services, less the State share of basic expendi-
tures described in paragraph (2), to 
‘‘(B) the total expenditures referred to in 
subparagraph (A). 
‘‘(2) STATE
SHARE
FOR
BASIC
EXPENDI-
TURES.— 
‘‘(A) IN GENERAL.—The State share of ex-
penditures attributable to required populations 
and services under this title for a quarter in a 
fiscal year is equal to 1⁄4 of the product of the 
following: 
‘‘(i) BASE
AMOUNT.—The base FY 
2010 amount (specified in subparagraph 
(B) for the State). 
‘‘(ii) CHILD INCREASE FACTOR.—One 
plus the percentage increase in the number 
of children residing in the State, as esti-
mated by the Secretary, from fiscal year 
2010 to the fiscal year involved. 
‘‘(iii) COST INCREASE FACTOR.—One 
plus the percentage increase in the medical 
care component of the consumer price 
index for all urban consumers (U.S. city 
average), as estimated by the Secretary, 
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from fiscal year 2010 to the fiscal year in-
volved. 
‘‘(B) BASE
FY
2010
AMOUNT.—For pur-
poses of this paragraph, the ‘base FY 2010 
amount’ for a State is equal to the sum of— 
‘‘(i) the total amount of expenditures 
made by the State during calendar quar-
ters in fiscal year 2010 under title XIX 
(including under any waiver under section 
1115) that are attributable to coverage of 
individuals who meet the requirement to be 
all healthy children eligible individuals, in-
cluding an appropriate portion of adminis-
trative expenses, reduced by the amount of 
Federal financial participation provided 
with respect to such expenditures; and 
‘‘(ii) the total amount of expenditures 
made by the State during calendar quar-
ters in fiscal year 2010 under title XXI 
(including under any waiver under section 
1115), reduced by the amount of payment 
received by the State under such title for 
such quarters. 
‘‘(3) 
COUNTER-CYCLICAL
REDUCTION.—The 
Secretary shall establish a formula for providing, in 
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addition to the base Federal matching amounts, 
automatic supplemental assistance to States that ex-
perience a sustained economic downturn, based upon 
State’s quarterly unemployment rate exceeding the 
State’s average of such rates during a period of pre-
vious calendar quarters (in such number as the Sec-
retary shall specify) and by a percentage to be deter-
mined by the Secretary and in an amount calculated 
on the basis of the relationship between changes in 
unemployment and anticipated increases in providing 
services under this title. The supplemental assistance 
shall be distributed quarterly through a supplement 
to the State’s Federal payment and shall be for such 
duration as the Secretary determines appropriate. 
‘‘(c) BONUS
FOR MEETING ENROLLMENT TAR-
GETS.—The Secretary is authorized to establish a system 
for providing additional bonus payments for States that 
meet or exceed enrollment targets established for each 
State by the Secretary, taking into account the cir-
cumstances in each State. 
‘‘(d) ADVANCE PAYMENT; RETROSPECTIVE ADJUST-
MENT.—The Secretary may make payments under this 
section for each quarter on the basis of advance estimates 
of expenditures submitted by the State and such other in-
vestigation as the Secretary may find necessary, and may 
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reduce or increase the payments as necessary to adjust 
for any overpayment or underpayment for prior quarters. 
‘‘(e) TREATMENT OF TERRITORIES.—In the case of 
any State that is not one of the 50 States or the District 
of Columbia, the Secretary shall, by regulation, establish 
a formula for allocating funds to provide all healthy chil-
dren assistance in such a State. Such formula shall 
produce a funding level for such a State that comparable 
to the level of funding for the provision of all healthy chil-
dren assistance in the 50 States or the District of Colum-
bia. 
‘‘SEC. 2205. APPLICATION OF SCHIP, MEDICAID AND RE-
LATED SSA PROVISIONS; WAIVERS; ADMINIS-
TRATION. 
‘‘(a) SCHIP PROVISIONS RELATING TO PLAN SUB-
MISSION, STRATEGIC OBJECTIVES
AND PERFORMANCE 
GOALS, AND AUDITS.—Except to the extent inconsistent 
with the provisions of this title, sections 2106, 2107, and 
2108(d) shall apply with respect to State plans under this 
title in the same manner as they applied with respect to 
State plans under title XXI. 
‘‘(b) MEDICAID PROVISIONS.—Except to the extent 
inconsistent with the provisions of this title, the provisions 
of title XIX (and the provisions of title XI, including sec-
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tion 1115, insofar as they are applicable to title XIX) shall 
apply to activities under this title. 
‘‘(c) LIMITATION ON WAIVERS.—No waiver shall be 
granted under section 1115 with respect to this title if 
it is likely to result in— 
‘‘(1) an increase in health care or health pre-
mium costs for all healthy children eligible individ-
uals under this title; or 
‘‘(2) a reduction in benefits, eligibility, guaran-
teed eligibility, health care access, or health care 
quality for such individuals under this title. 
‘‘(d) 
ANNUAL
REPORTS.—The 
Secretary 
shall 
present annual reports to Congress describing implemen-
tation of this title. Such reports shall include a description 
of— 
‘‘(1) optional coverage chosen by States; and 
‘‘(2) for each category of coverage and method 
of enrollment, nationwide and State-specific data 
showing the number and characteristics of all 
healthy children eligible individuals receiving cov-
erage, services provided, categories and amounts of 
expenditures. 
‘‘SEC. 2206. DEFINITIONS. 
‘‘(a) IN GENERAL.—For purposes of this title: 
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‘‘(1) ALL HEALTHY CHILDREN ELIGIBLE INDI-
VIDUAL.—The term ‘all healthy children eligible in-
dividual’ means individuals described in section 
2202(b)(1). 
‘‘(2) ALL HEALTHY CHILDREN ASSISTANCE.— 
The term ‘all healthy children assistance’ means 
payment under this title for part or all of the cost 
of health benefits coverage for all healthy children 
eligible individual. 
‘‘(3) CHILD, GROUP HEALTH PLAN, AND POV-
ERTY LINE.—The terms ‘child’, ‘group health plan’, 
and ‘poverty line’ have the meanings given such 
terms in section 2110(c). 
‘‘(4) STATE
ALL
HEALTHY
CHILDREN
PLAN; 
STATE PLAN.—The terms ‘State all healthy children 
plan’ and ‘State plan’ mean such a plan as approved 
under this title. 
‘‘(5) STATE.—The term ‘State’ has the mean-
ing given such term for purposes of titles XIX and 
XXI. 
‘‘SEC. 2207. EFFECTIVE DATES; TRANSITION. 
‘‘(a) EFFECTIVE DATE.—Benefits and payments to 
States shall first be available under this title for items and 
services furnished on or after October 1, 2010 (in this sec-
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shall be substituted for the Federal medical assist-
ance percentage (FMAP) for purposes of section 
1903(a)(1). 
‘‘(3) GUIDANCE.—The Secretary shall provide 
guidance and assistance to the States in carrying 
out this section. 
‘‘(c) MEDICAID; SCHIP TRANSITION.—Notwith-
standing any other provision of law, as of the All Healthy 
Children Program effective date, any all healthy children 
eligible individual shall not be eligible for medical assist-
ance under title XIX or child health assistance under title 
XXI and no Federal financial participation shall be avail-
able under either such title with respect to such individ-
uals.’’. 
SEC. 3. COMMISSION ON CHILDREN’S HEALTH COVERAGE. 
(a) ESTABLISHMENT.—There is hereby established a 
Commission on Children’s Health Coverage (in this sec-
tion referred to as the ‘‘Commission’’). 
(b) COMPOSITION.— 
(1) IN
GENERAL.—The Commission shall be 
composed of the following: 
(A) Four members, one each appointed by 
the majority and minority leaders of the House 
of Representatives and the majority and minor-
ity leaders of the Senate. 
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(B) One member appointed by the Sec-
retary of Health and Human Services. 
(C) Two members, one each appointed by 
the American Academy of Pediatrics and by the 
Institute of Medicine of the National Academies 
of Science. 
(D) One member appointed by the Sec-
retary of Health and Human Services who is a 
representative of parents of children with spe-
cial health care needs. 
(E) One member appointed by the Sec-
retary of Health and Human Services who is a 
representative of a children’s advocacy group. 
(F) Two non-voting advisory members ap-
pointed by the National Governors Association. 
Appointment of members of the Commission shall 
first be made not later than 60 days after the date 
of the enactment of this Act. 
(2) TERMS.—The term of each member of the 
Commission shall be for 2 years. A vacancy shall be 
filled in the same manner as the original appoint-
ment but the member so appointed shall serve for 
the remainder of the term of the vacating member. 
(3) COMPENSATION.—Members of the Commis-
sion who are not Federal officers or employees shall 
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be entitled to compensation, including travel time, at 
a per diem rate equivalent of rate for level IV of Ex-
ecutive Schedule under section 5315 of title 5, 
United States Code, and for travel expense reim-
bursement, at rates authorized for employees of 
agencies under such title. 
(4) CHAIR.—The Secretary shall designate a 
member to serve as Chair of the Commission. 
(5) MEETINGS.—The Commission shall meet at 
the call of the Chair. 
(6) USE
OF
COMMITTEES.—The Commission 
may establish committees if necessary to carry out 
its duties. 
(c) SUPERMAJORITY REQUIREMENT FOR ACTIONS.— 
Commission actions must be approved by at least six of 
the members described in subparagraphs (A) through (E) 
of subsection (b)(1). 
(d) ADMINISTRATION.— 
(1) POWERS.— 
(A) HEARINGS.—The Commission may 
hold such hearings, sit and act at such times 
and places, take such testimony, and receive 
such evidence as the Commission considers ad-
visable to carry out this section. 
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(B) INFORMATION FROM FEDERAL AGEN-
CIES.—The Commission may secure directly 
from any Federal department or agency such 
information as the Commission considers nec-
essary to carry out this section. Upon request 
of the Chairperson of the Commission, the head 
of such department or agency shall furnish such 
information to the Commission. 
(C) POSTAL SERVICES.—The Commission 
may use the United States mails in the same 
manner and under the same conditions as other 
departments and agencies of the Federal Gov-
ernment. 
(D) GIFTS.—The Commission may accept, 
use, and dispose of gifts or donations of serv-
ices or property. 
(2) COMPENSATION.—While serving on the 
business of the Commission (including travel time), 
a member of the Commission who is not a Federal 
officer or employee shall be entitled to compensation 
at the per diem equivalent of the rate provided for 
level IV of the Executive Schedule under section 
5315 of title 5, United States Code, and while so 
serving away from home and the member’s regular 
place of business, any member may be allowed travel 
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expenses, as authorized by the chairperson of the 
Commission. All members of the Commission who 
are officers or employees of the United States shall 
serve without compensation in addition to that re-
ceived for their services as officers or employees of 
the United States. 
(3) STAFF.— 
(A) IN GENERAL.—The Chair of the Com-
mission may, without regard to the civil service 
laws and regulations, appoint and terminate— 
(i) subject to the approval of a major-
ity of the Commission, an executive direc-
tor; and 
(ii) such other additional personnel as 
may be necessary to enable the Commis-
sion to perform its duties. 
(B) STAFF COMPENSATION.—The Chair of 
the Commission may fix the compensation of 
the executive director and other personnel with-
out regard to chapter 51 and subchapter III of 
chapter 53 of title 5, United States Code, relat-
ing to classification of positions and General 
Schedule pay rates, except that the rate of pay 
for the executive director and other personnel 
may not exceed the rate payable for level V of 
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the Executive Schedule under section 5316 of 
such title. 
(C) DETAIL
OF
GOVERNMENT
EMPLOY-
EES.—Any Federal Government employee may 
be detailed to the Commission without reim-
bursement, and such detail shall be without 
interruption or loss of civil service status or 
privilege. 
(D) PROCUREMENT OF TEMPORARY AND 
INTERMITTENT
SERVICES.—The Chair of the 
Commission may procure temporary and inter-
mittent services under section 3109(b) of title 
5, United States Code, at rates for individuals 
which do not exceed the daily equivalent of the 
annual rate of basic pay prescribed for level V 
of the Executive Schedule under section 5316 
of such title. 
(e) REIMBURSEMENT
OF COSTS.—The Secretary 
shall provide, from general operating funds of the Depart-
ment of Health and Human Services, the Commission 
with such funds and support as may be necessary to sup-
port its activities. 
(f) ANNUAL REPORTS.—Beginning one year after the 
All Healthy Children Program effective date under section 
2207(a) of the Social Security Act, the Commission shall 
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transmit to Congress an annual report that evaluates the 
status of children’s health coverage in the United States, 
including an evaluation of the implementation of title 
XXII of the such Act and recommendations for policy im-
provements at the State and national levels and in the pri-
vate sector to improve such coverage. 
(g) SUBMISSION OF LEGISLATIVE PROPOSAL FOR 
UNIVERSAL COVERAGE OF CHILDREN.—Not later than 
three years after the date of the enactment of this Act, 
the Commission shall submit to Congress a report that 
contains a legislative proposal that would assure health 
benefits coverage for all children in the United States. 
Such proposal may include a requirement that parents ob-
tain coverage for their children or that employers fund 
coverage for children of their workers. The proposal shall 
provide for the following: 
(1) Coverage shall include all medically nec-
essary care for all children. 
(2) Enrollment shall be simple and seamless. 
(3) Unnecessary costs shall be avoided. 
(4) Quality, access, and continuity of care shall 
be promoted. 
Æ 
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