In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Glacier Bay National Park Boundary 
Adjustment Act of 1998''.

SEC. 2. LAND EXCHANGE AND WILDERNESS DESIGNATION.

    (a) In General.--(1) Subject to conditions set forth in subsection 
(c), if the State of Alaska, in a manner consistent with this Act, 
offers to transfer to the United States the lands identified in 
paragraph (2) in exchange for the lands identified in paragraph (4), 
selected from the area described in section 3(b)(1), the Secretary of 
the Interior (in this Act referred to as the ``Secretary'') shall 
complete such exchange no later than 6 months after the issuance of a 
license to Gustavus Electric Company by the Federal Energy Regulatory 
Commission (in this Act referred to as ``FERC''), in accordance with 
this Act. This land exchange shall be subject to the laws applicable to 
exchanges involving lands managed by the Secretary as part of the 
National Park System in Alaska and the appropriate process for the 
exchange of State lands required by State law.
    (2) The lands to be conveyed to the United States by the State of 
Alaska shall be determined by mutual agreement of the Secretary and the 
State of Alaska. Lands that will be considered for conveyance to the 
United States pursuant to the process required by State law are lands 
owned by the State of Alaska in the Long Lake area within Wrangell-St. 
Elias National Park and Preserve, or other lands owned by the State of 
Alaska.
    (3) If the Secretary and the State of Alaska have not agreed on 
which lands the State of Alaska will convey by a date not later than 6 
months after a license is issued pursuant to this Act, the United 
States shall accept, within 1 year after a license is issued, title to 
land having a sufficiently equal value to satisfy State and Federal 
law, subject to clear title and valid existing rights, and absence of 
environmental contamination, and as provided by the laws applicable to 
exchanges involving lands managed by the Secretary as part of the 
National Park System in Alaska and the appropriate process for the 
exchange of State lands required by State law. Such land shall be 
accepted by the United States, subject to the other provisions of this 
Act, from among the following State lands in the priority listed:


                          copper river meridian

        (A) T.6 S., R. 12 E., partially surveyed, Sec. 5, lots 1, 2, 
    and 3, NE\1/4\, S\1/2\NW\1/4\, and S\1/2\. Containing 617.68 acres, 
    as shown on the plat of survey accepted June 9, 1922.
        (B) T.6 S., R. 11 E., partially surveyed, Sec. 11, lots 1 and 
    2, NE\1/4\, S\1/2\NW\1/4\, SW\1/4\, and N\1/2\SE\1/4\; Sec. 12; 
    Sec. 14, lots 1 and 2, NW\1/4\NW\1/4\. Containing 1,191.75 acres, 
    as shown on the plat of survey accepted June 9, 1922.
        (C) T.6 S., R. 11 E., partially surveyed, Sec. 2, NW\1/4\NE\1/
    4\ and NW\1/4\. Containing 200.00 acres, as shown on the plat of 
    survey accepted June 9, 1922.
        (D) T.6 S., R. 12 E., partially surveyed, Sec. 6. lots 1 
    through 10, E\1/2\SW\1/4\ and SE\1/4\. Containing approximately 
    529.94 acres, as shown on the plat of survey accepted June 9, 1922.
    (4) The lands to be conveyed to the State of Alaska by the United 
States under paragraph (1) are lands to be designated by the Secretary 
and the State of Alaska, consistent with sound land management 
principles, based on those lands determined by FERC with the 
concurrence of the Secretary and the State of Alaska, in accordance 
with section 3(b), to be the minimum amount of land necessary for the 
construction and operation of a hydroelectric project.
    (5) The time periods set forth for the completion of the land 
exchanges described in this Act may be extended as necessary by the 
Secretary should the processes of State law or Federal law delay 
completion of an exchange.
    (6) For purposes of this Act, the term ``land'' means lands, 
waters, and interests therein.
    (b) Wilderness.--(1) To ensure that this transaction maintains, 
within the National Wilderness Preservation System, approximately the 
same amount of area of designated wilderness as currently exists, the 
following lands in Alaska shall be designated as wilderness in the 
priority listed, upon consummation of the land exchange authorized by 
this Act and shall be administered according to the laws governing 
national wilderness areas in Alaska:
        (A) An unnamed island in Glacier Bay National Park lying 
    southeasterly of Blue Mouse Cove in sections 5, 6, 7, and 8, T. 36 
    S., R. 54 E., CRM, and shown on United States Geological Survey 
    quadrangle Mt. Fairweather (D-2), Alaska, containing approximately 
    789 acres.
        (B) Cenotaph Island of Glacier Bay National Park lying within 
    Lituya Bay in sections 23, 24, 25, and 26, T. 37 S., R. 47 E., CRM, 
    and shown on United States Geological Survey quadrangle Mt. 
    Fairweather (C-5), Alaska, containing approximately 280 acres.
        (C) An area of Glacier Bay National Park lying in T. 31. S., R. 
    43 E and T. 32 S., R. 43 E., CRM, that is not currently designated 
    wilderness, containing approximately 2,270 acres.
    (2) The specific boundaries and acreage of these wilderness 
designations may be reasonably adjusted by the Secretary, consistent 
with sound land management principles, to approximately equal, in sum, 
the total wilderness acreage deleted from Glacier Bay National Park and 
Preserve pursuant to the land exchange authorized by this Act.
    (c) Conditions.--Any exchange of lands under this Act may occur 
only if--
        (1) following the submission of a complete license application, 
    FERC has conducted economic and environmental analyses under the 
    Federal Power Act (16 U.S.C. 791-828) (notwithstanding provisions 
    of that Act and the Federal regulations that otherwise exempt this 
    project from economic analyses), the National Environmental Policy 
    Act of 1969 (42 U.S.C. 4321-4370), and the Fish and Wildlife 
    Coordination Act (16 U.S.C. 661-666), that conclude, with the 
    concurrence of the Secretary of the Interior with respect to 
    subparagraphs (A) and (B), that the construction and operation of a 
    hydroelectric power project on the lands described in section 
    3(b)--
            (A) will not adversely impact the purposes and values of 
        Glacier Bay National Park and Preserve (as constituted after 
        the consummation of the land exchange authorized by this 
        section);
            (B) will comply with the requirements of the National 
        Historic Preservation Act (16 U.S.C. 470-470w); and
            (C) can be accomplished in an economically feasible manner;
        (2) FERC held at least one public meeting in Gustavus, Alaska, 
    allowing the citizens of Gustavus to express their views on the 
    proposed project;
        (3) FERC has determined, with the concurrence of the Secretary 
    and the State of Alaska, the minimum amount of land necessary to 
    construct and operate this hydroelectric power project; and
        (4) Gustavus Electric Company has been granted a license by 
    FERC that requires Gustavus Electric Company to submit an 
    acceptable financing plan to FERC before project construction may 
    commence, and the FERC has approved such plan.

SEC. 3. ROLE OF FERC.

    (a) License Application.--(1) The FERC licensing process shall 
apply to any application submitted by Gustavus Electric Company to the 
FERC for the right to construct and operate a hydropower project on the 
lands described in subsection (b).
    (2) FERC is authorized to accept and consider an application filed 
by Gustavus Electric Company for the construction and operation of a 
hydropower plant to be located on lands within the area described in 
subsection (b), notwithstanding section 3(2) of the Federal Power Act 
(16 U.S.C. 796(2)). Such application must be submitted within 3 years 
after the date of the enactment of this Act.
    (3) FERC will retain jurisdiction over any hydropower project 
constructed on this site.
    (b) Analyses.--(1) The lands referred to in subsection (a) of this 
section are lands in the State of Alaska described as follows:


                          copper river meridian

    Township 39 South, Range 59 East, partially surveyed, Section 36 
(unsurveyed), SE\1/4\SW\1/4\, S\1/2\SW\1/4\SW\1/4\, NE\1/4\SW\1/4\, 
W\1/2\W\1/2\NW\1/4\SE\1/4\, and S\1/2\SE\1/4\NW\1/4\. Containing 
approximately 130 acres.
    Township 40 South, Range 59 East, partially surveyed, Section 1 
(unsurveyed), NW\1/4\, SW\1/4\, W\1/2\SE\1/4\, and SW\1/4\SW\1/4\NE\1/
4\, excluding U.S. Survey 944 and Native allotment A-442; Section 2 
(unsurveyed), fractional, that portion lying above the mean high tide 
line of Icy Passage, excluding U.S. Survey 944 and U.S. Survey 945; 
Section 11 (unsurveyed), fractional, that portion lying above the mean 
high tide line of Icy Passage, excluding U.S. Survey 944; Section 12 
(unsurveyed), fractional, NW\1/4\NE\1/4\, W\1/2\NW\1/4\SW\1/4\NE\1/4\, 
and those portions of NW\1/4\ and SW\1/4\ lying above the mean high 
tide line of Icy Passage, excluding U.S. Survey 944 and Native 
allotment A-442. Containing approximately 1,015 acres.
    (2) Additional lands and acreage will be included as needed in the 
study area described in paragraph (1) to account for accretion to these 
lands from natural forces.
    (3) With the concurrence of the Secretary and the State of Alaska, 
the FERC shall determine the minimum amount of lands necessary for 
construction and operation of such project.
    (4) The National Park Service shall participate as a joint lead 
agency in the development of any environmental document under the 
National Environmental Policy Act of 1969 in the licensing of such 
project. Such environmental document shall consider both the impacts 
resulting from licensing and any land exchange necessary to authorize 
such project.
    (c) Issuance of License.--(1) A condition of the license to 
construct and operate any portion of the hydroelectric power project 
shall be FERC's approval, prior to any commencement of construction, of 
a finance plan submitted by Gustavus Electric Company.
    (2) The National Park Service, as the existing supervisor of 
potential project lands ultimately to be deleted from the Federal 
reservation in accordance with this Act, waives its right to impose 
mandatory conditions on such project lands pursuant to section 4(e) of 
the Federal Power Act (16 U.S.C. 797(e)).
    (3) FERC shall not license or relicense the project, or amend the 
project license unless it determines, with the Secretary's concurrence, 
that the project will not adversely impact the purposes and values of 
Glacier Bay National Park and Preserve (as constituted after the 
consummation of the land exchange authorized by this Act). 
Additionally, a condition of the license, or any succeeding license, to 
construct and operate any portion of the hydroelectric power project 
shall require the licensee to mitigate any adverse effects of the 
project on the purposes and values of Glacier Bay National Park and 
Preserve identified by the Secretary after the initial licensing.
    (4) A condition of the license to construct and operate any portion 
of the hydroelectric power project shall be the completion, prior to 
any commencement of construction, of the land exchange described in 
this Act.

SEC. 4. ROLE OF SECRETARY OF THE INTERIOR.

    (a) Special Use Permit.--Notwithstanding the provisions of the 
Wilderness Act (16 U.S.C. 1133-1136), the Secretary shall issue a 
special use permit to Gustavus Electric Company to allow the completion 
of the analyses referred to in section 3. The Secretary shall impose 
conditions in the permit as needed to protect the purposes and values 
of Glacier Bay National Park and Preserve.
    (b) Park System.--The lands acquired from the State of Alaska under 
this Act shall be added to and administered as part of the National 
Park System, subject to valid existing rights. Upon completion of the 
exchange of lands under this Act, the Secretary shall adjust, as 
necessary, the boundaries of the affected National Park System units to 
include the lands acquired from the State of Alaska; and adjust the 
boundary of Glacier Bay National Park and Preserve to exclude the lands 
transferred to the State of Alaska under this Act. Any such adjustment 
to the boundaries of National Park System units resulting from this Act 
shall not be charged against any acreage limitations under section 
103(b) of Public Law 96-487.
    (c) Wilderness Area Boundaries.--The Secretary shall make any 
necessary modifications or adjustments of boundaries of wilderness 
areas as a result of the additions and deletions caused by the land 
exchange referenced in section 2. Any such adjustment to the boundaries 
of National Park System units shall not be considered in applying any 
acreage limitations under section 103(b) of Public Law 96-487.
    (d) Concurrence of the Secretary.--Whenever in this Act the 
concurrence of the Secretary is required, it shall not be unlawfully 
withheld or unreasonably delayed.

SEC. 5. APPLICABLE LAW.

    The authorities and jurisdiction provided in this Act shall 
continue in effect until such time as this Act is expressly modified or 
repealed by Congress.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
Glacier Bay National Park Boundary Adjustment Act of 1998 - Provides for:  (1) an exchange of specified State lands in Alaska for specified Federal lands to be completed within six months after the issuance of a license to Gustavus Electric Company (GEC) by the Federal Energy Regulatory Commission (FERC) for the construction and operation of a hydroelectric project on such Federal lands; or (2) the exchange of other specified Alaska lands having a sufficiently equal value to satisfy State and Federal law within one year after such license is issued if the Secretary of the Interior and Alaska have not agreed on which lands Alaska will convey within such six-month period. 
Designates specified State lands and waters in Alaska as wilderness upon consummation of such exchange to ensure that this transaction maintains approximately the same amount of area of designated wilderness. 
Conditions such land exchange on:  (1) FERC's having conducted economic and environmental analyses pursuant to the Federal Power Act (FPA), the National Environmental Policy Act of 1969, and the Fish and Wildlife Coordination Act that conclude that the construction and operation of a hydroelectric power project on such lands will not adversely impact the purposes and values of the Glacier Bay National Park and Preserve, will comply with the requirements of the National Historic Preservation Act, and can be accomplished in an economically feasible manner; (2) FERC holding at least one public meeting in Gustavus, Alaska, allowing its citizens to express their views on the proposed project; (3) FERC having determined, with the concurrence of the Secretary and Alaska, the minimum amount of land necessary to construct and operate the project; (4) GEC having been granted a FERC license that requires it to submit an acceptable financing plan to FERC before project construction commences; and (5) FERC approving such plan. 
Makes the FERC licensing process applicable to any application submitted by GEC to FERC for the right to construct and operate a hydropower project on specified Alaska lands.  Authorizes FERC to accept and consider an application filed by GEC for construction and operation of such a project, notwithstanding FPA provisions, if submitted within three years after this Act's enactment.  Provides for FERC to retain jurisdiction over any hydropower project constructed on such site.  Sets forth additional provisions regarding issuance of a license for construction or operation of such a project. 
(Sec. 4) Directs the Secretary to issue a special use permit to GEC to allow completion of the required analyses.  Requires the Secretary to impose conditions in the permit as needed to protect the purposes and values of the Preserve.  Requires the lands acquired from Alaska to be added to and administered as part of the National Park System, subject to valid existing rights. 
Continues the authorities and jurisdiction provided in this Act until expressly modified or repealed by the Congress.

SECTION 1. AUTOMATIC INCREASE IN THE FEDERAL MEDICAL ASSISTANCE 
              PERCENTAGE DURING PERIODS OF NATIONAL ECONOMIC DOWNTURN.

    (a) National Economic Downturn Assistance FMAP.--
            (1) In general.--Section 1905 of the Social Security Act 
        (42 U.S.C. 1396d) is amended--
                    (A) in subsection (b), in the first sentence--
                            (i) by striking ``and (4)'' and inserting 
                        ``(4)''; and
                            (ii) by inserting ``and (5) with respect to 
                        each fiscal year quarter other than the first 
                        quarter of a national economic downturn 
                        assistance period described in subsection 
                        (y)(1), the Federal medical assistance 
                        percentage for any State described in 
                        subsection (y)(2) shall be equal to the 
                        national economic downturn assistance FMAP 
                        determined for the State for the quarter under 
                        subsection (y)(3)'' before the period; and
                    (B) by adding at the end the following:
    ``(y) National Economic Downturn Assistance FMAP.--For purposes of 
clause (5) of the first sentence of subsection (b):
            ``(1) National economic downturn assistance period.--A 
        national economic downturn assistance period described in this 
        paragraph--
                    ``(A) begins with the first fiscal year quarter for 
                which the Secretary determines that for at least 23 
                States, the rolling average unemployment rate for that 
                quarter has increased by at least 10 percent over the 
                corresponding quarter for the most recent preceding 12-
                month period for which data are available (in this 
                subsection referred to as the `trigger quarter'); and
                    ``(B) ends with the first succeeding fiscal year 
                quarter for which the Secretary determines that less 
                than 23 States have a rolling average unemployment rate 
                for that quarter with an increase of at least 10 
                percent over the corresponding quarter for the most 
                recent preceding 12-month period for which data are 
                available.
            ``(2) Eligible state.--A State described in this paragraph 
        is a State for which the Secretary determines that the rolling 
        average unemployment rate for the State for any quarter 
        occurring during a national economic downturn assistance period 
        described in paragraph (1) has increased over the corresponding 
        quarter for the most recent preceding 12-month period for which 
        data are available.
            ``(3) Determination of national economic downturn 
        assistance fmap.--
                    ``(A) In general.--The national economic downturn 
                assistance FMAP for a fiscal year quarter determined 
                with respect to a State under this paragraph is equal 
                to the Federal medical assistance percentage for the 
                State for that quarter increased by the number of 
                percentage points determined by--
                            ``(i) dividing--
                                    ``(I) the Medicaid additional 
                                unemployed increased cost amount 
                                determined under subparagraph (B) for 
                                the quarter; by
                                    ``(II) the State's total Medicaid 
                                quarterly spending amount determined 
                                under subparagraph (C) for the quarter; 
                                and
                            ``(ii) multiplying the quotient determined 
                        under clause (i) by 100.
                    ``(B) Medicaid additional unemployed increased cost 
                amount.--For purposes of subparagraph (A)(i)(I), the 
                Medicaid additional unemployed increased cost amount 
                determined under this subparagraph with respect to a 
                State and a quarter is the product of the following:
                            ``(i) State increase in rolling average 
                        number of unemployed individuals from the base 
                        quarter of unemployment.--
                                    ``(I) In general.--The amount 
                                determined by subtracting the rolling 
                                average number of unemployed 
                                individuals in the State for the base 
                                unemployment quarter for the State 
                                determined under subclause (II) from 
                                the rolling average number of 
                                unemployed individuals in the State for 
                                the quarter.
                                    ``(II) Base unemployment quarter 
                                defined.--
                                            ``(aa) In general.--For 
                                        purposes of subclause (I), 
                                        except as provided in item 
                                        (bb), the base quarter for a 
                                        State is the quarter with the 
                                        lowest rolling average number 
                                        of unemployed individuals in 
                                        the State in the 12-month 
                                        period preceding the trigger 
                                        quarter for a national economic 
                                        downturn assistance period 
                                        described in paragraph (1).
                                            ``(bb) Exception.--If the 
                                        rolling average number of 
                                        unemployed individuals in a 
                                        State for a quarter occurring 
                                        during a national economic 
                                        downturn assistance period 
                                        described in paragraph (1) is 
                                        less than the rolling average 
                                        number of unemployed 
                                        individuals in the State for 
                                        the base quarter determined 
                                        under item (aa), that quarter 
                                        shall be treated as the base 
                                        quarter for the State for such 
                                        national economic downturn 
                                        assistance period.
                            ``(ii) National average amount of 
                        additional federal medicaid spending per 
                        additional unemployed individual.--In the case 
                        of--
                                    ``(I) a calendar quarter occurring 
                                in fiscal year 2012, $350; and
                                    ``(II) a calendar quarter occurring 
                                in any succeeding fiscal year, the 
                                amount applicable under this clause for 
                                calendar quarters occurring during the 
                                preceding fiscal year, increased by the 
                                annual percentage increase in the 
                                medical care component of the consumer 
                                price index for all urban consumers 
                                (U.S. city average), as rounded up in 
                                an appropriate manner.
                            ``(iii) State nondisabled, nonelderly 
                        adults and children medicaid spending index.--
                                    ``(I) In general.--With respect to 
                                a State, the quotient (not to exceed 
                                1.00) of--
                                            ``(aa) the State 
                                        expenditure per person in 
                                        poverty amount determined under 
                                        subclause (II); divided by--
                                            ``(bb) the National 
                                        expenditure per person in 
                                        poverty amount determined under 
                                        subclause (III).
                                    ``(II) State expenditure per person 
                                in poverty amount.--For purposes of 
                                subclause (I)(aa), the State 
                                expenditure per person in poverty 
                                amount is the quotient of--
                                            ``(aa) the total amount of 
                                        annual expenditures by the 
                                        State for providing medical 
                                        assistance under the State plan 
                                        to nondisabled, nonelderly 
                                        adults and children; divided by
                                            ``(bb) the total number of 
                                        nonelderly adults and children 
                                        in poverty who reside in the 
                                        State, as determined under 
                                        paragraph (4)(A).
                                    ``(III) National expenditure per 
                                person in poverty amount.--For purposes 
                                of subclause (I)(bb), the National 
                                expenditure per person in poverty 
                                amount is the quotient of--
                                            ``(aa) the sum of the total 
                                        amounts determined under 
                                        subclause (II)(aa) for all 
                                        States; divided by
                                            ``(bb) the sum of the total 
                                        amounts determined under 
                                        subclause (II)(bb) for all 
                                        States.
                    ``(C) State's total medicaid quarterly spending 
                amount.--For purposes of subparagraph (A)(i)(II), the 
                State's total Medicaid quarterly spending amount 
                determined under this subparagraph with respect to a 
                State and a quarter is the amount equal to--
                            ``(i) the total amount of expenditures by 
                        the State for providing medical assistance 
                        under the State plan to all individuals 
                        enrolled in the plan for the most recent fiscal 
                        year for which data is available; divided by
                            ``(ii) 4.
            ``(4) Data.--In making the determinations required under 
        this subsection, the Secretary shall use, in addition to the 
        most recent available data from the Bureau of Labor Statistics 
        Local Area Unemployment Statistics for each State referred to 
        in paragraph (5), the most recently available--
                    ``(A) data from the Bureau of the Census with 
                respect to the number of nonelderly adults and children 
                who reside in a State described in paragraph (2) with 
                family income below the poverty line (as defined in 
                section 2110(c)(5)) applicable to a family of the size 
                involved (or, if the Secretary determines it 
                appropriate, a multiyear average of such data);
                    ``(B) data reported to the Secretary by a State 
                described in paragraph (2) with respect to expenditures 
                for medical assistance under the State plan under this 
                title for nondisabled, nonelderly adults and children; 
                and
                    ``(C) econometric studies of the responsiveness of 
                Medicaid enrollments and spending to changes in rolling 
                average unemployment rates and other factors, including 
                State spending on certain Medicaid populations.
            ``(5) Definition of `rolling average number of unemployed 
        individuals', `rolling average unemployment rate'.--In this 
        subsection, the term--
                    ``(A) `rolling average number of unemployed 
                individuals' means, with respect to a calendar quarter 
                and a State, the average of the 12 most recent months 
                of seasonally adjusted unemployment data for each 
                State;
                    ``(B) `rolling average unemployment rate' means, 
                with respect to a calendar quarter and a State, the 
                average of the 12 most recent monthly unemployment 
                rates for the State; and
                    ``(C) `monthly unemployment rate' means, with 
                respect to a State, the quotient of--
                            ``(i) the monthly seasonally adjusted 
                        number of unemployed individuals for the State; 
                        divided by
                            ``(ii) the monthly seasonally adjusted 
                        number of the labor force for the State,
        using the most recent data available from the Bureau of Labor 
        Statistics Local Area Unemployment Statistics for each State.
            ``(6) Increase in cap on payments to territories.--With 
        respect to any fiscal year quarter for which the national 
        economic downturn assistance Federal medical assistance 
        percentage applies to Puerto Rico, the Virgin Islands, Guam, 
        the Northern Mariana Islands, or American Samoa, the amounts 
        otherwise determined for such commonwealth or territory under 
        subsections (f) and (g) of section 1108 shall be increased by 
        such percentage of such amounts as the Secretary determines is 
        equal to twice the average increase in the national economic 
        downturn assistance FMAP determined for all States described in 
        paragraph (2) for the quarter.
            ``(7) Scope of application.--The national economic downturn 
        assistance FMAP shall only apply for purposes of payments under 
        section 1903 for a quarter and shall not apply with respect 
        to--
                    ``(A) disproportionate share hospital payments 
                described in section 1923;
                    ``(B) payments under title IV or XXI; or
                    ``(C) any payments under this title that are based 
                on the enhanced FMAP described in section 2105(b).
            ``(8) Additional requirement for certain states.--In the 
        case of a State described in paragraph (2) that requires 
        political subdivisions within the State to contribute toward 
        the non-Federal share of expenditures required under section 
        1902(a)(2), the State shall not require that such political 
        subdivisions pay for any fiscal year quarters occurring during 
        a national economic downturn assistance period a greater 
        percentage of the non-Federal share of such expenditures, or a 
        greater percentage of the non-Federal share of payments under 
        section 1923, than the respective percentage that would have 
        been required by the State under State law in effect on the 
        first day of the fiscal year quarter occurring immediately 
        prior to the trigger quarter for the period.''.
            (2) Effective date; no retroactive application.--The 
        amendments made by paragraph (1) take effect on January 1, 
        2012. In no event may a State receive a payment on the basis of 
        the national economic downturn assistance Federal medical 
        assistance percentage determined for the State under section 
        1905(y)(3) of the Social Security Act for amounts expended by 
        the State prior to January 1, 2012.
    (b) GAO Study and Report.--
            (1) Study.--The Comptroller General of the United States 
        shall analyze the previous periods of national economic 
        downturn, including the most recent such period in effect as of 
        the date of enactment of this Act, and the past and projected 
        effects of temporary increases in the Federal medical 
        assistance percentage under the Medicaid program with respect 
        to such periods.
            (2) Report.--Not later than April 1, 2011, the Comptroller 
        General of the United States shall submit a report to Congress 
        on the results of the analysis conducted under paragraph (1). 
        Such report shall include such recommendations as the 
        Comptroller General determines appropriate for modifying the 
        national economic downturn assistance FMAP established under 
        section 1905(y) of the Social Security Act (as added by 
        subsection (a)) to improve the effectiveness of the application 
        of such percentage in addressing the needs of States during 
        periods of national economic downturn, including 
        recommendations for--
                    (A) improvements to the factors that begin and end 
                the application of such percentage;
                    (B) how the determination of such percentage could 
                be adjusted to address State and regional economic 
                variations during such periods; and
                    (C) how the determination of such percentage could 
                be adjusted to be more responsive to actual Medicaid 
                costs incurred by States during such periods, as well 
                as to the effects of any other specific economic 
                indicators that the Comptroller General determines 
                appropriate.
Amends title XIX (Medicaid) of the Social Security Act to authorize an automatic increase in the federal medical assistance percentage (FMAP) for any eligible state during periods of national economic downturn.

Directs the Comptroller General to analyze and report to Congress on previous periods of national economic downturn, including the most recent one, and the past and projected effects of temporary increases in the Medicaid FMAP with respect to them.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Undocumented Alien Emergency Medical 
Assistance Amendments of 2004''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The provision of medical care by public or private 
        health care providers to undocumented aliens is appropriate 
        only--
                    (A) to protect the health and safety of United 
                States citizens;
                    (B) to save the life of an undocumented alien in a 
                life-threatening medical emergency; and
                    (C) to stabilize an emergency medical condition so 
                that an undocumented alien can be repatriated for 
                medical treatment in the alien's own country.
            (2) Federal reimbursement of emergency hospital services 
        furnished to undocumented aliens should be conditioned upon 
        obtaining sufficient information to promptly remove the aliens.
            (3) Employers who employ undocumented aliens without 
        completing employment authorization verification procedures 
        should be held liable for uncompensated emergency services 
        furnished to such aliens.

SEC. 3. CONDITIONS FOR RECEIPT OF FEDERAL ASSISTANCE FOR EMERGENCY 
              SERVICES FOR UNDOCUMENTED ALIENS.

    (a) In General.--Section 1011 of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173) is 
amended--
            (1) in subsection (d)(1), by adding at the end the 
        following new subparagraph:
                    ``(C) Application of requirement.--Under such 
                process, the Secretary shall not provide payment under 
                subsection (c) to an eligible provider that is a 
                hospital for eligible services for an alien described 
                in subsection (c)(5)(A) unless the requirements of 
                subsection (f) are met by that provider with respect to 
                such alien.'';
            (2) in subsection (e)(2), by adding at the end the 
        following new sentence: ``Such term also includes, with respect 
        to an undocumented alien described in subsection (c)(5)(A), 
        costs for emergency medical transportation and evacuation 
        incurred by a hospital in transferring and removing the alien 
        to a foreign country for receipt of appropriate health care 
        services.''; and
            (3) by adding at the end the following new subsection:
    ``(f) Requirement for Collection of Immigration-Related Information 
for Undocumented Aliens.--
            ``(1) In general.--No payment may be made under subsection 
        (c) to a hospital with respect to the provision of eligible 
        services to an undocumented alien described in subsection 
        (c)(5)(A) unless the following requirements are met:
                    ``(A) The hospital has obtained in good faith from 
                the alien (or a legal guardian or other representative 
                on behalf of the alien) the following information in a 
                document that is signed by the alien (or such guardian 
                or representative) under oath or affirmation and that 
                is in a form that includes a notice that fraudulent or 
                false statements constitute a criminal act punishable 
                under Federal law:
                            ``(i) The citizenship of the alien.
                            ``(ii) The immigration status of the alien.
                            ``(iii) The address of the alien in the 
                        United States.
                            ``(iv) Such personal or financial data 
                        regarding the alien as the hospital routinely 
                        requires of non-indigent patients, including 
                        information regarding health insurance.
                            ``(v) Information on the identity of any 
                        current employer of the alien for whom the 
                        alien has executed an Internal Revenue Service 
                        Form W-4.
                A hospital is not liable for the accuracy of the 
                information provided under this subparagraph so long as 
                it exercises reasonable care and good faith in 
                obtaining the information.
                    ``(B) The hospital obtains one or more identifiers 
                for the alien and records such identifiers in a 
                digital, electronic format specified by the Secretary 
                in consultation with the Secretary of Homeland 
                Security. Such format shall be compatible with at least 
                one interoperable database maintained by the Secretary 
                of Homeland Security for the purpose of verifying the 
                identity and immigration status of aliens.
                    ``(C) The hospital transmits to the Secretary of 
                Homeland Security, in a digital, electronic format and 
                manner specified by such Secretary, the information 
                provided under subparagraph (A) and the identifier (or 
                identifiers) obtained under subparagraph (B).
            ``(2) Maintenance of hospital records.--For a period of at 
        least 5 years, a hospital referred to in paragraph (1) shall 
        maintain the original documents described in paragraph (1)(A) 
        on file and makes such documents available for examination by 
        the Secretary and the Secretary of Homeland Security or their 
        designees.
            ``(3) Provision of technical support.--The Secretary of 
        Homeland Security shall provide hospitals under this section 
        with software, training, and technical support services, at no 
        cost to the hospital, to assist and enable hospitals to comply 
        with the requirements of paragraph (1).
            ``(4) Prompt action by dhs.--The Secretary of Homeland 
        Security shall take steps as may be necessary--
                    ``(A) to obtain, process, and promptly review 
                information transmitted under paragraph (1)(C);
                    ``(B) to determine whether an alien for whom such 
                information is transmitted is removable under any 
                provision of Federal immigration law; and
                    ``(C) to initiate removal proceedings under the 
                relevant provisions of the Immigration and Nationality 
                Act in the case of any such alien who is identified as 
                being removable.
            ``(5) Removability.--An undocumented alien who obtains 
        eligible services through a hospital and does not provide for 
        payment for such services and who fails to provide accurate 
        information described in paragraph (1)(A) or an identifier (as 
        defined in paragraph (6)) shall be treated as removable on the 
        ground described in section 237(a)(5) of the Immigration and 
        Nationality Act (8 U.S.C. 1227(a)(5)).
            ``(6) Definition of identifier.--In this section, the term 
        `identifier' means a fingerprint or other biometric identifier 
        as the Secretary of Homeland Security may require.
    ``(g) Responsibility of Certain Employers.--
            ``(1) In general.--In the case of an employer of an 
        undocumented alien worker described in paragraph (2) for whom 
        payments are made to a hospital for eligible services under 
        this section, subject to paragraph (3), the employer shall be 
        liable to the Secretary for the amount of the payments so made.
            ``(2) Undocumented alien worker defined.--
                    ``(A) In general.--For purposes of this subsection, 
                the term `undocumented alien worker' means, with 
                respect to an employer, an undocumented alien described 
                in subsection (c)(5)(A)--
                            ``(i) who is an unauthorized alien (as 
                        defined in section 274A(h)(3) of the 
                        Immigration and Nationality Act (8 U.S.C. 
                        1324a(h)(3));
                            ``(ii) who has provided the employer with 
                        an Internal Revenue Service Form W-4; and
                            ``(iii) with respect to whom neither the 
                        conditions described in subparagraph (B)(i) or 
                        the condition described in subparagraph (B)(ii) 
                        have been met.
                    ``(B) Conditions for exemption.--For purposes of 
                subparagraph (A)(iii)--
                            ``(i) First set of conditions.--The 
                        conditions described in this clause for an 
                        employer and alien are the following:
                                    ``(I) The employer and alien have 
                                fully complied with all requirements of 
                                the employment verification system 
                                prescribed in section 274A(b) of the 
                                Immigration and Nationality Act (8 
                                U.S.C. 1324a(b)).
                                    ``(II) The employer has enrolled 
                                the alien in a State workmen's 
                                compensation plan.
                                    ``(III) The alien is enrolled under 
                                a health benefits plan or health 
                                insurance coverage that provides such 
                                level of coverage with respect to 
                                emergency medical and hospitalization 
                                benefits as the Secretary shall 
                                specify, in consultation with the 
                                Secretary of Homeland Security.
                                    ``(IV) The employer has assumed 
                                responsibility for any cost-sharing 
                                (including applicable deductibles and 
                                coinsurance) that applies to the alien.
                            ``(ii) Alternative condition.--The 
                        condition described in this clause for an 
                        employer and alien are that the employer has 
                        verified the employment authorization of the 
                        alien through the voluntary basic employment 
                        verification pilot program under section 403(a) 
                        of the Immigration Reform and Immigrant 
                        Responsibility Act of 1996 (division C of 
                        Public Law 104-208), where available, or by any 
                        other means made available for such 
                        verification purposes by the Secretary of 
                        Homeland Security.
            ``(3) Limitation on liability.--The liability of an 
        employer under this subsection shall be limited to an employer 
        that employs an undocumented alien worker at the time (as 
        specified under rules of the Secretary of Homeland Security) 
        the eligible services are provided for which payment may be 
        made by the Secretary under this section.
    ``(h) Limitation on Care Required.--Notwithstanding any other 
provision of law (including section 1867 of the Social Security Act, 42 
U.S.C. 1395dd), a hospital is not required to make available to an 
undocumented alien described in subsection (c)(5)(A) care or services 
if--
            ``(1) the alien may be transported to the alien's country 
        of origin (as determined in accordance with rules of the 
        Secretary of Homeland Security) without a significant 
        likelihood of material deterioration of medical condition of 
        the alien (or, in the case of an alien in active labor, of the 
        child), within reasonable medical probability, resulting from 
        the transfer of the alien from the hospital; or
            ``(2) the care--
                    ``(A) involves organ transplantation or other 
                extraordinary medical treatment (or other treatment the 
                estimated cost of which exceeds $50,000); and
                    ``(B) is for treatment of a condition that existed 
                before the alien entered the United States or is not 
                required as a direct and immediate result of an 
                accident in the United States.''.
    (b) Effective Date.--The amendments made by subsection (a) shall be 
effective as if included in the enactment of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003.
    (c) Regulations.--
            (1) In general.--The Secretary of Homeland Security, in 
        consultation with the Secretary of Health and Human Services, 
        shall issue interim regulations implementing the amendments 
        made by subsection (a) no later than 60 days after the date of 
        the enactment of this Act and shall permit a period of public 
        notice and comment of at least 90 days.
            (2) Final regulations.--The Secretary of Homeland Security, 
        in consultation with the Secretary of Health and Human 
        Services, shall issue final regulations implementing such 
        amendments not later than one year after the date of 
        publication of such interim regulations.
    (d) Annual Report on Implementation.--
            (1) In general.--The Secretary of Homeland Security, in 
        consultation with the Secretary of Health and Human Services, 
        shall submit to the chairman and ranking minority member of the 
        Judiciary and Appropriations Committees of the House of 
        Representatives and the Senate, the Select Committee on 
        Homeland Security of the House of Representatives, and the 
        Senate Committee on Governmental Affairs an annual report on 
        the implementation of section 1011 of the Medicare Prescription 
        Drug, Improvement, and Modernization Act of 2003, as amended by 
        this section.
            (2) Items to be included.--Each annual report under 
        paragraph (1) shall include--
                    (A) a cost analysis of Federal expenditures under 
                such section 1011;
                    (B) a description of the assistance provided to 
                hospitals under subsection (f)(2) of such section;
                    (C) the number of undocumented aliens removed under 
                subsection (f)(3) of such section; and
                    (D) amounts recovered from employers under 
                subsection (g) of such section.
    (e) Feasibility of Effecting Treaties for International Medical 
Evacuation.--
            (1) Study.--The Secretary of State shall conduct an 
        analysis of the feasibility and appropriateness of the 
        following:
                    (A) Negotiating with foreign states treaties under 
                which such states provide payment for the cost of 
                international medical evacuation for their nationals 
                who require emergency health care in the United States 
                and who do not otherwise have insurance or other 
                coverage for the costs of such care.
                    (B) In the case of nationals of a foreign state for 
                whom significant costs are incurred under section 1011 
                of the Medicare Prescription Drug, Improvement, and 
                Modernization Act of 2003 and for which state a treaty 
                described in subparagraph (A) is not in effect, 
                imposing a visa, port of entry, or similar surcharge 
                the proceeds of which may be used towards such costs 
                and towards the cost of international medical 
                evacuation described in such clause.
            (2) Report.--The Secretary of State shall submit to the 
        committees described in subsection (d)(1) a report on the 
        analysis under paragraph (1).

Undocumented Alien Emergency Medical Assistance Amendments of 2004 - Amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to: (1) prohibit Federal reimbursement of hospital-provided emergency and certain transportation services to undocumented aliens unless the hospital provides the Secretary of Homeland Security with information regarding an alien's citizenship, immigration status, financial data, and employer; (2) make the employer of certain undocumented aliens responsible for such costs; and (3) direct the Secretary to initiate removal procedures against an alien determined to be removable under Federal immigration law.

Directs the Secretary of State to analyze the feasibility of effecting treaties for international medical evacuations.