S.Amdt. 3040

SA 3040. Mr. ROCKEFELLER 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:

On page 436, between lines 14 and 15, insert the following:

SEC. 2008. 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), as amended by sections 2001(a)(3), 2006,
4106(b), and 4107, is amended--
(A) in subsection (b), in the first sentence--
(i) by striking ``and (5)'' and inserting ``(5)''; and
(ii) by inserting ``and (6) with respect to each fiscal
year quarter other than the first quarter of a national
economic downturn assistance period described in subsection
(cc)(1), the Federal medical assistance percentage for any
State described in subsection (cc)(2) shall be equal to the
national economic downturn assistance FMAP determined for the
State for the quarter under subsection (cc)(3)'' before the
period; and
(B) by adding at the end the following:
``(cc) National Economic Downturn Assistance FMAP.--For
purposes of clause (6) 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

[[Page S12724]]

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(cc)(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(cc) 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.
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