Sec. 4008. Medicaid fallback coverage program for low-income adults in non-expansion States
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/bill/118/s/4773/is/section-4008·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
As soon as possible after the date of enactment of this Act the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall— directly or by contract, establish a program that offers eligible individuals the opportunity to enroll in health benefits coverage that meets the requirements described in subsection
(c)and any requirements applicable to such coverage pursuant to subsection (d); and ensure that such program is administered consistent with the requirements of section 431.10(c)(2) of title 42, Code of Federal Regulations. In this section, the term eligible individual means an individual who— is described in section 1902(a)(10)(A)(i)(VIII) of the Social Security Act ( 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) ); resides in a State that— does not expend amounts for medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) for all individuals described in such section; and did not expend amounts for medical assistance under such title for all such individuals as of the date of enactment of this Act; and would not be eligible for medical assistance under such State's plan for medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ), or a waiver of such plan, as such plan or waiver was in effect on such date. The requirements described in this subsection with respect to health benefits coverage are the following: At a minimum, the coverage meets the minimum standards required under paragraph
(5)of section 1937(b) of the Social Security Act ( 42 U.S.C. 1396u–7(b) ) for benchmark coverage described in paragraph
(1)of such section or benchmark equivalent coverage described in paragraph
(2)of such section. No premiums are imposed for the coverage, and deductibles, cost-sharing, or similar charges may only be imposed in accordance with the requirements imposed on State Medicaid plans under section 1916 of the Social Security Act ( 42 U.S.C. 1396o ). The Secretary shall specify that— any requirement applicable to the furnishing of medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) by States that have elected to make medical assistance available to individuals described in section 1902(a)(10)(A)(i)(VIII) of such title ( 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) ) that does not conflict with the requirements specified in subsection
(c)applies to the program established under this section; and other provisions of such title apply to such program. Nothing in this section shall be construed as requiring a State to make expenditures related to the program established under this section and the Secretary shall not impose any such requirement. There are appropriated to the Secretary for each fiscal year beginning with fiscal year 2025 from any funds in the Treasury not otherwise appropriated, such sums as are necessary to carry out this section.
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- 42 USC 1396u–7(b)
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Sec. 4008
Medicaid fallback coverage program for low-income adults in non-expansion States
Cite42 USC 1396u–7(b)
Cites 4Cited by 0 across 0 sources