H.R. 5552 (ih) To amend title 38, United States Code, to enhance outreach programs [Introduced in House] ...

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106th CONGRESS
  2d Session
                                H. R. 5551

     To provide access to affordable health care for all Americans.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 25, 2000

Mr. Dingell (for himself, Mr. Waxman, Mr. Green of Texas, Mr. Pallone, 
Mr. Brown of Ohio, Mr. Stark, and Mr. Conyers) introduced the following 
         bill; which was referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
     To provide access to affordable health care for all Americans.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Basic Access to 
Secure Health Insurance Coverage Health Plan (BASIC Health Plan) Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
     TITLE I--AFFORDABLE HEALTH INSURANCE FOR PARENTS AND CHILDREN

Sec. 101. Coverage of parents and children under the medicaid program 
                            and CHIP.
Sec. 102. Coverage of legal immigrants under the medicaid program.
Sec. 103. Coverage of children through age 20 under the medicaid 
                            program and title XXI.
Sec. 104. Application of simplified title XXI procedures under the 
                            medicaid program.
Sec. 105. Expansion of basic services required for benchmark-equivalent 
                            coverage under CHIP.
Sec. 106. Elimination of 100 hour rule and other AFDC-related 
                            eligibility restrictions.
Sec. 107. Limitations on conflicts of interest.
Sec. 108. Demonstration programs to improve medicaid and CHIP outreach 
                            to homeless individuals and families.
         TITLE II--ACCESS TO AFFORDABLE CARE FOR ALL AMERICANS

Sec. 201. Extension of coverage to single individuals.
                    TITLE III--ADDITIONAL PROVISIONS

Sec. 301. Availability of unsubsidized coverage.

     TITLE I--AFFORDABLE HEALTH INSURANCE FOR PARENTS AND CHILDREN

SEC. 101. COVERAGE OF PARENTS AND CHILDREN UNDER THE MEDICAID PROGRAM 
              AND CHIP.

    (a) Requirement To Provide Coverage for Medicaid Participation.--
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is 
amended--
            (1) in paragraph (64), by striking ``and'' at the end;
            (2) in paragraph (65), by striking the period and inserting 
        a semicolon; and
            (3) by inserting after paragraph (65), the following new 
        paragraph:
            ``(66) provide that the State will provide medical 
        assistance under paragraph (10)(A)(ii)((XVIII) or health 
        coverage under section 2111 for families described in 
        subsection (k)(1) in accordance with the conditions described 
        in subsection (k)(2).''.
    (b) Coverage Under Medicaid.--
            (1) In general.--Section 1902(a)(10)(A)(ii) of the Social 
        Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
                    (A) by striking ``or'' at the end of subclause 
                (XVI);
                    (B) by adding ``or'' at the end of subclause 
                (XVII); and
                    (C) by adding at the end the following new 
                subclause:
                                    ``(XVIII) who are families 
                                described in subsection (k)(1);''.
            (2) Conditions for coverage.--Section 1902 of such Act is 
        further amended by inserting after subsection (j) the following 
        new subsection:
    ``(k)(1) The families described in this paragraph are families 
(consisting of individuals who are under 21 years of age and parents of 
such individuals)--
            ``(A) who are not otherwise eligible for medical assistance 
        under subsection(a)(10)(A); and
            ``(B) whose income is at least--
                    ``(i) with respect to fiscal year 2001, 200 percent 
                of the poverty line; and
                    ``(ii) with respect to each subsequent fiscal year, 
                300 percent of the poverty line.
    ``(2) The conditions described in this paragraph are as follows:
            ``(A) The State provides that families described in 
        paragraph (1) remain eligible for medical assistance for a 
        period (of at least 12 months) following the eligibility 
        determination required under such paragraph.
            ``(B) The State has a State child health plan under title 
        XXI which (whether implemented under such title or under this 
        title) does not limit the acceptance of applications for 
        families described in paragraph (1), does not use a waiting 
        list for such families who meet eligibility standards to 
        qualify for assistance (under this title or under title XXI), 
        and provides benefits to all families in the State who apply 
        for and meet eligibility standards.
            ``(C) The State does not cover families described in 
        paragraph (1) with higher family income without covering 
        families with a lower family income.
    ``(3) In the case of a parent in a family described in paragraph 
(1) who is also the parent of a child who is eligible and enrolled for 
medical assistance under this title or for child health assistance 
under title XXI, the State may elect (on a uniform basis) to enroll the 
parent in the same program as the child. If such a parent has children 
enrolled under both programs, the State may elect (on such basis) which 
program to enroll the parent in.''.
    ``(4) In this subsection, the term `parent' has the meaning given 
the term `caretaker' for purposes of carrying out section 1931.''.
            (3) Application of presumptive eligibility provisions.--
        Section 1920A of such Act (42 U.S.C. 1396r-1a) is amended by 
        adding at the end the following new subsection:
    ``(e) In accordance with regulations, a State shall apply the 
previous provisions of this section to provide for a period of 
presumptive eligibility for medical assistance for a parent of a child 
with respect to whom such a period is provided under this section.''.
            (4) Conforming amendments.--
                    (A) Eligibility categories.--Section 1905(a) of 
                such Act (42 U.S.C. 1396d(a)) is amended in the matter 
                before paragraph (1)--
                            (i) by striking ``or'' at the end of clause 
                        (x);
                            (ii) by inserting ``or'' at the end of 
                        clause (xi); and
                            (iii) by inserting after clause (xi) the 
                        following new clause:
            ``(xii) who are families described in section 
        1902(k)(1),''.
                    (B) Income limitations.--Section 1903(f)(4) of such 
                Act (42 U.S.C. 1396b(f)(4)) is amended by inserting 
                ``1902(a)(10)(A)(ii)(XVIII),'' after 
                ``1902(a)(10)(A)(ii)(XVI),''.
    (c) Coverage Under CHIP.--
            (1) In general.--Title XXI of such Act (42 U.S.C. 1397aa et 
        seq.) is amended by adding at the end the following new 
        section:

``SEC. 2111. COVERAGE OF FAMILIES.

    ``(a) In General.--Notwithstanding any other provision of this 
title, with respect to a State that does not provide medical assistance 
under section 1902(a)(10)(A)(ii)(XVIII) for families described in 
section 1902(k)(1), the State shall provide health coverage under this 
title for such families through an amendment to its State child health 
plan under section 2102 in accordance with this section and the 
conditions described in section 1902(k)(2).
    ``(b) Definitions.--For purposes of this section:
            ``(1) Health coverage.--The term `health coverage' has the 
        meaning given the term child health assistance in section 
        2110(a) as if any reference to targeted low-income children 
        were a reference to families described in section 1902(k)(1).
            ``(2) Treatment of pregnant women as parents.--A State 
        child health plan shall treat a pregnant woman who is not 
        otherwise a parent as a parent in a family described in section 
        1902(k)(1) for purposes of this section.
    ``(c) References to Terms and Special Rules.--In the case of, and 
with respect to, a State providing health coverage for families 
described in section 1902(k)(1) under subsection (a), the following 
special rules apply:
            ``(1) Any reference in this title (other than subsection 
        (b)) to a targeted low-income child is deemed to include a 
        reference to a family described in section 1902(k)(1).
            ``(2) Any such reference to child health assistance with 
        respect to such families is deemed a reference to health 
        coverage (as defined in subsection (b)(1)).
            ``(3) In applying section 2103(e)(3)(B) in the case of a 
        family provided coverage under this section, the limitation on 
        total annual aggregate cost-sharing shall be applied to the 
        entire family.
            ``(4) Section 1905(u)(2)(A) shall be applied as if any 
        reference to optional targeted low-income children includes a 
        reference to a family described in section 1902(k)(1).''.
            (2) Enhanced matching funds.--
                    (A) In general.--Section 1905 of such Act (42 
                U.S.C. 1396d) is amended--
                            (i) in the fourth sentence of subsection 
                        (b), by striking ``or subsection (u)(3)'' and 
                        inserting ``, (u)(3), or (u)(4)''; and
                            (ii) in subsection (u)--
                                    (I) by redesignating paragraph (4) 
                                as paragraph (5), and
                                    (II) by inserting after paragraph 
                                (3) the following new paragraph:
    ``(4) For purposes of subsection (b) and section 2105(a)(1):
            ``(A) Families.--The expenditures described in this 
        subparagraph are the following:
                    ``(i) Families.--Expenditures for medical 
                assistance made available under section 
                1902(a)(10)(A)(ii)(XVIII) for families described in 
                section 1902(k)(1), the income of which exceeds the 
                income level applicable under such section 1931 to a 
                family of the size involved as of January 1, 2000.
                    ``(ii) Certain pregnant women.--Expenditures for 
                medical assistance for pregnant women under section 
                1902(l)(1)(A) in a family the income of which exceeds 
                the income level applicable under section 1902(l)(2)(A) 
                to a family of the size involved as of January 1, 
                2000.''.
                    (B) Post fy 2006 expansion of availability of 
                enhanced match under medicaid for pre-chip 
                expansions.--Effective October 1, 2005, paragraph (4) 
                of section 1905(u) of such Act (42 U.S.C. 1396d(u)), as 
                inserted by subparagraph (A)(ii)(II), is amended--
                            (i) by amending clause (ii) of subparagraph 
                        (A) to read as follows:
                    ``(ii) Certain pregnant women.--Expenditures for 
                medical assistance for pregnant women under section 
                1902(l)(1)(A) in a family the income of which exceeds 
                the 133 percent of the income official poverty line.''; 
                and
                            (ii) by adding at the end the following new 
                        subparagraphs:
            ``(B) Parents with income above 100 percent of poverty but 
        below january 1, 2000 income level.--The expenditures described 
        in this subparagraph are expenditures for medical assistance 
        made available for any parents described in section 
        1902(a)(10)(A)(i)(VIII), whose income exceeds 100 percent of 
        the income official poverty line applicable to a family of the 
        size involved but does not exceed the applicable income level 
        established under this title (under section 1931 or otherwise) 
        for a parent in a family of the size involved as of January 1, 
        2000.
            ``(C) Children in families with income above medicaid 
        mandatory level not previously described.--The expenditures 
        described in this subparagraph are expenditures (other than 
        expenditures described in paragraph (2) or (3)) for medical 
        assistance made available to any child who is eligible for 
        assistance under section 1902(a)(10)(A) and the income of whose 
        family exceeds the minimum income level required under 
        subsection 1902(l)(2) for a child of the age involved (treating 
any child who is 19 or 20 years of age as being 18 years of age).''.
            (3) Transformation of chip into permanent entitlement.--
                    (A) Elimination of allotments and capped 
                appropriations.--Section 2104 of the Social Security 
                Act (42 U.S.C. 1397dd) is amended to read as follows:

``SEC. 2104. APPROPRIATION.

    ``For the purpose of making payments to States under this title, 
there is appropriated, out of any money in the Treasury not otherwise 
appropriated, such sums as may be necessary for fiscal year 2001 and 
each fiscal year thereafter.''.
                    (B) Conforming amendments.--
                            (i) Section 1905 of the Social Security Act 
                        (42 U.S.C. 1396d) is amended--
                                    (I) in subsection (b), in the 
                                fourth sentence, by striking ``, and 
                                that do not exceed the amount of the 
                                State's allotment under section 2104 
                                (not taking into account reductions 
                                under section 2104(d)(2)) for the 
                                fiscal year reduced by the amount of 
                                any payments made under section 2105 to 
                                the State from such allotment for such 
                                fiscal year''; and
                                    (II) by striking subsection (u)(1) 
                                and inserting the following:
    ``(u)(1) The condition described in this paragraph for a State plan 
is that the State is complying with the requirement of section 
2105(d)(1).''.
                            (ii) Section 2105(a) of such Act (42 U.S.C. 
                        1397ee(a)) is amended by striking ``from its 
                        allotment under section 2104 (taking into 
                        account any adjustment under section 
                        2104(d)),''.
            (4) No cost-sharing for pregnancy-related benefits.--
        Section 2103(e)(2) of such Act (42 U.S.C. 1397cc(e)(2)) is 
        amended--
                    (A) in the heading, by inserting ``and pregnancy-
                related services'' after ``preventive services''; and
                    (B) by inserting before the period at the end the 
                following: ``and for pregnancy-related services''.
            (5) Conforming amendment relating to no waiting period for 
        certain women.--Section 2102(b)(1)(B) of such Act (42 U.S.C. 
        1397bb(b)(1)(B)) is amended--

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