II 

109TH CONGRESS 

1ST SESSION S. 747 

To give States the flexibility to reduce bureaucracy by streamlining enrollment 

processes for the medicaid and State children’s health insurance programs through better linkages with programs providing nutrition and 

related assistance to low-income families. 

IN THE SENATE OF THE UNITED STATES 

APRIL 11, 2005 

Mr. LUGAR (for himself, Mr. BINGAMAN, Mr. COCHRAN, Mr. KERRY, Mr. 

DURBIN, and Mrs. FEINSTEIN) introduced the following bill; which was 

read twice and referred to the Committee on Finance 

A BILL 

To give States the flexibility to reduce bureaucracy by 

streamlining enrollment processes for the medicaid and 

State children’s health insurance programs through better linkages with programs providing nutrition and related assistance to low-income families. 

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 Express 

5 Lane to Health Coverage Act of 2005’’. 

6 SEC. 2. FINDINGS; PURPOSE. 

7 (a) FINDINGS.—Congress finds the following: 
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1 (1) Despite gains made in recent years, 

2 8,900,000 children in the United States are unin3 sured. Of those, 6,900,000 are eligible for public 

4 health insurance coverage. 

5 (2) Most low-income uninsured children are en6 rolled in nutrition and related programs that operate 

7 under income guidelines similar to those of the med8 icaid program. In fact, 63 percent, or 4,300,000, 

9 low-income uninsured children are in families that 

10 receive benefits through the food stamps program, 

11 the National school lunch program, or the special 

12 supplemental nutrition program for women, infants 

13 and children (commonly referred to as ‘‘WIC’’). 

14 (3) The public would be well served if Federal 

15 means-tested public programs were able to improve 

16 administrative efficiency and coordination as well as 

17 reduce unnecessary bureaucracy. 

18 (4) Uninsured children would be well served if 

19 their enrollment in a nutrition-based or other means20 tested program could serve as a gateway to health 

21 coverage. 

22 (5) Existing law already allows children to be 

23 found income eligible for WIC based on their enroll24 ment in the medicaid program. Current law does 

25 not, however, give States adequate flexibility to 
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1 make an income determination for eligibility for the 

2 medicaid or State children’s health insurance pro3 gram based on an uninsured child’s enrollment in 

4 WIC or another public program. 

5 (b) PURPOSE.—The purpose of this Act is to give 

6 States the flexibility to find children income eligible for 

7 the medicaid program or State children’s health insurance 

8 program based on the fact that the children are eligible 

9 for nutrition assistance or similar public programs with 

10 comparable income standards and methodologies. 

11 SEC. 3. STATE OPTION TO PROVIDE FOR SIMPLIFIED DE12 TERMINATIONS OF A CHILD’S FINANCIAL ELI13 GIBILITY FOR MEDICAL ASSISTANCE UNDER 

14 MEDICAID OR CHILD HEALTH ASSISTANCE 

15 UNDER SCHIP. 

16 (a) MEDICAID.—Section 1902(e) of the Social Secu17 rity Act (42 U.S.C. 1396a(e)) is amended by adding at 

18 the end the following: 

19 ‘‘(13)(A) At the option of the State, the plan 

20 may provide that financial eligibility requirements 

21 for medical assistance are met for an individual who 

22 is under an age specified by the State (except as 

23 provided in subparagraph (C), not to exceed 21 

24 years of age) by using a determination made within 

25 a reasonable period (as determined by the State) be-
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1 fore its use for this purpose, of the individual’s fam2 ily or household income, or if applicable for purposes 

3 of determining eligibility under this title or title 

4 XXI, assets or resources, by a Federal or State 

5 agency, or a public or private entity making such de6 termination on behalf of such agency, specified by 

7 the plan, including (but not limited to) an agency 

8 administering the Food Stamp Act of 1977, the 

9 Richard B. Russell National School Lunch Act, or 

10 the Child Nutrition Act of 1966, notwithstanding 

11 any differences in budget unit, disregard, deeming, 

12 or other methodology, but only if— 

13 ‘‘(i) the agency has fiscal liabilities or re14 sponsibilities affected or potentially affected by 

15 such determination; and 

16 ‘‘(ii) any information furnished by the 

17 agency pursuant to this subparagraph is used 

18 solely for purposes of determining eligibility for 

19 medical assistance under this title or for child 

20 health assistance under title XXI. 

21 ‘‘(B) Nothing in subparagraph (A) shall be con22 strued— 

23 ‘‘(i) to authorize the denial of medical as24 sistance under this title or of child health as25 sistance under title XXI to an individual who, 
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1 without the application of this paragraph, would 

2 qualify for such assistance; 

3 ‘‘(ii) to relieve a State of the obligation 

4 under subsection (a)(8) to furnish medical as5 sistance with reasonable promptness after the 

6 submission of an initial application that is eval7 uated or for which evaluation is requested pur8 suant to this paragraph; or 

9 ‘‘(iii) to relieve a State of the obligation to 

10 determine eligibility for medical assistance 

11 under this title or for child health assistance 

12 under title XXI on a basis other than family or 

13 household income (or, if applicable, assets or re14 sources) if an individual is determined ineligible 

15 for such assistance on the basis of information 

16 furnished pursuant to this paragraph. 

17 ‘‘(C) At the option of a State, the financial eli18 gibility process described in subparagraph (A) may 

19 apply to an individual who is older than age 21 if 

20 the individual’s eligibility for medical assistance 

21 under this title is based on pregnancy or if the indi22 vidual is a parent, guardian, or other caretaker rel23 ative of an individual found eligible under subpara24 graph (A).’’. 
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1 (b) SCHIP.—Section 2107(e)(1) of the Social Secu2 rity Act (42 U.S.C. 1397gg(e)(1)) is amended by adding 

3 at the end the following: 

4 ‘‘(E) Section 1902(e)(13) (relating to the 

5 State option to base an individual’s eligibility 

6 for assistance on financial determinations made 

7 by a program providing nutrition or other pub8 lic assistance (except that the State option 

9 under subparagraph (C) of such section shall 

10 apply under this title only if an individual is 

11 pregnant)).’’. 

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

13 this section take effect on October 1, 2005. 

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