I
107TH CONGRESS
1ST SESSION
H. R. 2789
To amend title XIX of the Social Security Act to permit States to expand
Medicaid eligibility to uninsured, poor adults.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 2, 2001
Ms. MILLENDER-MCDONALD (for herself and Mr. RANGEL) introduced the
following bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend title XIX of the Social Security Act to permit
States to expand Medicaid eligibility to uninsured, poor
adults.
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 ‘‘Keep America Healthy
Act of 2001’’.
SEC. 2. OPTIONAL MEDICAID COVERAGE OF UNINSURED,
POOR ADULTS.
(a) AVAILABILITY OF MEDICAID COVERAGE FOR UN-
INSURED, POOR ADULTS.—
(1) 
ADDITION
OF
OPTIONAL
COVERAGE
GROUP.—Section 1902(a)(10)(A)(ii) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is
amended—
(A) by striking ‘‘or’’ at the end of sub-
clause (XVII);
(B) by striking the semicolon at the end of
subclause (XVIII) and inserting ‘‘, or’’; and
(C) by adding at the end the following new
subclause:
‘‘(XIX) described in subsection
(cc);’’.
(2) ELIGIBILITY STANDARDS FOR NEW ELIGI-
BILITY GROUP.—Section 1902 of such Act is further
amended by adding at the end the following new
subsection:
‘‘(cc) For purposes of subsection (a)(10)(A)(ii)(XIX),
individuals described in this subsection are individuals who
meet the following requirements:
‘‘(1) The individual is at least 21 years of age
but is under 65 years of age.
‘‘(2) The income of the individual’s family does
not exceed a percentage (not to exceed 200 percent)
specified by the State of the poverty line (as defined
in section 2110(c)(5)) applicable to a family of the
size involved and, at the option of a State, the indi-
vidual’s resources do not exceed such resource level
as the State may establish, so long as such resource
level is not more restrictive than the resources an in-
dividual may have and obtain benefits under the
supplemental security income program under title
XVI.’’.
(b) PROVISION OF ENHANCED FEDERAL MEDICAL
ASSISTANCE AS INCENTIVE FOR STATES TO INCREASE
COVERAGE.—
(1) APPLICATION
OF
ENHANCED
FEDERAL
MEDICAL
ASSISTANCE
PERCENTAGE.—Section
1905(b)(4) of such Act (42 U.S.C. 1396d(b)(4)) is
amended 
by 
inserting 
‘‘or 
section
1902(a)(10)(A)(ii)(XIX)’’ 
after 
‘‘section
1902(a)(10)(A)(ii)(XVIII)’’.
(2) INCREASE
IN
MEDICAID
PAYMENT
LIMIT
FOR
TERRITORIES
TO
ACCOMMODATE
EXPANDED
COVERAGE FOR RESIDENTS OF PUERTO RICO, THE
VIRGIN ISLANDS, GUAM, AMERICAN SAMOA, AND THE
NORTHERN
MARIANA
ISLANDS.—Section 1108 of
such Act (42 U.S.C. 1308) is amended—
(A) in subsection (f), by striking ‘‘sub-
section (g)’’ and inserting ‘‘subsections (g) and
(h)’’; and
(B) by adding at the end the following new
subsection:
‘‘(h) INCREASE IN MEDICAID PAYMENT LIMIT TO
ACCOMMODATE EXPANDED COVERAGE UNDER THE KEEP
AMERICA HEALTHY ACT.—(1) With respect to fiscal year
2002 and each succeeding fiscal year, if Puerto Rico, the
Virgin Islands, Guam, the Northern Mariana Islands, or
American Samoa provides for coverage of individuals
under section 1902(a)(10)(A)(ii)(XIX) in a fiscal year, the
amounts otherwise determined for the respective territory
under subsections (f) and (g) for such fiscal year shall be
increased by a percentage (estimated by the Secretary)
equal to 120 percent of the State average Keep America
Healthy percentage, estimated by the Secretary under
paragraph (2) for the fiscal year involved.
‘‘(2) For each such fiscal year the Secretary shall es-
timate a State average Keep America Healthy percentage
equal to (A) the total Federal payments under title XIX
for the fiscal year for the 50 States and the District of
Columbia that are attributable to individuals made eligible
for benefits under section 1902(a)(10)(A)(ii)(XIX), di-
vided by (B) the total Federal payments under such title
the fiscal year for such States and District.’’.
(c) CONFORMING AND TECHNICAL AMENDMENTS.—
(1) Section 1903(f)(4) of such Act (42 U.S.C.
1396b(f)(4)) 
is 
amended 
by 
inserting
‘‘1902(a)(10)(A)(ii)(XIX),’’ 
after
‘‘1902(a)(10)(A)(ii)(XVIII),’’.
(2) Section 1905(a) of such Act (42 U.S.C.
1396d(a)) is amended, in the matter before paragraph
(1)—
(A) by striking ‘‘or’’ at the end of clause (xi);
(B) by adding ‘‘or’’ at the end of clause (xii);
and
(C) by inserting after clause (xii) the following
new clause:
‘‘(xiii) 
individuals 
described 
in 
section
1902(cc),’’.
(3) Section 1905(u)(4) of such Act (42 U.S.C.
1396d(u)(4)) is amended by inserting before the period
at the end the following: ‘‘for individuals not covered
under section 1902(a)(10)(A)(ii)(XIX)’’.
(4)(A) Section 1902 of such Act (42 U.S.C. 1396a),
as amended by section 702(b) of the Medicare, Medicaid,
and SCHIP Benefits Improvement and Protection Act of
2000 (as enacted into law by section 1(a)(6) of Public Law
106–554), is amended by redesignating the subsection
(aa) added by such section as subsection (bb).
(B) Section 1902(a)(15) of such Act (42 U.S.C.
1396a(a)(15)), as added by section 702(a)(2) of the Medi-
care, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 (as so enacted into law), is amend-
ed by striking ‘‘subsection (aa)’’ and inserting ‘‘subsection
(bb)’’.
(C) Section 1915(b) of such Act (42 U.S.C.
1396n(b)), as amended by section 702(c)(2) of the Medi-
care, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 (as so enacted into law), is amend-
ed by striking ‘‘1902(aa)’’ and inserting ‘‘1902(bb)’’.
(d) EFFECTIVE DATE.—The amendments made by
this section shall take effect on October 1, 2001.
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