MEDICAID BENEFITS FOR POOR CHILDREN AND PREGNANT WOMEN.

SEC. 4101. MEDICAID BENEFITS FOR POOR CHILDREN AND PREGNANT WOMEN. (a) Medicaid Optional Coverage for Additional Low-Income Pregnant Women and Children.— (1) Section 1902(1) of the Social Security Act (42 U.S.C. 1396a(l)) is amended— (A) in paragraph (2)— (i) striking “(2) For purposes of paragraph (1)” and inserting “(2)(A) For purposes of paragraph (1) with respect to individuals described in subparagraph (A) or (B) of that paragraph”, (ii) by striking “100 percent” and inserting “185 percent”, and (iii) by adding at the end the following new subparagraph: “(B) If a State elects, under subsection (a)(10)(A)(ii)(IX), to cover individuals not described in subparagraph (A) or (B) of paragraph (1), for purposes of that paragraph and with respect to individuals not described in such subparagraphs the State shall establish an income level which is a percentage (not more than 100 percent, or, if101 STAT. 1330–141less, the percentage established under subparagraph (A)) of the income official poverty line described in subparagraph (A).“; and (B) in paragraph (3)(D), by inserting “appropriate” after “applied is the”. (2) Section 1902(e)(4) of such Act (42 U.S.C. 1396a(e)(4)) is amended by adding at the end the following new sentence: “During the period in which a child is deemed under the preceding sentence to be eligible for medical assistance, the medical assistance eligibility identification number of the mother shall also serve as the identification number of the child, and all claims shall be submitted and paid under such number (unless the State issues a separate identification number for the child before such period expires).”. (3) The amendments made by this subsection shall apply to medical assistance furnished on or after July 1, 1988. (b) Allowing Accelerated Coverage of Children Up 4848Copy read “up”. to Age 5.— (1) Section 1902(1)(1) of such Act (42 U.S.C. 1396a(1)(1)) is amended— (A) by inserting “and” at the end of subparagraph (B), and (B) by striking subparagraphs (C) through (F) and inserting the following: “(C) children born after September 30, 1983, and who have attained one year of age but have not attained 2, 3, 4, or 5 years of age (as selected by the State),”. (2) (A) Section 1902(1) of such Act is further amended— (i) in paragraph (3)(C), by striking “, (C), (D), (E), or (F)” and inserting “or (C)”, and (ii) in paragraph (4)(B)(ii), by striking “, (D), (E), or (F)”. (B) Section 1902(e)(7) of such Act (42 U.S.C. 1396a(e)(7)) is amended by striking “, (C), (D), (E), or (F)” and inserting “or (C)”. (C) Section 9401(f)(2) of the Omnibus Budget Reconciliation Act of 1986 is amended by striking “(A)” after “(2)” and by striking subparagraphs (B) through (D). (3) The amendments made by this subsection shall apply with respect to medical assistance furnished on or after July 1, 1988. (c) Coverage of Children Up 4949Copy read “up”. to Age 8.— (1) Section 1905(n)(2) of such Act (42 U.S.C. 1396d(n)(2)) is amended by striking “is under 5 years of age” and inserting “has not attained the age of 7 (or any age designated by the State that exceeds 7 but does not exceed 8)”. (2) Section 1902(1)(1)(C) of such Act, as amended by subsection (n)(1)(B), is further amended by striking “or 5 years” and inserting “5, 6, 7, or 8 years”. (3) (A) The amendments made by this subsection shall apply to medical assistance furnished on or after October 1, 1988. (B) For purposes of section 1905(n)(2) of the Social Security Act (as amended by subsection (a)) for medical assistance furnished during fiscal year 1989, any reference to “age of 7” is deemed to be a reference to “age of 6”. (d) Premium.— 101 STAT. 1330–142 (1) Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended— (A) in subsection (a)(1), by inserting “(except for a premium imposed under subsection (c))” before the semicolon; (B) by redesignating subsections (c) and (d) as subsections (d) and (e), respectively; and (C) by inserting after subsection (b) the following new subsection: “(c) (1) The State plan of a State may at the option of the State provide for imposing a monthly premium (in an amount that does not exceed the limit established under paragraph (2)) with respect to an individual described in subparagraph (A) or (B) of section 1902(1)(1) who is receiving medical assistance on the basis of section 1902(a)(10)(A)(ii)(IX) and whose family income (as determined in accordance with the methodology specified in section 1902(1)(3)) equals or exceeds 150 percent of the nonfarm income official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981) applicable to a family of the size involved. “(2) In no case may the amount of any premium imposed under paragraph (1) exceed 10 percent of the amount by which the family income (less expenses for the care of a dependent child) of an individual exceeds 150 percent of the line described in paragraph (1). “(3) A State shall not require prepayment of a premium imposed pursuant to paragraph (1) and shall not terminate eligibility of an individual for medical assistance under this title on the basis of failure to pay any such premium until such failure continues for a period of not less than 60 days. The State may waive payment of any such premium in any case where the State determines that requiring such payment would create an undue hardship. “(4) A State may permit State or local funds available under other programs to be used for payment of a premium imposed under paragraph (1). Payment of a premium with such funds shall not be counted as income to the individual with respect to whom such payment is made.”. (2) The amendments made by paragraph (1) shall become effective on July 1, 1988. (e) Miscellaneous Provisions Relating to Services for Pregnant Women and Children.— (1) Section 1902(a)(10) of such Act (42 U.S.C. 1396a(a)(10)) is amended, in subdivision (VII) of the matter following subparagraph (E), by striking “and postpartum” and inserting “postpartum, and family planning”. (2) Section 1902(e)(5) of such Act (42 U.S.C. 1396a(e)(5)) is amended by striking “until the end of the 60-day period beginning on the last day of her pregnancy” and inserting “through the end of the month in which the 60-day period (beginning on the last day of her pregnancy) ends”. (3) Section 1902(1)(3)(E) of such Act (42 U.S.C. 1396a(1)(3)(E)) is amended by inserting after “title IV” the following: “(except to the extent such methodology is inconsistent with clause (D) of subsection (a)(17))”. (4) Section 1902(1)(4)(A) of such Act (42 U.S.C. 1396a(1)(4)(A)) is amended by striking “April 17, 1986” and inserting “July 1, 1987”. 101 STAT. 1330–143 (5) Section 1902(1)(4) of such Act (42 U.S.C. 1396a(1)(4)) is amended by adding at the end the following new subparagraph: “(C) A State plan may not provide, in its election of the option of furnishing medical assistance to individuals described in paragraph (1), that such individuals must apply for benefits under part A of title IV as a condition of applying for, or receiving, medical assistance under this title.”. (6) (A) The amendment made by paragraph 5050Copy read “paragraphs”. (1) shall become effective on the date of enactment of this Act. (B) The amendments made by paragraphs (2) and (3) shall be effective as if they had been included in the enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985. (C) The amendment made by paragraph (4) shall apply to elections made on or after the enactment of this Act. (D) The amendment made by paragraph (5) shall apply as if included in the enactment of section 9401 of the Omnibus Budget Reconciliation Act of 1986.