Title: Medicaid Improvement and State Flexibility Act of 2019
Policy area: Health

Summary:
Medicaid Improvement and State Flexibility Act of 2019
This bill authorizes states to approve their own experimental, pilot, or demonstration project under Medicaid if the project provides certain benefits involving electronic benefits transfer (EBT) cards. (Currently, the Centers for Medicare & Medicaid Services approves Medicaid demonstration projects; such projects are also known as Section 1115 Demonstrations.)
Specifically, the project must provide enrollees who elect to participate with an EBT card to purchase primary care services; enrollees must receive any remaining balance at the end of the year in the form of a cash payment and must also obtain catastrophic health insurance.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2715 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 2715

   To amend title XI of the Social Security Act to provide for State 
  approval and implementation of specified waivers under the Medicaid 
                                program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 14, 2019

  Mr. Green of Tennessee (for himself, Mr. Wright, Mr. Armstrong, Mr. 
 Norman, Mr. Marshall, and Mr. Kevin Hern of Oklahoma) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend title XI of the Social Security Act to provide for State 
  approval and implementation of specified waivers under the Medicaid 
                                program.

    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 Improvement and State 
Flexibility Act of 2019''.

SEC. 2. PROVIDING FOR STATE APPROVAL AND IMPLEMENTATION OF SPECIFIED 
              WAIVERS UNDER THE MEDICAID PROGRAM.

    Section 1115 of the Social Security Act (42 U.S.C. 1315) is 
amended--
            (1) in subsection (d)--
                    (A) in paragraph (1), by striking ``An 
                application'' and inserting ``Subject to paragraph (4), 
                an application''; and
                    (B) by adding at the end the following new 
                paragraph:
    ``(4)(A) An experimental, pilot, or demonstration project 
undertaken under subsection (a) may be approved or renewed by a State 
if such project is described in subparagraph (B).
    ``(B) An experimental, pilot, or demonstration project is described 
in this subparagraph if such project provides for a waiver of 
requirements with respect to a State plan (or a waiver of such plan) 
under title XIX such that--
            ``(i) individuals enrolled under such plan (or such waiver) 
        may elect to participate in such project with respect to a 
        year;
            ``(ii) such individuals who elect to so participate--
                    ``(I) are furnished with an electronic benefits 
                transfer card in an amount determined appropriate by 
                the State for purposes of purchasing primary care 
                services and medications during such year;
                    ``(II) are furnished a cash payment by the State 
                equal to the amount of funds remaining on the 
                individual's electronic benefits transfer card at the 
                end of such year; and
                    ``(III) are enrolled in a catastrophic insurance 
                program determined appropriate by the State for 
                purposes of covering services not described in 
                subclause (I) and covering services that are described 
                in such subclause if such individual exceeds the amount 
                of funds provided to such individual on such card for 
                such year; and
            ``(iii) Federal expenditures under such title for the 
        period during which such project is in effect are equal to or 
        lesser than what such expenditures would have been during such 
        period if such project were not in effect.
    ``(C)(i) In no case may a project described in subparagraph (B) 
result in an expenditure to pay for any abortion or to assist in the 
purchase, in whole or in part, of health benefit coverage that includes 
coverage of abortion.
    ``(ii) Clause (i) shall not apply to an abortion only if necessary 
to save the life of the mother or if the pregnancy is the result of an 
act of rape or incest.
    ``(D) For purposes of a State's approval or renewal of an 
experimental, pilot, or demonstration project under subparagraph (A), 
each reference to `the Secretary' in subsection (a) shall be deemed to 
be a reference to `the State'.''; and
            (2) in subsection (e), by inserting ``(other than such a 
        project that is described in paragraph (4)(B))'' before the 
        period at the end.
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