Medicaid Saves Lives Act
Bill: H.R.4595 | Sponsor: Rep. Bourdeaux, Carolyn (D-GA)
Policy area: Health

Summary:
Medicaid Saves Lives Act
This bill requires and provides funds for the Department of Health and Human Services to establish a program that provides health benefits to the Medicaid expansion population in states that have not expanded Medicaid.
Specifically, the program must provide coverage for individuals who are newly eligible for Medicaid under the Patient Protection and Affordable Care Act (i.e., the Medicaid expansion population) without premiums and in accordance with Medicaid cost-sharing and other requirements.
The bill also extends and increases the temporarily enhanced Federal Medical Assistance Percentage (i.e., federal matching rate) for states that elect to participate in Medicaid expansion if they have not already done so.

To require the Secretary of Health and Human Services to establish a 
program to provide health care coverage to low-income adults in States 
                    that have not expanded Medicaid.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Saves Lives Act''.

SEC. 2. MEDICAID FALLBACK COVERAGE PROGRAM FOR LOW-INCOME ADULTS IN 
              NON-EXPANSION STATES.

    (a) In General.--As soon as possible after the date of enactment of 
this Act the Secretary of Health and Human Services (in this section 
referred to as the ``Secretary'') shall--
            (1) directly or by contract, establish a program that 
        offers eligible individuals the opportunity to enroll in health 
        benefits coverage that meets the requirements described in 
        subsection (c) and any requirements applicable to such coverage 
        pursuant to subsection (d); and
            (2) ensure that such program is administered consistent 
        with the requirements of section 431.10(c)(2) of title 42, Code 
        of Federal Regulations.
    (b) Definition of Eligible Individual.--In this section, the term 
``eligible individual'' means an individual who--
            (1) is described in section 1902(a)(10)(A)(i)(VIII) of the 
        Social Security Act (42 U.S.C. 1396a(a)(10)(A)(i)(VIII));
            (2) resides in a State that--
                    (A) does not expend amounts for medical assistance 
                under title XIX of the Social Security Act (42 U.S.C. 
                1396 et seq.) for all individuals described in such 
                section; and
                    (B) did not expend amounts for medical assistance 
                under such title for all such individuals as of the 
                date of enactment of this Act; and
            (3) would not be eligible for medical assistance under such 
        State's plan for medical assistance under title XIX of the 
        Social Security Act (42 U.S.C. 1396 et seq.), or a waiver of 
        such plan, as such plan or waiver was in effect on such date.
    (c) Health Benefits Coverage Requirements.--The requirements 
described in this subsection with respect to health benefits coverage 
are the following:
            (1) Essential health benefits.--At a minimum, the coverage 
        meets the minimum standards required under paragraph (5) of 
        section 1937(b) of the Social Security Act (42 U.S.C. 1396u-
        7(b)) for benchmark coverage described in paragraph (1) of such 
        section or benchmark equivalent coverage described in paragraph 
        (2) of such section.
            (2) Premiums and cost-sharing.--No premiums are imposed for 
        the coverage, and deductibles, cost sharing, or similar charges 
        may only be imposed in accordance with the requirements imposed 
        on State Medicaid plans under section 1916 of the Social 
        Security Act (42 U.S.C. 1396o).
    (d) Application of Requirements and Provisions of Title XIX of the 
Social Security Act.--The Secretary shall specify that--
            (1) any requirement applicable to the furnishing of medical 
        assistance under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) by States that have elected to make 
        medical assistance available to individuals described in 
        section 1902(a)(10)(A)(i)(VIII) of such title (42 U.S.C. 
        1396a(a)(10)(A)(i)(VIII)) that does not conflict with the 
        requirements specified in subsection (c) applies to the program 
        established under this section; and
            (2) other provisions of such title apply to such program.
    (e) No State Mandate.--Nothing in this section shall be construed 
as requiring a State to make expenditures related to the program 
established under this section and the Secretary shall not impose any 
such requirement.
    (f) Funding.--There are appropriated to the Secretary for each 
fiscal year beginning with fiscal year 2021 from any funds in the 
Treasury not otherwise appropriated, such sums as are necessary to 
carry out this section.

SEC. 3. INCREASE AND EXTENSION OF TEMPORARY ENHANCED FMAP FOR STATES 
              WHICH BEGIN TO EXPEND AMOUNTS FOR CERTAIN MANDATORY 
              INDIVIDUALS.

    (a) In General.--Section 1905(ii)(1) of the Social Security Act (42 
U.S.C. 1396d(ii)(1)) is amended--
            (1) by striking ``8-quarter period'' and inserting ``40-
        quarter period''; and
            (2) by striking ``5 percentage points'' and inserting ``10 
        percentage points''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of section 9814 of the American 
Rescue Plan Act of 2021 (Public Law 117-2).
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