Title: Medicaid Extenders Act of 2019
Policy area: Health

Summary:
Medicaid Extenders Act of 2019
This bill alters several Medicaid programs and funding mechanisms. Specifically, the bill

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 259 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 259

      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, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 4, 2019

Mr. Pallone (for himself and Mr. Walden) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
      addition to the Committee on 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, 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 Extenders Act of 2019''.

SEC. 2. 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. 3. 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. 4. 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. 5. 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. 6. BUDGETARY EFFECTS.

    (a) Statutory PAYGO Scorecards.--The budgetary effects of this Act 
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 Act 
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 Act 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.
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