Sec. 2. Enhancing Medicaid and CHIP benefits for low-income pregnant women
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/bill/115/s/3494/is/section-2A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1902(l)(1)(A) of the Social Security Act ( 42 U.S.C. 1396a(l)(1)(A) ) is amended by striking 60-day period and inserting 365-day period . Section 1902(e)(6) of the Social Security Act ( 42 U.S.C. 1396a(e)(6) ) is amended by striking 60-day period and inserting 365-day period . Section 1903(v)(4)(A)(i) of the Social Security Act ( 42 U.S.C. 1396b(v)(4)(A)(i) ) is amended by striking 60-day period and inserting 365-day period . Section 1902(a)(10) of the Social Security Act ( 42 U.S.C. 1396a(a)(10) ) is amended in the matter following subparagraph
(G)by striking
(VII)the medical assistance and all that follows through complicate pregnancy, . Section 1902(e)(5) of the Social Security Act ( 42 U.S.C. 1396a(e)(5) ) is amended by striking 60-day period and inserting 365-day period . Section 2112 of the Social Security Act ( 42 U.S.C. 1397ll ) is amended by striking 60-day period each place it appears and inserting 365-day period . Section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) is amended— in paragraph (74), by striking subsection (gg); and and inserting subsections
(gg)and (nn); ; and by adding at the end the following new subsection: For calendar quarters beginning on or after the date of enactment of this subsection, and before January 1, 2023, no Federal payment shall be made to a State under section 1903(a) for amounts expended under a State plan under this title or a waiver of such plan if the State— has in effect under such plan eligibility standards, methodologies, or procedures (including any enrollment cap or other numerical limitation on enrollment, any waiting list, any procedures designed to delay the consideration of applications for enrollment, or similar limitation with respect to enrollment) for individuals described in subsection (l)(1) who are eligible for medical assistance under the State plan or waiver under subsection (a)(10)(A)(ii)(IX) that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, for such individuals under such plan or waiver that are in effect on the date of the enactment of the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services Act ; or provides medical assistance to individuals described in subsection (l)(1) who are eligible for medical assistance under such plan or waiver under subsection (a)(10)(A)(ii)(IX) at a level that is less than the level at which the State provides such assistance to such individuals under such plan or waiver on the date of the enactment of the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services Act . . Section 2112 of the Social Security Act ( 42 U.S.C. 1397ll ), as amended by subsection (b), is further amended by adding at the end the following subsection: For calendar quarters beginning on or after January 1, 2020, and before January 1, 2023, no payment may be made under section 2105(a) with respect to a State child health plan if the State— has in effect under such plan eligibility standards, methodologies, or procedures (including any enrollment cap or other numerical limitation on enrollment, any waiting list, any procedures designed to delay the consideration of applications for enrollment, or similar limitation with respect to enrollment) for targeted low-income pregnant women that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan that are in effect on the date of the enactment of the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services Act ; or provides pregnancy-related assistance to targeted low-income pregnant women under such plan at a level that is less than the level at which the State provides such assistance to such women under such plan on the date of the enactment of the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services Act . . Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) is amended— in subsection (b), by striking and
(aa)and inserting (aa), and
(ee); and by adding at the end the following: For calendar quarters beginning on or after January 1, 2020, notwithstanding subsection (b), the Federal medical assistance percentage for a State, with respect to the additional amounts expended by such State for medical assistance under the State plan under this title or a waiver of such plan that are attributable to requirements imposed by the amendments made by the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services Act (as determined by the Secretary), shall be equal to 100 percent. . Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the gaps in coverage for— pregnant women under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) and the Children's Health Insurance Program under title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq.); and postpartum women under the Medicaid program and the Children's Health Insurance Program who received assistance under either such program during their pregnancy. The report required under this subsection shall include the following: Information about the abilities and successes of State Medicaid agencies in determining whether pregnant and postpartum women are eligible under another insurance affordability program, and in transitioning any such women who are so eligible to coverage under such a program, pursuant to section 435.1200 of the title 42, Code of Federal Regulations (as in effect on September 1, 2018). Information on factors contributing to gaps in coverage that disproportionately impact underserved populations, including low-income women, women of color, women who reside in a health professional shortage area (as defined in section 332(a)(1)(A) of the Public Health Service Act ( 42 U.S.C. 254e(a)(1)(A) )) or who are members of a medically underserved population (as defined by section 330(b)(3) of such Act ( 42 U.S.C. 254b(b)(3)(A) )). Recommendations for addressing and reducing such gaps in coverage. Such other information as the Comptroller General deems necessary. The amendments made by subsections
(a)and
(b)shall take effect January 1, 2020.
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U.S. Code
- State plans for medical assistance§ 1396a
- Payment to States§ 1396b
- Optional coverage of targeted low-income pregnant women through a State plan amendment§ 1397ll
- Definitions§ 1396d
- Medicaid and CHIP Payment and Access Commission§ 1396
- Purpose; State child health plans§ 1397aa
- Health professional shortage areas§ 254e
- Health centers§ 254b
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Sec. 2
Enhancing Medicaid and CHIP benefits for low-income pregnant women
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