I 
111TH CONGRESS 
1ST SESSION 
H. R. 563 
To amend title XXI of the Social Security Act to require States to provide 
priority under the State Children’s Health Insurance Program (SCHIP) 
to children in families with gross income below 200 percent of the 
Federal poverty level. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 15, 2009 
Mrs. BIGGERT (for herself, Mr. MCCAUL, Ms. GINNY BROWN-WAITE of Flor-
ida, Mr. EHLERS, Mr. FORTENBERRY, and Mr. KIRK) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend title XXI of the Social Security Act to require 
States to provide priority under the State Children’s 
Health Insurance Program (SCHIP) to children in fami-
lies with gross income below 200 percent of the Federal 
poverty level. 
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 ‘‘SCHIP Expansion for 
Kids in Need Act of 2009’’. 
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SEC. 2. REQUIRING PRIORITY FOR SCHIP COVERAGE OF 
CHILDREN 
IN 
FAMILIES 
WITH 
INCOME 
UNDER 200 PERCENT OF THE FEDERAL POV-
ERTY LEVEL. 
(a) DATA
COLLECTION
REQUIREMENT.—Section 
2108 of the Social Security Act (42 U.S.C. 1397hh) is 
amended by adding at the end the following new sub-
section: 
‘‘(e) INCLUSION
OF
CERTAIN
INCOME-RELATED 
DATA.— 
‘‘(1) IN GENERAL.—Each annual report under 
this section for each fiscal year (beginning with fis-
cal year 2010) shall include information, consistent 
with regulations promulgated under paragraph (2), 
on the success of the State in providing health insur-
ance coverage for children at various family income 
levels. 
‘‘(2) REGULATIONS.—In order to provide con-
sistency in the reporting of information under para-
graph (1), the Secretary shall promulgate, not later 
than September 30, 2009, standards for data collec-
tion and statistical methodologies that must be used 
in submitting such information. Such standards 
shall provide for family income levels to be deter-
mined based on gross income relative to percentages 
of the poverty line for a family of the size involved.’’. 
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(b) PLAN FOR COVERAGE OF LOW INCOME CHIL-
DREN.—Section 2101 of such Act (42 U.S.C. 1397aa) is 
amended by adding at the end the following new sub-
section: 
‘‘(e) INCLUSION OF PLAN FOR COVERAGE OF LOW 
INCOME CHILDREN.— 
‘‘(1) DEVELOPMENT.—No State child health 
plan shall be considered approved under section 
2106 for a fiscal year (beginning with fiscal year 
2010) unless— 
‘‘(A) the State has developed and sub-
mitted to the Secretary, not later than 6 
months after the date of the enactment of this 
subsection, a plan to assure that all qualified 
low-income children (as defined in paragraph 
(3)) are covered by creditable health coverage; 
‘‘(B) such a plan has been approved under 
paragraph (2); and 
‘‘(C) the State implements such plan be-
ginning with fiscal year 2010. 
‘‘(2) REVIEW AND APPROVAL.—The Secretary 
shall— 
‘‘(A) promptly review plans submitted 
under paragraph (1)(A); 
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‘‘(B) who meets all eligibility requirements, 
other than those related to income, to be a tar-
geted low-income child.’’. 
(c) LIMITATION ON USE OF SCHIP FUNDS.—Sec-
tion 2105(c) of such Act (42 U.S.C. 1397ee(c)) is amend-
ed by adding at the end the following new paragraph: 
‘‘(8) LIMITATION BASED ON INCREASES IN IN-
COME ELIGIBILITY.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), in the case of a State that increases 
its income eligibility level under its State child 
health plan above the level in effect as of the 
date of the enactment of this paragraph, pay-
ment shall not be made to a State under this 
section for any amount expended for an indi-
vidual whose family income exceeds the income 
eligibility level under its State child health plan 
as of such date unless the State demonstrates 
to the satisfaction of the Secretary that no 
more than 10 percent of qualified low-income 
children (as defined in section 2101(e)(5)) re-
siding in the State are not covered under cred-
itable health coverage. 
‘‘(B) SAFE HARBOR FOR QUALIFIED LOW- 
INCOME CHILDREN AND CURRENTLY ELIGIBLE 
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CHILDREN.—Subparagraph (A) shall not apply 
to limit payment under this section for amounts 
expended for— 
‘‘(i) qualified low-income children (as 
so defined); or 
‘‘(ii) any child who meets eligibility 
standards under the State child health 
plan as in effect as of the date of the en-
actment of this paragraph.’’. 
Æ 
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