Medicaid Improvement and State Flexibility Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 2715 To amend title XI of the Social Security Act to provide for State approval and implementation of specified waivers under the Medicaid program. IN THE HOUSE OF REPRESENTATIVES MAY 14, 2019 Mr. GREEN of Tennessee (for himself, Mr. WRIGHT, Mr. ARMSTRONG, Mr. NORMAN, Mr. MARSHALL, and Mr. KEVIN HERN of Oklahoma) intro- duced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XI of the Social Security Act to provide for State approval and implementation of specified waiv- ers under the Medicaid program. 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 Improvement 4 and State Flexibility Act of 2019’’. 5 VerDate Sep 11 2014 05:04 May 24, 2019 Jkt 034408 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2715.IH H2715 pbinns on DSK79D2C42PROD with BILLS 2 •HR 2715 IH SEC. 2. PROVIDING FOR STATE APPROVAL AND IMPLEMEN- 1 TATION OF SPECIFIED WAIVERS UNDER THE 2 MEDICAID PROGRAM. 3 Section 1115 of the Social Security Act (42 U.S.C. 4 1315) is amended— 5 (1) in subsection (d)— 6 (A) in paragraph (1), by striking ‘‘An ap- 7 plication’’ and inserting ‘‘Subject to paragraph 8 (4), an application’’; and 9 (B) by adding at the end the following new 10 paragraph: 11 ‘‘(4)(A) An experimental, pilot, or demonstration 12 project undertaken under subsection (a) may be approved 13 or renewed by a State if such project is described in sub- 14 paragraph (B). 15 ‘‘(B) An experimental, pilot, or demonstration project 16 is described in this subparagraph if such project provides 17 for a waiver of requirements with respect to a State plan 18 (or a waiver of such plan) under title XIX such that— 19 ‘‘(i) individuals enrolled under such plan (or 20 such waiver) may elect to participate in such project 21 with respect to a year; 22 ‘‘(ii) such individuals who elect to so partici- 23 pate— 24 ‘‘(I) are furnished with an electronic bene- 25 fits transfer card in an amount determined ap- 26 VerDate Sep 11 2014 05:04 May 24, 2019 Jkt 034408 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2715.IH H2715 pbinns on DSK79D2C42PROD with BILLS 3 •HR 2715 IH propriate by the State for purposes of pur- 1 chasing primary care services and medications 2 during such year; 3 ‘‘(II) are furnished a cash payment by the 4 State equal to the amount of funds remaining 5 on the individual’s electronic benefits transfer 6 card at the end of such year; and 7 ‘‘(III) are enrolled in a catastrophic insur- 8 ance program determined appropriate by the 9 State for purposes of covering services not de- 10 scribed in subclause (I) and covering services 11 that are described in such subclause if such in- 12 dividual exceeds the amount of funds provided 13 to such individual on such card for such year; 14 and 15 ‘‘(iii) Federal expenditures under such title for 16 the period during which such project is in effect are 17 equal to or lesser than what such expenditures would 18 have been during such period if such project were 19 not in effect. 20 ‘‘(C)(i) In no case may a project described in sub- 21 paragraph (B) result in an expenditure to pay for any 22 abortion or to assist in the purchase, in whole or in part, 23 of health benefit coverage that includes coverage of abor- 24 tion. 25 VerDate Sep 11 2014 05:04 May 24, 2019 Jkt 034408 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2715.IH H2715 pbinns on DSK79D2C42PROD with BILLS 4 •HR 2715 IH ‘‘(ii) Clause (i) shall not apply to an abortion only 1 if necessary to save the life of the mother or if the preg- 2 nancy is the result of an act of rape or incest. 3 ‘‘(D) For purposes of a State’s approval or renewal 4 of an experimental, pilot, or demonstration project under 5 subparagraph (A), each reference to ‘the Secretary’ in 6 subsection (a) shall be deemed to be a reference to ‘the 7 State’.’’; and 8 (2) in subsection (e), by inserting ‘‘(other than 9 such a project that is described in paragraph 10 (4)(B))’’ before the period at the end. 11 Æ VerDate Sep 11 2014 05:04 May 24, 2019 Jkt 034408 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H2715.IH H2715 pbinns on DSK79D2C42PROD with BILLS