I 
111TH CONGRESS 
1ST SESSION H. R. 4260 
To provide adjusted Federal medical assistance percentage rates during a 
transitional assistance period. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 10, 2009 
Mr. GENE GREEN of Texas (for himself, Ms. DEGETTE, Ms. BALDWIN, and 
Mr. ENGEL) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To provide adjusted Federal medical assistance percentage 
rates during a transitional assistance period. 
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 ‘‘Transitional Federal 
Medical Assistance Percentage Act’’. 
SEC. 2. EXTENSION OF ARRA INCREASE IN FMAP. 
Section 5001 of ARRA is amended— 
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(1) in subsection (a)(3), by striking ‘‘first cal-
endar quarter’’ and inserting ‘‘first 3 calendar quar-
ters’’; 
(2) in subsection (b)(2), by inserting before the 
period at the end the following: ‘‘and such para-
graph shall not apply to calendar quarters beginning 
on or after October 1, 2010’’; 
(3) in subsection (d), by inserting ‘‘ending be-
fore October 1, 2010’’ after ‘‘entire fiscal years’’ and 
after ‘‘with respect to fiscal years’’; 
(4) in subsection (g)(1), by striking ‘‘September 
30, 2011’’ and inserting ‘‘December 31, 2011’’; and 
(5) in subsection (h)(3), by striking ‘‘December 
31, 2010’’ and inserting ‘‘June 30, 2011’’. 
SEC. 3. ARRA TRANSITIONAL ASSISTANCE PERIOD. 
For each fiscal quarter occurring during the period 
beginning on July 1, 2011, and ending on December 31, 
2013 (referred to in this Act as the ‘‘ARRA transitional 
assistance period’’), a State’s FMAP shall be equal to the 
sum of— 
(1) the adjusted base FMAP (as determined 
under section 4(a)(1)); 
(2) the general FMAP adjustment (as deter-
mined under section 4(a)(2)); and 
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(3) the unemployment FMAP adjustment (as 
determined under section 4(a)(3)). 
SEC. 4. ADJUSTMENTS TO FEDERAL MEDICAL ASSISTANCE 
PERCENTAGE. 
(a) DETERMINATION OF ADJUSTED FMAP.— 
(1) ADJUSTED BASE FMAP.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the adjusted base FMAP is deter-
mined as follows: 
(i) For the fourth quarter of fiscal 
year 2011, the FMAP that would have ap-
plied to the State under section 5001(a) of 
ARRA (assuming that such section ap-
plied) for such fiscal quarter minus 2 per-
centage points. 
(ii) For any subsequent fiscal quarter 
occurring during the ARRA transitional 
assistance period, the FMAP as deter-
mined under this paragraph for the pre-
ceding fiscal quarter minus 2 percentage 
points. 
(B) ELIMINATION OF NEGATIVE ADJUST-
MENT.—If the adjusted base FMAP applicable 
to a State under this paragraph for any fiscal 
quarter occurring during the ARRA transitional 
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assistance period would be less than the FMAP 
determined for the State for such quarter with-
out regard to this paragraph, this paragraph 
shall not apply to such State. 
(2) GENERAL FMAP ADJUSTMENT.—The gen-
eral FMAP adjustment shall be equal to the fol-
lowing: 
(A) For the fourth quarter of fiscal year 
2011, 5.7 percentage points. 
(B) For the first quarter of fiscal year 
2012, 4.95 percentage points. 
(C) For the second quarter of fiscal year 
2012, 3.95 percentage points. 
(D) For the third quarter of fiscal year 
2012, 2.7 percentage points. 
(E) For the fourth quarter of fiscal year 
2012, 1.2 percentage points. 
(F) For any subsequent fiscal quarter oc-
curring during the ARRA transitional assist-
ance period, 0.2 percentage points. 
(3) UNEMPLOYMENT FMAP ADJUSTMENT.— 
(A) IN
GENERAL.—Subject to subpara-
graphs (C) and (D), the unemployment FMAP 
adjustment shall be equal to the increase in the 
State’s FMAP that would have applied to the 
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State under section 5001(c) of ARRA (assum-
ing that such section applied) for such fiscal 
quarter minus the applicable reduction amount 
(as described under subparagraph (B)). 
(B) APPLICABLE REDUCTION AMOUNT.— 
For purposes of subparagraph (A), the applica-
ble reduction amount shall be equal to the fol-
lowing: 
(i) For the fourth fiscal quarter of fis-
cal year 2011, 0.20 percentage points. 
(ii) For any subsequent fiscal quarter 
occurring during the ARRA transitional 
assistance period, the sum of— 
(I) 
the 
applicable 
reduction 
amount for the preceding fiscal quar-
ter; and 
(II) 0.05 percentage points. 
(C) ELIMINATION OF NEGATIVE ADJUST-
MENT.—If the unemployment FMAP adjust-
ment applicable to a State under this paragraph 
for any fiscal quarter during the ARRA transi-
tional assistance period would be less than zero, 
this paragraph shall not apply to such State. 
(D) SPECIAL RULE.— 
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