I 
110TH CONGRESS 
2D SESSION 
H. R. 5998 
To nullify any effectiveness of the August 17, 2007, State health official 
letter issued by the Centers for Medicare & Medicaid Services. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 8, 2008 
Mr. PALLONE (for himself, Ms. SHEA-PORTER, Mr. ALTMIRE, Ms. BALDWIN, 
Mr. BRALEY of Iowa, Mrs. CAPPS, Mr. COURTNEY, Ms. DEGETTE, Ms. 
DELAURO, Mr. DINGELL, Mr. DOYLE, Mr. ELLISON, Mr. ENGEL, Ms. 
ESHOO, Mr. GENE GREEN of Texas, Ms. HARMAN, Mr. HODES, Ms. 
HOOLEY, Mr. INSLEE, Mr. LARSON of Connecticut, Mr. MARKEY, Mr. 
MURPHY of Connecticut, Mr. PATRICK J. MURPHY of Pennsylvania, Mr. 
RANGEL, Mr. RUSH, Ms. SCHAKOWSKY, Ms. SOLIS, Mr. STARK, Mr. STU-
PAK, Mr. TOWNS, Mr. WALZ of Minnesota, Mr. WAXMAN, and Mr. 
WELCH of Vermont) introduced the following bill; which was referred to 
the Committee on Energy and Commerce 
A BILL 
To nullify any effectiveness of the August 17, 2007, State 
health official letter issued by the Centers for Medicare 
& Medicaid Services. 
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 ‘‘Protecting Children’s 
Health Coverage Act of 2008’’. 
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SEC. 2. NULLIFYING ANY EFFECTIVENESS OF AUGUST 17, 
2007, LETTER. 
(a) IN GENERAL.—With respect to the August 17th 
Letter (as defined in subsection (c)(1)), the following shall 
apply: 
(1) Such Letter shall have no force or effect. 
(2) The Secretary of Health and Human Serv-
ices is prohibited from applying or enforcing any pol-
icy, directive, or requirement contained in such Let-
ter, or any other policy, directive, or requirement 
issued on or after August 17, 2007, substantially 
similar to those contained in such Letter, unless 
such policy, directive, or requirement is explicitly 
contained in a regulation in effect before such date. 
(3) In order to restore States, to the maximum 
extent practicable, to the position they would have 
been in if the August 17 Letter had not been issued 
or applied, to the extent that a State’s request 
(through CHIP or Medicaid plan amendment, dem-
onstration project, or otherwise) made before the 
date of the enactment of this Act to extend health 
insurance through CHIP or Medicaid to uninsured 
children, or to maintain previously existing CHIP or 
Medicaid eligibility for children— 
(A) was denied, in whole or in part, by 
CMS on or after August 17, 2007, and before 
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the date of the enactment of this Act based, in 
whole or in part, on the application of any pol-
icy, directive, or requirement contained in the 
August 17th Letter, CMS shall, upon the writ-
ten request of a State made within 30 days 
after such date of enactment, reconsider and 
issue a new decision on the State’s request 
within 30 days of the date of such written re-
quest and without reliance on any such policy, 
directive, or requirement; 
(B) was approved before such date of en-
actment but had been modified, in whole or in 
part, by a State before such approval specifi-
cally in response to the application of any such 
policy, directive, or requirement, CMS shall, 
upon the written request of the State made 
within 30 days after such date of enactment, 
issue a decision to approve or disapprove re-
moval of the modification (and restoration of 
the original request) within 30 days of the date 
of such written request and without reliance on 
any such policy, directive, or requirement; or 
(C) has been modified by a State, but not 
acted upon by CMS, before such date of enact-
ment specifically in response to the application 
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(2) The term ‘‘CHIP’’ means the State Chil-
dren’s Health Insurance Program under title XXI of 
the Social Security Act. 
(3) The term ‘‘CMS’’ means the Centers for 
Medicare & Medicaid Services. 
(4) The term ‘‘Medicaid’’ means the program 
under title XIX of the Social Security Act. 
(5) The term ‘‘State’’ has the meaning given 
such term for purposes of CHIP. 
Æ 
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