S.Amdt. 245

SA 245. Ms. HIRONO submitted an amendment intended to be proposed to
amendment SA 201 proposed by Mr. Shelby to the bill H.R. 268, making
supplemental appropriations for the fiscal year ending September 30,
2019, and for other purposes; which was ordered to lie on the table; as
follows:

At the appropriate place, insert the following:
Sec. ___. (a) Section 1108(g) of the Social Security Act
(42 U.S.C. 1308(g)) is amended--
(1) in paragraph (5)--
(A) in subparagraph (A), by inserting ``and paragraph (6)''
after ``and (E)'';
(B) in subparagraph (C)--
(i) in the matter preceding clause (i), by striking
``2019'' and inserting ``2021'';
(ii) in clause (i), by striking ``of the increase otherwise
provided under subparagraphs (A) and (B)'' and inserting
``otherwise determined under this subsection (including, if
any, any increase otherwise provided under subparagraphs (A)
and (B))''; and
(iii) in clause (ii), by striking ``the amount of the
increase otherwise provided under subparagraph (A)'' and
inserting ``the amount otherwise determined under this
subsection (including, if any, any increase otherwise
provided under subparagraph (A))'';
(C) in subparagraph (D), in the matter preceding clause
(i), by striking ``the amount of the increase otherwise
provided under subparagraph (A)'' and inserting ``the amount
otherwise determined under this subsection (including, if
any, any increase otherwise provided under subparagraph
(A))''; and
(D) in subparagraph (E)--
(i) by striking ``title XIX, during'' and inserting,
``title XIX--
``(i) during'';
(ii) by striking the period at the end and inserting ``;
and''; and
(iii) by adding at the end the following:
``(ii) during the period beginning January 1, 2019, and
ending September 30, 2020, with respect to payments to Guam,
the Virgin Islands, the Northern Mariana Islands, and
American Samoa from the additional funds provided under
subparagraph (A) and paragraph (6), and from funds provided
under section 1323 of the Patient Protection and Affordable
Care Act, the Secretary shall increase the Federal medical
assistance percentage or other rate that would otherwise
apply to such payments to 100 percent.''; and
(2) by adding at the end the following new paragraph:
``(6) Further additional increase for northern mariana
islands.--(A) For the period beginning January 1, 2019, and
ending September 30, 2020, the Secretary shall increase the
amounts otherwise determined under this subsection for the
Northern Mariana Islands (after application of subsection (f)
and the preceding paragraphs of this subsection), including
the amount of any increase otherwise provided under paragraph
(5) for the Northern Mariana Islands for such period (or any
portion thereof), by such amounts that the total additional
payments under title XIX to the Northern Mariana Islands
equals $78,432,368.
``(B) The amount of the increase otherwise provided under
subparagraph (A) for the Northern Mariana Islands shall be
further increased by $26,144,367 if the Secretary certifies
that the Northern Mariana Islands has taken reasonable and
appropriate steps during such period, in accordance with a
timeline established by the Secretary, to meet the conditions
for certification specified in subclauses (I) and (II) of
paragraph (5)(D)(i).''.
(b) The amounts provided by the amendments made by
subsection (a) are designated by Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of
the Balanced Budget and Emergency Deficit Control Act of
1985.
Sec. ___. (a) 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 new subparagraph:
``(G) Medicaid exception for citizens of freely associated
states.--With respect to eligibility for benefits for the
designated Federal program defined in paragraph (3)(C)
(relating to the Medicaid program), section 401(a) and
paragraph (1) shall not apply to any individual who lawfully
resides in 1 of the 50 States or the District of Columbia in
accordance with the Compacts of Free Association between the
Government of the United States and the Governments of the
Federated States of Micronesia, the Republic of the Marshall
Islands, and the Republic of Palau and shall not apply, at
the option of the Governor of Puerto Rico, the Virgin
Islands, Guam, the Northern Mariana Islands, or American
Samoa as communicated to the Secretary of Health and Human
Services in writing, to any individual who lawfully resides
in the respective territory in accordance with such
Compacts.''.
(b) Section 403(d) of such Act (8 U.S.C. 1613(d)) is
amended--
(1) in paragraph (1), by striking ``or'' at the end;
(2) in paragraph (2), by striking the period at the end and
inserting ``; or''; and
(3) by adding at the end the following new paragraph:
``(3) an individual described in section 402(b)(2)(G), but
only with respect to the designated Federal program defined
in section 402(b)(3)(C).''.
(c) Section 431(b) of such Act (8 U.S.C. 1641(b)) is
amended--
(1) in paragraph (6), by striking ``; or'' at the end and
inserting a comma;
(2) in paragraph (7), by striking the period at the end and
inserting ``, or''; and
(3) by adding at the end the following new paragraph:
``(8) an individual who lawfully resides in the United
States in accordance with a Compact of Free Association
referred to in section 402(b)(2)(G), but only with respect to
the designated Federal program defined in section
402(b)(3)(C) (relating to the Medicaid program).''.
(d) Section 1108 of the Social Security Act (42 U.S.C.
1308) is amended--
(1) in subsection (f), in the matter preceding paragraph
(1), by striking ``subsection (g)'' and inserting
``subsections (g) and (h)''; and
(2) by adding at the end the following:
``(h) Expenditures for medical assistance provided to an
individual described in section 431(b)(8) of the Personal
Responsibility and Work Opportunity Reconciliation Act of
1996 shall not be taken into account for purposes of applying
payment limits under subsections (f) and (g).''.
(e) The amendments made by this section shall apply to
benefits for items and services furnished on or after the
date of the enactment of this Act.
(f) The amounts provided by the amendments made by this
section are designated by Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

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