I

103D CONGRESS

1ST SESSION H. R. 1612

To amend title XIX of the Social Security Act to reduce infant mortality

through improvement of coverage of services to pregnant women and

infants under the medicaid program.

IN THE HOUSE OF REPRESENTATIVES

APRIL 1, 1993

Mrs. COLLINS of Illinois 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 reduce

infant mortality through improvement of coverage of

services to pregnant women and infants under the medicaid program.

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 ‘‘Medicaid Infant Mor5 tality Amendments of 1993’’.
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1 SEC. 2. PHASED-IN COVERAGE OF PREGNANT WOMEN AND

2 INFANTS UP TO 185 PERCENT OF POVERTY

3 LEVEL.

4 (a) IN GENERAL.—Section 1902(l)(2)(A) of the So5 cial Security Act (42 U.S.C. 1396a(l)(2)(A)) is amend6 ed—

7 (1) in clause (ii)—

8 (A) in subclause (I), by striking ‘‘and’’ at

9 the end,

10 (B) by striking the period at the end of

11 subclause (II) and inserting a comma, and

12 (C) by adding at the end the following new

13 subclauses:

14 ‘‘(III) July 1, 1994, 150 percent, or, if greater,

15 the percentage provided under clause (v), and

16 ‘‘(IV) July 1, 1995, 185 percent.’’; and

17 (2) by adding at the end the following new

18 clause:

19 ‘‘(v) In the case of a State which, as of the date of

20 the enactment of this clause, has established under clause

21 (i), or has enacted legislation authorizing, or appropriat22 ing funds, to provide for, a percentage (of the income offi23 cial poverty line) that is greater than 150 percent, the per24 centage provided under clause (ii) for medical assistance

25 on or after July 1, 1994, shall not be less than—
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1 ‘‘(I) the percentage specified by the State in an

2 amendment to its State plan (whether approved or

3 not) as of the date of the enactment of this clause,

4 or

5 ‘‘(II) if no such percentage is specified as of the

6 date of the enactment of this clause, the percentage

7 established under the State’s authorizing legislation

8 or provided for under the State’s appropriations.’’.

9 (b) FLEXIBILITY IN INCOME METHODOLOGY AND

10 DEDUCTION OF CHILD CARE IN COMPUTATION OF IN11 COME.—Section 1902(l)(3)(E) of such Act (42 U.S.C.

12 1396a(l)(3)(E)) is amended by striking ‘‘(E)’’ and insert13 ing the following:

14 ‘‘(E)(i) with respect to an individual described

15 in subparagraph (A) or (B) of paragraph (1), family

16 income shall be determined in accordance with a

17 methodology which is no more restrictive than the

18 methodology employed under the State plan under

19 part A or E of title IV (except to the extent such

20 methodology is inconsistent with clause (D) of sub21 section (a)(17) and except that there shall be dis22 regarded costs for such child care as is necessary for

23 the employment of the pregnant woman or the care24 taker of the infant), and costs incurred for medical
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1 care or for any other type of remedial care shall not

2 be taken into account, and

3 ‘‘(ii) with respect to an individual described in

4 paragraph (1)(C) or (1)(D),’’.

5 (c) PROHIBITING APPLICATION OF RESOURCE

6 TEST.—Section 1902(l)(3) of such Act (42 U.S.C.

7 1396a(l)(3)) is amended—

8 (1) by amending subparagraph (A) to read as

9 follows:

10 ‘‘(A)(i) no resource standard or methodology

11 shall be applied to individuals who are eligible for

12 medical assistance because of subsection

13 (a)(10)(A)(i)(IV), and (ii) application of a resource

14 standard or methodology for individuals who are

15 eligible for medical assistance because of subsection

16 (a)(10)(A)(i)(VI) or (a)(10)(A)(ii)(IX) shall be at

17 the option of the State, but any such resource stand18 ard or methodology may not be more restrictive than

19 the corresponding standard or methodology that is

20 applied under the State plan under part A of title

21 IV;’’,

22 (2) by striking subparagraphs (B) and (C), and

23 (3) by redesignating subparagraphs (D) and

24 (E) as subparagraphs (B) and (C), respectively.

25 (d) EFFECTIVE DATES.—
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1 (1) HIGHER INCOME STANDARDS.—Except as

2 provided in paragraph (3), the amendments made by

3 subsection (a) shall apply to payments under title

4 XIX of the Social Security Act for calendar quarters

5 beginning on or after July 1, 1994, with respect to

6 eligibility for medical assistance on or after such

7 date, without regard to whether or not final regula8 tions to carry out such amendments have been pro9 mulgated by such date.

10 (2) INCOME METHODOLOGY AND RESOURCE

11 STANDARD.—Except as provided in paragraph (3),

12 the amendments made by subsections (b) and (c)

13 shall apply to payments under title XIX of the So14 cial Security Act for calendar quarters beginning on

15 or after July 1, 1994, with respect to eligibility for

16 medical assistance on or after such date, without re17 gard to whether or not final regulations to carry out

18 such amendments have been promulgated by such

19 date.

20 (3) EXCEPTION FOR CERTAIN STATES.—In the

21 case of a State plan for medical assistance under

22 title XIX of the Social Security Act which the Sec23 retary of Health and Human Services determines re24 quires State legislation (other than legislation au25 thorizing or appropriating funds) in order for the
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1 plan to meet the additional requirements imposed by

2 the amendments made by this section, the State

3 plan shall not be regarded as failing to comply with

4 the requirements of such title solely on the basis of

5 its failure to meet these additional requirements be6 fore the first day of the first calendar quarter begin7 ning after the close of the first regular session of the

8 State legislature that begins after the date of the en9 actment of this Act. For purposes of the previous

10 sentence, in the case of a State that has a 2-year

11 legislative session, each year of such session shall be

12 deemed to be a separate regular session of the State

13 legislature.

14 SEC. 3. OPTIONAL COVERAGE OF PRENATAL AND POST

15 PARTUM HOME VISITATION SERVICES.

16 (a) IN GENERAL.—Section 1905(a) of the Social Se17 curity Act (42 U.S.C. 1396d(a)) is amended—

18 (1) by striking ‘‘and’’ at the end of paragraph

19 (21),

20 (2) by redesignating paragraph (22) as para21 graph (25),

22 (3) by redesignating paragraphs (23) and (24)

23 as paragraphs (22) and (23), respectively,

24 (4) by inserting after paragraph (23) the fol25 lowing new paragraph:
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1 ‘‘(24) prenatal home visitation services for high2 risk pregnant women, post partum home visitation

3 services with respect to high-risk infants under 1

4 year of age, or both (as specified by the State), as

5 prescribed by a physician; and’’.

6 (b) CONFORMING AMENDMENTS.—Section 1902 of

7 such Act (42 U.S.C. 1396a) is amended—

8 (1) in subsection (a)(10)(C)(iv), by striking

9 ‘‘(21)’’ and inserting ‘‘(24)’’, and

10 (2) in subsection (j), by striking ‘‘(22)’’ and in11 serting ‘‘(25)’’.

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

13 this section shall apply to services furnished on or after

14 July 1, 1994, without regard to whether or not final regu15 lations to carry out such amendments have been promul16 gated by such date.

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