text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Unintended Pregnancy Reduction Act 
  of 2006''.
  
  SEC. 2. FINDINGS.
  
      Congress makes the following findings:
              (1) Rates of unintended pregnancy in the United States 
          increased by nearly 30 percent among low-income women between 
          1994 and 2002, and a low-income woman today is 4 times as 
          likely to have an unintended pregnancy as her higher income 
          counterpart.
              (2) Abortion rates decreased among higher income women but 
          increased among low income women between 1994 and 2002, and a 
          low income woman is more than 4 times as likely to have an 
          abortion as her higher income counterpart.
              (3) Contraceptive use reduces a woman's probability of 
          having an abortion by 85 percent.
              (4) Levels of contraceptive use among low-income women at 
          risk of unintended pregnancy declined significantly between 
          1994 and 2002, from 92 percent to 86 percent.
              (5) Publicly funded contraceptive services have been shown 
          to prevent 1,300,000 unintended pregnancies each year, and in 
          the absence of these services the United States abortion rate 
          would likely be 40 percent higher than it is.
              (6) By helping couples avoid unintended pregnancy, 
          Medicaid-funded contraceptive services are highly cost-
          effective, and every public dollar spent on family planning 
          saves $3 in the cost of pregnancy-related care alone.
              (7) Federal law requires State Medicaid programs to cover 
          pregnancy-related care for women with incomes up to 133 percent 
          of poverty, and 17 States have expanded this coverage to women 
          with incomes up to 200 percent of poverty.
              (8) 18 States have expanded Medicaid coverage for family 
          planning services to the same level at which they provide 
          Medicaid funded pregnancy-related care.
              (9) Equalizing the eligibility levels for family planning 
          and pregnancy-related care nationwide would maximize the cost-
          savings to both the Federal and State Governments.
              (10) A woman should have equal access to contraceptive 
          services to help prevent an unintended pregnancy and to 
          pregnancy-related care if she does become pregnant.
  
  SEC. 3. CLARIFICATION OF COVERAGE OF FAMILY PLANNING SERVICES AND 
                SUPPLIES.
  
      Section 1937(b) of the Social Security Act (42 U.S.C. 1396u-7(b)) 
  is amended by adding at the end the following:
              ``(5) Coverage of family planning services and supplies.--
          Notwithstanding the previous provisions of this section, a 
          State may not provide for medical assistance through enrollment 
          of an individual with benchmark coverage or benchmark-
          equivalent coverage under this section unless that coverage 
          includes family planning services and supplies as described in 
          section 1905(a)(4)(C).''.
  
  SEC. 4. EXPANSION OF FAMILY PLANNING SERVICES.
  
      (a) Coverage as Mandatory Categorically Needy Group.--
              (1) In general.--Section 1902(a)(10)(A)(i) of the Social 
          Security Act (42 U.S.C. 1396a(a)(10)(A)(i)) is amended--
                      (A) in subclause (VI), by striking ``or'' at the 
                  end;
                      (B) in subclause (VII), by adding ``or'' at the 
                  end; and
                      (C) by adding at the end the following new 
                  subclause:
                                      ``(VIII) who are described in 
                                  subsection (dd) (relating to 
                                  individuals who meet the income 
                                  standards for pregnant women);''.
              (2) Group described.--Section 1902 of the Social Security 
          Act (42 U.S.C. 1396a) is amended by adding at the end the 
          following new subsection:
      ``(dd)(1) Individuals described in this subsection are individuals 
  who--
              ``(A) meet at least the income eligibility standards 
          established under the State plan as of May 1, 2006, for 
          pregnant women or such higher income eligibility standard for 
          such women as the State may establish; and
              ``(B) are not pregnant.
      ``(2) At the option of a State, individuals described in this 
  subsection may include individuals who are determined to meet the 
  income eligibility standards referred to in paragraph (1)(A) under the 
  terms and conditions applicable to making eligibility determinations 
  for medical assistance under this title under a waiver to provide the 
  benefits described in clause (XV) of the matter following subparagraph 
  (G) of section 1902(a)(10) granted to the State under section 1115 as 
  of May 1, 2006.''.
              (3) Limitation on benefits.--Section 1902(a)(10) of the 
          Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the 
          matter following subparagraph (G)--
                      (A) by striking ``and (XIV)'' and inserting 
                  ``(XIV)''; and
                      (B) by inserting ``, and (XV) the medical 
                  assistance made available to an individual described in 
                  subsection (dd) who is eligible for medical assistance 
                  only because of subparagraph (A)(10)(i)(VIII) shall be 
                  limited to family planning services and supplies 
                  described in 1905(a)(4)(C) and, at the State's option, 
                  medical diagnosis or treatment services that are 
                  provided in conjunction with a family planning service 
                  in a family planning setting provided during the period 
                  in which such an individual is eligible;'' after 
                  ``cervical cancer''.
              (4) Conforming amendments.--Section 1905(a) of the Social 
          Security Act (42 U.S.C. 1396d(a)) is amended in the matter 
          preceding paragraph (1)--
                      (A) in clause (xii), by striking ``or'' at the end;
                      (B) in clause (xii), by adding ``or'' at the end; 
                  and
                      (C) by inserting after clause (xiii) the following:
                              ``(xiv) individuals described in section 
                          1902(dd),''.
      (b) Presumptive Eligibility.--
              (1) In general.--Title XIX of the Social Security Act (42 
          U.S.C. 1396 et seq.) is amended by inserting after section 
          1920B the following:
  
           ``presumptive eligibility for family planning services
  
      ``Sec. 1920C.  (a) State Option.--A State plan approved under 
  section 1902 may provide for making medical assistance available to an 
  individual described in section 1902(dd) (relating to individuals who 
  meet the income eligibility standard for pregnant women in the State) 
  during a presumptive eligibility period. In the case of an individual 
  described in section 1902(dd) who is eligible for medical assistance 
  only because of subparagraph (A)(10)(i)(VIII), such medical assistance 
  may be limited to family planning services and supplies described in 
  1905(a)(4)(C) and, at the State's option, medical diagnosis or 
  treatment services that are provided in conjunction with a family 
  planning service in a family planning setting provided during the 
  period in which such an individual is eligible.
      ``(b) Definitions.--For purposes of this section:
              ``(1) Presumptive eligibility period.--The term 
          `presumptive eligibility period' means, with respect to an 
          individual described in subsection (a), the period that--
                      ``(A) begins with the date on which a qualified 
                  entity determines, on the basis of preliminary 
                  information, that the individual is described in 
                  section 1902(dd); and
                      ``(B) ends with (and includes) the earlier of--
                              ``(i) the day on which a determination is 
                          made with respect to the eligibility of such 
                          individual for services under the State plan; 
                          or
                              ``(ii) in the case of such an individual 
                          who does not file an application by the last 
                          day of the month following the month during 
                          which the entity makes the determination 
                          referred to in subparagraph (A), such last day.
              ``(2) Qualified entity.--
                      ``(A) In general.--Subject to subparagraph (B), the 
                  term `qualified entity' means any entity that--
                              ``(i) is eligible for payments under a 
                          State plan approved under this title; and
                              ``(ii) is determined by the State agency to 
                          be capable of making determinations of the type 
                          described in paragraph (1)(A).
                      ``(B) Regulations.--The Secretary may issue 
                  regulations further limiting those entities that may 
                  become qualified entities in order to prevent fraud and 
                  abuse and for other reasons.
                      ``(C) Rule of construction.--Nothing in this 
                  paragraph shall be construed as preventing a State from 
                  limiting the classes of entities that may become 
                  qualified entities, consistent with any limitations 
                  imposed under subparagraph (B).
      ``(c) Administration.--
              ``(1) In general.--The State agency shall provide qualified 
          entities with--
                      ``(A) such forms as are necessary for an 
                  application to be made by an individual described in 
                  subsection (a) for medical assistance under the State 
                  plan; and
                      ``(B) information on how to assist such individuals 
                  in completing and filing such forms.
              ``(2) Notification requirements.--A qualified entity that 
          determines under subsection (b)(1)(A) that an individual 
          described in subsection (a) is presumptively eligible for 
          medical assistance under a State plan shall--
                      ``(A) notify the State agency of the determination 
                  within 5 working days after the date on which 
                  determination is made; and
                      ``(B) inform such individual at the time the 
                  determination is made that an application for medical 
                  assistance is required to be made by not later than the 
                  last day of the month following the month during which 
                  the determination is made.
              ``(3) Application for medical assistance.--In the case of 
          an individual described in subsection (a) who is determined by 
          a qualified entity to be presumptively eligible for medical 
          assistance under a State plan, the individual shall apply for 
          medical assistance by not later than the last day of the month 
          following the month during which the determination is made.
      ``(d) Payment.--Notwithstanding any other provision of this title, 
  medical assistance that--
              ``(1) is furnished to an individual described in subsection 
          (a)--
                      ``(A) during a presumptive eligibility period;
                      ``(B) by a entity that is eligible for payments 
                  under the State plan; and
              ``(2) is included in the care and services covered by the 
          State plan, shall be treated as medical assistance provided by 
          such plan for purposes of clause (4) of the first sentence of 
          section 1905(b).''.
              (2) Conforming amendments.--
                      (A) Section 1902(a)(47) of the Social Security Act 
                  (42 U.S.C. 1396a(a)(47)) is amended by inserting before 
                  the semicolon at the end the following: ``and provide 
                  for making medical assistance available to individuals 
                  described in subsection (a) of section 1920C during a 
                  presumptive eligibility period in accordance with such 
                  section.''.
                      (B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 
                  1396b(u)(1)(D)(v)) is amended--
                              (i) by striking ``or for'' and inserting 
                          ``, for''; and
                              (ii) by inserting before the period the 
                          following: ``, or for medical assistance 
                          provided to an individual described in 
                          subsection (a) of section 1920C during a 
                          presumptive eligibility period under such 
                          section''.
  
  SEC. 5. EFFECTIVE DATE.
  
      (a) In General.--Except as provided in paragraph (2), the 
  amendments made by this Act take effect on October 1, 2006.
      (b) Extension of Effective Date for State Law Amendment.--In the 
  case of a State plan under title XIX of the Social Security Act (42 
  U.S.C. 1396 et seq.) which the Secretary of Health and Human Services 
  determines requires State legislation in order for the plan to meet the 
  additional requirements imposed by the amendments made by this Act, the 
  State plan shall not be regarded as failing to comply with the 
  requirements of such title solely on the basis of its failure to meet 
  these additional requirements 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.
target: Unintended Pregnancy Reduction Act of 2006 - Amends title XIX (Medicaid) of the Social Security Act to: (1) prohibit a state from providing for medical assistance through enrollment of an individual with benchmark coverage or benchmark-equivalent coverage unless it includes certain family planning services and supplies; (2 ) include women who are not pregnant but who meet certain income eligibility standards in a mandatory categorically needy group for family planning services purposes; and (3) allow a state Medicaid plan to provide for making medical assistance available to such individuals during a presumptive eligibility period.
feat_title: To amend title XIX of the Social Security Act to expand access to contraceptive services for women and men under the Medicaid Program, help low income women and couples prevent unintended pregnancies and reduce abortion, and for other purposes.