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II
116TH CONGRESS
1ST SESSION
S. 2000
To amend title XIX of the Social Security Act to remove an institutional
bias by making permanent the protection for recipients of home and
community-based services against spousal impoverishment.
IN THE SENATE OF THE UNITED STATES
JUNE 27, 2019
Mr. CASEY (for himself, Ms. SMITH, Mr. VAN HOLLEN, Mrs. GILLIBRAND,
Mr. BLUMENTHAL, Mrs. SHAHEEN, Mr. BROWN, Ms. STABENOW, and
Ms. KLOBUCHAR) introduced the following bill; which was read twice and
referred to the Committee on Finance
A BILL
To amend title XIX of the Social Security Act to remove
an institutional bias by making permanent the protection
for recipients of home and community-based services
against spousal impoverishment.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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•S 2000 IS
SECTION
1.
MAKING
PERMANENT
THE
PROTECTION
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UNDER MEDICAID FOR RECIPIENTS OF HOME
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AND COMMUNITY-BASED SERVICES AGAINST
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SPOUSAL IMPOVERISHMENT.
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(a) IN GENERAL.—Section 1924(h)(1)(A) of the So-
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cial Security Act (42 U.S.C. 1396r–5(h)(1)(A)) is amend-
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ed by striking ‘‘or who (at the option of the State) is de-
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scribed in section 1902(a)(10)(A)(ii)(VI)’’ and inserting
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the following: ‘‘or who, before October 1, 2019, at the op-
9
tion
of
the
State,
is
described
in
section
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1902(a)(10)(A)(ii)(VI) or, beginning October 1, 2019, is
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eligible for medical assistance for home and community-
12
based services provided under subsection (c), (d), or (i)
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of section 1915, under a waiver approved under section
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1115, or who is eligible for such medical assistance by rea-
15
son
of
being
determined
eligible
under
section
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1902(a)(10)(C) or by reason of section 1902(f) or other-
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wise on the basis of a reduction of income based on costs
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incurred for medical or other remedial care, or who is eligi-
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ble for medical assistance for home and community-based
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attendant services and supports under section 1915(k)’’.
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(b) RULE OF CONSTRUCTION.—Nothing in section
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2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note),
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section 1924 of the Social Security Act (42 U.S.C. 1396r–
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5), or section 1902(a)(17) of such Act (42 U.S.C.
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1396a(a)(17)) shall be construed as prohibiting a State
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•S 2000 IS
from applying an income or resource disregard authorized
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under section 1902(r)(2) of such Act (42 U.S.C.
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1396a(r)(2))—
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(1) to the income or resources of individuals de-
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scribed in section 1902(a)(10)(A)(ii)(VI) of such Act
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(42 U.S.C. 1396a(a)(10)(A)(ii)(VI)) (including a
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disregard of the income or resources of such individ-
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ual’s spouse); or
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(2) on the basis of an individual’s need for
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home and community-based services authorized
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under subsection (c), (d), (i), or (k) of section 1915
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of such Act (42 U.S.C. 1396n) or under section
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1115 of such Act (42 U.S.C. 1315).
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Æ
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