I 
111TH CONGRESS 
1ST SESSION 
H. R. 747 
To amend the Social Security Act to provide health insurance coverage for 
children and pregnant women throughout the United States by combining 
the children and pregnant woman health coverage under Medicaid and 
SCHIP into a new All Healthy Children Program, and for other pur-
poses. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 28, 2009 
Mr. SCOTT of Virginia (for himself, Mr. WATT, Mr. THOMPSON of Mississippi, 
Mr. BISHOP of Georgia, Mr. JOHNSON of Georgia, Mr. SARBANES, Mr. 
ROTHMAN of New Jersey, Mr. GRIJALVA, and Ms. MCCOLLUM) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce 
A BILL 
To amend the Social Security Act to provide health insurance 
coverage for children and pregnant women throughout 
the United States by combining the children and preg-
nant woman health coverage under Medicaid and SCHIP 
into a new All Healthy Children Program, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS; FINDINGS; 
PURPOSE. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘All 
Healthy Children Act of 2009’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents; findings; purpose. 
Sec. 2. Creation of new title XXII of the Social Security Act. 
‘‘TITLE XXII—ALL HEALTHY CHILDREN PROGRAM 
‘‘Sec. 2201. All Healthy Children Program. 
‘‘Sec. 2202. General contents of State All Healthy Children Plan; eligi-
bility; enrollment. 
‘‘Sec. 2203. Benefits; premiums; cost-sharing; provider payment rates. 
‘‘Sec. 2204. Payments to States. 
‘‘Sec. 2205. Application of SCHIP, medicaid and related SSA provisions; 
waivers; administration. 
‘‘Sec. 2206. Definitions. 
‘‘Sec. 2207. Effective dates; transition. 
Sec. 3. Commission on Children’s Health Coverage. 
(c) FINDINGS.—Congress finds the following: 
(1) More than nine million children in the 
United States, one in nine, have no health insurance 
coverage. 
(2) Every 39 seconds, another baby is born un-
insured in the United States. 
(3) Existing health care programs for low-in-
come children vary widely, with different standards 
for eligibility, cost-sharing, and benefits in each of 
the 50 States and the District of Columbia. 
(4) More than six million uninsured children 
are eligible for coverage under Medicaid or the State 
Children’s Health Insurance Program (SCHIP), but 
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are not enrolled in existing programs because of dif-
ferent eligibility and enrollment barriers that make 
it difficult to obtain or keep coverage. 
(5) Millions more children are underinsured or 
at risk of losing coverage if their parents change 
jobs or more employers drop family coverage. 
(6) Uninsured children are almost 12 times as 
likely as insured children to have an untreated med-
ical need and are four times as likely as insured chil-
dren to have an unmet dental need. 
(7) Uninsured children are more than five times 
as likely as insured children to have gone more than 
two years without a doctor visit. 
(8) The majority of uninsured children live in 
two-parent households and almost 90 percent of 
such children live in families where at least one par-
ent works. 
(9) An estimated two-thirds of children and 
adolescents with mental health needs are not getting 
the care they need and only one in five children with 
serious emotional disturbances receives specialized 
treatment. 
(10) It costs less to provide health insurance 
coverage to children than to any other group of peo-
ple. 
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(11) Increases in private health insurance costs 
are dramatically outpacing increases in wages. 
(12) The United States spending on health care 
per person is more than twice the average spent in 
industrialized countries, yet the United States ranks 
near the bottom among those countries in infant 
mortality rates. 
(13) Children enrolled in a health coverage pro-
gram experienced significant improvements in health 
after just one year and significant decreases of limi-
tations in their daily activities. 
(14) Enrollment in health insurance has been 
associated with improvements in school. 
(15) When juvenile offenders arrested for minor 
offenses had access to intensive and coordinated 
mental health services, more than a third fewer were 
re-arrested the following year, compared to those 
who only had access to basic mental health services. 
(d) PURPOSE.—It is the purpose of this Act to sim-
plify and consolidate children’s health coverage under 
Medicaid and SCHIP into a single program that guaran-
tees children in all States, territories, and the District of 
Columbia all medically necessary services. 
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SEC. 2. CREATION OF NEW TITLE XXII OF THE SOCIAL SE-
CURITY ACT. 
The Social Security Act is amended by adding at the 
end the following new title: 
‘‘TITLE XXII—ALL HEALTHY 
CHILDREN PROGRAM 
‘‘SEC. 2201. ALL HEALTHY CHILDREN PROGRAM. 
‘‘(a) IN GENERAL.—There is established under this 
title a State-operated program receiving Federal financial 
assistance to provide comprehensive health coverage for 
children, pregnant women, and post-partum women in 
place of benefits previously provided for children, pregnant 
women, and post-partum women under the Medicaid pro-
gram under title XIX and the State Children’s Health In-
surance Program under title XXI. 
‘‘(b) STATE ALL HEALTHY CHILDREN PLAN RE-
QUIRED.—A State is not eligible for payment under sec-
tion 2204 unless the State has submitted to the Secretary 
under section 2202 a plan that— 
‘‘(1) sets forth how the State intends to use the 
funds provided under this title to provide all healthy 
children assistance to uninsured children and preg-
nant women consistent with the provisions of this 
title; and 
‘‘(2) has been approved under section 2202. 
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‘‘(c) STATE AND INDIVIDUAL ENTITLEMENT.—This 
title constitutes budget authority in advance of appropria-
tions Acts and represents the obligation of the Federal 
Government to provide for the payment to States of 
amounts provided under section 2204. Each individual 
who is an all healthy children eligible individual and who 
qualifies for benefits under this title has an entitlement 
to such benefits in accordance with this title. 
‘‘(d) PRIVATE RIGHT OF ACTION.— 
‘‘(1) IN GENERAL.—Any person aggrieved by a 
violation of this title or a failure of an individual or 
entity, including a State or Federal agency, to com-
ply with the provisions of this title, including any 
regulation promulgated pursuant to this title, may 
bring a civil action in any Federal district court, re-
gardless of amount in controversy, or State court of 
competent jurisdiction to enforce such person’s 
rights. 
‘‘(2) NO EXCLUSION OF OTHER REMEDIES.— 
The availability of a private right of action under 
this subsection shall not be construed to preclude 
the ability of any person aggrieved to obtain relief 
for a violation of this title or a failure of an indi-
vidual or entity to comply with the provision of this 
title, or any regulations promulgated pursuant to 
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this title, under any other applicable statute or other 
basis for relief. 
‘‘(3) RELIEF.—In an action under this sub-
section, the court may award all relief allowed by 
law, including but not limited to compensatory and 
exemplary damages and injunctive relief, and attor-
neys’ fees and court costs. 
‘‘(4) PERSON
AGGRIEVED
DEFINED.—In this 
subsection, the term ‘person aggrieved’ includes a 
child or individual entitled to benefits under this 
title, the parent or guardian of such child, a provider 
of services to children or other individuals entitled to 
such benefits, or an association or other entity 
whose mission is to ensure that children, pregnant 
women, or post-partum women receive adequate 
health care services. 
‘‘(e) EFFECTIVE DATE.—No State is eligible for pay-
ments under section 2204 for all healthy children assist-
ance for coverage provided for periods beginning before 
October 1, 2010. 
‘‘SEC. 2202. GENERAL CONTENTS OF STATE ALL HEALTHY 
CHILDREN PLAN; ELIGIBILITY; ENROLLMENT. 
‘‘(a) GENERAL CONTENTS.—A State all healthy chil-
dren plan shall include a description, consistent with the 
requirements of this title, of— 
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‘‘(1) the all healthy children assistance provided 
under the plan for all healthy children eligible indi-
viduals, including the proposed methods of delivery 
and utilization control systems; 
‘‘(2) eligibility standards consistent with sub-
section (b); 
‘‘(3) enrollment and outreach activities con-
sistent with subsection (c); and 
‘‘(4) methods (including monitoring) used— 
‘‘(A) to assure the quality and appropriate-
ness of care, particularly with respect to pre- 
natal care, well-baby care, well-child care, and 
immunizations provided under the plan, and 
‘‘(B) to assure access to all medically nec-
essary health care services, including emergency 
services. 
‘‘(b) 
ELIGIBILITY
STANDARDS
AND
METHOD-
OLOGY.— 
‘‘(1) IN
GENERAL.—The all healthy children 
plan for a State shall provide that all of the fol-
lowing are all healthy children eligible individuals if 
they are residents: 
‘‘(A) FULL SUBSIDY INDIVIDUALS.— 
‘‘(i) All children under age 19 whose 
family income does not exceed 300 percent 
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of the poverty line (as defined in section 
2110(c)(5)). 
‘‘(ii) All pregnant women and post- 
partum women whose family income does 
not exceed 300 percent of the poverty line. 
‘‘(iii) All children under age 19, preg-
nant women, and post-partum women who 
would have qualified for medical assistance 
under title XIX (as applied in the State as 
of October 1, 2005). 
‘‘(iv) All children under age 19 who 
meet the requirements of subparagraphs 
(A) and (B) of section 1905(w)(1) (relat-
ing to independent foster care adolescents). 
‘‘(B) TRANSITIONAL ASSISTANCE.—An in-
dividual who loses eligibility as an individual de-
scribed in subparagraph (A) because of an in-
crease in family income, but only during the 3- 
month period beginning with the first month in 
which such eligibility is lost. 
‘‘(C) BUY-IN ELIGIBLE INDIVIDUALS.—In-
dividuals who, but for the amount of family in-
come, would be an individual described in sub-
paragraph (A) and who are not described in 
subparagraph (B) if they meet such terms and 
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conditions as the Secretary determines appro-
priate. 
‘‘(2) RESIDENCY REQUIREMENT.—For purposes 
of this title, an individual is a resident of a State if 
the individual is present in the State with intent to 
remain, and includes any individual who would be 
treated as such a resident under title XIX (as in ef-
fect as of January 1, 2007). 
‘‘(3) POST-PARTUM WOMAN DEFINED.—In this 
title, the term ‘post-partum woman’ means a woman 
during the period beginning on the date of comple-
tion of pregnancy and ending on the last day of the 
first month that ends at least 60 days after such 
date. 
‘‘(4) INCOME
METHODOLOGY.—The method-
ology for determining income under a State all 
healthy children plan shall not be more restrictive 
than the income methodology described in section 
1931(b)(1)(B), to the extent such methodology is 
consistent 
with 
the 
requirements 
of 
section 
1902(a)(17). 
‘‘(5) COST-SHARING.—Any cost-sharing re-
quired by the State to be paid by an individual 
under paragraph (1)(B) during the period described 
in that paragraph may not exceed the amount the 
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State plan charged for such individual prior to such 
period. 
‘‘(6) NO ASSET TEST.—The State plan may not 
impose any asset or resource test for eligibility. 
‘‘(7) CONSTRUCTION.—Nothing in this title 
shall be construed as preventing a State from cov-
ering individuals under Title XIX (such as individ-
uals who are 19 or 20 years of age) who are not all 
healthy children eligible individuals. 
‘‘(8) EXCLUSION OF PUBLIC BENEFIT DEFINI-
TION.—The benefits provided under this title shall 
not be deemed to constitute a Federal or State pub-
lic benefit within the meaning of title IV of the Per-
sonal Responsibility and Work Opportunity Rec-
onciliation Act of 1996 (Public Law 104–193) nor 
shall any documentation of citizenship be required 
for the purpose of securing benefits under this title. 
‘‘(9) SPECIAL
RULES
FOR
TERRITORIES.—In 
the case of any State that is not one of the 50 
States or the District of Columbia, the Secretary 
may, by regulation, adjust the income eligibility lev-
els set forth in this title, taking into account factors 
such as average income, cost of living, and avail-
ability of health care coverage in a manner that 
assures the level of access to health coverage for 
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children, pregnant women, and post-partum women 
residing in such a State is comparable to the level 
of access for children, pregnant women, and post- 
partum women residing in the 50 States or the Dis-
trict of Columbia. 
‘‘(c) ENROLLMENT.— 
‘‘(1) STREAMLINED
ENROLLMENT
SYSTEM.— 
Each State plan shall provide for a system of 
streamlined enrollment that includes the following 
(as specified by the Secretary): 
‘‘(A) A simple, short application form 
translated into multiple languages. 
‘‘(B) Applicant self-attestation of eligi-
bility, subject to verification, random audits, or 
both. 
‘‘(C) The option for applications to be sub-
mitted in-person, on-line, by mail, or as part of 
applications for other programs. 
‘‘(D) Automatic enrollment, as provided 
under paragraph (2). 
‘‘(E) 12-month continuous eligibility for 
children. 
‘‘(F) Presumptive eligibility during an in-
terim period of coverage for individuals who ap-
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pear to qualify for assistance under this title, 
on the basis of preliminary information. 
‘‘(G) A determination of continued eligi-
bility at the end of an individual’s eligibility pe-
riod, based on all data available to the State. If 
such determination cannot be made, the indi-
vidual or family shall be contacted for addi-
tional information, but only to the extent such 
information is not available to State officials 
from other sources. The family shall be notified 
of all determinations and findings and given an 
opportunity to contest and appeal them. An in-
dividual’s eligibility shall continue until the re-
determination process is complete. 
‘‘(2) AUTOMATIC ENROLLMENT PROCEDURES.— 
‘‘(A) IN GENERAL.—The automatic enroll-
ment procedures under this paragraph shall in-
clude enrollment of any all healthy children eli-
gible individual at the following points, unless 
the individual (or parent or guardian on the in-
dividual’s behalf) affirmatively declines such en-
rollment: 
‘‘(i) Unless the individual otherwise 
establishes enrollment in a health benefits 
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plan or coverage, at the point of a final de-
termination— 
‘‘(I) of individual’s eligibility to 
participate in any federally-funded, 
means-tested program, regardless of 
any differences between the program’s 
eligibility or income methodology and 
those otherwise used under this title, 
or 
‘‘(II) that, based on the income 
determinations made as part of such 
eligibility determination, the indi-
vidual is eligible to participate under 
this title. 
‘‘(ii) Birth of a child in the United 
States. 
‘‘(iii) Assignment of a social security 
account number for a child. 
‘‘(iv) A visit with any health care pro-
vider eligible to participate in the program 
established under this title. 
‘‘(v) Enrollment in any public elemen-
tary or secondary school within the State 
or any other elementary or secondary 
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school subject to mandatory immunization 
requirements. 
‘‘(vi) Enrollment in a publicly sub-
sidized child care program. 
‘‘(vii) Upon discharge of a child from 
a public institution or other institution 
where the child has been confined. 
‘‘(viii) Such other points of enrollment 
as the State or Secretary may establish. 
For purposes of this subparagraph, the term 
‘federally-funded, means-tested program’ in-
cludes the National School Lunch Program 
under the Richard B. Russell National School 
Lunch Act (42 U.S.C. 1751 et seq.), the Food 
Stamp Program under the Food and Nutrition 
Act of 2008 (7 U.S.C. 2011), the special sup-
plemental nutrition program for women, in-
fants, and children (WIC) under section 17 of 
the Child Nutrition Act of 1966 (42 U.S.C. 
1786), subsidized child care under the Child 
Care Development Block Grant Act of 1990 (42 
U.S.C. 9858 et seq.), programs carried out 
under the Head Start Act (42 U.S.C. 9831 et 
seq.), and other means-tested programs des-
ignated by the Secretary. 
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‘‘(B) OPERATION OF AUTOMATIC ENROLL-
MENT.— 
‘‘(i) IN GENERAL.—In the case of an 
individual who is automatically enrolled 
under subparagraph (A) who does not pay 
any applicable initial premiums, such indi-
vidual shall be deemed to have affirma-
tively declined such enrollment and such 
individual shall be disenrolled from cov-
erage under the all healthy children pro-
gram under section 2201. 
‘‘(ii) NOTICE
AT
TIME
OF
ENROLL-
MENT.—The State plan shall implement 
effective procedures, consistent with the 
Secretary’s guidelines, for ensuring that, at 
the time of enrollment, each auto-enrolled 
individual (or parent or guardian of such 
individual) is advised of— 
‘‘(I) the level of premiums and 
cost-sharing 
applicable, 
consistent 
with section 2203; 
‘‘(II) the fact that enrollment is 
conditioned upon payment of any ap-
plicable premiums; and 
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‘‘(III) such individual’s right to 
decline the coverage made available 
through auto-enrollment. 
‘‘(iii) NOTICE AFTER ENROLLMENT.— 
The State plan shall implement effective 
procedures, consistent with the Secretary’s 
guidelines, for ensuring that, after enroll-
ment, each auto-enrolled individual (or 
parent or guardian of such individual) re-
ceives confirmation of coverage and infor-
mation on benefits under the title. 
‘‘(iv) EQUAL
TREATMENT.—A State 
plan shall implement effective procedures 
to ensure that individuals covered through 
auto-enrollment do not receive fewer serv-
ices, on average, than do similar individ-
uals enrolled through other means. 
‘‘(v) INFORMATION
SHARING.—Each 
State shall develop the information tech-
nology infrastructure needed for automated 
transmission and analysis of data involving 
means-tested programs referred to in sub-
paragraph (A) and other sources of data 
pertinent to eligibility under this title, in-
cluding State and Federal income tax 
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records and information contained in the 
National Directory of New Hires. Con-
sistent with standards developed by the 
Secretary, the State shall implement effec-
tive safeguards that protect the confiden-
tiality of such data and limit its use to the 
effective administration of this title, includ-
ing an identification of potentially eligible 
individuals not enrolled in the State plan 
as well as eligibility verification. 
‘‘(3) OUTREACH.—Each State plan shall pro-
vide for a system for culturally and linguistically 
competent outreach to families of potentially eligible 
individuals, which shall— 
‘‘(A) be fully accessible to those whose 
ability to communicate is affected by disability; 
and 
‘‘(B) incorporate proactive communication 
(via telephone or in-person visits) to such fami-
lies, consumer education, a preliminary or final 
eligibility determination, and enrollment com-
pleted within a single encounter, whenever pos-
sible, and proactive follow-up, when necessary. 
‘‘(d) AVOIDING CROWD-OUT
AND COORDINATION 
WITH OTHER HEALTH COVERAGE PROGRAMS.— 
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‘‘(1) IN GENERAL.—The State plan shall in-
clude a description of procedures, consistent with 
this subsection, to be used to ensure— 
‘‘(A) that benefits provided under the 
State all healthy children plan do not substitute 
for coverage under group health plans; 
‘‘(B) the provision of all healthy children 
assistance to all healthy children eligible indi-
viduals in the State who are Indians (as defined 
in section 4(c) of the Indian Health Care Im-
provement Act, 25 U.S.C. 1603(c)); and 
‘‘(C) coordination with other public and 
private programs providing creditable coverage 
for low-income children and pregnant women. 
‘‘(2) GROUP
HEALTH
PLAN
COVERAGE
PER-
MITTED.—Notwithstanding paragraph (1)(A), a 
State plan may not deny enrollment under this title 
in the case of any of the following individuals or cir-
cumstances: 
‘‘(A) The individual would have qualified 
for medical assistance under title XIX under 
State law as in effect on October 1, 2005. 
‘‘(B) The individual has family income that 
does not exceed 150 percent of the poverty line. 
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‘‘(C) The individual’s enrollment under a 
group health plan— 
‘‘(i) ended more than four months be-
fore applying for enrollment under this 
title; or 
‘‘(ii) was involuntarily terminated be-
cause of the death of a parent, job loss, or 
other circumstance. 
‘‘(D) Other than for the subsidies de-
scribed in section 2203(b)(2)(B) (in the case of 
all healthy children eligible individuals with 
family income that exceeds 300 percent of the 
poverty line), the failure of a parent or other in-
dividual (other than the enrollee) to enroll the 
all healthy children eligible individual in an 
available group health plan. 
‘‘(3) SUPPLEMENTAL COVERAGE.— 
‘‘(A) IN GENERAL.—In the case of an all 
healthy children eligible individual who is en-
rolled in a group health plan, the State plan— 
‘‘(i) must provide full supplemental 
coverage (described in subparagraph (B)) 
if— 
‘‘(I) the individual would have 
qualified for supplemental coverage 
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under title XIX under State law as in 
effect on October 1, 2005; or 
‘‘(II) the individual is disabled 
(as defined for purposes of the supple-
mental 
security 
income 
program 
under title XVI); and 
‘‘(ii) may provide some or all of such 
coverage to other healthy children eligible 
individuals (or to reasonable classifications 
of such individuals, as specified under the 
State plan). 
‘‘(B) FULL SUPPLEMENTAL COVERAGE DE-
SCRIBED.—Full 
supplemental 
coverage 
de-
scribed in this subparagraph includes the fol-
lowing: 
‘‘(i) Benefits covered by the State 
plan that are outside the scope of benefits 
offered under the group health plan. 
‘‘(ii) Reimbursement of families’ pre-
mium payments under the group health 
plan for all healthy children eligible indi-
viduals so that costs do not exceed levels 
otherwise permitted by the State plan. 
‘‘(iii) Coverage of out-of-pocket costs 
incurred under the group health plan 
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where such coverage prevents those costs 
from exceeding the levels otherwise per-
mitted under the State plan. 
‘‘(e) ASSISTANCE FOR CHILDREN WHO AGE OUT OF 
ASSISTANCE.—The State plan shall provide assistance in 
obtaining health benefits to individuals who lose eligibility 
under this title because of age. 
‘‘(f) EMERGENCY COVERAGE.—When an all healthy 
children eligible individual enrolled in a State plan in one 
State moves to another State because of natural disaster 
or other reasons, the individual shall receive immediate 
and automatic presumptive eligibility under this title in 
the State to which the individual moves. 
‘‘SEC. 2203. BENEFITS; PREMIUMS; COST-SHARING; PRO-
VIDER PAYMENT RATES. 
‘‘(a) BENEFITS.— 
‘‘(1) IN GENERAL.—The all healthy children as-
sistance under this title shall include benefits for all 
medically necessary health care, including early and 
periodic screening, diagnostic, and treatment serv-
ices (as defined in section 1905(r)) consistent with 
the requirements of section 1902(a)(43). 
‘‘(2) BENEFIT PROTECTIONS.—The State plan 
shall provide for all benefit protections for all 
healthy children eligible individuals that would oth-
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erwise have applied under title XIX if such individ-
uals were entitled to medical assistance under such 
title, including the application of no preexisting con-
dition exclusion as defined in section 2701(b)(1)(A) 
of the Public Health Service Act and section 
701(b)(1)(A) of the Employee Retirement Income 
Security Act of 1974. 
‘‘(b) PREMIUMS.—Subject to subsection (d)— 
‘‘(1) NO PREMIUM FOR LOWER-INCOME INDI-
VIDUALS.—For all healthy children eligible individ-
uals described in subparagraph (A) or (B) of section 
2202(b)(1), there shall be no premium imposed for 
coverage under this title. 
‘‘(2) REQUIRED PREMIUMS FOR BUY-IN ELIGI-
BLE INDIVIDUALS.— 
‘‘(A) IN GENERAL.—Except as provided in 
this paragraph, in the case of all healthy chil-
dren eligible individuals described in section 
2202(b)(1)(C), the premium charged to an indi-
vidual for coverage under this title shall be the 
applicable percentage specified in subparagraph 
(D) of the total premium. The total premium 
(as estimated under a methodology specified by 
the Secretary) shall be equal to the full average 
per capita cost of benefits for all healthy chil-
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dren eligible individuals under the State all 
healthy children plan. 
‘‘(B) PROVISION OF PREMIUM SUBSIDY.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), in no case shall the premium charged 
to an individual for coverage under this 
title exceed (taking into account any pri-
vate coverage in which the individual is en-
rolled as well as supplemental coverage 
purchased under this title)— 
‘‘(I) 7.5 percent of the family in-
come; or 
‘‘(II) in the case of multiple eligi-
ble individuals within the same family, 
15 percent of family income. 
‘‘(ii) LIMITATION.—Clause (i) shall 
not apply for a healthy child eligible indi-
vidual in a family if— 
‘‘(I) the individual could be cov-
ered under a group health plan for 
which the employer (or other plan 
sponsor) provides for payment of at 
least 50 percent of the premium for 
coverage of such individual; and 
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‘‘(II) the individual is not so cov-
ered because of a rejection of such 
coverage option by the individual. 
‘‘(C) OPTIONAL SUBSIDIES.—A State plan 
may reduce premiums otherwise imposed for 
reasonable classifications of all healthy children 
eligible 
individuals 
described 
in 
section 
2202(b)(1)(C). Such classifications may in-
clude— 
‘‘(i) individuals with family income 
within specific income ranges; 
‘‘(ii) individuals with special health 
care needs; and 
‘‘(iii) individuals who could have 
qualified for medical assistance under an 
optional eligibility category under title XIX 
(as in effect as of January 1, 2007). 
‘‘(D) APPLICABLE
PERCENTAGE
SPECI-
FIED.—For purposes of subparagraph (A), with 
respect to all healthy children eligible individ-
uals described in section 2202(b)(1)(C), the ap-
plicable percentage specified in this subpara-
graph is as follows: 
‘‘(i) In the case of such all healthy 
children eligible individuals whose income 
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exceeds 300, but does not exceed 320 per-
cent of the poverty line, 25 percent. 
‘‘(ii) In the case of such all healthy 
children eligible individuals whose income 
exceeds 320, but does not exceed 340 per 
cent of the poverty line, 35 percent. 
‘‘(iii) In the case of such all healthy 
children eligible individuals whose income 
exceeds 340, but does not exceed 360 per-
cent of the poverty line, 45 percent. 
‘‘(iv) In the case of such all healthy 
children eligible individuals whose income 
exceeds 360, but does not exceed 380 per-
cent of the poverty line, 55 percent. 
‘‘(v) In the case of such all healthy 
children eligible individuals whose income 
exceeds 380, but does not exceed 400 per-
cent of the poverty line, 65 percent. 
‘‘(vi) In the case of such all healthy 
children eligible individuals whose income 
exceeds 400, but does not exceed 425 per-
cent of the poverty line, 80 percent. 
‘‘(vii) In the case of such all healthy 
children eligible individuals whose income 
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tion referred to as the ‘All Healthy Children Program ef-
fective date’). 
‘‘(b) TRANSITION PROVISIONS.— 
‘‘(1) IN GENERAL.—Any child under 19 years 
of age, any pregnant woman, or any independent 
foster care adolescent (as defined in section 
1905(w)(1)) who, as of the day before the All 
Healthy Children Program effective date, is enrolled 
under title XIX or XXI shall, as of such effective 
date, automatically qualify for and be enrolled in the 
State plan under this title, with the benefits based 
on the family income of the individual as most re-
cently determined for purposes of the title under 
which the individual was enrolled. 
‘‘(2) TREATMENT OF SCHIP ADULTS.—In the 
case of an individual not described in paragraph (1) 
who, as of the day before the All Healthy Children 
Program effective date, was enrolled under title XXI 
through a program waiver, during the remainder of 
such program waiver period, so long as the indi-
vidual continues to meet the conditions for eligibility 
under such program waiver, shall be eligible for 
medical assistance under the State plan under title 
XIX and, with respect to medical assistance to such 
individuals, the enhanced FMAP under title XXI 
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