II 

108TH CONGRESS 

1ST SESSION S. 264

To amend title XXI of the Social Security Act to extend the availability 

of allotments to States for fiscal years 1998 through 2000, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 30, 2003

Ms. CANTWELL (for herself and Mrs. MURRAY) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL

To amend title XXI of the Social Security Act to extend 

the availability of allotments to States for fiscal years 

1998 through 2000, 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. 

4 This Act may be cited as the ‘‘Children’s Health Pro5 tection and Eligibility Act of 2003’’. 
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1 SEC. 2. RETENTION AND REDISTRIBUTION OF SCHIP AL2 LOTMENTS FOR FISCAL YEARS 1998 

3 THROUGH 2000. 

4 (a) EXTENSION OF AVAILABILITY OF FISCAL YEARS

5 1998 AND 1999 ALLOTMENTS.—Section 2104(g) of the 

6 Social Security Act (42 U.S.C. 1397dd(g)) is amended—

7 (1) in paragraph (1)(B)(ii), by striking ‘‘2002’’ 

8 and inserting ‘‘2004’’; 

9 (2) in paragraph (2)(A)(i), by striking ‘‘2002’’ 

10 and inserting ‘‘2004’’; and 

11 (3) in paragraph (2)(A)(ii), by striking ‘‘2002’’ 

12 and inserting ‘‘2004’’. 

13 (b) APPLICATION AND MODIFICATION OF BIPA 

14 RULE FOR REDISTRIBUTION AND EXTENDED AVAIL15 ABILITY TO ALLOTMENTS FOR FISCAL YEAR 2000.—Sec16 tion 2104(g) of the Social Security Act (42 U.S.C. 

17 1397dd(g)), as amended by subsection (a), is amended—

18 (1) in the subsection heading, by striking ‘‘AND

19 1999’’ and inserting ‘‘, 1999, AND 2000’’; 

20 (2) in paragraph (1)—

21 (A) in subparagraph (A)—

22 (i) in the matter preceding clause 

23 (i)—

24 (I) by inserting ‘‘or for fiscal 

25 year 2000 by the end of fiscal year 

26 2002,’’ after ‘‘2001,’’; and 
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1 (II) by striking ‘‘1998 or 1999’’ 

2 and inserting ‘‘1998, 1999, or 2000’’; 

3 (ii) in clause (i)—

4 (I) in subclause (I), by striking 

5 ‘‘or’’ at the end; 

6 (II) in subclause (II), by striking 

7 the period and inserting ‘‘; or’’; and 

8 (III) by adding at the end the 

9 following: 

10 ‘‘(III) the fiscal year 2000 allot11 ment, the amount by which the 

12 State’s expenditures under this title in 

13 fiscal years 2000, 2001, and 2002 ex14 ceed the State’s allotment for fiscal 

15 year 2000 under subsection (b).’’; and 

16 (iii) in clause (ii), by striking ‘‘1998 

17 or 1999’’ and inserting ‘‘1998, 1999, or 

18 2000’’; and 

19 (B) in subparagraph (B), in the matter 

20 preceding clause (i), by striking ‘‘1998 or 

21 1999’’ and inserting ‘‘1998, 1999, or 2000’’; 

22 (3) in paragraph (2)—

23 (A) in the paragraph heading, by striking 

24 ‘‘1998 AND 1999’’ and inserting ‘‘1998, 1999, AND

25 2000’’; and 
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1 (B) in subparagraph (A), by adding at the 

2 end the following: 

3 ‘‘(iii) FISCAL YEAR 2000 ALLOT4 MENT.—

5 ‘‘(I) IN GENERAL.—Except as 

6 provided in subclause (II), of the 

7 amounts allotted to a State pursuant 

8 to this section for fiscal year 2000 

9 that were not expended by the State 

10 by the end of fiscal year 2002, the 

11 amount specified in subparagraph (B) 

12 for fiscal year 2000 for such State 

13 shall remain available for expenditure 

14 by the State through the end of fiscal 

15 year 2004. 

16 ‘‘(II) STATES WITH HIGH UNEM17 PLOYMENT.—In the case of a State 

18 for which the average rate of unem19 ployment in the State for any con20 secutive 2 months of 2002 or 2003 

21 exceeds 6 percent, as determined by 

22 the Secretary of Labor, the total 

23 amount allotted to the State pursuant 

24 to this section for fiscal year 2000 

25 that was not expended by the State by 
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1 the end of fiscal year 2002 shall re2 main available for expenditure by the 

3 State through the end of fiscal year 

4 2004 and shall not be subject to redis5 tribution under paragraph (1).’’; and 

6 (4) in paragraph (3)—

7 (A) by striking ‘‘or fiscal year 1999’’ and 

8 inserting ‘‘, fiscal year 1999, or fiscal year 

9 2000’’; and 

10 (B) by striking ‘‘or November 30, 2001,’’ 

11 and inserting ‘‘, November 30, 2001, or Novem12 ber 30, 2002,’’. 

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

14 this section shall take effect as if included in the enact15 ment of section 801 of Medicare, Medicaid, and SCHIP 

16 Benefits Improvement and Protection Act of 2000 (114 

17 Stat. 2763A–578), as enacted into law by section 1(a)(6) 

18 of Public Law 106–554. 

19 SEC. 3. AUTHORITY FOR QUALIFYING STATES TO USE 

20 SCHIP FUNDS FOR MEDICAID EXPENDI21 TURES. 

22 (a) AUTHORITY FOR QUALIFYING STATES TO USE

23 PORTION OF SCHIP FUNDS FOR MEDICAID EXPENDI24 TURES.—Section 2105 of the Social Security Act (42 
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1 U.S.C. 1397ee) is amended by adding at the end the fol2 lowing: 

3 ‘‘(g) AUTHORITY FOR QUALIFYING STATES TO USE

4 CERTAIN FUNDS FOR MEDICAID EXPENDITURES.—

5 ‘‘(1) STATE OPTION.—

6 ‘‘(A) IN GENERAL.—Notwithstanding any 

7 other provision of law, with respect to fiscal 

8 year 2003, a qualifying State (as defined in 

9 paragraph (2)) may elect to use any or all of 

10 the aggregate amount of funds available to the 

11 State under this title from allotments made to 

12 the State (or redistributed to the State) for fis13 cal years 1998 through 2000, plus an amount 

14 equal to 10 percent of allotments made to the 

15 State for each of fiscal years 2001 through 

16 2003, for payments for such fiscal years under 

17 title XIX in accordance with subparagraph (B). 

18 ‘‘(B) PAYMENTS TO STATES.—

19 ‘‘(i) IN GENERAL.—In the case of a 

20 qualifying State that has elected the option 

21 described in subparagraph (A), subject to 

22 the total amount of funds described with 

23 respect to the State in subparagraph (A), 

24 the Secretary shall pay the State an 

25 amount each quarter equal to the addi-
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1 tional amount that would have been paid 

2 to the State under title XIX for expendi3 tures of the State for the fiscal year de4 scribed in clause (ii) if the enhanced 

5 FMAP (as determined under subsection 

6 (b)) had been substituted for the Federal 

7 medical assistance percentage (as defined 

8 in section 1905(b)) of such expenditures. 

9 ‘‘(ii) EXPENDITURES DESCRIBED.—

10 For purposes of clause (i), the expendi11 tures described in this clause are expendi12 tures for the fiscal year for providing med13 ical assistance under title XIX to individ14 uals who have not attained age 19 or who 

15 are pregnant women. 

16 ‘‘(C) ADDITIONAL PAYMENTS PERMITTED

17 FOR CERTAIN STATES.—

18 ‘‘(i) IN GENERAL.—With respect to 

19 fiscal year 2004 and each fiscal year there20 after, a qualifying State that also has a 

21 State child health plan that (whether im22 plemented under title XIX or this title) 

23 has the highest income eligibility standard 

24 permitted under this title as of January 1, 

25 2001, may elect to have the Secretary pay 
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1 the State from the allotment for the State 

2 for such fiscal year under subsection (b) or 

3 (c) of section 2104, an amount each quar4 ter equal to the additional amount that 

5 would have been paid to the State under 

6 title XIX for expenditures of the State for 

7 the fiscal year described in clause (ii) if the 

8 enhanced FMAP (as determined under 

9 subsection (b)) had been substituted for 

10 the Federal medical assistance percentage 

11 (as defined in section 1905(b)) of such ex12 penditures. 

13 ‘‘(ii) EXPENDITURES DESCRIBED.—

14 For purposes of clause (i), the expendi15 tures described in this clause are expendi16 tures for the fiscal year for providing med17 ical assistance under title XIX to individ18 uals who have not attained age 19 and 

19 whose family income exceeds the minimum 

20 income eligibility level the State is required 

21 to establish under section 1902(l) but does 

22 not exceed 200 percent of the poverty line. 

23 ‘‘(2) QUALIFYING STATE.—In this subsection, 

24 the term ‘qualifying State’ means a State that satis25 fies the following:
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1 ‘‘(A) NO REDUCTION IN MEDICAID OR

2 SCHIP INCOME ELIGIBILITY.—Since January 1, 

3 2001, the State has not reduced the income, as4 sets, or resource requirements for eligibility for 

5 medical assistance under title XIX or for child 

6 health assistance under this title. 

7 ‘‘(B) NO WAITING LIST IMPOSED.—The 

8 State does not impose any numerical limitation, 

9 waiting list, or similar limitation on the eligi10 bility of children for medical assistance under 

11 title XIX or child health assistance under this 

12 title and does not limit the acceptance of appli13 cations for such assistance. 

14 ‘‘(C) PROVIDES ASSISTANCE TO ALL CHIL15 DREN WHO APPLY AND QUALIFY.—The State 

16 provides medical assistance under title XIX or 

17 child health assistance under this title to all 

18 children in the State who apply for and meet 

19 the eligibility standards for such assistance. 

20 ‘‘(D) PROTECTION AGAINST INABILITY TO

21 PAY PREMIUMS OR COPAYMENTS.—The State 

22 ensures that no child loses coverage under title 

23 XIX or this title, or is denied needed care, as 

24 a result of the child’s parents’ inability to pay 
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1 any premiums or cost-sharing required under 

2 such title. 

3 ‘‘(E) ADDITIONAL REQUIREMENTS.—The 

4 State has implemented at least 3 of the fol5 lowing policies and procedures (relating to cov6 erage of children under title XIX and this title): 

7 ‘‘(i) SIMPLIFIED APPLICATION

8 FORM.—With respect to children who are 

9 eligible for medical assistance under title 

10 XIX, the State uses the same simplified 

11 application form (including, if applicable, 

12 permitting application other than in per13 son) for purposes of establishing eligibility 

14 for assistance under title XIX and this 

15 title. 

16 ‘‘(ii) ELIMINATION OF ASSET TEST.—

17 The State does not apply any asset test for 

18 eligibility under title XIX or this title with 

19 respect to children. 

20 ‘‘(iii) ADOPTION OF 12-MONTH CON21 TINUOUS ENROLLMENT.—The State pro22 vides that eligibility shall not be regularly 

23 redetermined more often than once every 

24 year under this title or for children eligible 

25 for medical assistance under title XIX. 
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1 ‘‘(iv) SAME VERIFICATION AND REDE2 TERMINATION POLICIES; AUTOMATIC REAS3 SESSMENT OF ELIGIBILITY.—With respect 

4 to children who are eligible for medical as5 sistance under section 1902(a)(10)(A), the 

6 State provides for initial eligibility deter7 minations and redeterminations of eligi8 bility using the same verification policies 

9 (including with respect to face-to-face 

10 interviews), forms, and frequency as the 

11 State uses for such purposes under this 

12 title, and, as part of such redetermina13 tions, provides for the automatic reassess14 ment of the eligibility of such children for 

15 assistance under title XIX and this title. 

16 ‘‘(v) OUTSTATIONING ENROLLMENT

17 STAFF.—The State provides for the receipt 

18 and initial processing of applications for 

19 benefits under this title and for children 

20 under title XIX at facilities defined as dis21 proportionate share hospitals under section 

22 1923(a)(1)(A) and Federally-qualified 

23 health centers described in section 

24 1905(l)(2)(B) consistent with section 

25 1902(a)(55).’’. 
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1 (b) EFFECTIVE DATE.—The amendment made by 

2 this section shall take effect as if enacted on October 1, 

3 2002.

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