I 
110TH CONGRESS 
1ST SESSION H. R. 2357 
To amend the Social Security Act to guarantee comprehensive health care 
coverage for all children born after 2008. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 17, 2007 
Mr. STARK (for himself, Mr. ABERCROMBIE, Ms. BALDWIN, Mr. BERMAN, 
Mrs. CHRISTENSEN, Mr. CLAY, Mr. AL GREEN of Texas, Mr. GENE 
GREEN of Texas, Mr. GRIJALVA, Mr. HASTINGS of Florida, Mr. HIN-
CHEY, Mr. HONDA, Mr. KUCINICH, Ms. MATSUI, Mrs. MCCARTHY of New 
York, Mr. MCDERMOTT, Mr. MCGOVERN, Mr. MCNULTY, Mr. GEORGE 
MILLER of California, Mr. RANGEL, Mr. RUSH, Ms. SCHAKOWSKY, Ms. 
SCHWARTZ, Mr. SHERMAN, and Mr. WU) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addi-
tion to the Committee on Energy and Commerce, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of 
such provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend the Social Security Act to guarantee comprehen-
sive health care coverage for all children born after 2008. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS; FINDINGS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘MediKids Health Insurance Act of 2007’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents; findings. 
Sec. 2. Benefits for all children born after 2008. 
‘‘TITLE XXII—MEDIKIDS PROGRAM 
‘‘Sec. 2201. Eligibility. 
‘‘Sec. 2202. Benefits. 
‘‘Sec. 2203. Premiums. 
‘‘Sec. 2204. MediKids Trust Fund. 
‘‘Sec. 2205. Oversight and accountability. 
‘‘Sec. 2206. Inclusion of care coordination services. 
‘‘Sec. 2207. Administration and miscellaneous. 
Sec. 3. MediKids premium. 
Sec. 4. Refundable credit for certain cost-sharing expenses under MediKids pro-
gram. 
Sec. 5. Report on long-term revenues. 
(c) FINDINGS.—Congress finds the following: 
(1) More than 9 million American children are 
uninsured. 
(2) Children who are uninsured receive less 
medical care and less preventive care and have a 
poorer level of health, which result in lifetime costs 
to themselves and to the entire American economy. 
(3) Although SCHIP and Medicaid are success-
fully extending a health coverage safety net to a 
growing portion of the vulnerable low-income popu-
lation of uninsured children, they alone cannot 
achieve 100 percent health insurance coverage for 
our nation’s children due to inevitable gaps during 
outreach and enrollment, fluctuations in eligibility, 
variations in access to private insurance at all in-
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come levels, and variations in States’ ability to pro-
vide required matching funds. 
(4) As all segments of society continue to be-
come more transient, with many changes in employ-
ment over the working lifetime of parents, the need 
for a reliable safety net of health insurance which 
follows children across State lines, already a major 
problem for the children of migrant and seasonal 
farmworkers, will become a major concern for all 
families in the United States. 
(5) The medicare program has successfully 
evolved over the years to provide a stable, universal 
source of health insurance for the nation’s disabled 
and those over age 65, and provides a tested model 
for designing a program to reach out to America’s 
children. 
(6) The problem of insuring 100 percent of all 
American children could be gradually solved by auto-
matically enrolling all children born after December 
31, 2008, in a program modeled after Medicare (and 
to be known as ‘‘MediKids’’), and allowing those 
children to be transferred into other equivalent or 
better insurance programs, including either private 
insurance, SCHIP, or Medicaid, if they are eligible 
to do so, but maintaining the child’s default enroll-
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ment in MediKids for any times when the child’s ac-
cess to other sources of insurance is lost. 
(7) A family’s freedom of choice to use other in-
surers to cover children would not be interfered with 
in any way, and children eligible for SCHIP and 
Medicaid would continue to be enrolled in those pro-
grams, but the underlying safety net of MediKids 
would always be available to cover any gaps in insur-
ance due to changes in medical condition, employ-
ment, income, or marital status, or other changes af-
fecting a child’s access to alternate forms of insur-
ance. 
(8) The MediKids program can be administered 
without impacting the finances or status of the exist-
ing Medicare program. 
(9) The MediKids benefit package can be tai-
lored to the special needs of children and updated 
over time. 
(10) The financing of the program can be ad-
ministered without difficulty by a yearly payment of 
affordable premiums through a family’s tax filing (or 
adjustment of a family’s earned income tax credit). 
(11) The cost of the program will gradually rise 
as the number of children using MediKids as the in-
surer of last resort increases, and a future Congress 
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always can accelerate or slow down the enrollment 
process as desired, while the societal costs for emer-
gency room usage, lost productivity and work days, 
and poor health status for the next generation of 
Americans will decline. 
(12) Over time 100 percent of American chil-
dren will always have basic health insurance, and we 
can therefore expect a healthier, more equitable, and 
more productive society. 
SEC. 2. BENEFITS FOR ALL CHILDREN BORN AFTER 2008. 
(a) IN GENERAL.—The Social Security Act is amend-
ed by adding at the end the following new title: 
‘‘TITLE XXII—MEDIKIDS 
PROGRAM 
‘‘SEC. 2201. ELIGIBILITY. 
‘‘(a) ELIGIBILITY OF INDIVIDUALS BORN AFTER DE-
CEMBER 31, 2008; ALL CHILDREN UNDER 23 YEARS OF 
AGE IN FIFTH YEAR.—An individual who meets the fol-
lowing requirements with respect to a month is eligible to 
enroll under this title with respect to such month: 
‘‘(1) AGE.— 
‘‘(A) FIRST YEAR.—As of the first day of 
the first year in which this title is effective, the 
individual has not attained 6 years of age. 
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‘‘(B) SECOND YEAR.—As of the first day 
of the second year in which this title is effec-
tive, the individual has not attained 11 years of 
age. 
‘‘(C) THIRD YEAR.—As of the first day of 
the third year in which this title is effective, the 
individual has not attained 16 years of age. 
‘‘(D) FOURTH YEAR.—As of the first day 
of the fourth year in which this title is effective, 
the individual has not attained 21 years of age. 
‘‘(E) FIFTH AND SUBSEQUENT YEARS.— 
As of the first day of the fifth year in which 
this title is effective and each subsequent year, 
the individual has not attained 23 years of age. 
‘‘(2) CITIZENSHIP.—The individual is a citizen 
or national of the United States or is permanently 
residing in the United States under color of law. 
‘‘(b) ENROLLMENT PROCESS.—An individual may 
enroll in the program established under this title only in 
such manner and form as may be prescribed by regula-
tions, and only during an enrollment period prescribed by 
the Secretary consistent with the provisions of this section. 
Such regulations shall provide a process under which— 
‘‘(1) individuals who are born in the United 
States after December 31, 2008, are deemed to be 
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enrolled at the time of birth and a parent or guard-
ian of such an individual is permitted to pre-enroll 
in the month prior to the expected month of birth; 
‘‘(2) individuals who are born outside the 
United States after such date and who become eligi-
ble to enroll by virtue of immigration into (or an ad-
justment of immigration status in) the United 
States are deemed enrolled at the time of entry or 
adjustment of status; 
‘‘(3) eligible individuals may otherwise be en-
rolled at such other times and manner as the Sec-
retary shall specify, including the use of outstationed 
eligibility 
sites 
as 
described 
in 
section 
1902(a)(55)(A) and the use of presumptive eligi-
bility provisions like those described in section 
1920A; and 
‘‘(4) at the time of automatic enrollment of a 
child, the Secretary provides for issuance to a parent 
or custodian of the individual a card evidencing cov-
erage under this title and for a description of such 
coverage. 
The provisions of section 1837(h) apply with respect to 
enrollment under this title in the same manner as they 
apply to enrollment under part B of title XVIII. An indi-
vidual who is enrolled under this title is not eligible to 
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be enrolled under an MA or MA–PD plan under part C 
of title XVIII. 
‘‘(c) DATE COVERAGE BEGINS.— 
‘‘(1) IN GENERAL.—The period during which 
an individual is entitled to benefits under this title 
shall begin as follows, but in no case earlier than 
January 1, 2009: 
‘‘(A) In the case of an individual who is 
enrolled under paragraph (1) or (2) of sub-
section (b), the date of birth or date of obtain-
ing appropriate citizenship or immigration sta-
tus, as the case may be. 
‘‘(B) In the case of another individual who 
enrolls (including pre-enrolls) before the month 
in which the individual satisfies eligibility for 
enrollment under subsection (a), the first day of 
such month of eligibility. 
‘‘(C) In the case of another individual who 
enrolls during or after the month in which the 
individual first satisfies eligibility for enrollment 
under such subsection, the first day of the fol-
lowing month. 
‘‘(2) AUTHORITY
TO
PROVIDE
FOR
PARTIAL 
MONTHS
OF
COVERAGE.—Under regulations, the 
Secretary may, in the Secretary’s discretion, provide 
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for coverage periods that include portions of a 
month in order to avoid lapses of coverage. 
‘‘(3) LIMITATION ON PAYMENTS.—No payments 
may be made under this title with respect to the ex-
penses of an individual enrolled under this title un-
less such expenses were incurred by such individual 
during a period which, with respect to the individual, 
is a coverage period under this section. 
‘‘(d) EXPIRATION OF ELIGIBILITY.—An individual’s 
coverage period under this section shall continue until the 
individual’s enrollment has been terminated because the 
individual no longer meets the requirements of subsection 
(a) (whether because of age or change in immigration sta-
tus). 
‘‘(e) ENTITLEMENT TO MEDIKIDS BENEFITS FOR 
ENROLLED INDIVIDUALS.—An individual enrolled under 
this title is entitled to the benefits described in section 
2202. 
‘‘(f) LOW-INCOME INFORMATION.— 
‘‘(1) INQUIRY OF INCOME.—At the time of en-
rollment of a child under this title, the Secretary 
shall make an inquiry as to whether the family in-
come (as determined for purposes of section 
1905(p)) of the family that includes the child is 
within any of the following income ranges: 
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‘‘(A) UP TO 150 PERCENT OF POVERTY.— 
The income of the family does not exceed 150 
percent of the poverty line for a family of the 
size involved. 
‘‘(B) BETWEEN 150 AND 200 PERCENT OF 
POVERTY.—The income of the family exceeds 
150 percent, but does not exceed 200 percent, 
of such poverty line. 
‘‘(C) BETWEEN 200 AND 300 PERCENT OF 
POVERTY.—The income of the family exceeds 
200 percent, but does not exceed 300 percent, 
of such poverty line. 
‘‘(2) CODING.—If the family income is within a 
range described in paragraph (1), the Secretary 
shall encode in the identification card issued in con-
nection with eligibility under this title a code indi-
cating the range applicable to the family of the child 
involved. 
‘‘(3) PROVIDER VERIFICATION THROUGH ELEC-
TRONIC SYSTEM.—The Secretary also shall provide 
for an electronic system through which providers 
may verify which income range described in para-
graph (1), if any, is applicable to the family of the 
child involved. 
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‘‘(g) CONSTRUCTION.—Nothing in this title shall be 
construed as requiring (or preventing) an individual who 
is enrolled under this title from seeking medical assistance 
under a State medicaid plan under title XIX or child 
health assistance under a State child health plan under 
title XXI. 
‘‘SEC. 2202. BENEFITS. 
‘‘(a) SECRETARIAL
SPECIFICATION
OF
BENEFIT 
PACKAGE.— 
‘‘(1) IN GENERAL.—The Secretary shall specify 
the benefits to be made available under this title 
consistent with the provisions of this section and in 
a manner designed to meet the health needs of en-
rollees. 
‘‘(2) UPDATING.—The Secretary shall update 
the specification of benefits over time to ensure the 
inclusion of age-appropriate benefits to reflect the 
enrollee population. 
‘‘(3) ANNUAL UPDATING.—The Secretary shall 
establish procedures for the annual review and up-
dating of such benefits to account for changes in 
medical practice, new information from medical re-
search, and other relevant developments in health 
science. 
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