352
is amended by inserting ‘‘and under section 1931’’ after 
‘‘(a)(10)(A)(ii)(IX)’’. 
(i) EFFECTIVE DATES.—
(1) IN GENERAL.—Except as provided in this 
subsection, the amendments made by this section shall 
apply to calendar quarters beginning on or after Oc-
tober 1, 2003, without regard to whether or not final 
regulations to carry out such amendments have been 
promulgated by such date. 
(2) NOTICE.—The amendment made by sub-
section (g) shall take effect 6 months after the date of 
enactment of this Act. 
(3) DELAY PERMITTED FOR STATE PLAN AMEND-
MENT.—In the case of a State plan for medical assist-
ance under title XIX of the Social Security Act which 
the Secretary of Health and Human Services deter-
mines requires State legislation (other than legisla-
tion appropriating funds) in order for the plan to 
meet the additional requirements imposed by the 
amendments made by this section, the State plan 
shall not be regarded as failing to comply with the re-
quirements of such title solely on the basis of its fail-
ure to meet these additional requirements before the 
first day of the first calendar quarter beginning after 
the close of the first regular session of the State legis-
353
lature 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 such session shall be deemed to be a separate 
regular session of the State legislature. 
SEC. 602. PROHIBITION AGAINST COVERING CHILDLESS 
ADULTS WITH SCHIP FUNDS. 
(a) PROHIBITION ON USE OF SCHIP FUNDS.—
(1) IN
GENERAL.—Section 2107 (42 U.S.C. 
1397gg) is amended by adding at the end the fol-
lowing: 
‘‘(f) LIMITATION ON WAIVER AUTHORITY.—Notwith-
standing subsection (e)(2)(A) and section 1115(a), the Sec-
retary may not approve a waiver, experimental, pilot, or 
demonstration project, or an amendment to such a project 
that has been approved as of the date of enactment of this 
subsection, that would allow funds made available under 
this title to be used to provide child health assistance or 
other health benefits coverage to childless adults. For pur-
poses of the preceding sentence, a caretaker relative (as such 
term is defined for purposes of carrying out section 1931) 
shall not be considered a childless adult.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
2105(c)(1) (42 U.S.C. 1397ee(c)(1)) is amended by 
inserting before the period the following: ‘‘and may
354
not include coverage of childless adults. For purposes 
of the preceding sentence, a caretaker relative (as such 
term is defined for purposes of carrying out section 
1931) shall not be considered a childless adult.’’. 
(b) RULE OF CONSTRUCTION.—Nothing in this section 
or the amendments made by this section shall be construed 
to— 
(1) authorize the waiver of any provision of title 
XIX or XXI of the Social Security Act (42 U.S.C. 
1396 et seq., 1397aa et seq.) that is not otherwise au-
thorized to be waived under such titles or under title 
XI of such Act (42 U.S.C. 1301 et seq.) as of the date 
of enactment of this Act; or 
(2) imply congressional approval of any waiver, 
experimental, pilot, or demonstration project affecting 
the medicaid program under title XIX of the Social 
Security Act or the State children’s health insurance 
program under title XXI of such Act that has been 
approved as of such date of enactment. 
(c) EFFECTIVE DATE.—This section and the amend-
ments made by this section take effect on the date of enact-
ment of this Act and apply to proposals to conduct a waiv-
er, experimental, pilot, or demonstration project affecting 
the medicaid program under title XIX of the Social Secu-
rity Act or the State children’s health insurance program
355
under title XXI of such Act, and to any proposals to amend 
such projects, that are approved or extended on or after such 
date of enactment. 
TITLE VII—EFFECTIVE DATE 
SEC. 701. EFFECTIVE DATE. 
(a) IN GENERAL.—Subject to subsection (b) and except 
as otherwise provided, the amendments made by this Act 
take effect on the date of enactment of this Act. 
(b) EXCEPTION.—In the case of a State plan under 
part A or D of title IV of the Social Security Act which 
the Secretary determines requires State legislation in order 
for the plan to meet the additional requirements imposed 
by the amendments made by this Act, the effective date of 
the amendments imposing the additional requirements shall 
be 3 months after the first day of the first calendar quarter 
beginning after the close of the first regular session of the 
State legislature that begins after the date of enactment of 
this Act. For purposes of the preceding sentence, in the case 
of a State that has a 2-year legislative session, each year 
of the session shall be considered to be a separate regular 
session of the State legislature.
Calendar No. 305
108TH CONGRESS 
1ST SESSION 
H. R. 4
[Report No. 108–162] 
AN ACT 
To reauthorize and improve the program of block 
grants to States for temporary assistance for 
needy families, improve access to quality child 
care, and for other purposes. 
OCTOBER 3, 2003
Reported with an amendment