II 118th CONGRESS 1st Session S. 2816 IN THE SENATE OF THE UNITED STATES September 14, 2023 Mr. Casey introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XIX of the Social Security Act to make all children eligible for Medicaid from birth until age 19, to require States to automatically enroll children under age 19 in the State Medicaid program, and for other purposes.

1. Short title This Act may be cited as the Medicaid for Every Child Act . 2. Medicaid for every child from birth to age 19 (a) In general Section 1902(a)(10)(A)(i) of the Social Security Act ( 42 U.S.C. 1396a(a)(10)(A)(i) ) is amended— (1) by striking or at the end of subclause (VIII); (2) in subclause (IX)(dd), by inserting or at the end; and (3) by adding at the end the following new subclause: (X) beginning on the date that is 2 years after the date of enactment of this subclause, who are individuals who have not attained 19 years of age; . (b) Automatic enrollment (1) In general Section 1902(e) of the Social Security Act is amended by striking paragraph (4) and inserting the following: (4) Automatic enrollment of children (A) In general Any child born in a State on or after the date that is 2 years after the date of enactment of the Medicaid for Every Child Act shall be considered to have applied for medical assistance under the State plan and shall be automatically enrolled for such assistance on the date of their birth. (B) Notification requirement The State shall inform the parent, guardian, or custodial relative of a child who is automatically enrolled in the State plan under subparagraph (A) of the services that will be covered, appropriate methods for using such services, medical support obligations (under section 1912(a)) created by enrollment (if applicable), the actions the parent, guardian, or relative must take (if any) to maintain enrollment, and the actions the parent, guardian or relative may take to disenroll the child. (C) Opt-out if other coverage is available The State shall establish a process to allow the parent, guardian, or custodial relative of a child who is automatically enrolled in the State plan under subparagraph (A) to disenroll the child from the State plan through affirmation in writing if the child is enrolled in other health benefits coverage that— (i) at a minimum, provides the essential health benefits defined by the Secretary under section 1302(b) of the Patient Protection and Affordable Care Act; and (ii) meets such other requirements as the Secretary determines appropriate. . (2) Effective date The amendment made by this section shall take effect on the date that is 2 years after the date of enactment of this Act. (c) Continuous eligibility (1) In general Section 1902(e)(12) of the Social Security Act ( 42 U.S.C. 1396a(e)(12) ), as amended by section 5112(a) of division FF of Public Law 117–328 , is amended— (A) by striking subparagraph (A); and (B) by redesignating subparagraphs (B) and (C) as subparagraphs (A) and (B). (2) Effective date The amendments made by this section shall take effect on the date that is 2 years after the date of enactment of this Act. (d) Exclusion from definition of minimum essential coverage Section 36B(c)(2) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph: (D) Treatment of certain coverage under the Medicaid program For purposes of subparagraph (B), an individual shall not be treated as eligible for minimum essential coverage if— (i) such coverage consists of eligibility for medical assistance under a State Medicaid program under section 1902(a)(10)(A)(i)(X) of the Social Security Act; and (ii) the individual is not enrolled in such a program for such medical assistance. . (e) Coverage of children without regard to immigration status (1) In general Section 1903(v) of the Social Security Act ( 42 U.S.C. 1396b(v) ) is amended— (A) in paragraph (1), by striking and (4) and inserting , (4), and (5) ; (B) in paragraph (4)(A)(ii)— (i) in the clause header, by inserting aged 19 to 20 after Children ; and (ii) by inserting who have attained 19 years of age but are before under 21 years of age ; and (C) by adding at the end the following paragraph: (5) (A) Notwithstanding any other provision of law, on and after the date that is 2 years after the date of enactment of this paragraph, a State shall provide medical assistance under this title to any individual residing or present in the United States who is eligible for medical assistance under section 1902(a)(10)(A)(i)(X), without regard to whether the individual is lawfully residing or lawfully present in the United States. (B) No debt shall accrue under an affidavit of support against any sponsor of an individual provided medical assistance in accordance with subparagraph (A) and the cost of such assistance shall not be considered as an unreimbursed cost. . (2) Conforming amendments (A) Section 1137(f) of the Social Security Act ( 42 U.S.C. 1320b–7(f) ) is amended by inserting or to individuals who are eligible for medical assistance under section 1902(a)(10)(A)(i)(X) and are provided such assistance in accordance with section 1903(v)(5) before the period. (B) Section 2107(e)(1)(O) of the Social Security Act ( 42 U.S.C. 1397gg(e)(1)(O) ) is amended by inserting who have attained age 19 or 20 after immigrant children . (C) Section 402(b)(2) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ( 8 U.S.C. 1612(b)(2) ) is amended by adding at the end the following: (H) Medicaid exception for children With respect to eligibility for benefits for the program defined in paragraph (3)(C) (relating to the Medicaid program), section 401(a) and paragraph (1) shall not apply to any individual who has not attained 19 years of age. . (D) Section 403(d) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ( 8 U.S.C. 1613(d) ) is amended— (i) by striking or at the end of paragraph (1); (ii) by striking the period at the end of paragraph (2) and inserting ; or ; and (iii) by adding at the end the following: (3) an individual described in section 402(a)(2)(H), but only with respect to the program specified in subsection (b)(3)(C) of section 402. . (E) Section 431(b) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ( 8 U.S.C. 1641(b) ) is amended— (i) by striking or at the end of paragraph (7); (ii) by striking the period at the end of paragraph (8) and inserting , or ; and (iii) by adding at the end the following: (9) an individual who has not attained 19 years of age, but only with respect to the designated Federal program defined in section 402(b)(3)(C) (relating to the Medicaid program). . (f) 100 percent Federal matching payments for medical assistance for children (1) In general Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) is amended— (A) in subsection (b), by striking and (ii) and inserting (ii), and (jj) ; and (B) by adding at the end the following new subsection: (jj) Enhanced FMAP for certain children Notwithstanding subsection (b), beginning on the date that is 2 years after the date of enactment of this subsection, the Federal medical assistance percentage shall be 100 percent with respect to amounts expended by a State for medical assistance for individuals— (1) who are eligible for medical assistance under section 1902(a)(10)(A)(i)(X); and (2) who would not have been eligible for medical assistance for full benefits (as defined in subsection (y)(2)(B)) under the State plan under this title or a waiver of such plan as such plan or waiver was in effect on January 1, 2023. . (2) Conforming amendment Section 9817(a)(1) of the American Rescue Plan Act of 2021 ( Public Law 117–2 ) is amended by striking or (ii) of section 1905 and inserting (ii), or (jj) of section 1905 . (g) Effective date Except as otherwise provided, the amendments made by this section shall take effect on the date of enactment of this Act.