Medicaid REACH Act

I 116TH CONGRESS 2D SESSION H. R. 6149 To amend title XIX of the Social Security Act to enhance reporting requirements for nonexpansion States, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 9, 2020 Mr. CUNNINGHAM introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XIX of the Social Security Act to enhance reporting requirements for nonexpansion States, 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 ‘‘Medicaid Report on 4 Expansion of Access to Coverage for Health Act’’ or 5 ‘‘Medicaid REACH Act’’. 6 SEC. 2. ENHANCED REPORTING REQUIREMENTS FOR NON- 7 EXPANSION STATES. 8 Section 1903 of the Social Security Act (42 U.S.C. 9 1396b) is amended— 10 VerDate Sep 11 2014 03:27 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6149.IH H6149 ctelli on DSK30JT082PROD with BILLS 2 •HR 6149 IH (1) in subsection (a)(7), by inserting ‘‘sub- 1 section (bb) and’’ before ‘‘section 1919(g)(3)(B)’’; 2 and 3 (2) by adding at the end the following new sub- 4 section: 5 ‘‘(bb) REDUCTION OF FEDERAL PAYMENTS FOR 6 CERTAIN ADMINISTRATIVE COSTS OF NONEXPANSION 7 STATES THAT DO NOT SATISFY REPORTING REQUIRE- 8 MENTS.— 9 ‘‘(1) IN GENERAL.— 10 ‘‘(A) REDUCTION.—In the case of a non- 11 expansion State, with respect to a fiscal year 12 (beginning with fiscal year 2022) that does not 13 satisfy the reporting requirement under para- 14 graph (2) for such fiscal year, the percentage 15 specified in subsection (a)(7) for amounts de- 16 scribed in such subsection expended by such 17 State during a calendar quarter described in 18 paragraph (4) with respect to such fiscal year, 19 subject to subparagraph (B), shall be reduced 20 by the number of percentage points specified in 21 paragraph (4) for the respective calendar quar- 22 ter. 23 ‘‘(B) EXCEPTION.—In the case of a non- 24 expansion State that is subject to a reduction 25 VerDate Sep 11 2014 03:27 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6149.IH H6149 ctelli on DSK30JT082PROD with BILLS 3 •HR 6149 IH under subparagraph (A) for the calendar quar- 1 ter described in paragraph (4)(A) with respect 2 to a fiscal year, if the State satisfies the criteria 3 described in subparagraphs (A), (B), and (C) of 4 paragraph (2) (without regard to the dates 5 specified in such subparagraph (A) and (C)) be- 6 fore the beginning of a subsequent calendar 7 quarter described in paragraph (4) with respect 8 to such fiscal year, then such State shall not be 9 subject to a reduction under subparagraph (A) 10 for such subsequent calendar quarter. 11 ‘‘(2) REPORTING REQUIREMENT.—For pur- 12 poses of paragraph (1), a nonexpansion State satis- 13 fies the reporting requirement under this paragraph 14 for a fiscal year, if the nonexpansion State— 15 ‘‘(A) by not later than January 1 of such 16 year, posts on the public website of the State 17 agency administering the State plan, the infor- 18 mation described in paragraph (3) with respect 19 to such State for the previous year; 20 ‘‘(B) provides for at least a 30-day period 21 for notice and comment on such information; 22 and 23 ‘‘(C) by not later than March 1 of such 24 year, submits to the Secretary a complete re- 25 VerDate Sep 11 2014 03:27 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6149.IH H6149 ctelli on DSK30JT082PROD with BILLS 4 •HR 6149 IH port including such information, comments sub- 1 mitted pursuant to subparagraph (B), and a re- 2 sponse by the State to each such comment. 3 ‘‘(3) INFORMATION DESCRIBED.—The informa- 4 tion described in this paragraph, with respect to a 5 State and year, is the following: 6 ‘‘(A) The estimated number of individuals 7 who were uninsured for at least 6 months, 8 shown by age-groups of 0 to 18 years of age 9 and of 19 years of age to 64 years of age, as 10 well as a detailed description of the basis for 11 the estimates. 12 ‘‘(B) The estimated number of the individ- 13 uals estimated under subparagraph (A) in the 14 State who would be eligible for medical assist- 15 ance under the State plan if the State were to 16 make medical assistance under the State plan 17 available in accordance with section 1902(k)(1) 18 to all individuals described in section 19 1902(a)(10)(i)(VIII), and a detailed description 20 of the basis for the estimates. 21 ‘‘(C) A comprehensive listing of State in- 22 come eligibility criteria for all mandatory and 23 optional Medicaid eligibility groups for which 24 the State plan provides medical assistance 25 VerDate Sep 11 2014 03:27 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6149.IH H6149 ctelli on DSK30JT082PROD with BILLS 5 •HR 6149 IH (other than with respect to individuals described 1 in clause (i)(II), (ii)(VI), or (ii)(XXII) of sec- 2 tion 1902(a)(10)(A)). 3 ‘‘(D) The total amount of hospital uncom- 4 pensated-care costs and a breakdown of the 5 source of such costs, as well as a breakdown for 6 rural and non-rural hospitals. 7 ‘‘(4) PERCENTAGE DESCRIBED.—For purposes 8 of paragraph (1), a calendar quarter described in 9 this paragraph, with respect to a fiscal year, and the 10 percentage points described in this paragraph for 11 such quarter, with respect to a State, are— 12 ‘‘(A) for the calendar quarter beginning on 13 the April 1 occurring during such fiscal year, 14 0.5 percentage points; 15 ‘‘(B) for the calendar quarter beginning on 16 the July 1 occurring during such fiscal year, 17 1.0 percentage point; and 18 ‘‘(C) for the calendar quarter beginning on 19 the October 1 occurring during the subsequent 20 fiscal year, 1.5 percentage points. 21 ‘‘(5) PAYMENT IN CASE OF REPORTING 22 STATE.—The expenses incurred by a non-expansion 23 State, with respect to any calendar quarter with re- 24 spect to a fiscal year (beginning with 2021), for car- 25 VerDate Sep 11 2014 03:27 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6149.IH H6149 ctelli on DSK30JT082PROD with BILLS 6 •HR 6149 IH rying out subparagraphs (A) through (C) of para- 1 graph (2) shall, for purposes of section 1903(a)(7), 2 be considered to be expenses necessary for the prop- 3 er and efficient administration of the State plan 4 under this title. 5 ‘‘(6) NONEXPANION STATE DEFINED.—For 6 purposes of this subsection, the term ‘nonexpansion 7 State’ means, with respect to a fiscal year, a State 8 that as of the first quarter of such fiscal year does 9 not provide under the State plan of such State (or 10 waiver of such plan) for making medical assistance 11 available in accordance with section 1902(k)(1) to 12 all individuals described in section 13 1902(a)(10)(i)(VIII).’’. 14 Æ VerDate Sep 11 2014 03:27 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H6149.IH H6149 ctelli on DSK30JT082PROD with BILLS