I 
111TH CONGRESS 
1ST SESSION H. R. 2859 
To amend title XIX of the Social Security Act to provide for application 
of an enhanced Federal matching rate for children under the Medicaid 
Program if certain conditions are met. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 12, 2009 
Ms. MATSUI introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to provide 
for application of an enhanced Federal matching rate 
for children under the Medicaid Program if certain condi-
tions are met. 
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 ‘‘Strengthening Med-
icaid for America’s Children Act of 2009’’. 
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SEC. 2. ENHANCED FMAP FOR CHILDREN UNDER MED-
ICAID. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (b), by inserting ‘‘and sub-
section (y)’’ after ‘‘section 1933(d),’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(y) CONDITIONS-BASED ENHANCED FMAP FOR 
CHILDREN.— 
‘‘(1) IN GENERAL.—Subject to paragraph (4), 
in the case of a State that meets the requirements 
of paragraph (2) with respect to a quarter and that 
implements at least 3 of the policies described in 
paragraph (3)(B) for the quarter under the State 
plan under this title, the Federal medical assistance 
percentage applicable with respect to expenditures 
made for medical assistance for children shall be in-
creased by the percentage (specified in paragraph 
(3)(A)) of the number of percentage points by 
which— 
‘‘(A) the enhanced FMAP (as defined in 
section 2105(b)), exceeds 
‘‘(B) the Federal medical assistance per-
centage otherwise applicable. 
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‘‘(2) 
MAINTENANCE-OF-EFFORT
REQUIRE-
MENTS.—The requirements of this paragraph with 
respect to a State for a quarter are that the State 
must agree to the following two maintenance-of-ef-
fort requirements: 
‘‘(A) An amount equivalent to the aggre-
gate State general revenue funds being applied 
as of July 1, 2008, under this title for purposes 
of obtaining Federal financial participation 
under this title for medical assistance furnished 
to children must remain invested in health care 
programs and services for children and avail-
able to supplement (and not supplant) program 
funding, with priority given to increasing reim-
bursement rates for providers and coverage ex-
pansion. 
‘‘(B) To maintain eligibility, methods, 
standards, procedures, and provider rates appli-
cable to children under this title at levels not 
less than the levels in effect as of July 1, 2008. 
‘‘(3) SCALING OF INCREASE BASED ON DEGREE 
OF IMPLEMENTATION OF POLICIES.— 
‘‘(A) PERCENTAGE SPECIFIED.—For pur-
poses of paragraph (1), in the case of a State 
that implements— 
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‘‘(i) at least 6 of the policies described 
in subparagraph (B) for a calendar quar-
ter, the percentage under this subpara-
graph is 100 percent; 
‘‘(ii) 5 of such policies, the percentage 
under this paragraph is 75 percent; or 
‘‘(iii) fewer than 4 (but no less than 
3) of such policies, the percentage under 
this paragraph is 50 percent. 
‘‘(B) POLICIES DESCRIBED.—The policies 
described in this subparagraph are as follows 
(as more fully specified by the Secretary): 
‘‘(i) The State has implemented 12- 
month continuous coverage for children for 
medical assistance under this title. 
‘‘(ii) Children leaving foster care on 
their 18th birthday may maintain eligi-
bility for medical assistance under this title 
up to the age of 23 if they are attending 
college full- or part-time. 
‘‘(iii) As a condition of eligibility for 
children under section 1902(l), the State 
does not apply an asset test or applies a 
simplified asset verification system. 
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‘‘(iv) The State does not require a 
face-to-face interview as a condition of eli-
gibility for children for medical assistance 
under this title. 
‘‘(v) The State permits renewals of 
eligibility for children for medical assist-
ance under this title to be effected admin-
istratively or through an ex parte process. 
‘‘(vi) The State permits a joint appli-
cation for medical assistance under this 
title and for child health assistance under 
title XXI with the same information 
verification process to obtain assistance 
under this title or title XXI. 
‘‘(vii) The State has implemented 
under this title and title XXI presumptive 
eligibility for children described in section 
1920A. 
‘‘(viii) The State has implemented the 
Express Lane eligibility option under sec-
tion 1902(e)(13). 
‘‘(ix) The State provides for coordina-
tion of delivery of care for children for 
which medical assistance is available under 
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this title through a medical home or simi-
lar model. 
‘‘(4) LIMITATION.—This subsection shall not 
apply for any calendar quarter for a State for which 
the State may be eligible for an increase in FMAP 
under section 5001 of division B of the American 
Recovery and Reinvestment Act (Public Law 111– 
5). 
‘‘(5) CHILDREN DEFINED.—In this subsection, 
the term ‘children’ means an individual who is under 
21 years of age.’’. 
Æ 
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