S. 1377Senate111th Congress (2009-2011)In Committee

A bill to provide for an automatic increase in the federal matching rate for the Medicaid program during periods of national economic downturn to help States cope with increases in Medicaid costs.

Introduced June 25, 2009

Legislative Activity

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2 earlier actions
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S7090-7091)

June 25, 2009

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SenateIntro Referral

Introduced in Senate

June 25, 2009

SenateIntro Referral

Sponsor introductory remarks on measure. (CR S7089-7090)

June 25, 2009

SenateIntro Referral

Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S7090-7091)

June 25, 2009

Floor Debate

12 members

What members said about S. 1377 on the floor

3 Republicans9 Democrats
Chuck Grassley
Sen. Chuck GrassleyR-IA · Jun 25, 2009

Mr. President, President Obama, in his press briefing this past Tuesday, June 23, 2009, made the following statement regarding his assessment of the first four months of the American Recovery and…

Christopher J. Dodd
Sen. Christopher J. DoddD-CT · Jun 25, 2009

Mr. President, I rise today to join my fellow New Englander, Senator Susan Collins of Maine, in introducing the Lyme and Tick-Borne Disease Prevention, Education, and Research Act of 2009. As…

Ron Wyden
Sen. Ron WydenD-OR · Jun 25, 2009

Mr. President, along with my friend, Senator Barrasso, I am introducing legislation to keep rural America from becoming a health care sacrifice zone. Our legislation, the Rural Health Clinic Patient…

Patrick J. Leahy
Sen. Patrick J. LeahyD-VT · Jun 25, 2009

Mr. President, I rise today to introduce legislation that will correct an inequality in the Department of Justice's Public Safety Officers Benefits, PSOB, Program by extending benefits to non-profit…

Olympia J. Snowe
Sen. Olympia J. SnoweR-ME · Jun 25, 2009

Mr. President, today I rise to reintroduce legislation to offer a drastically simplified alternative for home-based businesses to benefit from the home office tax deduction. The U.S. Small Business…

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John D. Rockefeller IV
Sen. John D. Rockefeller IVD-WV · Jun 25, 2009

Mr. President, I believe that perhaps the most effective way to improve the education of our children is to invest in their teachers, and make certain that quality teachers have the incentive to stay…

Bill Nelson
Sen. Bill NelsonD-FL · Jun 25, 2009

Mr. President, I rise today to introduce, with my colleagues Senators Ensign and Martinez, the Clean Renewable Water Supply Bond Act of 2009. While many of us do not think twice when we turn on the…

John Cornyn
Sen. John CornynR-TX · Jun 25, 2009

Mr. President, I rise to introduce the Federal Research Public Access Act. I am very pleased to be joined again by my good friend and colleague, Senator Joe Lieberman, who has remained dedicated to…

Mark L. Pryor
Sen. Mark L. PryorD-AR · Jun 25, 2009

Mr. President, I rise today along with Senator Inhofe to introduce the Fueling America Act of 2009 which will provide incentives for the production and use of natural gas and propane vehicles…

Richard J. Durbin
Sen. Richard J. DurbinD-IL · Jun 25, 2009

I rise to introduce the Dextromethorphan Abuse Reduction Act of 2009. This legislation will help prevent the dangerous abuse by minors of cough medicines containing the ingredient dextromethorphan,…

Jack Reed
Sen. Jack ReedD-RI · Jun 25, 2009

Mr. President, today I am introducing the Success in the Middle Act, which will help provide new support for raising student achievement in the middle grades. I thank Senators Klobuchar, Stabenow,…

John D. Rockefeller IV
Sen. John D. Rockefeller IVD-WV · Jun 25, 2009

Mr. President, I rise today to introduce legislation that will guarantee that Medicaid remains available as a critical safety-net for working families in the event of another economic downturn.…

Barbara Boxer
Sen. Barbara BoxerD-CA · Jun 25, 2009

Mr. President, I rise on behalf of myself and Senator Feinstein to speak on the introduction of the Western States Trail Study Act of 2009. This legislation would provide for a study by the…

Bill Text

Latest available legislative text

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Introduced in SenateIssued June 25, 2009

II

111th CONGRESS

1st Session

S. 1377

IN THE SENATE OF THE UNITED STATES

June 25, 2009

Mr. Rockefeller introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To provide for an automatic increase in the Federal matching rate for the Medicaid program during periods of national economic downturn to help States cope with increases in Medicaid costs.

1.

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) is amended—

(A)

in subsection (b), in the first sentence—

(i)

by striking and (4) and inserting (4); and

(ii)

by inserting and (5) with respect to each fiscal year quarter other than the first quarter of a national economic downturn assistance period described in subsection (y)(1), the Federal medical assistance percentage for any State described in subsection (y)(2) shall be equal to the national economic downturn assistance FMAP determined for the State for the quarter under subsection (y)(3) before the period; and

(B)

by adding at the end the following:

(y)

National Economic Downturn Assistance FMAP

For purposes of clause (5) 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 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(y)(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(y) 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.