206
(1) in subsection (c)(2)(C), by inserting ‘‘part’’
before ‘‘C of title XVIII’’; and
(2) in subsection (d)—
(A) in paragraph (1)(C)(ii), by striking
‘‘Act’’ and inserting ‘‘Regulation’’; and
(B) in paragraph (2)(B), by striking
‘‘1903(t)(3)’’ and inserting ‘‘1905(t)(3)’’.
(x) Section 1933(b)(4) (42 U.S.C. 1396u–3(b)(4)) is
amended by inserting ‘‘a’’ after ‘‘for a month in’’.
(y)(1) The section 1908 (42 U.S.C. 1396g–1) that
relates to required laws relating to medical child support
is redesignated as section 1908A.
(2) Section 1902(a)(60) (42 U.S.C. 1396b(a)(60)) is
amended by striking ‘‘1908’’ and inserting ‘‘1908A’’.
(z) Effective October 1, 2004, section 1915(b) (42
U.S.C. 1396n(b)) is amended, in the matter preceding
paragraph (1), by striking ‘‘sections 1902(a)(13)(C) and’’
and inserting ‘‘section’’.
(aa) Effective as if included in the enactment of
BBA—
(1) section 1902(a)(10)(A)(ii)(XIV) (42 U.S.C.
1396a(a)(10)(A)(ii)(XIV)) is amended by striking
‘‘1905(u)(2)(C)’’ and inserting ‘‘1905(u)(2)(B)’’;
(2) section 1903(f)(4) (42 U.S.C. 1396b(f)(4))
is amended, in the matter preceding subparagraph
207
(A), by striking ‘‘1905(p)(1), or 1905(u)’’ and in-
serting 
‘‘1902(a)(10)(A)(ii)(XIII),
1902(a)(10)(A)(ii)(XIV), or 1905(p)(1)’’; and
(3) 
section 
1905(a)(15) 
(42 
U.S.C.
1396d(a)(15)) 
is 
amended 
by 
striking
‘‘1902(a)(31)(A)’’ and inserting ‘‘1902(a)(31)’’.
(bb) Except as otherwise provided, the amendments
made by this section shall take effect on the date of enact-
ment of this Act.
TITLE VII—STATE CHILDREN’S
HEALTH 
INSURANCE 
PRO-
GRAM (SCHIP)
SEC. 701. STABILIZING THE STATE CHILDREN’S HEALTH IN-
SURANCE PROGRAM ALLOTMENT FORMULA.
(a) IN
GENERAL.—Section 2104(b) (42 U.S.C.
1397dd(b)) is amended—
(1) in paragraph (2)(A)—
(A) in clause (i), by striking ‘‘through
2000’’ and inserting ‘‘and 1999’’; and
(B) in clause (ii), by striking ‘‘2001’’ and
inserting ‘‘2000’’;
(2) by amending paragraph (4) to read as fol-
lows:
‘‘(4) FLOORS AND CEILINGS IN STATE ALLOT-
MENTS.—
208
‘‘(A) IN GENERAL.—The proportion of the
allotment under this subsection for a subsection
(b) State (as defined in subparagraph (D)) for
fiscal year 2000 and each fiscal year thereafter
shall be subject to the following floors and ceil-
ings:
‘‘(i) FLOOR
OF
$2,000,000.—A floor
equal to $2,000,000 divided by the total of
the amount available under this subsection
for all such allotments for the fiscal year.
‘‘(ii) ANNUAL FLOOR OF 10 PERCENT
BELOW
PRECEDING
FISCAL
YEAR’S
PRO-
PORTION.—A floor of 90 percent of the
proportion for the State for the preceding
fiscal year.
‘‘(iii) CUMULATIVE FLOOR OF 30 PER-
CENT BELOW THE FY 1999 PROPORTION.—
A floor of 70 percent of the proportion for
the State for fiscal year 1999.
‘‘(iv) CUMULATIVE
CEILING
OF
PERCENT ABOVE FY 1999 PROPORTION.—A
ceiling of 145 percent of the proportion for
the State for fiscal year 1999.
‘‘(B) RECONCILIATION.—
209
‘‘(i) ELIMINATION OF ANY DEFICIT BY
ESTABLISHING
A
PERCENTAGE
INCREASE
CEILING FOR STATES WITH HIGHEST AN-
NUAL
PERCENTAGE
INCREASES.—To the
extent that the application of subpara-
graph (A) would result in the sum of the
proportions of the allotments for all sub-
section (b) States exceeding 1.0, the Sec-
retary shall establish a maximum percent-
age increase in such proportions for all
subsection (b) States for the fiscal year in
a manner so that such sum equals 1.0.
‘‘(ii) 
ALLOCATION
OF
SURPLUS
THROUGH PRO RATA INCREASE.—To the
extent that the application of subpara-
graph (A) would result in the sum of the
proportions of the allotments for all sub-
section (b) States being less than 1.0, the
proportions of such allotments (as com-
puted before the application of floors under
clauses (i), (ii), and (iii) of subparagraph
(A)) for all subsection (b) States shall be
increased in a pro rata manner (but not to
exceed the ceiling established under sub-
paragraph (A)(iv)) so that (after the appli-
210
cation of such floors and ceiling) such sum
equals 1.0.
‘‘(C) 
CONSTRUCTION.—This 
paragraph
shall not be construed as applying to (or taking
into account) amounts of allotments redistrib-
uted under subsection (f).
‘‘(D) DEFINITIONS.—In this paragraph:
‘‘(i) PROPORTION OF ALLOTMENT.—
The term ‘proportion’ means, with respect
to the allotment of a subsection (b) State
for a fiscal year, the amount of the allot-
ment of such State under this subsection
for the fiscal year divided by the total of
the amount available under this subsection
for all such allotments for the fiscal year.
‘‘(ii) SUBSECTION
(b)
STATE.—The
term ‘subsection (b) State’ means one of
the 50 States or the District of Colum-
bia.’’;
(3) in paragraph (2)(B), by striking ‘‘the fiscal
year’’ and inserting ‘‘the calendar year in which
such fiscal year begins’’; and
(4) in paragraph (3)(B), by striking ‘‘the fiscal
year involved’’ and inserting ‘‘the calendar year in
which such fiscal year begins’’.
211
(b) EFFECTIVE DATE.—The amendments made by
this section apply to allotments determined under title
XXI of the Social Security Act (42 U.S.C. 1397aa et seq.)
for fiscal year 2000 and each fiscal year thereafter.
SEC. 702. INCREASED ALLOTMENTS FOR TERRITORIES
UNDER THE STATE CHILDREN’S HEALTH IN-
SURANCE PROGRAM.
Section 2104(c)(4)(B) (42 U.S.C. 1397dd(c)(4)(B))
is amended by inserting ‘‘, $34,200,000 for each of fiscal
years 2000 and 2001, $25,200,000 for each of fiscal years
2002 through 2004, $32,400,000 for each of fiscal years
2005 and 2006, and $40,000,000 for fiscal year 2007’’
before the period.
SEC. 703. IMPROVED DATA COLLECTION AND EVALUA-
TIONS OF THE STATE CHILDREN’S HEALTH
INSURANCE PROGRAM.
(a) FUNDING FOR RELIABLE ANNUAL STATE-BY-
STATE ESTIMATES ON THE NUMBER OF CHILDREN WHO
DO NOT HAVE HEALTH INSURANCE COVERAGE.—Section
2109 (42 U.S.C. 1397ii) is amended by adding at the end
the following:
‘‘(b) ADJUSTMENT TO CURRENT POPULATION SUR-
VEY TO INCLUDE STATE-BY-STATE DATA RELATING TO
CHILDREN WITHOUT HEALTH INSURANCE COVERAGE.—
212
‘‘(1) IN
GENERAL.—The Secretary of Com-
merce shall make appropriate adjustments to the an-
nual Current Population Survey conducted by the
Bureau of the Census in order to produce statis-
tically reliable annual State data on the number of
low-income children who do not have health insur-
ance coverage, so that real changes in the
uninsurance rates of children can reasonably be de-
tected. The Current Population Survey should
produce data under this subsection that categorizes
such children by family income, age, and race or eth-
nicity. The adjustments made to produce such data
shall include, where appropriate, expanding the sam-
ple size used in the State sampling units, expanding
the number of sampling units in a State, and an ap-
propriate verification element.
‘‘(2) APPROPRIATION.—Out of any money in
the Treasury of the United States not otherwise ap-
propriated, there are appropriated $10,000,000 for
fiscal year 2000 and each fiscal year thereafter for
the purpose of carrying out this subsection.’’.
(b) FEDERAL EVALUATION OF STATE CHILDREN’S
HEALTH
INSURANCE
PROGRAMS.—Section 2108 (42
U.S.C. 1397hh) is amended by adding at the end the fol-
lowing:
213
‘‘(c) FEDERAL EVALUATION.—
‘‘(1) IN GENERAL.—The Secretary, directly or
through contracts or interagency agreements, shall
conduct an independent evaluation of 10 States with
approved child health plans.
‘‘(2) SELECTION
OF
STATES.—In selecting
States for the evaluation conducted under this sub-
section, the Secretary shall choose 10 States that
utilize diverse approaches to providing child health
assistance, represent various geographic areas (in-
cluding a mix of rural and urban areas), and contain
a significant portion of uncovered children.
‘‘(3) MATTERS INCLUDED.—In addition to the
elements described in subsection (b)(1), the evalua-
tion conducted under this subsection shall include
each of the following:
‘‘(A) Surveys of the target population (en-
rollees, disenrollees, and individuals eligible for
but not enrolled in the program under this
title).
‘‘(B) Evaluation of effective and ineffective
outreach and enrollment practices with respect
to children (for both the program under this
title and the medicaid program under title
XIX), and identification of enrollment barriers
214
and key elements of effective outreach and en-
rollment practices, including practices that have
successfully enrolled hard-to-reach populations
such as children who are eligible for medical as-
sistance under title XIX but have not been en-
rolled previously in the medicaid program under
that title.
‘‘(C) Evaluation of the extent to which
State medicaid eligibility practices and proce-
dures under the medicaid program under title
XIX are a barrier to the enrollment of children
under that program, and the extent to which
coordination (or lack of coordination) between
that program and the program under this title
affects the enrollment of children under both
programs.
‘‘(D) An assessment of the effect of cost-
sharing on utilization, enrollment, and coverage
retention.
‘‘(E) Evaluation of disenrollment or other
retention issues, such as switching to private
coverage, failure to pay premiums, or barriers
in the recertification process.
‘‘(4) SUBMISSION
TO
CONGRESS.—Not later
than December 31, 2001, the Secretary shall submit
215
to Congress the results of the evaluation conducted
under this subsection.
‘‘(5) FUNDING.—Out of any money in the
Treasury of the United States not otherwise appro-
priated, there are appropriated $10,000,000 for fis-
cal year 2000 for the purpose of conducting the eval-
uation authorized under this subsection. Amounts
appropriated under this paragraph shall remain
available for expenditure through fiscal year 2002.’’.
(c) INSPECTOR GENERAL AUDIT AND GAO REPORT
ON ENROLLEES ELIGIBLE FOR MEDICAID.—Section 2108
(42 U.S.C. 1397hh), as amended by subsection (b), is
amended by adding at the end the following:
‘‘(d) INSPECTOR GENERAL AUDIT AND GAO RE-
PORT.—
‘‘(1) AUDIT.—Beginning with fiscal year 2000,
and every third fiscal year thereafter, the Secretary,
through the Inspector General of the Department of
Health and Human Services, shall audit a sample
from among the States described in paragraph (2)
in order to—
‘‘(A) determine the number, if any,
of enrollees under the plan under this title who
are eligible for medical assistance under title
XIX (other than as optional targeted low-in-
217
(1) IN GENERAL.—Paragraphs (2)(D)(ii) and
(3)(D)(ii)(II) of section 506(a) (42 U.S.C. 706(a))
are each amended by inserting ‘‘or the State plan
under title XXI’’ after ‘‘title XIX’’.
(2) EFFECTIVE DATE.—The amendments made
by paragraph (1) apply to annual reports submitted
under section 506 of the Social Security Act (42
U.S.C. 706) for years beginning after the date of the
enactment of this Act.
(e) COORDINATION
OF DATA SURVEYS
AND RE-
PORTS.—The Secretary of Health and Human Services,
through the Assistant Secretary for Planning and Evalua-
tion, shall establish a clearinghouse for the consolidation
and coordination of all Federal databases and reports re-
garding children’s health.
SEC. 704. REFERENCES TO SCHIP AND STATE CHILDREN’S
HEALTH INSURANCE PROGRAM.
The Secretary of Health and Human Services or any
other Federal officer or employee, with respect to any ref-
erence to the program under title XXI of the Social Secu-
rity Act (42 U.S.C. 1397aa et seq.) in any publication or
other official communication, shall use—
(1) the term ‘‘SCHIP’’ instead of the term
‘‘CHIP’’; and
218
(2) the term ‘‘State children’s health insurance
program’’ instead of the term ‘‘children’s health in-
surance program’’.
SEC. 705. SCHIP TECHNICAL CORRECTIONS.
(a) 
Section 
2104(b)(3)(B) 
(42 
U.S.C.
1397dd(b)(3)(B)) is amended by striking ‘‘States.’’ and
inserting ‘‘States,’’.
(b) 
Section 
2105(d)(2)(B)(iii) 
(42 
U.S.C.
1397ee(d)(2)(B)(iii)) is amended by inserting ‘‘in’’ after
‘‘described’’.
(c) 
Section 
2109(a) 
(42 
U.S.C.1397ii(a)) 
is
amended—
(1) in paragraph (1), by striking ‘‘title II’’ and
inserting ‘‘title I’’; and
(2) in paragraph (2), by inserting ‘‘)’’ before
the period.
Æ