S.Amdt. 2852

SA 2852. Mr. SANDERS submitted an amendment intended to be proposed
to amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

Strike section 2001 and insert the following:

SEC. 2001. MEDICAID ELIGIBILITY FOR INDIVIDUALS WITH INCOME
BELOW 150 PERCENT OF THE FEDERAL POVERTY LEVEL.

(a) Eligibility for Non-Traditional Individuals With Income
Below 150 Percent of the Federal Poverty Level.--
(1) Full medicaid benefits for non-medicare eligible
individuals.--Section 1902(a)(10)(A)(i) of the Social
Security Act (42 U.S.C. 1396b(a)(10)(A)(i)) is amended--
(A) by striking ``or'' at the end of subclause (VI);
(B) by adding ``or'' at the end of subclause (VII); and
(C) by adding at the end the following new subclause:

``(VIII) who are under 65 years of age, who are not
described in a previous subclause of this clause, who are not
entitled to hospital insurance benefits under part A of title
XVIII, and whose family income (determined using
methodologies and procedures specified by the Secretary )
does not exceed 150 percent of the income official poverty
line (as defined by the Office of Management and Budget, and
revised annually in accordance with section 673(2) of the
Omnibus Budget Reconciliation Act of 1981) applicable to a
family of the size involved;''.

(2) Medicare cost sharing assistance for medicare-eligible
individuals.--Section 1902(a)(10)(E) of such Act (42 U.S.C.
1396b(a)(10)(E)) is amended--
(A) in clause (iii), by striking ``and'' at the end;
(B) in clause (iv), by adding ``and'' at the end; and
(C) by adding at the end the following new clause:
``(v) for making medical assistance available for medicare
cost-sharing described in

[[Page S12256]]

subparagraphs (B) and (C) of section 1905(p)(3), for
individuals under 65 years of age who would be qualified
medicare beneficiaries described in section 1905(p)(1) but
for the fact that their income exceeds the income level
established by the State under section 1905(p)(2) but is less
than 150 percent of the official poverty line (referred to in
such section) for a family of the size involved; and''.
(3) Increased fmap for non-traditional full medicaid
eligible individuals.--Section 1905 of such Act (42 U.S.C.
1396d) is amended--
(A) in the first sentence of subsection (b), by striking
``and'' before ``(4)'' and by inserting before the period at
the end the following: ``, and (5) 100 percent (for periods
before 2015 and 91 percent for periods beginning with 2015)
with respect to amounts described in subsection (y)''; and
(B) by adding at the end the following new subsection:
``(y) Additional Expenditures Subject to Increased FMAP.--
For purposes of section 1905(b)(5), the amounts described in
this subsection are the following:
``(1) Amounts expended for medical assistance for
individuals described in subclause (VIII) of section
1902(a)(10)(A)(i).''.
(4) Construction.--Nothing in this subsection shall be
construed as not providing for coverage under subparagraph
(A)(i)(VIII) or (E)(v) of section 1902(a)(10) of the Social
Security Act, as added by paragraphs (1) and (2), or an
increased FMAP under the amendments made by paragraph (3),
for an individual who has been provided medical assistance
under title XIX of the Act under a demonstration waiver
approved under section 1115 of such Act or with State funds.
(5) Conforming amendments.--
(A) Section 1903(f)(4) of the Social Security Act (42
U.S.C. 1396b(f)(4)) is amended--
(i) by inserting ``1902(a)(10)(A)(i)(VIII),'' after
``1902(a)(10)(A)(i)(VII),''; and
(ii) by inserting ``1902(a)(10)(E)(v),'' before
``1905(p)(1)''.
(B) Section 1905(a) of such Act (42 U.S.C. 1396d(a)), is
amended, in the matter preceding paragraph (1)--
(i) by striking ``or'' at the end of clause (xii);
(ii) by adding ``or'' at the end of clause (xiii); and
(iii) by inserting after clause (xiii) the following:
``(xiv) individuals described in section
1902(a)(10)(A)(i)(VIII),''.
(b) Eligibility for Traditional Medicaid Eligible
Individuals With Income Not Exceeding 150 Percent of the
Federal Poverty Level .--
(1) In general.--Section 1902(a)(10)(A)(i) of the Social
Security Act (42 U.S.C. 1396b(a)(10)(A)(i)), as amended by
subsection (a), is amended--
(A) by striking ``or'' at the end of subclause (VII); and
(B) by adding at the end the following new subclauses:

``(IX) who are over 18, and under 65 years of age, who
would be eligible for medical assistance under the State plan
under subclause (I) or section 1931 (based on the income
standards, methodologies, and procedures in effect as of June
16, 2009) but for income, who are in families whose income
does not exceed 150 percent of the income official poverty
line (as defined by the Office of Management and Budget, and
revised annually in accordance with section 673(2) of the
Omnibus Budget Reconciliation Act of 1981) applicable to a
family of the size involved; or
``(X) beginning with 2014, who are under 19, years of age,
who would be eligible for medical assistance under the State
plan under subclause (I), (IV) (insofar as it relates to
subsection (l)(1)(B)), (VI), or (VII) (based on the income
standards, methodologies, and procedures in effect as of June
16, 2009) but for income, who are in families whose income
does not exceed 150 percent of the income official poverty
line (as defined by the Office of Management and Budget, and
revised annually in accordance with section 673(2) of the
Omnibus Budget Reconciliation Act of 1981) applicable to a
family of the size involved; or''.

(2) Increased fmap for certain traditional medicaid
eligible individuals.--
(A) Increased fmap for adults.--Section 1905(y) of such Act
(42 U.S.C. 1396d(y)), as added by subsection (a)(2)(B), is
amended by inserting ``or (IX)'' after ``(VIII)''.
(B) Enhanced fmap for children.--Section 1905(b)(4) of such
Act is amended by inserting ``1902(a)(10)(A)(i)(X), or''
after ``on the basis of section''.
(3) Construction.--Nothing in this subsection shall be
construed as not providing for coverage under subclause (IX)
or (X) of section 1902(a)(10)(A)(i) of the Social Security
Act, as added by paragraph (1), or an increased or enhanced
FMAP under the amendments made by paragraph (2), for an
individual who has been provided medical assistance under
title XIX of the Act under a demonstration waiver approved
under section 1115 of such Act or with State funds.
(4) Conforming amendment.--Section 1903(f)(4) of the Social
Security Act (42 U.S.C. 1396b(f)(4)), as amended by
subsection (a)(4), is amended by inserting
``1902(a)(10)(A)(i)(IX), 1902(a)(10)(A)(i)(X),'' after
``1902(a)(10)(A)(i)(VIII),''.
(c) Network Adequacy.--Section 1932(a)(2) of the Social
Security Act (42 U.S.C. 1396u-2(a)(2)) is amended by adding
at the end the following new subparagraph:
``(D) Enrollment of non-traditional medicaid eligibles.--A
State may not require under paragraph (1) the enrollment in a
managed care entity of an individual described in section
1902(a)(10)(A)(i)(VIII) unless the State demonstrates, to the
satisfaction of the Secretary, that the entity, through its
provider network and other arrangements, has the capacity to
meet the health, mental health, and substance abuse needs of
such individuals.''.
(d) Effective Date.--The amendments made by this section
shall take effect on January 1, 2013, and shall apply with
respect to items and services furnished on or after such
date.
(e) Definitions.--In this section:
(1) Medicaid eligible individual.--The term ``Medicaid
eligible individual'' means an individual who is eligible for
medical assistance under Medicaid.
(2) Traditional medicaid eligible individual.--The term
``traditional Medicaid eligible individual'' means a Medicaid
eligible individual other than an individual who is--
(A) a Medicaid eligible individual by rea1son of the
application of subclause (VIII) of section 1902(a)(10)(A)(i)
of the Social Security Act; or
(B) a childless adult not described in section
1902(a)(10)(A) or (C) of such Act (as in effect as of the day
before the date of the enactment of this Act).
(3) Non-traditional medicaid eligible individual.--The term
``non-traditional Medicaid eligible individual'' means a
Medicaid eligible individual who is not a traditional
Medicaid eligible individual.
______