I 

110TH CONGRESS 

1ST SESSION H. R. 1688 

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

children and pregnant women throughout the United States by combining 

the children and pregnant woman health coverage under Medicaid and 

SCHIP into a new All Healthy Children Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 26, 2007 

Mr. SCOTT of Virginia introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committee 

on Rules, for a period to be subsequently determined by the Speaker, in 

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Social Security Act to provide health insurance 

coverage for children and pregnant women throughout 

the United States by combining the children and pregnant woman 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, 


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS; FINDINGS; 

2 PURPOSE. 

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

4 Healthy Children Act of 2007’’. 

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

6 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. 

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

8 (1) More than nine million children in the 

9 United States—one in nine—have no health insur10 ance coverage. 

11 (2) Every 46 seconds, another baby is born un12 insured in the United States. 

13 (3) Existing health care programs for low-in14 come children vary widely, with different standards 

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

16 the 50 States and the District of Columbia. 

17 (4) The majority of uninsured children are eli18 gible for coverage under Medicaid or the State Chil19 dren’s Health Insurance Program (SCHIP), but are 


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1 not enrolled in existing programs because of dif2 ferent eligibility and enrollment barriers that make 

3 it difficult to obtain or keep coverage. 

4 (5) Millions more children are underinsured or 

5 at risk of losing coverage if their parents change 

6 jobs or more employers drop family coverage. 

7 (6) Uninsured children are almost 12 times as 

8 likely as insured children to have an untreated med9 ical need and are four times as likely as insured chil10 dren to have an unmet dental need. 

11 (7) Uninsured children are more than five times 

12 as likely as insured children to have gone more than 

13 two years without a doctor visit. 

14 (8) The majority of uninsured children live in 

15 two-parent households and almost 90 percent live in 

16 families where at least one parent works. 

17 (9) An estimated two-thirds of children and 

18 adolescents with mental health needs are not getting 

19 the care they need and only one in five children with 

20 serious emotional disturbances receives specialized 

21 treatment. 

22 (10) It costs less to provide health insurance 

23 coverage to children than to any other group of peo24 ple. 


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1 (11) Increases in private health insurance costs 

2 are dramatically outpacing increases in wages. 

3 (12) The United States spending on health care 

4 per person is more than twice the average spent in 

5 industrialized countries, yet the United States ranks 

6 near the bottom among those countries in infant 

7 mortality rates. 

8 (13) Children enrolled in a health coverage pro9 gram experienced significant improvements in health 

10 after just one year and significant decreases of limi11 tations in their daily activities. 

12 (14) Enrollment in health insurance has been 

13 associated with improvements in school. 

14 (15) When juvenile offenders arrested for minor 

15 offenses had access to intensive and coordinated 

16 mental health services, more than a third fewer were 

17 re-arrested the following year, compared to those 

18 who only had access to basic mental health services. 

19 (d) PURPOSE.—It is the purpose of this Act to sim20 plify and consolidate children’s health coverage under 

21 Medicaid and SCHIP into a single program that guaran22 tees children in all 50 States and the District of Columbia 

23 all medically necessary services. 


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1 SEC. 2. CREATION OF NEW TITLE XXII OF THE SOCIAL SE2 CURITY ACT. 

3 (a) IN GENERAL.—The Social Security Act is amend4 ed by adding at the end the following new title: 

5 ‘‘TITLE XXII—ALL HEALTHY 

6 CHILDREN PROGRAM 

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

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

9 title a State-operated program receiving Federal financial 

10 assistance to provide comprehensive health coverage for 

11 children and pregnant and post-partum women in place 

12 of benefits previously provided for children and pregnant 

13 and post-partum women under the Medicaid program 

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

15 Program under title XXI. 

16 ‘‘(b) STATE ALL HEALTHY CHILDREN PLAN RE17 QUIRED.—A State is not eligible for payment under sec18 tion 2204 unless the State has submitted to the Secretary 

19 under section 2202 a plan that— 

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

21 funds provided under this title to provide all healthy 

22 children assistance to uninsured children and preg23 nant women consistent with the provisions of this 

24 title, and 

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


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

2 title constitutes budget authority in advance of appropria3 tions Acts and represents the obligation of the Federal 

4 Government to provide for the payment to States of 

5 amounts provided under section 2204. Each individual 

6 who is an all healthy children eligible individual and who 

7 qualifies for benefits under this title has an entitlement 

8 to such benefits in accordance with this title. 

9 ‘‘(d) PRIVATE RIGHT OF ACTION.— 

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

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

12 entity, including a State or Federal agency, to com13 ply with the provisions of this title, including any 

14 regulation promulgated pursuant to this title, may 

15 bring a civil action in any Federal district court, re16 gardless of amount in controversy, or State court of 

17 competent jurisdiction to enforce such person’s 

18 rights. 

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

20 The availability of a private right of action under 

21 this subsection shall not be construed to preclude 

22 the ability of any person aggrieved to obtain relief 

23 for a violation of this title or a failure of an indi24 vidual or entity to comply with the provision of this 

25 title, or any regulations promulgated pursuant to 


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1 this title, under any other applicable statute or other 

2 basis for relief. 

3 ‘‘(3) RELIEF.—In an action under this sub4 section, the court may award all relief allowed by 

5 law, including but not limited to compensatory and 

6 exemplary damages and injunctive relief, and attor7 neys’ fees and court costs. 

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

9 subsection, the term ‘person aggrieved’ includes a 

10 child or individual entitled to benefits under this 

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

12 of services to children or other individuals entitled to 

13 such benefits, or an association or other entity 

14 whose mission is to ensure that children or pregnant 

15 and post-partum women receive adequate health care 

16 services. 

17 ‘‘(e) EFFECTIVE DATE.—No State is eligible for pay18 ments under section 2204 for all healthy children assist19 ance for coverage provided for periods beginning before 

20 October 1, 2008. 

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

22 CHILDREN PLAN; ELIGIBILITY; ENROLLMENT. 

23 ‘‘(a) GENERAL CONTENTS.—A State all healthy chil24 dren plan shall include a description, consistent with the 

25 requirements of this title, of— 


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

2 under the plan for all healthy children eligible indi3 viduals, including the proposed methods of delivery 

4 and utilization control systems; 

5 ‘‘(2) eligibility standards consistent with sub6 section (b); 

7 ‘‘(3) enrollment and outreach activities con8 sistent with subsection (c); and 

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

10 ‘‘(A) to assure the quality and appropriate11 ness of care, particularly with respect to pre12 natal care, well-baby care, well-child care, and 

13 immunizations provided under the plan, and 

14 ‘‘(B) to assure access to all medically nec15 essary health care services, including emergency 

16 services. 

17 ‘‘(b) ELIGIBILITY STANDARDS AND METHOD18 OLOGY.— 

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

20 plan for a State shall provide that all of the fol21 lowing are all healthy children eligible individuals if 

22 they are residents: 

23 ‘‘(A) FULL SUBSIDY INDIVIDUALS.— 

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

25 family income does not exceed 300 percent 


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1 of the poverty line (as defined in section 

2 2110(c)(5)). 

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

4 women whose family income does not ex5 ceed 300 percent of the poverty line. 

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

7 pregnant and post-partum women who 

8 would have qualified for medical assistance 

9 under title XIX (as applied in the State as 

10 of October 1, 2005). 

11 ‘‘(iv) All children who are meet the re12 quirements of subparagraphs (A) and (B) 

13 of section 1905(w)(1) (relating to inde14 pendent foster care adolescents). 

15 ‘‘(B) TRANSITIONAL ASSISTANCE.—An in16 dividual who loses eligibility as an individual de17 scribed in subparagraph (A) because of an in18 crease in family income, but only during the 3- 

19 month period beginning with the first month in 

20 which such eligibility is lost. Cost-sharing for 

21 transition coverage may not exceed the amounts 

22 the State plan charged for such individual be23 fore receiving transitional assistance. 

24 ‘‘(C) BUY-IN ELIGIBLE INDIVIDUALS.—In25 dividuals who, but for the amount of family inVerDate Aug 31 2005 23:35 Apr 02, 2007 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1688.IH H1688

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1 come, would be an individual described in sub2 paragraph (A) and who are not described in 

3 subparagraph (B) if they meet such terms and 

4 conditions as the Secretary determines appro5 priate. 

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

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

8 the individual is present in the State with intent to 

9 remain, and includes any individual who would be 

10 treated as such a resident under title XIX (as in ef11 fect as of January 1, 2007). 

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

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

14 during the period beginning on the date of comple15 tion of pregnancy and ending on the last day of the 

16 first month that ends at least 60 days after such 

17 date. 

18 ‘‘(4) INCOME METHODOLOGY.—The method19 ology for determining income under a State all 

20 healthy children plan shall not be more restrictive 

21 than the income methodology described in section 

22 1931(b)(1)(B), to the extent such methodology is 

23 consistent with the requirements of section 

24 1902(a)(17). 


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

2 impose any asset or resource test for eligibility. 

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

4 shall be construed as preventing a State from cov5 ering individuals (such as individuals who are 19 or 

6 20 years of age) who are not all healthy children eli7 gible individuals under title XIX. 

8 ‘‘(7) EXCLUSION OF PUBLIC BENEFIT DEFINI9 TION.—The benefits provided under this title shall 

10 not be deemed to constitute a Federal or State pub11 lic benefit within the meaning of title IV of the Per12 sonal Responsibility and Work Opportunity Rec13 onciliation Act of 1996 (Public Law 104–193) nor 

14 shall any documentation of citizenship be required 

15 for the purpose of securing benefits under this title. 

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

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

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

19 regulation, adjust the income eligibility levels set 

20 forth in this title, taking into account factors such 

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

22 health care coverage in a manner that assures equi23 table access to health coverage for children and 

24 pregnant and post-partum women residing in such 

25 States. 


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1 ‘‘(c) ENROLLMENT.— 

2 ‘‘(1) STREAMLINED ENROLLMENT SYSTEM.— 

3 Each State plan shall provide for a system of 

4 streamlined enrollment that includes the following 

5 (as specified by the Secretary): 

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

7 translated into multiple languages. 

8 ‘‘(B) Applicant self-attestation of eligi9 bility, subject to verification, random audits, or 

10 both. 

11 ‘‘(C) The option for applications to be sub12 mitted in-person, on-line, by mail, or as part of 

13 applications for other programs. 

14 ‘‘(D) Automatic enrollment, as provided 

15 under paragraph (2). 

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

17 children. 

18 ‘‘(F) Presumptive eligibility during an in19 terim period of coverage for individuals who ap20 pear to qualify for assistance under this title, 

21 on the basis of preliminary information. 

22 ‘‘(G) A determination of continued eligi23 bility at the end of an individual’s eligibility pe24 riod, based on all data available to the State. If 

25 such determination cannot be made, the indiVerDate Aug 31 2005 23:35 Apr 02, 2007 Jkt 059200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H1688.IH H1688

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1 vidual or family shall be contacted for addi2 tional information, but only to the extent such 

3 information is not available to State officials 

4 from other sources. The family shall be notified 

5 of all determinations and findings and given an 

6 opportunity to contest and appeal them. An in7 dividual’s eligibility shall continue until the re8 determination process is complete. 

9 ‘‘(2) AUTOMATIC ENROLLMENT PROCEDURES.— 

10 ‘‘(A) IN GENERAL.—The automatic enroll11 ment procedures under this paragraph shall in12 clude enrollment of any all healthy children eli13 gible individual at the following points, unless 

14 the individual (or parent or guardian on the in15 dividual’s behalf) affirmatively declines such en16 rollment: 

17 ‘‘(i) Unless the individual otherwise 

18 establishes enrollment in health benefits 

19 plan or coverage, at the point of a final de20 termination— 

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

22 participate in any federally-funded, 

23 means-tested program, regardless of 

24 any differences between the program’s 

25 eligibility or income methodology and 


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1 those otherwise used under this title, 

2 or 

3 ‘‘(II) that, based on the income 

4 determinations made as part of such 

5 eligibility determination, the indi6 vidual is eligible to participate under 

7 this title. 

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

9 States. 

10 ‘‘(iii) Assignment of a social security 

11 account number for a child. 

12 ‘‘(iv) A visit with any health care pro13 vider eligible to participate in the program 

14 established under this title. 

15 ‘‘(v) Enrollment in any public elemen16 tary or secondary school within the State 

17 or any other elementary or secondary 

18 school subject to mandatory immunization 

19 requirements. 

20 ‘‘(vi) Enrollment in a publicly-sub21 sidized child care program. 

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

23 a public institution or other institution 

24 where the child has been confined. 


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1 ‘‘(viii) Such other points of enrollment 

2 as the State or Secretary may establish. 

3 For purposes of this subparagraph, the term 

4 ‘federally-funded, means-tested program’ in5 cludes the National School Lunch Program 

6 under the Richard B. Russell National School 

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

8 Stamp Program under the Food Stamp Act of 

9 1977, the special supplemental nutrition pro10 gram for women, infants, and children (WIC) 

11 under section 17 of the Child Nutrition Act of 

12 1966 (42 U.S.C. 1786), subsidized child care 

13 under the Child Care Development Block Grant 

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

15 carried out under the Head Start Act (42 

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

17 programs designated by the Secretary. 

18 ‘‘(B) OPERATION OF AUTOMATIC ENROLL19 MENT.— 

20 ‘‘(i) IN GENERAL.—In the case of 

21 automatic enrollment under subparagraph 

22 (A)— 

23 ‘‘(I) the enrolled individual (or 

24 parents or guardians of such indi25 vidual) shall be advised of the level of 


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1 premiums and cost-sharing applicable 

2 consistent with section 2203 and the 

3 fact that enrollment is conditioned 

4 upon payment of any applicable pre5 miums; and 

6 ‘‘(II) the failure to pay any ini7 tial applicable premiums shall be 

8 treated as an affirmative rejection of 

9 coverage. 

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

11 implement effective procedures, consistent 

12 with the Secretary’s guidelines, for ensur13 ing that— 

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

15 their parents or guardians) under16 stand their right to decline the cov17 erage made available through auto-en18 rollment; and 

19 ‘‘(II) after enrollment, they re20 ceive confirmation of coverage and in21 formation on benefits. 

22 ‘‘(iii) EQUAL TREATMENT.—A State 

23 plan shall implement effective procedures 

24 to ensure that individuals covered through 

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1 ices, on average, than do similar individ2 uals enrolled through other means. 

3 ‘‘(iv) INFORMATION SHARING.—Each 

4 State shall develop the information tech5 nology infrastructure needed for automated 

6 transmission and analysis of data involving 

7 means-tested programs referred to in sub8 paragraph (A) and other sources of data 

9 pertinent to eligibility under this title, in10 cluding State and Federal income tax 

11 records and information contained in the 

12 National Directory of New Hires. Con13 sistent with standards developed by the 

14 Secretary, the State shall implement effec15 tive safeguards that protect the confiden16 tiality of such data and limit its use to the 

17 effective administration of this title, includ18 ing an identification of potentially eligible 

19 individuals not enrolled in the State plan 

20 as well as eligibility verification. 

21 ‘‘(3) OUTREACH.—Each State plan shall pro22 vide for a system for culturally and linguistically 

23 competent outreach to families of potentially eligible 

24 individuals, which shall— 


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

2 ability to communicate is affected by disability; 

3 and 

4 ‘‘(B) incorporate proactive communication 

5 (via telephone or in-person visits) to such fami6 lies, consumer education, a preliminary or final 

7 eligibility determination, and enrollment com8 pleted within a single encounter, whenever pos9 sible, and proactive follow-up, when necessary. 

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

11 WITH OTHER HEALTH COVERAGE PROGRAMS.— 

12 ‘‘(1) IN GENERAL.—The State plan shall in13 clude a description of procedures, consistent with 

14 this subsection, to be used to ensure— 

15 ‘‘(A) that benefits provided under the 

16 State all healthy children plan do not substitute 

17 for coverage under group health plans; 

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

19 assistance to all healthy children eligible indi20 viduals in the State who are Indians (as defined 

21 in section 4(c) of the Indian Health Care Im22 provement Act, 25 U.S.C. 1603(c)); and 

23 ‘‘(C) coordination with other public and 

24 private programs providing creditable coverage 

25 for low-income children and pregnant women. 


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1 ‘‘(2) GROUP HEALTH PLAN COVERAGE PER2 MITTED.—Notwithstanding paragraph (1)(A), a 

3 State plan may not deny enrollment under this title 

4 in the case of any of the following individuals or cir5 cumstances: 

6 ‘‘(A) The individual would have qualified 

7 for medical assistance under title XIX under 

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

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

10 does not exceed 150 percent of the poverty line. 

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

12 group health plan— 

13 ‘‘(i) ended more than four months be14 fore applying for enrollment under this 

15 title; or 

16 ‘‘(ii) was involuntarily terminated be17 cause of the death of a parent, job loss, or 

18 other circumstance. 

19 ‘‘(D) Other than for the subsidies de20 scribed in section 2203(b)(2)(B) (in the case of 

21 all healthy children eligible individuals with 

22 family income that exceeds 300 percent of the 

23 poverty line), the failure of a parent or other in24 dividual (other than the enrollee) to enroll the 


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1 all healthy children eligible individual in an 

2 available group health plan. 

3 ‘‘(3) SUPPLEMENTAL COVERAGE.— 

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

5 healthy children eligible individual who is en6 rolled in a group health plan, the State plan— 

7 ‘‘(i) must provide full supplemental 

8 coverage (described in subparagraph (B)) 

9 if— 

10 ‘‘(I) the individual would have 

11 qualified for supplemental coverage 

12 under title XIX under State law as in 

13 effect on October 1, 2005; or 

14 ‘‘(II) the individual is disabled 

15 (as defined for purposes of the supple16 mental security income program 

17 under title XVI); and 

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

19 coverage to other healthy children eligible 

20 individuals (or to reasonable classifications 

21 of such individuals, as specified under the 

22 State plan). 

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1 scribed in this subparagraph includes the fol2 lowing: 

3 ‘‘(i) Benefits covered by the State 

4 plan that are outside the scope of benefits 

5 offered under the group health plan. 

6 ‘‘(ii) Reimbursement of families’ pre7 mium payments under the group health 

8 plan for all healthy children eligible indi9 viduals so that costs do not exceed levels 

10 otherwise permitted by the State plan. 

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

12 incurred under the group health plan 

13 where such coverage prevents those costs 

14 from exceeding the levels otherwise per15 mitted under the State plan. 

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

17 ASSISTANCE.—The State plan shall provide assistance in 

18 obtaining health benefits to individuals who lose eligibility 

19 under this title because of age. 

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

21 children eligible individual enrolled in a State plan in one 

22 State moves to another State because of natural disaster 

23 or other reasons, the individual shall receive immediate 

24 and automatic presumptive eligibility under this title in 

25 the State to which the individual moves. 


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1 ‘‘SEC. 2203. BENEFITS; PREMIUMS; COST-SHARING; PRO2 VIDER PAYMENT RATES. 

3 ‘‘(a) BENEFITS.— 

4 ‘‘(1) IN GENERAL.—The all healthy children as5 sistance under this title shall include benefits for all 

6 medically necessary health care, including early and 

7 periodic screening, diagnostic, and treatment serv8 ices (as defined in section 1905(r)) consistent with 

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

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

11 shall provide for all benefit protections for all 

12 healthy children eligible individuals that would oth13 erwise have applied under title XIX if such individ14 uals were entitled to medical assistance under such 

15 title, including the application of no preexisting ex16 clusion. 

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

18 ‘‘(1) NO PREMIUM FOR LOWER-INCOME INDI19 VIDUALS.—For all healthy children eligible individ20 uals described in subparagraph (A) or (B) of section 

21 2202(b)(1), there shall be no premium imposed for 

22 coverage under this title. 

23 ‘‘(2) REQUIRED PREMIUMS FOR BUY-IN ELIGI24 BLE INDIVIDUALS.— 

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

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1 dren eligible individuals described in section 

2 2202(b)(1)(C), the premium for coverage under 

3 this title shall be such premium (as estimated 

4 under a methodology specified by the Secretary) 

5 as is equal to the full average per capita cost 

6 of benefits for children (or pregnant women, as 

7 the case may be) under the State all healthy 

8 children plan. 

9 ‘‘(B) PROVISION OF PREMIUM SUBSIDY.— 

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

11 (ii), in no case shall the premium for cov12 erage under this title exceed (taking into 

13 account any private coverage in which the 

14 individual is enrolled as well as supple15 mental coverage purchased under this 

16 title)— 

17 ‘‘(I) 7.5 percent of the family in18 come; or 

19 ‘‘(II) in the case of multiple eligi20 ble individuals within the same family, 

21 15 percent of family income. 

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

23 not apply for a healthy child eligible indi24 vidual in a family if— 


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1 ‘‘(I) the individual could be cov2 ered under a group health plan for 

3 which the employer (or other plan 

4 sponsor) provides for payment of at 

5 least 50 percent of the premium for 

6 coverage of such individual; and 

7 ‘‘(II) the individual is not so cov8 ered because of a rejection of such 

9 coverage option. 

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

11 may reduce premiums otherwise imposed for 

12 reasonable classifications of all healthy children 

13 eligible individuals described in section 

14 2202(b)(1)(C). Such classifications may in15 clude— 

16 ‘‘(i) individuals with family income 

17 within specific income ranges; 

18 ‘‘(ii) individuals with special health 

19 care needs; and 

20 ‘‘(iii) individuals who could have 

21 qualified for medical assistance under an 

22 optional eligibility category under title XIX 

23 (as in effect as of January 1, 2007). 

24 ‘‘(3) PREMIUM PAYMENTS.— 


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

2 children plan shall provide effective measures, 

3 consistent with standards established by the 

4 Secretary, to make premium payment simple 

5 and convenient to parents (or other payers) and 

6 to preserve continuity of coverage. Such meas7 ures shall include— 

8 ‘‘(i) discounts to encourage the pay9 ment of quarterly or annual premiums in 

10 advance; 

11 ‘‘(ii) options to make premium pay12 ments automatically by credit card, debit 

13 account payments, electronic fund trans14 fers, payroll withholding, or otherwise; and 

15 ‘‘(iii) payment opportunities at mul16 tiple, convenient community locations. 

17 ‘‘(B) PROMOTING CONTINUITY OF COV18 ERAGE.—In the case of all healthy children eli19 gible individuals for whom premium payments 

20 are required under the State plan, the plan 

21 shall have effective procedures to prevent pre22 mium non-payment from interrupting con23 tinuity of coverage. If there is a default on pre24 mium payments, the State plan shall provide 

25 reasonable opportunities to cure such default, 


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1 including at least a 60-day period, following no2 tice of default, during which overdue premium 

3 payments may be made without interrupting 

4 coverage or incurring interest charges, late fees, 

5 or other costs. 

6 ‘‘(c) COST-SHARING.— 

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

8 for all healthy children eligible individuals with a 

9 family income that— 

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

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

12 cost-sharing imposed; 

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

14 exceed 300 percent, of the poverty line, only 

15 nominal out-of-pocket cost-sharing may be im16 posed; or 

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

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

19 exceed levels the Secretary finds to be con20 sistent with charges under employer-based 

21 health insurance for the majority of employees 

22 enrolled in such coverage nationally. 

23 In no case shall a child described in subparagraph 

24 (A) or (B) of section 2202(b)(1) be denied services 


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1 under this title because of failure to pay out-of-pock2 et cost-sharing. 

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

4 reduce out-of-pocket cost-sharing otherwise author5 ized under this subsection. 

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

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

8 healthy children eligible individual, premiums and 

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

10 that would have been charged for that individual 

11 under State Medicaid and SCHIP law as of October 

12 1, 2005, updated in a manner specified by the Sec13 retary based on changes, after that date, to average 

14 earnings among families with incomes that do not 

15 exceed 200 percent of the poverty line. 

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

17 provide effective measures, consistent with standards 

18 established by the Secretary, to further limit out-of19 pocket cost-sharing (taking into account both pre20 miums and cost-sharing) of all healthy children eligi21 ble individuals to affordable levels, for both indi22 vidual health care services and total family costs. 

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1 clude a requirement that households track incurred 

2 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 a health benefits plan, for 

6 each enrollee to have a choice of at least two health plan 

7 options, consistent with the requirements of section 1932. 

8 ‘‘(f) REIMBURSEMENT RATES.—The State shall es9 tablish under the State plan, in consultation with appro10 priate child health providers and experts— 

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

12 ‘‘(A) not less than 80 percent of the aver13 age of payment rates for similar services for 

14 providers under private health insurance plans 

15 within that State; and 

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

17 enrolled all healthy children eligible individuals 

18 have adequate access to all services covered 

19 under this title; and 

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

21 actuarially sound, based on comprehensive encounter 

22 data. 

23 ‘‘SEC. 2204. PAYMENTS TO STATES. 

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

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


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1 a plan approved under this title, an amount for each quar2 ter equal to the Federal all healthy children matching rate 

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

4 total expenditures under the plan for the quarter, except 

5 that the matching rate for the development and operation 

6 of information technology shall be the same as the Federal 

7 matching percentage in effect for such technology under 

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

9 ‘‘(b) COMPUTATION OF FEDERAL ALL HEALTHY

10 CHILDREN MATCHING RATE.— 

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

12 the Federal all healthy children matching rate under 

13 this subsection for a State for a calendar quarter in 

14 a fiscal year is equal to the ratio of— 

15 ‘‘(A) the total expenditures under the 

16 State plan under this title for the quarter that 

17 are attributable to required populations and 

18 services, less the State share of basic expendi19 tures described in paragraph (2), to 

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

21 subparagraph (A). 

22 ‘‘(2) STATE SHARE FOR BASIC EXPENDI23 TURES.— 

24 ‘‘(A) IN GENERAL.—The State share of ex25 penditures attributable to required populations 


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1 and services under this title for a quarter in a 

fiscal year is equal to 1 2 ⁄4 of the product of the 

3 following: 

4 ‘‘(i) BASE AMOUNT.—The base FY 

5 2006 amount (specified in subparagraph 

6 (B) for the State). 

7 ‘‘(ii) CHILD INCREASE FACTOR.—One 

8 plus the percentage increase in the number 

9 of children residing in the State, as esti10 mated by the Secretary, from fiscal year 

11 2006 to the fiscal year involved. 

12 ‘‘(iii) COST INCREASE FACTOR.—One 

13 plus the percentage increase in the medical 

14 care component of the consumer price 

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

16 average), as estimated by the Secretary, 

17 from fiscal year 2006 to the fiscal year in18 volved. 

19 ‘‘(B) BASE FY 2006 AMOUNT.—For pur20 poses of this paragraph, the ‘base FY 2006 

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

22 ‘‘(i) the total amount of expenditures 

23 made by the State during calendar quar24 ters in fiscal year 2006 under title XIX 

25 (including under any waiver under section 


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1 1115) that are attributable to coverage of 

2 individuals who meet the requirement to be 

3 all healthy children eligible individuals, in4 cluding an appropriate portion of adminis5 trative expenses, reduced by the amount of 

6 Federal financial participation provided 

7 with respect to such expenditures; and 

8 ‘‘(ii) the total amount of expenditures 

9 made by the State during calendar quar10 ters in fiscal year 2006 under title XXI 

11 (including under any waiver under section 

12 1115), reduced by the amount of payment 

13 received by the State under such title for 

14 such quarters. 

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

16 Secretary shall establish a formula for providing, in 

17 addition to the base Federal matching amounts, 

18 automatic supplemental assistance to States that ex19 perience a sustained economic downturn, based upon 

20 State’s quarterly unemployment rate exceeding the 

21 State’s average of such rates during a period of pre22 vious calendar quarters (in such number as the Sec23 retary shall specify) and by a percentage to be deter24 mined by the Secretary and in an amount calculated 

25 on the basis of the relationship between changes in 


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1 unemployment and anticipated increases in providing 

2 services under this title. The supplemental assistance 

3 shall be distributed quarterly through a supplement 

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

5 duration as the Secretary determines appropriate. 

6 ‘‘(c) BONUS FOR MEETING ENROLLMENT TAR7 GETS.—The Secretary is authorized to establish a system 

8 for providing additional bonus payments for States that 

9 meet or exceed enrollment targets established for each 

10 State by the Secretary, taking into account the cir11 cumstances in each State. 

12 ‘‘(d) ADVANCE PAYMENT; RETROSPECTIVE ADJUST13 MENT.—The Secretary may make payments under this 

14 section for each quarter on the basis of advance estimates 

15 of expenditures submitted by the State and such other in16 vestigation as the Secretary may find necessary, and may 

17 reduce or increase the payments as necessary to adjust 

18 for any overpayment or underpayment for prior quarters. 

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

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

21 of Columbia, the Secretary shall by regulation establish 

22 an equitable formula for allocating funds to provide serv23 ices to all all healthy children eligible individuals residing 

24 in such States. 


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1 ‘‘SEC. 2205. APPLICATION OF SCHIP, MEDICAID AND RE2 LATED SSA PROVISIONS; WAIVERS; ADMINIS3 TRATION. 

4 ‘‘(a) SCHIP PROVISIONS RELATING TO PLAN SUB5 MISSION, STRATEGIC OBJECTIVES AND PERFORMANCE

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

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

8 2108(d) shall apply with respect to State plans under this 

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

10 State plans under title XXI. 

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

12 inconsistent with the provisions of this title, the provisions 

13 of title XIX (and the provisions of title XI, including sec14 tion 1115, insofar as they are applicable to title XIX) shall 

15 apply to activities under this title. 

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

17 granted under section 1115 with respect to this title if 

18 it is likely to result in— 

19 ‘‘(1) an increase in health care or health pre20 mium costs for all healthy children eligible individ21 uals under this title; or 

22 ‘‘(2) a reduction in benefits, eligibility, guaran23 teed eligibility, health care access, or health care 

24 quality for such individuals under this title. 

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

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1 tation of this title. Such reports shall include a description 

2 of— 

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

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

5 of enrollment, nationwide and State-specific data 

6 showing the number and characteristics of all 

7 healthy children eligible individuals receiving cov8 erage, services provided, categories and amounts of 

9 expenditures. 

10 ‘‘SEC. 2206. DEFINITIONS. 

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

12 ‘‘(1) ALL HEALTHY CHILDREN ELIGIBLE INDI13 VIDUAL.—The term ‘all healthy children eligible in14 dividual’ means individuals described in section 

15 2202(b)(1). 

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

17 The term ‘all healthy children assistance’ means 

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

19 of health benefits coverage for all healthy children 

20 eligible individual. 

21 ‘‘(3) CHILD, GROUP HEALTH PLAN, AND POV22 ERTY LINE.—The terms ‘child’, ‘group health plan’, 

23 and ‘poverty line’ have the meanings given such 

24 terms in section 2110(c). 


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

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

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

4 under this title. 

5 ‘‘(5) STATE.—The term ‘State’ has the mean6 ing given such term for purposes of titles XIX and 

7 XXI. 

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

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

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

11 services furnished on or after October 1, 2008 (in this sec12 tion referred to as the ‘All Healthy Children Program ef13 fective date’). 

14 ‘‘(b) TRANSITION PROVISIONS.— 

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

16 of age, any pregnant woman, or any independent 

17 foster care adolescent (as defined in section 

18 1905(w)(1)) who, as of the day before the All 

19 Healthy Children Program effective date, is enrolled 

20 under title XIX or XXI shall, as of such effective 

21 date, automatically qualify for and be enrolled in the 

22 State plan under this title, with the benefits based 

23 on the family income of the individual as most re24 cently determined for purposes of the title under 

25 which the individual was enrolled. 


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

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

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

4 Program effective date, was enrolled under title XXI 

5 through a program waiver, during the remainder of 

6 such program waiver period, so long as the indi7 vidual continues to meet the conditions for eligibility 

8 under such program waiver, shall be eligible for 

9 medical assistance under the State plan under title 

10 XIX and, with respect to medical assistance to such 

11 individuals, the enhanced FMAP under title XXI 

12 shall be substituted for the Federal medical assist13 ance percentage (FMAP) for purposes of section 

14 1903(a)(1). 

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

16 guidance and assistance to the States in carrying 

17 out this section. 

18 ‘‘(c) MEDICAID; SCHIP TRANSITION.—Notwith19 standing any other provision of law, as of the All Healthy 

20 Children Program effective date, any all healthy children 

21 eligible individual shall not be eligible for medical assist22 ance under title XIX or child health assistance under title 

23 XXI and no Federal financial participation shall be avail24 able under either such title with respect to such individ25 uals.’’. 


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

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

3 Commission on Children’s Health Coverage (in this sec4 tion referred to as the ‘‘Commission’’). 

5 (b) COMPOSITION.— 

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

7 composed of the following: 

8 (A) Four members one each appointed by 

9 the majority and minority leaders of the House 

10 of Representatives and the majority and minor11 ity leaders of the Senate. 

12 (B) One member appointed by the Sec13 retary of Health and Human Services. 

14 (C) Two members one each appointed by 

15 the American Academy of Pediatrics and by the 

16 Institute of Medicine of the National Academies 

17 of Science. 

18 (D) One member appointed by the Sec19 retary of Health and Human Services who is a 

20 representative of parents of children with spe21 cial health care needs. 

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

24 representative of a children’s advocacy group. 

25 (F) Two non-voting advisory members ap26 pointed by the National Governors Association. 


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1 Appointment of members of the Commission shall 

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

3 of the enactment of this Act. 

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

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

6 filled in the same manner as the original appoint7 ment but the member so appointed shall serve for 

8 the remainder of the term of the vacating member. 

9 (3) COMPENSATION.—Members of the Commis10 sion who are not Federal officers or employees shall 

11 be entitled to compensation, including travel time, at 

12 a per diem rate equivalent of rate for level IV of Ex13 ecutive Schedule under section 5315 of title 5, 

14 United States Code, and for travel expense reim15 bursement, at rates authorized for employees of 

16 agencies under such title. 

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

18 member to serve as Chair of the Commission. 

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

20 the call of the Chair. 

21 (6) USE OF COMMITTEES.—The Commission 

22 may establish committees if necessary to carry out 

23 its duties. 

24 (c) SUPERMAJORITY REQUIREMENT FOR ACTIONS.— 

25 Commission actions must be approved by at least six of 


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

2 of subsection (b)(1). 

3 (d) ADMINISTRATION.— 

4 (1) POWERS.— 

5 (A) HEARINGS.—The Commission may 

6 hold such hearings, sit and act at such times 

7 and places, take such testimony, and receive 

8 such evidence as the Commission considers ad9 visable to carry out this section. 

10 (B) INFORMATION FROM FEDERAL AGEN11 CIES.—The Commission may secure directly 

12 from any Federal department or agency such 

13 information as the Commission considers nec14 essary to carry out this section. Upon request 

15 of the Chairperson of the Commission, the head 

16 of such department or agency shall furnish such 

17 information to the Commission. 

18 (C) POSTAL SERVICES.—The Commission 

19 may use the United States mails in the same 

20 manner and under the same conditions as other 

21 departments and agencies of the Federal Gov22 ernment. 

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

24 use, and dispose of gifts or donations of serv25 ices or property. 


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1 (2) COMPENSATION.—While serving on the 

2 business of the Commission (including travel time), 

3 a member of the Commission who is not a Federal 

4 officer or employee shall be entitled to compensation 

5 at the per diem equivalent of the rate provided for 

6 level IV of the Executive Schedule under section 

7 5315 of title 5, United States Code, and while so 

8 serving away from home and the member’s regular 

9 place of business, any member may be allowed travel 

10 expenses, as authorized by the chairperson of the 

11 Commission. All members of the Commission who 

12 are officers or employees of the United States shall 

13 serve without compensation in addition to that re14 ceived for their services as officers or employees of 

15 the United States. 

16 (3) STAFF.— 

17 (A) IN GENERAL.—The Chair of the Com18 mission may, without regard to the civil service 

19 laws and regulations, appoint and terminate an 

20 executive director and such other additional 

21 personnel as may be necessary to enable the 

22 Commission to perform its duties. The employ23 ment of an executive director shall be subject to 

24 confirmation by the Commission. 


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1 (B) STAFF COMPENSATION.—The Chair of 

2 the Commission may fix the compensation of 

3 the executive director and other personnel with4 out regard to chapter 51 and subchapter III of 

5 chapter 53 of title 5, United States Code, relat6 ing to classification of positions and General 

7 Schedule pay rates, except that the rate of pay 

8 for the executive director and other personnel 

9 may not exceed the rate payable for level V of 

10 the Executive Schedule under section 5316 of 

11 such title. 

12 (C) DETAIL OF GOVERNMENT EMPLOY13 EES.—Any Federal Government employee may 

14 be detailed to the Commission without reim15 bursement, and such detail shall be without 

16 interruption or loss of civil service status or 

17 privilege. 

18 (D) PROCUREMENT OF TEMPORARY AND

19 INTERMITTENT SERVICES.—The Chair of the 

20 Commission may procure temporary and inter21 mittent services under section 3109(b) of title 

22 5, United States Code, at rates for individuals 

23 which do not exceed the daily equivalent of the 

24 annual rate of basic pay prescribed for level V 


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1 of the Executive Schedule under section 5316 

2 of such title. 

3 (e) REIMBURSEMENT OF COSTS.—The Secretary 

4 shall provide, from general operating funds of the Depart5 ment of Health and Human Services, the Commission 

6 with such funds and support as may be necessary to sup7 port its activities. 

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

9 All Healthy Children Program effective date, the Commis10 sion shall transmit to Congress an annual report that eval11 uates the status of children’s health coverage in the 

12 United States, including an evaluation of the implementa13 tion of title XXII of the Social Security Act and rec14 ommendations for policy improvements at the State and 

15 national levels and in the private sector to improve such 

16 coverage. 

17 (g) SUBMISSION OF LEGISLATIVE PROPOSAL FOR

18 UNIVERSAL COVERAGE OF CHILDREN.—Not later than 

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

20 the Commission shall submit to Congress a report that 

21 contains a legislative proposal that would assure health 

22 benefits coverage for all children in the United States. 

23 Such proposal may include a requirement that parents ob24 tain coverage for their children or that employers fund 


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1 coverage for children of their workers. The proposal shall 

2 provide for the following: 

3 (1) Coverage shall include all medically nec4 essary care for all children. 

5 (2) Enrollment shall be simple and seamless. 

6 (3) Unnecessary costs shall be avoided. 

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

8 be promoted. 

9 (h) EXPEDITED CONGRESSIONAL CONSIDERATION

10 OF LEGISLATIVE PROPOSAL.— 

11 (1) BILL INTRODUCTION.— 

12 (A) IN GENERAL.—Any legislative proposal 

13 described in subsection (f) may be introduced 

14 as a bill by request in the following manner: 

15 (i) HOUSE OF REPRESENTATIVES.—In 

16 the House of Representatives, by the ma17 jority leader and the minority leader not 

18 later than 10 days after receipt of the leg19 islative proposal. 

20 (ii) SENATE.—In the Senate, by the 

21 majority leader and the minority leader not 

22 later than 10 days after receipt of the leg23 islative proposal. 

24 (B) ALTERNATIVE BY ADMINISTRATION.— 

25 The President may submit a legislative proposal 


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1 based on the recommendations of the Commis2 sion and such legislative proposal may be intro3 duced in the manner described in subparagraph 

4 (A). 

5 (2) COMMITTEE CONSIDERATION.— 

6 (A) IN GENERAL.—Any legislative proposal 

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

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

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

10 to the appropriate committees of the House of 

11 Representatives and the Senate. 

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

13 than 150 days after the date on which the im14 plementing legislation is referred to a com15 mittee under subparagraph (A), the committee 

16 has reported the implementing legislation or 

17 has reported an original bill whose subject is re18 lated to universal health benefits coverage of 

19 children, or to providing access to affordable 

20 health care coverage for all children, the regular 

21 rules of the applicable House of Congress shall 

22 apply to such legislation. 

23 (C) DISCHARGE FROM COMMITTEES.— 

24 (i) SENATE.— 


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1 (I) IN GENERAL.—If the imple2 menting legislation or an original bill 

3 described in paragraph (1) has not 

4 been reported by a committee of the 

5 Senate within 180 days after the date 

6 on which such legislation was referred 

7 to committee under subparagraph (A), 

8 it shall be in order for any Senator to 

9 move to discharge the committee from 

10 further consideration of such imple11 menting legislation. 

12 (II) SEQUENTIAL REFERRALS.— 

13 Should a sequential referral of the im14 plementing legislation be made, the 

15 additional committee has 30 days for 

16 consideration of implementing legisla17 tion before the discharge motion de18 scribed in subclause (I) would be in 

19 order. 

20 (III) PROCEDURE.—The motion 

21 described in subclause (I) shall not be 

22 in order after the implementing legis23 lation has been placed on the cal24 endar. While the motion described in 

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1 tions related to the motion described 

2 in subclause (I) shall be in order. De3 bate on a motion to discharge shall be 

4 limited to not more than 10 hours, 

5 equally divided and controlled by the 

6 majority leader and the minority lead7 er, or their designees. An amendment 

8 to the motion shall not be in order, 

9 nor shall it be in order to move to re10 consider the vote by which the motion 

11 is agreed or disagreed to. 

12 (IV) EXCEPTION.—If imple13 menting language is submitted on a 

14 date later than May 1 of the second 

15 session of a Congress, the committee 

16 shall have 90 days to consider the im17 plementing legislation before a motion 

18 to discharge under this clause would 

19 be in order. 

20 (ii) HOUSE OF REPRESENTATIVES.— 

21 If the implementing legislation or an origi22 nal bill described in paragraph (1) has not 

23 been reported out of a committee of the 

24 House of Representatives within 180 days 

25 after the date on which such legislation 


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1 was referred to committee under subpara2 graph (A), then on any day on which the 

3 call of the calendar for motions to dis4 charge committees is in order, any member 

5 of the House of Representatives may move 

6 that the committee be discharged from 

7 consideration of the implementing legisla8 tion, and this motion shall be considered 

9 under the same terms and conditions, and 

10 if adopted the House of Representatives 

11 shall follow the procedure described in 

12 sparagraph (4)(A). 

13 (3) FLOOR CONSIDERATION.— 

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

15 discharge made pursuant to paragraph 

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

17 not earlier than 5 legislative days after the date 

18 on which the motion to discharge is adopted, a 

19 motion may be made to proceed to the bill. 

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

21 to discharge made pursuant to either such 

22 paragraph fails, such motion may be made not 

23 more than 2 additional times, but in no case 

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1 vious motion. Debate on each of such motions 

2 shall be limited to 5 hours, equally divided. 

3 (C) APPLICABLE RULES.—Once the Senate 

4 is debating the implementing legislation the 

5 regular rules of the Senate shall apply. 

Æ 


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