I
105TH CONGRESS
1ST SESSION
H. R. 1491
To amend title XIX of the Social Security Act to encourage States to
expand health coverage of low income children and pregnant women
and to provide funds to promote outreach efforts to enroll eligible chil-
dren under health insurance programs.
IN THE HOUSE OF REPRESENTATIVES
APRIL 30, 1997
Mr. DINGELL (for himself, Mrs. ROUKEMA, Mr. BROWN of Ohio, Mr. WAX-
MAN, Mr. BERRY, Ms. DEGETTE, Ms. FURSE, Mr. GREEN, Mr. LA-
FALCE, Mr. MATSUI, Mr. PALLONE, Mr. PASCRELL, Mr. STRICKLAND,
Mr. STUPAK, and Mr. TOWNS) introduced the following bill; which was
referred to the Committee on Commerce
A BILL
To amend title XIX of the Social Security Act to encourage
States to expand health coverage of low income children
and pregnant women and to provide funds to promote
outreach efforts to enroll eligible children under health
insurance programs.
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 ‘‘Children’s Health In-
surance Provides Security (CHIPS) Act of 1997’’.
SEC. 2. ENCOURAGING STATES THROUGH INCREASED FED-
ERAL MEDICAL ASSISTANCE PERCENTAGE
(FMAP) TO EXPAND MEDICAID COVERAGE OF
CHILDREN AND PREGNANT WOMEN.
(a) INCREASED FMAP FOR MEDICAL ASSISTANCE
FOR CERTAIN INDIVIDUALS.—Section 1905 of the Social
Security Act (42 U.S.C. 1396d) is amended—
(1) in subsection (b), by adding at the end the
following new sentence: ‘‘Notwithstanding the first
sentence of this subsection, in the case of a State
plan that meets the conditions described in sub-
section (t)(1), with respect to expenditures for medi-
cal assistance for individuals within an optional cov-
erage group (as defined in subsection (t)(2)) the
Federal medical assistance percentage is equal to the
enhanced medical assistance percentage described in
subsection (t)(3).’’; and
(2) by adding at the end the following new sub-
section:
‘‘(t)(1) The conditions described in this paragraph for
a State plan are as follows:
‘‘(A) The plan provides (either through exercise
of the option under section 1902(l)(1)(D) or author-
ity under section 1902(r)(2)) for coverage under sec-
tion 1902(l)(1)(D) of individuals under 19 years of
age, regardless of date of birth.
‘‘(B) 
The 
plan 
provides 
under 
section
1902(e)(12) for continuous eligibility for a period of
12 months (under subparagraph (A) of such section)
of all individuals under 19 years of age who are de-
termined to be eligible for benefits under a State
plan approved under this title under section
1902(a)(10)(A).
‘‘(2) For purposes of subsection (b), the term ‘op-
tional coverage group’ means individuals described in each
of the following subparagraphs:
‘‘(A) PREGNANT WOMEN WITH FAMILY INCOME
BETWEEN 133 PERCENT AND 150 PERCENT OF POV-
ERTY LINE.—Women described in subparagraph (A)
of section 1902(l)(1) whose family income exceeds
133 percent, but does not exceed 150 percent, of the
poverty line for a family of the size involved.
‘‘(B) INFANTS WITH FAMILY INCOME BETWEEN
133
PERCENT
AND
150
PERCENT
OF
POVERTY
LINE.—Infants described in subparagraph (B) of
section 1902(l)(1) whose family income exceeds 133
percent, but does not exceed 150 percent, of the pov-
erty line for a family of the size involved.
‘‘(C) CHILDREN UNDER 6 YEARS OF AGE WITH
FAMILY INCOME BETWEEN 133 PERCENT AND 150
PERCENT OF POVERTY LINE.—Children described in
subparagraph (C) of section 1902(l)(1) whose family
income exceeds 133 percent, but does not exceed
150 percent, of the poverty line for a family of the
size involved.
‘‘(D) OLDER CHILDREN WITH FAMILY INCOME
BETWEEN 100 PERCENT AND 150 PERCENT OF POV-
ERTY
LINE.—Children described in subparagraph
(D) of section 1902(l)(1), who are not described in
any of subclauses (I) through (III) of section
1902(a)(10)(A)(i), and whose family income exceeds
100 percent, but does not exceed 150 percent, of the
poverty line for a family of the size involved.
‘‘(3) The enhanced medical assistance percentage de-
scribed in this paragraph for a State is equal to the Fed-
eral medical assistance percentage (as defined in the first
sentence of subsection (b)) for the State increased (but
not above 90 percent) by the number of percentage points
equal to 30 percent of the number of percentage points
by which (A) such Federal medical assistance percentage
for the State, is less than (B) 100 percent.’’.
(b) STATE OPTION TO EXPAND ELIGIBILITY TO 150
PERCENT OF POVERTY LINE FOR CHILDREN OVER 1
YEAR
OF AGE.—Section 1902(l)(2) of such Act (42
U.S.C. 1396a(l)(2)) is amended—
(1) in subparagraph (B), by striking ‘‘equal to
133 percent’’ and inserting ‘‘a percentage (specified
by the State and not less than 133 percent and not
more than 150 percent)’’, and
(2) in subparagraph (C), by striking ‘‘equal to
100 percent’’ and inserting ‘‘a percentage (specified
by the State and not less than 100 percent and not
more than 150 percent)’’.
(c) CLARIFICATION OF STATE OPTION TO COVER
ALL CHILDREN UNDER 19 YEARS
OF AGE.—Section
1902(l)(1)(D) of such Act (42 U.S.C. 1396a(l)(1)(D)) is
amended by inserting ‘‘(or, at the option of a State, after
any earlier date)’’ after ‘‘children born after September
30, 1983’’.
(d) STATE OPTION
OF CONTINUOUS ELIGIBILITY
FOR 12 MONTHS.—Section 1902(e) of such Act (42
U.S.C. 1396a(e)) is amended by adding at the end the
following new paragraph:
‘‘(12) At the option of the State, the plan may pro-
vide that an individual who is under an age specified by
the State (not to exceed 19 years of age) and who is deter-
mined to be eligible for benefits under a State plan ap-
proved under this title under subsection (a)(10)(A) shall
remain eligible for those benefits until the earlier of—
‘‘(A) the end of a period (not to exceed 12
months) following the determination; or
‘‘(B) the time that the individual exceeds that
age.’’.
(e) EFFECTIVE DATE.—The amendments made by
this section shall apply to medical assistance for items and
services furnished on or after January 1, 1998.
SEC. 3. EMPLOYER CONTRIBUTIONS TO PREMIUMS.
(a) GENERAL RULE.—Any employer which elects to
make employer contributions on behalf of an individual
who is an employee of such employer, or who is a depend-
ent of such employee, for health insurance coverage shall
not condition, or vary, such contributions with respect to
any such individual by reason of such individual’s status
as an individual eligible for medical assistance under a
State plan under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.).
(b) ELIMINATION OF CONTRIBUTIONS.—An employer
shall not be treated as failing to meet the requirements
of subsection (a) if the employer ceases to make employer
contributions for health insurance coverage for all its em-
ployees.
(c) ENFORCEMENT.—The enforcement provisions ap-
plicable to group health insurance coverage under the
amendments made by section 101(e)(2) of the Health In-
surance Portability and Accountability Act of 1996 (Pub-
lic Law 104–191; 110 Stat. 1952) shall apply with respect
to an employer that violates the provisions of this section
in the same manner as such provisions apply to employers
under such amendments.
SEC. 4. GRANT PROGRAM TO PROMOTE OUTREACH EF-
FORTS.
(a) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated, for each fiscal year be-
ginning with fiscal year 1998 to the Secretary of Health
and Human Services, $25,000,000 for grants to States,
localities, and nonprofit entities to promote outreach ef-
forts to enroll eligible children under the medicaid pro-
gram under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.) and related programs.
(b) USE OF FUNDS.—Funds under this section may
be used to reimburse States, localities, and nonprofit enti-
ties for additional training and administrative costs associ-
ated with outreach activities. Such activities include the
following:
(1) USE OF A COMMON APPLICATION FORM FOR
FEDERAL
CHILD
ASSISTANCE
PROGRAMS.—Imple-
menting use of a single application form (established
by the Secretary and based on the model application
forms developed under subsections (a) and (b) of
section 6506 of the Omnibus Budget Reconciliation
Act of 1989 (42 U.S.C. 701 note; 1396a note)) to
determine the eligibility of a child or the child’s fam-
ily (as applicable) for assistance or benefits under
the medicaid program and under other Federal child
assistance programs (such as the temporary assist-
ance for needy families program under part A of
title IV of the Social Security Act (42 U.S.C. 601
et seq.), the food stamp program, as defined in sec-
tion 3(h) of the Food Stamp Act of 1977 (7 U.S.C.
2012(h)), and the State program for foster care
maintenance payments and adoption assistance pay-
ments under part E of title IV of the Social Security
Act (42 U.S.C. 670 et seq.)).
(2) EXPANDING
OUTSTATIONING
OF
ELIGI-
BILITY PERSONNEL.—Providing for the stationing of
eligibility workers at sites, such as hospitals and
health clinics, at which children receive health care
or related services.
(c) APPLICATION, ETC.—Funding shall be made
available under this section only upon the approval of an
application by a State, locality, or nonprofit entity for such
funding and only upon such terms and conditions as the
Secretary specifies.
(d) ADMINISTRATION.—The Secretary may admin-
ister the grant program under this section through the
identifiable administrative unit designated under section
509(a) of the Social Security Act (42 U.S.C. 709(a)) to
promote coordination of medicaid and maternal and child
health activities and other child health related activities.
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