I 
113TH CONGRESS 
2D SESSION 
H. R. 4390 
To amend title XIX of the Social Security Act to protect the enrollment 
of incarcerated youth for medical assistance under the Medicaid program, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 3, 2014 
Mr. CA´RDENAS (for himself, Ms. BASS, Mr. GRIJALVA, Ms. NORTON, and Mr. 
RANGEL) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to protect 
the enrollment of incarcerated youth for medical assist-
ance under the Medicaid program, and for other pur-
poses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘At-Risk Youth Med-
icaid Protection Act of 2014’’. 
SEC. 2. AT-RISK YOUTH MEDICAID PROTECTION. 
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396a) is amended— 
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(1) in subsection (a)— 
(A) by striking ‘‘and’’ at the end of para-
graph (80); 
(B) by striking the period at the end of 
paragraph (81) and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (81) the 
following new paragraph: 
‘‘(82) provide that— 
‘‘(A) the State shall not terminate (but 
may suspend) enrollment under a State plan for 
medical assistance for an individual who is an 
eligible juvenile (as defined in subsection (ll)(2)) 
because the juvenile is an inmate of a public in-
stitution (as defined in subsection (ll)(3)); 
‘‘(B) the State shall automatically restore 
enrollment for such medical assistance to such 
an individual upon the individual’s release from 
any such public institution and shall take all 
necessary steps to ensure the enrollment is ef-
fective immediately upon release from such in-
stitution, unless (and until such date as) there 
is a determination that the individual no longer 
meets the eligibility requirements for such med-
ical assistance; and 
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‘‘(C) the State shall process any applica-
tion for medical assistance submitted by, or on 
behalf of, a juvenile who is an inmate of a pub-
lic institution notwithstanding that the juvenile 
is such an inmate.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(ll) JUVENILE; ELIGIBLE JUVENILE; PUBLIC INSTI-
TUTION.—For purposes of subsection (a)(82) and this 
subsection: 
‘‘(1) JUVENILE.—The term ‘juvenile’ means an 
individual who is— 
‘‘(A) under 19 years of age (or such higher 
age as the State has elected under section 
475(8)(B)(iii)); or 
‘‘(B) 
is 
described 
in 
subsection 
(a)(10)(A)(i)(IX). 
‘‘(2) ELIGIBLE JUVENILE.—The term ‘eligible 
juvenile’ means a juvenile who is an inmate of a 
public institution and was enrolled for medical as-
sistance under the State plan immediately before be-
coming an inmate of such a public institution or who 
becomes eligible to enroll for such medical assistance 
while an inmate of a public institution. 
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‘‘(3) INMATE OF A PUBLIC INSTITUTION.—The 
term ‘inmate of a public institution’ has the meaning 
given such term for purposes of applying the sub-
division (A) following paragraph (29) of section 
1905(a), taking into account the exception in such 
subdivision for a patient of a medical institution.’’. 
(b) NO CHANGE IN EXCLUSION FROM MEDICAL AS-
SISTANCE
FOR INMATES
OF PUBLIC INSTITUTIONS.— 
Nothing in this section shall be construed as changing the 
exclusion from medical assistance under the subdivision 
(A) following paragraph (29) of section 1905(a) of the So-
cial Security Act (42 U.S.C. 1396d(a)), including any ap-
plicable restrictions on a State submitting claims for Fed-
eral financial participation under title XIX of such Act 
for such assistance. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by subsection (a) 
shall apply to eligibility and enrollment of juveniles 
who become inmates of public institutions on or 
after the date that is 1 year after the date of the 
enactment of this Act. 
(2) RULE
FOR
CHANGES
REQUIRING
STATE 
LEGISLATION.—In the case of a State plan for med-
ical assistance under title XIX of the Social Security 
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Act which the Secretary of Health and Human Serv-
ices determines requires State legislation (other than 
legislation appropriating funds) in order for the plan 
to meet the additional requirements imposed by the 
amendments made by subsection (a), the State plan 
shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its 
failure to meet these additional requirements before 
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 the en-
actment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
Æ 
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