I 
110TH CONGRESS 
1ST SESSION H. R. 3719 
To prohibit implementation of a guidance letter proposing rules relating 
to the Federal-State financial partnerships under Medicaid and the State 
Children’s Health Insurance Program. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 2, 2007 
Ms. CASTOR introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To prohibit implementation of a guidance letter proposing 
rules relating to the Federal-State financial partnerships 
under Medicaid and the State Children’s Health Insur-
ance Program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. PROHIBITION ON IMPLEMENTATION OF A 
GUIDANCE LETTER PROPOSING RULES RE-
LATING TO THE FEDERAL-STATE FINANCIAL 
PARTNERSHIPS 
UNDER 
MEDICAID 
AND 
SCHIP. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) The August 17, 2007, letter to State Health 
Officials from the Director of the Center for Med-
icaid and State Operations in the Centers for Medi-
care & Medicaid Services would significantly change 
the Federal-State financial partnership under the 
Medicaid and the State Children’s Health Insurance 
Programs by— 
(A) limiting SCHIP eligibility to children 
in families with incomes greater than 250 per-
cent of the poverty level by requiring States to 
demonstrate that they have ‘‘enrolled at least 
95 percent of children in the state below 200% 
of the Federal poverty level’’; 
(B) establishing a minimum of a one year 
period of uninsurance for individuals in families 
with incomes greater than 250 percent of the 
poverty level; 
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(C) imposing co-payments and premiums 
similar to the cost of private health insurance 
on middle-income families; 
(D) imposing regulations that insure chil-
dren in families with annual incomes greater 
than 250 percent of the poverty level must 
prove that the number of children in the target 
population insured through private employers 
has not decreased by more than two percentage 
points over the prior five-year period; and 
(E) requiring States to adopt policies pre-
venting employers from changing dependent- 
coverage policies that would favor a shift to 
public coverage. 
(2) Permitting the proposed policy to take ef-
fect will have a negative impact for States, particu-
larly States with Medicaid or State Children’s 
Health Insurance Programs operating under financ-
ing arrangements that would be affected by such 
policy and that have been approved by the Secretary 
of Health and Human Services through the section 
1115 waiver process. 
(b) PROHIBITION ON IMPLEMENTATION.—Notwith-
standing any other provision of law, the Secretary of 
Health and Human Services shall not apply any require-
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