I 
109TH CONGRESS 
1ST SESSION H. R. 3040 
To amend titles XIX and XXI of the Social Security Act to permit States 
to cover low-income youth up to age 23. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 22, 2005 
Mr. SNYDER (for himself, Mr. ALLEN, Ms. JACKSON-LEE of Texas, Mr. 
OWENS, Mr. SANDERS, Mr. MCDERMOTT, Mr. ROSS, Mr. HINCHEY, Mrs. 
CHRISTENSEN, and Mr. BERRY) introduced the following bill; which was 
referred to the Committee on Energy and Commerce 
A BILL 
To amend titles XIX and XXI of the Social Security Act 
to permit States to cover low-income youth up to age 23. 
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 ‘‘Health Care for Young 
Adults Act of 2005’’. 
SEC. 2. PROVIDING STATE OPTION FOR SCHIP AND MED-
ICAID COVERAGE OF YOUNG ADULTS UP TO 
AGE 23. 
(a) IN GENERAL.—
(1) MEDICAID.—(A) Section 1902(l)(1)(D) of 
the Social Security Act (42 U.S.C. 1396a(l)(1)(D)) 
is amended by inserting ‘‘(or, at the option of the 
State, who have not attained 20, 21, or 22 years of 
age, as the State may elect)’’ after ‘‘have not at-
tained 19 years of age’’. 
(B) Clause (i) of section 1905(a) of the Social 
Security Act (42 U.S.C. 1396d(a)) is amended by 
striking ‘‘under the age of 21, or, at the option of 
the State, under the age of 20, 19, or 18 as the 
State may choose’’ and inserting ‘‘under the age of 
23, or, at the option of the State, under the age of 
22, 21, 20, 19, or 18 as the State may elect’’. 
(2) SCHIP.—Section 2110(c)(1) of such Act 
(42 U.S.C. 1397jj(c)(1)) is amended by inserting 
after ‘‘19 years of age’’ the following: ‘‘(or, at the 
option of the State and subject to the availability of 
additional allotments under section 2104(d), 20, 21, 
22, or 23 years of age)’’. 
(b) ADDITIONAL SCHIP ALLOTMENTS
FOR PRO-
VIDING COVERAGE OF OPTIONAL YOUNG ADULTS.— 
(1) IN GENERAL.—Section 2104 of such Act 
(42 U.S.C. 1397dd) is amended by inserting after 
subsection (c) the following:
‘‘(d) ADDITIONAL ALLOTMENTS FOR THE PROVISION 
OF COVERAGE TO OPTIONAL YOUNG ADULTS.— 
‘‘(1) APPROPRIATION; TOTAL
ALLOTMENT.— 
For the purpose of providing additional allotments 
to States under this title, there is appropriated, out 
of any money in the Treasury not otherwise appro-
priated, for each of fiscal years 2006 through 2009, 
$500,000,000. 
‘‘(2) STATE AND TERRITORIAL ALLOTMENTS.— 
In addition to the allotments provided under sub-
sections (b) and (c), subject to paragraph (3), of the 
amount available for the additional allotments under 
paragraph (1) for a fiscal year, the Secretary shall 
allot to each State with a State child health plan ap-
proved under this title— 
‘‘(A) in the case of such a State other than 
a commonwealth or territory described in sub-
paragraph (B), the same proportion as the pro-
portion of the State’s allotment under sub-
section (b) (determined without regard to sub-
section (f)) to the total amount of the allot-
ments under subsection (b) for such States eli-
gible for an allotment under this paragraph for 
such fiscal year; and
‘‘(B) in the case of a commonwealth or ter-
ritory described in subsection (c)(3), the same 
proportion as the proportion of the common-
wealth’s or territory’s allotment under sub-
section (c) (determined without regard to sub-
section (f)) to the total amount of the allot-
ments under subsection (c) for commonwealths 
and territories eligible for an allotment under 
this paragraph for such fiscal year. 
‘‘(3) USE OF ADDITIONAL ALLOTMENT.—Addi-
tional allotments provided under this subsection are 
not available for amounts expended before October 
1, 2005. Such amounts are available for amounts ex-
pended on or after such date only for— 
‘‘(A) expenditures described in section 
1905(u)(4)(A); and 
‘‘(B) child health assistance for individuals 
who are targeted low-income children and over 
18 years of age and who are low-income chil-
dren only because of an election by the State 
under section 2110(c)(1).’’. 
(2) CONFORMING AMENDMENTS.—Section 2104 
of such Act (42 U.S.C. 1397dd) is amended—
(A) in subsection (a), in the matter pre-
ceding paragraph (1), by inserting ‘‘subject to 
subsection (d),’’ after ‘‘under this section,’’; 
(B) in subsection (b)(1), by inserting ‘‘and 
subsection (d)’’ after ‘‘Subject to paragraph 
(4)’’; and 
(C) in subsection (c)(1), by inserting ‘‘sub-
ject to subsection (d),’’ after ‘‘for a fiscal 
year,’’. 
(c) MODIFICATION OF MEDICAID CAPS FOR TERRI-
TORIES.—Section 1108 of such Act (42 U.S.C. 1308) is 
amended— 
(1) in subsection (f), by striking ‘‘subsection 
(g)’’ and inserting ‘‘subsections (g) and (h)’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) The Secretary shall provide for such increase in 
the limitations under subsections (f) and (g) with respect 
to each of the territories as may be necessary for each 
such territory to provide for an expansion of medicaid cov-
erage 
to 
young 
adults 
described 
in 
section 
1902(l)(1)(D).’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section apply to items and services furnished on or 
after October 1, 2005, without regard to whether regula-
tions implementing such amendments have been promul-
gated. 
SEC. 3. GRANTS TO IMPLEMENT MEDICAID AND SCHIP EX-
PANSIONS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall provide for grants to States (as de-
fined for purposes of titles XIX and XXI of the Social 
Security Act) in order to enable such States to implement 
expansions of eligibility for children and young adults 
their State medicaid plans under title XIX of the Social 
Security Act and State child health plans under title XXI 
of such Act. Such grants shall be available for planning, 
implementation, and outreach with respect to such ex-
panded eligibility populations. 
(b) TERMS AND CONDITIONS.—Grants under this 
section shall be made available under such terms and con-
ditions, including the approval of a grant application, as 
the Secretary shall specify. 
(c) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to provide for grants under this section. 
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