amount available for the additional allotments 
under paragraph (1) for a fiscal year, the Sec-
retary shall allot to each State with a State 
child health plan approved under this title— 
‘‘(i) in the case of such a State other 
than a commonwealth or territory de-
scribed in clause (ii), the same proportion 
as the proportion of the State’s allotment 
under subsection (b) (determined without 
regard to subsection (f)) to 98.95 percent 
of the total amount of the allotments 
under such section for such States eligible 
for an allotment under this subparagraph 
for such fiscal year; and 
‘‘(ii) in the case of a commonwealth or 
territory described in subsection (c)(3), the 
same proportion as the proportion of the 
commonwealth’s or territory’s allotment 
under subsection (c) (determined without 
regard to subsection (f)) to 1.05 percent of 
the total amount of the allotments under 
such section for commonwealths and terri-
tories eligible for an allotment under this 
subparagraph for such fiscal year.
‘‘(B) AVAILABILITY AND REDISTRIBUTION 
OF
UNUSED
ALLOTMENTS.—In applying sub-
sections (e) and (f) with respect to additional 
allotments made available under this subsection, 
the procedures established under such sub-
sections shall ensure such additional allotments 
are only made available to States which have 
elected to provide coverage under section 2111. 
‘‘(3) USE OF ADDITIONAL ALLOTMENT.—Addi-
tional allotments provided under this subsection are 
not available for amounts expended before October 
1, 2005. Such amounts are available for amounts ex-
pended on or after such date for child health assist-
ance for targeted low-income children, as well as for 
parent health assistance for targeted low-income 
parents, and health care assistance for targeted low- 
income pregnant women. 
‘‘(4) REQUIRING ELECTION TO PROVIDE COV-
ERAGE.—No payments may be made to a State 
under this title from an allotment provided under 
this subsection unless the State has made an elec-
tion to provide parent health assistance for targeted 
low-income parents, or health care assistance for 
targeted low-income pregnant women.’’.
(ii) 
CONFORMING
AMENDMENTS.— 
Section 2104 of the Social Security Act 
(42 U.S.C. 1397dd) is amended— 
(I) in subsection (a), by inserting 
‘‘subject to subsection (d),’’ after 
‘‘under this section,’’; 
(II) in subsection (b)(1), by in-
serting ‘‘and subsection (d)’’ after 
‘‘Subject to paragraph (4)’’; and 
(III) in subsection (c)(1), by in-
serting ‘‘subject to subsection (d),’’ 
after ‘‘for a fiscal year,’’. 
(C) NO COST-SHARING FOR PREGNANCY- 
RELATED
BENEFITS.—Section 2103(e)(2) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1397cc(e)(2)) is amended— 
(i) in the heading, by inserting ‘‘AND 
PREGNANCY-RELATED
SERVICES’’ 
after 
‘‘PREVENTIVE SERVICES’’; and 
(ii) by inserting before the period at 
the end the following: ‘‘and for pregnancy- 
related services’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection apply to items and services fur-
nished on or after October 1, 2005, whether or not
regulations implementing such amendments have 
been issued. 
(b) RULES FOR IMPLEMENTATION BEGINNING WITH 
FISCAL YEAR 2007.— 
(1) EXPANSION
OF
AVAILABILITY
OF
EN-
HANCED
MATCH
UNDER
MEDICAID
FOR
PRE-CHIP 
EXPANSIONS.—Paragraph (4) of section 1905(u) of 
the Social Security Act (42 U.S.C. 1396d(u)), as in-
serted by subsection (a)(1)(C), is amended— 
(A) by amending clause (ii) of subpara-
graph (A) to read as follows: 
‘‘(ii) CERTAIN
PREGNANT
WOMEN.—Ex-
penditures for medical assistance for pregnant 
women under section 1902(l)(1)(A) in a family 
the income of which exceeds the 133 percent of 
the income official poverty line, but only if the 
income 
level 
established 
under 
section 
1902(l)(2) (or under a Statewide waiver under 
section 1115) for pregnant women is 185 per-
cent of the income official poverty line.’’; and 
(B) by adding at the end the following: 
‘‘(B) CHILDREN
IN
FAMILIES
WITH
INCOME 
ABOVE
MEDICAID
MANDATORY
LEVEL
NOT
PRE-
VIOUSLY
DESCRIBED.—The expenditures described 
in this subparagraph are expenditures (other than
expenditures described in paragraph (2) or (3)) for 
medical assistance made available to any child who 
is 
eligible 
for 
assistance 
under 
section 
1902(a)(10)(A) (other than under clause (i)) and 
the income of whose family exceeds the minimum in-
come level required under subsection 1902(l)(2) (or, 
if higher, the minimum level required under section 
1931 for that State) for a child of the age involved 
(treating any child who is 19 or 20 years of age as 
being 18 years of age).’’. 
(2) OFFSET
OF
ADDITIONAL
EXPENDITURES 
FOR
ENHANCED
MATCH
FOR
PRE-CHIP
EXPAN-
SION.—Section 1905 of the Social Security Act (42 
U.S.C. 1396d) is amended— 
(A) in the fourth sentence of subsection 
(b), by inserting ‘‘(except in the case of expend-
itures described in subsection (u)(5))’’ after ‘‘do 
not exceed’’; 
(B) in subsection (u), by inserting after 
paragraph (4) (as inserted by subparagraph 
(C)), the following: 
‘‘(5) For purposes of the fourth sentence of sub-
section (b) and section 2105(a), the following payments 
under this title do not count against a State’s allotment 
under section 2104: