I 
114TH CONGRESS 
2D SESSION 
H. R. 6462 
To amend title XIX of the Social Security Act for purposes of prioritizing 
the most vulnerable Medicaid patients. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 7, 2016 
Mr. COLLINS of New York (for himself, Mr. GUTHRIE, Mrs. BLACKBURN, 
Mrs. BROOKS of Indiana, Mr. FLORES, and Mr. MULLIN) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend title XIX of the Social Security Act for purposes 
of prioritizing the most vulnerable Medicaid patients. 
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 ‘‘Prioritizing the Most 
Vulnerable Americans Act’’. 
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SEC. 2. PRIORITIZING THE MOST VULNERABLE MEDICAID 
PATIENTS. 
(a) IN GENERAL.—Section 1115 of the Social Secu-
rity Act (42 U.S.C. 1315) is amended by adding at the 
end the following new subsection: 
‘‘(g) In making a determination using the authority 
under paragraph (2)(A) of subsection (a) (relating to 
treating costs that would not otherwise be included as ex-
penditures under section 1903 and which are not included 
as part of the costs of projects under section 1110 as ex-
penditures under the State plan or plans approved under 
title XIX) to approve an application or renewal of any ex-
perimental, pilot, or demonstration project undertaken 
under such subsection to promote the objectives of title 
XIX (referred to in this subsection as a ‘Medicaid dem-
onstration project’), the Secretary shall— 
‘‘(1) give priority to Medicaid demonstration 
projects that have been proven to be effective in im-
proving the medical care and health outcomes of in-
dividuals who are uninsured, individuals eligible to 
receive medical assistance under a State plan under 
title XIX, or individuals whose household income 
does not exceed 150 percent of the poverty line (as 
defined in section 2110(c)(5)) applicable to a family 
of the size involved; 
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‘‘(2) require that the State submitting such ap-
plication or renewal submit to the Secretary, and 
make publicly available, any available data or 
metrics regarding the health outcomes for the indi-
viduals to be served by such Medicaid demonstration 
project; 
‘‘(3) ensure that such Medicaid demonstration 
project is not duplicative of any Federal program or 
funding opportunity; and 
‘‘(4) require that the State submitting such ap-
plication or renewal submit to the Secretary, and 
make publicly available, an analysis of the degree to 
which such Medicaid demonstration project, if at all, 
precludes efforts undertaken by private sector and 
charitable sector entities to improve medical care 
and health outcomes for the individuals described in 
paragraph (1).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to applications or 
renewals submitted on or after January 1, 2018. 
Æ 
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