I
107TH CONGRESS
2D SESSION
H. R. 3729
To amend titles XIX and XXI of the Social Security Act to improve the
health benefits coverage of infants and children under the Medicaid
and State children’s health insurance program, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 12, 2002
Mr. STRICKLAND (for himself, Mr. NEY, Ms. DEGETTE, Mrs. MORELLA, Mr.
CROWLEY, Ms. WATERS, Mr. MCNULTY, Mr. BLAGOJEVICH, Mr. TOWNS,
Mr. WYNN, Mr. WAXMAN, Mr. SCHIFF, Mr. PASCRELL, Mr. GREEN of
Texas, Mr. STUPAK, Mr. FROST, Ms. ESHOO, Mr. RUSH, Mr. EVANS, Mr.
DOOLEY of California, Mr. CONYERS, Mr. OWENS, Mrs. CHRISTENSEN,
Mr. CAPUANO, Mr. LAFALCE, and Mr. BRADY of Pennsylvania) intro-
duced 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 improve the health benefits coverage of infants and
children under the Medicaid and State children’s health
insurance program, 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; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Start Healthy, Stay Healthy Act’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—START HEALTHY
Sec. 101. Enhanced Federal medicaid match for States that opt to continuously
enroll infants during the first year of life without regard to the
mother’s eligibility status.
Sec. 102. Optional coverage of low-income, uninsured pregnant women under a
State child health plan.
Sec. 103. Increase in SCHIP income eligibility.
TITLE II—STAY HEALTHY
Sec. 201. Enhanced Federal medicaid match for increased expenditures for
medical assistance for children.
Sec. 202. Increase in SCHIP appropriations.
Sec. 203. Optional coverage of children through age 20 under the medicaid pro-
gram and SCHIP.
TITLE I—START HEALTHY
SEC. 101. ENHANCED FEDERAL MEDICAID MATCH FOR
STATES THAT OPT TO CONTINUOUSLY EN-
ROLL INFANTS DURING THE FIRST YEAR OF
LIFE WITHOUT REGARD TO THE MOTHER’S
ELIGIBILITY STATUS.
(a) STATE OPTION.—Section 1902(e)(4) of the Social
Security Act (42 U.S.C. 1396a(e)(4)) is amended by add-
ing at the end the following new sentence: ‘‘A State may
elect (through a State plan amendment) to apply the first
sentence of this paragraph without regard to the require-
ments that the child remain a member of the woman’s
household and the woman remains (or would remain if
pregnant) eligible for medical assistance.’’.
(b) ENHANCED FMAP.—The first sentence of sec-
tion 1905(b) of the Social Security Act (42 U.S.C.
1396d(b)) is amended—
(1) by inserting ‘‘(A)’’ after ‘‘only’’; and
(2) by inserting ‘‘, or (B) on the basis of a
State election made under the third sentence of sec-
tion 1902(e)(4)’’ before the period.
(c) EFFECTIVE DATE.—The amendments made by
this section apply to medical assistance provided on or
after October 1, 2002.
SEC. 102. OPTIONAL COVERAGE OF LOW-INCOME, UNIN-
SURED PREGNANT WOMEN UNDER A STATE
CHILD HEALTH PLAN.
(a) IN GENERAL.—Title XXI of the Social Security
Act (42 U.S.C. 1397aa et seq.) is amended by adding at
the end the following new section:
‘‘SEC. 2111. OPTIONAL COVERAGE OF LOW-INCOME, UNIN-
SURED PREGNANT WOMEN.
‘‘(a) OPTIONAL COVERAGE.—Notwithstanding any
other provision of this title, a State child health plan
(whether implemented under this title or title XIX) may
provide for coverage of pregnancy-related assistance for
targeted low-income pregnant women in accordance with
this section, but only if the State has established an in-
come eligibility level under section 1902(l)(2)(A) for
women described in section 1902(l)(1)(A) that is 185 per-
cent of the income official poverty line.
‘‘(b) DEFINITIONS.—For purposes of this section:
‘‘(1) PREGNANCY-RELATED ASSISTANCE.—The
term ‘pregnancy-related assistance’ has the meaning
given the term child health assistance in section
2110(a) as if any reference to targeted low-income
children were a reference to targeted low-income
pregnant women, except that the assistance shall be
limited to services related to pregnancy (which in-
clude prenatal, delivery, and postpartum services)
and to other conditions that may complicate preg-
nancy.
‘‘(2) 
TARGETED
LOW-INCOME
PREGNANT
WOMAN.—The term ‘targeted low-income pregnant
woman’ has the meaning given the term targeted
low-income child in section 2110(b) as if any ref-
erence to a child were deemed a reference to a
woman during pregnancy and through the end of the
month in which the 60-day period (beginning on the
last day of her pregnancy) ends.
‘‘(c) 
REFERENCES
TO
TERMS
AND
SPECIAL
RULES.—In the case of, and with respect to, a State pro-
viding for coverage of pregnancy-related assistance to tar-
geted low-income pregnant women under subsection (a),
the following special rules apply:
‘‘(1) Any reference in this title (other than sub-
section (b)) to a targeted low income child is deemed
to include a reference to a targeted low-income preg-
nant woman.
‘‘(2) Any such reference to child health assist-
ance with respect to such women is deemed a ref-
erence to pregnancy-related assistance.
‘‘(3) Any such reference to a child is deemed a
reference to a woman during pregnancy and the pe-
riod described in subsection (b)(2).
‘‘(4) The medicaid applicable income level is
deemed a reference to the income level established
under section 1902(l)(2)(A).
‘‘(5) Subsection (a) of section 2103 (relating to
required scope of health insurance coverage) shall
not apply insofar as a State limits coverage to serv-
ices described in subsection (b)(1) and the reference
to such section in section 2105(a)(1) is deemed not
to require, in such case, compliance with the require-
ments of section 2103(a).
‘‘(6) There shall be no exclusion of benefits for
services described in subsection (b)(1) based on any
pre-existing condition and no waiting period (includ-
ing any waiting period imposed to carry out section
2102(b)(3)(C)) shall apply.
‘‘(d) NO IMPACT ON ALLOTMENTS.—Nothing in this
section shall be construed as affecting the amount of any
initial allotment provided to a State under section
2104(b).
‘‘(e) APPLICATION OF FUNDING RESTRICTIONS.—
The coverage under this section (and the funding of such
coverage) is subject to the restrictions of section 2105(c).
‘‘(f) AUTOMATIC
ENROLLMENT
FOR
CHILDREN
BORN TO WOMEN RECEIVING PREGNANCY-RELATED AS-
SISTANCE.—Notwithstanding any other provision of this
title or title XIX, if a child is born to a targeted low-in-
come pregnant woman who was receiving pregnancy-re-
lated assistance under this section on the date of the chil-
dren’s birth, the child shall be deemed to have applied for
child health assistance under the State child health plan
and to have been found eligible for such assistance under
such plan (or, in the case of a State that provides such
assistance through the provision of medical assistance
under a plan under title XIX, to have applied for medical
assistance under such title and to have been found eligible
for such assistance under such title) on the date of such
birth and to remain eligible for such assistance until the
child attains 1 year of age. During the period in which