SAME Act of 2021
Bill: S.245 | Sponsor: Sen. Warner, Mark R. (D-VA)
Policy area: Health

Summary:
States Achieve Medicaid Expansion Act of 2021 or the SAME Act of 2021
This bill provides an enhanced federal matching rate to every state that expands Medicaid coverage for individuals who are newly eligible under the Patient Protection and Affordable Care Act, regardless of when such expansion takes place.
Under current law, the enhanced Federal Medical Assistance Percentage (FMAP) is equivalent to 100% in 2014 through 2016, 95% in 2017, 94% in 2018, 93% in 2019, and 90% thereafter. The bill retains this enhanced FMAP, but bases it on a term of years rather than on specific dates.
The bill applies retroactively.

To amend title XIX of the Social Security Act to provide the same level 
 of Federal matching assistance for every State that chooses to expand 
  Medicaid coverage to newly eligible individuals, regardless of when 
          such expansion takes place, and for other purposes.

    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 ``States Achieve Medicaid Expansion 
Act of 2021'' or the ``SAME Act of 2021''.

SEC. 2. INCREASED FMAP FOR MEDICAL ASSISTANCE TO NEWLY ELIGIBLE 
              INDIVIDUALS.

    (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended--
            (1) in subsection (y)(1)--
                    (A) in subparagraph (A), by striking ``2014, 2015, 
                and 2016'' and inserting ``each of the first 3 
                consecutive 12-month periods in which the State 
                provides medical assistance to newly eligible 
                individuals'';
                    (B) in subparagraph (B), by striking ``2017'' and 
                inserting ``the fourth consecutive 12-month period in 
                which the State provides medical assistance to newly 
                eligible individuals'';
                    (C) in subparagraph (C), by striking ``2018'' and 
                inserting ``the fifth consecutive 12-month period in 
                which the State provides medical assistance to newly 
                eligible individuals'';
                    (D) in subparagraph (D), by striking ``2019'' and 
                inserting ``the sixth consecutive 12-month period in 
                which the State provides medical assistance to newly 
                eligible individuals''; and
                    (E) in subparagraph (E), by striking ``2020 and 
                each year thereafter'' and inserting ``the seventh 
                consecutive 12-month period in which the State provides 
                medical assistance to newly eligible individuals and 
                each such period thereafter''; and
            (2) in subsection (z)(2)(B)(i)(II), by inserting ``(as in 
        effect on the day before the enactment of the States Achieve 
        Medicaid Expansion Act of 2021)'' after ``subsection (y)(1)''.
    (b) Retroactive Application.--The amendments made by subsection 
(a)(1) shall take effect as if included in the enactment of Public Law 
111-148 and shall apply to amounts expended by any State for medical 
assistance for newly eligible individuals described in subclause (VIII) 
of section 1902(a)(10)(A)(i) of the Social Security Act under a State 
Medicaid plan (or a waiver of such plan) during the period before the 
date of enactment of this Act.
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