TEMPORARY STATE FISCAL RELIEF.

SEC. 401. TEMPORARY STATE FISCAL RELIEF.(a) $10,000,000,000 for a Temporary Increase of the Medicaid FMAP.—(1) Permitting maintenance of fiscal year 2002 fmap for last 2 calendar quarters of fiscal year 2003.—Subject to paragraph (5), if the FMAP determined without regard to this subsection for a State for fiscal year 2003 is less than the FMAP as so determined for fiscal year 2002, the FMAP for the State for fiscal year 2002 shall be substituted for the State’s FMAP for the third and fourth calendar quarters of fiscal year 2003, before the application of this subsection.117 STAT. 765(2) Permitting maintenance of fiscal year 2003 fmap for first 3 quarters of fiscal year 2004.—Subject to paragraph (5), if the FMAP determined without regard to this subsection for a State for fiscal year 2004 is less than the FMAP as so determined for fiscal year 2003, the FMAP for the State for fiscal year 2003 shall be substituted for the State’s FMAP for the first, second, and third calendar quarters of fiscal year 2004, before the application of this subsection.(3) General 2.95 percentage points increase for last 2 calendar quarters of fiscal year 2003 and first 3 calendar quarters of fiscal year 2004.—Subject to paragraphs (5), (6), and (7), for each State for the third and fourth calendar quarters of fiscal year 2003 and for the first, second, and third calendar quarters of fiscal year 2004, the FMAP (taking into account the application of paragraphs (1) and (2)) shall be increased by 2.95 percentage points.(4) Increase in cap on medicaid payments to territories.—Subject to paragraphs (6) and (7), with respect to the third and fourth calendar quarters of fiscal year 2003 and the first, second, and third calendar quarters of fiscal year 2004, the amounts otherwise determined for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa under subsections (f) and (g) of section 1108 of the Social Security Act (42 U.S.C. 1308) shall each be increased by an amount equal to 5.90 percent of such amounts.(5) Scope of application.—The increases in the FMAP for a State under this subsection shall apply only for purposes of title XIX of the Social Security Act and shall not apply with respect to—(A) disproportionate share hospital payments described in section 1923 of such Act (42 U.S.C. 1396r–4); (B) payments under title IV or XXI of such Act (42 U.S.C. 601 et seq. and 1397aa et seq.); or(C) any payments under XIX of such Act that are based on the enhanced FMAP described in section 2105(b) of such Act (42 U.S.C. 1397ee(b)).(6) State eligibility.—(A) In general.—Subject to subparagraph (B), a State is eligible for an increase in its FMAP under paragraph (3) or an increase in a cap amount under paragraph (4) only if the eligibility under its State plan under title XIX of the Social Security Act (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)) is no more restrictive than the eligibility under such plan (or waiver) as in effect on September 2, 2003.(B) State reinstatement of eligibility permitted.—A State that has restricted eligibility under its State plan under title XIX of the Social Security Act (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)) after September 2, 2003, is eligible for an increase in its FMAP under paragraph (3) or an increase in a cap amount under paragraph (4) in the first calendar quarter (and subsequent calendar quarters) in which the State has reinstated eligibility that is no more restrictive than the eligibility under such plan (or waiver) as in effect on September 2, 2003.117 STAT. 766(C) Rule of construction.—Nothing in subparagraph (A) or (B) shall be construed as affecting a State’s flexibility with respect to benefits offered under the State medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)).(7) Requirement for certain states.—In the case of a State that requires political subdivisions within the State to contribute toward the non-Federal share of expenditures under the State medicaid plan required under section 1902(a)(2) of the Social Security Act (42 U.S.C. 1396a(a)(2)), the State shall not require that such political subdivisions pay a greater percentage of the non-Federal share of such expenditures for the third and fourth calendar quarters of fiscal year 2003 and the first, second and third calendar quarters of fiscal year 2004, than the percentage that was required by the State under such plan on April 1, 2003, prior to application of this subsection.(8) Definitions.—In this subsection:(A) FMAP.—The term “FMAP” means the Federal medical assistance percentage, as defined in section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)).(B) State.—The term “State” has the meaning given such term for purposes of title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).(9) Repeal.—Effective as of October 1, 2004, this subsection is repealed.(b) $10,000,000,000 to Assist States in Providing Government Services.—The Social Security Act (42 U.S.C. 301 et seq.) is amended by inserting after title V the following:“TITLE VI—TEMPORARY STATE FISCAL RELIEF“SEC. 601. TEMPORARY STATE FISCAL RELIEF.“(a) Appropriation.—There is authorized to be appropriated and is appropriated for making payments to States under this section, $5,000,000,000 for each of fiscal years 2003 and 2004.“(b) Payments.—“(1) Fiscal year 2003.—From the amount appropriated under subsection (a) for fiscal year 2003, the Secretary of the Treasury shall, not later than the later of the date that is 45 days after the date of enactment of this Act or the date that a State provides the certification required by subsection (e) for fiscal year 2003, pay each State the amount determined for the State for fiscal year 2003 under subsection (c). “(2) Fiscal year 2004.—From the amount appropriated under subsection (a) for fiscal year 2004, the Secretary of the Treasury shall, not later than the later of October 1, 2003, or the date that a State provides the certification required by subsection (e) for fiscal year 2004, pay each State the amount determined for the State for fiscal year 2004 under subsection (c). “(c) Payments Based on Population.—“(1) In general.—Subject to paragraph (2), the amount appropriated under subsection (a) for each of fiscal years 2003 117 STAT. 767 and 2004 shall be used to pay each State an amount equal to the relative population proportion amount described in paragraph (3) for such fiscal year.“(2) Minimum payment.—“(A) In general.—No State shall receive a payment under this section for a fiscal year that is less than—“(i) in the case of 1 of the 50 States or the District of Columbia, ½ of 1 percent of the amount appropriated for such fiscal year under subsection (a); and“(ii) in the case of the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, the Commonwealth of the Northern Mariana Islands, or American Samoa, ⅒ of 1 percent of the amount appropriated for such fiscal year under subsection (a).“(B) Pro rata adjustments.—The Secretary of the Treasury shall adjust on a pro rata basis the amount of the payments to States determined under this section without regard to this subparagraph to the extent necessary to comply with the requirements of subparagraph (A).“(3) Relative population proportion amount.—The relative population proportion amount described in this paragraph is the product of—“(A) the amount described in subsection (a) for a fiscal year; and“(B) the relative State population proportion (as defined in paragraph (4)).“(4) Relative state population proportion defined.—For purposes of paragraph (3)(B), the term ‘relative State population proportion’ means, with respect to a State, the amount equal to the quotient of—“(A) the population of the State (as reported in the most recent decennial census); and“(B) the total population of all States (as reported in the most recent decennial census).“(d) Use of Payment.—“(1) In general.—Subject to paragraph (2), a State shall use the funds provided under a payment made under this section for a fiscal year to—“(A) provide essential government services; or“(B) cover the costs to the State of complying with any Federal intergovernmental mandate (as defined in section 421(5) of the Congressional Budget Act of 1974) to the extent that the mandate applies to the State, and the Federal Government has not provided funds to cover the costs.“(2) Limitation.—A State may only use funds provided under a payment made under this section for types of expenditures permitted under the most recently approved budget for the State. “(e) Certification.—In order to receive a payment under this section for a fiscal year, the State shall provide the Secretary of the Treasury with a certification that the State’s proposed uses of the funds are consistent with subsection (d).“(f) Definition of State.—In this section, the term ‘State’ means the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, the 117 STAT. 768 Commonwealth of the Northern Mariana Islands, and American Samoa.“(g) Repeal.—Effective as of October 1, 2004, this title is repealed.” .