under this title on the basis that the individual is a quali-
fied 
medicare 
beneficiary 
(as 
defined 
in 
section 
1905(p)(1)), a specified low-income medicare beneficiary, 
or is otherwise eligible for medical assistance for medicare 
cost-sharing or other benefits under title XIX.’’. 
(j) ADDITIONAL FUNDING FOR STATE HEALTH IN-
SURANCE ASSISTANCE PROGRAMS.— 
(1) GRANTS.— 
(A) 
IN
GENERAL.—The 
Secretary 
of 
Health and Human Services (in this subsection 
referred to as the ‘‘Secretary’’) shall use 
amounts made available under subparagraph 
(B) to make grants to States for State health 
insurance assistance programs receiving assist-
ance under section 4360 of the Omnibus Budg-
et Reconciliation Act of 1990. 
(B) FUNDING.—For purposes of making 
grants under this subsection, the Secretary 
shall provide for the transfer, from the Federal 
Hospital Insurance Trust Fund under section 
1817 of the Social Security Act (42 U.S.C. 
1395i) and the Federal Supplementary Medical 
Insurance Trust Fund under section 1841 of 
such Act (42 U.S.C. 1395t), in the same pro-
portion as the Secretary determines under sec-
VerDate Sep 11 2014 
22:00 Oct 16, 2019
Jkt 099200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H4671.IH
H4671
pamtmann on DSKBC07HB2PROD with BILLS
tion 1853(f) of such Act (42 U.S.C. 1395w– 
23(f)), of $50,000,000 to the Centers for Medi-
care & Medicaid Services Program Management 
Account for each of the fiscal years 2021 
through 2025, to remain available until ex-
pended. 
(2) AMOUNT OF GRANTS.—The amount of a 
grant to a State under this subsection from the total 
amount made available under paragraph (1) shall be 
equal to the sum of the amount allocated to the 
State under paragraph (3)(A) and the amount allo-
cated to the State under subparagraph (3)(B). 
(3) ALLOCATION TO STATES.— 
(A) ALLOCATION BASED ON PERCENTAGE 
OF LOW-INCOME BENEFICIARIES.—The amount 
allocated to a State under this subparagraph 
from 2⁄3 of the total amount made available 
under paragraph (1) shall be based on the num-
ber of individuals who meet the requirement 
under 
subsection 
(a)(3)(A)(ii) 
of 
section 
1860D–14 of the Social Security Act (42 
U.S.C. 1395w–114) but who have not enrolled 
to receive a subsidy under such section 1860D– 
14 relative to the total number of individuals 
who meet the requirement under such sub-
VerDate Sep 11 2014 
22:00 Oct 16, 2019
Jkt 099200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H4671.IH
H4671
pamtmann on DSKBC07HB2PROD with BILLS
section (a)(3)(A)(ii) in each State, as estimated 
by the Secretary. 
(B) ALLOCATION BASED ON PERCENTAGE 
OF RURAL BENEFICIARIES.—The amount allo-
cated to a State under this subparagraph from 
1⁄3 of the total amount made available under 
paragraph (1) shall be based on the number of 
part D eligible individuals (as defined in section 
1860D–1(a)(3)(A) of such Act (42 U.S.C. 
1395w–101(a)(3)(A))) residing in a rural area 
relative to the total number of such individuals 
in each State, as estimated by the Secretary. 
(4) PORTION OF GRANT BASED ON PERCENT-
AGE OF LOW-INCOME BENEFICIARIES TO BE USED 
TO PROVIDE OUTREACH TO INDIVIDUALS WHO MAY 
BE
SUBSIDY
ELIGIBLE
INDIVIDUALS
OR
ELIGIBLE 
FOR
THE
MEDICARE
SAVINGS
PROGRAM.—Each 
grant awarded under this subsection with respect to 
amounts allocated under paragraph (3)(A) shall be 
used to provide outreach to individuals who may be 
subsidy eligible individuals (as defined in section 
1860D–14(a)(3)(A) of the Social Security Act (42 
U.S.C. 1395w–114(a)(3)(A))) or eligible for the pro-
gram of medical assistance for payment of the cost 
of medicare cost-sharing under the Medicaid pro-
VerDate Sep 11 2014 
22:00 Oct 16, 2019
Jkt 099200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H4671.IH
H4671
pamtmann on DSKBC07HB2PROD with BILLS
gram pursuant to sections 1902(a)(10)(E) and 1933 
of such Act (42 U.S.C. 1396a(a)(10)(E), 1396u–3). 
(k) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments and repeal made by this 
section take effect on January 1, 2021, and, with re-
spect to title XIX of the Social Security Act, apply 
to calendar quarters beginning on or after January 
1, 2021. 
(2) EXCEPTION FOR STATE LEGISLATION.—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 appro-
priating funds) in order for the plan to meet the ad-
ditional requirements imposed by the amendments 
and repeal made by this section, the State plan shall 
not be regarded as failing to comply with the re-
quirements of such title solely on the basis of its 
failure to meet these additional requirements before 
the first day of the first calendar quarter beginning 
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 
VerDate Sep 11 2014 
22:00 Oct 16, 2019
Jkt 099200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H4671.IH
H4671
pamtmann on DSKBC07HB2PROD with BILLS
legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
Æ 
VerDate Sep 11 2014 
22:00 Oct 16, 2019
Jkt 099200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6301
E:\BILLS\H4671.IH
H4671
pamtmann on DSKBC07HB2PROD with BILLS