Medicaid Infant Mortality Amendments of 1993

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Infant Mortality Amendments 
of 1993''.

SEC. 2. PHASED-IN COVERAGE OF PREGNANT WOMEN AND INFANTS UP TO 185 
              PERCENT OF POVERTY LEVEL.

    (a) In General.--Section 1902(l)(2)(A) of the Social Security Act 
(42 U.S.C. 1396a(l)(2)(A)) is amended--
            (1) in clause (ii)--
                    (A) in subclause (I), by striking ``and'' at the 
                end,
                    (B) by striking the period at the end of subclause 
                (II) and inserting a comma, and
                    (C) by adding at the end the following new 
                subclauses:
            ``(III) July 1, 1994, 150 percent, or, if greater, the 
        percentage provided under clause (v), and
            ``(IV) July 1, 1995, 185 percent.''; and
            (2) by adding at the end the following new clause:
    ``(v) In the case of a State which, as of the date of the enactment 
of this clause, has established under clause (i), or has enacted 
legislation authorizing, or appropriating funds, to provide for, a 
percentage (of the income official poverty line) that is greater than 
150 percent, the percentage provided under clause (ii) for medical 
assistance on or after July 1, 1994, shall not be less than--
            ``(I) the percentage specified by the State in an amendment 
        to its State plan (whether approved or not) as of the date of 
        the enactment of this clause, or
            ``(II) if no such percentage is specified as of the date of 
        the enactment of this clause, the percentage established under 
        the State's authorizing legislation or provided for under the 
        State's appropriations.''.
    (b) Flexibility in Income Methodology and Deduction of Child Care 
in Computation of Income.--Section 1902(l)(3)(E) of such Act (42 U.S.C. 
1396a(l)(3)(E)) is amended by striking ``(E)'' and inserting the 
following:
            ``(E)(i) with respect to an individual described in 
        subparagraph (A) or (B) of paragraph (1), family income shall 
        be determined in accordance with a methodology which is no more 
        restrictive than the methodology employed under the State plan 
        under part A or E of title IV (except to the extent such 
        methodology is inconsistent with clause (D) of subsection 
        (a)(17) and except that there shall be disregarded costs for 
        such child care as is necessary for the employment of the 
        pregnant woman or the caretaker of the infant), and costs 
        incurred for medical care or for any other type of remedial 
        care shall not be taken into account, and
            ``(ii) with respect to an individual described in paragraph 
        (1)(C) or (1)(D),''.
    (c) Prohibiting Application of Resource Test.--Section 1902(l)(3) 
of such Act (42 U.S.C. 1396a(l)(3)) is amended--
            (1) by amending subparagraph (A) to read as follows:
            ``(A)(i) no resource standard or methodology shall be 
        applied to individuals who are eligible for medical assistance 
        because of subsection (a)(10)(A)(i)(IV), and (ii) application 
        of a resource standard or methodology for individuals who are 
        eligible for medical assistance because of subsection 
        (a)(10)(A)(i)(VI) or (a)(10)(A)(ii)(IX) shall be at the option 
        of the State, but any such resource standard or methodology may 
        not be more restrictive than the corresponding standard or 
        methodology that is applied under the State plan under part A 
        of title IV;'',
            (2) by striking subparagraphs (B) and (C), and
            (3) by redesignating subparagraphs (D) and (E) as 
        subparagraphs (B) and (C), respectively.
    (d) Effective Dates.--
            (1) Higher income standards.--Except as provided in 
        paragraph (3), the amendments made by subsection (a) shall 
        apply to payments under title XIX of the Social Security Act 
        for calendar quarters beginning on or after July 1, 1994, with 
        respect to eligibility for medical assistance on or after such 
        date, without regard to whether or not final regulations to 
        carry out such amendments have been promulgated by such date.
            (2) Income methodology and resource standard.--Except as 
        provided in paragraph (3), the amendments made by subsections 
        (b) and (c) shall apply to payments under title XIX of the 
        Social Security Act for calendar quarters beginning on or after 
        July 1, 1994, with respect to eligibility for medical 
        assistance on or after such date, without regard to whether or 
        not final regulations to carry out such amendments have been 
        promulgated by such date.
            (3) Exception for certain states.--In the case of a State 
        plan for medical assistance under title XIX of the Social 
        Security Act which the Secretary of Health and Human Services 
        determines requires State legislation (other than legislation 
        authorizing or 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 requirements of such title solely on 
        the basis of its failure 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 
        legislature that begins after the date of the 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. 3. OPTIONAL COVERAGE OF PRENATAL AND POST PARTUM HOME VISITATION 
              SERVICES.

    (a) In General.--Section 1905(a) of the Social Security Act (42 
U.S.C. 1396d(a)) is amended--
            (1) by striking ``and'' at the end of paragraph (21),
            (2) by redesignating paragraph (22) as paragraph (25),
            (3) by redesignating paragraphs (23) and (24) as paragraphs 
        (22) and (23), respectively,
            (4) by inserting after paragraph (23) the following new 
        paragraph:
            ``(24) prenatal home visitation services for high-risk 
        pregnant women, post partum home visitation services with 
        respect to high-risk infants under 1 year of age, or both (as 
        specified by the State), as prescribed by a physician; and''.
    (b) Conforming Amendments.--Section 1902 of such Act (42 U.S.C. 
1396a) is amended--
            (1) in subsection (a)(10)(C)(iv), by striking ``(21)'' and 
        inserting ``(24)'', and
            (2) in subsection (j), by striking ``(22)'' and inserting 
        ``(25)''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after July 1, 1994, without regard to 
whether or not final regulations to carry out such amendments have been 
promulgated by such date.

Summary: Medicaid Infant Mortality Amendments of 1993 - Amends title XIX (Medicaid) of the Social Security Act to phase-in mandatory State coverage of pregnant women and infants whose family income is below 185 percent of the Federal poverty level.  Deducts child and medical care costs from the income eligibility test. 
Authorizes States to provide Medicaid coverage of prenatal home visitation services for high-risk pregnant women and/or postpartum home visitation services for high-risk infants.