the Com23 mission may, without regard to the civil service 

24 laws and regulations, appoint and terminate an 

25 executive director and such other additional 


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•S 1564 IS

1 personnel as may be necessary to enable the 

2 Commission to perform its duties. The employ3 ment of an executive director shall be subject to 

4 confirmation by the Commission. 

5 (B) STAFF COMPENSATION.—The Chair of 

6 the Commission may fix the compensation of 

7 the executive director and other personnel with8 out regard to chapter 51 and subchapter III of 

9 chapter 53 of title 5, United States Code, relat10 ing to classification of positions and General 

11 Schedule pay rates, except that the rate of pay 

12 for the executive director and other personnel 

13 may not exceed the rate payable for level V of 

14 the Executive Schedule under section 5316 of 

15 such title. 

16 (C) DETAIL OF GOVERNMENT EMPLOY17 EES.—Any Federal Government employee may 

18 be detailed to the Commission without reim19 bursement, and such detail shall be without 

20 interruption or loss of civil service status or 

21 privilege. 

22 (D) PROCUREMENT OF TEMPORARY AND

23 INTERMITTENT SERVICES.—The Chair of the 

24 Commission may procure temporary and inter25 mittent services under section 3109(b) of title 


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•S 1564 IS

1 5, United States Code, at rates for individuals 

2 which do not exceed the daily equivalent of the 

3 annual rate of basic pay prescribed for level V 

4 of the Executive Schedule under section 5316 

5 of such title. 

6 (e) REIMBURSEMENT OF COSTS.—The Secretary 

7 shall provide, from general operating funds of the Depart8 ment of Health and Human Services, the Commission 

9 with such funds and support as may be necessary to sup10 port its activities. 

11 (f) ANNUAL REPORTS.—Beginning one year after the 

12 All Healthy Children Program effective date, the Commis13 sion shall transmit to Congress an annual report that eval14 uates the status of children’s health coverage in the 

15 United States, including an evaluation of the implementa16 tion of title XXII of the Social Security Act and rec17 ommendations for policy improvements at the State and 

18 national levels and in the private sector to improve such 

19 coverage. Each such report shall include an evaluation of 

20 the improvements in the quality of children’s health by 

21 assessing outcome measures achieved by providers of care, 

22 especially at Federally-qualified health centers (as defined 

23 in section 1905(l)(2)(B) of the Social Security Act (42 

24 U.S.C. 1396d(l)(2)(B)). 


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1 (g) SUBMISSION OF LEGISLATIVE PROPOSAL FOR

2 UNIVERSAL COVERAGE OF CHILDREN.—Not later than 

3 three years after the date of the enactment of this Act, 

4 the Commission shall submit to Congress a report that 

5 contains a legislative proposal that would assure health 

6 benefits coverage for all children in the United States. 

7 Such proposal may include a requirement that parents ob8 tain coverage for their children or that employers fund 

9 coverage for children of their workers. The proposal shall 

10 provide for the following: 

11 (1) Coverage shall include all medically nec12 essary care for all children. 

13 (2) Enrollment shall be simple and seamless. 

14 (3) Unnecessary costs shall be avoided. 

15 (4) Quality, access and continuity of care shall 

16 be promoted. 

17 (h) EXPEDITED CONGRESSIONAL CONSIDERATION

18 OF LEGISLATIVE PROPOSAL.— 

19 (1) BILL INTRODUCTION.— 

20 (A) IN GENERAL.—Any legislative proposal 

21 described in subsection (f) may be introduced 

22 as a bill by request in the following manner: 

23 (i) HOUSE OF REPRESENTATIVES.—In 

24 the House of Representatives, by the ma25 jority leader and the minority leader not 


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•S 1564 IS

1 later than 10 days after receipt of the leg2 islative proposal. 

3 (ii) SENATE.—In the Senate, by the 

4 majority leader and the minority leader not 

5 later than 10 days after receipt of the leg6 islative proposal. 

7 (B) ALTERNATIVE BY ADMINISTRATION.— 

8 The President may submit a legislative proposal 

9 based on the recommendations of the Commis10 sion and such legislative proposal may be intro11 duced in the manner described in subparagraph 

12 (A). 

13 (2) COMMITTEE CONSIDERATION.— 

14 (A) IN GENERAL.—Any legislative proposal 

15 submitted pursuant to subparagraph (A) or (B) 

16 of paragraph (1) (in this subsection referred to 

17 as ‘‘implementing legislation’’) shall be referred 

18 to the appropriate committees of the House of 

19 Representatives and the Senate. 

20 (B) COMMITTEE REPORTING.—If, not later 

21 than 150 days after the date on which the im22 plementing legislation is referred to a com23 mittee under subparagraph (A), the committee 

24 has reported the implementing legislation or 

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1 lated to universal health benefits coverage of 

2 children, or to providing access to affordable 

3 health care coverage for all children, the regular 

4 rules of the applicable House of Congress shall 

5 apply to such legislation. 

6 (C) DISCHARGE FROM COMMITTEES.— 

7 (i) SENATE.— 

8 (I) IN GENERAL.—If the imple9 menting legislation or an original bill 

10 described in paragraph (1) has not 

11 been reported by a committee of the 

12 Senate within 180 days after the date 

13 on which such legislation was referred 

14 to committee under subparagraph (A), 

15 it shall be in order for any Senator to 

16 move to discharge the committee from 

17 further consideration of such imple18 menting legislation. 

19 (II) SEQUENTIAL REFERRALS.— 

20 Should a sequential referral of the im21 plementing legislation be made, the 

22 additional committee has 30 days for 

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1 scribed in subclause (I) would be in 

2 order. 

3 (III) PROCEDURE.—The motion 

4 described in subclause (I) shall not be 

5 in order after the implementing legis6 lation has been placed on the cal7 endar. While the motion described in 

8 subclause (I) is pending, no other mo9 tions related to the motion described 

10 in subclause (I) shall be in order. De11 bate on a motion to discharge shall be 

12 limited to not more than 10 hours, 

13 equally divided and controlled by the 

14 majority leader and the minority lead15 er, or their designees. An amendment 

16 to the motion shall not be in order, 

17 nor shall it be in order to move to re18 consider the vote by which the motion 

19 is agreed or disagreed to. 

20 (IV) EXCEPTION.—If imple21 menting language is submitted on a 

22 date later than May 1 of the second 

23 session of a Congress, the committee 

24 shall have 90 days to consider the im25 plementing legislation before a motion 


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•S 1564 IS

1 to discharge under this clause would 

2 be in order. 

3 (ii) HOUSE OF REPRESENTATIVES.— 

4 If the implementing legislation or an origi5 nal bill described in paragraph (1) has not 

6 been reported out of a committee of the 

7 House of Representatives within 180 days 

8 after the date on which such legislation 

9 was referred to committee under subpara10 graph (A), then on any day on which the 

11 call of the calendar for motions to dis12 charge committees is in order, any member 

13 of the House of Representatives may move 

14 that the committee be discharged from 

15 consideration of the implementing legisla16 tion, and this motion shall be considered 

17 under the same terms and conditions, and 

18 if adopted the House of Representatives 

19 shall follow the procedure described in sub20 paragraph (4)(A). 

21 (3) FLOOR CONSIDERATION.— 

22 (A) MOTION TO PROCEED.—If a motion to 

23 discharge made pursuant to paragraph 

24 (3)(B)(ii)(I) or (3)(B)(ii)(II) is adopted, then, 

25 not earlier than 5 legislative days after the date 


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•S 1564 IS

1 on which the motion to discharge is adopted, a 

2 motion may be made to proceed to the bill. 

3 (B) FAILURE OF MOTION.—If the motion 

4 to discharge made pursuant to either such 

5 paragraph fails, such motion may be made not 

6 more than 2 additional times, but in no case 

7 more frequently than within 30 days of the pre8 vious motion. Debate on each of such motions 

9 shall be limited to 5 hours, equally divided. 

10 (C) APPLICABLE RULES.—Once the Senate 

11 is debating the implementing legislation the 

12 regular rules of the Senate shall apply. 

Æ 


rwilkins on PROD1PC63 with BILLS