(1) Every year millions of people are enrolled in 
Medicaid and the Children’s Health Insurance Pro-
gram (in this section referred to as ‘‘CHIP’’), but 
subsequently lose their coverage, despite still being 
eligible, because of inefficient and cumbersome pa-
perwork and logistical requirements. 
(2) Data show that the typical enrollee receives 
Medicaid coverage for about three-quarters of a 
year. Coverage periods are lower for non-elderly, 
non-disabled adults than for those with disabilities, 
seniors, and children. 
(3) Medicaid enrollees with coverage disruptions 
are more likely to be hospitalized for illnesses like 
asthma, diabetes, or cardiovascular disease that can 
be effectively managed through ongoing primary 
medical care and medication, are less likely to be 
screened for breast cancer, and may have poorer 
cancer outcomes. 
(4) Children enrolled in CHIP also experience 
disruptions in health coverage and care. For exam-
ple, during just a one-year period, over one-third of 
CHIP enrollees were also enrolled in a State’s Med-
icaid program. Transitions between Medicaid and 
CHIP can cause disruptions in care because the 
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health care coverage and participating providers vary 
between the two programs. 
(5) Interruptions in coverage can impair the re-
ceipt of effective primary care and lead to expensive 
hospitalizations or emergency room visits. Unneces-
sary enrollment, disenrollment, and reenrollment in 
Medicaid and CHIP result in higher administrative 
expenses for reenrollment and result in more people 
uninsured at any given time. 
(6) Stable coverage under Medicaid and CHIP 
lowers average monthly medical costs. 
(7) Continuous enrollment also permits better 
prevention and disease management, leading to 
fewer serious illnesses and hospitalizations. 
(8) Children with stable coverage are less likely 
to have unmet medical needs, allowing children to 
receive the preventive care that is necessary to help 
them grow into healthy adults. 
SEC. 3. 12-MONTH CONTINUOUS ENROLLMENT. 
(a) REQUIREMENT OF 12-MONTH CONTINUOUS EN-
ROLLMENT UNDER MEDICAID.—Section 1902(e)(12) of 
the Social Security Act (42 U.S.C. 1396a(e)(12)) is 
amended to read as follows: 
‘‘(12) 12-MONTH CONTINUOUS ENROLLMENT.— 
Notwithstanding any other provision of this title, a 
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State plan approved under this title (or under any 
waiver of such plan approved pursuant to section 
1115 or section 1915), shall provide that an indi-
vidual who is determined to be eligible for benefits 
under such plan (or waiver) shall remain eligible and 
enrolled for such benefits through the end of the 
month in which the 12-month period (beginning on 
the date of determination of eligibility) ends.’’. 
(b) REQUIREMENT OF 12-MONTH CONTINUOUS EN-
ROLLMENT UNDER CHIP.— 
(1) IN GENERAL.—Section 2102(b) of the So-
cial Security Act (42 U.S.C. 1397bb(b)) is amended 
by adding at the end the following new paragraph: 
‘‘(6) REQUIREMENT
FOR
12-MONTH
CONTIN-
UOUS
ENROLLMENT.—Notwithstanding any other 
provision of this title, a State child health plan that 
provides child health assistance under this title 
through a means other than described in section 
2101(a)(2), shall provide that an individual who is 
determined to be eligible for benefits under such 
plan shall remain eligible and enrolled for such bene-
fits through the end of the month in which the 12- 
month period (beginning on the date of determina-
tion of eligibility) ends.’’. 
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(2) 
CONFORMING
AMENDMENT.—Section 
2105(a)(4)(A) of the Social Security Act (42 U.S.C. 
1397ee(a)(4)(A)) is amended— 
(A) by striking ‘‘has elected the option of’’ 
and inserting ‘‘is in compliance with the re-
quirement for’’; and 
(B) by striking ‘‘applying such policy 
under its State child health plan under this 
title’’ and inserting ‘‘in compliance with section 
2102(b)’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2) or (3), the amendments made by sub-
sections (a) and (b) shall apply to determinations 
(and redeterminations) of eligibility made on or after 
the date that is 18 months after the date of the en-
actment of this Act. 
(2) EXTENSION
OF
EFFECTIVE
DATE
FOR 
STATE LAW AMENDMENT.—In the case of a State 
plan under title XIX or State child health plan 
under title XXI of the Social Security Act (42 
U.S.C. 1396 et seq.; 42 U.S.C. 1397aa et seq.) 
which the Secretary of Health and Human Services 
determines requires State legislation (other than leg-
islation appropriating funds) in order for the respec-
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tive plan to meet the additional requirement imposed 
by the amendment made by subsection (a) or (b), re-
spectively, the respective plan shall not be regarded 
as failing to comply with the requirements of such 
title solely on the basis of its failure to meet such 
applicable additional requirement before the first 
day of the first calendar quarter beginning after the 
close of the first regular session of the State legisla-
ture that begins after the date of enactment of this 
Act. For purposes of the previous sentence, in the 
case of a State that has a 2-year legislative session, 
each year of the session is considered to be a sepa-
rate regular session of the State legislature. 
(3) OPTION TO IMPLEMENT 12-MONTH CONTIN-
UOUS ELIGIBILITY PRIOR TO EFFECTIVE DATE.—A 
State may elect through a State plan amendment 
under title XIX or XXI of the Social Security Act 
(42 U.S.C. 1396 et seq.; 42 U.S.C. 1397aa et seq.) 
to apply the amendment made by subsection (a) or 
(b), respectively, on any date prior to the 18-month 
date specified in paragraph (1), but not sooner than 
the date of the enactment of this Act. 
Æ 
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