I 
108TH CONGRESS 
1ST SESSION 
H. R. 816
To provide certain temporary increases in the Federal medical assistance 
percentage (FMAP) under the Medicaid Program to help States finance 
increases in enrollment due to rising unemployment and to prevent reduc-
tions in health insurance coverage due to State budget crises. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 13, 2003
Mr. KING of New York (for himself, Mr. BROWN of Ohio, Mr. HOUGHTON, 
Mr. DINGELL, Mr. LAHOOD, Mr. MCNULTY, Mr. REYNOLDS, Mr. LAN-
TOS, Mr. PALLONE, Ms. HOOLEY of Oregon, Mr. CARDOZA, Mr. 
WEXLER, Mr. KILDEE, Mr. FILNER, Mr. STARK, Mr. RAHALL, Mr. 
MCGOVERN, Mr. LIPINSKI, Mr. UDALL of Colorado, Mrs. JONES of Ohio, 
Mrs. MALONEY, Ms. BALDWIN, Mr. ENGEL, Mr. GRIJALVA, Mr. 
SWEENEY, Mr. MEEHAN, Mr. WATT, Mr. THOMPSON of California, Mr. 
ACKERMAN, Mr. CAPUANO, Mr. QUINN, Mr. LYNCH, Mr. TOWNS, Mr. 
BERMAN, Mr. DOYLE, Mr. FRANK of Massachusetts, Mr. INSLEE, Mr. 
SCHIFF, Mr. HINCHEY, Mr. FARR, Mr. BOUCHER, Mr. MATSUI, Mrs. 
MCCARTHY of New York, Mr. POMEROY, Ms. KAPTUR, Mr. DAVIS of Ala-
bama, Mr. COSTELLO, Mr. MICHAUD, Mrs. LOWEY, Mr. TANCREDO, Mr. 
MILLER of North Carolina, Mr. DELAHUNT, Mr. EVANS, Mr. ALLEN, Mr. 
ISRAEL, Mr. KIND, Mr. GUTIERREZ, Mr. DAVIS of Illinois, Mr. BERRY, 
Ms. MCCOLLUM, Mr. LUCAS
of Kentucky, Ms. SLAUGHTER, Ms. 
VELA´ZQUEZ, Mr. ROSS, Mr. STRICKLAND, Ms. DELAURO, Mr. MURTHA, 
Mr. CROWLEY, Mr. GORDON, Mrs. KELLY, Mr. REYES, Ms. WOOLSEY, 
Mr. DICKS, Mr. OWENS, Ms. BORDALLO, Mr. RUSH, Mr. NADLER, Ms. 
MCCARTHY of Missouri, Mr. FROST, Mr. WAXMAN, Mr. HOLDEN, Mr. 
DEUTSCH, Mr. BISHOP of New York, Mr. EMANUEL, Ms. NORTON, Ms. 
LEE, Ms. LINDA
T. SA´NCHEZ
of California, Mr. FORD, Mrs. 
CHRISTENSEN, Ms. PELOSI, Mr. ETHERIDGE, Mr. MCHUGH, Ms. ROY-
BAL-ALLARD, Mr. GREEN of Texas, Mr. PRICE of North Carolina, Mr. 
WEINER, Mr. FOLEY, Mr. BOEHLERT, Mr. MOLLOHAN, Mrs. CAPPS, Mr. 
WALSH, Mr. PASTOR, Mr. MCDERMOTT, Mr. CARSON of Oklahoma, Ms. 
MILLENDER-MCDONALD, Mr. SMITH of Washington, Mr. RANGEL, Ms. 
SCHAKOWSKY, Mr. BAIRD, Mr. MCINTYRE, Mr. SERRANO, Mr. 
RODRIGUEZ, Mr. BRADY of Pennsylvania, Mr. RYAN of Ohio, Ms. SOLIS, 
Mr. SNYDER, and Ms. DEGETTE) introduced the following bill; which was 
referred to the Committee on Energy and Commerce
A BILL 
To provide certain temporary increases in the Federal med-
ical assistance percentage (FMAP) under the Medicaid 
Program to help States finance increases in enrollment 
due to rising unemployment and to prevent reductions 
in health insurance coverage due to State budget crises.
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 ‘‘State Budget Relief 
Act of 2003’’. 
SEC. 2. TEMPORARY INCREASES OF MEDICAID FMAP. 
(a) PERMITTING MAINTENANCE OF FISCAL YEAR 
2002 FMAP.—Notwithstanding any other provision of 
law, but subject to subsection (d), if the FMAP deter-
mined without regard to this section for a State for a cov-
ered calendar quarter (as defined in subsection (g)(1)) is 
less than the FMAP as so determined for fiscal year 2002, 
the FMAP for the State for fiscal year 2002 shall be sub-
stituted for the State’s FMAP for each of such covered 
calendar quarters, before the application of this section. 
(b) GENERAL 2 PERCENTAGE POINT INCREASE.—
Notwithstanding any other provision of law, but subject 
to subsections (d) and (e), for each State for each covered 
calendar quarter, the FMAP (taking into account the ap-
plication of subsection (a)) shall be increased by 2 percent-
age points. 
(c) FURTHER INCREASE FOR STATES WITH HIGH 
UNEMPLOYMENT RATES.—
(1) IN GENERAL.—Notwithstanding any other 
provision of law, but subject to subsections (d) and 
(e), if a State is a high unemployment State for any 
covered calendar quarter, then the FMAP for that 
State for that calendar quarter and for any subse-
quent calendar quarter in such fiscal year regardless 
of whether the State continues to be high unemploy-
ment State for that subsequent calendar quarter 
shall be increased (after the application of sub-
sections (a) and (b)) by 2.5 percentage points. 
(2) HIGH UNEMPLOYMENT STATE.—For pur-
poses of this subsection, a State is a high unemploy-
ment State for a calendar quarter if, for any 3 con-
secutive month period beginning on or after June 
2002 and ending with the second month before the 
beginning of the calendar quarter, the State has an 
average seasonally adjusted unemployment rate that 
exceeds the average weighted unemployment rate 
during such period. Such unemployment rates for 
such months shall be determined based on publica-
tions of the Bureau of Labor Statistics of the De-
partment of Labor. 
(3) AVERAGE WEIGHTED UNEMPLOYMENT RATE 
DEFINED.—For purposes of paragraph (2), the ‘‘av-
erage weighted unemployment rate’’ for a period 
is—
(A) the sum of the seasonally adjusted 
number of unemployed civilians in each State 
and the District of Columbia for the period, di-
vided by 
(B) the sum of the civilian labor force in 
each State and the District of Columbia for the 
period. 
(d) SCOPE OF APPLICATION.—The increases in the 
FMAP for a State under this section shall apply only for 
purposes of title XIX of the Social Security Act and shall 
not apply with respect to—
(1) disproportionate share hospital payments 
described in section 1923 of such Act; and 
(2) payments under titles IV and XXI of such 
Act. 
(e) STATE ELIGIBILITY.—A State is eligible for an 
increase in its FMAP under subsection (b) or (c) or an 
increase in a cap amount under subsection (f) only if the 
eligibility under its State plan under title XIX of the So-
cial Security Act (including any waiver under such title 
or under section 1115 of such Act) is no more restrictive 
than the eligibility under such plan (or waiver) as in effect 
on September 30, 2003. 
(f) ONE-YEAR INCREASE IN CAP ON MEDICAID PAY-
MENTS
TO TERRITORIES.—Notwithstanding any other 
provision of law, but subject to section (e), with respect 
to a covered calendar quarter, the amounts otherwise de-
termined for Puerto Rico, the Virgin Islands, Guam, the 
Northern Mariana Islands, and American Samoa under 
subsections (f) and (g)(2) of section 1108 of the Social 
Security Act (42 U.S.C 1308) shall each be increased by 
9 percent of such amounts. 
(g) DEFINITIONS.—For purposes of this section: 
(1) COVERED CALENDAR QUARTER.—The term 
‘‘covered calendar quarter’’ means the last two cal-
endar quarters of fiscal year 2003 and the first two 
calendar quarters of fiscal year 2004. 
(2) FMAP.—The term ‘‘FMAP’’ means the 
Federal medical assistance percentage, as defined in 
section 1905(b) of the Social Security Act (42 
U.S.C. 1396d(b)).