I 
109TH CONGRESS 
1ST SESSION H. R. 2948
To give States the flexibility to reduce bureaucracy by streamlining enrollment 
processes for the Medicaid and State children’s health insurance pro-
grams through better linkages with programs providing nutrition and 
related assistance to low-income families. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 16, 2005
Ms. MILLENDER-MCDONALD (for herself, Mr. OWENS, Mr. MOORE of Kansas, 
Mr. JEFFERSON, Mr. WEXLER, and Ms. WOOLSEY) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To give States the flexibility to reduce bureaucracy by 
streamlining enrollment processes for the Medicaid and 
State children’s health insurance programs through bet-
ter linkages with programs providing nutrition and re-
lated assistance to low-income families.
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 ‘‘Children’s Express 
Lane to Health Coverage Act of 2005’’.
SEC. 2. FINDINGS; PURPOSE. 
(a) FINDINGS.—Congress finds the following: 
(1) Despite gains made in recent years, 
8,900,000 children in the United States are unin-
sured. Of those, 6,900,000 are eligible for public 
health insurance coverage. 
(2) Most low-income uninsured children are en-
rolled in nutrition and related programs that operate 
under income guidelines similar to those of the med-
icaid program. In fact, 63 percent, or 4,300,000, 
low-income uninsured children are in families that 
receive benefits through the food stamps program, 
the National school lunch program, or the special 
supplemental nutrition program for women, infants 
and children (commonly referred to as ‘‘WIC’’). 
(3) The public would be well served if Federal 
means-tested public programs were able to improve 
administrative efficiency and coordination as well as 
reduce unnecessary bureaucracy. 
(4) Uninsured children would be well served if 
their enrollment in a nutrition-based or other means-
tested program could serve as a gateway to health 
coverage. 
(5) Existing law already allows children to be 
found income eligible for WIC based on their enroll-
ment in the medicaid program. Current law does
not, however, give States adequate flexibility to 
make an income determination for eligibility for the 
medicaid or State children’s health insurance pro-
gram based on an uninsured child’s enrollment in 
WIC or another public program. 
(b) PURPOSE.—The purpose of this Act is to give 
States the flexibility to find children income eligible for 
the medicaid program or State children’s health insurance 
program based on the fact that the children are eligible 
for nutrition assistance or similar public programs with 
comparable income standards and methodologies. 
SEC. 3. STATE OPTION TO PROVIDE FOR SIMPLIFIED DE-
TERMINATIONS OF A CHILD’S FINANCIAL ELI-
GIBILITY FOR MEDICAL ASSISTANCE UNDER 
MEDICAID OR CHILD HEALTH ASSISTANCE 
UNDER SCHIP. 
(a) MEDICAID.— Section 1902(e) of the Social Secu-
rity Act (42 U.S.C. 1396a(e)) is amended by adding at 
the end the following: 
‘‘(13)(A) At the option of the State, the plan may 
provide that financial eligibility requirements for medical 
assistance are met for an individual who is under an age 
specified by the State (except as provided in subparagraph 
(C), not to exceed 21 years of age) by using a determina-
tion made within a reasonable period (as determined by
the State) before its use for this purpose, of the individ-
ual’s family or household income, or if applicable for pur-
poses of determining eligibility under this title or title 
XXI, assets or resources, by a Federal or State agency, 
or a public or private entity making such determination 
on behalf of such agency, specified by the plan, including 
(but not limited to) an agency administering the Food 
Stamp Act of 1977, the Richard B. Russell National 
School Lunch Act, or the Child Nutrition Act of 1966, 
notwithstanding any differences in budget unit, disregard, 
deeming, or other methodology, but only if—
‘‘(i) the agency has fiscal liabilities or respon-
sibilities affected or potentially affected by such de-
termination; and 
‘‘(ii) any information furnished by the agency 
pursuant to this subparagraph is used solely for pur-
poses of determining eligibility for medical assistance 
under this title or for child health assistance under 
title XXI. 
‘‘(B) Nothing in subparagraph (A) shall be con-
strued—
‘‘(i) to authorize the denial of medical assist-
ance under this title or of child health assistance 
under title XXI to an individual who, without the