H.R. 4595, Medicaid Saves Lives Act
Summary
H. R. 4595, the Medicaid Saves Lives Act, was introduced in the House of Representatives on July 21, 2021, by Bourdeaux (for herself and other members) and referred to the Committee on Energy and Commerce. It is a bill to require the Secretary of Health and Human Services to establish a program to provide health care coverage to low-income adults in States that have not expanded Medicaid. Section 2 sets up a Medicaid fallback coverage program for eligible individuals who reside in such States. The coverage imposes no premiums. A later amendment changes an 8-quarter period to a 40-quarter period and 5 percentage points to 10 percentage points, effective as if included in section 9814 of the American Rescue Plan Act of 2021.
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Cite this document
“H.R. 4595, Medicaid Saves Lives Act.”
Original at www.govinfo.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/bills-bills-117hr4595ih-bills-117hr4595ih/
, SHA-256 e2e5a8d84814bc88d776948aaa207779b568b8e1f109096d3084eeff1144e50b.Full text
I
117TH CONGRESS
1ST SESSION
H. R. 4595
To require the Secretary of Health and Human Services to establish a
program to provide health care coverage to low-income adults in States
that have not expanded Medicaid.
IN THE HOUSE OF REPRESENTATIVES
JULY 21, 2021
Ms. BOURDEAUX (for herself, Ms. CASTOR of Florida, Mrs. MCBATH, Ms.
ROSS, Ms. MANNING, Ms. WILLIAMS of Georgia, Mr. VEASEY, Ms.
MOORE of Wisconsin, Mr. CARSON, Mr. THOMPSON of Mississippi, Mr.
DANNY K. DAVIS of Illinois, Mr. CLYBURN, Mrs. MURPHY of Florida,
Mr. COOPER, Mr. BISHOP of Georgia, Mr. JOHNSON of Georgia, Mr.
KIND, Mr. BUTTERFIELD, Ms. LOIS FRANKEL of Florida, Ms. SEWELL,
Mr. COHEN, Mr. CRIST, Mr. PRICE of North Carolina, Mr. SOTO, Ms.
WASSERMAN SCHULTZ, Mrs. DEMINGS, Mr. DEUTCH, Ms. JACKSON LEE,
Mr. LAWSON of Florida, Mr. DAVID SCOTT of Georgia, Ms. ADAMS, Mr.
GREEN of Texas, Mr. CASTRO of Texas, and Mr. ALLRED) introduced the
following bill; which was referred to the Committee on Energy and Com-
merce
A BILL
To require the Secretary of Health and Human Services
to establish a program to provide health care coverage
to low-income adults in States that have not expanded
Medicaid.
1 Be it enacted by the Senate and House of Representa-
2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE.
2 This Act may be cited as the ‘‘Medicaid Saves Lives
3 Act’’.
4 SEC. 2. MEDICAID FALLBACK COVERAGE PROGRAM FOR
5 LOW-INCOME ADULTS IN NON-EXPANSION
6 STATES.
7 (a) IN GENERAL.—As soon as possible after the date
8 of enactment of this Act the Secretary of Health and
9 Human Services (in this section referred to as the ‘‘Sec-
10 retary’’) shall—
11 (1) directly or by contract, establish a program
12 that offers eligible individuals the opportunity to en-
13 roll in health benefits coverage that meets the re-
14 quirements described in subsection (c) and any re-
15 quirements applicable to such coverage pursuant to
16 subsection (d); and
17 (2) ensure that such program is administered
18 consistent with the requirements of section
19 431.10(c)(2) of title 42, Code of Federal Regula-
20 tions.
21 (b) DEFINITION OF ELIGIBLE INDIVIDUAL.—In this
22 section, the term ‘‘eligible individual’’ means an individual
23 who—
24 (1) is described in section
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25 1902(a)(10)(A)(i)(VIII) of the Social Security Act
26 (42 U.S.C. 1396a(a)(10)(A)(i)(VIII));
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1 (2) resides in a State that—
2 (A) does not expend amounts for medical
3 assistance under title XIX of the Social Secu-
4 rity Act (42 U.S.C. 1396 et seq.) for all individ-
5 uals described in such section; and
6 (B) did not expend amounts for medical
7 assistance under such title for all such individ-
8 uals as of the date of enactment of this Act;
9 and
10 (3) would not be eligible for medical assistance
11 under such State’s plan for medical assistance under
12 title XIX of the Social Security Act (42 U.S.C. 1396
13 et seq.), or a waiver of such plan, as such plan or
14 waiver was in effect on such date.
15 (c) HEALTH BENEFITS COVERAGE REQUIRE-
16 MENTS.—The requirements described in this subsection
17 with respect to health benefits coverage are the following:
18 (1) ESSENTIAL HEALTH BENEFITS.—At a min-
19 imum, the coverage meets the minimum standards
20 required under paragraph (5) of section 1937(b) of
21 the Social Security Act (42 U.S.C. 1396u–7(b)) for
22 benchmark coverage described in paragraph (1) of
23 such section or benchmark equivalent coverage de-
24 scribed in paragraph (2) of such section.
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1 (2) PREMIUMS AND COST-SHARING.—No pre-
2 miums are imposed for the coverage, and deduct-
3 ibles, cost sharing, or similar charges may only be
4 imposed in accordance with the requirements im-
5 posed on State Medicaid plans under section 1916 of
6 the Social Security Act (42 U.S.C. 1396o).
7 (d) APPLICATION OF REQUIREMENTS AND PROVI-
8 SIONS OF TITLE XIX OF THE SOCIAL SECURITY ACT.—
9 The Secretary shall specify that—
10 (1) any requirement applicable to the furnishing
11 of medical assistance under title XIX of the Social
12 Security Act (42 U.S.C. 1396 et seq.) by States that
13 have elected to make medical assistance available to
14 individuals described in section
15 1902(a)(10)(A)(i)(VIII) of such title (42 U.S.C.
16 1396a(a)(10)(A)(i)(VIII)) that does not conflict with
17 the requirements specified in subsection (c) applies
18 to the program established under this section; and
19 (2) other provisions of such title apply to such
20 program.
21 (e) NO STATE MANDATE.—Nothing in this section
22 shall be construed as requiring a State to make expendi-
23 tures related to the program established under this section
24 and the Secretary shall not impose any such requirement.
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1 (f) FUNDING.—There are appropriated to the Sec-
2 retary for each fiscal year beginning with fiscal year 2021
3 from any funds in the Treasury not otherwise appro-
4 priated, such sums as are necessary to carry out this sec-
5 tion.
6 SEC. 3. INCREASE AND EXTENSION OF TEMPORARY EN-
7 HANCED FMAP FOR STATES WHICH BEGIN TO
8 EXPEND AMOUNTS FOR CERTAIN MANDA-
9 TORY INDIVIDUALS.
10 (a) IN GENERAL.—Section 1905(ii)(1) of the Social
11 Security Act (42 U.S.C. 1396d(ii)(1)) is amended—
12 (1) by striking ‘‘8-quarter period’’ and inserting
13 ‘‘40-quarter period’’; and
14 (2) by striking ‘‘5 percentage points’’ and in-
15 serting ‘‘10 percentage points’’.
16 (b) EFFECTIVE DATE.—The amendments made by
17 this section shall take effect as if included in the enact-
18 ment of section 9814 of the American Rescue Plan Act
19 of 2021 (Public Law 117–2).
Æ
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