serting ‘‘(or such higher age as the State has elected under 
section 1902(l)(1)(D))’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section take effect on January 1, 2006, and apply to 
medical assistance and child health assistance provided on 
or after such date, whether or not regulations imple-
menting such amendments have been issued. 
SEC. 106. ALLOWING STATES TO SIMPLIFY RULES FOR FAM-
ILIES. 
(a) PRESUMPTIVE ELIGIBILITY.— 
(1) APPLICATION TO PRESUMPTIVE ELIGIBILITY 
FOR PREGNANT WOMEN UNDER MEDICAID.—Section 
1920(b) of the Social Security Act (42 U.S.C. 
1396r–1(b)) is amended by adding at the end after 
and below paragraph (2) the following flush sen-
tence: ‘‘The term ‘qualified provider’ includes a 
qualified entity as defined in section 1920A(b)(3).’’. 
(2) OPTIONAL APPLICATION OF PRESUMPTIVE 
ELIGIBILITY
PROVISIONS
TO
PARENTS.—Section 
1920A of the Social Security Act (42 U.S.C. 1396r– 
1a) is amended by adding at the end the following: 
‘‘(e) A State may elect to apply the previous provi-
sions of this section to provide for a period of presumptive 
eligibility for medical assistance for a parent of a child
with respect to whom such a period is provided under this 
section.’’. 
(3) APPLICATION UNDER TITLE XXI.—Section 
2107(e)(1)(D) of the Social Security Act (42 U.S.C. 
1397gg(e)(1)) is amended to read as follows: 
‘‘(D) Sections 1920 and 1920A (relating to 
presumptive eligibility).’’. 
(b) 12-MONTHS CONTINUOUS ELIGIBILITY.— 
(1) MEDICAID.—Section 1902(e)(12) of the So-
cial Security Act (42 U.S.C. 1396a(e)(12)) is 
amended— 
(A) by striking ‘‘At the option of the State, 
the plan may’’ and inserting ‘‘The plan shall’’; 
(B) by striking ‘‘an age specified by the 
State (not to exceed 19 years of age)’’ and in-
serting ‘‘19 years of age (or such higher age as 
the 
State 
has 
elected 
under 
subsection 
(l)(1)(D)) or, at the option of the State, who is 
eligible for medical assistance as the parent of 
such a child’’; and 
(C) in subparagraph (A), by striking ‘‘a 
period (not to exceed 12 months) ’’ and insert-
ing ‘‘the 12-month period beginning on the 
date’’.
(2) TITLE
XXI.—Section 2102(b)(2) of such 
Act (42 U.S.C. 1397bb(b)(2)) is amended by adding 
at the end the following: ‘‘Such methods shall pro-
vide continuous eligibility for children under this 
title in a manner that is no less generous than the 
12-months continuous eligibility provided under sec-
tion 1902(e)(12) for children described in such sec-
tion under title XIX. If a State has elected to apply 
section 1902(e)(12) to parents, such methods may 
provide continuous eligibility for parents under this 
title in a manner that is no less generous than the 
12-months continuous eligibility provided under such 
section for parents described in such section under 
title XIX.’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect on July 1, 2006 
(or, if later, 60 days after the date of the enactment 
of this Act), whether or not regulations imple-
menting such amendments have been issued. 
(c) PROVISION OF MEDICAID AND CHIP APPLICA-
TIONS AND INFORMATION UNDER THE SCHOOL LUNCH 
PROGRAM.—Section 9(b)(2)(B) of the Richard B. Russell 
National School Lunch Act (42 U.S.C. 1758(b)(2)(B)) is 
amended—
(1) by striking ‘‘(B) Applications’’ and inserting 
‘‘(B)(i) Applications’’; and 
(2) by adding at the end the following: 
‘‘(ii)(I) Applications for free and reduced price 
lunches that are distributed pursuant to clause (i) to par-
ents or guardians of children in attendance at schools par-
ticipating in the school lunch program under this Act shall 
also contain information on the availability of medical as-
sistance under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) and of child health and FamilyCare 
assistance under title XXI of such Act, including informa-
tion on how to obtain an application for assistance under 
such programs. 
‘‘(II) Information on the programs referred to in sub-
clause (I) shall be provided on a form separate from the 
application form for free and reduced price lunches under 
clause (i).’’. 
SEC. 107. DEMONSTRATION PROGRAMS TO IMPROVE MED-
ICAID AND CHIP OUTREACH TO HOMELESS 
INDIVIDUALS AND FAMILIES. 
(a) AUTHORITY.—The Secretary of Health and 
Human Services may award demonstration grants to not 
more than 7 States (or other qualified entities) to conduct 
innovative programs that are designed to improve out-
reach to homeless individuals and families under the pro-
grams described in subsection (b) with respect to enroll-
ment of such individuals and families under such pro-
grams and the provision of services (and coordinating the 
provision of such services) under such programs. 
(b) PROGRAMS FOR HOMELESS DESCRIBED.—The 
programs described in this subsection are as follows: 
(1) MEDICAID.—The program under title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.). 
(2) CHIP.—The program under title XXI of 
the Social Security Act (42 U.S.C. 1397aa et seq.). 
(3) TANF.—The program under part of A of 
title IV of the Social Security Act (42 U.S.C. 601 
et seq.). 
(4) SAMHSA BLOCK GRANTS.—The program 
of grants under part B of title XIX of the Public 
Health Service Act (42 U.S.C. 300x–1 et seq.). 
(5) FOOD
STAMP
PROGRAM.—The program 
under the Food Stamp Act of 1977 (7 U.S.C. 2011 
et seq.). 
(6) WORKFORCE INVESTMENT ACT.—The pro-
gram under the Workforce Investment Act of 1999 
(29 U.S.C. 2801 et seq.). 
(7) WELFARE-TO-WORK.—The welfare-to-work 
program under section 403(a)(5) of the Social Secu-
rity Act (42 U.S.C. 603(a)(5)).
(8) OTHER PROGRAMS.—Other public and pri-
vate benefit programs that serve low-income individ-
uals. 
(c) APPROPRIATIONS.—For the purposes of carrying 
out this section, there is appropriated for fiscal year 2006, 
out of any funds in the Treasury not otherwise appro-
priated, $10,000,000, to remain available until expended. 
SEC. 108. ADDITIONAL CHIP REVISIONS. 
(a) LIMITING COST-SHARING TO 2.5 PERCENT FOR 
FAMILIES WITH INCOME BELOW 150 PERCENT OF POV-
ERTY.—Section 2103(e)(3)(A) of the Social Security Act 
(42 U.S.C. 1397cc(e)(3)(A)) is amended— 
(1) by striking ‘‘and’’ at the end of clause (i); 
(2) by striking the period at the end of clause 
(ii) and inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
clause: 
‘‘(iii) total annual aggregate cost- 
sharing described in clauses (i) and (ii) 
with respect to all such targeted low-in-
come children in a family under this title 
that exceeds 2.5 percent of such family’s 
income for the year involved.’’.
(b) EMPLOYER COVERAGE WAIVER CHANGES.—Sec-
tion 2105(c)(3) of such Act (42 U.S.C. 1397ee(c)(3)) is 
amended— 
(1) by redesignating subparagraphs (A) and 
(B) as clauses (i) and (ii) and indenting appro-
priately; 
(2) by designating the matter beginning with 
‘‘Payment may be made’’ as a subparagraph (A) 
with the heading ‘‘IN GENERAL’’ and indenting ap-
propriately; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(B) APPLICATION OF REQUIREMENTS.— 
In carrying out subparagraph (A)— 
‘‘(i) in determining cost-effectiveness, 
the Secretary shall measure against family 
coverage costs to the extent that a State 
has expanded coverage to parents pursuant 
to section 2111; 
‘‘(ii) subject to clause (iii), the State 
shall provide satisfactory assurances that 
the minimum benefits and cost-sharing 
protections established under this title are 
provided, either through the coverage
under subparagraph (A) or as a supple-
ment to such coverage; and 
‘‘(iii) coverage under such subpara-
graph shall not be considered to violate 
clause (ii) because it does not comply with 
requirements relating to reviews of health 
service decisions if the enrollee involved is 
provided the option of being provided bene-
fits directly under this title.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section apply as of January 1, 2006, whether or not 
regulations implementing such amendments have been 
issued. 
SEC. 109. COORDINATION OF TITLE XXI WITH THE MATER-
NAL AND CHILD HEALTH PROGRAM. 
(a) IN GENERAL.—Section 2102(b)(3) of the Social 
Security Act (42 U.S.C. 1397bb(b)(3)) is amended— 
(1) in subparagraph (D), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (E), by striking the period 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(F) that operations and activities under 
this title are developed and implemented in con-
sultation and coordination with the program op-
erated by the State under title V in areas in-
cluding outreach and enrollment, benefits and 
services, service delivery standards, public 
health and social service agency relationships, 
and quality assurance and data reporting.’’. 
(b) CONFORMING MEDICAID AMENDMENT.—Section 
1902(a)(11) of such Act (42 U.S.C. 1396a(a)(11)) is 
amended— 
(1) by striking ‘‘and’’ before ‘‘(C)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (D) provide that operations and 
activities under this title are developed and imple-
mented in consultation and coordination with the 
program operated by the State under title V in areas 
including outreach and enrollment, benefits and 
services, service delivery standards, public health 
and social service agency relationships, and quality 
assurance and data reporting’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section take effect on January 1, 2006.
Subtitle B—State Option to Pro-
vide Coverage for All Residents 
With Income at or Below the 
Poverty Line 
SEC. 121. STATE OPTION TO PROVIDE COVERAGE FOR ALL 
RESIDENTS WITH INCOME AT OR BELOW THE 
POVERTY LINE. 
(a) IN GENERAL.—Section 1902(a)(10)(A)(ii) of the 
Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is 
amended— 
(1) by striking ‘‘or’’ at the end of subclause 
(XVII); 
(2) by adding ‘‘or’’ at the end of subclause 
(XVIII); and 
(3) by adding at the end the following new sub-
clause: 
‘‘(XIX) any individual whose 
family income does not exceed 100 
percent of the income official poverty 
line (as defined by the Office of Man-
agement and Budget, and revised an-
nually in accordance with section 
673(2) of the Omnibus Budget Rec-
onciliation Act of 1981) applicable to 
a family of the size involved and who
is not otherwise eligible for medical 
assistance under this title;’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 1905(a) of such Act (42 U.S.C. 
1396d(a)) is amended, in the matter before para-
graph (1)— 
(A) by striking ‘‘or’’ at the end of clause 
(xii); 
(B) by adding ‘‘or’’ at the end of clause 
(xiii); and 
(C) by inserting after clause (xiii) the fol-
lowing new clause: 
‘‘(xii) 
individuals 
described 
in 
section 
1902(a)(10)(A)(ii)(XIX),’’. 
(2) 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),’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on October 1, 2006.