II 

108TH CONGRESS 

2D SESSION S. 2685 

To amend titles XIX and XXI of the Social Security Act to provide States 

with the option to cover certain legal immigrants under the medicaid 

and State children’s health insurance programs. 

IN THE SENATE OF THE UNITED STATES 

JULY 19, 2004 

Mr. GRAHAM of Florida introduced the following bill; which was read twice 

and referred to the Committee on Finance 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

to provide States with the option to cover certain legal 

immigrants under the medicaid and State children’s 

health insurance programs. 

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 ‘‘Immigrant Children’s 

5 Health Improvement Act of 2004’’. 
2 

•S 2685 IS 

1 SEC. 2. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS 

2 UNDER THE MEDICAID PROGRAM AND SCHIP. 

3 (a) MEDICAID PROGRAM.—Section 1903(v) of the 

4 Social Security Act (42 U.S.C. 1396b(v)) is amended— 

5 (1) in paragraph (1), by striking ‘‘paragraph 

6 (2)’’ and inserting ‘‘paragraphs (2) and (4)’’; and 

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

8 ‘‘(4)(A) A State may elect (in a plan amendment 

9 under this title) to provide medical assistance under this 

10 title for aliens who are lawfully residing in the United 

11 States (including battered aliens described in section 

12 431(c) of the Personal Responsibility and Work Oppor13 tunity Reconciliation Act of 1996) and who are otherwise 

14 eligible for such assistance, within any of the following eli15 gibility categories: 

16 ‘‘(i) PREGNANT WOMEN.—Women during preg17 nancy (and during the 60-day period beginning on 

18 the last day of the pregnancy). 

19 ‘‘(ii) CHILDREN.—Children (as defined under 

20 such plan), including optional targeted low-income 

21 children described in section 1905(u)(2)(B). 

22 ‘‘(B)(i) In the case of a State that has elected to pro23 vide medical assistance to a category of aliens under sub24 paragraph (A), no debt shall accrue under an affidavit of 

25 support against any sponsor of such an alien on the basis 

26 of provision of assistance to such category and the cost 
3 

•S 2685 IS 

1 of such assistance shall not be considered as an unreim2 bursed cost. 

3 ‘‘(ii) The provisions of sections 401(a), 402(b), 403, 

4 and 421 of the Personal Responsibility and Work Oppor5 tunity Reconciliation Act of 1996 shall not apply to a 

6 State that makes an election under subparagraph (A).’’. 

7 (b) TITLE XXI.—Section 2107(e)(1) of the Social 

8 Security Act (42 U.S.C. 1397gg(e)(1)) is amended by add9 ing at the end the following: 

10 ‘‘(E) Section 1903(v)(4) (relating to op11 tional coverage of permanent resident alien chil12 dren), but only if the State has elected to apply 

13 such section to that category of children under 

14 title XIX.’’. 

15 (c) EXTENSION OF CONVEYANCE/PASSENGER CUS16 TOMS USER FEES.—Section 13031(j)(3) of the Consoli17 dated Omnibus Budget Reconciliation Act of 1985 (19 

18 U.S.C. 58c(j)(3)) is amended— 

19 (1) by striking ‘‘Fees’’ and inserting ‘‘(A) Ex20 cept as provided in subparagraph (B), fees’’; and 

21 (2) by adding at the end the following: 

22 ‘‘(B) Fees may not be charged under paragraphs (1) 

23 through (8) of subsection (a) after March 1, 2015.’’. 
4 

•S 2685 IS 

1 (d) EFFECTIVE DATE.—The amendments made by 

2 this section take effect on October 1, 2004. 

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