STUDY REGARDING BARRIERS TO PARTICIPATION OF FARMWORKERS IN HEALTH PROGRAMS.

SEC. 404. STUDY REGARDING BARRIERS TO PARTICIPATION OF FARMWORKERS IN HEALTH PROGRAMS. (a) In General.—The Secretary shall conduct a study of the problems experienced by farmworkers (including their families) under Medicaid and SCHIP. Specifically, the Secretary shall examine the following: (1) Barriers to enrollment.—Barriers to their enrollment, including a lack of outreach and outstationed eligibility 116 STAT. 1663workers, complicated applications and eligibility determination procedures, and linguistic and cultural barriers. (2) Lack of portability.—The lack of portability of Medicaid and SCHIP coverage for farmworkers who are determined eligible in one State but who move to other States on a seasonal or other periodic basis. (3) Possible solutions.—The development of possible solutions to increase enrollment and access to benefits for farmworkers, because, in part, of the problems identified in paragraphs (1) and (2), and the associated costs of each of the possible solutions described in subsection (b). (b) Possible Solutions.—Possible solutions to be examined shall include each of the following: (1) Interstate compacts.—The use of interstate compacts among States that establish portability and reciprocity for eligibility for farmworkers under the Medicaid and SCHIP and potential financial incentives for States to enter into such compacts. (2) Demonstration projects.—The use of multi-state demonstration waiver projects under section 1115 of the Social Security Act (42 U.S.C. 1315) to develop comprehensive migrant coverage demonstration projects. (3) Use of current law flexibility.—Use of current law Medicaid and SCHIP State plan provisions relating to coverage of residents and out-of-State coverage. (4) National migrant family coverage.—The development of programs of national migrant family coverage in which States could participate. (5) Public-private partnerships.—The provision of incentives for development of public-private partnerships to develop private coverage alternatives for farmworkers. (6) Other possible solutions.—Such other solutions as the Secretary deems appropriate. (c) Consultations.—In conducting the study, the Secretary shall consult with the following: (1) Farmworkers affected by the lack of portability of coverage under the Medicaid program or the State children’s health insurance program (under titles XIX and XXI of the Social Security Act). (2) Individuals with expertise in providing health care to farmworkers, including designees of national and local organizations representing migrant health centers and other providers. (3) Resources with expertise in health care financing. (4) Representatives of foundations and other nonprofit entities that have conducted or supported research on farmworker health care financial issues. (5) Representatives of Federal agencies which are involved in the provision or financing of health care to farmworkers, including the Health Care Financing Administration and the Health Research and Services Administration. (6) Representatives of State governments. (7) Representatives from the farm and agricultural industries. (8) Designees of labor organizations representing farmworkers. (d) Definitions.—For purposes of this section: 116 STAT. 1664 (1) Farmworker.—The term “farmworker” means a migratory agricultural worker or seasonal agricultural worker, as such terms are defined in section 330(g)(3) of the Public Health Service Act (42 U.S.C. 254c(g)(3)), and includes a family member of such a worker. (2) Medicaid.—The term “Medicaid” means the program under title XIX of the Social Security Act. (3) SCHIP.—The term “SCHIP” means the State children’s health insurance program under title XXI of the Social Security Act. (e) Report.—Not later than one year after the date of the enactment of this Act, the Secretary shall transmit a report to the President and the Congress on the study conducted under this section. The report shall contain a detailed statement of findings and conclusions of the study, together with its recommendations for such legislation and administrative actions as the Secretary considers appropriate.