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in subsection (a)(15) of section 1905 of such 
Act. 
(B) 
NON-INSTITUTIONALLY-BASED
LONG- 
TERM SERVICES AND SUPPORTS.—Services not 
provided in an institution, including the fol-
lowing: 
(i) Home and community-based serv-
ices provided under subsection (c), (d), or 
(i) of section 1915 of such Act or under a 
waiver under section 1115 of such Act. 
(ii) Home health care services. 
(iii) Personal care services. 
(iv) Services described in subsection 
(a)(26) of section 1905 of such Act (relating 
to PACE program services). 
(v) Self-directed personal assistance 
services described in section 1915(j) of such 
Act. 
(2) BALANCING INCENTIVE PERIOD.—The term 
‘‘balancing incentive period’’ means the period that 
begins on October 1, 2011, and ends on September 30, 
2015. 
(3) POVERTY
LINE.—The term ‘‘poverty line’’ 
has the meaning given that term in section 2110(c)(5) 
of the Social Security Act (42 U.S.C. 1397jj(c)(5)). 
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(4) STATE
MEDICAID
PROGRAM.—The term 
‘‘State Medicaid program’’ means the State program 
for medical assistance provided under a State plan 
under title XIX of the Social Security Act and under 
any waiver approved with respect to such State plan. 
SEC. 10203. EXTENSION OF FUNDING FOR CHIP THROUGH 
FISCAL YEAR 2015 AND OTHER CHIP-RELATED 
PROVISIONS. 
(a) Section 1311(c)(1) of this Act is amended by strik-
ing ‘‘and’’ at the end of subparagraph (G), by striking the 
period at the end of subparagraph (H) and inserting ‘‘; 
and’’, and by adding at the end the following: 
‘‘(I) report to the Secretary at least annu-
ally and in such manner as the Secretary shall 
require, pediatric quality reporting measures 
consistent with the pediatric quality reporting 
measures established under section 1139A of the 
Social Security Act.’’. 
(b) Effective as if included in the enactment of the 
Children’s Health Insurance Program Reauthorization Act 
of 2009 (Public Law 111–3): 
(1) Section 1906(e)(2) of the Social Security Act 
(42 U.S.C. 1396e(e)(2)) is amended by striking 
‘‘means’’ and all that follows through the period and 
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inserting ‘‘has the meaning given that term in section 
2105(c)(3)(A).’’. 
(2)(A) Section 1906A(a) of the Social Security 
Act (42 U.S.C. 1396e–1(a)), is amended by inserting 
before the period the following: ‘‘and the offering of 
such a subsidy is cost-effective, as defined for purposes 
of section 2105(c)(3)(A)’’. 
(B) This Act shall be applied without regard to 
subparagraph (A) of section 2003(a)(1) of this Act 
and that subparagraph and the amendment made by 
that subparagraph are hereby deemed null, void, and 
of no effect. 
(3) Section 2105(c)(10) of the Social Security 
Act (42 U.S.C. 1397ee(c)(10)) is amended— 
(A) in subparagraph (A), in the first sen-
tence, by inserting before the period the fol-
lowing: ‘‘if the offering of such a subsidy is cost- 
effective, as defined for purposes of paragraph 
(3)(A)’’; 
(B) by striking subparagraph (M); and 
(C) by redesignating subparagraph (N) as 
subparagraph (M). 
(4) Section 2105(c)(3)(A) of the Social Security 
Act (42 U.S.C. 1397ee(c)(3)(A)) is amended— 
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(A) in the matter preceding clause (i), by 
striking ‘‘to’’ and inserting ‘‘to—’’; and 
(B) in clause (ii), by striking the period 
and inserting a semicolon. 
(c) Section 2105 of the Social Security Act (42 U.S.C. 
1397ee), as amended by section 2101, is amended— 
(1) in subsection (b), in the second sentence, by 
striking ‘‘2013’’ and inserting ‘‘2015’’; and 
(2) in subsection (d)(3)— 
(A) in subparagraph (A)— 
(i) in the first sentence, by inserting 
‘‘as a condition of receiving payments 
under section 1903(a),’’ after ‘‘2019,’’; 
(ii) in clause (i), by striking ‘‘or’’ at 
the end; 
(iii) by redesignating clause (ii) as 
clause (iii); and 
(iv) by inserting after clause (i), the 
following: 
‘‘(ii) after September 30, 2015, enroll-
ing children eligible to be targeted low-in-
come children under the State child health 
plan in a qualified health plan that has 
been certified by the Secretary under sub-
paragraph (C); or’’; 
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(B) in subparagraph (B), by striking ‘‘pro-
vided coverage’’ and inserting ‘‘screened for eligi-
bility for medical assistance under the State 
plan under title XIX or a waiver of that plan 
and, if found eligible, enrolled in such plan or a 
waiver. In the case of such children who, as a re-
sult of such screening, are determined to not be 
eligible for medical assistance under the State 
plan or a waiver under title XIX, the State shall 
establish procedures to ensure that the children 
are enrolled in a qualified health plan that has 
been certified by the Secretary under subpara-
graph (C) and is offered’’; and 
(C) by adding at the end the following: 
‘‘(C) CERTIFICATION OF COMPARABILITY OF 
PEDIATRIC COVERAGE OFFERED BY QUALIFIED 
HEALTH PLANS.—With respect to each State, the 
Secretary, not later than April 1, 2015, shall re-
view the benefits offered for children and the 
cost-sharing imposed with respect to such bene-
fits by qualified health plans offered through an 
Exchange established by the State under section 
1311 of the Patient Protection and Affordable 
Care Act and shall certify those plans that offer 
benefits for children and impose cost-sharing 
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with respect to such benefits that the Secretary 
determines are at least comparable to the benefits 
offered and cost-sharing protections provided 
under the State child health plan.’’. 
(d)(1) Section 2104(a) of such Act (42 U.S.C. 
1397dd(a)) is amended— 
(A) in paragraph (15), by striking ‘‘and’’ at the 
end; and 
(B) by striking paragraph (16) and inserting the 
following: 
‘‘(16) for fiscal year 2013, $17,406,000,000; 
‘‘(17) for fiscal year 2014, $19,147,000,000; and 
‘‘(18) for fiscal year 2015, for purposes of mak-
ing 2 semi-annual allotments— 
‘‘(A) $2,850,000,000 for the period begin-
ning on October 1, 2014, and ending on March 
31, 2015, and 
‘‘(B) $2,850,000,000 for the period begin-
ning on April 1, 2015, and ending on September 
30, 2015.’’. 
(2)(A) Section 2104(m) of such Act (42 U.S.C. 
1397dd(m)), as amended by section 2102(a)(1), is amend-
ed— 
(i) in the subsection heading, by striking ‘‘2013’’ 
and inserting ‘‘2015’’; 
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(ii) in paragraph (2)— 
(I) in the paragraph heading, by striking 
‘‘2012’’ and inserting ‘‘2014’’; and 
(II) by adding at the end the following: 
‘‘(B) FISCAL YEARS 2013 AND 2014.—Subject 
to paragraphs (4) and (6), from the amount 
made available under paragraphs (16) and (17) 
of subsection (a) for fiscal years 2013 and 2014, 
respectively, the Secretary shall compute a State 
allotment for each State (including the District 
of Columbia and each commonwealth and terri-
tory) for each such fiscal year as follows: 
‘‘(i) REBASING IN FISCAL YEAR 2013.— 
For fiscal year 2013, the allotment of the 
State is equal to the Federal payments to 
the State that are attributable to (and 
countable towards) the total amount of al-
lotments available under this section to the 
State in fiscal year 2012 (including pay-
ments made to the State under subsection 
(n) for fiscal year 2012 as well as amounts 
redistributed to the State in fiscal year 
2012), multiplied by the allotment increase 
factor under paragraph (5) for fiscal year 
2013. 
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‘‘(ii) GROWTH
FACTOR
UPDATE
FOR 
FISCAL YEAR 2014.—For fiscal year 2014, 
the allotment of the State is equal to the 
sum of— 
‘‘(I) the amount of the State allot-
ment under clause (i) for fiscal year 
2013; and 
‘‘(II) the amount of any payments 
made to the State under subsection (n) 
for fiscal year 2013, 
multiplied by the allotment increase factor 
under paragraph (5) for fiscal year 2014.’’; 
(iii) in paragraph (3)— 
(I) in the paragraph heading, by strik-
ing ‘‘2013’’ and inserting ‘‘2015’’; 
(II) in subparagraphs (A) and (B), by 
striking ‘‘paragraph (16)’’ each place it ap-
pears and inserting ‘‘paragraph (18)’’; 
(III) in subparagraph (C)— 
(aa) by striking ‘‘2012’’ each 
place it appears and inserting ‘‘2014’’; 
and 
(bb) by striking ‘‘2013’’ and in-
serting ‘‘2015’’; and 
(IV) in subparagraph (D)— 
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(aa) in clause (i)(I), by striking 
‘‘subsection (a)(16)(A)’’ and inserting 
‘‘subsection (a)(18)(A)’’; and 
(bb) in clause (ii)(II), by striking 
‘‘subsection (a)(16)(B)’’ and inserting 
‘‘subsection (a)(18)(B)’’; 
(iv) in paragraph (4), by striking ‘‘2013’’ 
and inserting ‘‘2015’’; 
(v) in paragraph (6)— 
(I) in subparagraph (A), by striking 
‘‘2013’’ and inserting ‘‘2015’’; and 
(II) in the flush language after and 
below subparagraph (B)(ii), by striking ‘‘or 
fiscal year 2012’’ and inserting ‘‘, fiscal 
year 2012, or fiscal year 2014’’; and 
(vi) in paragraph (8)— 
(I) in the paragraph heading, by strik-
ing ‘‘2013’’ and inserting ‘‘2015’’; and 
(II) by striking ‘‘2013’’ and inserting 
‘‘2015’’. 
(B) Section 2104(n) of such Act (42 U.S.C. 1397dd(n)) 
is amended— 
(i) in paragraph (2)— 
(I) in subparagraph (A)(ii)— 
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(aa) by striking ‘‘2012’’ and inserting 
‘‘2014’’; and 
(bb) by striking ‘‘2013’’ and inserting 
‘‘2015’’; 
(II) in subparagraph (B)— 
(aa) by striking ‘‘2012’’ and inserting 
‘‘2014’’; and 
(bb) by striking ‘‘2013’’ and inserting 
‘‘2015’’; and 
(ii) in paragraph (3)(A), by striking ‘‘or a semi- 
annual allotment period for fiscal year 2013’’ and in-
serting ‘‘fiscal year 2013, fiscal year 2014, or a semi- 
annual allotment period for fiscal year 2015’’. 
(C) Section 2105(g)(4) of such Act (42 U.S.C. 
1397ee(g)(4)) is amended— 
(i) in the paragraph heading, by striking ‘‘2013’’ 
and inserting ‘‘2015’’; and 
(ii) in subparagraph (A), by striking ‘‘2013’’ 
and inserting ‘‘2015’’. 
(D) Section 2110(b) of such Act (42 U.S.C. 1397jj(b)) 
is amended— 
(i) in paragraph (2)(B), by inserting ‘‘except as 
provided in paragraph (6),’’ before ‘‘a child’’; and 
(ii) by adding at the end the following new 
paragraph: 
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‘‘(6) EXCEPTIONS TO EXCLUSION OF CHILDREN 
OF
EMPLOYEES
OF
A
PUBLIC
AGENCY
IN
THE 
STATE.— 
‘‘(A) IN
GENERAL.—A child shall not be 
considered to be described in paragraph (2)(B) 
if— 
‘‘(i) the public agency that employs a 
member of the child’s family to which such 
paragraph applies satisfies subparagraph 
(B); or 
‘‘(ii) subparagraph (C) applies to such 
child. 
‘‘(B) MAINTENANCE OF EFFORT WITH RE-
SPECT TO PER PERSON AGENCY CONTRIBUTION 
FOR FAMILY COVERAGE.—For purposes of sub-
paragraph (A)(i), a public agency satisfies this 
subparagraph if the amount of annual agency 
expenditures made on behalf of each employee en-
rolled in health coverage paid for by the agency 
that includes dependent coverage for the most re-
cent State fiscal year is not less than the amount 
of such expenditures made by the agency for the 
1997 State fiscal year, increased by the percent-
age increase in the medical care expenditure cat-
egory of the Consumer Price Index for All-Urban 
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