Sec. 201. Flexible block grant option for States
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Title XIX of the Social Security Act is amended— in section 1903 ( 42 U.S.C. 1396b )— in subsection (a), in the matter before paragraph (1), by inserting and section 1903A(a) after except as otherwise provided in this section ; and in subsection (d)(1), by striking to which and inserting to which, subject to section 1903A(a), ; and by inserting after such section 1903 the following new section: In the case of a State that elects the option of applying this section for a 10-fiscal-year period (beginning no earlier than fiscal year 2020 and, at the State option, for any succeeding 10-fiscal-year period) and that has a plan approved by the Secretary under subsection
(b)to carry out the option for such period— the State shall receive, instead of amounts otherwise payable to the State under this title for medical assistance for block grant individuals within the applicable block grant category (as defined in subsection (f)) for the State during the period in which the election is in effect, the amount specified in subsection (d); the payment under this section may only be used consistent with the State plan under subsection
(b)for block grant health care assistance (as defined in subsection (g)); and with respect to block grant individuals within the applicable block grant category for the State for which block grant health care assistance is made available under this section, such assistance shall be instead of medical assistance otherwise provided to the individual under this title. No payment shall be made under this section to a State pursuant to an election for a 10-fiscal-year period under subsection
(a)unless the State has a plan, approved under paragraph (2), for such period that specifies— the applicable block grant category with respect to which the State will apply the option under this section for such period; the conditions for eligibility of block grant individuals within such applicable block grant category for block grant health care assistance under the option, which shall be instead of other conditions for eligibility under this title, except that in the case of a State that has elected the applicable block grant category described in— paragraph
(1)of subsection (f), the plan must provide for eligibility for pregnant women and children required to be provided medical assistance under subsections (a)(10)(A)(i) and (e)(4) of section 1902; or paragraph
(2)of subsection (f), the plan must provide for eligibility for pregnant women required to be provided medical assistance under subsection (a)(10)(A)(i); and the types of items and services, the amount, duration, and scope of such services, the cost-sharing with respect to such services, and the method for delivery of block grant health care assistance under this section, which shall be instead of the such types, amount, duration, and scope, cost-sharing, and methods of delivery for medical assistance otherwise required under this title, except that the plan must provide for assistance for— hospital care; surgical care and treatment; medical care and treatment; obstetrical and prenatal care and treatment; prescribed drugs, medicines, and prosthetic devices; other medical supplies and services; and health care for children under 18 years of age. A plan described in paragraph
(1)shall be deemed approved by the Secretary unless the Secretary determines, within 30 days after the date of the Secretary’s receipt of the plan, that the plan is incomplete or actuarially unsound and, with respect to such plan and its implementation under this section, the requirements of paragraphs (1), (10)(B), (17), and
(23)of section 1902(a) shall not apply. The block grant amount under this subsection for a State for the initial fiscal year in the first 10-fiscal-year period is equal to an amount determined by the Secretary to equal the per capita spending on the population covered by the State plan established in subsection
(b)of section 1903A. The block grant amount under this section for a State for each succeeding fiscal year (in any 10-fiscal-year period) is equal to the block grant amount under paragraph
(1)(or this paragraph) for the State for the previous fiscal year increased by the annual increase in the consumer price index for all urban consumers (all items; U.S. city average) for the fiscal year involved. The block grant amount under this subsection for a State for a fiscal year shall remain available to the State for expenditures under this section for the succeeding fiscal year but only if an election is in effect under this section for the State in such succeeding fiscal year. The Secretary shall pay to each State with an election in effect under this section for a fiscal year, from its block grant amount under subsection
(c)available for such fiscal year, an amount for each quarter of such fiscal year equal to the enhanced FMAP described in the first sentence of section 2105(b) of the total amount expended under the State plan under this section during such quarter, and the State is responsible for the balance of funds to carry out such plan. In this section, the term block grant individual means, with respect to a State for a 10-fiscal-year period, an individual who is within an applicable block grant category for the State and such period. In this section, the term applicable block grant category means with respect to a State for a 10-fiscal-year period, either of the following as specified by the State for such period in its plan under subsection (b)(1)(A): Both of the following categories: Individuals who are 65 years of age or older. Individuals (not described in the previous subparagraph) who are eligible for medical assistance under this title on the basis of being blind or disabled. All of the following categories: Individuals who are 65 years of age or older. Individuals (not described in the previous subparagraph) who are eligible for medical assistance under this title on the basis of being blind or disabled. Individuals (not described in a previous subparagraph) who are children under 19 years of age. Individuals (not described in a previous subparagraph) for whom the amounts expended for medical assistance are subject to an increase or change in the Federal medical assistance percentage under subsection
(y)or (z)(2), respectively, of section 1905. Individuals who are not described in any of the previous subparagraphs and whose income does not exceed 60 percent of the poverty line (as defined in section 2110(c)(5)) applicable to a family of the size involved. In this section, the term block grant health care assistance means assistance for health-care-related items and medical services for block grant individuals within the applicable block grant category for the State and 10-fiscal-year period involved who are low-income individuals (as defined by the State). As a condition of receiving funds under this section, a State shall contract with an independent entity to conduct audits of its expenditures made with respect to activities funded under this section for each fiscal year for which the State elects to apply this section to ensure that such funds are used consistent with this section and shall make such audits available to the Secretary upon the request of the Secretary. .
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Sec. 201
Flexible block grant option for States
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