What This Bill Does
This bill changes Medicaid and CHIP (Children's Health Insurance Program) rules to let states keep children and certain adults on health insurance coverage for longer periods without losing eligibility. The bill also requires states to review demographic information annually for people enrolled in Medicaid programs when they apply for new waivers.
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Who It Affects
- Children under age 19 enrolled in Medicaid
- Children under age 19 enrolled in CHIP
- Adults over age 18 with very low incomes who experienced homelessness or incarceration in the past 2 years
- State Medicaid programs
- The federal government (through the Secretary of Health and Human Services)
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Key Provisions
- States can allow children under age 6 to keep Medicaid coverage until they turn 6 or leave the state (Sec. 2(a))
- States can allow children ages 6 through 18 to keep Medicaid coverage for up to 24 months or until they turn 19, whichever comes first (Sec. 2(a))
- States can allow eligible low-income adults to keep Medicaid coverage for up to 12 months without losing it (Sec. 3(a))
- States seeking new Medicaid waivers must conduct yearly reviews of enrolled individuals' names, birth dates and contact information (Sec. 4)
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What Changes
If this bill becomes law, states will have the option to extend how long children and certain vulnerable adults can stay on Medicaid without their coverage being interrupted. States will also be required to keep better records of who is enrolled in their Medicaid programs when they apply for new waivers from the federal government.
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Important Definitions
- "Eligible individual" for continuous coverage means an adult over 18 whose income does not exceed 28 percent of the poverty line, or who experienced homelessness or incarceration within 2 years before applying for Medicaid (Sec. 3(b))
- "Homelessness" is defined by reference to section 103 of the McKinney-Vento Homeless Assistance Act (Sec. 3(b))
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Effective Date
The first day following the end of the emergency period described in section 1135(g)(1)(B) of the Social Security Act
I
118TH CONGRESS
1ST SESSION H. R. 1316
To amend titles XIX and XXI of the Social Security Act to allow States
to provide for extended periods of continuous coverage under the Med-
icaid and CHIP programs for children, to provide a period of continuous
eligibility under the Medicaid program for certain adults, and for other
purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 1, 2023
Mr. NEGUSE 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 allow States to provide for extended periods of contin-
uous coverage under the Medicaid and CHIP programs
for children, to provide a period of continuous eligibility
under the Medicaid program for certain adults, 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 ‘‘Save Children’s Cov-
4
erage Act’’.
5
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•HR 1316 IH
SEC. 2. OPTIONAL EXTENSION OF CONTINUOUS ELIGI-
1
BILITY FOR CHILDREN UNDER MEDICAID
2
AND CHIP.
3
(a) UNDER
THE
MEDICAID
PROGRAM.—Section
4
1902(e) of the Social Security Act (42 U.S.C. 1396a(e))
5
is amended by adding at the end the following new para-
6
graph:
7
‘‘(17) OPTIONAL EXTENSION OF CONTINUOUS
8
ELIGIBILITY FOR CHILDREN.—
9
‘‘(A) CHILDREN
UNDER
AGE
6.—At the
10
option of the State, the State plan (or waiver
11
of such State plan) may provide that an indi-
12
vidual who is under the age of 6 and who is de-
13
termined to be eligible for benefits under a
14
State plan (or waiver of such plan) approved
15
under this title may remain eligible for such
16
benefits until the earlier of—
17
‘‘(i) the time that such individual at-
18
tains the age of 6; or
19
‘‘(ii) the date that such individual
20
ceases to be a resident of such State.
21
‘‘(B) CHILDREN AGE 6 THROUGH 18.—At
22
the option of the State, the State plan (or waiv-
23
er of such State plan) may provide that an indi-
24
vidual who is over the age of 5 and under the
25
age of 19, and who is determined to be eligible
26
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•HR 1316 IH
for benefits under a State plan (or waiver of
1
such plan) approved under this title, may re-
2
main eligible for such benefits until the earlier
3
of—
4
‘‘(i) the end of the 24-month period
5
beginning on the date of such determina-
6
tion;
7
‘‘(ii) the time that such individual at-
8
tains the age of 19; or
9
‘‘(iii) the date that such individual
10
ceases to be a resident of such State.’’.
11
(b) UNDER THE CHILDREN’S HEALTH INSURANCE
12
PROGRAM.—Section 2107(e)(1) of the Social Security Act
13
(42 U.S.C. 1397gg(e)(1)) is amended—
14
(1) by redesignating subparagraphs (L) through
15
(U) as subparagraphs (M) through (V), respectively;
16
and
17
(2) by inserting after subparagraph (K) the fol-
18
lowing new subparagraph:
19
‘‘(L) Section 1902(e)(17) (relating to the
20
State option to extend continuous eligibility for
21
children under the age of 19).’’.
22
(c) EFFECTIVE DATE.—The amendments made by
23
this section shall take effect on the first day following the
24
end of the emergency period described in section
25
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•HR 1316 IH
1135(g)(1)(B) of the Social Security Act (42 U.S.C.
1
1320b–5(g)(1)(B)).
2
SEC. 3. OPTION TO PROVIDE CONTINUOUS ELIGIBILITY
3
FOR CERTAIN INDIVIDUALS UNDER MED-
4
ICAID.
5
(a) IN GENERAL.—Section 1902(e) of the Social Se-
6
curity Act (42 U.S.C. 1396a(e)), as amended by section
7
2, is further amended by adding at the end the following
8
new paragraph:
9
‘‘(18) OPTION
FOR
CONTINUOUS
ELIGIBILITY
10
FOR CERTAIN INDIVIDUALS.—
11
‘‘(A) IN GENERAL.—At the option of the
12
State, the State plan (or waiver of such State
13
plan) may provide that an eligible individual (as
14
defined in subparagraph (B)) who is determined
15
to be eligible for benefits under a State plan (or
16
waiver of such plan) approved under this title,
17
may remain eligible for such benefits until the
18
earlier of—
19
‘‘(i) the end of the 12-month period
20
beginning on the date of such determina-
21
tion; or
22
‘‘(ii) the date that such individual
23
ceases to be a resident of such State.
24
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•HR 1316 IH
‘‘(B) ELIGIBLE
INDIVIDUAL
DEFINED.—
1
For purposes of this paragraph, the term ‘eligi-
2
ble individual’ means an individual over the age
3
of 18—
4
‘‘(i) whose income does not exceed 28
5
percent of the poverty line (as defined by
6
the Office of Management and Budget,
7
and revised annually in accordance with
8
section 673(2) of the Omnibus Budget
9
Reconciliation Act of 1981);
10
‘‘(ii) who, in the 2 years prior to such
11
individual’s application for medical assist-
12
ance under a plan under this title, experi-
13
enced homelessness (as defined in section
14
103 of the McKinney-Vento Homeless As-
15
sistance Act); or
16
‘‘(iii) who, in the 2 years prior to such
17
individual’s application for medical assist-
18
ance under a plan under this title, was in-
19
carcerated in a prison or psychiatric hos-
20
pital.’’.
21
(b) EFFECTIVE DATE.—The amendment made by
22
this section shall take effect on the first day following the
23
end of the emergency period described in section
24
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•HR 1316 IH
1135(g)(1)(B) of the Social Security Act (42 U.S.C.
1
1320b–5(g)(1)(B)).
2
SEC. 4. DATA VERIFICATION REQUIREMENT FOR NEW
3
WAIVERS.
4
(a) PROGRAM WAIVERS.—Section 1915 of the Social
5
Security Act (42 U.S.C. 1396n) is amended—
6
(1) in subsection (b), by striking ‘‘The Sec-
7
retary’’ and inserting ‘‘Subject to subsection (m),
8
the Secretary’’;
9
(2) in subsection (c)(1), by striking ‘‘The Sec-
10
retary may by waiver’’ and inserting ‘‘Subject to
11
subsection (m), the Secretary may by waiver’’; and
12
(3) by adding at the end the following new sub-
13
section:
14
‘‘(m) DATA VERIFICATION REQUIREMENT FOR NEW
15
WAIVERS.—In the case of a waiver granted under this sec-
16
tion on or after the first day following the end of the emer-
17
gency period described in section 1135(g)(1)(B) of the So-
18
cial Security Act, as a condition of receiving such waiver,
19
a State shall agree to conduct an annual review of the
20
demographic information of individuals enrolled under a
21
State plan under this title, including the names, dates of
22
birth, and contact information for such individuals.’’.
23
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•HR 1316 IH
(b) RESEARCH AND DEMONSTRATION WAIVERS.—
1
Section 1115 of the Social Security Act (42 U.S.C. 1315)
2
is amended—
3
(1) in subsection (a)(1), by inserting ‘‘subject
4
to subsection (g),’’ before ‘‘the Secretary’’; and
5
(2) by adding at the end the following new sub-
6
section:
7
‘‘(g) In the case of a waiver granted under this sec-
8
tion on or after the first day following the end of the emer-
9
gency period described in section 1135(g)(1)(B) of the So-
10
cial Security Act, as a condition of receiving such waiver,
11
a State shall agree to conduct an annual review of the
12
demographic information of individuals enrolled under a
13
State plan under this title, including the names, dates of
14
birth, and contact information for such individuals.’’.
15
Æ
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