I 
116TH CONGRESS 
1ST SESSION H. R. 4141 
To amend title XIX of the Social Security Act to provide a consistent 
standard of health care to the incarcerated, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 2, 2019 
Ms. KUSTER of New Hampshire (for herself and Ms. NORTON) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on the Judiciary, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend title XIX of the Social Security Act to provide 
a consistent standard of health care to the incarcerated, 
and for other purposes. 
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 ‘‘Humane Correctional 
Health Care Act’’. 
SEC. 2. REPEAL OF MEDICAID INMATE EXCLUSION. 
(a) IN GENERAL.—Section 1905(a) of the Social Se-
curity Act (42 U.S.C. 1396d(a)) is amended, in the matter 
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following paragraph (30), by striking ‘‘such term does not 
include—’’ and all that follows through ‘‘patient in an in-
stitution for mental diseases’’ and inserting ‘‘such term 
does not include any such payments with respect to care 
or services for any individual who is under 65 years of 
age and is a patient in an institution for mental diseases’’. 
(b) CONFORMING AMENDMENTS.—Section 1902 of 
the Social Security Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)— 
(A) by striking paragraph (84); 
(B) by redesignating paragraphs (85) and 
(86) as paragraphs (84) and (85), respectively; 
(C) in paragraph (84), as redesignated by 
subparagraph (B), by striking ‘‘(oo)(1)’’ and in-
serting ‘‘(nn)(1)’’; and 
(D) in paragraph (85), as redesignated by 
subparagraph (B), by striking ‘‘(pp)’’ and in-
serting ‘‘(oo)’’; 
(2) by striking subsection (nn); 
(3) by redesignating subsections (oo) and (pp) 
as subsections (nn) and (oo), respectively; 
(4) in subsection (nn), as redesignated by para-
graph (3), by striking ‘‘(85)’’ and inserting ‘‘(84)’’; 
and 
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(5) in subsection (oo), as redesignated by para-
graph (3), by striking ‘‘(86)’’ and inserting ‘‘(85)’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to medical assistance 
provided on or after January 1, 2020. 
SEC. 3. REPORT BY COMPTROLLER GENERAL. 
Not later than the date that is three years after the 
date of the enactment of this Act, and annually thereafter 
for each of the following five years, the Comptroller Gen-
eral of the United States shall submit to Congress a report 
containing the following information: 
(1) The percentage of inmates that receive med-
ical assistance under a State plan under title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.). 
(2) The access of inmates to health care serv-
ices, including specialty care, and health care pro-
viders. 
(3) The quality of health care services provided 
to inmates. 
(4) Any impact of coverage under such a State 
plan on recidivism. 
(5) The percentage of inmates who, upon re-
lease, are— 
(A) enrolled under such a State plan; and 
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(B) connected to a primary care provider 
in their community. 
(6) Trends in the prevalence and incidence of 
illness and injury among inmates. 
(7) Any other information the Comptroller Gen-
eral determines necessary regarding the health of in-
mates. 
SEC. 4. SENSE OF CONGRESS ON INCARCERATION AND 
COMMUNITY-BASED HEALTH SERVICES. 
It is the sense of Congress that— 
(1) no individual in the United States should be 
incarcerated for the purpose of being provided with 
health care that is unavailable to the individual in 
the individual’s community; 
(2) each State and unit of local government 
should establish programs that offer community- 
based health services (including mental health and 
substance use disorder services) commensurate with 
the principle stated in paragraph (1); and 
(3) Federal reimbursement for expenditures on 
medical assistance made available through the 
amendments made by this Act should not supplant 
an investment in community-based services. 
Æ 
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