H.R. 260House116th Congress (2019-2021)In Committee

Medicaid Provisions and TANF Extenders Act of 2019

Introduced January 4, 2019

AI-Generated Summary

Updated April 14, 2026 at 12:03 AM UTC

The Medicaid Provisions and TANF Extenders Act of 2019 keeps several Medicaid programs running and adds new rules, while also extending funding for the Temporary Assistance for Needy Families (TANF) program through fiscal years 2019 and 2020. It continues the Money‑Follows‑the‑Person rebalancing demonstration, prolongs spousal‑impoverishment protections for home‑ and community‑based services, and penalizes states that do not run an asset‑verification program. The bill also reduces the Medicaid Improvement Fund and creates new reporting and data‑exchange requirements for TANF.

Key Provisions

  • Provides $112 million for FY 2019 to continue the Money‑Follows‑the‑Person rebalancing demonstration and extends its deadline to September 30 2021; funds go only to states with an approved project as of Dec 31 2018.
  • Adds $500,000 for quality‑assurance and technical assistance for the demonstration.
  • Extends the period during which Medicaid recipients of home‑ and community‑based services are protected from spousal impoverishment (Jan 1 2014 – Mar 31 2019) and clarifies that states may disregard a spouse’s income or assets when determining eligibility under certain waivers.
  • Introduces a step‑down reduction in the Federal Medical Assistance Percentage for states that lack an asset‑verification program, decreasing FMAP by up to 0.5 percentage points each year after 2020.
  • Cuts the Medicaid Improvement Fund allocation from $31 million to $6 million.
  • Extends TANF authorizations for FY 2019‑2020 across family assistance, healthy marriage, contingency, tribal, child‑care, and territorial grant programs.
  • Requires states to report detailed employment, earnings, and education outcomes for families exiting TANF and for current recipients, and directs HHS to develop a statistical adjustment model for those data.
  • Mandates HHS, in coordination with an interagency work group, to set interoperable data‑exchange standards for state programs and to issue a proposed rule within 24 months of enactment.

Legislative Activity

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3 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Worker and Family Support.

January 31, 2019

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HouseIntro Referral

Introduced in House

January 4, 2019

HouseIntro Referral

Referred to the Committee on Ways and Means, and in addition to the Committees on Energy and Commerce, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

January 4, 2019

HouseCommittee

Referred to the Subcommittee on Health.

January 25, 2019

HouseCommittee

Referred to the Subcommittee on Worker and Family Support.

January 31, 2019

Bill Text

Latest available legislative text

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Latest
Introduced in HouseIssued January 4, 2019

I

116th CONGRESS

1st Session

H. R. 260

IN THE HOUSE OF REPRESENTATIVES

January 4, 2019

Mr. Pallone (for himself, Mr. Walden, and Mr. Neal) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committees on Energy and Commerce, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To extend the Medicaid Money Follows the Person Rebalancing demonstration, to extend protection for Medicaid recipients of home and community-based services against spousal impoverishment, to extend the Temporary Assistance for Needy Families program, and for other purposes.

1.

Short title

This Act may be cited as the Medicaid Provisions and TANF Extenders Act of 2019.

I

Medicaid Extenders

101.

Extension of Money Follows the Person Rebalancing demonstration

(a)

General Funding

Section 6071(h) of the Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) is amended—

(1)

in paragraph (1)—

(A)

in subparagraph (D), by striking and after the semicolon;

(B)

in subparagraph (E), by striking the period at the end and inserting ; and; and

(C)

by adding at the end the following:

(F)

subject to paragraph (3), $112,000,000 for fiscal year 2019.

;

(2)

in paragraph (2)—

(A)

by striking Amounts made and inserting Subject to paragraph (3), amounts made; and

(B)

by striking September 30, 2016 and inserting September 30, 2021; and

(3)

by adding at the end the following new paragraph:

(3)

Special rule for FY 2019

Funds appropriated under paragraph (1)(F) shall be made available for grants to States only if such States have an approved MFP demonstration project under this section as of December 31, 2018.

.

(b)

Funding for quality assurance and improvement; technical assistance; oversight

Section 6071(f) of the Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) is amended by striking paragraph (2) and inserting the following:

(2)

Funding

From the amounts appropriated under subsection (h)(1)(F) for fiscal year 2019, $500,000 shall be available to the Secretary for such fiscal year to carry out this subsection.

.

(c)

Technical amendment

Section 6071(b) of the Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) is amended by adding at the end the following:

(10)

Secretary

The term Secretary means the Secretary of Health and Human Services.

.

102.

Extension of protection for Medicaid recipients of home and community-based services against spousal impoverishment

(a)

In general

Section 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) is amended by striking the 5-year period that begins on January 1, 2014, and inserting the period beginning on January 1, 2014, and ending on March 31, 2019,.

(b)

Rule of construction

(1)

Protecting State spousal income and asset disregard flexibility under waivers and plan amendments

Nothing in section 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) or section 1924 of the Social Security Act (42 U.S.C. 1396r–5) shall be construed as prohibiting a State from disregarding an individual’s spousal income and assets under a State waiver or plan amendment described in paragraph (2) for purposes of making determinations of eligibility for home and community-based services or home and community-based attendant services and supports under such waiver or plan amendment.

(2)

State waiver or plan amendment described

A State waiver or plan amendment described in this paragraph is any of the following:

(A)

A waiver or plan amendment to provide medical assistance for home and community-based services under a waiver or plan amendment under subsection (c), (d), or (i) of section 1915 of the Social Security Act (42 U.S.C. 1396n) or under section 1115 of such Act (42 U.S.C. 1315).

(B)

A plan amendment to provide medical assistance for home and community-based services for individuals by reason of being determined eligible under section 1902(a)(10)(C) of such Act (42 U.S.C. 1396a(a)(10)(C)) or by reason of section 1902(f) of such Act (42 U.S.C. 1396a(f)) or otherwise on the basis of a reduction of income based on costs incurred for medical or other remedial care under which the State disregarded the income and assets of the individual’s spouse in determining the initial and ongoing financial eligibility of an individual for such services in place of the spousal impoverishment provisions applied under section 1924 of such Act (42 U.S.C. 1396r–5).

(C)

A plan amendment to provide medical assistance for home and community-based attendant services and supports under section 1915(k) of such Act (42 U.S.C. 1396n(k)).

103.

Reduction in FMAP after 2020 for States without asset verification program

Section 1940 of the Social Security Act (42 U.S.C. 1396w) is amended by adding at the end the following new subsection:

(k)

Reduction in FMAP after 2020 for non-Compliant States

(1)

In general

With respect to a calendar quarter beginning on or after January 1, 2021, the Federal medical assistance percentage otherwise determined under section 1905(b) for a non-compliant State shall be reduced—

(A)

for calendar quarters in 2021 and 2022, by 0.12 percentage points;

(B)

for calendar quarters in 2023, by 0.25 percentage points;

(C)

for calendar quarters in 2024, by 0.35 percentage points; and

(D)

for calendar quarters in 2025 and each year thereafter, by 0.5 percentage points.

(2)

Non-compliant State defined

For purposes of this subsection, the term non-compliant State means a State—

(A)

that is one of the 50 States or the District of Columbia;

(B)

with respect to which the Secretary has not approved a State plan amendment submitted under subsection (a)(2); and

(C)

that is not operating, on an ongoing basis, an asset verification program in accordance with this section.

.

104.

Medicaid Improvement Fund

Section 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w–1(b)(1)) is amended by striking $31,000,000 and inserting $6,000,000.

105.

Budgetary Effects

(a)

Statutory PAYGO scorecards

The budgetary effects of this title shall not be entered on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(d)).

(b)

Senate PAYGO scorecards

The budgetary effects of this title shall not be entered on any PAYGO scorecard maintained for purposes of section 4106 of H. Con. Res. 71 (115th Congress).

(c)

Classification of budgetary effects

Notwithstanding Rule 3 of the Budget Scorekeeping Guidelines set forth in the joint explanatory statement of the committee of conference accompanying Conference Report 105–217 and section 250(c)(8) of the Balanced Budget and Emergency Deficit Control Act of 1985, the budgetary effects of this title shall not be estimated—

(1)

for purposes of section 251 of the Balanced Budget and Emergency Deficit Control Act of 1985; and

(2)

for purposes of paragraph (4)(C) of section 3 of the Statutory Pay-As-You-Go Act of 2010 as being included in an appropriation Act.

(d)

PAYGO annual report

For the purposes of the annual report issued pursuant to section 5 of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 934) after adjournment of the second session of the 115th Congress, and for determining whether a sequestration order is necessary under such section, the debit for the budget year on the 5-year scorecard, if any, and the 10-year scorecard, if any, shall be deducted from such scorecard in 2019 and added to such scorecard in 2020.

II

TANF and Technical Corrections

201.

TANF program extensions

(a)

Family assistance grants

Section 403(a)(1) of the Social Security Act (42 U.S.C. 603(a)(1)) is amended in each of subparagraphs (A) and (C) by striking 2017 and 2018 and inserting 2019 and 2020.

(b)

Healthy marriage promotion and responsible fatherhood grants

Section 403(a)(2)(D) of such Act (42 U.S.C. 603(a)(2)(D)) is amended—

(1)

by striking 2017 and 2018 and inserting 2019 and 2020; and

(2)

by striking for fiscal year 2017 or 2018.

(c)

Contingency fund

Section 403(b)(2) of such Act (42 U.S.C. 603(b)(2)) is amended by striking fiscal year 2018 and inserting each of fiscal years 2019 and 2020.

(d)

Tribal family assistance grants

Paragraphs (1)(A) and (2)(A) of section 412(a) of such Act (42 U.S.C. 612(a)) are each amended by striking 2017 and 2018 and inserting 2019 and 2020.

(e)

Child care

Section 418(a)(3) of such Act (42 U.S.C. 618(a)(3)) is amended by striking 2017 and 2018 and inserting 2019 and 2020.

(f)

Grants to the territories

Section 1108(b)(2) of such Act (42 U.S.C. 1308(b)(2)) is amended by striking 2017 and 2018 and inserting 2019 and 2020.

202.

Measuring and understanding outcomes

(a)

In general

Section 411(a) of the Social Security Act (42 U.S.C. 611(a)) is amended by redesignating paragraph (7) as paragraph (8) and inserting after paragraph (6) the following:

(7)

Report on engagement, employment and outcomes

(A)

Reporting agreement

Each State and the Secretary shall enter into an agreement specifying the manner by which the information and data described in this paragraph shall be collected and reported to the Secretary beginning in fiscal year 2020.

(i)

Outcomes for exiting recipients

Information and data regarding families who formerly received assistance and included a work-eligible individual (disaggregated by type of family, reason for exit, and participation in work activities during the preceding fiscal year) under the State program funded under this part or under any State program funded with qualified State expenditures (as defined in section 409(a)(7)(B)(i)), with respect to the following:

(I)

The percentage with at least 1 formerly work-eligible individual employed during the 2nd quarter after exiting from the program.

(II)

The percentage with at least 1 formerly work-eligible individual employed during the 4th quarter after exiting from the program.

(III)

The median earnings when at least 1 formerly work-eligible individual is employed during the 2d quarter after exiting from the program.

(IV)

The percentage with at least 1 formerly work-eligible individual employed during any of the first 4 quarters after exiting from the program.

(V)

The distribution of income and earnings, including relative to poverty and deep poverty, for each of the first 4 quarters ending after the quarter of exit from assistance.

(VI)

The percentage who, at the time of exit from the program, were subject to the following:

(aa)

A penalty under section 407(e).

(bb)

A sanction or penalty described in section 404 or 408.

(cc)

A penalty or sanction not described in item (aa) or (bb).

(ii)

Engagement and employment of current recipients

(I)

Work-eligible individuals

In the case of current work-eligible individuals under the State program funded under this part or under any State program funded with qualified State expenditures (as defined in section 409(a)(7)(B)(i)), the following information relative to the current quarter being reported:

(aa)

Earnings in each of the 4 quarters immediately preceding the quarter.

(bb)

Standard measures of employment, earnings, receipt of assistance, and participation in work activities (as defined in section 407(d)) in each of the first 4 quarters following the quarter.

(II)

All recipients

The percentage of recipients of assistance under the State program funded under this part or under any State program funded with qualified State expenditures (as defined in section 409(a)(7)(B)(i)) who have not attained 24 years of age and who obtain a high school degree or its recognized equivalent while receiving the assistance.

(B)

Statistical adjustment model for employment outcomes

The Secretary, in consultation with the Secretary of Labor and relevant experts, shall develop recommendations by March 1, 2020, on how to establish and disseminate an objective statistical model that will allow the Secretary to make adjustments to the data reported pursuant to subclauses (I) through (IV) of subparagraph (A)(i) of this paragraph, based on economic conditions and the characteristics of participants. To the extent practicable, the recommendations shall be compatible with the statistical adjustment model developed under section 116(b)(3)(A)(viii) of the Workforce Innovation and Opportunity Act (29 U.S.C. 3141(b)(3)(A)(viii)) and, with respect to a State, the State adjusted levels of performance established for the State under that section.

.

203.

Technical corrections to data exchange standards to improve program coordination

(a)

In general

Section 411(d) of the Social Security Act (42 U.S.C. 611(d)) is amended to read as follows:

(d)

Data exchange standards for improved interoperability

(1)

Designation

The Secretary shall, in consultation with an interagency work group established by the Office of Management and Budget and considering State government perspectives, by rule, designate data exchange standards to govern, under this part—

(A)

necessary categories of information that State agencies operating programs under State plans approved under this part are required under applicable Federal law to electronically exchange with another State agency; and

(B)

Federal reporting and data exchange required under applicable Federal law.

(2)

Requirements

The data exchange standards required by paragraph (1) shall, to the extent practicable—

(A)

incorporate a widely accepted, non-proprietary, searchable, computer-readable format, such as the eXtensible Markup Language;

(B)

contain interoperable standards developed and maintained by intergovernmental partnerships, such as the National Information Exchange Model;

(C)

incorporate interoperable standards developed and maintained by Federal entities with authority over contracting and financial assistance;

(D)

be consistent with and implement applicable accounting principles;

(E)

be implemented in a manner that is cost-effective and improves program efficiency and effectiveness; and

(F)

be capable of being continually upgraded as necessary.

(3)

Rule of construction

Nothing in this subsection shall be construed to require a change to existing data exchange standards found to be effective and efficient.

.

(b)

Effective date

Not later than the date that is 24 months after the date of the enactment of this section, the Secretary of Health and Human Services shall issue a proposed rule that—

(1)

identifies federally required data exchanges, include specification and timing of exchanges to be standardized, and address the factors used in determining whether and when to standardize data exchanges; and

(2)

specifies State implementation options and describes future milestones.

204.

Unemployment insurance technical corrections

Section 306(a) of the Social Security Act (42 U.S.C. 506(a)) is amended—

(1)

by striking individuals and inserting claimants of regular compensation, including claimants; and

(2)

by inserting a comma after section 303(j).