I
105TH CONGRESS
1ST SESSION
H. R. 358
To amend title XIX of the Social Security Act to reduce infant mortality
through improvement of coverage of services to pregnant women and
infants under the Medicaid program.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 7, 1997
Mr. TOWNS introduced the following bill; which was referred to the Committee
on Commerce
A BILL
To amend title XIX of the Social Security Act to reduce
infant mortality through improvement of coverage of
services to pregnant women and infants under the Medic-
aid program.
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 ‘‘Medicaid Infant Mor-
tality Amendments of 1997’’.
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SEC. 2. PHASED–IN COVERAGE OF PREGNANT WOMEN AND
INFANTS UP TO 185 PERCENT OF POVERTY
LEVEL.
(a) IN GENERAL.—Section 1902(l)(2)(A) of the So-
cial Security Act (42 U.S.C. 1396a(l)(2)(A)) is amend-
ed—
(1) in clause (ii)—
(A) in subclause (I), by striking ‘‘and’’ at
the end,
(B) by striking the period at the end of
subclause (II) and inserting a comma, and
(C) by adding at the end the following new
subclauses:
‘‘(III) July 1, 1998, 150 percent, or, if greater,
the percentage provided under clause (v), and
‘‘(IV) July 1, 1999, 185 percent.’’; and
(2) by adding at the end the following new
clause:
‘‘(v) In the case of a State which, as of the date of
the enactment of this clause, has established under clause
(i), or has enacted legislation authorizing, or appropriat-
ing funds, to provide for, a percentage (of the income offi-
cial poverty line) that is greater than 150 percent, the per-
centage provided under clause (ii) for medical assistance
on or after July 1, 1998, shall not be less than—
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‘‘(I) the percentage specified by the State in an
amendment to its State plan (whether approved or
not) as of the date of the enactment of this clause,
or
‘‘(II) if no such percentage is specified as of the
date of the enactment of this clause, the percentage
established under the State’s authorized legislation
or provided for under the State’s appropriations.’’.
(b) FLEXIBILITY IN INCOME METHODOLOGY AND
DEDUCTION OF CHILD CARE IN COMPUTATION OF IN-
COME.—Section 1902(l)(3)(E) of such Act (42 U.S.C.
1396a(l)(3)(E)) is amended by striking ‘‘(E)’’ and insert-
ing the following:
‘‘(E)(i) with respect to an individual described
in subparagraph (A) or (B) of paragraph (1), family
income shall be determined in accordance with a
methodology which is no more restrictive than the
methodology employed under the State plan under
part A or E of title IV (except to the extent such
methodology is inconsistent with clause (D) of sub-
section (a)(17) and except that there shall be dis-
regarded costs for such child care as is necessary for
the employment of the pregnant woman or the care-
taker of the infant), and costs incurred for medical
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care or for any other type of remedial care shall not
be taken into account, and
‘‘(ii) with respect to an individual described in
paragraph (1)(C) or (1)(D),’’.
(c) PROHIBITING
APPLICATION
OF
RESOURCE
TEST.—Section 1902(l)(3) of such Act (42 U.S.C.
1396a(l)(3)) is amended—
(1) by amending subparagraph (A) to read as
follows:
‘‘(A)(i) no resource standard or methodology
shall be applied to individuals who are eligible for
medical 
assistance 
because 
of 
subsection
(a)(10)(A)(i)(IV), and (ii) application of a resource
standard or methodology for individuals who are eli-
gible for medical assistance because of subsection
(a)(10)(A)(i)(VI) or (a)(10)(A)(ii)(IX) shall be at
the option of the State, but any such resource stand-
ard or methodology may not be more restrictive than
the corresponding standard or methodology that is
applied under the State plan under part A of title
IV;’’,
(2) by striking subparagraphs (B) and (C), and
(3) by redesignating subparagraphs (D) and
(E) as subparagraphs (B) and (C), respectively.
(d) EFFECTIVE DATES.—
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(1) HIGHER INCOME STANDARDS.—Except as
provided in paragraph (3), the amendments made by
subsection (a) shall apply to payments under title
XIX of the Social Security Act for calendar quarters
beginning on or after July 1, 1998, with respect to
eligibility for medical assistance on or after such
date, without regard to whether or not final regula-
tions to carry out such amendments have been pro-
mulgated by such date.
(2) INCOME
METHODOLOGY
AND
RESOURCE
STANDARD.—Except as provided in paragraph (3),
the amendments made by subsections (b) and (c)
shall apply to payments under title XIX of the So-
cial Security Act for calendar quarters beginning on
or after July 1, 1998, with respect to eligibility for
medical assistance on or after such date, without re-
gard to whether or not final regulations to carry out
such amendments have been promulgated by such
date.
(3) EXCEPTION FOR CERTAIN STATES.—In the
case of a State plan for medical assistance under
title XIX of the Social Security Act which the Sec-
retary of Health and Human Services determines re-
quires State legislation (other than legislation au-
thorizing or appropriating funds) in order for the
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plan to meet the additional requirements imposed by
the amendments made by this section, 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 be-
fore the first day of the first calendar quarter begin-
ning 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.
SEC. 3. OPTIONAL COVERAGE OF PRENATAL AND POST
PARTUM HOME VISITATION SERVICES.
(a) IN GENERAL.—Section 1905(a) of the Social Se-
curity Act (42 U.S.C. 1396d(a)) is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(24),
(2) by redesignating paragraph (25) as para-
graph (26), and
(3) by inserting after paragraph (24) the fol-
lowing new paragraph:
‘‘(25) prenatal home visitation services for high-
risk pregnant women, post partum home visitation
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services with respect to high-risk infants under 1
year of age, or both (as specified by the State), as
prescribed by a physician; and’’
(b) CONFORMING AMENDMENTS.—Section 1902 of
such Act (42 U.S.C. 1396a) is amended—
(1) in subsection (a)(10)(C)(iv), by striking
‘‘(24)’’ and inserting ‘‘(25)’’, and
(2) in subsection (j), by striking ‘‘(25)’’ and in-
serting ‘‘(26)’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
July 1, 1998, without regard to whether or not final regu-
lations to carry out such amendments have been promul-
gated by such date.
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