I 
111TH CONGRESS 
1ST SESSION 
H. R. 319 
To amend titles XIX and XXI of the Social Security Act to permit States 
the option of coverage of legal immigrants under the Medicaid Program 
and the State children’s health insurance program (SCHIP). 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 8, 2009 
Mr. LINCOLN DIAZ-BALART of Florida introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committee on the Judiciary, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend titles XIX and XXI of the Social Security Act 
to permit States the option of coverage of legal immi-
grants under the Medicaid Program and the State chil-
dren’s health insurance program (SCHIP). 
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 ‘‘Legal Immigrant Chil-
dren’s Health Improvement Act of 2009’’. 
VerDate Nov 24 2008 
21:57 Jan 11, 2009
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H319.IH
H319
rwilkins on PROD1PC63 with BILLS
SEC. 2. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS 
UNDER THE MEDICAID PROGRAM AND SCHIP. 
(a) MEDICAID PROGRAM.—Section 1903(v) of the 
Social Security Act (42 U.S.C. 1396b(v)) is amended— 
(1) in paragraph (1), by striking ‘‘paragraph 
(2)’’ and inserting ‘‘paragraphs (2) and (4)’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(4)(A) A State may elect (in a plan amendment 
under this title) to provide medical assistance under this 
title, notwithstanding sections 401(a), 402(b), 403, and 
421 of the Personal Responsibility and Work Opportunity 
Reconciliation Act of 1996, for aliens who are lawfully re-
siding in the United States (including battered aliens de-
scribed in section 431(c) of such Act) and who are other-
wise eligible for such assistance, within either or both of 
the following eligibility categories: 
‘‘(i) PREGNANT WOMEN.—Women during preg-
nancy (and during the 60-day period beginning on 
the last day of the pregnancy). 
‘‘(ii) CHILDREN.—Individuals under 21 years of 
age, including optional targeted low-income children 
described in section 1905(u)(2)(B). 
‘‘(B) In the case of a State that has elected to provide 
medical assistance to a category of aliens under subpara-
graph (A), no debt shall accrue under an affidavit of sup-
VerDate Nov 24 2008 
21:57 Jan 11, 2009
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H319.IH
H319
rwilkins on PROD1PC63 with BILLS
port against any sponsor of such an alien on the basis 
of provision of assistance to such category and the cost 
of such assistance shall not be considered as an unreim-
bursed cost.’’. 
(b) SCHIP.—Section 2107(e)(1) of such Act (42 
U.S.C. 1397gg(e)(1)) is amended by redesignating sub-
paragraphs (C) and (D) as subparagraph (D) and (E), 
respectively, and by inserting after subparagraph (B) the 
following new subparagraph: 
‘‘(C) Section 1903(v)(4) (relating to op-
tional coverage of categories of lawfully residing 
immigrant children), but only if the State has 
elected to apply such section to the category of 
children under title XIX.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section take effect on July 1, 2009, and apply to med-
ical assistance and child health assistance furnished on or 
after such date. 
Æ 
VerDate Nov 24 2008 
21:57 Jan 11, 2009
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6301
E:\BILLS\H319.IH
H319
rwilkins on PROD1PC63 with BILLS