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[[Page 891]]

     STATE CHILDREN'S HEALTH INSURANCE PROGRAM ALLOTMENTS EXTENSION

[[Page 117 STAT. 892]]

Public Law 108-74
108th Congress

                                 An Act


 
To amend title XXI of the Social Security Act to extend the availability 
    of allotments for fiscal years 1998 through 2001 under the State 
           Children's Health Insurance Program, and for other 
            purposes. <<NOTE: Aug. 15, 2003 -  [H.R. 2854]>> 

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

SECTION 1. EXTENSION OF AVAILABILITY OF SCHIP ALLOTMENTS FOR FISCAL 
            YEARS 1998 THROUGH 2001.

    (a) Extending Availability of SCHIP Allotments for Fiscal Years 1998 
Through 2001.--
            (1) Retained and redistributed allotments for fiscal years 
        1998 and 1999.--Paragraphs (2)(A)(i) and (2)(A)(ii) of section 
        2104(g) of the Social Security Act (42 U.S.C. 1397dd(g)) are 
        each amended by striking ``fiscal year 2002'' and inserting 
        ``fiscal year 2004''.
            (2) Extension and revision of retained and redistributed 
        allotments for fiscal year 2000.--
                    (A) Permitting and extending retention of portion of 
                fiscal year 2000 allotment.--Paragraph (2) of such 
                section 2104(g) is amended--
                          (i) in the heading, by striking ``and 1999'' 
                      and inserting ``through 2000''; and
                          (ii) by adding at the end of subparagraph (A) 
                      the following:
                          ``(iii) Fiscal year 2000 allotment.--Of the 
                      amounts allotted to a State pursuant to this 
                      section for fiscal year 2000 that were not 
                      expended by the State by the end of fiscal year 
                      2002, 50 percent of that amount shall remain 
                      available for expenditure by the State through the 
                      end of fiscal year 2004.''.
                    (B) Redistributed allotments.--Paragraph (1) of such 
                section 2104(g) is amended--
                          (i) in subparagraph (A), by inserting ``or for 
                      fiscal year 2000 by the end of fiscal year 2002,'' 
                      after ``fiscal year 2001,'';
                          (ii) in subparagraph (A), by striking ``1998 
                      or 1999'' and inserting ``1998, 1999, or 2000'';
                          (iii) in subparagraph (A)(i)--
                                    (I) by striking ``or'' at the end of 
                                subclause (I),
                                    (II) by striking the period at the 
                                end of subclause (II) and inserting ``; 
                                or''; and
                                    (III) by adding at the end the 
                                following new subclause:

[[Page 117 STAT. 893]]

                                    ``(III) the fiscal year 2000 
                                allotment, the amount specified in 
                                subparagraph (C)(i) (less the total of 
                                the amounts under clause (ii) for such 
                                fiscal year), multiplied by the ratio of 
                                the amount specified in subparagraph 
                                (C)(ii) for the State to the amount 
                                specified in subparagraph (C)(iii).'';
                          (iv) in subparagraph (A)(ii), by striking ``or 
                      1999'' and inserting ``, 1999, or 2000'';
                          (v) in subparagraph (B), by striking ``with 
                      respect to fiscal year 1998 or 1999'';
                          (vi) in subparagraph (B)(ii)--
                                    (I) by inserting ``with respect to 
                                fiscal year 1998, 1999, or 2000,'' after 
                                ``subsection (e),''; and
                                    (II) by striking ``2002'' and 
                                inserting ``2004''; and
                          (vii) by adding at the end the following new 
                      subparagraph:
                    ``(C) Amounts used in computing redistributions for 
                fiscal year 2000.--For purposes of subparagraph 
                (A)(i)(III)--
                          ``(i) the amount specified in this clause is 
                      the amount specified in paragraph (2)(B)(i)(I) for 
                      fiscal year 2000, less the total amount remaining 
                      available pursuant to paragraph (2)(A)(iii);
                          ``(ii) the amount specified in this clause for 
                      a State is the amount by which the State's 
                      expenditures under this title in fiscal years 
                      2000, 2001, and 2002 exceed the State's allotment 
                      for fiscal year 2000 under subsection (b); and
                          ``(iii) the amount specified in this clause is 
                      the sum, for all States entitled to a 
                      redistribution under subparagraph (A) from the 
                      allotments for fiscal year 2000, of the amounts 
                      specified in clause (ii).''.
                    (C) Conforming <<NOTE: 42 USC 
                1397dd.>> amendments.--Such section 2104(g) is further 
                amended--
                          (i) in its heading, by striking ``and 1999'' 
                      and inserting ``, 1999, and 2000''; and
                          (ii) in paragraph (3)--
                                    (I) by striking ``or fiscal year 
                                1999'' and inserting ``, fiscal year 
                                1999, or fiscal year 2000''; and
                                    (II) by striking ``or November 30, 
                                2001'' and inserting ``November 30, 
                                2001, or November 30, 2002'', 
                                respectively.
            (3) Extension and revision of retained and redistributed 
        allotments for fiscal year 2001.--
                    (A) Permitting and extending retention of portion of 
                fiscal year 2001 allotment.--Paragraph (2) of such 
                section 2104(g), as amended in paragraph (2)(A)(ii), is 
                further amended--
                          (i) in the heading, by striking ``2000'' and 
                      inserting ``2001''; and
                          (ii) by adding at the end of subparagraph (A) 
                      the following:
                          ``(iv) Fiscal year 2001 allotment.--Of the 
                      amounts allotted to a State pursuant to this 
                      section for fiscal year 2001 that were not 
                      expended by the

[[Page 117 STAT. 894]]

                      State by the end of fiscal year 2003, 50 percent 
                      of that amount shall remain available for 
                      expenditure by the State through the end of fiscal 
                      year 2005.''.
                    (B) Redistributed allotments.--Paragraph <<NOTE: 42 
                USC 1397dd.>> (1) of such section 2104(g), as amended in 
                paragraph (2)(B), is further amended--
                          (i) in subparagraph (A), by inserting ``or for 
                      fiscal year 2001 by the end of fiscal year 2003,'' 
                      after ``fiscal year 2002,'';
                          (ii) in subparagraph (A), by striking ``1999, 
                      or 2000'' and inserting ``1999, 2000, or 2001'';
                          (iii) in subparagraph (A)(i)--
                                    (I) by striking ``or'' at the end of 
                                subclause (II),
                                    (II) by striking the period at the 
                                end of subclause (III) and inserting ``; 
                                or''; and
                                    (III) by adding at the end the 
                                following new subclause:
                                    ``(IV) the fiscal year 2001 
                                allotment, the amount specified in 
                                subparagraph (D)(i) (less the total of 
                                the amounts under clause (ii) for such 
                                fiscal year), multiplied by the ratio of 
                                the amount specified in subparagraph 
                                (D)(ii) for the State to the amount 
                                specified in subparagraph (D)(iii).'';
                          (iv) in subparagraph (A)(ii), by striking ``or 
                      2000'' and inserting ``2000, or 2001'';
                          (v) in subparagraph (B)--
                                    (I) by striking ``and'' at the end 
                                of clause (ii);
                                    (II) by redesignating clause (iii) 
                                as clause (iv); and
                                    (III) by inserting after clause (ii) 
                                the following new clause:
                          ``(iii) notwithstanding subsection (e), with 
                      respect to fiscal year 2001, shall remain 
                      available for expenditure by the State through the 
                      end of fiscal year 2005; and''; and
                          (vi) by adding at the end the following new 
                      subparagraph:
                    ``(D) Amounts used in computing redistributions for 
                fiscal year 2001.--For purposes of subparagraph 
                (A)(i)(IV)--
                          ``(i) the amount specified in this clause is 
                      the amount specified in paragraph (2)(B)(i)(I) for 
                      fiscal year 2001, less the total amount remaining 
                      available pursuant to paragraph (2)(A)(iv);
                          ``(ii) the amount specified in this clause for 
                      a State is the amount by which the State's 
                      expenditures under this title in fiscal years 
                      2001, 2002, and 2003 exceed the State's allotment 
                      for fiscal year 2001 under subsection (b); and
                          ``(iii) the amount specified in this clause is 
                      the sum, for all States entitled to a 
                      redistribution under subparagraph (A) from the 
                      allotments for fiscal year 2001, of the amounts 
                      specified in clause (ii).''.
                    (C) Conforming amendments.--Such section 2104(g) is 
                further amended--

[[Page 117 STAT. 895]]

                          (i) in its heading, by striking ``and 2000'' 
                      and inserting ``2000, and 2001''; and
                          (ii) in paragraph (3)--
                                    (I) by striking ``or fiscal year 
                                2000'' and inserting ``fiscal year 2000, 
                                or fiscal year 2001''; and
                                    (II) by striking ``or November 30, 
                                2002,'' and inserting ``November 30, 
                                2002, or November 30, 2003,'', 
                                respectively.
            (4) Effective <<NOTE: 42 USC 1397dd note.>> date.--This 
        subsection, and the amendments made by this subsection, shall be 
        effective as if this subsection had been enacted on September 
        30, 2002, and amounts under title XXI of the Social Security Act 
        (42 U.S.C. 1397aa et seq.) from allotments for fiscal years 1998 
        through 2000 are available for expenditure on and after October 
        1, 2002, under the amendments made by this subsection as if this 
        subsection had been enacted on September 30, 2002.

    (b) Authority for Qualifying States To Use Portion of SCHIP Funds 
for Medicaid Expenditures.--Section 2105 of the Social Security Act (42 
U.S.C. 1397ee) is amended by adding at the end the following:
    ``(g) Authority for Qualifying States To Use Certain Funds for 
Medicaid Expenditures.--
            ``(1) State option.--
                    ``(A) In general.--Notwithstanding any other 
                provision of law, a qualifying State (as defined in 
                paragraph (2)) may elect to use not more than 20 percent 
                of any allotment under section 2104 for fiscal year 
                1998, 1999, 2000, or 2001 (insofar as it is available 
                under subsections (e) and (g) of such section) for 
                payments under title XIX in accordance with subparagraph 
                (B), instead of for expenditures under this title.
                    ``(B) Payments to states.--
                          ``(i) In general.--In the case of a qualifying 
                      State that has elected the option described in 
                      subparagraph (A), subject to the availability of 
                      funds under such subparagraph with respect to the 
                      State, the Secretary shall pay the State an amount 
                      each quarter equal to the additional amount that 
                      would have been paid to the State under title XIX 
                      with respect to expenditures described in clause 
                      (ii) if the enhanced FMAP (as determined under 
                      subsection (b)) had been substituted for the 
                      Federal medical assistance percentage (as defined 
                      in section 1905(b)).
                          ``(ii) Expenditures described.--For purposes 
                      of this subparagraph, the expenditures described 
                      in this clause are expenditures, made after the 
                      date of the enactment of this subsection and 
                      during the period in which funds are available to 
                      the qualifying State for use under subparagraph 
                      (A), for medical assistance under title XIX to 
                      individuals who have not attained age 19 and whose 
                      family income exceeds 150 percent of the poverty 
                      line.
                          ``(iii) No impact on determination of budget 
                      neutrality for waivers.--In the case of a 
                      qualifying State that uses amounts paid under this 
                      subsection for expenditures described in clause 
                      (ii) that are

[[Page 117 STAT. 896]]

                      incurred under a waiver approved for the State, 
                      any budget neutrality determinations with respect 
                      to such waiver shall be determined without regard 
                      to such amounts paid.
            ``(2) Qualifying state.--In this subsection, the term 
        `qualifying State' means a State that, on and after April 15, 
        1997, has an income eligibility standard that is at least 185 
        percent of the poverty line with respect to any 1 or more 
        categories of children (other than infants) who are eligible for 
        medical assistance under section 1902(a)(10)(A) or, in the case 
        of a State that has a statewide waiver in effect under section 
        1115 with respect to title XIX that was first implemented on 
        July 1, 1995, has an income eligibility standard under such 
        waiver for children that is at least 185 percent of the poverty 
        line, or, in the case of a State that has a statewide waiver in 
        effect under section 1115 with respect to title XIX that was 
        first implemented on January 1, 1994, has an income eligibility 
        standard under such waiver for children who lack health 
        insurance that is at least 185 percent of the poverty line.
            ``(3) Construction.--Nothing in paragraphs (1) and (2) shall 
        be construed as modifying the requirements applicable to States 
        implementing State child health plans under this title.''.

SEC. 2. TECHNICAL CORRECTION.

    (a) Temporary Increase of the Medicaid FMAP.--Subparagraphs (A) and 
(B) of section 401(a)(6) of the Jobs and Growth Tax Relief 
Reconciliation Act of 2003 (Public Law 108-27) <<NOTE: Ante, p. 765.>>  
are amended to read as follows:
                    ``(A) In general.--Subject to subparagraph (B), a 
                State is eligible for an increase in its FMAP under 
                paragraph (3) or an increase in a cap amount under 
                paragraph (4) for any date after September 2, 2003, only 
                if the eligibility under its State plan under title XIX 
                of the Social Security Act (including any waiver under 
                such title or under section 1115 of such Act (42 U.S.C. 
                1315)) applied as of such date is no more restrictive 

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