Medicaid REACH Act

I 117TH CONGRESS 1ST SESSION H. R. 1784 To amend title XIX of the Social Security Act to enhance reporting requirements for nonexpansion States, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 11, 2021 Mr. DOGGETT (for himself, Mr. CASTRO of Texas, Mr. COOPER, Mr. CRIST, Mr. CUELLAR, Mr. DEUTCH, Ms. ESCOBAR, Mrs. FLETCHER, Mr. GREEN of Texas, Mr. HASTINGS, Ms. JACKSON LEE, Ms. JOHNSON of Texas, Ms. SEWELL, Ms. WILLIAMS of Georgia, Ms. GARCIA of Texas, Mr. THOMPSON of Mississippi, Mr. DAVID SCOTT of Georgia, Ms. WASSERMAN SCHULTZ, Mr. BUTTERFIELD, Mr. COHEN, Ms. MOORE of Wisconsin, Mr. JOHNSON of Georgia, Mr. VICENTE GONZALEZ of Texas, and Mr. VELA) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XIX of the Social Security Act to enhance reporting requirements for nonexpansion States, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Medicaid Report on 4 Expansion of Access to Coverage for Health Act’’ or the 5 ‘‘Medicaid REACH Act’’. 6 VerDate Sep 11 2014 19:47 May 03, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1784.IH H1784 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 1784 IH SEC. 2. ENHANCED REPORTING REQUIREMENTS FOR NON- 1 EXPANSION STATES. 2 Section 1903 of the Social Security Act (42 U.S.C. 3 1396b) is amended— 4 (1) in subsection (a)(7), by inserting ‘‘sub- 5 section (cc) and’’ before ‘‘section 1919(g)(3)(B)’’; 6 and 7 (2) by adding at the end the following new sub- 8 section: 9 ‘‘(cc) REDUCTION OF FEDERAL PAYMENTS FOR CER- 10 TAIN ADMINISTRATIVE COSTS OF NONEXPANSION STATES 11 THAT DO NOT SATISFY REPORTING REQUIREMENTS.— 12 ‘‘(1) IN GENERAL.— 13 ‘‘(A) REDUCTION.—In the case of a non- 14 expansion State, with respect to a fiscal year 15 (beginning with fiscal year 2022) that does not 16 satisfy the reporting requirement under para- 17 graph (2) for such fiscal year, the percentage 18 specified in subsection (a)(7) for amounts de- 19 scribed in such subsection expended by such 20 State during a calendar quarter described in 21 paragraph (4) with respect to such fiscal year, 22 subject to subparagraph (B), shall be reduced 23 by the number of percentage points specified in 24 paragraph (4) for the respective calendar quar- 25 ter. 26 VerDate Sep 11 2014 19:47 May 03, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1784.IH H1784 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 1784 IH ‘‘(B) EXCEPTION.—In the case of a non- 1 expansion State that is subject to a reduction 2 under subparagraph (A) for the calendar quar- 3 ter described in paragraph (4)(A) with respect 4 to a fiscal year, if the State satisfies the criteria 5 described in subparagraphs (A), (B), and (C) of 6 paragraph (2) (without regard to the dates 7 specified in such subparagraph (A) and (C)) be- 8 fore the beginning of a subsequent calendar 9 quarter described in paragraph (4) with respect 10 to such fiscal year, then such State shall not be 11 subject to a reduction under subparagraph (A) 12 for such subsequent calendar quarter. 13 ‘‘(2) REPORTING REQUIREMENT.—For pur- 14 poses of paragraph (1), a nonexpansion State satis- 15 fies the reporting requirement under this paragraph 16 for a fiscal year, if the nonexpansion State— 17 ‘‘(A) by not later than January 1 of such 18 year, posts on the public website of the State 19 agency administering the State plan, the infor- 20 mation described in paragraph (3) with respect 21 to such State for the previous year; 22 ‘‘(B) provides for at least a 30-day period 23 for notice and comment on such information; 24 and 25 VerDate Sep 11 2014 19:47 May 03, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1784.IH H1784 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 1784 IH ‘‘(C) by not later than March 1 of such 1 year, submits to the Secretary a complete re- 2 port including such information, comments sub- 3 mitted pursuant to subparagraph (B), and a re- 4 sponse by the State to each such comment. 5 ‘‘(3) INFORMATION DESCRIBED.—The informa- 6 tion described in this paragraph, with respect to a 7 State and year, is the following: 8 ‘‘(A) The estimated number of individuals 9 who were uninsured for at least 6 months 10 (disaggregated by race, ethnicity, gender, and 11 age-groups of 0 to 18 years of age and of 19 12 years of age to 64 years of age), as well as a 13 detailed description of the basis for the esti- 14 mates. 15 ‘‘(B) The estimated number of the individ- 16 uals estimated under subparagraph (A) in the 17 State who would be eligible for medical assist- 18 ance under the State plan if the State were to 19 make medical assistance under the State plan 20 available in accordance with section 1902(k)(1) 21 to all individuals described in section 22 1902(a)(10)(i)(VIII), and a detailed description 23 of the basis for the estimates. 24 VerDate Sep 11 2014 19:47 May 03, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1784.IH H1784 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 1784 IH ‘‘(C) A comprehensive listing of State in- 1 come eligibility criteria for all mandatory and 2 optional Medicaid eligibility groups for which 3 the State plan provides medical assistance 4 (other than with respect to individuals described 5 in clause (i)(II), (ii)(VI), or (ii)(XXII) of sec- 6 tion 1902(a)(10)(A)). 7 ‘‘(D) The total amount of hospital uncom- 8 pensated-care costs and a breakdown of the 9 source of such costs, as well as a breakdown for 10 rural and non-rural hospitals. 11 ‘‘(E) The total amount received through an 12 uncompensated care pool (as defined by the 13 Secretary). 14 ‘‘(4) PERCENTAGE DESCRIBED.—For purposes 15 of paragraph (1), a calendar quarter described in 16 this paragraph, with respect to a fiscal year, and the 17 percentage points described in this paragraph for 18 such quarter, with respect to a State, are— 19 ‘‘(A) for the calendar quarter beginning on 20 the April 1 occurring during such fiscal year, 21 0.5 percentage points; 22 ‘‘(B) for the calendar quarter beginning on 23 the July 1 occurring during such fiscal year, 24 1.0 percentage point; and 25 VerDate Sep 11 2014 19:47 May 03, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1784.IH H1784 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 1784 IH ‘‘(C) for the calendar quarter beginning on 1 the October 1 occurring during the subsequent 2 fiscal year, 1.5 percentage points. 3 ‘‘(5) PAYMENT IN CASE OF REPORTING 4 STATE.—The expenses incurred by a non-expansion 5 State, with respect to any calendar quarter with re- 6 spect to a fiscal year (beginning with 2021), for car- 7 rying out subparagraphs (A) through (C) of para- 8 graph (2) shall, for purposes of section 1903(a)(7), 9 be considered to be expenses necessary for the prop- 10 er and efficient administration of the State plan 11 under this title. 12 ‘‘(6) NONEXPANION STATE DEFINED.—For 13 purposes of this subsection, the term ‘nonexpansion 14 State’ means, with respect to a fiscal year, a State 15 that as of the first quarter of such fiscal year does 16 not provide under the State plan of such State (or 17 waiver of such plan) for making medical assistance 18 available in accordance with section 1902(k)(1) to 19 all individuals described in section 20 1902(a)(10)(i)(VIII).’’. 21 Æ VerDate Sep 11 2014 19:47 May 03, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H1784.IH H1784 pamtmann on DSKBC07HB2PROD with BILLS