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 ‘‘At-Risk Youth Medicaid 
Protection Act of 2018’’. 
SEC. 2. AT-RISK YOUTH MEDICAID PROTECTION. 
(a) IN GENERAL.—Section 1902 of the Social Security 
Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘and’’ at the end of para-
graph (82); 
(B) by striking the period at the end of 
paragraph (83) and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (83) the 
following new paragraph: 
‘‘(84) provide that— 
‘‘(A) the State shall not terminate eligibility 
for medical assistance under the State plan for 
an individual who is an eligible juvenile (as de-
fined in subsection (nn)(2)) because the juvenile 
is an inmate of a public institution (as defined 
in subsection (nn)(3)), but may suspend coverage 
during the period the juvenile is such an inmate; 
‘‘(B) in the case of an individual who is an 
eligible juvenile described in paragraph (2)(A) of 
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subsection (nn), the State shall, prior to the indi-
vidual’s release from such a public institution, 
conduct a redetermination of eligibility for such 
individual with respect to such medical assist-
ance (without requiring a new application from 
the individual) and, if the State determines pur-
suant to such redetermination that the indi-
vidual continues to meet the eligibility require-
ments for such medical assistance, the State shall 
restore coverage for such medical assistance to 
such an individual upon the individual’s release 
from such public institution; and 
‘‘(C) in the case of an individual who is an 
eligible juvenile described in paragraph (2)(B) of 
subsection (nn), the State shall process any ap-
plication for medical assistance submitted by, or 
on behalf of, such individual such that the State 
makes a determination of eligibility for such in-
dividual with respect to such medical assistance 
upon release of such individual from such public 
institution.’’; and 
(2) by adding at the end the following new sub-
section: 
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‘‘(nn) JUVENILE; ELIGIBLE JUVENILE; PUBLIC INSTI-
TUTION.—For purposes of subsection (a)(84) and this sub-
section: 
‘‘(1) JUVENILE.—The term ‘juvenile’ means an 
individual who is— 
‘‘(A) under 21 years of age; or 
‘‘(B) 
described 
in 
subsection 
(a)(10)(A)(i)(IX). 
‘‘(2) ELIGIBLE JUVENILE.—The term ‘eligible ju-
venile’ means a juvenile who is an inmate of a public 
institution and who— 
‘‘(A) was determined eligible for medical as-
sistance under the State plan immediately before 
becoming an inmate of such a public institution; 
or 
‘‘(B) is determined eligible for such medical 
assistance while an inmate of a public institu-
tion. 
‘‘(3) INMATE OF A PUBLIC INSTITUTION.—The 
term ‘inmate of a public institution’ has the meaning 
given such term for purposes of applying the subdivi-
sion (A) following paragraph (29) of section 1905(a), 
taking into account the exception in such subdivision 
for a patient of a medical institution.’’. 
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(b) NO CHANGE IN EXCLUSION FROM MEDICAL AS-
SISTANCE FOR INMATES OF PUBLIC INSTITUTIONS.—Noth-
ing in this section shall be construed as changing the exclu-
sion from medical assistance under the subdivision (A) fol-
lowing paragraph (29) of section 1905(a) of the Social Se-
curity Act (42 U.S.C. 1396d(a)), including any applicable 
restrictions on a State submitting claims for Federal finan-
cial participation under title XIX of such Act for such as-
sistance. 
(c) NO CHANGE IN CONTINUITY OF ELIGIBILITY BE-
FORE ADJUDICATION OR SENTENCING.—Nothing in this 
section shall be construed to mandate, encourage, or suggest 
that a State suspend or terminate coverage for individuals 
before they have been adjudicated or sentenced. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by subsection (a) 
shall apply to eligibility of juveniles who become in-
mates of public institutions on or after the date that 
is 1 year after the date of the enactment of this Act. 
(2) RULE FOR CHANGES REQUIRING STATE LEG-
ISLATION.—In the case of a State plan for medical 
assistance under title XIX of the Social Security Act 
which the Secretary of Health and Human Services 
determines requires State legislation (other than legis-
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lation appropriating funds) in order for the plan to 
meet the additional requirements imposed by the 
amendments made by subsection (a), the State plan 
shall not be regarded as failing to comply with the re-
quirements of such title solely on the basis of its fail-
ure to meet these additional requirements before the 
first day of the first calendar quarter beginning after 
the close of the first regular session of the State legis-
lature that begins after the date of the enactment of 
this Act. For purposes of the previous sentence, in the 
case of a State that has a 2-year legislative session, 
each year of such session shall be deemed to be a sepa-
rate regular session of the State legislature. 
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Union Calendar No. 572 
115TH CONGRESS 
2D SESSION 
H. R. 1925 
[Report No. 115–738] 
A BILL 
To amend title XIX of the Social Security Act to 
protect at-risk youth against termination of Med-
icaid eligibility while an inmate of a public insti-
tution. 
JUNE 12, 2018 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
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