Sec. 205. State flexibility to use administrative simplification policies for enrollment
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/bill/116/s/4521/is/section-205A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1902(e)(13) of the Social Security Act ( 42 U.S.C. 1396a(e)(13) ) is amended by striking subparagraph (I). Section 1902(e)(13)(A) of the Social Security Act ( 42 U.S.C. 1396a(e)(13)(A) ) is amended by adding at the end the following new clause: At the option of the State, the State may apply the provisions of this paragraph with respect to determining eligibility under this title for an eligible individual (as defined in subclause (II)). In applying this paragraph in the case of a State making such an option, any reference in this paragraph to a child with respect to this title (other than a reference to child health assistance) shall be deemed to be a reference to an eligible individual.
In this clause, the term eligible individual means— any individual (other than a child) whose income eligibility under the State plan or under a waiver of the plan for medical assistance is determined under paragraph (14); and an individual included in any other group of individuals the Secretary determines appropriate. . Section 1902(e)(13)(D)(i) of the Social Security Act ( 42 U.S.C. 1396a(e)(13)(D)(i) ) is amended by inserting by using medical assistance to access care, after through electronic signature, .
The Secretary of Health and Human Services, by grant, contract, or interagency agency, shall conduct a study to identify options for, and barriers to, States automatically enrolling individuals who, on the basis of data and information from income tax returns and other sources, are likely to be eligible for medical assistance under the State Medicaid plan established under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) (or a waiver of such plan) or for child health assistance (or, if applicable, pregnancy-related assistance) under the State child health plan established under title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq.
) (or a waiver of such plan), and would not be required to pay a premium for enrollment in such a plan or waiver. Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall submit a report to Congress on the results of the study conducted under subsection (a). The report shall include the following: An analysis of the financial, regulatory, and legislative barriers that limit the ability of States to implement automatic enrollment for individuals described in subsection (a).
An analysis of the extent to which State implementation of automatic enrollment for such individuals would reduce the number of uninsured individuals in each State. Recommendations for administrative and legislative actions that, if taken, would eliminate the barriers identified under subparagraph
(A)and allow States to elect to automatically enroll individuals described in subsection
(a)in the State Medicaid plan established under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) (or a waiver of such plan) or for child health assistance (or, if applicable, pregnancy-related assistance) under the State child health plan established under title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq.) (or a waiver of such plan).
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Sec. 205
State flexibility to use administrative simplification policies for enrollment
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