this title or title XXI, as approved by the 
Secretary; and 
‘‘(ii) the State provides ‘wrap-around’ 
coverage under this title or title XXI. 
‘‘(C) DEEMED SATISFACTION FOR CERTAIN 
STATES.—A State that, as of January 1, 2007, 
provides medical assistance under this title or 
child health assistance under title XXI to chil-
dren whose family income is 300 percent of the 
poverty line shall be deemed to satisfy this 
paragraph. 
‘‘(2) COVERAGE
FOR
CHILDREN
UNDER
AGE 
21.—The State agrees to define a child for purposes 
of this title and title XXI as an individual who has 
not attained 21 years of age. 
‘‘(3) OPPORTUNITY FOR HIGHER INCOME CHIL-
DREN TO PURCHASE SCHIP COVERAGE.—The State 
agrees to permit any child whose family income ex-
ceeds 300 percent of the poverty line to purchase 
full or ‘wrap-around’ coverage under title XXI at the 
full cost of providing such coverage, as determined 
by the State. 
‘‘(4) COVERAGE FOR LEGAL IMMIGRANT CHIL-
DREN.—The State agrees to— 
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‘‘(A) provide medical assistance under this 
title and child health assistance under title XXI 
for alien children who are lawfully residing in 
the United States (including battered aliens de-
scribed in section 431(c) of the Personal Re-
sponsibility and Work Opportunity Reconcili-
ation Act of 1996) and who are otherwise eligi-
ble for such assistance in accordance with sec-
tion 1903(v)(4) and 2107(e)(1)(F); and 
‘‘(B) not establish or enforce barriers that 
deter applications by such aliens, including 
through the application of the removal of the 
barriers described in subsection (c). 
‘‘(c) REMOVAL OF ENROLLMENT AND ACCESS BAR-
RIERS.—The condition described in this subsection is that 
the State agrees to do the following: 
‘‘(1) PRESUMPTIVE
ELIGIBILITY
FOR
CHIL-
DREN.—The State agrees to— 
‘‘(A) provide presumptive eligibility for 
children under this title and title XXI in ac-
cordance with section 1920A; and 
‘‘(B) treat any items or services that are 
provided to an uncovered child (as defined in 
section 2110(c)(8)) who is determined ineligible 
for medical assistance under this title as child 
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health assistance for purposes of paying a pro-
vider of such items or services, so long as such 
items or services would be considered child 
health assistance for a targeted low-income 
child under title XXI. 
‘‘(2) ADOPTION OF 12-MONTH CONTINUOUS EN-
ROLLMENT.—The State agrees to provide that eligi-
bility for assistance under this title and title XXI 
shall not be regularly redetermined more often than 
once every year for children. 
‘‘(3) ACCEPTANCE OF SELF-DECLARATION OF 
INCOME.—The State agrees to permit the family of 
a child applying for medical assistance under this 
title or child health assistance under title XXI to de-
clare and certify by signature under penalty of per-
jury family income for purposes of collecting finan-
cial eligibility information. 
‘‘(4) ADOPTION
OF
ACCEPTANCE
OF
ELIGI-
BILITY DETERMINATIONS FOR OTHER ASSISTANCE 
PROGRAMS.—The State agrees to accept determina-
tions (made within a reasonable period, as found by 
the State, before its use for this purpose) of an indi-
vidual’s family or household income made by a Fed-
eral or State agency (or a public or private entity 
making such determination on behalf of such agen-
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cy), including the agencies administering the Food 
Stamp Act of 1977, the Richard B. Russell National 
School Lunch Act, and the Child Nutrition Act of 
1966, notwithstanding any differences in budget 
unit, disregard, deeming, or other methodology, but 
only if— 
‘‘(A) such agency has fiscal liabilities or 
responsibilities affected or potentially affected 
by such determinations; and 
‘‘(B) any information furnished by such 
agency pursuant to this subparagraph is used 
solely for purposes of determining eligibility for 
medical assistance under this title or for child 
health assistance under title XXI. 
‘‘(5) NO ASSETS TEST.—The State agrees to 
not (or demonstrates that it does not) apply any as-
sets or resources test for eligibility under this title 
or title XXI with respect to children. 
‘‘(6) ELIGIBILITY DETERMINATIONS AND REDE-
TERMINATIONS.— 
‘‘(A) IN GENERAL.—The State agrees for 
purposes of initial eligibility determinations and 
redeterminations of children under this title and 
title XXI not to require a face-to-face interview 
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and to permit applications and renewals by 
mail, telephone, and the Internet. 
‘‘(B) 
NONDUPLICATION
OF
INFORMA-
TION.— 
‘‘(i) IN
GENERAL.—For purposes of 
redeterminations of eligibility for currently 
or previously enrolled children under this 
title and title XXI, the State agrees to use 
all information in its possession (including 
information available to the State under 
other Federal or State programs) to deter-
mine eligibility or redetermine continued 
eligibility before seeking similar informa-
tion from parents. 
‘‘(ii) 
RULE
OF
CONSTRUCTION.— 
Nothing in clause (i) shall be construed as 
limiting any obligation of a State to pro-
vide notice and a fair hearing before deny-
ing, terminating, or reducing a child’s cov-
erage based on such information in the 
possession of the State. 
‘‘(7) NO WAITING LIST FOR CHILDREN UNDER 
SCHIP.—The State agrees to not impose any numer-
ical limitation, waiting list, waiting period, or similar 
limitation on the eligibility of children for child 
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health assistance under title XXI or to establish or 
enforce other barriers to the enrollment of eligible 
children based on the date of their application for 
coverage. 
‘‘(8) ADEQUATE PROVIDER PAYMENT RATES.— 
The State agrees to— 
‘‘(A) establish payment rates for children’s 
health care providers under this title that are 
no less than the average of payment rates for 
similar services for such providers provided 
under the benchmark benefit packages de-
scribed in section 2103(b); 
‘‘(B) establish such rates in amounts that 
are sufficient to ensure that children enrolled 
under this title or title XXI have adequate ac-
cess to comprehensive care, in accordance with 
the requirements of section 1902(a)(30)(A); 
and 
‘‘(C) include provisions in its contracts 
with providers under this title guaranteeing 
compliance with these requirements. 
‘‘(d) MAINTENANCE OF MEDICAID ELIGIBILITY LEV-
ELS FOR CHILDREN.— 
‘‘(1) IN GENERAL.—The condition described in 
this subsection is that the State agrees to maintain 
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eligibility income, resources, and methodologies ap-
plied under this title (including under a waiver of 
such title or under section 1115) with respect to 
children that are no more restrictive than the eligi-
bility income, resources, and methodologies applied 
with respect to children under this title (including 
under such a waiver) as of January 1, 2007. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
this section shall be construed as implying that a 
State does not have to comply with the minimum in-
come levels required for children under section 
1902(l)(2). 
‘‘(e) DATE DESCRIBED.—The date described in this 
subsection is the date on which, with respect to a State, 
a plan amendment that satisfies the requirements of sub-
sections (b), (c), and (d) is approved by the Secretary. 
‘‘(f) DEFINITION OF POVERTY LINE.—In this sec-
tion, the term ‘poverty line’ has the meaning given that 
term in section 2110(c)(5).’’. 
(b) CONFORMING AMENDMENTS.— 
(1) The third sentence of section 1905(b) of the 
Social Security Act (42 U.S.C. 1396d(b)) is amend-
ed by inserting before the period the following: ‘‘, 
and with respect to amounts expended for medical 
assistance for children on or after the date described 
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ccoleman on PROD1PC60 with BILLS
in subsection (e) of section 1939, in the case of a 
State that has, in accordance with such section, an 
approved plan amendment under this title and title 
XXI’’. 
(2) Section 1903(f)(4) of the Social Security 
Act (42 U.S.C. 1396b(f)(4)) is amended— 
(A) in subparagraph (C), by adding ‘‘or’’ 
after ‘‘section 1611(b)(1),’’; and 
(B) by inserting after subparagraph (C), 
the following: 
‘‘(D) who would not receive such medical assist-
ance but for State electing the option under section 
1939 and satisfying the conditions described in sub-
sections (b), (c), and (d) of such section,’’. 
SEC. 102. ELIMINATION OF CAP ON SCHIP FUNDING FOR 
STATES 
THAT 
EXPAND 
ELIGIBILITY 
FOR 
CHILDREN. 
(a) IN GENERAL.—Section 2105 of the Social Secu-
rity Act (42 U.S.C. 1397dd) is amended by adding at the 
end the following: 
‘‘(h) GUARANTEED FUNDING FOR CHILD HEALTH 
ASSISTANCE FOR COVERAGE EXPANSION STATES.— 
‘‘(1) IN GENERAL.—Only in the case of a State 
that has, in accordance with section 1939, an ap-
proved plan amendment under this title and title 
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XIX, any payment cap that would otherwise apply to 
the State under this title as a result of having ex-
pended all allotments available for expenditure by 
the State with respect to a fiscal year shall not apply 
with respect to amounts expended by the State on 
or after the date described in section 1939(e). 
‘‘(2) 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 quarter beginning on or after the date 
described in section 1939(e), an amount equal to the 
enhanced FMAP of expenditures described in para-
graph (1) and incurred during such quarter.’’. 
(b) CONFORMING AMENDMENTS.—Section 2104 of 
the Social Security Act (42 U.S.C. 1397dd) is amended— 
(1) in subsection (a), by inserting ‘‘and section 
2105(h)’’ after ‘‘subsection (d)’’; 
(2) in subsection (b)(1), by striking ‘‘and sub-
section (d)’’ and inserting ‘‘, subsection (d), and sec-
tion 2105(h)’’; and 
(3) in subsection (c)(1), by inserting ‘‘and sec-
tion 2105(h)’’ after ‘‘subsection (d)’’. 
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TITLE II—STATE OPTIONS FOR 
INCREMENTAL 
CHILD 
COV-
ERAGE EXPANSIONS 
SEC. 201. STATE OPTION TO PROVIDE WRAP-AROUND 
SCHIP COVERAGE TO CHILDREN WHO HAVE 
OTHER HEALTH COVERAGE. 
(a) IN GENERAL.—Section 2110(b) of the Social Se-
curity Act (42 U.S.C. 1397jj(b)) is amended— 
(1) in paragraph (1)(C), by inserting ‘‘, subject 
to paragraph (5),’’ after ‘‘under title XIX or’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(5) STATE OPTION TO PROVIDE WRAP-AROUND 
COVERAGE.— 
‘‘(A) IN
GENERAL.—A State may waive 
the requirement of paragraph (1)(C) that a tar-
geted low-income child may not be covered 
under a group health plan or under health in-
surance coverage in order to provide— 
‘‘(i) items or services that are not cov-
ered, or are only partially covered, under 
such plan or coverage; or 
‘‘(ii) cost-sharing protection. 
‘‘(B) ELIGIBILITY.—In waiving such re-
quirement, a State may limit the application of 
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the waiver to children whose family income does 
not exceed a level specified by the State, so long 
as the level so specified does not exceed the 
maximum income level otherwise established for 
other children under the State child health 
plan. 
‘‘(C) CONTINUED APPLICATION OF DUTY 
TO PREVENT SUBSTITUTION OF EXISTING COV-
ERAGE.—Nothing in this paragraph shall be 
construed as modifying the application of sec-
tion 2102(b)(3)(C) to a State.’’. 
(b) APPLICATION
OF ENHANCED MATCH UNDER 
MEDICAID.—Section 1905 of such Act (42 U.S.C. 1396d) 
is amended— 
(1) in subsection (b), in the fourth sentence, by 
striking ‘‘subsection (u)(3)’’ and inserting ‘‘, (u)(3), 
or (u)(4)’’; and 
(2) in subsection (u), by redesignating para-
graph (4) as paragraph (5) and by inserting after 
paragraph (3) the following: 
‘‘(4) For purposes of subsection (b), the expenditures 
described in this paragraph are expenditures for items and 
services for children described in section 2110(b)(5).’’. 
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