Title: Medicaid Provisions and TANF Extenders Act of 2019
Policy area: Health

Summary:
Medicaid Provisions and TANF Extenders Act of 2019
This bill reauthorizes and revises several Medicaid programs and funding mechanisms, as well as the Temporary Assistance for Needy Families (TANF) program.
Specifically, the bill

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 260 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 260

      To extend the Medicaid Money Follows the Person Rebalancing 
demonstration, to extend protection for Medicaid recipients of home and 
community-based services against spousal impoverishment, to extend the 
    Temporary Assistance for Needy Families program, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 4, 2019

  Mr. Pallone (for himself, Mr. Walden, and Mr. Neal) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
   and in addition to the Committees on Energy and Commerce, and the 
 Budget, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
      To extend the Medicaid Money Follows the Person Rebalancing 
demonstration, to extend protection for Medicaid recipients of home and 
community-based services against spousal impoverishment, to extend the 
    Temporary Assistance for Needy Families program, 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 Provisions and TANF 
Extenders Act of 2019''.

                      TITLE I--MEDICAID EXTENDERS

SEC. 101. EXTENSION OF MONEY FOLLOWS THE PERSON REBALANCING 
              DEMONSTRATION.

    (a) General Funding.--Section 6071(h) of the Deficit Reduction Act 
of 2005 (42 U.S.C. 1396a note) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (D), by striking ``and'' after 
                the semicolon;
                    (B) in subparagraph (E), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following:
                    ``(F) subject to paragraph (3), $112,000,000 for 
                fiscal year 2019.'';
            (2) in paragraph (2)--
                    (A) by striking ``Amounts made'' and inserting 
                ``Subject to paragraph (3), amounts made''; and
                    (B) by striking ``September 30, 2016'' and 
                inserting ``September 30, 2021''; and
            (3) by adding at the end the following new paragraph:
            ``(3) Special rule for fy 2019.--Funds appropriated under 
        paragraph (1)(F) shall be made available for grants to States 
        only if such States have an approved MFP demonstration project 
        under this section as of December 31, 2018.''.
    (b) Funding for Quality Assurance and Improvement; Technical 
Assistance; Oversight.--Section 6071(f) of the Deficit Reduction Act of 
2005 (42 U.S.C. 1396a note) is amended by striking paragraph (2) and 
inserting the following:
            ``(2) Funding.--From the amounts appropriated under 
        subsection (h)(1)(F) for fiscal year 2019, $500,000 shall be 
        available to the Secretary for such fiscal year to carry out 
        this subsection.''.
    (c) Technical Amendment.--Section 6071(b) of the Deficit Reduction 
Act of 2005 (42 U.S.C. 1396a note) is amended by adding at the end the 
following:
            ``(10) Secretary.--The term `Secretary' means the Secretary 
        of Health and Human Services.''.

SEC. 102. EXTENSION OF PROTECTION FOR MEDICAID RECIPIENTS OF HOME AND 
              COMMUNITY-BASED SERVICES AGAINST SPOUSAL IMPOVERISHMENT.

    (a) In General.--Section 2404 of Public Law 111-148 (42 U.S.C. 
1396r-5 note) is amended by striking ``the 5-year period that begins on 
January 1, 2014,'' and inserting ``the period beginning on January 1, 
2014, and ending on March 31, 2019,''.
    (b) Rule of Construction.--
            (1) Protecting state spousal income and asset disregard 
        flexibility under waivers and plan amendments.--Nothing in 
        section 2404 of Public Law 111-148 (42 U.S.C. 1396r-5 note) or 
        section 1924 of the Social Security Act (42 U.S.C. 1396r-5) 
        shall be construed as prohibiting a State from disregarding an 
        individual's spousal income and assets under a State waiver or 
        plan amendment described in paragraph (2) for purposes of 
        making determinations of eligibility for home and community-
        based services or home and community-based attendant services 
        and supports under such waiver or plan amendment.
            (2) State waiver or plan amendment described.--A State 
        waiver or plan amendment described in this paragraph is any of 
        the following:
                    (A) A waiver or plan amendment to provide medical 
                assistance for home and community-based services under 
                a waiver or plan amendment under subsection (c), (d), 
                or (i) of section 1915 of the Social Security Act (42 
                U.S.C. 1396n) or under section 1115 of such Act (42 
                U.S.C. 1315).
                    (B) A plan amendment to provide medical assistance 
                for home and community-based services for individuals 
                by reason of being determined eligible under section 
                1902(a)(10)(C) of such Act (42 U.S.C. 1396a(a)(10)(C)) 
                or by reason of section 1902(f) of such Act (42 U.S.C. 
                1396a(f)) or otherwise on the basis of a reduction of 
                income based on costs incurred for medical or other 
                remedial care under which the State disregarded the 
                income and assets of the individual's spouse in 
                determining the initial and ongoing financial 
                eligibility of an individual for such services in place 
                of the spousal impoverishment provisions applied under 
                section 1924 of such Act (42 U.S.C. 1396r-5).
                    (C) A plan amendment to provide medical assistance 
                for home and community-based attendant services and 
                supports under section 1915(k) of such Act (42 U.S.C. 
                1396n(k)).

SEC. 103. REDUCTION IN FMAP AFTER 2020 FOR STATES WITHOUT ASSET 
              VERIFICATION PROGRAM.

    Section 1940 of the Social Security Act (42 U.S.C. 1396w) is 
amended by adding at the end the following new subsection:
    ``(k) Reduction in FMAP After 2020 for Non-Compliant States.--
            ``(1) In general.--With respect to a calendar quarter 
        beginning on or after January 1, 2021, the Federal medical 
        assistance percentage otherwise determined under section 
        1905(b) for a non-compliant State shall be reduced--
                    ``(A) for calendar quarters in 2021 and 2022, by 
                0.12 percentage points;
                    ``(B) for calendar quarters in 2023, by 0.25 
                percentage points;
                    ``(C) for calendar quarters in 2024, by 0.35 
                percentage points; and
                    ``(D) for calendar quarters in 2025 and each year 
                thereafter, by 0.5 percentage points.
            ``(2) Non-compliant state defined.--For purposes of this 
        subsection, the term `non-compliant State' means a State--
                    ``(A) that is one of the 50 States or the District 
                of Columbia;
                    ``(B) with respect to which the Secretary has not 
                approved a State plan amendment submitted under 
                subsection (a)(2); and
                    ``(C) that is not operating, on an ongoing basis, 
                an asset verification program in accordance with this 
                section.''.

SEC. 104. MEDICAID IMPROVEMENT FUND.

    Section 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w-
1(b)(1)) is amended by striking ``$31,000,000'' and inserting 
``$6,000,000''.

SEC. 105. BUDGETARY EFFECTS.

    (a) Statutory PAYGO Scorecards.--The budgetary effects of this 
title shall not be entered on either PAYGO scorecard maintained 
pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 
U.S.C. 933(d)).
    (b) Senate PAYGO Scorecards.--The budgetary effects of this title 
shall not be entered on any PAYGO scorecard maintained for purposes of 
section 4106 of H. Con. Res. 71 (115th Congress).
    (c) Classification of Budgetary Effects.--Notwithstanding Rule 3 of 
the Budget Scorekeeping Guidelines set forth in the joint explanatory 
statement of the committee of conference accompanying Conference Report 
105-217 and section 250(c)(8) of the Balanced Budget and Emergency 
Deficit Control Act of 1985, the budgetary effects of this title shall 
not be estimated--
            (1) for purposes of section 251 of the Balanced Budget and 
        Emergency Deficit Control Act of 1985; and
            (2) for purposes of paragraph (4)(C) of section 3 of the 
        Statutory Pay-As-You-Go Act of 2010 as being included in an 
        appropriation Act.
    (d) PAYGO Annual Report.--For the purposes of the annual report 
issued pursuant to section 5 of the Statutory Pay-As-You-Go Act of 2010 
(2 U.S.C. 934) after adjournment of the second session of the 115th 
Congress, and for determining whether a sequestration order is 
necessary under such section, the debit for the budget year on the 5-
year scorecard, if any, and the 10-year scorecard, if any, shall be 
deducted from such scorecard in 2019 and added to such scorecard in 
2020.

                TITLE II--TANF AND TECHNICAL CORRECTIONS

SEC. 201. TANF PROGRAM EXTENSIONS.

    (a) Family Assistance Grants.--Section 403(a)(1) of the Social 
Security Act (42 U.S.C. 603(a)(1)) is amended in each of subparagraphs 
(A) and (C) by striking ``2017 and 2018'' and inserting ``2019 and 
2020''.
    (b) Healthy Marriage Promotion and Responsible Fatherhood Grants.--
Section 403(a)(2)(D) of such Act (42 U.S.C. 603(a)(2)(D)) is amended--
            (1) by striking ``2017 and 2018'' and inserting ``2019 and 
        2020''; and
            (2) by striking ``for fiscal year 2017 or 2018''.
    (c) Contingency Fund.--Section 403(b)(2) of such Act (42 U.S.C. 
603(b)(2)) is amended by striking ``fiscal year 2018'' and inserting 
``each of fiscal years 2019 and 2020''.
    (d) Tribal Family Assistance Grants.--Paragraphs (1)(A) and (2)(A) 
of section 412(a) of such Act (42 U.S.C. 612(a)) are each amended by 
striking ``2017 and 2018'' and inserting ``2019 and 2020''.
    (e) Child Care.--Section 418(a)(3) of such Act (42 U.S.C. 
618(a)(3)) is amended by striking ``2017 and 2018'' and inserting 
``2019 and 2020''.
    (f) Grants to the Territories.--Section 1108(b)(2) of such Act (42 
U.S.C. 1308(b)(2)) is amended by striking ``2017 and 2018'' and 
inserting ``2019 and 2020''.

SEC. 202. MEASURING AND UNDERSTANDING OUTCOMES.

    (a) In General.--Section 411(a) of the Social Security Act (42 
U.S.C. 611(a)) is amended by redesignating paragraph (7) as paragraph 
(8) and inserting after paragraph (6) the following:
            ``(7) Report on engagement, employment and outcomes.--
                    ``(A) Reporting agreement.--Each State and the 
                Secretary shall enter into an agreement specifying the 
                manner by which the information and data described in 
                this paragraph shall be collected and reported to the 
                Secretary beginning in fiscal year 2020.
                            ``(i) Outcomes for exiting recipients.--
                        Information and data regarding families who 
                        formerly received assistance and included a 
                        work-eligible individual (disaggregated by type 
                        of family, reason for exit, and participation 
                        in work activities during the preceding fiscal 
                        year) under the State program funded under this 
                        part or under any State program funded with 
                        qualified State expenditures (as defined in 
                        section 409(a)(7)(B)(i)), with respect to the 
                        following:
                                    ``(I) The percentage with at least 
                                1 formerly work-eligible individual 
                                employed during the 2nd quarter after 
                                exiting from the program.
                                    ``(II) The percentage with at least 
                                1 formerly work-eligible individual 
                                employed during the 4th quarter after 
                                exiting from the program.
                                    ``(III) The median earnings when at 
                                least 1 formerly work-eligible 
                                individual is employed during the 2d 
                                quarter after exiting from the program.
                                    ``(IV) The percentage with at least 
                                1 formerly work-eligible individual 
                                employed during any of the first 4 
                                quarters after exiting from the 
                                program.
                                    ``(V) The distribution of income 
                                and earnings, including relative to 
                                poverty and deep poverty, for each of 
                                the first 4 quarters ending after the 
                                quarter of exit from assistance.
                                    ``(VI) The percentage who, at the 
                                time of exit from the program, were 
                                subject to the following:
                                            ``(aa) A penalty under 
                                        section 407(e).
                                            ``(bb) A sanction or 
                                        penalty described in section 
                                        404 or 408.
                                            ``(cc) A penalty or 
                                        sanction not described in item 
                                        (aa) or (bb).
                            ``(ii) Engagement and employment of current 
                        recipients.--
                                    ``(I) Work-eligible individuals.--
                                In the case of current work-eligible 
                                individuals under the State program 
                                funded under this part or under any 
                                State program funded with qualified 
                                State expenditures (as defined in 
                                section 409(a)(7)(B)(i)), the following 
                                information relative to the current 
                                quarter being reported:
                                            ``(aa) Earnings in each of 
                                        the 4 quarters immediately 
                                        preceding the quarter.
                                            ``(bb) Standard measures of 
                                        employment, earnings, receipt 
                                        of assistance, and 
                                        participation in work 
                                        activities (as defined in 
                                        section 407(d)) in each of the 
                                        first 4 quarters following the 
                                        quarter.
                                    ``(II) All recipients.--The 
                                percentage of recipients of assistance 
                                under the State program funded under 
                                this part or under any State program 
                                funded with qualified State 
                                expenditures (as defined in section 
                                409(a)(7)(B)(i)) who have not attained 
                                24 years of age and who obtain a high 
                                school degree or its recognized 
                                equivalent while receiving the 
                                assistance.
                    ``(B) Statistical adjustment model for employment 
                outcomes.--The Secretary, in consultation with the 
                Secretary of Labor and relevant experts, shall develop 
                recommendations by March 1, 2020, on how to establish 
                and disseminate an objective statistical model that 
                will allow the Secretary to make adjustments to the 
                data reported pursuant to subclauses (I) through (IV) 
                of subparagraph (A)(i) of this paragraph, based on 
                economic conditions and the characteristics of 
                participants. To the extent practicable, the 
                recommendations shall be compatible with the 
                statistical adjustment model developed under section 
                116(b)(3)(A)(viii) of the Workforce Innovation and 
                Opportunity Act (29 U.S.C. 3141(b)(3)(A)(viii)) and, 
                with respect to a State, the State adjusted levels of 
                performance established for the State under that 
                section.''.

SEC. 203. TECHNICAL CORRECTIONS TO DATA EXCHANGE STANDARDS TO IMPROVE 
              PROGRAM COORDINATION.

    (a) In General.--Section 411(d) of the Social Security Act (42 
U.S.C. 611(d)) is amended to read as follows:
    ``(d) Data Exchange Standards for Improved Interoperability.--
            ``(1) Designation.--The Secretary shall, in consultation 
        with an interagency work group established by the Office of 
        Management and Budget and considering State government 
        perspectives, by rule, designate data exchange standards to 
        govern, under this part--
                    ``(A) necessary categories of information that 
                State agencies operating programs under State plans 
                approved under this part are required under applicable 
                Federal law to electronically exchange with another 
                State agency; and
                    ``(B) Federal reporting and data exchange required 
                under applicable Federal law.
            ``(2) Requirements.--The data exchange standards required 
        by paragraph (1) shall, to the extent practicable--
                    ``(A) incorporate a widely accepted, non-
                proprietary, searchable, computer-readable format, such 
                as the eXtensible Markup Language;
                    ``(B) contain interoperable standards developed and 
                maintained by intergovernmental partnerships, such as 
                the National Information Exchange Model;
                    ``(C) incorporate interoperable standards developed 
                and maintained by Federal entities with authority over 
                contracting and financial assistance;
                    ``(D) be consistent with and implement applicable 
                accounting principles;
                    ``(E) be implemented in a manner that is cost-
                effective and improves program efficiency and 
                effectiveness; and
                    ``(F) be capable of being continually upgraded as 
                necessary.
            ``(3) Rule of construction.--Nothing in this subsection 
        shall be construed to require a change to existing data 
        exchange standards found to be effective and efficient.''.
    (b) Effective Date.--Not later than the date that is 24 months 
after the date of the enactment of this section, the Secretary of 
Health and Human Services shall issue a proposed rule that--
            (1) identifies federally required data exchanges, include 
        specification and timing of exchanges to be standardized, and 
        address the factors used in determining whether and when to 
        standardize data exchanges; and
            (2) specifies State implementation options and describes 
        future milestones.

SEC. 204. UNEMPLOYMENT INSURANCE TECHNICAL CORRECTIONS.

    Section 306(a) of the Social Security Act (42 U.S.C. 506(a)) is 
amended--
            (1) by striking ``individuals'' and inserting ``claimants 
        of regular compensation, including claimants''; and
            (2) by inserting a comma after ``section 303(j)''.
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