MOMMIES Act

I 117TH CONGRESS 1ST SESSION H. R. 3063 To amend titles XIX and XXI of the Social Security Act to improve Medicaid and the Children’s Health Insurance Program for low-income mothers. IN THE HOUSE OF REPRESENTATIVES MAY 7, 2021 Ms. PRESSLEY (for herself, Ms. BUSH, Ms. NORTON, Mr. COHEN, Ms. JACK- SON LEE, Ms. ROYBAL-ALLARD, Ms. TLAIB, Mr. WELCH, Mr. JONES, Mr. JOHNSON of Georgia, Ms. UNDERWOOD, Ms. KELLY of Illinois, Ms. MATSUI, Ms. ESCOBAR, Mr. CARSON, Mr. FOSTER, Mrs. CAROLYN B. MALONEY of New York, Ms. ADAMS, Ms. BLUNT ROCHESTER, Ms. VELA´ZQUEZ, Mrs. HAYES, Ms. CLARKE of New York, Mrs. WATSON COLEMAN, Ms. LEE of California, Ms. KAPTUR, and Ms. WILSON of Flor- ida) 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 improve Medicaid and the Children’s Health Insurance Program for low-income mothers. 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 ‘‘Maximizing Outcomes 4 for Moms through Medicaid Improvement and Enhance- 5 ment of Services Act’’ or the ‘‘MOMMIES Act’’. 6 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 3063 IH SEC. 2. ENHANCING MEDICAID AND CHIP BENEFITS FOR 1 LOW-INCOME PREGNANT INDIVIDUALS. 2 (a) EXTENDING CONTINUOUS MEDICAID AND CHIP 3 COVERAGE FOR PREGNANT AND POSTPARTUM INDIVID- 4 UALS.— 5 (1) MEDICAID.—Title XIX of the Social Secu- 6 rity Act (42 U.S.C. 1396 et seq.) is amended— 7 (A) in section 1902(e)— 8 (i) in paragraph (6), by striking ‘‘60- 9 day period (beginning on the last day of 10 her pregnancy)’’ and inserting ‘‘1-year pe- 11 riod beginning on the last day of the preg- 12 nancy (or such longer period beginning on 13 such day as the State may elect)’’; and 14 (ii) by striking paragraph (16); 15 (B) in section 1902(l)(1)(A), by striking 16 ‘‘60-day period beginning on the last day of the 17 pregnancy’’ and inserting ‘‘1-year period begin- 18 ning on the last day of the pregnancy or such 19 longer period beginning on such day as the 20 State may elect’’; 21 (C) in section 1903(v)(4)(A)(i), by striking 22 ‘‘60-day period beginning on the last day of the 23 pregnancy’’ and inserting ‘‘1-year period begin- 24 ning on the last day of the pregnancy or such 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 3063 IH longer period beginning on such day as the 1 State may elect’’; and 2 (D) in section 1905(a), in the 4th sentence 3 in the matter following paragraph (30), by 4 striking ‘‘60-day period beginning on the last 5 day of her pregnancy’’ and inserting ‘‘1-year 6 period beginning on the last day of the preg- 7 nancy, or such longer period beginning on such 8 day as the State may elect,’’. 9 (2) CHIP.—Title XXI of the Social Security 10 Act (42 U.S.C. 1397 et seq.) is amended— 11 (A) in section 2107(e)(1)(J)— 12 (i) by striking ‘‘Paragraphs (5) and 13 (16)’’; and 14 (ii) by striking ‘‘(relating to’’ and all 15 that follows through the period and insert- 16 ing ‘‘(relating to the provision of medical 17 assistance to pregnant individuals during 18 and following pregnancy under title 19 XIX).’’; and 20 (B) in section 2112— 21 (i) in subsection (d)(2)(A), by striking 22 ‘‘60-day period’’ and all that follows 23 through the semicolon and inserting ‘‘1- 24 year period beginning on the last day of 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 3063 IH the pregnancy, or such longer period begin- 1 ning on such day as the State may elect, 2 ends;’’; 3 (ii) in subsection (f)(2)— 4 (I) by striking ‘‘60-day period 5 (beginning on the last day of the 6 pregnancy)’’ and inserting ‘‘1-year pe- 7 riod beginning on the last day of the 8 pregnancy, or such longer period be- 9 ginning on such day as the State may 10 elect,’’. 11 (b) REQUIRING FULL BENEFITS FOR PREGNANT 12 AND POSTPARTUM INDIVIDUALS.— 13 (1) IN GENERAL.—Paragraph (5) of section 14 1902(e) of the Social Security Act (24 U.S.C. 15 1396a(e)) is amended to read as follows: 16 ‘‘(5) COVERAGE OF FULL BENEFITS FOR AT 17 LEAST 1 YEAR FOR PREGNANT AND POSTPARTUM IN- 18 DIVIDUALS.— 19 ‘‘(A) IN GENERAL.—Any individual who, 20 while pregnant, is eligible for and has received 21 medical assistance under the State plan ap- 22 proved under this title or a waiver of such plan 23 (including during a period of retroactive eligi- 24 bility under subsection (a)(34)) shall continue 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 3063 IH to be eligible under the plan or waiver for med- 1 ical assistance through the end of the month in 2 which the 1-year period beginning on the last 3 day of the pregnancy, or such longer period be- 4 ginning on such day as the State may elect, 5 ends, regardless of the basis for the individual’s 6 eligibility for medical assistance, including if the 7 individual’s eligibility for medical assistance is 8 on the basis of being pregnant. 9 ‘‘(B) SCOPE OF BENEFITS.—The medical 10 assistance provided for a pregnant or 11 postpartum individual described in subpara- 12 graph (A) shall— 13 ‘‘(i) include all items and services cov- 14 ered under the State plan (or waiver) that 15 are not less in amount, duration, or scope, 16 or are determined by the Secretary to be 17 substantially equivalent, to the medical as- 18 sistance available for an individual de- 19 scribed in subsection (a)(10)(A)(i); and 20 ‘‘(ii) be provided for the individual 21 while pregnant and during the 1-year pe- 22 riod that begins on the last day of the 23 pregnancy, or such longer period beginning 24 on such day as the State may elect, and 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 3063 IH ends on the last day of the month in which 1 such period ends.’’. 2 (2) CONFORMING AMENDMENT.—Section 3 1902(a)(10) of the Social Security Act (42 U.S.C. 4 1396a(a)(10)) is amended in the matter following 5 subparagraph (G) by striking ‘‘(VII) the medical as- 6 sistance’’ and all that follows through ‘‘during the 7 period described in such section,’’. 8 (c) REQUIRING COVERAGE OF ORAL HEALTH SERV- 9 ICES FOR PREGNANT AND POSTPARTUM INDIVIDUALS.— 10 (1) MEDICAID.—Section 1905 of the Social Se- 11 curity Act (42 U.S.C. 1396d) is amended— 12 (A) in subsection (a)(4)— 13 (i) by striking ‘‘; and (D)’’ and insert- 14 ing ‘‘; (D)’’; 15 (ii) by striking ‘‘; and (E)’’ and in- 16 serting ‘‘; (E)’’; 17 (iii) by striking ‘‘; and (F)’’ and in- 18 serting ‘‘; (F)’’; and 19 (iv) by inserting ‘‘; and (G) oral 20 health services for pregnant and 21 postpartum individuals (as defined in sub- 22 section (jj))’’ after ‘‘(or waiver of such 23 plan)’’; and 24 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 3063 IH (B) by adding at the end the following new 1 subsection: 2 ‘‘(jj) ORAL HEALTH SERVICES FOR PREGNANT AND 3 POSTPARTUM INDIVIDUALS.— 4 ‘‘(1) IN GENERAL.—For purposes of this title, 5 the term ‘oral health services for pregnant and 6 postpartum individuals’ means dental services nec- 7 essary to prevent disease and promote oral health, 8 restore oral structures to health and function, and 9 treat emergency conditions that are furnished to an 10 individual during pregnancy (or during the 1 year 11 period that begins on the last day of the pregnancy, 12 or such longer period beginning on such day as the 13 State may elect). 14 ‘‘(2) COVERAGE REQUIREMENTS.—To satisfy 15 the requirement to provide oral health services for 16 pregnant and postpartum individuals, a State shall, 17 at a minimum, provide coverage for preventive, diag- 18 nostic, periodontal, and restorative care consistent 19 with recommendations for comprehensive perinatal 20 oral health services and dental services during preg- 21 nancy from the American Academy of Pediatric 22 Dentistry and the American College of Obstetricians 23 and Gynecologists.’’. 24 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 3063 IH (2) CHIP.—Section 2103(c)(6)(A) of the Social 1 Security Act (42 U.S.C. 1397cc(c)(6)(A)) is amend- 2 ed by inserting ‘‘or a targeted low-income pregnant 3 individual’’ after ‘‘targeted low-income child’’. 4 (3) TECHNICAL AMENDMENT.—Section 5 2112(d)(2) of the Social Security Act (42 U.S.C. 6 1397ll(d)(2)) is amended— 7 (A) in the paragraph header, by inserting 8 ‘‘; TARGETED LOW-INCOME PREGNANT INDI- 9 VIDUAL’’ after ‘‘WOMAN’’; and 10 (B) by striking ‘‘the term ‘targeted low-in- 11 come pregnant woman’ means’’ and inserting 12 ‘‘the terms ‘targeted low-income pregnant 13 woman’ and ‘targeted low-income pregnant indi- 14 vidual’ mean’’. 15 (d) MAINTENANCE OF EFFORT.— 16 (1) MEDICAID.—Section 1902 of the Social Se- 17 curity Act (42 U.S.C. 1396a) is amended— 18 (A) in paragraph (74), by striking ‘‘sub- 19 section (gg); and’’ and inserting ‘‘subsections 20 (gg) and (tt);’’; and 21 (B) by adding at the end the following new 22 subsection: 23 ‘‘(tt) MAINTENANCE OF EFFORT RELATED TO LOW- 24 INCOME PREGNANT INDIVIDUALS.—For calendar quar- 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 3063 IH ters beginning on or after the date of enactment of this 1 subsection, and before January 1, 2025, no Federal pay- 2 ment shall be made to a State under section 1903(a) for 3 amounts expended under a State plan under this title or 4 a waiver of such plan if the State— 5 ‘‘(1) has in effect under such plan eligibility 6 standards, methodologies, or procedures (including 7 any enrollment cap or other numerical limitation on 8 enrollment, any waiting list, any procedures designed 9 to delay the consideration of applications for enroll- 10 ment, any income counting rules, or similar limita- 11 tion with respect to enrollment) for individuals de- 12 scribed in subsection (l)(1) who are eligible for med- 13 ical assistance under the State plan or waiver under 14 subsection (a)(10)(A)(ii)(IX) that are more restric- 15 tive than the eligibility standards, methodologies, or 16 procedures, respectively, for such individuals under 17 such plan or waiver that are in effect on the date 18 of the enactment of the Maximizing Outcomes for 19 Moms through Medicaid Improvement and Enhance- 20 ment of Services Act; or 21 ‘‘(2) reduces the amount, duration, or scope of 22 medical assistance available to individuals described 23 in subsection (l)(1) who are eligible for medical as- 24 sistance under such plan or waiver under subsection 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 3063 IH (a)(10)(A)(ii)(IX) from what the State provided to 1 such individuals under such plan or waiver on the 2 date of the enactment of the Maximizing Outcomes 3 for Moms through Medicaid Improvement and En- 4 hancement of Services Act.’’. 5 (2) CHIP.—Section 2112 of the Social Security 6 Act (42 U.S.C. 1397ll), as amended by subsection 7 (a), is further amended by adding at the end the fol- 8 lowing subsection: 9 ‘‘(g) MAINTENANCE OF EFFORT.—For calendar 10 quarters beginning on or after January 1, 2022, and be- 11 fore January 1, 2025, no payment may be made under 12 section 2105(a) with respect to a State child health plan 13 if the State— 14 ‘‘(1) has in effect under such plan eligibility 15 standards, methodologies, or procedures (including 16 any enrollment cap or other numerical limitation on 17 enrollment, any waiting list, any procedures designed 18 to delay the consideration of applications for enroll- 19 ment, or similar limitation with respect to enroll- 20 ment) for targeted low-income pregnant individuals 21 that are more restrictive than the eligibility stand- 22 ards, methodologies, or procedures, respectively, 23 under such plan that are in effect on the date of the 24 enactment of the Maximizing Outcomes for Moms 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 3063 IH through Medicaid Improvement and Enhancement of 1 Services Act; or 2 ‘‘(2) provides pregnancy-related assistance to 3 targeted low-income pregnant individuals under such 4 plan at a level that is less than the level at which 5 the State provides such assistance to such individ- 6 uals under such plan on the date of the enactment 7 of the Maximizing Outcomes for Moms through 8 Medicaid Improvement and Enhancement of Services 9 Act.’’. 10 (e) ENHANCED FMAP.—Section 1905 of the Social 11 Security Act (42 U.S.C. 1396d), as amended by sub- 12 section (c), is further amended— 13 (1) in subsection (b), by striking ‘‘and (ii)’’ and 14 inserting ‘‘(ii), and (kk)’’; and 15 (2) by adding at the end the following new sub- 16 section: 17 ‘‘(kk) INCREASED FMAP FOR ADDITIONAL EXPEND- 18 ITURES FOR LOW-INCOME PREGNANT INDIVIDUALS.— 19 For calendar quarters beginning on or after January 1, 20 2021, notwithstanding subsection (b), the Federal medical 21 assistance percentage for a State, with respect to the addi- 22 tional amounts expended by such State for medical assist- 23 ance under the State plan under this title or a waiver of 24 such plan that are attributable to requirements imposed 25 VerDate Sep 11 2014 06:14 Jun 22, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3063.IH H3063 pbinns on DSKJLVW7X2PROD with BILLS 12 •HR 3063 IH by the amendments made by the Maximizing Outcomes 1 for Moms through Medicaid Improvement and Enhance- 2 ment of Services Act (as determined by the Secretary), 3 shall be equal to 100 percent.’’. 4 (f) GAO STUDY AND REPORT.— 5 (1) IN GENERAL.—Not later than 1 year after 6 the date of the enactment of this Act, the Comp- 7 troller General of the United States shall submit to 8 Congress a report on the gaps in coverage for— 9 (A) pregnant individuals under the Med- 10 icaid program under title XIX of the Social Se- 11 curity Act (42 U.S.C. 1396 et seq.) and the 12 Children’s Health Insurance Program under 13 title XXI of the Soci [Text truncated for display. 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