I 
110TH CONGRESS 
1ST SESSION H. R. 1535 
To amend titles XIX and XXI of the Social Security Act to ensure that 
every child in the United States has access to affordable, quality health 
insurance coverage, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 15, 2007 
Mr. DINGELL (for himself, Ms. DEGETTE, Mr. PALLONE, Mr. WAXMAN, Ms. 
BALDWIN, Mr. ENGEL, Ms. SCHAKOWSKY, Mr. BOUCHER, Ms. ESHOO, 
Mr. GENE GREEN of Texas, Mr. GONZALEZ, Mr. GORDON of Tennessee, 
Mrs. CAPPS, Mr. BUTTERFIELD, Mr. MARKEY, Mr. WEINER, Mr. ALLEN, 
Mr. WYNN, Mr. MELANCON, Ms. MATSUI, Mr. MCNULTY, Ms. HIRONO, 
and Mr. ROSS) introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend titles XIX and XXI of the Social Security Act 
to ensure that every child in the United States has 
access to affordable, quality health insurance coverage, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; AMENDMENTS TO SOCIAL SECU-
RITY ACT; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Children’s Health First Act’’. 
VerDate Aug 31 2005 
00:50 Mar 17, 2007
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H1535.IH
H1535
hmoore on PROD1PC68 with HMBILLS
(b) AMENDMENTS TO SOCIAL SECURITY ACT.—Ex-
cept as otherwise specifically provided, whenever in this 
Act an amendment is expressed in terms of an amendment 
to or repeal of a section or other provision, the reference 
shall be considered to be made to that section or other 
provision of the Social Security Act. 
(c) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; amendments to Social Security Act; table of contents. 
TITLE I—OPTIONS FOR AFFORDABLE COVERAGE FOR ALL 
CHILDREN 
Subtitle A—Expanded Coverage of Children Under SCHIP and Through 
Employer-Sponsored Coverage 
Sec. 101. State option to expand coverage of children under SCHIP. 
Sec. 102. Authority for States to offer purchase of coverage for uncovered chil-
dren under SCHIP. 
Sec. 103. Support for employment-based coverage of children eligible for 
SCHIP or Medicaid. 
Sec. 104. Modification of prohibition on coverage of children of State employees. 
Subtitle B—Ensuring Dependable Coverage for All Children 
Sec. 111. Improving benchmark coverage options. 
Sec. 112. Requiring coverage of EPSDT services, including dental services, and 
federally-qualified health services and improving coverage of 
additional categories of services. 
Sec. 113. Clarification of requirement to provide EPSDT services for all chil-
dren in benchmark benefit packages under Medicaid. 
Sec. 114. Medicaid-SCHIP Payment Advisory Commission. 
Subtitle C—Ensuring a Fair Partnership 
Sec. 121. Increase in FMAP for medical assistance for children for States that 
expand coverage of children. 
Subtitle D—State Options for Additional Coverage Expansions 
Sec. 131. Optional coverage of older children under Medicaid and SCHIP. 
Sec. 132. Optional coverage of legal immigrants under the Medicaid program 
and SCHIP. 
Sec. 133. State option to expand or add coverage of certain pregnant women 
under SCHIP. 
TITLE II—REMOVAL OF OTHER BARRIERS TO COVERAGE 
VerDate Aug 31 2005 
00:50 Mar 17, 2007
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6211
E:\BILLS\H1535.IH
H1535
hmoore on PROD1PC68 with HMBILLS
Sec. 201. Establishment of new base SCHIP allotments that are responsive to 
increases in health care costs and enrollment expansions. 
Sec. 202. 2-year initial availability of SCHIP allotments. 
Sec. 203. Redistribution of unused allotments to address State funding short-
falls. 
Sec. 204. Incentives for school-based outreach and enrollment. 
Sec. 205. Medicaid citizenship documentation requirements. 
Sec. 206. State option to provide for ‘‘express lane’’ and simplified determina-
tions of a child’s financial eligibility for medical assistance 
under Medicaid or child health assistance under SCHIP. 
Sec. 207. Information technology connections to improve health coverage deter-
minations. 
Sec. 208. Encouraging culturally appropriate enrollment practices. 
Sec. 209. Model of Interstate coordinated enrollment and coverage process. 
Sec. 210. Elimination of counting medicaid child presumptive eligibility costs 
against title XXI allotment. 
Sec. 211. Authority for qualifying States to use portion of SCHIP allotment for 
any fiscal year for certain medicaid expenditures. 
Sec. 212. Application of Medicaid outreach procedures to all pregnant women 
and children. 
TITLE III—EFFECTIVE DATE 
Sec. 301. Effective date. 
TITLE I—OPTIONS FOR AFFORD-
ABLE COVERAGE FOR ALL 
CHILDREN 
Subtitle A—Expanded Coverage of 
Children 
Under 
SCHIP 
and 
Through 
Employer-Sponsored 
Coverage 
SEC. 101. STATE OPTION TO EXPAND COVERAGE OF CHIL-
DREN UNDER SCHIP. 
(a) OPTION FOR COVERAGE OF CHILDREN UP TO 400 
PERCENT OF POVERTY LINE.—Section 2110(c)(4) (42 
U.S.C. 1397jj(c)(4)) is amended by inserting ‘‘(or, at the 
option of the State, any percentage up to 400 percent)’’ 
after ‘‘200 percent’’. 
VerDate Aug 31 2005 
00:50 Mar 17, 2007
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1535.IH
H1535
hmoore on PROD1PC68 with HMBILLS
(b) ENSURING FUNDING FOR STATE ELIGIBILITY 
EXPANSION.— 
(1) IN
GENERAL.—Section 2105 (42 U.S.C. 
1397dd) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(i) FUNDING FOR CHILD HEALTH ASSISTANCE FOR 
COVERAGE EXPANSION STATES.— 
‘‘(1) IN
GENERAL.—Notwithstanding section 
2104, in the case of a State that has elected the op-
tion under section 2110(c)(4) to apply for a calendar 
quarter in a fiscal year a percentage that is 400 per-
cent and that meets the requirement of paragraph 
(2) (relating to no limitation on enrollment), the al-
lotment determined for the State for such fiscal year 
under section 2104 shall be increased by such sums 
as are necessary for making payments to the State 
for expenditures described in subsection (a)(1). 
‘‘(2) NO LIMITATION ON ENROLLMENT.—The 
requirement of this paragraph with respect to a 
State for a calendar quarter is that the State does 
not impose, with respect to the enrollment under the 
State child health plan of targeted low-income chil-
dren during the quarter, any enrollment cap or other 
numerical limitation on enrollment, any waiting list, 
any procedures designed to delay the consideration 
VerDate Aug 31 2005 
00:50 Mar 17, 2007
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H1535.IH
H1535
hmoore on PROD1PC68 with HMBILLS
of applications for enrollment, or similar limitation 
with respect to enrollment. 
‘‘(3) APPROPRIATION.—There is appropriated, 
out of any money in the Treasury not otherwise ap-
propriated, such sums as may be necessary for the 
purpose of paying a State described in paragraph 
(1) for each calendar quarter described in such para-
graph, an amount equal to the enhanced FMAP of 
expenditures described in such paragraph and in-
curred during such quarter.’’. 
(2) CONFORMING AMENDMENTS.—Section 2104 
(42 U.S.C. 1397dd) is amended— 
(A) in subsection (a), by striking ‘‘sub-
section (d)’’ and inserting ‘‘ subsections (d) and 
(h) and section 2105(i)’’; 
(B) in subsection (b)(1), by striking ‘‘sub-
section (d)’’ and inserting ‘‘ subsections (d) and 
(h) and section 2105(i)’’; and 
(C) in subsection (c)(1), by striking ‘‘sub-
section (d)’’ and inserting ‘‘ subsections (d) and 
(h) and section 2105(i)’’. 
VerDate Aug 31 2005 
00:50 Mar 17, 2007
Jkt 059200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H1535.IH
H1535
hmoore on PROD1PC68 with HMBILLS