Stabilize Medicaid and CHIP Coverage Act - Amends title XIX (Medicaid) of the Social Security Act (SSA) to require a state Medicaid plan to provide 12-month continuous enrollment for an eligible individual, regardless of age.
Amends SSA title XXI (State Children's Health Insurance) (CHIP) to require a state CHIP plan also to provide 12-month continuous enrollment for an eligible individual.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1698 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 1698
To amend titles XIX and XXI of the Social Security Act to provide for
12-month continuous enrollment of individuals under the Medicaid
program and Children's Health Insurance Program, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 24, 2013
Mr. Gene Green of Texas (for himself and Mr. Barton) 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 provide for
12-month continuous enrollment of individuals under the Medicaid
program and Children's Health Insurance Program, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Stabilize Medicaid and CHIP Coverage
Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Every year millions of people are enrolled in Medicaid
and the Children's Health Insurance Program (in this section
referred to as ``CHIP''), but subsequently lose their coverage,
despite still being eligible, because of inefficient and
cumbersome paperwork and logistical requirements.
(2) Data show that the typical enrollee receives Medicaid
coverage for about three-quarters of a year. Coverage periods
are lower for non-elderly, non-disabled adults than for those
with disabilities, seniors, and children.
(3) Medicaid enrollees with coverage disruptions are more
likely to be hospitalized for illnesses like asthma, diabetes,
or cardiovascular disease that can be effectively managed
through ongoing primary medical care and medication, are less
likely to be screened for breast cancer, and may have poorer
cancer outcomes.
(4) Children enrolled in CHIP also experience disruptions
in health coverage and care. For example, during just a one-
year period, over one-third of CHIP enrollees were also
enrolled in a State's Medicaid program. Transitions between
Medicaid and CHIP can cause disruptions in care because the
health care coverage and participating providers vary between
the two programs.
(5) Interruptions in coverage can impair the receipt of
effective primary care and lead to expensive hospitalizations
or emergency room visits. Unnecessary enrollment,
disenrollment, and reenrollment in Medicaid and CHIP result in
higher administrative expenses for re-enrollment and result in
more people uninsured at any given time.
(6) Stable coverage under Medicaid and CHIP lowers average
monthly medical costs.
(7) Continuous enrollment also permits better prevention
and disease management, leading to fewer serious illnesses and
hospitalizations.
(8) Children with stable coverage are less likely to have
unmet medical needs, allowing children to receive the
preventive care that is necessary to help them grow into
healthy adults.
SEC. 3. 12-MONTH CONTINUOUS ENROLLMENT.
(a) Requirement of 12-Month Continuous Enrollment Under Medicaid.--
Section 1902(e)(12) of the Social Security Act (42 U.S.C. 1396a(e)(12))
is amended to read as follows:
``(12) 12-month continuous enrollment.--Notwithstanding any
other provision of this title, a State plan approved under this
title (or under any waiver of such plan approved pursuant to
section 1115 or section 1915), shall provide that an individual
who is determined to be eligible for benefits under such plan
(or waiver) shall remain eligible and enrolled for such
benefits through the end of the month in which the 12-month
period (beginning on the date of determination of eligibility)
ends.''.
(b) Requirement of 12-Month Continuous Enrollment Under CHIP.--
(1) In general.--Section 2102(b) of the Social Security Act
(42 U.S.C. 1397bb(b)) is amended by adding at the end the
following new paragraph:
``(6) Requirement for 12-month continuous enrollment.--
Notwithstanding any other provision of this title, a State
child health plan that provides child health assistance under
this title through a means other than described in section
2101(a)(2), shall provide that an individual who is determined
to be eligible for benefits under such plan shall remain
eligible and enrolled for such benefits through the end of the
month in which the 12-month period (beginning on the date of
determination of eligibility) ends.''.
(2) Conforming amendment.--Section 2105(a)(4)(A) of the
Social Security Act (42 U.S.C. 1397ee(a)(4)(A)) is amended--
(A) by striking ``has elected the option of'' and
inserting ``is in compliance with the requirement
for''; and
(B) by striking ``applying such policy under its
State child health plan under this title'' and
inserting ``in compliance with section 2102(b)''.
(c) Effective Date.--
(1) In general.--Except as provided in paragraph (2) or
(3), the amendments made by subsections (a) and (b) shall apply
to determinations (and redeterminations) of eligibility made on
or after the date that is 18 months after the date of the
enactment of this Act.
(2) Extension of effective date for state law amendment.--
In the case of a State plan under title XIX or State child
health plan under title XXI of the Social Security Act (42
U.S.C. 1396 et seq., 42 U.S.C. 1397aa et seq.) which the
Secretary of Health and Human Services determines requires
State legislation (other than legislation appropriating funds)
in order for the respective plan to meet the additional
requirement imposed by the amendment made by subsection (a) or
(b), respectively, the respective plan shall not be regarded as
failing to comply with the requirements of such title solely on
the basis of its failure to meet such applicable additional
requirement before the first day of the first calendar quarter
beginning after the close of the first regular session of the
State legislature that begins after the date of enactment of
this Act. For purposes of the previous sentence, in the case of
a State that has a 2-year legislative session, each year of the
session is considered to be a separate regular session of the
State legislature.
(3) Option to implement 12-month continuous eligibility
prior to effective date.--A State may elect through a State
plan amendment under title XIX or XXI of the Social Security
Act (42 U.S.C. 1396 et seq., 42 U.S.C. 1397aa et seq.) to apply
the amendment made by subsection (a) or (b), respectively, on
any date prior to the 18-month date specified in paragraph (1),
but not sooner than the date of the enactment of this Act.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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