I 
116TH CONGRESS 
2D SESSION 
H. R. 6539 
To amend title XIX of the Social Security Act to increase Federal support 
to State Medicaid programs during economic downturns, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 17, 2020 
Mrs. LEE of Nevada introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to increase 
Federal support to State Medicaid programs during eco-
nomic downturns, 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. 
This Act may be cited as the ‘‘Coronavirus Medicaid 
Response Act’’. 
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SEC. 2. INCREASING FEDERAL SUPPORT TO STATE MED-
ICAID 
PROGRAMS 
DURING 
ECONOMIC 
DOWNTURNS. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (b), by striking ‘‘and (ff)’’ and 
inserting ‘‘(ff), and (gg)’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(gg) 
INCREASED
FMAP 
DURING
ECONOMIC 
DOWNTURNS.— 
‘‘(1) IN GENERAL.—Notwithstanding subsection 
(b), (y), or (z)(2), if a fiscal quarter that begins on 
or after January 1, 2020, is an economic downturn 
quarter (as defined in paragraph (2)) with respect to 
a State, then the Federal medical assistance percent-
age applicable to amounts expended by the State for 
medical assistance for services furnished during such 
quarter shall be increased in accordance with para-
graphs (3) and (4). 
‘‘(2) ECONOMIC DOWNTURN QUARTER.— 
‘‘(A) IN GENERAL.— 
‘‘(i) IN GENERAL.—In this subsection, 
the term ‘economic downturn quarter’ 
means, with respect to a State, a fiscal 
quarter during which the State’s unem-
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ployment rate for the quarter exceeds the 
percentage determined for the State and 
quarter under clause (ii). 
‘‘(ii) THRESHOLD PERCENTAGE.—The 
percentage determined under this clause 
for a State and fiscal quarter is the per-
centage equal to the lower of— 
‘‘(I) the State unemployment 
rate at the 20th percentile of the dis-
tribution of the State’s quarterly un-
employment rates for the 60-quarter 
period preceding the quarter involved, 
increased by 1 percentage point; and 
‘‘(II) the State’s average quar-
terly unemployment rate for the 12- 
quarter period preceding the quarter 
involved, increased by 1 percentage 
point. 
‘‘(B) UNEMPLOYMENT DATA.— 
‘‘(i) IN
GENERAL.—Except as pro-
vided in clause (ii), for purposes of deter-
mining unemployment rates for a State 
and a quarter under this paragraph, the 
Secretary shall use data from the Local 
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Area Unemployment Statistics from the 
Bureau of Labor Statistics. 
‘‘(ii) APPLICATION TO CERTAIN TER-
RITORIES.—In the case of the Virgin Is-
lands, Guam, the Northern Mariana Is-
lands, or American Samoa, the Secretary 
shall use data from the U–6 unemployment 
measure of the Bureau of Labor Statistics 
to make any necessary determinations 
under subparagraph (A). 
‘‘(3) FMAP 
INCREASE
DURING
ECONOMIC 
DOWNTURN QUARTER.— 
‘‘(A) IN GENERAL.—During a fiscal quar-
ter that is an economic downturn quarter with 
respect to a State, the Federal medical assist-
ance percentage otherwise determined for the 
State and quarter under subsection (b) and, if 
applicable, the Federal medical assistance per-
centage applicable under subsection (y), (z)(2), 
or (ff) with respect to medical assistance fur-
nished by the State during such quarter to indi-
viduals described in either such subsection shall 
be increased by the number of percentage 
points (rounded to the nearest tenth of a per-
centage point) equal to the product of— 
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‘‘(i) the number of percentage points 
(rounded to the nearest tenth of a percent-
age point) by which the unemployment 
rate for the State and quarter exceeds the 
percentage determined for the State and 
quarter under paragraph (2)(A)(ii); and 
‘‘(ii) 4.8. 
‘‘(B) APPLICATION OF COVID–19 FMAP IN-
CREASE.—Any increase applicable to the Fed-
eral medical assistance percentage of a State 
for a fiscal quarter under subparagraph (A) 
shall be in addition to any increase to such per-
centage for such quarter made pursuant to sec-
tion 6008(a) of the Families First Coronavirus 
Response Act. 
‘‘(C) LIMITATION.—In no case shall an in-
crease to the Federal medical assistance per-
centage of a State under this paragraph result 
in a Federal medical assistance percentage that 
exceeds 95 percent. 
‘‘(D) SCOPE
OF
APPLICATION.—Any in-
crease to the Federal medical assistance per-
centage of a State for a fiscal quarter under 
this paragraph shall only apply with respect to 
payments for amounts expended by the State 
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