204 
(E) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For purposes of carrying out this sub-
section, there is authorized to be appropriated 
$10,000,000 for each of fiscal years 2021 
through 2025. 
(4) FUNDING
FOR
STATE-BASED
PERINATAL 
QUALITY COLLABORATIVES DEVELOPMENT AND SUS-
TAINABILITY.— 
(A) IN GENERAL.—Not later than one year 
after the date of enactment of this Act, the Sec-
retary of Health and Human Services (referred 
to in this subsection as the ‘‘Secretary’’), acting 
through the Division of Reproductive Health of 
the Centers for Disease Control and Prevention, 
shall establish a grant program to be known as 
the State-Based Perinatal Quality Collaborative 
grant program under which the Secretary 
awards grants to eligible entities for the pur-
pose of development and sustainability of 
perinatal quality collaboratives in every State, 
the District of Columbia, and eligible terri-
tories, in order to measurably improve perinatal 
care and perinatal health outcomes for preg-
nant and postpartum women and their infants. 
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205 
(B) GRANT
AMOUNTS.—Grants awarded 
under this subsection shall be in amounts not to 
exceed $250,000 per year, for the duration of 
the grant period. 
(C) STATE-BASED
PERINATAL
QUALITY 
COLLABORATIVE
DEFINED.—For purposes of 
this subsection, the term ‘‘State-based perinatal 
quality collaborative’’ means a network of mul-
tidisciplinary teams that— 
(i) work to improve measurable out-
comes for maternal and infant health by 
advancing evidence-informed clinical prac-
tices using quality improvement principles; 
(ii) work with hospital-based or out-
patient facility-based clinical teams, ex-
perts, and stakeholders, including patients 
and families, to spread best practices and 
optimize resources to improve perinatal 
care and outcomes; 
(iii) employ strategies that include the 
use of the collaborative learning model to 
provide opportunities for hospitals and 
clinical teams to collaborate on improve-
ment strategies, rapid-response data to 
provide timely feedback to hospital and 
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206 
other clinical teams to track progress, and 
quality improvement science to provide 
support and coaching to hospital and clin-
ical teams; and 
(iv) have the goal of improving popu-
lation-level outcomes in maternal and in-
fant health. 
(D) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For purposes of carrying out this sub-
section, there is authorized to be appropriated 
$14,000,000 per year for each of fiscal years 
2021 through 2025. 
(5) EXPANSION OF MEDICAID AND CHIP COV-
ERAGE FOR PREGNANT AND POSTPARTUM WOMEN.— 
(A) 
REQUIRING
COVERAGE
OF
ORAL 
HEALTH
SERVICES
FOR
PREGNANT
AND 
POSTPARTUM WOMEN.— 
(i) MEDICAID.—Section 1905 of the 
Social Security Act (42 U.S.C. 1396d) is 
amended— 
(I) in subsection (a)(4)— 
(aa) by striking ‘‘; and (D)’’ 
and inserting ‘‘; (D)’’; and 
(bb) by inserting ‘‘; and (E) 
oral health services for pregnant 
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207 
and postpartum women (as de-
fined in subsection (ee))’’ after 
‘‘subsection (bb))’’; and 
(II) by adding at the end the fol-
lowing new subsection: 
‘‘(ee) ORAL HEALTH SERVICES FOR PREGNANT AND 
POSTPARTUM WOMEN.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘oral health services for pregnant and 
postpartum women’ means dental services necessary 
to prevent disease and promote oral health, restore 
oral structures to health and function, and treat 
emergency conditions that are furnished to a woman 
during pregnancy (or during the 1-year period be-
ginning on the last day of the pregnancy). 
‘‘(2) COVERAGE
REQUIREMENTS.—To satisfy 
the requirement to provide oral health services for 
pregnant and postpartum women, a State shall, at 
a minimum, provide coverage for preventive, diag-
nostic, periodontal, and restorative care consistent 
with recommendations for perinatal oral health care 
and dental care during pregnancy from the Amer-
ican Academy of Pediatric Dentistry and the Amer-
ican College of Obstetricians and Gynecologists.’’. 
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208 
(ii) CHIP.—Section 2103(c)(5)(A) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1397cc(c)(5)(A)) is amended by inserting 
‘‘or 
a 
targeted 
low-income 
pregnant 
woman’’ after ‘‘targeted low-income child’’. 
(B) EXTENDING MEDICAID COVERAGE FOR 
PREGNANT AND POSTPARTUM WOMEN.—Section 
1902 of the Social Security Act (42 U.S.C. 
1396a) is amended— 
(i) in subsection (e)— 
(I) in paragraph (5)— 
(aa) by inserting ‘‘(including 
oral health services for pregnant 
and postpartum women (as de-
fined in section 1905(ee))’’ after 
‘‘postpartum medical assistance 
under the plan’’; and 
(bb) by striking ‘‘60-day’’ 
and inserting ‘‘1-year’’; and 
(II) in paragraph (6), by striking 
‘‘60-day’’ and inserting ‘‘1-year’’; and 
(ii) in subsection (l)(1)(A), by striking 
‘‘60-day’’ and inserting ‘‘1-year’’. 
(C) EXTENDING MEDICAID COVERAGE FOR 
LAWFUL RESIDENTS.—Section 1903(v)(4)(A) of 
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209 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396b(v)(4)(A)) is amended by striking ‘‘60- 
day’’ and inserting ‘‘1-year’’. 
(D) EXTENDING
CHIP
COVERAGE
FOR 
PREGNANT AND POSTPARTUM WOMEN.—Section 
2112(d)(2)(A) of the Social Security Act (42 
U.S.C. 1397ll(d)(2)(A)) is amended by striking 
‘‘60-day’’ and inserting ‘‘1-year’’. 
(E) MAINTENANCE OF EFFORT.— 
(i) MEDICAID.—Section 1902(l) of the 
Social Security Act (42 U.S.C. 1396a(l)) is 
amended by adding at the end the fol-
lowing new paragraph: 
‘‘(5) During the period that begins on the date of 
enactment of this paragraph and ends on the date that 
is five years after such date of enactment, as a condition 
for receiving any Federal payments under section 1903(a) 
for calendar quarters occurring during such period, a 
State shall not have in effect, with respect to women who 
are eligible for medical assistance under the State plan 
or under a waiver of such plan on the basis of being preg-
nant or having been pregnant, eligibility standards, meth-
odologies, or procedures under the State plan or waiver 
that are more restrictive than the eligibility standards, 
methodologies, or procedures, respectively, under such 
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210 
plan or waiver that are in effect on the date of enactment 
of this paragraph.’’. 
(ii) CHIP.—Section 2105(d) of the 
Social Security Act (42 U.S.C. 1397ee(d)) 
is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(4) IN
ELIGIBILITY
STANDARDS
FOR
TAR-
GETED
LOW-INCOME
PREGNANT
WOMEN.—During 
the period that begins on the date of enactment of 
this paragraph and ends on the date that is five 
years after such date of enactment, as a condition 
of receiving payments under subsection (a) and sec-
tion 1903(a), a State that elects to provide assist-
ance to women on the basis of being pregnant (in-
cluding pregnancy-related assistance provided to tar-
geted low-income pregnant women (as defined in 
section 2112(d)), pregnancy-related assistance pro-
vided to women who are eligible for such assistance 
through application of section 1902(v)(4)(A)(i) 
under section 2107(e)(1), or any other assistance 
under the State child health plan (or a waiver of 
such plan) which is provided to women on the basis 
of being pregnant) shall not have in effect, with re-
spect to such women, eligibility standards, meth-
odologies, or procedures under such plan (or waiver) 
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211 
that are more restrictive than the eligibility stand-
ards, methodologies, or procedures, respectively, 
under such plan (or waiver) that are in effect on the 
date of enactment of this paragraph.’’. 
(F) INFORMATION
ON
BENEFITS.—The 
Secretary of Health and Human Services shall 
make publicly available on the internet website 
of the Department of Health and Human Serv-
ices, information regarding benefits available to 
pregnant and postpartum women and under the 
Medicaid program and the Children’s Health 
Insurance Program, including information on— 
(i) benefits that States are required to 
provide 
to 
pregnant 
and 
postpartum 
women under such programs; 
(ii) optional benefits that States may 
provide 
to 
pregnant 
and 
postpartum 
women under such programs; and 
(iii) the availability of different kinds 
of benefits for pregnant and postpartum 
women, including oral health and mental 
health benefits, under such programs. 
(G) FEDERAL FUNDING FOR COST OF EX-
TENDED MEDICAID AND CHIP COVERAGE FOR 
POSTPARTUM WOMEN.— 
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212 
(i) MEDICAID.—Section 1905 of the 
Social Security Act (42 U.S.C. 1396d), as 
amended by paragraph (1), is further 
amended— 
(I) in subsection (b), by striking 
‘‘and (aa)’’ and inserting ‘‘(aa), and 
(ff)’’; and 
(II) by adding at the end the fol-
lowing: 
‘‘(ff) INCREASED FMAP FOR EXTENDED MEDICAL 
ASSISTANCE
FOR
POSTPARTUM
WOMEN.—Notwith-
standing subsection (b), the Federal medical assistance 
percentage for a State, with respect to amounts expended 
by such State for medical assistance for a woman who is 
eligible for such assistance on the basis of being pregnant 
or having been pregnant that is provided during the 305- 
day period that begins on the 60th day after the last day 
of her pregnancy (including any such assistance provided 
during the month in which such period ends), shall be 
equal to— 
‘‘(1) 100 percent for the first 20 calendar quar-
ters during which this subsection is in effect; and 
‘‘(2) 90 percent for calendar quarters there-
after.’’. 
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213 
(ii) CHIP.—Section 2105(c) of the 
Social Security Act (42 U.S.C. 1397ee(c)) 
is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(12) ENHANCED
PAYMENT
FOR
EXTENDED 
ASSISTANCE
PROVIDED
TO
PREGNANT
WOMEN.— 
Notwithstanding 
subsection 
(b), 
the 
enhanced 
FMAP, with respect to payments under subsection 
(a) for expenditures under the State child health 
plan (or a waiver of such plan) for assistance pro-
vided under the plan (or waiver) to a woman who is 
eligible for such assistance on the basis of being 
pregnant (including pregnancy-related assistance 
provided to a targeted low-income pregnant woman 
(as defined in section 2112(d)), pregnancy-related 
assistance provided to a woman who is eligible for 
such assistance through application of section 
1902(v)(4)(A)(i) under section 2107(e)(1), or any 
other assistance under the plan (or waiver) provided 
to a woman who is eligible for such assistance on the 
basis of being pregnant) during the 305-day period 
that begins on the 60th day after the last day of her 
pregnancy (including any such assistance provided 
during the month in which such period ends), shall 
be equal to— 
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214 
‘‘(A) 100 percent for the first 20 calendar 
quarters during which this paragraph is in ef-
fect; and 
‘‘(B) 90 percent for calendar quarters 
thereafter.’’. 
(H) EFFECTIVE DATE.— 
(i) IN GENERAL.—Subject to subpara-
graph (B), the amendments made by this 
subsection shall take effect on the first day 
of the first calendar quarter that begins on 
or after the date that is one year after the 
date of enactment of this Act. 
(ii) EXCEPTION FOR STATE LEGISLA-
TION.—In the case of a State plan under 
title XIX of the Social Security Act or a 
State child health plan under title XXI of 
such Act that the Secretary of Health and 
Human Services determines requires State 
legislation in order for the respective plan 
to meet any requirement imposed by 
amendments made by this subsection, the 
respective plan shall not be regarded as 
failing to comply with the requirements of 
such title solely on the basis of its failure 
to meet such an additional requirement be-
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215 
fore the first day of the first calendar 
quarter beginning after the close of the 
first regular session of the State legislature 
that begins after the date of enactment of 
this Act. For purposes of the previous sen-
tence, in the case of a State that has a 2- 
year legislative session, each year of the 
session shall be considered to be a separate 
regular session of the State legislature. 
(6) REGIONAL
CENTERS
OF
EXCELLENCE.— 
Part P of title III of the Public Health Service Act 
is amended by adding at the end the following new 
section: 
‘‘SEC. 399V–7. REGIONAL CENTERS OF EXCELLENCE AD-
DRESSING IMPLICIT BIAS AND CULTURAL 
COMPETENCY IN PATIENT-PROVIDER INTER-
ACTIONS EDUCATION. 
‘‘(a) IN GENERAL.—Not later than one year after the 
date of enactment of this section, the Secretary, in con-
sultation with such other agency heads as the Secretary 
determines appropriate, shall award cooperative agree-
ments for the establishment or support of regional centers 
of excellence addressing implicit bias and cultural com-
petency in patient-provider interactions education for the 
purpose of enhancing and improving how health care pro-
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216 
fessionals are educated in implicit bias and delivering cul-
turally competent health care. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a cooper-
ative agreement under subsection (a), an entity shall— 
‘‘(1) be a public or other nonprofit entity speci-
fied by the Secretary that provides educational and 
training opportunities for students and health care 
professionals, which may be a health system, teach-
ing hospital, community health center, medical 
school, school of public health, dental school, social 
work school, school of professional psychology, or 
any other health professional school or program at 
an institution of higher education (as defined in sec-
tion 101 of the Higher Education Act of 1965) fo-
cused on the prevention, treatment, or recovery of 
health conditions that contribute to maternal mor-
tality and the prevention of maternal mortality and 
severe maternal morbidity; 
‘‘(2) demonstrate community engagement and 
participation, such as through partnerships with 
home visiting and case management programs; and 
‘‘(3) provide to the Secretary such information, 
at such time and in such manner, as the Secretary 
may require. 
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217 
‘‘(c) DIVERSITY.—In awarding a cooperative agree-
ment under subsection (a), the Secretary shall take into 
account any regional differences among eligible entities 
and make an effort to ensure geographic diversity among 
award recipients. 
‘‘(d) DISSEMINATION OF INFORMATION.— 
‘‘(1) PUBLIC
AVAILABILITY.—The Secretary 
shall make publicly available on the internet website 
of the Department of Health and Human Services 
information submitted to the Secretary under sub-
section (b)(3). 
‘‘(2) EVALUATION.—The Secretary shall evalu-
ate each regional center of excellence established or 
supported pursuant to subsection (a) and dissemi-
nate the findings resulting from each such evalua-
tion to the appropriate public and private entities. 
‘‘(3) DISTRIBUTION.—The Secretary shall share 
evaluations and overall findings with State depart-
ments of health and other relevant State level offices 
to inform State and local best practices. 
‘‘(e) MATERNAL MORTALITY DEFINED.—In this sec-
tion, the term ‘maternal mortality’ means death of a 
woman that occurs during pregnancy or within the one- 
year period following the end of such pregnancy. 
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218 
‘‘(f) AUTHORIZATION
OF
APPROPRIATIONS.—For 
purposes of carrying out this section, there is authorized 
to be appropriated $5,000,000 for each of fiscal years 
2021 through 2025.’’. 
(7) SPECIAL SUPPLEMENTAL NUTRITION PRO-
GRAM FOR WOMEN, INFANTS, AND CHILDREN.—Sec-
tion 17(d)(3)(A)(ii) of the Child Nutrition Act of 
1966 (42 U.S.C. 1786(d)(3)(A)(ii)) is amended— 
(A) by striking the clause designation and 
heading and all that follows through ‘‘A State’’ 
and inserting the following: 
‘‘(ii) WOMEN.— 
‘‘(I) BREASTFEEDING WOMEN.— 
A State’’; 
(B) in subclause (I) (as so designated), by 
striking ‘‘1 year’’ and all that follows through 
‘‘earlier’’ and inserting ‘‘2 years postpartum’’; 
and 
(C) by adding at the end the following: 
‘‘(II) POSTPARTUM
WOMEN.—A 
State 
may 
elect 
to 
certify 
a 
postpartum woman for a period of 2 
years.’’. 
(8) DEFINITIONS.—In this section: 
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219 
(A) MATERNAL
MORTALITY.—The term 
‘‘maternal mortality’’ means death of a woman 
that occurs during pregnancy or within the one- 
year period following the end of such preg-
nancy. 
(B) SEVERE MATERNAL MORBIDITY.—The 
term ‘‘severe maternal morbidity’’ includes un-
expected outcomes of labor and delivery that re-
sult in significant short-term or long-term con-
sequences to a woman’s health. 
(d) INCREASING EXCISE TAXES ON CIGARETTES AND 
ESTABLISHING EXCISE TAX EQUITY AMONG ALL TO-
BACCO PRODUCT TAX RATES.— 
(1) TAX
PARITY
FOR
ROLL-YOUR-OWN
TO-
BACCO.—Section 5701(g) of the Internal Revenue 
Code of 1986 is amended by striking ‘‘$24.78’’ and 
inserting ‘‘$49.56’’. 
(2) TAX PARITY FOR PIPE TOBACCO.—Section 
5701(f) of the Internal Revenue Code of 1986 is 
amended by striking ‘‘$2.8311 cents’’ and inserting 
‘‘$49.56’’. 
(3) TAX PARITY FOR SMOKELESS TOBACCO.— 
(A) Section 5701(e) of the Internal Rev-
enue Code of 1986 is amended— 
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220 
(i) in paragraph (1), by striking 
‘‘$1.51’’ and inserting ‘‘$26.84’’; 
(ii) in paragraph (2), by striking 
‘‘50.33 cents’’ and inserting ‘‘$10.74’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(3) SMOKELESS TOBACCO SOLD IN DISCRETE 
SINGLE-USE
UNITS.—On discrete single-use units, 
$100.66 per thousand.’’. 
(B) Section 5702(m) of such Code is 
amended— 
(i) in paragraph (1), by striking ‘‘or 
chewing tobacco’’ and inserting ‘‘, chewing 
tobacco, or discrete single-use unit’’; 
(ii) in paragraphs (2) and (3), by in-
serting ‘‘that is not a discrete single-use 
unit’’ before the period in each such para-
graph; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(4) DISCRETE SINGLE-USE UNIT.—The term 
‘discrete single-use unit’ means any product con-
taining tobacco that— 
‘‘(A) is not intended to be smoked; and 
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221 
‘‘(B) is in the form of a lozenge, tablet, 
pill, pouch, dissolvable strip, or other discrete 
single-use or single-dose unit.’’. 
(4) TAX
PARITY
FOR
SMALL
CIGARS.—Para-
graph (1) of section 5701(a) of the Internal Revenue 
Code of 1986 is amended by striking ‘‘$50.33’’ and 
inserting ‘‘$100.66’’. 
(5) TAX PARITY FOR LARGE CIGARS.— 
(A) IN GENERAL.—Paragraph (2) of sec-
tion 5701(a) of the Internal Revenue Code of 
1986 is amended by striking ‘‘52.75 percent’’ 
and all that follows through the period and in-
serting the following: ‘‘$49.56 per pound and a 
proportionate tax at the like rate on all frac-
tional parts of a pound but not less than 
10.066 cents per cigar.’’. 
(B) GUIDANCE.—The Secretary of the 
Treasury, or the Secretary’s delegate, may issue 
guidance regarding the appropriate method for 
determining the weight of large cigars for pur-
poses of calculating the applicable tax under 
section 5701(a)(2) of the Internal Revenue 
Code of 1986. 
(6) TAX PARITY FOR ROLL-YOUR-OWN TOBACCO 
AND CERTAIN PROCESSED TOBACCO.—Subsection (o) 
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222 
of section 5702 of the Internal Revenue Code of 
1986 is amended by inserting ‘‘, and includes proc-
essed tobacco that is removed for delivery or deliv-
ered to a person other than a person with a permit 
provided under section 5713, but does not include 
removals of processed tobacco for exportation’’ after 
‘‘wrappers thereof’’. 
(7) CLARIFYING
TAX
RATE
FOR
OTHER
TO-
BACCO PRODUCTS.— 
(A) IN GENERAL.—Section 5701 of the In-
ternal Revenue Code of 1986 is amended by 
adding at the end the following new subsection: 
‘‘(i) OTHER TOBACCO PRODUCTS.—Any product not 
otherwise described under this section that has been deter-
mined to be a tobacco product by the Food and Drug Ad-
ministration through its authorities under the Family 
Smoking Prevention and Tobacco Control Act shall be 
taxed at a level of tax equivalent to the tax rate for ciga-
rettes on an estimated per use basis as determined by the 
Secretary.’’. 
(B) ESTABLISHING PER USE BASIS.—For 
purposes of section 5701(i) of the Internal Rev-
enue Code of 1986, not later than 12 months 
after the later of the date of the enactment of 
this Act or the date that a product has been de-
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223 
termined to be a tobacco product by the Food 
and Drug Administration, the Secretary of the 
Treasury (or the Secretary of the Treasury’s 
delegate) shall issue final regulations estab-
lishing the level of tax for such product that is 
equivalent to the tax rate for cigarettes on an 
estimated per use basis. 
(8) CLARIFYING
DEFINITION
OF
TOBACCO 
PRODUCTS.— 
(A) IN GENERAL.—Subsection (c) of sec-
tion 5702 of the Internal Revenue Code of 1986 
is amended to read as follows: 
‘‘(c) TOBACCO PRODUCTS.—The term ‘tobacco prod-
ucts’ means— 
‘‘(1) cigars, cigarettes, smokeless tobacco, pipe 
tobacco, and roll-your-own tobacco, and 
‘‘(2) any other product subject to tax pursuant 
to section 5701(i).’’. 
(B) CONFORMING
AMENDMENTS.—Sub-
section (d) of section 5702 of such Code is 
amended by striking ‘‘cigars, cigarettes, smoke-
less tobacco, pipe tobacco, or roll-your-own to-
bacco’’ each place it appears and inserting ‘‘to-
bacco products’’. 
(9) INCREASING TAX ON CIGARETTES.— 
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224 
(A) 
SMALL
CIGARETTES.—Section 
5701(b)(1) of such Code is amended by striking 
‘‘$50.33’’ and inserting ‘‘$100.66’’. 
(B) 
LARGE
CIGARETTES.—Section 
5701(b)(2) of such Code is amended by striking 
‘‘$105.69’’ and inserting ‘‘$211.38’’. 
(10) TAX RATES ADJUSTED FOR INFLATION.— 
Section 5701 of such Code, as amended by sub-
section (g), is amended by adding at the end the fol-
lowing new subsection: 
‘‘(j) INFLATION ADJUSTMENT.— 
‘‘(1) IN GENERAL.—In the case of any calendar 
year beginning after 2021, the dollar amounts pro-
vided under this chapter shall each be increased by 
an amount equal to— 
‘‘(A) such dollar amount, multiplied by 
‘‘(B) the cost-of-living adjustment deter-
mined under section 1(f)(3) for the calendar 
year, determined by substituting ‘calendar year 
2017’ for ‘calendar year 2016’ in subparagraph 
(A)(ii) thereof. 
‘‘(2) ROUNDING.—If any amount as adjusted 
under paragraph (1) is not a multiple of $0.01, such 
amount shall be rounded to the next highest multiple 
of $0.01.’’. 
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225 
(11) FLOOR STOCKS TAXES.— 
(A) IMPOSITION
OF
TAX.—On tobacco 
products manufactured in or imported into the 
United States which are removed before any tax 
increase date and held on such date for sale by 
any person, there is hereby imposed a tax in an 
amount equal to the excess of— 
(i) the tax which would be imposed 
under section 5701 of the Internal Rev-
enue Code of 1986 on the article if the ar-
ticle had been removed on such date, over 
(ii) the prior tax (if any) imposed 
under section 5701 of such Code on such 
article. 
(B) CREDIT AGAINST TAX.—Each person 
shall be allowed as a credit against the taxes 
imposed by paragraph (1) an amount equal to 
$500. Such credit shall not exceed the amount 
of taxes imposed by paragraph (1) on such date 
for which such person is liable. 
(C) LIABILITY FOR TAX AND METHOD OF 
PAYMENT.— 
(i) LIABILITY
FOR
TAX.—A person 
holding tobacco products on any tax in-
crease date to which any tax imposed by 
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226 
paragraph (1) applies shall be liable for 
such tax. 
(ii) METHOD OF PAYMENT.—The tax 
imposed by paragraph (1) shall be paid in 
such manner as the Secretary shall pre-
scribe by regulations. 
(iii) TIME
FOR
PAYMENT.—The tax 
imposed by paragraph (1) shall be paid on 
or before the date that is 120 days after 
the effective date of the tax rate increase. 
(D) 
ARTICLES
IN
FOREIGN
TRADE 
ZONES.—Notwithstanding the Act of June 18, 
1934 (commonly known as the Foreign Trade 
Zone Act, 48 Stat. 998, 19 U.S.C. 81a et seq.), 
or any other provision of law, any article which 
is located in a foreign trade zone on any tax in-
crease date shall be subject to the tax imposed 
by paragraph (1) if— 
(i) internal revenue taxes have been 
determined, or customs duties liquidated, 
with respect to such article before such 
date pursuant to a request made under the 
1st proviso of section 3(a) of such Act; or 
(ii) such article is held on such date 
under the supervision of an officer of the 
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227 
United States Customs and Border Protec-
tion of the Department of Homeland Secu-
rity pursuant to the 2d proviso of such sec-
tion 3(a). 
(E) DEFINITIONS.—For purposes of this 
subsection— 
(i) IN GENERAL.—Any term used in 
this subsection which is also used in sec-
tion 5702 of such Code shall have the 
same meaning as such term has in such 
section. 
(ii) TAX INCREASE DATE.—The term 
‘‘tax increase date’’ means the effective 
date of any increase in any tobacco prod-
uct excise tax rate pursuant to the amend-
ments made by this section (other than 
subsection (j) thereof). 
(iii) SECRETARY.—The term ‘‘Sec-
retary’’ means the Secretary of the Treas-
ury or the Secretary’s delegate. 
(F) CONTROLLED GROUPS.—Rules similar 
to the rules of section 5061(e)(3) of such Code 
shall apply for purposes of this subsection. 
(G) OTHER LAWS APPLICABLE.—All provi-
sions of law, including penalties, applicable with 
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228 
respect to the taxes imposed by section 5701 of 
such Code shall, insofar as applicable and not 
inconsistent with the provisions of this sub-
section, apply to the floor stocks taxes imposed 
by paragraph (1), to the same extent as if such 
taxes were imposed by such section 5701. The 
Secretary may treat any person who bore the 
ultimate burden of the tax imposed by para-
graph (1) as the person to whom a credit or re-
fund under such provisions may be allowed or 
made. 
(12) EFFECTIVE DATES.— 
(A) IN GENERAL.—Except as provided in 
paragraphs (2) through (4), the amendments 
made by this section shall apply to articles re-
moved (as defined in section 5702(j) of the In-
ternal Revenue Code of 1986) after the last day 
of the month which includes the date of the en-
actment of this Act. 
(B) DISCRETE
SINGLE-USE
UNITS
AND 
PROCESSED TOBACCO.—The amendments made 
by subsections (c)(1)(C), (c)(2), and (f) shall 
apply to articles removed (as defined in section 
5702(j) of the Internal Revenue Code of 1986) 
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kjohnson on DSK79L0C42PROD with BILLS
229 
after the date that is 6 months after the date 
of the enactment of this Act. 
(C) LARGE
CIGARS.—The amendments 
made by subsection (e) shall apply to articles 
removed after December 31, 2021. 
(D) OTHER
TOBACCO
PRODUCTS.—The 
amendments made by subsection (g)(1) shall 
apply to products removed after the last day of 
the month which includes the date that the Sec-
retary of the Treasury (or the Secretary of the 
Treasury’s delegate) issues final regulations es-
tablishing the level of tax for such product. 
SEC. 504. ALLOWING FOR MEDICAL ASSISTANCE UNDER 
MEDICAID FOR INMATES DURING 30-DAY PE-
RIOD PRECEDING RELEASE. 
(a) IN GENERAL.—The subdivision (A) following 
paragraph (30) of section 1905(a) of the Social Security 
Act (42 U.S.C. 1396d(a)) is amended by inserting ‘‘and 
except during the 30-day period preceding the date of re-
lease of such individual from such public institution’’ after 
‘‘medical institution’’. 
(b) REPORT.—Not later than June 30, 2022, the 
Medicaid and CHIP Payment and Access Commission 
shall submit a report to Congress on the Medicaid inmate 
exclusion under the subdivision (A) following paragraph 
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kjohnson on DSK79L0C42PROD with BILLS
230 
(30) of section 1905(a) of the Social Security Act (42 
U.S.C. 1396d(a)). Such report may, to the extent prac-
ticable, include the following information: 
(1) The number of incarcerated individuals who 
would otherwise be eligible to enroll for medical as-
sistance under a State plan approved under title 
XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.) (or a waiver of such a plan). 
(2) Access to health care for incarcerated indi-
viduals, including a description of medical services 
generally available to incarcerated individuals. 
(3) A description of current practices related to 
the discharge of incarcerated individuals, including 
how prisons interact with State Medicaid agencies to 
ensure that such individuals who are eligible to en-
roll for medical assistance under a State plan or 
waiver described in paragraph (1) are so enrolled. 
(4) If determined appropriate by the Commis-
sion, recommendations for Congress, the Depart-
ment of Health and Human Services, or States re-
garding the Medicaid inmate exclusion. 
(5) Any other information that the Commission 
determines would be useful to Congress. 
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SEC. 505. PROVIDING FOR IMMEDIATE MEDICAID ELIGI-
BILITY FOR FORMER FOSTER YOUTH. 
Section 1002(a)(2) of the SUPPORT for Patients 
and Communities Act (Public Law 115–271) is amended 
by striking ‘‘January 1, 2023’’ and inserting ‘‘the date 
of enactment of the Ending Health Disparities During 
COVID–19 Act of 2020’’. 
SEC. 506. EXPANDED COVERAGE FOR FORMER FOSTER 
YOUTH. 
(a) COVERAGE CONTINUITY FOR FORMER FOSTER 
CARE CHILDREN UP TO AGE 26.— 
(1) IN GENERAL.—Section 1002(a)(1)(B) of the 
SUPPORT for Patients and Communities Act (Pub-
lic Law 115–271) is amended by striking all that 
follows after ‘‘item (cc),’’ and inserting the following: 
‘‘by striking ‘responsibility of the State’ and all that 
follows through ‘475(8)(B)(iii); and’ and inserting 
‘responsibility of a State on the date of attaining 18 
years of age (or such higher age as such State has 
elected under section 475(8)(B)(iii)), or who were in 
such care at any age but subsequently left such care 
to enter into a legal guardianship with a kinship 
caregiver (without regard to whether kinship guard-
ianship payments are being made on behalf of the 
child under this part) or were emancipated from 
such care prior to attaining age 18;’ ’’. 
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(1) enter into an agreement with the National 
Academies of Sciences, Engineering, and Medicine to 
conduct a study on the development, implementa-
tion, and effectiveness of health information tech-
nology within medically underserved areas (as de-
scribed in subsection (c)); and 
(2) submit a report to Congress describing the 
results of such study, including any recommenda-
tions for legislative or administrative action. 
(b) STUDY.—The study described in subsection 
(a)(1) shall— 
(1) identify barriers to successful implementa-
tion of health information technology in medically 
underserved areas; 
(2) survey a cross-section of individuals in 
medically underserved areas and report their opin-
ions about the various topics of study; 
(3) examine the degree of interoperability 
among health information technology and users of 
health information technology in medically under-
served areas, including patients, providers, and com-
munity services; 
(4) examine the impact of health information 
technology on providing quality care and reducing 
the cost of care to individuals in such areas, includ-
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