Medicaid REACH Act
Bill: H.R.1784 | Sponsor: Rep. Doggett, Lloyd (D-TX)
Policy area: Health

Summary:
Medicaid Report on Expansion of Access to Coverage for Health Act or the Medicaid REACH Act
This bill reduces federal payment for Medicaid administrative expenses incurred by states that have not elected to participate in Medicaid expansion under the Patient Protection and Affordable Care Act (i.e., nonexpansion states) if the state does not comply with specified reporting requirements. The bill requires nonexpansion states to report, among other information, the number of uninsured individuals under the age of 65 and the estimated percentage of such individuals who would be eligible to receive coverage if the state expanded Medicaid.

To amend title XIX of the Social Security Act to enhance reporting 
     requirements for nonexpansion States, 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 ``Medicaid Report on Expansion of 
Access to Coverage for Health Act'' or the ``Medicaid REACH Act''.

SEC. 2. ENHANCED REPORTING REQUIREMENTS FOR NONEXPANSION STATES.

    Section 1903 of the Social Security Act (42 U.S.C. 1396b) is 
amended--
            (1) in subsection (a)(7), by inserting ``subsection (cc) 
        and'' before ``section 1919(g)(3)(B)''; and
            (2) by adding at the end the following new subsection:
    ``(cc) Reduction of Federal Payments for Certain Administrative 
Costs of Nonexpansion States That Do Not Satisfy Reporting 
Requirements.--
            ``(1) In general.--
                    ``(A) Reduction.--In the case of a nonexpansion 
                State, with respect to a fiscal year (beginning with 
                fiscal year 2022) that does not satisfy the reporting 
                requirement under paragraph (2) for such fiscal year, 
                the percentage specified in subsection (a)(7) for 
                amounts described in such subsection expended by such 
                State during a calendar quarter described in paragraph 
                (4) with respect to such fiscal year, subject to 
                subparagraph (B), shall be reduced by the number of 
                percentage points specified in paragraph (4) for the 
                respective calendar quarter.
                    ``(B) Exception.--In the case of a nonexpansion 
                State that is subject to a reduction under subparagraph 
                (A) for the calendar quarter described in paragraph 
                (4)(A) with respect to a fiscal year, if the State 
                satisfies the criteria described in subparagraphs (A), 
                (B), and (C) of paragraph (2) (without regard to the 
                dates specified in such subparagraph (A) and (C)) 
                before the beginning of a subsequent calendar quarter 
                described in paragraph (4) with respect to such fiscal 
                year, then such State shall not be subject to a 
                reduction under subparagraph (A) for such subsequent 
                calendar quarter.
            ``(2) Reporting requirement.--For purposes of paragraph 
        (1), a nonexpansion State satisfies the reporting requirement 
        under this paragraph for a fiscal year, if the nonexpansion 
        State--
                    ``(A) by not later than January 1 of such year, 
                posts on the public website of the State agency 
                administering the State plan, the information described 
                in paragraph (3) with respect to such State for the 
                previous year;
                    ``(B) provides for at least a 30-day period for 
                notice and comment on such information; and
                    ``(C) by not later than March 1 of such year, 
                submits to the Secretary a complete report including 
                such information, comments submitted pursuant to 
                subparagraph (B), and a response by the State to each 
                such comment.
            ``(3) Information described.--The information described in 
        this paragraph, with respect to a State and year, is the 
        following:
                    ``(A) The estimated number of individuals who were 
                uninsured for at least 6 months (disaggregated by race, 
                ethnicity, gender, and age-groups of 0 to 18 years of 
                age and of 19 years of age to 64 years of age), as well 
                as a detailed description of the basis for the 
                estimates.
                    ``(B) The estimated number of the individuals 
                estimated under subparagraph (A) in the State who would 
                be eligible for medical assistance under the State plan 
                if the State were to make medical assistance under the 
                State plan available in accordance with section 
                1902(k)(1) to all individuals described in section 
                1902(a)(10)(i)(VIII), and a detailed description of the 
                basis for the estimates.
                    ``(C) A comprehensive listing of State income 
                eligibility criteria for all mandatory and optional 
                Medicaid eligibility groups for which the State plan 
                provides medical assistance (other than with respect to 
                individuals described in clause (i)(II), (ii)(VI), or 
                (ii)(XXII) of section 1902(a)(10)(A)).
                    ``(D) The total amount of hospital uncompensated-
                care costs and a breakdown of the source of such costs, 
                as well as a breakdown for rural and non-rural 
                hospitals.
                    ``(E) The total amount received through an 
                uncompensated care pool (as defined by the Secretary).
            ``(4) Percentage described.--For purposes of paragraph (1), 
        a calendar quarter described in this paragraph, with respect to 
        a fiscal year, and the percentage points described in this 
        paragraph for such quarter, with respect to a State, are--
                    ``(A) for the calendar quarter beginning on the 
                April 1 occurring during such fiscal year, 0.5 
                percentage points;
                    ``(B) for the calendar quarter beginning on the 
                July 1 occurring during such fiscal year, 1.0 
                percentage point; and
                    ``(C) for the calendar quarter beginning on the 
                October 1 occurring during the subsequent fiscal year, 
                1.5 percentage points.
            ``(5) Payment in case of reporting state.--The expenses 
        incurred by a non-expansion State, with respect to any calendar 
        quarter with respect to a fiscal year (beginning with 2021), 
        for carrying out subparagraphs (A) through (C) of paragraph (2) 
        shall, for purposes of section 1903(a)(7), be considered to be 
        expenses necessary for the proper and efficient administration 
        of the State plan under this title.
            ``(6) Nonexpanion state defined.--For purposes of this 
        subsection, the term `nonexpansion State' means, with respect 
        to a fiscal year, a State that as of the first quarter of such 
        fiscal year does not provide under the State plan of such State 
        (or waiver of such plan) for making medical assistance 
        available in accordance with section 1902(k)(1) to all 
        individuals described in section 1902(a)(10)(i)(VIII).''.
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