I 
110TH CONGRESS 
1ST SESSION H. R. 1688 
To amend the Social Security Act to provide health insurance coverage for 
children and pregnant women throughout the United States by combining 
the children and pregnant woman health coverage under Medicaid and 
SCHIP into a new All Healthy Children Program, and for other pur-
poses. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 26, 2007 
Mr. SCOTT of Virginia introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on Rules, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To amend the Social Security Act to provide health insurance 
coverage for children and pregnant women throughout 
the United States by combining the children and preg-
nant woman health coverage under Medicaid and SCHIP 
into a new All Healthy Children Program, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
SECTION 1. SHORT TITLE; TABLE OF CONTENTS; FINDINGS; 
PURPOSE. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘All 
Healthy Children Act of 2007’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents; findings; purpose. 
Sec. 2. Creation of new title XXII of the Social Security Act. 
‘‘TITLE XXII—ALL HEALTHY CHILDREN PROGRAM 
‘‘Sec. 2201. All Healthy Children Program. 
‘‘Sec. 2202. General contents of State all healthy children plan; eligibility; 
enrollment. 
‘‘Sec. 2203. Benefits; premiums; cost-sharing; provider payment rates. 
‘‘Sec. 2204. Payments to States. 
‘‘Sec. 2205. Application of SCHIP, medicaid and related SSA provisions; 
waivers; administration. 
‘‘Sec. 2206. Definitions. 
‘‘Sec. 2207. Effective dates; transition. 
Sec. 3. Commission on Children’s Health Coverage. 
(c) FINDINGS.—Congress finds the following: 
(1) More than nine million children in the 
United States—one in nine—have no health insur-
ance coverage. 
(2) Every 46 seconds, another baby is born un-
insured in the United States. 
(3) Existing health care programs for low-in-
come children vary widely, with different standards 
for eligibility, cost sharing, and benefits in each of 
the 50 States and the District of Columbia. 
(4) The majority of uninsured children are eli-
gible for coverage under Medicaid or the State Chil-
dren’s Health Insurance Program (SCHIP), but are 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
not enrolled in existing programs because of dif-
ferent eligibility and enrollment barriers that make 
it difficult to obtain or keep coverage. 
(5) Millions more children are underinsured or 
at risk of losing coverage if their parents change 
jobs or more employers drop family coverage. 
(6) Uninsured children are almost 12 times as 
likely as insured children to have an untreated med-
ical need and are four times as likely as insured chil-
dren to have an unmet dental need. 
(7) Uninsured children are more than five times 
as likely as insured children to have gone more than 
two years without a doctor visit. 
(8) The majority of uninsured children live in 
two-parent households and almost 90 percent live in 
families where at least one parent works. 
(9) An estimated two-thirds of children and 
adolescents with mental health needs are not getting 
the care they need and only one in five children with 
serious emotional disturbances receives specialized 
treatment. 
(10) It costs less to provide health insurance 
coverage to children than to any other group of peo-
ple. 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
(11) Increases in private health insurance costs 
are dramatically outpacing increases in wages. 
(12) The United States spending on health care 
per person is more than twice the average spent in 
industrialized countries, yet the United States ranks 
near the bottom among those countries in infant 
mortality rates. 
(13) Children enrolled in a health coverage pro-
gram experienced significant improvements in health 
after just one year and significant decreases of limi-
tations in their daily activities. 
(14) Enrollment in health insurance has been 
associated with improvements in school. 
(15) When juvenile offenders arrested for minor 
offenses had access to intensive and coordinated 
mental health services, more than a third fewer were 
re-arrested the following year, compared to those 
who only had access to basic mental health services. 
(d) PURPOSE.—It is the purpose of this Act to sim-
plify and consolidate children’s health coverage under 
Medicaid and SCHIP into a single program that guaran-
tees children in all 50 States and the District of Columbia 
all medically necessary services. 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
SEC. 2. CREATION OF NEW TITLE XXII OF THE SOCIAL SE-
CURITY ACT. 
(a) IN GENERAL.—The Social Security Act is amend-
ed by adding at the end the following new title: 
‘‘TITLE XXII—ALL HEALTHY 
CHILDREN PROGRAM 
‘‘SEC. 2201. ALL HEALTHY CHILDREN PROGRAM. 
‘‘(a) IN GENERAL.—There is established under this 
title a State-operated program receiving Federal financial 
assistance to provide comprehensive health coverage for 
children and pregnant and post-partum women in place 
of benefits previously provided for children and pregnant 
and post-partum women under the Medicaid program 
under title XIX and the State Children’s Health Insurance 
Program under title XXI. 
‘‘(b) STATE ALL HEALTHY CHILDREN PLAN RE-
QUIRED.—A State is not eligible for payment under sec-
tion 2204 unless the State has submitted to the Secretary 
under section 2202 a plan that— 
‘‘(1) sets forth how the State intends to use the 
funds provided under this title to provide all healthy 
children assistance to uninsured children and preg-
nant women consistent with the provisions of this 
title, and 
‘‘(2) has been approved under section 2202. 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
‘‘(c) STATE AND INDIVIDUAL ENTITLEMENT.—This 
title constitutes budget authority in advance of appropria-
tions Acts and represents the obligation of the Federal 
Government to provide for the payment to States of 
amounts provided under section 2204. Each individual 
who is an all healthy children eligible individual and who 
qualifies for benefits under this title has an entitlement 
to such benefits in accordance with this title. 
‘‘(d) PRIVATE RIGHT OF ACTION.— 
‘‘(1) IN GENERAL.—Any person aggrieved by a 
violation of this title or a failure of an individual or 
entity, including a State or Federal agency, to com-
ply with the provisions of this title, including any 
regulation promulgated pursuant to this title, may 
bring a civil action in any Federal district court, re-
gardless of amount in controversy, or State court of 
competent jurisdiction to enforce such person’s 
rights. 
‘‘(2) NO EXCLUSION OF OTHER REMEDIES.— 
The availability of a private right of action under 
this subsection shall not be construed to preclude 
the ability of any person aggrieved to obtain relief 
for a violation of this title or a failure of an indi-
vidual or entity to comply with the provision of this 
title, or any regulations promulgated pursuant to 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
this title, under any other applicable statute or other 
basis for relief. 
‘‘(3) RELIEF.—In an action under this sub-
section, the court may award all relief allowed by 
law, including but not limited to compensatory and 
exemplary damages and injunctive relief, and attor-
neys’ fees and court costs. 
‘‘(4) PERSON
AGGRIEVED
DEFINED.—In this 
subsection, the term ‘person aggrieved’ includes a 
child or individual entitled to benefits under this 
title, the parent or guardian of such child, a provider 
of services to children or other individuals entitled to 
such benefits, or an association or other entity 
whose mission is to ensure that children or pregnant 
and post-partum women receive adequate health care 
services. 
‘‘(e) EFFECTIVE DATE.—No State is eligible for pay-
ments under section 2204 for all healthy children assist-
ance for coverage provided for periods beginning before 
October 1, 2008. 
‘‘SEC. 2202. GENERAL CONTENTS OF STATE ALL HEALTHY 
CHILDREN PLAN; ELIGIBILITY; ENROLLMENT. 
‘‘(a) GENERAL CONTENTS.—A State all healthy chil-
dren plan shall include a description, consistent with the 
requirements of this title, of— 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
‘‘(1) the all healthy children assistance provided 
under the plan for all healthy children eligible indi-
viduals, including the proposed methods of delivery 
and utilization control systems; 
‘‘(2) eligibility standards consistent with sub-
section (b); 
‘‘(3) enrollment and outreach activities con-
sistent with subsection (c); and 
‘‘(4) methods (including monitoring) used— 
‘‘(A) to assure the quality and appropriate-
ness of care, particularly with respect to pre- 
natal care, well-baby care, well-child care, and 
immunizations provided under the plan, and 
‘‘(B) to assure access to all medically nec-
essary health care services, including emergency 
services. 
‘‘(b) 
ELIGIBILITY
STANDARDS
AND
METHOD-
OLOGY.— 
‘‘(1) IN
GENERAL.—The all healthy children 
plan for a State shall provide that all of the fol-
lowing are all healthy children eligible individuals if 
they are residents: 
‘‘(A) FULL SUBSIDY INDIVIDUALS.— 
‘‘(i) All children under age 19 whose 
family income does not exceed 300 percent 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
of the poverty line (as defined in section 
2110(c)(5)). 
‘‘(ii) All pregnant and post-partum 
women whose family income does not ex-
ceed 300 percent of the poverty line. 
‘‘(iii) All children under age 19 and 
pregnant and post-partum women who 
would have qualified for medical assistance 
under title XIX (as applied in the State as 
of October 1, 2005). 
‘‘(iv) All children who are meet the re-
quirements of subparagraphs (A) and (B) 
of section 1905(w)(1) (relating to inde-
pendent foster care adolescents). 
‘‘(B) TRANSITIONAL ASSISTANCE.—An in-
dividual who loses eligibility as an individual de-
scribed in subparagraph (A) because of an in-
crease in family income, but only during the 3- 
month period beginning with the first month in 
which such eligibility is lost. Cost-sharing for 
transition coverage may not exceed the amounts 
the State plan charged for such individual be-
fore receiving transitional assistance. 
‘‘(C) BUY-IN ELIGIBLE INDIVIDUALS.—In-
dividuals who, but for the amount of family in-
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
come, would be an individual described in sub-
paragraph (A) and who are not described in 
subparagraph (B) if they meet such terms and 
conditions as the Secretary determines appro-
priate. 
‘‘(2) RESIDENCY REQUIREMENT.—For purposes 
of this title, an individual is a resident of a State if 
the individual is present in the State with intent to 
remain, and includes any individual who would be 
treated as such a resident under title XIX (as in ef-
fect as of January 1, 2007). 
‘‘(3) POST-PARTUM WOMAN DEFINED.—In this 
title, the term ‘post-partum woman’ means a woman 
during the period beginning on the date of comple-
tion of pregnancy and ending on the last day of the 
first month that ends at least 60 days after such 
date. 
‘‘(4) INCOME
METHODOLOGY.—The method-
ology for determining income under a State all 
healthy children plan shall not be more restrictive 
than the income methodology described in section 
1931(b)(1)(B), to the extent such methodology is 
consistent 
with 
the 
requirements 
of 
section 
1902(a)(17). 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS
‘‘(5) NO ASSET TEST.—The State plan may not 
impose any asset or resource test for eligibility. 
‘‘(6) CONSTRUCTION.—Nothing in this title 
shall be construed as preventing a State from cov-
ering individuals (such as individuals who are 19 or 
20 years of age) who are not all healthy children eli-
gible individuals under title XIX. 
‘‘(7) EXCLUSION OF PUBLIC BENEFIT DEFINI-
TION.—The benefits provided under this title shall 
not be deemed to constitute a Federal or State pub-
lic benefit within the meaning of title IV of the Per-
sonal Responsibility and Work Opportunity Rec-
onciliation Act of 1996 (Public Law 104–193) nor 
shall any documentation of citizenship be required 
for the purpose of securing benefits under this title. 
‘‘(8) SPECIAL
RULES
FOR
TERRITORIES.—In 
the case of States that are not one of the 50 states 
or the District of Columbia, the Secretary may, by 
regulation, adjust the income eligibility levels set 
forth in this title, taking into account factors such 
as average income, costs of living, and availability of 
health care coverage in a manner that assures equi-
table access to health coverage for children and 
pregnant and post-partum women residing in such 
States. 
VerDate Aug 31 2005 
23:35 Apr 02, 2007
Jkt 059200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H1688.IH
H1688
pwalker on PROD1PC71 with BILLS