I 
110TH CONGRESS 
2D SESSION 
H. R. 6963 
To amend title XXI of the Social Security Act to expand coverage options 
under the State Children’s Health Insurance Program (SCHIP) through 
premium assistance. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 18, 2008 
Mr. FORTENBERRY (for himself, Mr. BURGESS, Mr. SESSIONS, and Mr. 
TERRY) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means and Education and Labor, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XXI of the Social Security Act to expand 
coverage options under the State Children’s Health In-
surance Program (SCHIP) through premium assistance. 
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 ‘‘SCHIP Plus Act of 
2008’’. 
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SEC. 
2. 
EXPANDING 
COVERAGE 
OPTIONS 
IN 
SCHIP 
THROUGH PREMIUM ASSISTANCE. 
(a) REQUIRING OFFERING OF ALTERNATIVE COV-
ERAGE OPTIONS.—Section 2102 of the Social Security Act 
(42 U.S.C. 1397b) is amended— 
(1) in subsection (a)— 
(A) in paragraph (6), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (7), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
paragraph: 
‘‘(8) effective for plan years beginning on or 
after October 1, 2009, how the plan will provide for 
child health assistance with respect to applicable tar-
geted low-income children through alternative cov-
erage options in accordance with subsection (d).’’; 
and 
(2) by adding at the end the following new sub-
section: 
‘‘(d) ALTERNATIVE COVERAGE OPTIONS.— 
‘‘(1) IN GENERAL.—Effective October 1, 2009, 
a State child health plan shall provide for the offer-
ing of any qualified alternative coverage that a 
qualified entity seeks to offer to applicable targeted 
low-income children through the plan in the State. 
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‘‘(2) APPLICATION
OF
UNIFORM
FINANCIAL 
LIMITATION FOR ALL ALTERNATIVE COVERAGE OP-
TIONS.—With respect to all qualified alternative cov-
erage offered in a State, the State child health plan 
shall establish a uniform dollar limitation on the per 
capita monthly amount that will be paid by the 
State to the qualified entity with respect to such 
coverage provided to a targeted low-income child. 
Such limitation may not be less than 90 percent of 
the per capita monthly payment made for coverage 
offered under the State child health plan that is not 
in the form of an alternative coverage option. Noth-
ing in this paragraph shall be construed— 
‘‘(A) as requiring a State to provide for 
the full payment of premiums for qualified al-
ternative coverage; 
‘‘(B) as preventing a State from charging 
additional premiums to cover the difference be-
tween the cost of qualified alternative coverage 
and the amount of such payment limitation; 
‘‘(C) as preventing a State from using its 
own funds to provide a dollar limitation that ex-
ceeds the Federal financial participation as lim-
ited under section 2105(c)(8). 
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‘‘(3) QUALIFIED ALTERNATIVE COVERAGE DE-
FINED.—In this section, the term ‘qualified alter-
native coverage’ means health insurance coverage 
that— 
‘‘(A) meets the coverage requirements of 
section 2103 (other than cost-sharing require-
ments of such section); and 
‘‘(B) is offered by a qualified insurer, and 
not directly by the State. 
‘‘(4) QUALIFIED
INSURER
DEFINED.—In this 
section, the term ‘qualified insurer’ means, with re-
spect to a State, an entity that is licensed to offer 
health insurance coverage in the State. 
‘‘(5) 
APPLICABLE
TARGETED
LOW-INCOME 
CHILDREN DEFINED.—In this title, the term ‘appli-
cable targeted low-income children’ means targeted 
low-income children with family income that does 
not exceed 200 percent of the poverty line applicable 
to family of the size involved.’’. 
(b) FEDERAL
FINANCIAL
PARTICIPATION
FOR 
QUALIFIED ALTERNATIVE COVERAGE.—Section 2105 of 
such Act (42 U.S.C. 1397d) is amended— 
(1) in subsection (a)(1)(C), by inserting before 
the semicolon at the end the following: ‘‘and, subject 
to paragraph (8)(C), in the form of payment of the 
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