text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Children's Health Equity Act of 
  1998''.
  
  SEC. 2. USE OF STATE CHILDREN'S HEALTH INSURANCE PROGRAM FUNDS FOR 
                ENHANCED MATCHING RATE FOR COVERAGE OF ADDITIONAL 
                CHILDREN UNDER THE MEDICAID PROGRAM.
  
      (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
  1396d) is amended--
              (1) in subsection (b), by striking ``or subsection (u)(3)'' 
          and inserting ``, subsection (u)(3), or subsection (u)(4)(A)''; 
          and
              (2) in subsection (u) (as added by section 4911(a)(2) of 
          the Balanced Budget Act of 1997 and as amended by section 162 
          of Public Law 105-100)--
                      (A) by redesignating paragraph (4) as paragraph 
                  (5); and
                      (B) by inserting after paragraph (3) the following 
                  new paragraph:
      ``(4)(A) For purposes of subsection (b), the expenditures described 
  in this subparagraph are expenditures for medical assistance for 
  waivered low-income children described in subparagraph (B) but--
              ``(i) only in the case of children residing in a State 
          described in subparagraph (C); and
              ``(ii) only to the extent the number of full-year 
          equivalent waivered low-income children enrolled under the 
          State plan under this title for the fiscal year exceeds the 
          number of waivered low-income children described in 
          subparagraph (D)(i) for the State for the fiscal year.
      ``(B) For purposes of this paragraph, the term `waivered low-income 
  child' means a child whose family income exceeds the minimum income 
  level required to be established for the age of such child under 
  section 1902(l)(2) in order for the child to be eligible for medical 
  assistance under this title, but does not exceed the medicaid 
  applicable income level (as defined in section 2110(b)(4) but 
  determined as if `June 1, 1997' were substituted for `March 31, 1997') 
  for that child.
      ``(C) A State described in this subparagraph is a State that--
              ``(i) has under a waiver authorized by the Secretary or 
          under section 1902(r)(2) established a medicaid applicable 
          income level (as defined in section 2110(b)(4) but determined 
          as if `June 1, 1997' were substituted for `March 31, 1997') for 
          children under 19 years of age residing in the State that is at 
          or above 200 percent of the poverty line; and
              ``(ii) demonstrates to the satisfaction of the Secretary a 
          commitment to reach and enroll children who are eligible for, 
          but not enrolled under, the State plan through means, such as 
          the following:
                      ``(I) Eliminating the assets test for eligibility 
                  of waivered low-income children.
                      ``(II) Using shortened and simplified applications 
                  for such children.
                      ``(III) Allowing applications for such children to 
                  be submitted by mail or through telephone.
                      ``(IV) Outstationing State eligibility workers at 
                  sites that are frequented by families with children, 
                  including schools, child care centers, churches, 
                  centers providing Head Start services, local offices of 
                  the special supplemental food program for women, 
                  infants and young children (WIC) established under 
                  section 17 of the Child Nutrition Act of 1966, 
                  community centers, Job Corps centers established under 
                  part B of title IV of the Job Training Partnership Act 
                  or subtitle C of title I of the Workforce Investment 
                  Act of 1998, sites offering the recognized equivalent 
                  of a secondary school degree, offices of tribal 
                  organizations (as defined in section 4(l) of the Indian 
                  Self-Determination and Education Assistance Act), and 
                  Social Security Administration field offices.
                      ``(V) Using presumptive eligibility for waivered 
                  low-income children.
                      ``(VI) Collaborating with public and private 
                  entities to conduct outreach campaigns to enroll such 
                  children.
      ``(D)(i) For purposes of subparagraph (A)(ii), the number of 
  waivered low-income children for a State described in this clause for--
              ``(I) fiscal year 1998, is equal to the number of full-year 
          equivalent waivered low-income children enrolled under the 
          State plan under this title for fiscal year 1997; and
              ``(II) fiscal year 1999 or a succeeding fiscal year, is 
          equal to the number of waivered low-income children determined 
          under this clause for the preceding fiscal year increased by 
          the number of percentage points determined under clause (ii) 
          for the State for the fiscal year involved.
      ``(ii) The number of percentage points determined under this clause 
  for a State for a fiscal year is equal to the number of percentage 
  points by which--
              ``(I) the arithmetic average of the total number of 
          children in the State set forth in the 3 most recent March 
          supplements to the Current Population Survey of the Bureau of 
          the Census before the beginning of the fiscal year; exceeds
              ``(II) the arithmetic average of such total number set 
          forth in the second, third, and fourth most recent March 
          supplements to such Survey before the beginning of the fiscal 
          year.
      ``(E) For purposes of section 2104(d) (regarding the reduction of 
  an allotment under title XXI) the amount determined under paragraph (2) 
  of that section shall, with respect to expenditures described in 
  subparagraph (A), only take into account the amount by which--
              ``(i) the payments made to a State for such expenditures 
          for a fiscal year on the basis of an enhanced FMAP under the 
          fourth sentence of subsection (b); exceed
              ``(ii) the amount of payments that would have been made for 
          the expenditures if the enhanced FMAP did not apply.
      ``(F) Each State shall submit to the Secretary such information, at 
  such time and in such manner, as the Secretary determines is necessary 
  to ensure that the requirements of this paragraph are satisfied. The 
  Secretary shall ensure that information is provided under this 
  subsection in a manner that is consistent with other reporting 
  requirements for information required to be submitted by a State under 
  this title and title XXI, and avoids duplication of reporting 
  requirements.
      ``(G) The Secretary shall regularly examine the payments made to a 
  State for the expenditures described in subparagraph (A) to confirm 
  that the payments are attributable to expenditures described in such 
  subparagraph.''.
      (b) Conforming Amendments.--
              (1) Section 1902(a)(10)(A)(ii)(XIV) of the Social Security 
          Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XIV)) is amended by striking 
          ``1905(u)(2)(C)'' and inserting ``1905(u)(2)(B)''.
              (2) Section 2104(d)(2) of the Social Security Act (42 
          U.S.C. 1397dd(d)(2)) is amended by inserting ``subject to 
          section 1905(u)(4)(E),'' after ``(2)''.
      (c) Effective Date.--The amendments made by this section shall be 
  effective as if included in the enactment of section 4911 of the 
  Balanced Budget Act of 1997 (Public Law 105-33; 111 Stat. 570).
  
  SEC. 3. EXPANSION OF PRESUMPTIVE ELIGIBILITY OPTION FOR CHILDREN UNDER 
                THE MEDICAID PROGRAM.
  
      (a) In General.--Section 1920A(b)(3)(A)(i) of the Social Security 
  Act (42 U.S.C. 1396r-1a(b)(3)(A)(i)) is amended--
              (1) by striking ``or (II)'' and inserting ``, (II)''; and
              (2) by inserting before the semicolon ``, eligibility for 
          assistance under the State plan under part A of title IV, 
          eligibility of a child to receive medical assistance under the 
          State plan under this title or title XXI, (III) is a staff 
          member of an elementary school or secondary school, as such 
          terms are defined in section 14101 of the Elementary and 
          Secondary Education Act of 1965 (20 U.S.C. 8801), a child care 
          resource and referral center, or an agency administering a 
          State plan under part D of title IV, or (IV) is so designated 
          by the State''.
      (b) Conforming Amendments.--Section 1920A of such Act (42 U.S.C. 
  1396r-1a) is amended--
              (1) in subsection (b)(3)(A)(ii), by striking ``paragraph 
          (1)(A)'' and inserting ``paragraph (2)(A)''; and
              (2) in subsection (c)(2), in the matter preceding 
          subparagraph (A), by striking ``subsection (b)(1)(A)'' and 
          inserting ``subsection (b)(2)(A)''.
target: Children's Health Equity Act of 1998 - Amends title XIX (Medicaid) of the Social Security Act to provide for an increased Federal medical assistance percentage for expanded coverage of certain waivered low-income children in States which:  (1) have established a Medicaid applicable income level for children under age 19 that is at or above 200 percent of the poverty line; and (2) demonstrate a commitment to reach and enroll such children.  Defines "waivered low-income children" as those whose family income:  (1) exceeds certain minimum Medicaid-eligible levels required to be established for the age of the child; but (2) does not exceed the Medicaid applicable income level for that child. 
  Provides for expansion of the individuals and entities which may serve as qualified entities with regard to the Medicaid presumptive eligibility option for low-income children. 
  Limits the number of waivered low-income children for a State for FY 1998 and each succeeding fiscal year.
feat_title: Children's Health Equity Act of 1998