S.Amdt. 3167

SA 3167. Mr. BINGAMAN 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 1413 and insert the following:

SEC. 1413. STREAMLINING OF PROCEDURES FOR ENROLLMENT THROUGH
AN EXCHANGE AND STATE MEDICAID, CHIP, AND
HEALTH SUBSIDY PROGRAMS.

(a) In General.--The Secretary shall establish a system
meeting the requirements of this section under which
residents of each State may apply for enrollment in, receive
a determination of eligibility for participation in, and
continue participation in, applicable State health subsidy
programs. Such system shall ensure that if an individual
applying to an Exchange, to a State Medicaid program under
title XIX of the Social Security Act, or to a State
children's health insurance program (CHIP) under title XXI of
such Act, is found to be ineligible for the program to which
the individual applied, the individual shall be screened for
eligibility for all other potentially applicable such
programs and shall be enrolled in the program for which the
individual qualifies.
(b) Requirements Relating to Forms and Notice.--
(1) Requirements relating to forms.--
(A) In general.--The Secretary shall develop and provide to
each State a single, streamlined form that--
(i) may be used to apply for all applicable State health
subsidy programs within the State;
(ii) may be filed online, in person, by mail, or by
telephone;
(iii) may be filed with an Exchange or with State officials
operating one of the other applicable State health subsidy
programs; and
(iv) is structured to maximize an applicant's ability to
complete the form satisfactorily, taking into account the
characteristics of individuals who qualify for applicable
State health subsidy programs.
(B) State authority to establish form.--A State may develop
and use its own single, streamlined form as an alternative to
the form developed under subparagraph (A) if the alternative
form is consistent with standards promulgated by the
Secretary under this section.
(C) Supplemental eligibility forms.--The Secretary may
allow a State to use a supplemental or alternative form in
the case of individuals who apply for eligibility that is not
determined on the basis of the household income (as defined
in section 36B of the Internal Revenue Code of 1986).
(D) Relevance.--The forms described in subparagraphs (A)
and (B) shall not require the applicant to answer any
questions that are irrelevant to establishing eligibility for
applicable State health subsidy programs. The Secretary shall
establish procedures that avoid any need for such
requirements, which shall include determining the amounts
expended for medical assistance that are described in
subsection (y)(1) of section 1905 of the Social Security Act
(as added by section 2001(a)(3) of this Act) through the use
of the post-enrollment procedures described in section
1903(u)(1)(C) of the Social Security Act.
(2) Notice.--The Secretary shall provide that an applicant
filing a form under paragraph (1) shall receive notice of
eligibility for an applicable State health subsidy program
without any need to provide additional information or
paperwork unless such information or paperwork is
specifically required by law when information provided on the
form is inconsistent with data used for the electronic
verification under paragraph (3) or is otherwise insufficient
to determine eligibility.
(c) Requirements Relating to Eligibility Based on Data
Exchanges.--
(1) Development of secure interfaces.--Each State shall
develop for all applicable State health subsidy programs a
secure, electronic interface allowing an exchange of data
(including information contained in the application forms
described in subsection (b)) that allows a determination of
eligibility for all such programs based on a single
application. Such interface shall be compatible with the
method established for data verification under section
1411(c)(4).
(2) Data matching program.--Each applicable State health
subsidy program shall participate in a data matching
arrangement for determining eligibility for participation in
the program under paragraph (3) that--
(A) provides access to data described in paragraph (3);
(B) applies only to individuals who--
(i) receive assistance from an applicable State health
subsidy program; or
(ii) apply for such assistance--

(I) by filing a form described in subsection (b); or
(II) notwithstanding section 1411(b), by requesting a
determination of eligibility and authorizing disclosure of
the information described in paragraph (3) to applicable
State health coverage subsidy programs for purposes of
determining and establishing eligibility; and

(C) is consistent with standards promulgated by the
Secretary, including the privacy and data security safeguards
described in section 1942 of the Social Security Act or that
are otherwise applicable to such programs.
(3) Determination of eligibility.--
(A) In general.--Each applicable State health subsidy
program shall, to the maximum extent practicable--
(i) establish, verify, and update eligibility for
participation in the program using the data matching
arrangement under paragraph (2); and
(ii) determine such eligibility on the basis of reliable,
third party data, including information described in sections
1137, 453(i), and 1942(a) of the Social Security Act,
obtained through such arrangement, provided that if such data
do not establish an individual's eligibility for medical
assistance under title XIX of the Social Security Act, the
rules described in section 1902(e)(14)(H) of such Act shall
apply to such individual.
(B) Exception.--This paragraph shall not apply in
circumstances with respect to which the Secretary determines
that the administrative and other costs of use of the data
matching arrangement under paragraph (2) outweigh its
expected gains in accuracy, efficiency, and program
participation.
(4) Secretarial standards.--The Secretary shall, after
consultation with persons in possession of the data to be
matched and representatives of applicable State health
subsidy programs, promulgate standards governing the timing,
contents, and procedures for data matching described in this
subsection. Such standards shall take into account
administrative and other costs and the value of data matching
to the establishment, verification, and updating of
eligibility for applicable State health subsidy programs.
(d) Administrative Authority.--
(1) Agreements.--Subject to section 1411 and section
6103(l)(21) of the Internal Revenue Code of 1986 and any
other requirement providing safeguards of privacy and data
integrity, the Secretary may establish model

[[Page S13041]]

agreements, and enter into agreements, for the sharing of
data under this section.
(2) Authority of exchange to contract out.--Nothing in this
section shall be construed to--
(A) prohibit contractual arrangements through which a State
medicaid agency determines eligibility for all applicable
State health subsidy programs, but only if such agency
complies with the Secretary's requirements ensuring reduced
administrative costs, eligibility errors, and disruptions in
coverage; or
(B) change any requirement under title XIX that eligibility
for participation in a State's medicaid program must be
determined by a public agency.
(e) Applicable State Health Subsidy Program.--In this
section, the term ``applicable State health subsidy program''
means--
(1) the program under this title for the determination of
eligibility for premium tax credits under section 36B of the
Internal Revenue Code of 1986 and cost-sharing reductions
under section 1402;
(2) a State medicaid program under title XIX of the Social
Security Act;
(3) a State children's health insurance program (CHIP)
under title XXI of such Act; and
(4) a State program under section 1331 establishing
qualified basic health plans.
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