I 
116TH CONGRESS 
1ST SESSION 
H. R. 260 
To extend the Medicaid Money Follows the Person Rebalancing demonstra-
tion, to extend protection for Medicaid recipients of home and commu-
nity-based services against spousal impoverishment, to extend the Tem-
porary Assistance for Needy Families program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 4, 2019 
Mr. PALLONE (for himself, Mr. WALDEN, and Mr. NEAL) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committees on Energy and Commerce, and the 
Budget, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To extend the Medicaid Money Follows the Person Rebal-
ancing demonstration, to extend protection for Medicaid 
recipients of home and community-based services against 
spousal impoverishment, to extend the Temporary Assist-
ance for Needy Families 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, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicaid Provisions 
and TANF Extenders Act of 2019’’. 
TITLE I—MEDICAID EXTENDERS 
SEC. 101. EXTENSION OF MONEY FOLLOWS THE PERSON 
REBALANCING DEMONSTRATION. 
(a) GENERAL FUNDING.—Section 6071(h) of the 
Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) is 
amended— 
(1) in paragraph (1)— 
(A) in subparagraph (D), by striking 
‘‘and’’ after the semicolon; 
(B) in subparagraph (E), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(F) 
subject 
to 
paragraph 
(3), 
$112,000,000 for fiscal year 2019.’’; 
(2) in paragraph (2)— 
(A) by striking ‘‘Amounts made’’ and in-
serting ‘‘Subject to paragraph (3), amounts 
made’’; and 
(B) by striking ‘‘September 30, 2016’’ and 
inserting ‘‘September 30, 2021’’; and 
(3) by adding at the end the following new 
paragraph: 
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‘‘(3) SPECIAL RULE FOR FY 2019.—Funds ap-
propriated under paragraph (1)(F) shall be made 
available for grants to States only if such States 
have an approved MFP demonstration project under 
this section as of December 31, 2018.’’. 
(b) FUNDING FOR QUALITY ASSURANCE AND IM-
PROVEMENT; TECHNICAL
ASSISTANCE; OVERSIGHT.— 
Section 6071(f) of the Deficit Reduction Act of 2005 (42 
U.S.C. 1396a note) is amended by striking paragraph (2) 
and inserting the following: 
‘‘(2) FUNDING.—From the amounts appro-
priated under subsection (h)(1)(F) for fiscal year 
2019, $500,000 shall be available to the Secretary 
for such fiscal year to carry out this subsection.’’. 
(c) TECHNICAL AMENDMENT.—Section 6071(b) of 
the Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) 
is amended by adding at the end the following: 
‘‘(10) 
SECRETARY.—The 
term 
‘Secretary’ 
means the Secretary of Health and Human Serv-
ices.’’. 
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SEC. 102. EXTENSION OF PROTECTION FOR MEDICAID RE-
CIPIENTS OF HOME AND COMMUNITY-BASED 
SERVICES AGAINST SPOUSAL IMPOVERISH-
MENT. 
(a) IN GENERAL.—Section 2404 of Public Law 111– 
148 (42 U.S.C. 1396r–5 note) is amended by striking ‘‘the 
5-year period that begins on January 1, 2014,’’ and in-
serting ‘‘the period beginning on January 1, 2014, and 
ending on March 31, 2019,’’. 
(b) RULE OF CONSTRUCTION.— 
(1) PROTECTING STATE SPOUSAL INCOME AND 
ASSET
DISREGARD
FLEXIBILITY
UNDER
WAIVERS 
AND PLAN AMENDMENTS.—Nothing in section 2404 
of Public Law 111–148 (42 U.S.C. 1396r–5 note) or 
section 1924 of the Social Security Act (42 U.S.C. 
1396r–5) shall be construed as prohibiting a State 
from disregarding an individual’s spousal income 
and assets under a State waiver or plan amendment 
described in paragraph (2) for purposes of making 
determinations of eligibility for home and commu-
nity-based services or home and community-based 
attendant services and supports under such waiver 
or plan amendment. 
(2) STATE WAIVER OR PLAN AMENDMENT DE-
SCRIBED.—A State waiver or plan amendment de-
scribed in this paragraph is any of the following: 
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(A) A waiver or plan amendment to pro-
vide medical assistance for home and commu-
nity-based services under a waiver or plan 
amendment under subsection (c), (d), or (i) of 
section 1915 of the Social Security Act (42 
U.S.C. 1396n) or under section 1115 of such 
Act (42 U.S.C. 1315). 
(B) A plan amendment to provide medical 
assistance for home and community-based serv-
ices for individuals by reason of being deter-
mined eligible under section 1902(a)(10)(C) of 
such Act (42 U.S.C. 1396a(a)(10)(C)) or by 
reason of section 1902(f) of such Act (42 
U.S.C. 1396a(f)) or otherwise on the basis of a 
reduction of income based on costs incurred for 
medical or other remedial care under which the 
State disregarded the income and assets of the 
individual’s spouse in determining the initial 
and ongoing financial eligibility of an individual 
for such services in place of the spousal impov-
erishment provisions applied under section 1924 
of such Act (42 U.S.C. 1396r–5). 
(C) A plan amendment to provide medical 
assistance for home and community-based at-
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‘‘(A) that is one of the 50 States or the 
District of Columbia; 
‘‘(B) with respect to which the Secretary 
has not approved a State plan amendment sub-
mitted under subsection (a)(2); and 
‘‘(C) that is not operating, on an ongoing 
basis, an asset verification program in accord-
ance with this section.’’. 
SEC. 104. MEDICAID IMPROVEMENT FUND. 
Section 1941(b)(1) of the Social Security Act (42 
U.S.C. 
1396w–1(b)(1)) 
is 
amended 
by 
striking 
‘‘$31,000,000’’ and inserting ‘‘$6,000,000’’. 
SEC. 105. BUDGETARY EFFECTS. 
(a) STATUTORY PAYGO SCORECARDS.—The budg-
etary effects of this title shall not be entered on either 
PAYGO scorecard maintained pursuant to section 4(d) of 
the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 
933(d)). 
(b) SENATE PAYGO SCORECARDS.—The budgetary 
effects of this title shall not be entered on any PAYGO 
scorecard maintained for purposes of section 4106 of H. 
Con. Res. 71 (115th Congress). 
(c) CLASSIFICATION
OF BUDGETARY EFFECTS.— 
Notwithstanding Rule 3 of the Budget Scorekeeping 
Guidelines set forth in the joint explanatory statement of 
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the committee of conference accompanying Conference Re-
port 105–217 and section 250(c)(8) of the Balanced 
Budget and Emergency Deficit Control Act of 1985, the 
budgetary effects of this title shall not be estimated— 
(1) for purposes of section 251 of the Balanced 
Budget and Emergency Deficit Control Act of 1985; 
and 
(2) for purposes of paragraph (4)(C) of section 
3 of the Statutory Pay-As-You-Go Act of 2010 as 
being included in an appropriation Act. 
(d) PAYGO ANNUAL REPORT.—For the purposes of 
the annual report issued pursuant to section 5 of the Stat-
utory Pay-As-You-Go Act of 2010 (2 U.S.C. 934) after 
adjournment of the second session of the 115th Congress, 
and for determining whether a sequestration order is nec-
essary under such section, the debit for the budget year 
on the 5-year scorecard, if any, and the 10-year scorecard, 
if any, shall be deducted from such scorecard in 2019 and 
added to such scorecard in 2020. 
TITLE II—TANF AND TECHNICAL 
CORRECTIONS 
SEC. 201. TANF PROGRAM EXTENSIONS. 
(a) 
FAMILY
ASSISTANCE
GRANTS.—Section 
403(a)(1) of the Social Security Act (42 U.S.C. 603(a)(1)) 
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is amended in each of subparagraphs (A) and (C) by strik-
ing ‘‘2017 and 2018’’ and inserting ‘‘2019 and 2020’’. 
(b) HEALTHY MARRIAGE PROMOTION AND RESPON-
SIBLE FATHERHOOD GRANTS.—Section 403(a)(2)(D) of 
such Act (42 U.S.C. 603(a)(2)(D)) is amended— 
(1) by striking ‘‘2017 and 2018’’ and inserting 
‘‘2019 and 2020’’; and 
(2) by striking ‘‘for fiscal year 2017 or 2018’’. 
(c) CONTINGENCY FUND.—Section 403(b)(2) of such 
Act (42 U.S.C. 603(b)(2)) is amended by striking ‘‘fiscal 
year 2018’’ and inserting ‘‘each of fiscal years 2019 and 
2020’’. 
(d) TRIBAL FAMILY ASSISTANCE GRANTS.—Para-
graphs (1)(A) and (2)(A) of section 412(a) of such Act 
(42 U.S.C. 612(a)) are each amended by striking ‘‘2017 
and 2018’’ and inserting ‘‘2019 and 2020’’. 
(e) CHILD CARE.—Section 418(a)(3) of such Act (42 
U.S.C. 618(a)(3)) is amended by striking ‘‘2017 and 
2018’’ and inserting ‘‘2019 and 2020’’. 
(f) 
GRANTS
TO
THE
TERRITORIES.—Section 
1108(b)(2) of such Act (42 U.S.C. 1308(b)(2)) is amend-
ed by striking ‘‘2017 and 2018’’ and inserting ‘‘2019 and 
2020’’. 
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SEC. 202. MEASURING AND UNDERSTANDING OUTCOMES. 
(a) IN GENERAL.—Section 411(a) of the Social Secu-
rity Act (42 U.S.C. 611(a)) is amended by redesignating 
paragraph (7) as paragraph (8) and inserting after para-
graph (6) the following: 
‘‘(7) REPORT ON ENGAGEMENT, EMPLOYMENT 
AND OUTCOMES.— 
‘‘(A) 
REPORTING
AGREEMENT.—Each 
State and the Secretary shall enter into an 
agreement specifying the manner by which the 
information and data described in this para-
graph shall be collected and reported to the 
Secretary beginning in fiscal year 2020. 
‘‘(i) OUTCOMES FOR EXITING RECIPI-
ENTS.—Information and data regarding 
families who formerly received assistance 
and included a work-eligible individual 
(disaggregated by type of family, reason 
for exit, and participation in work activi-
ties during the preceding fiscal year) under 
the State program funded under this part 
or under any State program funded with 
qualified State expenditures (as defined in 
section 409(a)(7)(B)(i)), with respect to 
the following: 
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‘‘(I) The percentage with at least 
1 formerly work-eligible individual em-
ployed during the 2nd quarter after 
exiting from the program. 
‘‘(II) The percentage with at 
least 1 formerly work-eligible indi-
vidual employed during the 4th quar-
ter after exiting from the program. 
‘‘(III) The median earnings when 
at least 1 formerly work-eligible indi-
vidual is employed during the 2d 
quarter after exiting from the pro-
gram. 
‘‘(IV) The percentage with at 
least 1 formerly work-eligible indi-
vidual employed during any of the 
first 4 quarters after exiting from the 
program. 
‘‘(V) The distribution of income 
and earnings, including relative to 
poverty and deep poverty, for each of 
the first 4 quarters ending after the 
quarter of exit from assistance. 
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‘‘(VI) The percentage who, at the 
time of exit from the program, were 
subject to the following: 
‘‘(aa) A penalty under sec-
tion 407(e). 
‘‘(bb) A sanction or penalty 
described in section 404 or 408. 
‘‘(cc) A penalty or sanction 
not described in item (aa) or 
(bb). 
‘‘(ii) ENGAGEMENT
AND
EMPLOY-
MENT OF CURRENT RECIPIENTS.— 
‘‘(I) WORK-ELIGIBLE
INDIVID-
UALS.—In the case of current work-el-
igible individuals under the State pro-
gram funded under this part or under 
any State program funded with quali-
fied State expenditures (as defined in 
section 409(a)(7)(B)(i)), the following 
information relative to the current 
quarter being reported: 
‘‘(aa) Earnings in each of 
the 4 quarters immediately pre-
ceding the quarter. 
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‘‘(bb) Standard measures of 
employment, earnings, receipt of 
assistance, and participation in 
work activities (as defined in sec-
tion 407(d)) in each of the first 
4 quarters following the quarter. 
‘‘(II) 
ALL
RECIPIENTS.—The 
percentage of recipients of assistance 
under the State program funded 
under this part or under any State 
program funded with qualified State 
expenditures (as defined in section 
409(a)(7)(B)(i)) who have not at-
tained 24 years of age and who obtain 
a high school degree or its recognized 
equivalent while receiving the assist-
ance. 
‘‘(B) STATISTICAL
ADJUSTMENT
MODEL 
FOR EMPLOYMENT OUTCOMES.—The Secretary, 
in consultation with the Secretary of Labor and 
relevant experts, shall develop recommendations 
by March 1, 2020, on how to establish and dis-
seminate an objective statistical model that will 
allow the Secretary to make adjustments to the 
data reported pursuant to subclauses (I) 
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through (IV) of subparagraph (A)(i) of this 
paragraph, based on economic conditions and 
the characteristics of participants. To the ex-
tent practicable, the recommendations shall be 
compatible with the statistical adjustment 
model 
developed 
under 
section 
116(b)(3)(A)(viii) of the Workforce Innovation 
and 
Opportunity 
Act 
(29 
U.S.C. 
3141(b)(3)(A)(viii)) and, with respect to a 
State, the State adjusted levels of performance 
established for the State under that section.’’. 
SEC. 203. TECHNICAL CORRECTIONS TO DATA EXCHANGE 
STANDARDS TO IMPROVE PROGRAM COORDI-
NATION. 
(a) IN GENERAL.—Section 411(d) of the Social Secu-
rity Act (42 U.S.C. 611(d)) is amended to read as follows: 
‘‘(d) DATA EXCHANGE STANDARDS FOR IMPROVED 
INTEROPERABILITY.— 
‘‘(1) DESIGNATION.—The Secretary shall, in 
consultation with an interagency work group estab-
lished by the Office of Management and Budget and 
considering State government perspectives, by rule, 
designate data exchange standards to govern, under 
this part— 
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‘‘(A) necessary categories of information 
that State agencies operating programs under 
State plans approved under this part are re-
quired under applicable Federal law to elec-
tronically exchange with another State agency; 
and 
‘‘(B) Federal reporting and data exchange 
required under applicable Federal law. 
‘‘(2) 
REQUIREMENTS.—The 
data 
exchange 
standards required by paragraph (1) shall, to the ex-
tent practicable— 
‘‘(A) incorporate a widely accepted, non- 
proprietary, searchable, computer-readable for-
mat, such as the eXtensible Markup Language; 
‘‘(B) contain interoperable standards devel-
oped and maintained by intergovernmental 
partnerships, such as the National Information 
Exchange Model; 
‘‘(C) incorporate interoperable standards 
developed and maintained by Federal entities 
with authority over contracting and financial 
assistance; 
‘‘(D) be consistent with and implement ap-
plicable accounting principles; 
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‘‘(E) be implemented in a manner that is 
cost-effective and improves program efficiency 
and effectiveness; and 
‘‘(F) be capable of being continually up-
graded as necessary. 
‘‘(3) RULE
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed to require a 
change to existing data exchange standards found to 
be effective and efficient.’’. 
(b) EFFECTIVE DATE.—Not later than the date that 
is 24 months after the date of the enactment of this sec-
tion, the Secretary of Health and Human Services shall 
issue a proposed rule that— 
(1) identifies federally required data exchanges, 
include specification and timing of exchanges to be 
standardized, and address the factors used in deter-
mining whether and when to standardize data ex-
changes; and 
(2) specifies State implementation options and 
describes future milestones. 
SEC. 204. UNEMPLOYMENT INSURANCE TECHNICAL COR-
RECTIONS. 
Section 306(a) of the Social Security Act (42 U.S.C. 
506(a)) is amended— 
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(1) by striking ‘‘individuals’’ and inserting 
‘‘claimants of regular compensation, including claim-
ants’’; and 
(2) by inserting a comma after ‘‘section 
303(j)’’. 
Æ 
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