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or (b), and regulate the nature of the eligibility of
such individuals, in order—
(A) to preserve the public health of
communities,
(B) to compensate States for the addi-
tional health care financing burdens created by
such individuals, and
(C) to prevent adverse financial and medi-
cal consequences of uncompensated care,
while inhibiting travel and immigration to the
United States for the sole purpose of obtaining
health care services.
(2) BY STATES.—Any State health security pro-
gram may make individuals described in paragraph
(1) eligible for benefits at the expense of the State.
(d) LAWFUL RESIDENT ALIEN DEFINED.—For pur-
poses of this section, the term ‘‘lawful resident alien’’
means an alien lawfully admitted for permanent residence
and any other alien lawfully residing permanently in the
United States under color of law, including an alien with
lawful temporary resident status under section 210, 210A,
or 234A of the Immigration and Nationality Act (8 U.S.C.
1160, 1161, or 1255a).
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SEC. 103. ENROLLMENT.
(a) IN GENERAL.—Each State health security pro-
gram shall provide a mechanism for the enrollment of indi-
viduals entitled or eligible for benefits under this Act. The
mechanism shall—
(1) include a process for the automatic enroll-
ment of individuals at the time of birth in the
United States and at the time of immigration into
the United States or other acquisition of lawful resi-
dent status in the United States,
(2) provide for the enrollment, as of January 1,
1995, of all individuals who are eligible to be en-
rolled as of such date, and
(3) include a process for the enrollment of indi-
viduals made eligible for health care services under
subsections (b) and (c) of section 102.
(b) AVAILABILITY OF APPLICATIONS.—Each State
health security program shall make applications for enroll-
ment under the program available—
(1) at local offices of the Social Security
Administration,
(2) at social services locations,
(3) at out-reach sites (such as provider and
practitioner locations), and
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(4) at other locations (including post offices
and schools) accessible to a broad cross-section of
individuals eligible to enroll.
(c) ISSUANCE OF HEALTH SECURITY CARDS.—In
conjunction with an individual’s enrollment for benefits
under this Act, the State health security program shall
provide for the issuance of a health security card which
shall be used for purposes of identification and processing
of claims for benefits under the program.
SEC. 104. PORTABILITY OF BENEFITS.
(a) IN GENERAL.—To ensure continuous access to
benefits for health care services covered under this Act,
each State health security program—
(1) shall not impose any minimum period of
residence in the State, or waiting period, in excess
of three months before residents of the State are
entitled to, or eligible for, such benefits under the
program;
(2) shall provide continuation of payment for
covered health care services to individuals who have
terminated their residence in the State and estab-
lished their residence in another State, for the dura-
tion of any waiting period imposed in the State of
new residency for establishing entitlement to, or
eligibility for, such services; and
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(3) shall provide for the payment for health
care services covered under this Act provided to indi-
viduals while temporarily absent from the State, for
reasons other than to obtain the services, based on
the following principles:
(A) Payment for such health care services
is at the rate that is approved by the State
health security program in the State in which
the services are provided, unless the States con-
cerned agree to apportion the cost between
them in a different manner.
(B) Payment for such health care services
provided outside the United States is made on
the basis of the amount that would have been
paid by the State health security program for
similar services rendered in the State, with due
regard, in the case of hospital services, to the
size of the hospital, standards of service, and
other relevant factors.
(b) 
CROSS-BORDER
ARRANGEMENTS.—A 
State
health security program for a State may negotiate with
such a program in an adjacent State a reciprocal arrange-
ment for the coverage under such other program of health
care services to enrollees residing in the border region.
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SEC. 105. EFFECTIVE DATE OF BENEFITS.
Benefits shall first be available under this Act for
items and services furnished on or after January 1, 1995.
SEC. 106. RELATIONSHIP TO EXISTING FEDERAL HEALTH
PROGRAMS.
(a) MEDICARE AND MEDICAID.—
(1) IN GENERAL.—Notwithstanding any other
provision of law, subject to paragraph (2)—
(A) no benefits shall be available under
title XVIII of the Social Security Act for any
item or service furnished after December 31,
1994,
(B) no individual is entitled to medical as-
sistance under a State plan approved under
title XIX of such Act for any item or service
furnished after such date, and
(C) no payment shall be made to a State
under section 1903(a) of such Act with respect
to medical assistance for any item or service
furnished after such date.
(2) TRANSITION.—In the case of inpatient hos-
pital services and extended care services during a
continuous period of stay which began before Janu-
ary 1, 1995, and which had not ended as of such
date, for which benefits are provided under title
XVIII, or under a State plan under title XIX, of the
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Social Security Act, the Secretary of Health and
Human Services and each State plan, respectively,
shall provide for continuation of benefits under such
title or plan until the end of the period of stay.
(b) FEDERAL EMPLOYEES HEALTH BENEFITS PRO-
GRAM.—No benefits shall be made available under chapter
89 of title 5, United States Code, for any part of a cov-
erage period occurring after December 31, 1994.
(c) CHAMPUS.—No benefits shall be made available
under sections 1079 and 1086 of title 10, United States
Code, for items or services furnished after December 31,
1994.
(d) TREATMENT OF BENEFITS FOR VETERANS AND
NATIVE AMERICANS.—Nothing in this Act shall affect the
eligibility of veterans for the medical benefits and services
provided under title 38, United States Code, or of Indians
for the medical benefits and services provided by or
through the Indian Health Service.
TITLE II—COMPREHENSIVE BEN-
EFITS, INCLUDING PREVEN-
TIVE BENEFITS AND BENE-
FITS FOR LONG TERM CARE
SEC. 201. COMPREHENSIVE BENEFITS.
(a) IN GENERAL.—Subject to the succeeding provi-
sions of this title, individuals enrolled for benefits under