[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3293 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 3293
To amend titles XIX and XXI of the Social Security Act to provide
States with the option to expand or add coverage of pregnant women
under the Medicaid and State children's health insurance programs, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 15, 2003
Ms. DeGette introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend titles XIX and XXI of the Social Security Act to provide
States with the option to expand or add coverage of pregnant women
under the Medicaid and State children's health insurance programs, and
for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Prevent Prematurity and Improve
Child Health Act of 2003''.
SEC. 2. STATE OPTION TO EXPAND OR ADD COVERAGE OF CERTAIN PREGNANT
WOMEN UNDER MEDICAID AND SCHIP.
(a) Medicaid.--
(1) Authority to expand coverage.--Section 1902(l)(2)(A)(i)
of the Social Security Act (42 U.S.C. 1396a(l)(2)(A)(i)) is
amended by inserting ``(or such higher percentage as the State
may elect for purposes of expenditures for medical assistance
for pregnant women described in section 1905(u)(4)(A))'' after
``185 percent''.
(2) Enhanced matching funds available if certain conditions
met.--Section 1905 of the Social Security Act (42 U.S.C. 1396d)
is amended--
(A) in the fourth sentence of subsection (b), by
striking ``or subsection (u)(3)'' and inserting ``,
(u)(3), or (u)(4)''; and
(B) in subsection (u)--
(i) by redesignating paragraph (4) as
paragraph (5); and
(ii) by inserting after paragraph (3) the
following new paragraph:
``(4) For purposes of the fourth sentence of subsection (b) and
section 2105(a), the expenditures described in this paragraph are the
following:
``(A) Certain pregnant women.--If the conditions described
in subparagraph (B) are met, expenditures for medical
assistance for pregnant women described in subsection (n) or
under section 1902(l)(1)(A) in a family the income of which
exceeds 185 percent of the poverty line, but does not exceed
the income eligibility level established under title XXI for a
targeted low-income child.
``(B) Conditions.--The conditions described in this
subparagraph are the following:
``(i) The State plans under this title and title
XXI do not provide coverage for pregnant women
described in subparagraph (A) with higher family income
without covering such pregnant women with a lower
family income.
``(ii) The State does not apply an effective income
level for pregnant women that is lower than the
effective income level (expressed as a percent of the
poverty line and considering applicable income
disregards) that has been specified under the State
plan under subsection (a)(10)(A)(i)(III) or (l)(2)(A)
of section 1902, as of January 1, 2003, to be eligible
for medical assistance as a pregnant woman.
``(C) Definition of poverty line.--In this subsection, the
term `poverty line' has the meaning given such term in section
2110(c)(5).''.
(3) Payment from title xxi allotment for medicaid expansion
costs; elimination of counting medicaid child presumptive
eligibility costs against title xxi allotment.--Section
2105(a)(1) of the Social Security Act (42 U.S.C. 1397ee(a)(1))
is amended--
(A) in the matter preceding subparagraph (A), by
striking ``(or, in the case of expenditures described
in subparagraph (B), the Federal medical assistance
percentage (as defined in the first sentence of section
1905(b)))''; and
(B) by striking subparagraph (B) and inserting the
following new subparagraph:
``(B) for the provision of medical assistance that
is attributable to expenditures described in section
1905(u)(4)(A);''.
(b) SCHIP.--
(1) Coverage.--Title XXI of the Social Security Act (42
U.S.C. 1397aa et seq.) is amended by adding at the end the
following new section:
``SEC. 2111. OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN.
``(a) Optional Coverage.--Notwithstanding any other provision of
this title, a State may provide for coverage, through an amendment to
its State child health plan under section 2102, of pregnancy-related
assistance for targeted low-income pregnant women in accordance with
this section, but only if--
``(1) the State has established an income eligibility level
for pregnant women under subsection (a)(10)(A)(i)(III) or
(l)(2)(A) of section 1902 that is at least 185 percent of the
income official poverty line; and
``(2) the State meets the conditions described in section
1905(u)(4)(B).
``(b) Definitions.--For purposes of this title:
``(1) Pregnancy-related assistance.--The term `pregnancy-
related assistance' has the meaning given the term child health
assistance in section 2110(a) as if any reference to targeted
low-income children were a reference to targeted low-income
pregnant women, except that the assistance shall be limited to
services related to pregnancy (which include prenatal,
delivery, and postpartum services and services described in
section 1905(a)(4)(C)) and to other conditions that may
complicate pregnancy.
``(2) Targeted low-income pregnant woman.--The term
`targeted low-income pregnant woman' means a woman--
``(A) during pregnancy and through the end of the
month in which the 60-day period (beginning on the last
day of her pregnancy) ends;
``(B) whose family income exceeds the effective
income level (expressed as a percent of the poverty
line and considering applicable income disregards) that
has been specified under subsection (a)(10)(A)(i)(III)
or (l)(2)(A) of section 1902, as of January 1, 2003, to
be eligible for medical assistance as a pregnant woman
under title XIX but does not exceed the income
eligibility level established under the State child
health plan under this title for a targeted low-income
child; and
``(C) who satisfies the requirements of paragraphs
(1)(A), (1)(C), (2), and (3) of section 2110(b).
``(c) References to Terms and Special Rules.--In the case of, and
with respect to, a State providing for coverage of pregnancy-related
assistance to targeted low-income pregnant women under subsection (a),
the following special rules apply:
``(1) Any reference in this title (other than in subsection
(b)) to a targeted low-income child is deemed to include a
reference to a targeted low-income pregnant woman.
``(2) Any such reference to child health assistance with
respect to such women is deemed a reference to pregnancy-
related assistance.
``(3) Any such reference to a child is deemed a reference
to a woman during pregnancy and the period described in
subsection (b)(2)(A).
``(4) In applying section 2102(b)(3)(B), any reference to
children found through screening to be eligible for medical
assistance under the State medicaid plan under title XIX is
deemed a reference to pregnant women.
``(5) There shall be no exclusion of benefits for services
described in subsection (b)(1) based on any preexisting
condition and no waiting period (including any waiting period
imposed to carry out section 2102(b)(3)(C)) shall apply.
``(6) Subsection (a) of section 2103 (relating to required
scope of health insurance coverage) shall not apply insofar as
a State limits coverage to services described in subsection
(b)(1) and the reference to such section in section
2105(a)(1)(C) is deemed not to require, in such case,
compliance with the requirements of section 2103(a).
``(7) In applying section 2103(e)(3)(B) in the case of a
pregnant woman provided coverage under this section, the
limitation on total annual aggregate cost-sharing shall be
applied to such pregnant woman.
``(8) The reference in section 2107(e)(1)(D) to section
1920A (relating to presumptive eligibility for children) is
deemed a reference to section 1920 (relating to presumptive
eligibility for pregnant women).
``(d) Automatic Enrollment for Children Born to Women Receiving
Pregnancy-Related Assistance.--If a child is born to a targeted low-
income pregnant woman who was receiving pregnancy-related assistance
under this section on the date of the child's birth, the child shall be
deemed to have applied for child health assistance under the State
child health plan and to have been found eligible for such assistance
under such plan or to have applied for medical assistance under title
XIX and to have been found eligible for such assistance under such
title, as appropriate, on the date of such birth and to remain eligible
for such assistance until the child attains 1 year of age. During the
period in which a child is deemed under the preceding sentence to be
eligible for child health or medical assistance, the child health or
medical assistance eligibility identification number of the mother
shall also serve as the identification number of the child, and all
claims shall be submitted and paid under such number (unless the State
issues a separate identification number for the child before such
period expires).''.
(2) Additional allotments for providing coverage of
pregnant women.--
(A) In general.--Section 2104 of the Social
Security Act (42 U.S.C. 1397dd) is amended by inserting
after subsection (c) the following new subsection:
``(d) Additional Allotments for Providing Coverage of Pregnant
Women.--
``(1) Appropriation; total allotment.--For the purpose of
providing additional allotments to States under this title,
there is appropriated, out of any money in the Treasury not
otherwise appropriated, for each of fiscal years 2004 through
2007, $200,000,000.
``(2) State and territorial allotments.--In addition to the
allotments provided under subsections (b) and (c), subject to
paragraphs (3) and (4), of the amount available for the
additional allotments under paragraph (1) for a fiscal year,
the Secretary shall allot to each State with a State child
health plan approved under this title--
``(A) in the case of such a State other than a
commonwealth or territory described in subparagraph
(B), the same proportion as the proportion of the
State's allotment under subsection (b) (determined
without regard to subsection (f)) to the total amount
of the allotments under subsection (b) for such States
eligible for an allotment under this paragraph for such
fiscal year; and
``(B) in the case of a commonwealth or territory
described in subsection (c)(3), the same proportion as
the proportion of the commonwealth's or territory's
allotment under subsection (c) (determined without
regard to subsection (f)) to the total amount of the
allotments under subsection (c) for commonwealths and
territories eligible for an allotment under this
paragraph for such fiscal year.
``(3) Use of additional allotment.--Additional allotments
provided under this subsection are not available for amounts
expended before October 1, 2003. Such amounts are available for amounts
expended on or after such date for child health assistance for targeted
low-income children, as well as for pregnancy-related assistance for
targeted low-income pregnant women.
``(4) No payments unless election to expand coverage of
pregnant women.--No payments may be made to a State under this
title from an allotment provided under this subsection unless
the State provides pregnancy-related assistance for targeted
low-income pregnant women under this title, or provides medical
assistance for pregnant women under title XIX, whose family
income exceeds the effective income level applicable under
subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902 to a
family of the size involved as of January 1, 2003.''.
(B) Conforming amendments.--Section 2104 of the
Social Security Act (42 U.S.C. 1397dd) is amended--
(i) in subsection (a), in the matter
preceding paragraph (1), by inserting ``subject
to subsection (d),'' after ``under this
section,'';
(ii) in subsection (b)(1), by inserting
``and subsection (d)'' after ``Subject to
paragraph (4)''; and
(iii) in subsection (c)(1), by inserting
``subject to subsection (d),'' after ``for a
fiscal year,''.
(3) Additional conforming amendments.--
(A) No cost-sharing for pregnancy-related
benefits.--Section 2103(e)(2) of the Social Security
Act (42 U.S.C. 1397cc(e)(2)) is amended--
(i) in the heading, by inserting ``or
pregnancy-related services'' after ``preventive
services''; and
(ii) by inserting before the period at the
end the following: ``or for pregnancy-related
services''.
(B) No waiting period.--Section 2102(b)(1)(B) (42
U.S.C. 1397bb(b)(1)(B)) is amended--
(i) in clause (i), by striking ``, and'' at
the end and inserting a semicolon;
(ii) in clause (ii), by striking the period
at the end and inserting ``; and''; and
(iii) by adding at the end the following
new clause:
``(iii) may not apply a waiting period
(including a waiting period to carry out
paragraph (3)(C)) in the case of a targeted
low-income pregnant woman.''.
(c) Authority for States That Provide Medicaid or SCHIP Coverage
for Pregnant Women With Income Above 185 Percent of the Poverty Line To
Use Portion of SCHIP Funds for Medicaid Expenditures.--Section 2105(g)
of the Social Security Act (42 U.S.C. 1397ee(g)), as added by section
1(b) of Public Law 108-74, is amended--
(1) in the subsection heading, by inserting ``and Certain
Pregnancy Coverage Expansion States'' after ``Qualifying
States'';
(2) by adding at the end the following:
``(4) Special authority for certain pregnancy coverage
expansion states.--
``(A) In general.--In the case of a State that, as
of the date of enactment of the Prevent Prematurity and
Improve Child Health Act of 2003, has an income
eligibility standard under title XIX or this title
(under section 1902(a)(10)(A) or under a statewide
waiver in effect under section 1115 with respect to
title XIX or this title) that is at least 185 percent
of the poverty line with respect to pregnant women, the
State may elect to use not more than 20 percent of any
allotment under section 2104 for any fiscal year
(insofar as it is available under subsections (e) and
(g) of such section) for payments under title XIX in
accordance with subparagraph (B), instead of for
expenditures under this title.
``(B) Payments to states.--
``(i) In general.--In the case of a State
described in subparagraph (A) that has elected
the option described in that subparagraph,
subject to the availability of funds under such
subparagraph and, if applicable, paragraph
(1)(A), with respect to the State, the
Secretary shall pay the State an amount each
quarter equal to the additional amount that
would have been paid to the State under title
XIX with respect to expenditures described in
clause (ii) if the enhanced FMAP (as determined
under subsection (b)) had been substituted for
the Federal medical assistance percentage (as
defined in section 1905(b)).
``(ii) Expenditures described.--For
purposes of this subparagraph, the expenditures
described in this clause are expenditures, made
after the date of the enactment of this
paragraph and during the period in which funds
are available to the State for use under
subparagraph (A), for medical assistance under
title XIX for pregnant women whose family
income is at least 185 percent of the poverty
line.
``(iii) No impact on determination of
budget neutrality for waivers.--In the case of
a State described in subparagraph (A) that uses
amounts paid under this paragraph for
expenditures described in clause (ii) that are
incurred under a waiver approved for the State,
any budget neutrality determinations with
respect to such waiver shall be determined
without regard to such amounts paid.''; and
(3) in paragraph (3), by striking ``and (2)'' and inserting
``(2), and (4)''.
(d) Other Amendments to Medicaid.--
(1) Eligibility of a newborn.--Section 1902(e)(4) of the
Social Security Act (42 U.S.C. 1396a(e)(4)) is amended in the
first sentence by striking ``so long as the child is a member
of the woman's household and the woman remains (or would remain
if pregnant) eligible for such assistance''.
(2) Application of qualified entities to presumptive
eligibility for pregnant women under medicaid.--Section 1920(b)
of the Social Security Act (42 U.S.C. 1396r-1(b)) is amended by
adding after paragraph (2) the following flush sentence:
``The term `qualified provider' includes a qualified entity as defined
in section 1920A(b)(3).''.
(e) Effective Date.--The amendments made by this section apply to
items and services furnished on or after October 1, 2003, without
regard to whether regulations implementing such amendments have been
promulgated.
SEC. 3. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS UNDER THE MEDICAID
PROGRAM AND SCHIP.
(a) Medicaid Program.--Section 1903(v) of the Social Security Act
(42 U.S.C. 1396b(v)) is amended--
(1) in paragraph (1), by striking ``paragraph (2)'' and
inserting ``paragraphs (2) and (4)''; and
(2) by adding at the end the following new paragraph:
``(4)(A) A State may elect (in a plan amendment under this title)
to provide medical assistance under this title for aliens who are
lawfully residing in the United States (including battered aliens
described in section 431(c) of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996) and who are otherwise eligible
for such assistance, within any of the following eligibility
categories:
``(i) Pregnant women.--Women during pregnancy (and during
the 60-day period beginning on the last day of the pregnancy).
``(ii) Children.--Children (as defined under such plan),
including optional targeted low-income children described in
section 1905(u)(2)(B).
``(B)(i) In the case of a State that has elected to provide medical
assistance to a category of aliens under subparagraph (A), no debt
shall accrue under an affidavit of support against any sponsor of such
an alien on the basis of provision of assistance to such category and
the cost of such assistance shall not be considered as an unreimbursed
cost.
``(ii) The provisions of sections 401(a), 402(b), 403, and 421 of
the Personal Responsibility and Work Opportunity Reconciliation Act of
1996 shall not apply to a State that makes an election under
subparagraph (A).''.
(b) Title XXI.--Section 2107(e)(1) of the Social Security Act (42
U.S.C. 1397gg(e)(1)) is amended by adding at the end the following new
subparagraph:
``(E) Section 1903(v)(4) (relating to optional
coverage of permanent resident alien pregnant women and
children), but only with respect to an eligibility
category under this title, if the same eligibility
category has been elected under such section for
purposes of title XIX.''.
(c) Effective Date.--The amendments made by this section take
effect on October 1, 2003, and apply to medical assistance and child
health assistance furnished on or after such date.
SEC. 4. PROMOTING CESSATION OF TOBACCO USE UNDER THE MEDICAID PROGRAM.
(a) Dropping Exception From Medicaid Prescription Drug Coverage for
Tobacco Cessation Medications.--Section 1927(d)(2) of the Social
Security Act (42 U.S.C. 1396r-8(d)(2)) is amended--
(1) by striking subparagraph (E);
(2) by redesignating subparagraphs (F) through (J) as
subparagraphs (E) through (I), respectively; and
(3) in subparagraph (F) (as redesignated by paragraph (2)),
by inserting before the period at the end the following: ``,
except agents approved by the Food and Drug Administration for
purposes of promoting, and when used to promote, tobacco
cessation''.
(b) Requiring Coverage of Tobacco Cessation Counseling Services for
Pregnant Women.--Section 1905 of the Social Security Act (42 U.S.C.
1396d(a)(4)) is amended--
(1) in subsection (a)(4)--
(A) by striking ``and'' before ``(C)''; and
(B) by inserting before the semicolon at the end
the following new subparagraph: ``; and (D) counseling
for cessation of tobacco use (as defined in subsection
(x)) for pregnant women''; and
(2) by adding at the end the following:
``(x)(1) For purposes of this title, the term `counseling for
cessation of tobacco use' means therapy and counseling for cessation of
tobacco use for pregnant women who use tobacco products or who are
being treated for tobacco use that is furnished--
``(A) by or under the supervision of a physician; or
``(B) by any other health care professional who--
``(i) is legally authorized to furnish such
services under State law (or the State regulatory
mechanism provided by State law) of the State in which
the services are furnished; and
``(ii) is authorized to receive payment for other
services under this title or is designated by the
Secretary for this purpose.
``(2) Subject to paragraph (3), such term is limited to--
``(A) therapy and counseling services recommended in
`Treating Tobacco Use and Dependence: A Clinical Practice
Guideline', published by the Public Health Service in June
2000, or any subsequent modification of such Guideline; and
``(B) such other therapy and counseling services that the
Secretary recognizes to be effective.
``(3) Such term shall not include coverage for drugs or biologicals
that are not otherwise covered under this title.''.
(c) Removal of Cost-Sharing for Tobacco Cessation Counseling
Services for Pregnant Women.--Section 1916 of the Social Security Act
(42 U.S.C. 1396o) is amended in each of subsections (a)(2)(B) and
(b)(2)(B) by inserting ``, and counseling for cessation of tobacco use
(as defined in section 1905(x))'' after ``complicate the pregnancy''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after the date that is 1 year after
the date of enactment of this Act.
SEC. 5. PROMOTING CESSATION OF TOBACCO USE UNDER THE MATERNAL AND CHILD
HEALTH SERVICES BLOCK GRANT PROGRAM.
(a) Quality Maternal and Child Health Services Includes Tobacco
Cessation Counseling and Medications.--
(1) In general.--Section 501 of the Social Security Act (42
U.S.C. 701) is amended by adding at the end the following new
subsection:
``(c) For purposes of this title, counseling for cessation of
tobacco use (as defined in section 1905(x)), drugs and biologicals used
to promote smoking cessation, and the inclusion of antitobacco messages
in health promotion counseling shall be considered to be part of
quality maternal and child health services.''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect on the date that is 1 year after the date of
enactment of this Act.
(b) Evaluation of National Core Performance Measures.--
(1) In general.--The Administrator of the Health Resources
and Services Administration shall assess the current national
core performance measures and national core outcome measures
utilized under the Maternal and Child Health Block Grant under
title V of the Social Security Act (42 U.S.C. 701 et seq.) for
purposes of expanding such measures to include some of the
known causes of low birthweight and prematurity, including the
percentage of infants born to pregnant women who smoked during
pregnancy.
(2) Report.--Not later than 1 year after the date of
enactment of this Act, the Administrator of the Health
Resources and Services Administration shall submit to the
appropriate committees of Congress a report concerning the
results of the evaluation conducted under paragraph (1).
SEC. 6. STATE OPTION TO PROVIDE FAMILY PLANNING SERVICES AND SUPPLIES
TO INDIVIDUALS WITH INCOMES THAT DO NOT EXCEED A STATE'S
INCOME ELIGIBILITY LEVEL FOR MEDICAL ASSISTANCE.
(a) In General.--Title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) is amended--
(1) by redesignating section 1935 as section 1936; and
(2) by inserting after section 1934 the following new
section:
``state option to provide family planning services and supplies
``Sec. 1935. (a) In General.--Subject to subsections (b) and (c), a
State may elect (through a State plan amendment) to make medical
assistance described in section 1905(a)(4)(C) available to any
individual whose family income does not exceed the greater of--
``(1) 185 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) the eligibility income level (expressed as a
percentage of such poverty line) that has been specified under
a waiver authorized by the Secretary or under section
1902(r)(2)), as of October 1, 2003, for an individual to be
eligible for medical assistance under the State plan.
``(b) Comparability.--Medical assistance described in section
1905(a)(4)(C) that is made available under a State plan amendment under
subsection (a) shall--
``(1) not be less in amount, duration, or scope than the
medical assistance described in that section that is made
available to any other individual under the State plan; and
``(2) be provided in accordance with the restrictions on
deductions, cost sharing, or similar charges imposed under
section 1916(a)(2)(D).
``(c) Option To Extend Coverage During a Post-Eligibility Period.--
``(1) Initial period.--A State plan amendment made under
subsection (a) may provide that any individual who was
receiving medical assistance described in section 1905(a)(4)(C)
as a result of such amendment, and who becomes ineligible for
such assistance because of hours of, or income from,
employment, may remain eligible for such medical assistance
through the end of the 6-month period that begins on the first
day the individual becomes so ineligible.
``(2) Additional extension.--A State plan amendment made
under subsection (a) may provide that any individual who has
received medical assistance described in section 1905(a)(4)(C)
during the entire 6-month period described in paragraph (1) may
be extended coverage for such assistance for a succeeding 6-
month period.''.
(b) Effective Date.--The amendments made by subsection (a) apply to
medical assistance provided on and after October 1, 2003.
SEC. 7. STATE OPTION TO EXTEND THE POSTPARTUM PERIOD FOR PROVISION OF
FAMILY PLANNING SERVICES AND SUPPLIES.
(a) In General.--Section 1902(e)(5) of the Social Security Act (42
U.S.C. 1396a(e)(5)) is amended--
(1) by striking ``eligible under the plan, as though'' and
inserting ``eligible under the plan--
``(A) as though'';
(2) by striking the period and inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(B) for medical assistance described in section
1905(a)(4)(C) for so long as the family income of such woman
does not exceed the maximum income level established by the
State for the woman to be eligible for medical assistance under
the State plan (as a result of pregnancy or otherwise).''.
(b) Effective Date.--The amendments made by subsection (a) apply to
medical assistance provided on and after October 1, 2003.
SEC. 8. STATE OPTION TO PROVIDE WRAP-AROUND SCHIP COVERAGE TO CHILDREN
WHO HAVE OTHER HEALTH COVERAGE.
(a) In General.--
(1) SCHIP.--
(A) State option to provide wrap-around coverage.--
Section 2110(b) of the Social Security Act (42 U.S.C.
1397jj(b)) is amended--
(i) in paragraph (1)(C), by inserting ``,
subject to paragraph (5),'' after ``under title
XIX or''; and
(ii) by adding at the end the following:
``(5) State option to provide wrap-around coverage.--A
State may waive the requirement of paragraph (1)(C) that a
targeted low-income child may not be covered under a group
health plan or under health insurance coverage, if the State
satisfies the conditions described in subsection (c)(8). The
State may waive such requirement in order to provide--
``(A) services for a child with special health care
needs; or
``(B) all services.
In waiving such requirement, a State may limit the application
of the waiver to children whose family income does not exceed a
level specified by the State, so long as the level so specified
does not exceed the maximum income level otherwise established
for other children under the State child health plan .''.
(B) Conditions described.--Section 2105(c) of the
Social Security Act (42 U.S.C. 1397ee(c)) is amended by
adding at the end the following:
``(8) Conditions for provision of wrap-around coverage.--
For purposes of section 2110(b)(5), the conditions described in
this paragraph are the following:
``(A) Income eligibility.--The State child health
plan (whether implemented under title XIX or this
XXI)--
``(i) has the highest income eligibility
standard permitted under this title as of
January 1, 2003;
``(ii) subject to subparagraph (B), does
not limit the acceptance of applications for
children; and
``(iii) provides benefits to all children
in the State who apply for and meet eligibility
standards.
``(B) No waiting list imposed.--With respect to
children whose family income is at or below 200 percent
of the poverty line, the State does not impose any
numerical limitation, waiting list, or similar
limitation on the eligibility of such children for
child health assistance under such State plan.
``(C) No more favorable treatment.--The State child
health plan may not provide more favorable coverage of
dental services to the children covered under section
2110(b)(5) than to children otherwise covered under
this title.''.
(C) State option to waive waiting period.--Section
2102(b)(1)(B) of the Social Security Act (42 U.S.C.
1397bb(b)(1)(B)), as amended by section 2(b)(3)(B), is
amended--
(i) in clause (ii), by striking ``, and''
at the end and inserting a semicolon;
(ii) in clause (iii), by striking the
period at the end and inserting ``; and''; and
(iii) by adding at the end the following
new clause:
``(iv) at State option, may not apply a
waiting period in the case of a child described
in section 2110(b)(5), if the State satisfies
the requirements of section 2105(c)(8).''.
(2) Application of enhanced match under medicaid.--Section
1905 of the Social Security Act (42 U.S.C. 1396d), as amended
by section 2(a)(2), is amended--
(A) in subsection (b), in the fourth sentence, by
striking ``or (u)(4)'' and inserting ``(u)(4), or
(u)(5)''; and
(B) in subsection (u)--
(i) by redesignating paragraph (5) as
paragraph (6); and
(ii) by inserting after paragraph (4) the
following:
``(5) For purposes of subsection (b), the expenditures
described in this paragraph are expenditures for items and
services for children described in section 2110(b)(5), but only
in the case of a State that satisfies the requirements of
section 2105(c)(8).''.
(3) Application of secondary payor provisions.--Section
2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)),
as amended by section 3(b), is amended by adding at the end the
following:
``(F) Section 1902(a)(25) (relating to coordination
of benefits and secondary payor provisions) with
respect to children covered under a waiver described in
section 2110(b)(5).''.
(b) Effective Date.--The amendments made by subsection (a) shall
take effect on January 1, 2003, and shall apply to child health
assistance and medical assistance provided on or after that date.
<all>