[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5961 Introduced in House (IH)]
110th CONGRESS
2d Session
H. R. 5961
To amend titles XIX and XXI of the Social Security Act to place a
general eligibility ceiling of 250 percent of the poverty level on
gross income for eligibility for benefits under Medicaid and SCHIP.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 5, 2008
Mr. Gingrey (for himself, Mr. Feeney, Mr. Walden of Oregon, Mr. Herger,
Mr. Bartlett of Maryland, Mr. Kingston, Mr. Broun of Georgia, Mr.
Miller of Florida, Mr. Wilson of South Carolina, Mr. Price of Georgia,
Mr. Westmoreland, and Mr. Deal of Georgia) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend titles XIX and XXI of the Social Security Act to place a
general eligibility ceiling of 250 percent of the poverty level on
gross income for eligibility for benefits under Medicaid and SCHIP.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicaid and SCHIP Abuse Prevention
Act of 2008''.
SEC. 2. SCHIP AND MEDICAID GROSS INCOME ELIGIBILITY CEILING.
(a) Application of SCHIP Eligibility Ceiling.--
(1) In general.--Section 2110 of the Social Security Act
(42 U.S.C. 1397jj) is amended--
(A) in subsection (b)(1)--
(i) by striking ``and'' at the end of
subparagraph (B);
(ii) by striking the period at the end of
subparagraph (C) and inserting ``; and''; and
(iii) by adding at the end the following
new subparagraph:
``(D) whose gross family income (as defined in
subsection (c)(9)) does not exceed 250 percent of the
poverty line.''; and
(B) in subsection (c), by adding at the end the
following new paragraph:
``(9) Gross family income.--
``(A) In general.--Subject to subparagraph (B), the
term `gross family income' means, with respect to an
individual, gross income (as defined by the Secretary
in regulations) for the members of the individual's
family. For purposes of the previous sentence, in
defining `gross income' the Secretary shall, to the
maximum extent practicable, include income from
whatever source, other than amounts deducted under
section 62(a)(1) of the Internal Revenue Code of 1986.
``(B) Income disregards authorized.--A State may
provide, through a State plan amendment and with the
approval of the Secretary, for the disregard from gross
family income of one or more amounts so long as the
total amount of such disregards for a family does not
exceed $250 per month, or $3,000 per year.''.
(2) Denial of federal matching payments for state schip
expenditures for individuals with gross family income above 250
percent of the poverty line.--Section 2105(c) of the Social
Security Act (42 U.S.C. 1397ee(c)) is amended by adding at the
end the following new paragraph:
``(8) Denial of payments for expenditures for child health
assistance for individuals whose gross family income exceeds
250 percent of the poverty line.--No payment may be made under
this section, for any expenditures for providing child health
assistance or health benefits coverage under a State child
health plan under this title, including under a waiver under
section 1115, with respect to an individual whose gross family
income (as defined in section 2110(c)(9)) exceeds 250 percent
of the poverty line.''.
(3) Conforming amendment to maintenance of effort.--Section
2105(d)(1) of such Act (42 U.S.C. 1397ee(d)(1)) is amended by
inserting before the period at the end the following: ``,
unless such income standards were adopted in order to comply
with the requirements of section 1939''.
(b) Medicaid Gross Income Eligibility Ceiling.--
(1) In general.--Title XIX of the Social Security Act is
amended by redesignating section 1939 as section 1940 and by
inserting after section 1940 the following new section:
``SEC. 1939. INCOME ELIGIBILITY LIMITATION.
``Notwithstanding any other provision of this title, no individual
with gross family income (as defined in section 2110(c)(9)) that
exceeds 250 percent of the poverty line shall be eligible to receive
medical assistance under a State plan under this title, including under
a waiver under section 1915 or 1115.''.
(2) Denial of federal matching payments for state
expenditures for medical assistance for individuals whose gross
family income exceeds 250 percent of the federal poverty
line.--Section 1903(i) of such Act (42 U.S.C. 1396b(i)) is
amended--
(A) in paragraph (22) by striking ``or'' at the
end;
(B) in paragraph (23) by striking the period at the
end and inserting ``; or''; and
(C) by inserting after paragraph (23) the following
new paragraph:
``(24) if a State fails to comply with the provisions of
section 1939, with respect to amounts expended by a State for
medical assistance for individuals to whom the income
eligibility limitation under such section applies.''.
(3) Medicaid state plan requirements.--Section 1902(a) of
such Act (42 U.S.C. 1396a(a)) is amended--
(A) in paragraph (69) by striking ``and'' at the
end;
(B) in paragraph (70) by striking the period at the
end and inserting ``; and''; and
(C) by inserting after paragraph (70) the following
new paragraph:
``(71) provide that the State complies with the
requirements of section 1939.''.
(4) Conforming amendment relating to income eligibility.--
Section 1903(f)(1)(A) of such Act (42 U.S.C. 1396b(f)(1)(A)) is
amended by inserting before the period at the end the
following: ``, if such payments are not otherwise prohibited
under subsection (i)(24),''.
(c) Effective Date; Transition.--
(1) In general.--Subject to paragraph (2), the amendments
made by this section shall apply to payments made for items and
services furnished on or after the first day of the first
calendar quarter beginning more than 90 days after the date of
the enactment of this Act.
(2) Transition.--The amendments made by--
(A)(i) subsection (a)(1) shall not apply to an
individual who was receiving, or was determined
eligible to receive, child health assistance or health
benefits coverage under a State child health plan under
title XXI of the Social Security Act, including under a
waiver under section 1115 of such Act, as of the day
before the date of the enactment of this Act, until
such date as the individual is determined ineligible
using income standards or methodologies in place as of
the day before the date of the enactment of this Act;
and
(ii) subsection (a)(2) shall not apply to payment
for items and services furnished to an individual
described in clause (i);
(B)(i) subsection (b)(1) shall not apply to an
individual who was receiving, or was determined
eligible to receive, medical assistance or health
benefits coverage under a State plan under title XIX of
the Social Security Act, including under a waiver under
section 1115 of such Act, as of the day before the date
of the enactment of this Act, until such date as the
individual is determined ineligible using income
standards or methodologies in place as of the day
before the date of the enactment of this Act; and
(ii) subsection (b)(2) shall not apply to payment
for items and services furnished to an individual
described in clause (i).
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