Sec. 203. State option to provide 12 months of postpartum Medicaid eligibility

949 words·~4 min read·/bill/116/s/4521/is/section-203

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Title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) is amended— in section 1902(l)(1)(A), by inserting (or, at the option of the State, 365-day period) after 60-day period ; in section 1902(e)(6), by inserting (or, at the option of the State, 365-day period) after 60-day period ; in section 1903(v)(4)(A)(i), by inserting (or, at the option of the State, 365-day period) after 60-day period ; and in section 1905(a), in the 4th sentence in the matter following paragraph (30), by inserting (or, at the option of the State, 365-day period) after 60-day period .

Section 2112 of the Social Security Act ( 42 U.S.C. 1397ll ) is amended by inserting (or, at the option of the State, 365-day period) after 60-day period each place it appears. Paragraph

(5)of section 1902(e) of the Social Security Act ( 24 U.S.C. 1396a(e) ) is amended to read as follows: Any woman who is eligible for medical assistance under the State plan or a waiver of such plan and who is, or who while so eligible becomes, pregnant, shall continue to be eligible under the plan or waiver for medical assistance through the end of the month in which the 60-day period (or, at the option of the State, 365-day period) (beginning on the last day of her pregnancy) ends, regardless of the basis for the woman's eligibility for medical assistance, including if the woman's eligibility for medical assistance is on the basis of being pregnant. . 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 2107(e)(1) of the Social Security Act ( 42 U.S.C. 1397gg(e)(1) ) is amended— by redesignating subparagraphs

(H)through

(S)as subparagraphs

(I)through (T), respectively; and by inserting after subparagraph (G), the following: Section 1902(e)(5) (requiring 60-day (or, at the option of the State, 365-day) continuous coverage for pregnant and postpartum women). . 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 (qq); ; and by adding at the end the following new subsection: For calendar quarters beginning on or after the effective date described in section 204(d) of the Health Care Improvement Act of 2020 , 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 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 this subsection; 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 this subsection. . 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 the effective date described in section 204(d) of the Health Care Improvement Act of 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 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 this subsection; 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 this subsection. . Except as provided under paragraph (2), the amendments made by subsections

(a)and

(b)shall take effect on (and the effective date described in this subsection shall be) the first day of the calendar quarter during which the last day of the emergency period described in section 1135(g)(1)(B) of the Social Security Act ( 42 U.S.C. 1320b–5(g)(1)(B) ) occurs. In the case of a State plan under title XIX or State child health plan under title XXI of the Social Security Act ( 42 U.S.C. 1396 et seq.; 42 U.S.C. 1397aa et seq.) which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the respective plan to meet the additional requirement imposed by the amendments made by subsection

(a)or (b), respectively, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such applicable additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.

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