Medicaid Provisions and TANF Extenders Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 260 To extend the Medicaid Money Follows the Person Rebalancing demonstra- tion, to extend protection for Medicaid recipients of home and commu- nity-based services against spousal impoverishment, to extend the Tem- porary Assistance for Needy Families program, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JANUARY 4, 2019 Mr. PALLONE (for himself, Mr. WALDEN, and Mr. NEAL) introduced the fol- lowing bill; which was referred to the Committee on Ways and Means, and in addition to the Committees on Energy and Commerce, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned A BILL To extend the Medicaid Money Follows the Person Rebal- ancing demonstration, to extend protection for Medicaid recipients of home and community-based services against spousal impoverishment, to extend the Temporary Assist- ance for Needy Families program, and for other pur- poses. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 260 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Medicaid Provisions 2 and TANF Extenders Act of 2019’’. 3 TITLE I—MEDICAID EXTENDERS 4 SEC. 101. EXTENSION OF MONEY FOLLOWS THE PERSON 5 REBALANCING DEMONSTRATION. 6 (a) GENERAL FUNDING.—Section 6071(h) of the 7 Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) is 8 amended— 9 (1) in paragraph (1)— 10 (A) in subparagraph (D), by striking 11 ‘‘and’’ after the semicolon; 12 (B) in subparagraph (E), by striking the 13 period at the end and inserting ‘‘; and’’; and 14 (C) by adding at the end the following: 15 ‘‘(F) subject to paragraph (3), 16 $112,000,000 for fiscal year 2019.’’; 17 (2) in paragraph (2)— 18 (A) by striking ‘‘Amounts made’’ and in- 19 serting ‘‘Subject to paragraph (3), amounts 20 made’’; and 21 (B) by striking ‘‘September 30, 2016’’ and 22 inserting ‘‘September 30, 2021’’; and 23 (3) by adding at the end the following new 24 paragraph: 25 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 260 IH ‘‘(3) SPECIAL RULE FOR FY 2019.—Funds ap- 1 propriated under paragraph (1)(F) shall be made 2 available for grants to States only if such States 3 have an approved MFP demonstration project under 4 this section as of December 31, 2018.’’. 5 (b) FUNDING FOR QUALITY ASSURANCE AND IM- 6 PROVEMENT; TECHNICAL ASSISTANCE; OVERSIGHT.— 7 Section 6071(f) of the Deficit Reduction Act of 2005 (42 8 U.S.C. 1396a note) is amended by striking paragraph (2) 9 and inserting the following: 10 ‘‘(2) FUNDING.—From the amounts appro- 11 priated under subsection (h)(1)(F) for fiscal year 12 2019, $500,000 shall be available to the Secretary 13 for such fiscal year to carry out this subsection.’’. 14 (c) TECHNICAL AMENDMENT.—Section 6071(b) of 15 the Deficit Reduction Act of 2005 (42 U.S.C. 1396a note) 16 is amended by adding at the end the following: 17 ‘‘(10) SECRETARY.—The term ‘Secretary’ 18 means the Secretary of Health and Human Serv- 19 ices.’’. 20 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 260 IH SEC. 102. EXTENSION OF PROTECTION FOR MEDICAID RE- 1 CIPIENTS OF HOME AND COMMUNITY-BASED 2 SERVICES AGAINST SPOUSAL IMPOVERISH- 3 MENT. 4 (a) IN GENERAL.—Section 2404 of Public Law 111– 5 148 (42 U.S.C. 1396r–5 note) is amended by striking ‘‘the 6 5-year period that begins on January 1, 2014,’’ and in- 7 serting ‘‘the period beginning on January 1, 2014, and 8 ending on March 31, 2019,’’. 9 (b) RULE OF CONSTRUCTION.— 10 (1) PROTECTING STATE SPOUSAL INCOME AND 11 ASSET DISREGARD FLEXIBILITY UNDER WAIVERS 12 AND PLAN AMENDMENTS.—Nothing in section 2404 13 of Public Law 111–148 (42 U.S.C. 1396r–5 note) or 14 section 1924 of the Social Security Act (42 U.S.C. 15 1396r–5) shall be construed as prohibiting a State 16 from disregarding an individual’s spousal income 17 and assets under a State waiver or plan amendment 18 described in paragraph (2) for purposes of making 19 determinations of eligibility for home and commu- 20 nity-based services or home and community-based 21 attendant services and supports under such waiver 22 or plan amendment. 23 (2) STATE WAIVER OR PLAN AMENDMENT DE- 24 SCRIBED.—A State waiver or plan amendment de- 25 scribed in this paragraph is any of the following: 26 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 260 IH (A) A waiver or plan amendment to pro- 1 vide medical assistance for home and commu- 2 nity-based services under a waiver or plan 3 amendment under subsection (c), (d), or (i) of 4 section 1915 of the Social Security Act (42 5 U.S.C. 1396n) or under section 1115 of such 6 Act (42 U.S.C. 1315). 7 (B) A plan amendment to provide medical 8 assistance for home and community-based serv- 9 ices for individuals by reason of being deter- 10 mined eligible under section 1902(a)(10)(C) of 11 such Act (42 U.S.C. 1396a(a)(10)(C)) or by 12 reason of section 1902(f) of such Act (42 13 U.S.C. 1396a(f)) or otherwise on the basis of a 14 reduction of income based on costs incurred for 15 medical or other remedial care under which the 16 State disregarded the income and assets of the 17 individual’s spouse in determining the initial 18 and ongoing financial eligibility of an individual 19 for such services in place of the spousal impov- 20 erishment provisions applied under section 1924 21 of such Act (42 U.S.C. 1396r–5). 22 (C) A plan amendment to provide medical 23 assistance for home and community-based at- 24 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 260 IH tendant services and supports under section 1 1915(k) of such Act (42 U.S.C. 1396n(k)). 2 SEC. 103. REDUCTION IN FMAP AFTER 2020 FOR STATES 3 WITHOUT ASSET VERIFICATION PROGRAM. 4 Section 1940 of the Social Security Act (42 U.S.C. 5 1396w) is amended by adding at the end the following 6 new subsection: 7 ‘‘(k) REDUCTION IN FMAP AFTER 2020 FOR NON- 8 COMPLIANT STATES.— 9 ‘‘(1) IN GENERAL.—With respect to a calendar 10 quarter beginning on or after January 1, 2021, the 11 Federal medical assistance percentage otherwise de- 12 termined under section 1905(b) for a non-compliant 13 State shall be reduced— 14 ‘‘(A) for calendar quarters in 2021 and 15 2022, by 0.12 percentage points; 16 ‘‘(B) for calendar quarters in 2023, by 17 0.25 percentage points; 18 ‘‘(C) for calendar quarters in 2024, by 19 0.35 percentage points; and 20 ‘‘(D) for calendar quarters in 2025 and 21 each year thereafter, by 0.5 percentage points. 22 ‘‘(2) NON-COMPLIANT STATE DEFINED.—For 23 purposes of this subsection, the term ‘non-compliant 24 State’ means a State— 25 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 260 IH ‘‘(A) that is one of the 50 States or the 1 District of Columbia; 2 ‘‘(B) with respect to which the Secretary 3 has not approved a State plan amendment sub- 4 mitted under subsection (a)(2); and 5 ‘‘(C) that is not operating, on an ongoing 6 basis, an asset verification program in accord- 7 ance with this section.’’. 8 SEC. 104. MEDICAID IMPROVEMENT FUND. 9 Section 1941(b)(1) of the Social Security Act (42 10 U.S.C. 1396w–1(b)(1)) is amended by striking 11 ‘‘$31,000,000’’ and inserting ‘‘$6,000,000’’. 12 SEC. 105. BUDGETARY EFFECTS. 13 (a) STATUTORY PAYGO SCORECARDS.—The budg- 14 etary effects of this title shall not be entered on either 15 PAYGO scorecard maintained pursuant to section 4(d) of 16 the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 17 933(d)). 18 (b) SENATE PAYGO SCORECARDS.—The budgetary 19 effects of this title shall not be entered on any PAYGO 20 scorecard maintained for purposes of section 4106 of H. 21 Con. Res. 71 (115th Congress). 22 (c) CLASSIFICATION OF BUDGETARY EFFECTS.— 23 Notwithstanding Rule 3 of the Budget Scorekeeping 24 Guidelines set forth in the joint explanatory statement of 25 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 260 IH the committee of conference accompanying Conference Re- 1 port 105–217 and section 250(c)(8) of the Balanced 2 Budget and Emergency Deficit Control Act of 1985, the 3 budgetary effects of this title shall not be estimated— 4 (1) for purposes of section 251 of the Balanced 5 Budget and Emergency Deficit Control Act of 1985; 6 and 7 (2) for purposes of paragraph (4)(C) of section 8 3 of the Statutory Pay-As-You-Go Act of 2010 as 9 being included in an appropriation Act. 10 (d) PAYGO ANNUAL REPORT.—For the purposes of 11 the annual report issued pursuant to section 5 of the Stat- 12 utory Pay-As-You-Go Act of 2010 (2 U.S.C. 934) after 13 adjournment of the second session of the 115th Congress, 14 and for determining whether a sequestration order is nec- 15 essary under such section, the debit for the budget year 16 on the 5-year scorecard, if any, and the 10-year scorecard, 17 if any, shall be deducted from such scorecard in 2019 and 18 added to such scorecard in 2020. 19 TITLE II—TANF AND TECHNICAL 20 CORRECTIONS 21 SEC. 201. TANF PROGRAM EXTENSIONS. 22 (a) FAMILY ASSISTANCE GRANTS.—Section 23 403(a)(1) of the Social Security Act (42 U.S.C. 603(a)(1)) 24 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 260 IH is amended in each of subparagraphs (A) and (C) by strik- 1 ing ‘‘2017 and 2018’’ and inserting ‘‘2019 and 2020’’. 2 (b) HEALTHY MARRIAGE PROMOTION AND RESPON- 3 SIBLE FATHERHOOD GRANTS.—Section 403(a)(2)(D) of 4 such Act (42 U.S.C. 603(a)(2)(D)) is amended— 5 (1) by striking ‘‘2017 and 2018’’ and inserting 6 ‘‘2019 and 2020’’; and 7 (2) by striking ‘‘for fiscal year 2017 or 2018’’. 8 (c) CONTINGENCY FUND.—Section 403(b)(2) of such 9 Act (42 U.S.C. 603(b)(2)) is amended by striking ‘‘fiscal 10 year 2018’’ and inserting ‘‘each of fiscal years 2019 and 11 2020’’. 12 (d) TRIBAL FAMILY ASSISTANCE GRANTS.—Para- 13 graphs (1)(A) and (2)(A) of section 412(a) of such Act 14 (42 U.S.C. 612(a)) are each amended by striking ‘‘2017 15 and 2018’’ and inserting ‘‘2019 and 2020’’. 16 (e) CHILD CARE.—Section 418(a)(3) of such Act (42 17 U.S.C. 618(a)(3)) is amended by striking ‘‘2017 and 18 2018’’ and inserting ‘‘2019 and 2020’’. 19 (f) GRANTS TO THE TERRITORIES.—Section 20 1108(b)(2) of such Act (42 U.S.C. 1308(b)(2)) is amend- 21 ed by striking ‘‘2017 and 2018’’ and inserting ‘‘2019 and 22 2020’’. 23 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 260 IH SEC. 202. MEASURING AND UNDERSTANDING OUTCOMES. 1 (a) IN GENERAL.—Section 411(a) of the Social Secu- 2 rity Act (42 U.S.C. 611(a)) is amended by redesignating 3 paragraph (7) as paragraph (8) and inserting after para- 4 graph (6) the following: 5 ‘‘(7) REPORT ON ENGAGEMENT, EMPLOYMENT 6 AND OUTCOMES.— 7 ‘‘(A) REPORTING AGREEMENT.—Each 8 State and the Secretary shall enter into an 9 agreement specifying the manner by which the 10 information and data described in this para- 11 graph shall be collected and reported to the 12 Secretary beginning in fiscal year 2020. 13 ‘‘(i) OUTCOMES FOR EXITING RECIPI- 14 ENTS.—Information and data regarding 15 families who formerly received assistance 16 and included a work-eligible individual 17 (disaggregated by type of family, reason 18 for exit, and participation in work activi- 19 ties during the preceding fiscal year) under 20 the State program funded under this part 21 or under any State program funded with 22 qualified State expenditures (as defined in 23 section 409(a)(7)(B)(i)), with respect to 24 the following: 25 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 11 •HR 260 IH ‘‘(I) The percentage with at least 1 1 formerly work-eligible individual em- 2 ployed during the 2nd quarter after 3 exiting from the program. 4 ‘‘(II) The percentage with at 5 least 1 formerly work-eligible indi- 6 vidual employed during the 4th quar- 7 ter after exiting from the program. 8 ‘‘(III) The median earnings when 9 at least 1 formerly work-eligible indi- 10 vidual is employed during the 2d 11 quarter after exiting from the pro- 12 gram. 13 ‘‘(IV) The percentage with at 14 least 1 formerly work-eligible indi- 15 vidual employed during any of the 16 first 4 quarters after exiting from the 17 program. 18 ‘‘(V) The distribution of income 19 and earnings, including relative to 20 poverty and deep poverty, for each of 21 the first 4 quarters ending after the 22 quarter of exit from assistance. 23 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 12 •HR 260 IH ‘‘(VI) The percentage who, at the 1 time of exit from the program, were 2 subject to the following: 3 ‘‘(aa) A penalty under sec- 4 tion 407(e). 5 ‘‘(bb) A sanction or penalty 6 described in section 404 or 408. 7 ‘‘(cc) A penalty or sanction 8 not described in item (aa) or 9 (bb). 10 ‘‘(ii) ENGAGEMENT AND EMPLOY- 11 MENT OF CURRENT RECIPIENTS.— 12 ‘‘(I) WORK-ELIGIBLE INDIVID- 13 UALS.—In the case of current work-el- 14 igible individuals under the State pro- 15 gram funded under this part or under 16 any State program funded with quali- 17 fied State expenditures (as defined in 18 section 409(a)(7)(B)(i)), the following 19 information relative to the current 20 quarter being reported: 21 ‘‘(aa) Earnings in each of 22 the 4 quarters immediately pre- 23 ceding the quarter. 24 VerDate Sep 11 2014 02:10 Jan 17, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H260.IH H260 pamtmann on DSKBFK8HB2PROD with BILLS 13 •HR 260 IH ‘‘(bb) Standard measures of 1 employment, earnings, receipt of 2 assistance, and participation in 3 work activities (as defined in sec- 4 tion 407(d)) in each of the first 5 4 quarters following the quarter. 6 ‘‘(II) ALL RECIPIENTS.—The 7 percentage of recipients of assistance 8 under the State program [Text truncated for display. 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