I
107TH CONGRESS
1ST SESSION
H. R. 2630
To amend titles XIX and XXI of the Social Security Act to provide for
FamilyCare coverage for parents of enrolled children, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JULY 25, 2001
Mr. DINGELL (for himself, Mr. BROWN of Ohio, Mr. WAXMAN, Mr. STARK,
Mr. GEPHARDT, Mr. ALLEN, Mr. BALDACCI, Mr. DOYLE, Mr. FRANK,
Mr. FROST, Mr. GREEN of Texas, Mr. MORAN of Virginia, Mr. MOORE,
Mr. PALLONE, Ms. SCHAKOWSKY, Ms. NORTON, Mr. BLAGOJEVICH, Mr.
RUSH, Mr. TOWNS, Mr. STRICKLAND, Mr. KLECZKA, Mr. BOUCHER,
Mrs. CHRISTENSEN, Mrs. THURMAN, Mr. ENGEL, Mr. TIERNEY, Mr.
JOHN, Mr. MARKEY, Mr. WATT of North Carolina, Mr. OWENS, Mr.
WYNN, Mr. NADLER, Mrs. CAPPS, Mr. MCGOVERN, Mr. GEORGE MILLER
of California, Mr. KILDEE, and Mr. JEFFERSON) introduced the following
bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend titles XIX and XXI of the Social Security Act
to provide for FamilyCare coverage for parents of en-
rolled children, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE OF TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘FamilyCare Act of 2001’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title of title; table of contents.
Sec. 2. Renaming of title XXI program.
Sec. 3. FamilyCare coverage of parents under the medicaid program and title
XXI.
Sec. 4. Automatic enrollment of children born to title XXI parents.
Sec. 5. Optional coverage of legal immigrants under the medicaid program and
title XXI.
Sec. 6. Optional coverage of children through age 20 under the medicaid pro-
gram and title XXI.
Sec. 7. Application of simplified title XXI procedures under the medicaid pro-
gram.
Sec. 8. Improving welfare-to-work transition under the medicaid program.
Sec. 9. Elimination of 100 hour rule and other AFDC-related eligibility restric-
tions.
Sec. 10. State grant program for market innovation.
Sec. 11. Limitations on conflicts of interest.
Sec. 12. Increase in CHIP allotment for each of fiscal years 2002 through
2004.
Sec. 13. Demonstration programs to improve medicaid and CHIP outreach to
homeless individuals and families.
Sec. 14. Technical and conforming amendments to authority to pay medicaid
expansion costs from title XXI appropriation.
Sec. 15. Additional CHIP revisions.
Sec. 16. Creation of community access program.
SEC. 2. RENAMING OF TITLE XXI PROGRAM.
(a) IN GENERAL.—The heading of title XXI of the
Social Security Act (42 U.S.C. 1397aa et seq.) is amended
to read as follows:
‘‘TITLE XXI—FAMILYCARE PROGRAM’’.
(b) PROGRAM REFERENCES.—Any reference in any
provision of Federal law or regulation to ‘‘SCHIP’’ or
‘‘State children’s health insurance program’’ under title
XXI of the Social Security Act shall be deemed a reference
to the FamilyCare program under such title.
SEC. 3. FAMILYCARE COVERAGE OF PARENTS UNDER THE
MEDICAID PROGRAM AND TITLE XXI.
(a) INCENTIVES TO IMPLEMENT FAMILYCARE COV-
ERAGE.—
(1) UNDER MEDICAID.—
(A) ESTABLISHMENT OF NEW OPTIONAL
ELIGIBILITY
CATEGORY.—Section
1902(a)(10)(A)(ii) of the Social Security Act
(42 U.S.C. 1396a(a)(10)(A)(ii)) is amended—
(i) by striking ‘‘or’’ at the end of sub-
clause (XVII);
(ii) by adding ‘‘or’’ at the end of sub-
clause (XVIII); and
(iii) by adding at the end the fol-
lowing:
‘‘(XIX) who are individuals de-
scribed in subsection (k)(1) (relating
to parents of categorically eligible chil-
dren);’’.
(B) PARENTS DESCRIBED.—Section 1902
of the Social Security Act is further amended
by inserting after subsection (j) the following:
‘‘(k)(1)(A) Individuals described in this paragraph
are individuals—
‘‘(i) who are the parents of an individual who
is under 19 years of age (or such higher age as the
State may have elected under section 1902(l)(1)(D))
and who is eligible for medical assistance under sub-
section (a)(10)(A);
‘‘(ii) who are not otherwise eligible for medical
assistance under such subsection, under section
1931, or under a waiver approved under section
1115 
or 
otherwise 
(except 
under 
subsection
(a)(10)(A)(ii)(XIX)); and
‘‘(iii) whose family income exceeds the income
level applicable under the State plan under part A
of title IV as in effect as of July 16, 1996, but does
not exceed the highest income level applicable to a
child in the family under this title.
‘‘(B) In establishing an income eligibility level for in-
dividuals described in this paragraph, a State may vary
such level consistent with the various income levels estab-
lished under subsection (l)(2) based on the ages of chil-
dren described in subsection (l)(1) in order to ensure, to
the maximum extent possible, that such individuals shall
be enrolled in the same program as their children.
‘‘(C) An individual may not be treated as being de-
scribed in this paragraph unless, at the time of the individ-
ual’s enrollment under this title, the child referred to in
subparagraph (A)(i) of the individual is also enrolled
under this title.
‘‘(D) In this subsection, the term ‘parent’ includes
an individual treated as a caregiver for purposes of car-
rying out section 1931.
‘‘(2) In the case of a parent described in paragraph
(1) who is also the parent of a child who is eligible for
child health assistance under title XXI, the State may
elect (on a uniform basis) to cover all such parents under
section 2111 or under this title.’’.
(C) ENHANCED MATCHING FUNDS AVAIL-
ABLE IF CERTAIN CONDITIONS MET.—Section
1905 of the Social Security Act (42 U.S.C.
1396d) is amended—
(i) in the fourth sentence of sub-
section (b), by striking ‘‘or subsection
(u)(3)’’ and inserting ‘‘, (u)(3), or (u)(4)’’;
and
(ii) in subsection (u)—
(I) by redesignating paragraph
(4) as paragraph (6), and
(II) by inserting after paragraph
(3) the following:
‘‘(4) For purposes of subsection (b) and section
2105(a)(1):
‘‘(A) FAMILYCARE
PARENTS.—The expendi-
tures described in this subparagraph are the expend-
itures described in the following clauses (i) and (ii):
‘‘(i) PARENTS.—If the conditions described
in clause (iii) are met, expenditures for medical
assistance for parents described in section
1902(k)(1) and for parents who would be de-
scribed in such section but for the fact that
they are eligible for medical assistance under
section 1931 or under a waiver approved under
section 1115.
‘‘(ii) CERTAIN
PREGNANT
WOMEN.—Ex-
penditures for medical assistance for pregnant
women under section 1902(l)(1)(A) in a family
the income of which exceeds the income level
applicable under section 1902(l)(2)(A) to a
family of the size involved as of January 1,
2000.
‘‘(iii) CONDITIONS.—The conditions de-
scribed in this clause are the following:
‘‘(I) The State has a State child
health plan under title XXI which (wheth-
er implemented under such title or under
this title) has an effective income level for
children that is at least 200 percent of the
poverty line.
‘‘(II) Such State child health plan
does not limit the acceptance of applica-
tions, does not use a waiting list for chil-
dren who meet eligibility standards to
qualify for assistance, and provides bene-
fits to all children in the State who apply
for and meet eligibility standards.
‘‘(III) The State plans under this title
and title XXI do not provide coverage for
parents with higher family income without
covering parents with a lower family in-
come.
‘‘(IV) The State does not apply an in-
come level for parents that is lower than
the effective income level (expressed as a
percent of the poverty line) that has been
specified under the State plan under title
XIX (including under a waiver authorized
by 
the 
Secretary 
or 
under 
section
1902(r)(2)), as of January 1, 2000, to be
eligible for medical assistance as a parent
under this title.
‘‘(iv) DEFINITIONS.—For purposes of this
subsection:
‘‘(I) The term ‘parent’ has the mean-
ing given such term for purposes of section
1902(k)(1).
‘‘(II) The term ‘poverty line’ has the
meaning given such term in section
2110(c)(5).’’.
(D) APPROPRIATION FROM TITLE XXI AL-
LOTMENT FOR CERTAIN MEDICAID EXPANSION
COSTS.—Subparagraph 
(B) 
of 
section
2105(a)(1) of the Social Security Act, as
amended by section 14(a), is amended to read
as follows:
‘‘(B) FAMILYCARE
PARENTS.—Expendi-
tures for medical assistance that is attributable
to 
expenditures 
described 
in 
section
1905(u)(4)(A).’’.
(E) ONLY COUNTING ENHANCED PORTION
FOR
COVERAGE
OF
ADDITIONAL
PREGNANT
WOMEN.—Section 1905 of the Social Security
Act (42 U.S.C. 1396d) is amended—
(i) in the fourth sentence of sub-
section (b), by inserting ‘‘(except in the
case of expenditures described in sub-
section (u)(5))’’ after ‘‘do not exceed’’;
(ii) in subsection (u), by inserting
after paragraph (4) (as inserted by sub-
paragraph (C)), the following:
‘‘(5) For purposes of the fourth sentence of sub-
section (b) and section 2105(a), the following payments
under this title do not count against a State’s allotment
under section 2104:
‘‘(A) REGULAR FMAP FOR EXPENDITURES FOR
PREGNANT WOMEN WITH INCOME ABOVE JANUARY
1, 2000 INCOME LEVEL AND BELOW 185 PERCENT OF
POVERTY.—The portion of the payments made for
expenditures described in paragraph (4)(A)(ii) that
represents the amount that would have been paid if
the enhanced FMAP had not been substituted for
the Federal medical assistance percentage.’’.
(2) UNDER TITLE XXI.—
(A) FAMILYCARE COVERAGE.—Title XXI
of the Social Security Act (42 U.S.C. 1397aa et
seq.) is amended by adding at the end the fol-
lowing:
‘‘SEC. 2111. OPTIONAL FAMILYCARE COVERAGE OF PAR-
ENTS OF TARGETED LOW-INCOME CHILDREN.
‘‘(a) OPTIONAL COVERAGE.—Notwithstanding any
other provision of this title, a State child health plan may
provide for coverage, through an amendment to its State
child health plan under section 2102, of FamilyCare as-
sistance for individuals who are targeted low-income par-
ents in accordance with this section, but only if—
‘‘(1) the State meets the conditions described in
section 1905(u)(4)(A)(iii); and
‘‘(2) the State elects to provide medical assist-
ance under section 1902(a)(10)(A)(ii)(XIX), under
section 1931, or under a waiver under section 1115
to individuals described in section 1902(k)(1)(A)(i)
and elects an applicable income level for such indi-
viduals that consistent with paragraphs (1)(B) and
(2) of section 1902(k), ensures to the maximum ex-
tent possible, that those individuals shall be enrolled
in the same program as their children if their chil-
dren are eligible for coverage under title XIX (in-
cluding under a waiver authorized by the Secretary
or under section 1902(r)(2)).’’.
‘‘(b) DEFINITIONS.—For purposes of this title:
‘‘(1) FAMILYCARE
ASSISTANCE.—The term
‘FamilyCare assistance’ has the meaning given the
term child health assistance in section 2110(a) as if
any reference to targeted low-income children were
a reference to targeted low-income parents.
‘‘(2) TARGETED
LOW-INCOME
PARENT.—The
term ‘targeted low-income parent’ has the meaning
given the term targeted low-income child in section
2110(b) as if the reference to a child were deemed
a reference to a parent (as defined in paragraph (3))
of the child; except that in applying such section—
‘‘(A) there shall be substituted for the in-
come level described in paragraph (1)(B)(ii)(I)
the applicable income level in effect for a tar-
geted low-income child;
‘‘(B) in paragraph (3), January 1, 2000,
shall be substituted for July 1, 1997; and
‘‘(C) in paragraph (4), January 1, 2000,
shall be substituted for March 31, 1997.
‘‘(3) PARENT.—The term ‘parent’ includes an
individual treated as a caregiver for purposes of car-
rying out section 1931.
‘‘(4) OPTIONAL
TREATMENT
OF
PREGNANT
WOMEN
AS
PARENTS.—A State child health plan
may treat a pregnant woman who is not otherwise
a parent as a targeted low-income parent for pur-
poses of this section but only if the State has estab-
lished an income level under section 1902(l)(2)(A)(i)