S. 585Senate116th Congress (2019-2021)In Committee

SAME Act of 2019

AI-Generated Summary

Updated April 14, 2026 at 2:17 AM UTC

The SAME Act of 2019 changes the Medicaid matching formula so that any state that decides to expand Medicaid receives the same higher level of federal funding as the states that expanded earlier. The law removes the requirement that the extra match only apply to expansions that occurred in specific years, and it makes the higher match apply retroactively to past expansions.

Key Provisions

Amends the Social Security Act to replace year‑specific references (2014‑2020) with language that ties the higher federal match to the first, second, … seventh and subsequent 12‑month periods a state provides Medicaid to newly eligible individuals.
Ensures the increased Federal Medical Assistance Percentage (FMAP) applies to any state that expands Medicaid, no matter when the expansion happens.
Makes the changes retroactive, treating them as if they were part of the original Medicaid expansion law, so states can receive the higher match for expenses incurred before the bill’s enactment.

Legislative Activity

Stay on top of the latest movement without scrolling through every action

1 earlier action

SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

Finance Committee

February 27, 2019

View full timeline

SenateIntro Referral

Introduced in Senate

February 27, 2019

SenateIntro Referral

Read twice and referred to the Committee on Finance.

Finance Committee

February 27, 2019

Bill Text

Latest available legislative text

Reading Mode

Raw Text PDF XML

Introduced in SenateIssued February 27, 2019

116th CONGRESS

1st Session

S. 585

IN THE SENATE OF THE UNITED STATES

February 27, 2019

Mr. Warner (for himself, Mr. Jones, Mr. Kaine, Ms. Baldwin, Mr. Carper, Mr. Coons, Mr. King, Mr. Peters, and Ms. Stabenow) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XIX of the Social Security Act to provide the same level of Federal matching assistance for every State that chooses to expand Medicaid coverage to newly eligible individuals, regardless of when such expansion takes place.

Short title

This Act may be cited as the States Achieve Medicaid Expansion Act of 2019 or the SAME Act of 2019.

Increased FMAP for medical assistance to newly eligible individuals

(a)

In general

Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended—

(1)

in subsection (y)(1)—

(A)

in subparagraph (A), by striking 2014, 2015, and 2016 and inserting each of the first 3 consecutive 12-month periods in which the State provides medical assistance to newly eligible individuals;

(B)

in subparagraph (B), by striking 2017 and inserting the fourth consecutive 12-month period in which the State provides medical assistance to newly eligible individuals;

(C)

in subparagraph (C), by striking 2018 and inserting the fifth consecutive 12-month period in which the State provides medical assistance to newly eligible individuals;

(D)

in subparagraph (D), by striking 2019 and inserting the sixth consecutive 12-month period in which the State provides medical assistance to newly eligible individuals; and

(E)

in subparagraph (E), by striking 2020 and each year thereafter and inserting the seventh consecutive 12-month period in which the State provides medical assistance to newly eligible individuals and each such period thereafter; and

(2)

in subsection (z)(2)(B)(i)(II), by inserting (as in effect on the day before the enactment of the States Achieve Medicaid Expansion Act of 2019) after subsection (y)(1).

(b)

Retroactive application

The amendments made by subsection (a)(1) shall take effect as if included in the enactment of Public Law 111–148 and shall apply to amounts expended by any State for medical assistance for newly eligible individuals described in subclause (VIII) of section 1902(a)(10)(A)(i) of the Social Security Act under a State Medicaid plan (or a waiver of such plan) during the period before the date of enactment of this Act.