I 

111TH CONGRESS 

1ST SESSION H. R. 2859 

To amend title XIX of the Social Security Act to provide for application 

of an enhanced Federal matching rate for children under the Medicaid 

Program if certain conditions are met. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 12, 2009 

Ms. MATSUI introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to provide 

for application of an enhanced Federal matching rate 

for children under the Medicaid Program if certain conditions are met. 

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 ‘‘Strengthening Med5 icaid for America’s Children Act of 2009’’. 


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1 SEC. 2. ENHANCED FMAP FOR CHILDREN UNDER MED2 ICAID. 

3 (a) IN GENERAL.—Section 1905 of the Social Secu4 rity Act (42 U.S.C. 1396d) is amended— 

5 (1) in subsection (b), by inserting ‘‘and sub6 section (y)’’ after ‘‘section 1933(d),’’; and 

7 (2) by adding at the end the following new sub8 section: 

9 ‘‘(y) CONDITIONS-BASED ENHANCED FMAP FOR

10 CHILDREN.— 

11 ‘‘(1) IN GENERAL.—Subject to paragraph (4), 

12 in the case of a State that meets the requirements 

13 of paragraph (2) with respect to a quarter and that 

14 implements at least 3 of the policies described in 

15 paragraph (3)(B) for the quarter under the State 

16 plan under this title, the Federal medical assistance 

17 percentage applicable with respect to expenditures 

18 made for medical assistance for children shall be in19 creased by the percentage (specified in paragraph 

20 (3)(A)) of the number of percentage points by 

21 which— 

22 ‘‘(A) the enhanced FMAP (as defined in 

23 section 2105(b)), exceeds 

24 ‘‘(B) the Federal medical assistance per25 centage otherwise applicable. 


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1 ‘‘(2) MAINTENANCE-OF-EFFORT REQUIRE2 MENTS.—The requirements of this paragraph with 

3 respect to a State for a quarter are that the State 

4 must agree to the following two maintenance-of-ef5 fort requirements: 

6 ‘‘(A) An amount equivalent to the aggre7 gate State general revenue funds being applied 

8 as of July 1, 2008, under this title for purposes 

9 of obtaining Federal financial participation 

10 under this title for medical assistance furnished 

11 to children must remain invested in health care 

12 programs and services for children and avail13 able to supplement (and not supplant) program 

14 funding, with priority given to increasing reim15 bursement rates for providers and coverage ex16 pansion. 

17 ‘‘(B) To maintain eligibility, methods, 

18 standards, procedures, and provider rates appli19 cable to children under this title at levels not 

20 less than the levels in effect as of July 1, 2008. 

21 ‘‘(3) SCALING OF INCREASE BASED ON DEGREE

22 OF IMPLEMENTATION OF POLICIES.— 

23 ‘‘(A) PERCENTAGE SPECIFIED.—For pur24 poses of paragraph (1), in the case of a State 

25 that implements— 


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1 ‘‘(i) at least 6 of the policies described 

2 in subparagraph (B) for a calendar quar3 ter, the percentage under this subpara4 graph is 100 percent; 

5 ‘‘(ii) 5 of such policies, the percentage 

6 under this paragraph is 75 percent; or 

7 ‘‘(iii) fewer than 4 (but no less than 

8 3) of such policies, the percentage under 

9 this paragraph is 50 percent. 

10 ‘‘(B) POLICIES DESCRIBED.—The policies 

11 described in this subparagraph are as follows 

12 (as more fully specified by the Secretary): 

13 ‘‘(i) The State has implemented 12- 

14 month continuous coverage for children for 

15 medical assistance under this title. 

16 ‘‘(ii) Children leaving foster care on 

17 their 18th birthday may maintain eligi18 bility for medical assistance under this title 

19 up to the age of 23 if they are attending 

20 college full- or part-time. 

21 ‘‘(iii) As a condition of eligibility for 

22 children under section 1902(l), the State 

23 does not apply an asset test or applies a 

24 simplified asset verification system. 


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1 ‘‘(iv) The State does not require a 

2 face-to-face interview as a condition of eli3 gibility for children for medical assistance 

4 under this title. 

5 ‘‘(v) The State permits renewals of 

6 eligibility for children for medical assist7 ance under this title to be effected admin8 istratively or through an ex parte process. 

9 ‘‘(vi) The State permits a joint appli10 cation for medical assistance under this 

11 title and for child health assistance under 

12 title XXI with the same information 

13 verification process to obtain assistance 

14 under this title or title XXI. 

15 ‘‘(vii) The State has implemented 

16 under this title and title XXI presumptive 

17 eligibility for children described in section 

18 1920A. 

19 ‘‘(viii) The State has implemented the 

20 Express Lane eligibility option under sec21 tion 1902(e)(13). 

22 ‘‘(ix) The State provides for coordina23 tion of delivery of care for children for 

24 which medical assistance is available under 


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1 this title through a medical home or simi2 lar model. 

3 ‘‘(4) LIMITATION.—This subsection shall not 

4 apply for any calendar quarter for a State for which 

5 the State may be eligible for an increase in FMAP 

6 under section 5001 of division B of the American 

7 Recovery and Reinvestment Act (Public Law 111– 

8 5). 

9 ‘‘(5) CHILDREN DEFINED.—In this subsection, 

10 the term ‘children’ means an individual who is under 

11 21 years of age.’’. 

Æ 


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