I 

115TH CONGRESS 

2D SESSION H. R. 7397 

To provide further additional continuing appropriations for fiscal year 2019, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 22, 2018 

Mr. HOYER introduced the following bill; which was referred to the Committee 

on Appropriations, and in addition to the Committee on the Budget, 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 provide further additional continuing appropriations for 

fiscal year 2019, 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 DIVISION A—FURTHER ADDITIONAL 

4 CONTINUING APPROPRIATIONS ACT, 2019 

5 SEC. 101. The Continuing Appropriations Act, 2019 

6 (division C of Public Law 115–245) is further amended— 

7 (1) by striking the date specified in section 

8 105(3) and inserting ‘‘February 8, 2019’’; and 

9 (2) by adding after section 136 the following: 


pamtmann on DSKBFK8HB2PROD with BILLS
2 

•HR 7397 IH

1 ‘‘SEC. 137. Notwithstanding section 251(a)(1) of the 

2 Balanced Budget and Emergency Deficit Control Act of 

3 1985 and the timetable in section 254(a) of such Act, the 

4 final sequestration report for fiscal year 2019 pursuant 

5 to section 254(f)(1) of such Act and any order for fiscal 

6 year 2019 pursuant to section 254(f)(5) of such Act shall 

7 be issued, for the Congressional Budget Office, 10 days 

8 after the date specified in section 105(3), and for the Of9 fice of Management and Budget, 15 days after the date 

10 specified in section 105(3). 

11 ‘‘SEC. 138. The authority provided under title XXI 

12 of the Homeland Security Act of 2002 (6 U.S.C. 621 et 

13 seq.), as amended by section 2(a) of the Protecting and 

14 Securing Chemical Facilities from Terrorist Attacks Act 

15 of 2014 (Public Law 113–254), shall continue in effect 

16 through the date specified in section 105(3). 

17 ‘‘SEC. 139. Section 319L(e)(1)(A) of the Public 

18 Health Service Act (42 U.S.C. 247d–7e(e)(1)(A)) shall 

19 continue in effect through the date specified in section 

20 105(3) of this Act. 

21 ‘‘SEC. 140. Section 405(a) of the Pandemic and All 

22 Hazards Preparedness Act (42 U.S.C. 247d–6a note) shall 

23 continue in effect through the date specified in section 

24 105(3) of this Act.’’. 


pamtmann on DSKBFK8HB2PROD with BILLS
3 

•HR 7397 IH

1 This division may be cited as the ‘‘Further Additional 

2 Continuing Appropriations Act, 2019’’. 

3 DIVISION B—MEDICAID 

4 EXTENDERS 

5 SEC. 101. EXTENSION OF MONEY FOLLOWS THE PERSON 

6 REBALANCING DEMONSTRATION. 

7 (a) GENERAL FUNDING.—Section 6071(h) of the 

8 Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) is 

9 amended— 

10 (1) in paragraph (1)— 

11 (A) in subparagraph (D), by striking 

12 ‘‘and’’ after the semicolon; 

13 (B) in subparagraph (E), by striking the 

14 period at the end and inserting ‘‘; and’’; and 

15 (C) by adding at the end the following: 

16 ‘‘(F) subject to paragraph (3), 

17 $112,000,000 for fiscal year 2019.’’; 

18 (2) in paragraph (2)— 

19 (A) by striking ‘‘Amounts made’’ and in20 serting ‘‘Subject to paragraph (3), amounts 

21 made’’; and 

22 (B) by striking ‘‘September 30, 2016’’ and 

23 inserting ‘‘September 30, 2021’’; and 

24 (3) by adding at the end the following new 

25 paragraph: 


pamtmann on DSKBFK8HB2PROD with BILLS
4 

•HR 7397 IH

1 ‘‘(3) SPECIAL RULE FOR FY 2019.—Funds ap2 propriated under paragraph (1)(F) shall be made 

3 available for grants to States only if such States 

4 have an approved MFP demonstration project under 

5 this section as of December 31, 2018.’’. 

6 (b) FUNDING FOR QUALITY ASSURANCE AND IM7 PROVEMENT; TECHNICAL ASSISTANCE; OVERSIGHT.— 

8 Section 6071(f) of the Deficit Reduction Act of 2005 (42 

9 U.S.C. 1396a note) is amended by striking paragraph (2) 

10 and inserting the following: 

11 ‘‘(2) FUNDING.—From the amounts appro12 priated under subsection (h)(1)(F) for fiscal year 

13 2019, $500,000 shall be available to the Secretary 

14 for such fiscal year to carry out this subsection.’’. 

15 (c) TECHNICAL AMENDMENT.—Section 6071(b) of 

16 the Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) 

17 is amended by adding at the end the following: 

18 ‘‘(10) SECRETARY.—The term ‘Secretary’ 

19 means the Secretary of Health and Human Serv20 ices.’’. 


pamtmann on DSKBFK8HB2PROD with BILLS
5 

•HR 7397 IH

1 SEC. 102. EXTENSION OF PROTECTION FOR MEDICAID RE2 CIPIENTS OF HOME AND COMMUNITY-BASED 

3 SERVICES AGAINST SPOUSAL IMPOVERISH4 MENT. 

5 (a) IN GENERAL.—Section 2404 of Public Law 111– 

6 148 (42 U.S.C. 1396r–5 note) is amended by striking ‘‘the 

7 5-year period that begins on January 1, 2014,’’ and in8 serting ‘‘the period beginning on January 1, 2014, and 

9 ending on March 31, 2019,’’. 

10 (b) RULE OF CONSTRUCTION.— 

11 (1) PROTECTING STATE SPOUSAL INCOME AND

12 ASSET DISREGARD FLEXIBILITY UNDER WAIVERS

13 AND PLAN AMENDMENTS.—Nothing in section 2404 

14 of Public Law 111–148 (42 U.S.C. 1396r–5 note) or 

15 section 1924 of the Social Security Act (42 U.S.C. 

16 1396r–5) shall be construed as prohibiting a State 

17 from disregarding an individual’s spousal income 

18 and assets under a State waiver or plan amendment 

19 described in paragraph (2) for purposes of making 

20 determinations of eligibility for home and commu21 nity-based services or home and community-based 

22 attendant services and supports under such waiver 

23 or plan amendment. 

24 (2) STATE WAIVER OR PLAN AMENDMENT DE25 SCRIBED.—A State waiver or plan amendment de26 scribed in this paragraph is any of the following: 


pamtmann on DSKBFK8HB2PROD with BILLS
6 

•HR 7397 IH

1 (A) A waiver or plan amendment to pro2 vide medical assistance for home and commu3 nity-based services under a waiver or plan 

4 amendment under subsection (c), (d), or (i) of 

5 section 1915 of the Social Security Act (42 

6 U.S.C. 1396n) or under section 1115 of such 

7 Act (42 U.S.C. 1315). 

8 (B) A plan amendment to provide medical 

9 assistance for home and community-based serv10 ices for individuals by reason of being deter11 mined eligible under section 1902(a)(10)(C) of 

12 such Act (42 U.S.C. 1396a(a)(10)(C)) or by 

13 reason of section 1902(f) of such Act (42 

14 U.S.C. 1396a(f)) or otherwise on the basis of a 

15 reduction of income based on costs incurred for 

16 medical or other remedial care under which the 

17 State disregarded the income and assets of the 

18 individual’s spouse in determining the initial 

19 and ongoing financial eligibility of an individual 

20 for such services in place of the spousal impov21 erishment provisions applied under section 1924 

22 of such Act (42 U.S.C. 1396r–5). 

23 (C) A plan amendment to provide medical 

24 assistance for home and community-based atVerDate Sep 11 2014 21:50 Dec 22, 2018 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H7397.IH H7397

pamtmann on DSKBFK8HB2PROD with BILLS
7 

•HR 7397 IH

1 tendant services and supports under section 

2 1915(k) of such Act (42 U.S.C. 1396n(k)). 

3 SEC. 103. REDUCTION IN FMAP AFTER 2020 FOR STATES 

4 WITHOUT ASSET VERIFICATION PROGRAM. 

5 Section 1940 of the Social Security Act (42 U.S.C. 

6 1396w) is amended by adding at the end the following 

7 new subsection: 

8 ‘‘(k) REDUCTION IN FMAP AFTER 2020 FOR NON9 COMPLIANT STATES.— 

10 ‘‘(1) IN GENERAL.—With respect to a calendar 

11 quarter beginning on or after January 1, 2021, the 

12 Federal medical assistance percentage otherwise de13 termined under section 1905(b) for a non-compliant 

14 State shall be reduced— 

15 ‘‘(A) for calendar quarters in 2021 and 

16 2022, by 0.12 percentage points; 

17 ‘‘(B) for calendar quarters in 2023, by 

18 0.25 percentage points; 

19 ‘‘(C) for calendar quarters in 2024, by 

20 0.35 percentage points; and 

21 ‘‘(D) for calendar quarters in 2025 and 

22 each year thereafter, by 0.5 percentage points. 

23 ‘‘(2) NON-COMPLIANT STATE DEFINED.—For 

24 purposes of this subsection, the term ‘non-compliant 

25 State’ means a State— 


pamtmann on DSKBFK8HB2PROD with BILLS
8 

•HR 7397 IH

1 ‘‘(A) that is one of the 50 States or the 

2 District of Columbia; 

3 ‘‘(B) with respect to which the Secretary 

4 has not approved a State plan amendment sub5 mitted under subsection (a)(2); and 

6 ‘‘(C) that is not operating, on an ongoing 

7 basis, an asset verification program in accord8 ance with this section.’’. 

9 SEC. 104. MEDICAID IMPROVEMENT FUND. 

10 Section 1941(b)(1) of the Social Security Act (42 

11 U.S.C. 1396w–1(b)(1)) is amended by striking 

12 ‘‘$31,000,000’’ and inserting ‘‘$6,000,000’’. 

13 SEC. 105. BUDGETARY EFFECTS. 

14 (a) STATUTORY PAYGO SCORECARDS.—The budg15 etary effects of this division shall not be entered on either 

16 PAYGO scorecard maintained pursuant to section 4(d) of 

17 the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 

18 933(d)). 

19 (b) SENATE PAYGO SCORECARDS.—The budgetary 

20 effects of this division shall not be entered on any PAYGO 

21 scorecard maintained for purposes of section 4106 of H. 

22 Con. Res. 71 (115th Congress). 

23 (c) CLASSIFICATION OF BUDGETARY EFFECTS.— 

24 Notwithstanding Rule 3 of the Budget Scorekeeping 

25 Guidelines set forth in the joint explanatory statement of 


pamtmann on DSKBFK8HB2PROD with BILLS
9 

•HR 7397 IH

1 the committee of conference accompanying Conference Re2 port 105–217 and section 250(c)(8) of the Balanced 

3 Budget and Emergency Deficit Control Act of 1985, the 

4 budgetary effects of this division shall not be estimated— 

5 (1) for purposes of section 251 of such Act; and 

6 (2) for purposes of paragraph (4)(C) of section 

7 3 of the Statutory Pay-As-You-Go Act of 2010 as 

8 being included in an appropriation Act. 

9 (d) PAYGO ANNUAL REPORT.—For the purposes of 

10 the annual report issued pursuant to section 5 of the Stat11 utory Pay-As-You-Go Act of 2010 (2 U.S.C. 934) after 

12 adjournment of the second session of the 115th Congress, 

13 and for determining whether a sequestration order is nec14 essary under such section, the debit for the budget year 

15 on the 5-year scorecard, if any, and the 10-year scorecard, 

16 if any, shall be deducted from such scorecard in 2019 and 

17 added to such scorecard in 2020. 

Æ 


pamtmann on DSKBFK8HB2PROD with BILLS