S 142 ISCommentsClose CommentsPermalink

To amend titles XIX and XXI of the Social Security Act to ensure that every uninsured child in America has health insurance coverage, and for other purposes.CommentsClose CommentsPermalink

January 6, 2009CommentsClose CommentsPermalink

Mr. KERRY introduced the following bill; which was read twice and referred to the Committee on FinanceCommentsClose CommentsPermalink

To amend titles XIX and XXI of the Social Security Act to ensure that every uninsured child in America has health insurance coverage, and for other purposes.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the ‘Kids Come First Act of 2009’.CommentsClose CommentsPermalink





(b) Table of Contents- The table of contents of this Act is as follows:CommentsClose CommentsPermalink





Sec. 1. Short title; table of contents.CommentsClose CommentsPermalink





Sec. 2. Findings.CommentsClose CommentsPermalink

TITLE I--EXPANDED COVERAGE OF CHILDREN UNDER MEDICAID AND SCHIP

Sec. 101. State option to receive 100 percent FMAP for medical assistance for children in poverty in exchange for expanded coverage of children in working poor families under Medicaid or SCHIP.CommentsClose CommentsPermalink





Sec. 102. Elimination of cap on SCHIP funding for States that expand eligibility for children.CommentsClose CommentsPermalink

TITLE II--STATE OPTIONS FOR INCREMENTAL CHILD COVERAGE EXPANSIONS

Sec. 201. State option to provide wrap-around SCHIP coverage to children who have other health coverage.CommentsClose CommentsPermalink





Sec. 202. State option to enroll low-income children of State employees in SCHIP.CommentsClose CommentsPermalink





Sec. 203. Optional coverage of legal immigrant children under Medicaid and SCHIP.CommentsClose CommentsPermalink





Sec. 204. State option for passive renewal of eligibility for children under Medicaid and SCHIP.CommentsClose CommentsPermalink

TITLE III--TAX INCENTIVES FOR HEALTH INSURANCE COVERAGE OF CHILDREN

Sec. 301. Refundable credit for health insurance coverage of children.CommentsClose CommentsPermalink





Sec. 302. Forfeiture of personal exemption for any child not covered by health insurance.CommentsClose CommentsPermalink

TITLE IV--SMALL BUSINESS CHILDREN’S HEALTH EDUCATION TASK FORCE

Sec. 401. Definitions.CommentsClose CommentsPermalink





Sec. 402. Establishment of task force.CommentsClose CommentsPermalink

TITLE V--MISCELLANEOUS

Sec. 501. Requirement for group market health insurers to offer dependent coverage option for workers with children.CommentsClose CommentsPermalink

TITLE VI--REVENUE PROVISION

Sec. 601. Partial repeal of rate reduction in the highest income tax bracket.CommentsClose CommentsPermalink

SEC. 2. FINDINGS.

Congress makes the following findings:CommentsClose CommentsPermalink





(1) NEED FOR UNIVERSAL COVERAGE-CommentsClose CommentsPermalink





(A) There are nearly 9,000,000 children under the age of 19 that are uninsured. One out of every 9 children are uninsured while 1 in 5 Hispanic children and 1 in 8 African-American children are uninsured. Three-fifths, approximately 5,400,000, of these children are eligible but not enrolled in the Medicaid program or the State Children’s Health Insurance Program (SCHIP).CommentsClose CommentsPermalink





(B) Low-income children are 3 times as likely as children in higher income families to be uninsured. It is estimated that over 60 percent of uninsured children have at least 1 parent working full time over the course of the year.CommentsClose CommentsPermalink





(C) It is estimated that legal immigrant children are three times as likely to be uninsured as native born children. Nearly 1/2 of low-income immigrant children are uninsured.CommentsClose CommentsPermalink





(D) Children in the South are twice as likely to be uninsured than children in the Midwest. In the Northeast, 8.5 percent of children are uninsured, while in the Midwest 7.2, percent are uninsured. The South’s rate of uninsured children is 14.8 percent while the West has an uninsured rate of 11.5 percent.CommentsClose CommentsPermalink





(E) Children’s health care needs are neglected in the United States. Over 20 percent of children in the United States are not fully up to date on their basic immunizations. Half of all children with asthma who do not have health insurance do not receive preventative care. One out of every 4 children do not receive annual dental exams. Minority children are less likely to receive proven treatments such as prescription medications to treat chronic disease.CommentsClose CommentsPermalink





(F) According to a study conducted by the Urban Institute in February 2007, among those eligible for SCHIP, children whose families are self-employed or who work for small business concerns are far less likely to be enrolled in that program, specifically that 1 out of every 4 eligible children with parents who work for a small business concern or are self-employed are not enrolled, compared with 1 out of 10 eligible children whose parents work for a large firm who are not enrolled.CommentsClose CommentsPermalink





(2) ROLE OF THE MEDICAID AND STATE CHILDREN’S HEALTH INSURANCE PROGRAMS-CommentsClose CommentsPermalink





(A) The Medicaid program and SCHIP serve as a crucial health safety net for 30,600,000 children. During the recent economic downturn and the highest number of uninsured individuals ever recorded in the United States, the Medicaid program and SCHIP offset losses in employer-sponsored coverage.CommentsClose CommentsPermalink





(B) 23,500,000 children are enrolled today in the Medicaid program, accounting for approximately 1/2 of all enrollees and only 19 percent of total program costs.CommentsClose CommentsPermalink





(C) The Medicaid program and SCHIP do more than just fill in the gaps. Gains in public coverage have reduced the percentage of low-income uninsured children by 1/3 in the last decade. In addition, a study found that publicly insured children are more likely to obtain medical care, preventive care, and dental care than similar low-income privately insured children.CommentsClose CommentsPermalink





(D) Publicly funded programs such as the Medicaid program and SCHIP actually improve children’s health. Children who are currently insured by public programs are in better health than they were a year ago. Expansion of coverage for children and pregnant women under the Medicaid program and SCHIP reduces rates of avoidable hospitalizations, and has been proven to reduce childhood deaths, infant mortality rates, and the incidence of low birth weight.CommentsClose CommentsPermalink





(E) Studies have found that children enrolled in public insurance programs experience a significant improvement in measures of school performance.CommentsClose CommentsPermalink





(F) Despite the success of expansions in general under the Medicaid program and SCHIP, due to current budget constraints, many states have stopped doing aggressive outreach and have raised premiums and cost-sharing requirements on families under these programs.CommentsClose CommentsPermalink





(G) Difficult renewal policies and reenrollment barriers make seamless coverage in SCHIP unattainable. In addition to children who do not remain in the system due to reenrollment barriers, studies indicate that as many as 67 percent of children who were eligible but not enrolled for SCHIP had applied for coverage but were denied due to procedural issues.CommentsClose CommentsPermalink





(H) While the Medicaid program and SCHIP expansions to date have done much to offset what otherwise would have been a significant loss of coverage among children because of declining employer coverage, the shortcomings of previous expansions, such as the failure to enroll all eligible children and caps on enrollment in SCHIP because of under-funding, also are clear.CommentsClose CommentsPermalink

TITLE I--EXPANDED COVERAGE OF CHILDREN UNDER MEDICAID AND SCHIPCommentsClose CommentsPermalink

SEC. 101. STATE OPTION TO RECEIVE 100 PERCENT FMAP FOR MEDICAL ASSISTANCE FOR CHILDREN IN POVERTY IN EXCHANGE FOR EXPANDED COVERAGE OF CHILDREN IN WORKING POOR FAMILIES UNDER MEDICAID OR SCHIP.

(a) State Option- Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘STATE OPTION FOR INCREASED FMAP FOR MEDICAL ASSISTANCE FOR CHILDREN IN POVERTY IN EXCHANGE FOR EXPANDED COVERAGE OF CHILDREN IN WORKING POOR FAMILIES UNDER THIS TITLE OR title XXI

‘Sec. 1942. (a) 100 Percent FMAP-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Notwithstanding any other provision of this title, in the case of a State that, through an amendment to each of its State plans under this title and title XXI (or to a waiver of either such plan), agrees to satisfy the conditions described in subsections (b), (c), and (d), the Federal medical assistance percentage shall be 100 percent with respect to the total amount expended by the State for providing medical assistance under this title for each fiscal year quarter beginning on or after the date described in subsection (e) for children whose family income does not exceed 100 percent of the poverty line.CommentsClose CommentsPermalink





‘(2) LIMITATION ON SCOPE OF APPLICATION OF INCREASE- The increase in the Federal medical assistance percentage for a State under this section shall apply only with respect to the total amount expended for providing medical assistance under this title for a fiscal year quarter for children described in paragraph (1) and shall not apply with respect to--CommentsClose CommentsPermalink





‘(A) any other payments made under this title, including disproportionate share hospital payments described in section 1923;CommentsClose CommentsPermalink





‘(B) payments under title IV or XXI; orCommentsClose CommentsPermalink





‘(C) any payments made under this title or title XXI that are based on the enhanced FMAP described in section 2105(b).CommentsClose CommentsPermalink





‘(b) Eligibility Expansions- The condition described in this subsection is that the State agrees to do the following:CommentsClose CommentsPermalink





‘(1) COVERAGE UNDER MEDICAID OR SCHIP FOR CHILDREN IN FAMILIES WHOSE INCOME DOES NOT EXCEED 300 PERCENT OF THE POVERTY LINE-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The State agrees to provide medical assistance under this title or child health assistance under title XXI to children whose family income exceeds the medicaid applicable income level (as defined in section 2110(b)(4) but by substituting ‘January 1, 2009’ for ‘March 31, 1997’), but does not exceed 300 percent of the poverty line.CommentsClose CommentsPermalink





‘(B) STATE OPTION TO EXPAND COVERAGE THROUGH SUBSIDIZED PURCHASE OF FAMILY COVERAGE- A State may elect to carry out subparagraph (A) through the provision of assistance for the purchase of dependent coverage under a group health plan or health insurance coverage if--CommentsClose CommentsPermalink





‘(i) the dependent coverage is consistent with the benefit standards under this title or title XXI, as approved by the Secretary; andCommentsClose CommentsPermalink





‘(ii) the State provides ‘wrap-around’ coverage under this title or title XXI.CommentsClose CommentsPermalink





‘(C) DEEMED SATISFACTION FOR CERTAIN STATES- A State that, as of January 1, 2009, provides medical assistance under this title or child health assistance under title XXI to children whose family income is 300 percent of the poverty line shall be deemed to satisfy this paragraph.CommentsClose CommentsPermalink





‘(2) COVERAGE FOR CHILDREN UNDER AGE 21- The State agrees to define a child for purposes of this title and title XXI as an individual who has not attained 21 years of age.CommentsClose CommentsPermalink





‘(3) OPPORTUNITY FOR HIGHER INCOME CHILDREN TO PURCHASE SCHIP COVERAGE- The State agrees to permit any child whose family income exceeds 300 percent of the poverty line to purchase full or ‘wrap-around’ coverage under title XXI at the full cost of providing such coverage, as determined by the State.CommentsClose CommentsPermalink





‘(4) COVERAGE FOR LEGAL IMMIGRANT CHILDREN- The State agrees to--CommentsClose CommentsPermalink





‘(A) provide medical assistance under this title and child health assistance under title XXI for alien children who are lawfully residing in the United States (including battered aliens described in section 431(c) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996) and who are otherwise eligible for such assistance in accordance with section 1903(v)(4) and 2107(e)(1)(F); andCommentsClose CommentsPermalink





‘(B) not establish or enforce barriers that deter applications by such aliens, including through the application of the removal of the barriers described in subsection (c).CommentsClose CommentsPermalink





‘(c) Removal of Enrollment and Access Barriers- The condition described in this subsection is that the State agrees to do the following:CommentsClose CommentsPermalink





‘(1) PRESUMPTIVE ELIGIBILITY FOR CHILDREN- The State agrees to--CommentsClose CommentsPermalink





‘(A) provide presumptive eligibility for children under this title and title XXI in accordance with section 1920A; andCommentsClose CommentsPermalink





‘(B) treat any items or services that are provided to an uncovered child (as defined in section 2110(c)(8)) who is determined ineligible for medical assistance under this title as child health assistance for purposes of paying a provider of such items or services, so long as such items or services would be considered child health assistance for a targeted low-income child under title XXI.CommentsClose CommentsPermalink





‘(2) ADOPTION OF 12-MONTH CONTINUOUS ENROLLMENT- The State agrees to provide that eligibility for assistance under this title and title XXI shall not be regularly redetermined more often than once every year for children.CommentsClose CommentsPermalink





‘(3) ACCEPTANCE OF SELF-DECLARATION OF INCOME- The State agrees to permit the family of a child applying for medical assistance under this title or child health assistance under title XXI to declare and certify by signature under penalty of perjury family income for purposes of collecting financial eligibility information.CommentsClose CommentsPermalink





‘(4) ADOPTION OF ACCEPTANCE OF ELIGIBILITY DETERMINATIONS FOR OTHER ASSISTANCE PROGRAMS- The State agrees to accept determinations (made within a reasonable period, as found by the State, before its use for this purpose) of an individual’s family or household income made by a Federal or State agency (or a public or private entity making such determination on behalf of such agency), including the agencies administering the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.), the Richard B. Russell National School Lunch Act, and the Child Nutrition Act of 1966, notwithstanding any differences in budget unit, disregard, deeming, or other methodology, but only if--CommentsClose CommentsPermalink





‘(A) such agency has fiscal liabilities or responsibilities affected or potentially affected by such determinations; andCommentsClose CommentsPermalink





‘(B) any information furnished by such agency pursuant to this subparagraph is used solely for purposes of determining eligibility for medical assistance under this title or for child health assistance under title XXI.CommentsClose CommentsPermalink





‘(5) NO ASSETS TEST- The State agrees to not (or demonstrates that it does not) apply any assets or resources test for eligibility under this title or title XXI with respect to children.CommentsClose CommentsPermalink





‘(6) ELIGIBILITY DETERMINATIONS AND REDETERMINATIONS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The State agrees for purposes of initial eligibility determinations and redeterminations of children under this title and title XXI not to require a face-to-face interview and to permit applications and renewals by mail, telephone, and the Internet.CommentsClose CommentsPermalink





‘(B) NONDUPLICATION OF INFORMATION-CommentsClose CommentsPermalink





‘(i) IN GENERAL- For purposes of redeterminations of eligibility for currently or previously enrolled children under this title and title XXI, the State agrees to use all information in its possession (including information available to the State under other Federal or State programs) to determine eligibility or redetermine continued eligibility before seeking similar information from parents.CommentsClose CommentsPermalink





‘(ii) RULE OF CONSTRUCTION- Nothing in clause (i) shall be construed as limiting any obligation of a State to provide notice and a fair hearing before denying, terminating, or reducing a child’s coverage based on such information in the possession of the State.CommentsClose CommentsPermalink





‘(7) NO WAITING LIST FOR CHILDREN UNDER SCHIP- The State agrees to not impose any numerical limitation, waiting list, waiting period, or similar limitation on the eligibility of children for child health assistance under title XXI or to establish or enforce other barriers to the enrollment of eligible children based on the date of their application for coverage.CommentsClose CommentsPermalink





‘(8) ADEQUATE PROVIDER PAYMENT RATES- The State agrees to--CommentsClose CommentsPermalink





‘(A) establish payment rates for children’s health care providers under this title that are no less than the average of payment rates for similar services for such providers provided under the benchmark benefit packages described in section 2103(b);CommentsClose CommentsPermalink





‘(B) establish such rates in amounts that are sufficient to ensure that children enrolled under this title or title XXI have adequate access to comprehensive care, in accordance with the requirements of section 1902(a)(30)(A); andCommentsClose CommentsPermalink





‘(C) include provisions in its contracts with providers under this title guaranteeing compliance with these requirements.CommentsClose CommentsPermalink





‘(d) Maintenance of Medicaid Eligibility Levels for Children-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The condition described in this subsection is that the State agrees to maintain eligibility income, resources, and methodologies applied under this title (including under a waiver of such title or under section 1115) with respect to children that are no more restrictive than the eligibility income, resources, and methodologies applied with respect to children under this title (including under such a waiver) as of January 1, 2009.CommentsClose CommentsPermalink





‘(2) RULE OF CONSTRUCTION- Nothing in this section shall be construed as implying that a State does not have to comply with the minimum income levels required for children under section 1902(l)(2).CommentsClose CommentsPermalink





‘(e) Date Described- The date described in this subsection is the date on which, with respect to a State, a plan amendment that satisfies the requirements of subsections (b), (c), and (d) is approved by the Secretary.CommentsClose CommentsPermalink





‘(f) Definition of Poverty Line- In this section, the term ‘poverty line’ has the meaning given that term in section 2110(c)(5).’.CommentsClose CommentsPermalink





(b) Conforming Amendments-CommentsClose CommentsPermalink





(1) The third sentence of section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is amended by inserting before the period the following: ‘, and with respect to amounts expended for medical assistance for children on or after the date described in subsection (e) of section 1942, in the case of a State that has, in accordance with such section, an approved plan amendment under this title and title XXI’.CommentsClose CommentsPermalink





(2) Section 1903(f)(4) of the Social Security Act (42 U.S.C. 1396b(f)(4)) is amended--CommentsClose CommentsPermalink





(A) in subparagraph (C), by adding ‘or’ after ‘section 1611(b)(1),’; andCommentsClose CommentsPermalink





(B) by inserting after subparagraph (C), the following:CommentsClose CommentsPermalink





‘(D) who would not receive such medical assistance but for State electing the option under section 1942 and satisfying the conditions described in subsections (b), (c), and (d) of such section,’.CommentsClose CommentsPermalink

SEC. 102. ELIMINATION OF CAP ON SCHIP FUNDING FOR STATES THAT EXPAND ELIGIBILITY FOR CHILDREN.

(a) In General- Section 2105 of the Social Security Act (42 U.S.C. 1397dd) is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(h) Guaranteed Funding for Child Health Assistance for Coverage Expansion States-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Only in the case of a State that has, in accordance with section 1942, an approved plan amendment under this title and title XIX, any payment cap that would otherwise apply to the State under this title as a result of having expended all allotments available for expenditure by the State with respect to a fiscal year shall not apply with respect to amounts expended by the State on or after the date described in section 1942(e).CommentsClose CommentsPermalink





‘(2) APPROPRIATION- There is appropriated, out of any money in the Treasury not otherwise appropriated, such sums as may be necessary for the purpose of paying a State described in paragraph (1) for each quarter beginning on or after the date described in section 1942(e), an amount equal to the enhanced FMAP of expenditures described in paragraph (1) and incurred during such quarter.’.CommentsClose CommentsPermalink





(b) Conforming Amendments- Section 2104 of the Social Security Act (42 U.S.C. 1397dd) is amended--CommentsClose CommentsPermalink





(1) in subsection (a), by inserting ‘and section 2105(h)’ after ‘subsection (d)’;CommentsClose CommentsPermalink





(2) in subsection (b)(1), by striking ‘and subsection (d)’ and inserting ‘, subsection (d), and section 2105(h)’; andCommentsClose CommentsPermalink





(3) in subsection (c)(1), by inserting ‘and section 2105(h)’ after ‘subsection (d)’.CommentsClose CommentsPermalink

TITLE II--STATE OPTIONS FOR INCREMENTAL CHILD COVERAGE EXPANSIONSCommentsClose CommentsPermalink

SEC. 201. STATE OPTION TO PROVIDE WRAP-AROUND SCHIP COVERAGE TO CHILDREN WHO HAVE OTHER HEALTH COVERAGE.

(a) In General- Section 2110(b) of the Social Security Act (42 U.S.C. 1397jj(b)) is amended--CommentsClose CommentsPermalink





(1) in paragraph (1)(C), by inserting ‘, subject to paragraph (5),’ after ‘under title XIX or’; andCommentsClose CommentsPermalink





(2) by adding at the end the following new paragraph:CommentsClose CommentsPermalink





‘(5) STATE OPTION TO PROVIDE WRAP-AROUND COVERAGE-CommentsClose CommentsPermalink





‘(A) IN GENERAL- A State may waive the requirement of paragraph (1)(C) that a targeted low-income child may not be covered under a group health plan or under health insurance coverage in order to provide--CommentsClose CommentsPermalink





‘(i) items or services that are not covered, or are only partially covered, under such plan or coverage; orCommentsClose CommentsPermalink





‘(ii) cost-sharing protection.CommentsClose CommentsPermalink





‘(B) ELIGIBILITY- In waiving such requirement, a State may limit the application of the waiver to children whose family income does not exceed a level specified by the State, so long as the level so specified does not exceed the maximum income level otherwise established for other children under the State child health plan.CommentsClose CommentsPermalink





‘(C) CONTINUED APPLICATION OF DUTY TO PREVENT SUBSTITUTION OF EXISTING COVERAGE- Nothing in this paragraph shall be construed as modifying the application of section 2102(b)(3)(C) to a State.’.CommentsClose CommentsPermalink





(b) Application of Enhanced Match Under Medicaid- Section 1905 of such Act (42 U.S.C. 1396d) is amended--CommentsClose CommentsPermalink





(1) in subsection (b), in the fourth sentence, by striking ‘subsection (u)(3)’ and inserting ‘, (u)(3), or (u)(4)’; andCommentsClose CommentsPermalink





(2) in subsection (u), by redesignating paragraph (4) as paragraph (5) and by inserting after paragraph (3) the following:CommentsClose CommentsPermalink





‘(4) For purposes of subsection (b), the expenditures described in this paragraph are expenditures for items and services for children described in section 2110(b)(5).’.CommentsClose CommentsPermalink





(c) Application of Secondary Payor Provisions- Section 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)) is amended--CommentsClose CommentsPermalink





(1) by redesignating subparagraphs (B) through (D) as subparagraphs (C) through (E), respectively; andCommentsClose CommentsPermalink





(2) by inserting after subparagraph (A) the following new subparagraph:CommentsClose CommentsPermalink





‘(B) Section 1902(a)(25) (relating to coordination of benefits and secondary payor provisions) with respect to children covered under a waiver described in section 2110(b)(5).’.CommentsClose CommentsPermalink

SEC. 202. STATE OPTION TO ENROLL LOW-INCOME CHILDREN OF STATE EMPLOYEES IN SCHIP.

Section 2110(b)(2) of the Social Security Act (42 U.S.C. 1397jj(b)(2)) is amended--CommentsClose CommentsPermalink





(1) by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively and realigning the left margins of such clauses appropriately;CommentsClose CommentsPermalink





(2) by striking ‘Such term’ and inserting the following:CommentsClose CommentsPermalink





‘(A) IN GENERAL- Such term’; andCommentsClose CommentsPermalink





(3) by adding at the end the following:CommentsClose CommentsPermalink





‘(B) STATE OPTION TO ENROLL LOW-INCOME CHILDREN OF STATE EMPLOYEES- At the option of a State, subparagraph (A)(ii) shall not apply to any low-income child who would otherwise be eligible for child health assistance under this title but for such subparagraph.’.CommentsClose CommentsPermalink

SEC. 203. OPTIONAL COVERAGE OF LEGAL IMMIGRANT CHILDREN UNDER MEDICAID AND SCHIP.

(a) Medicaid Program- Section 1903(v) of the Social Security Act (42 U.S.C. 1396b(v)) is amended--CommentsClose CommentsPermalink





(1) in paragraph (1), by striking ‘paragraph (2)’ and inserting ‘paragraphs (2) and (4)’; andCommentsClose CommentsPermalink





(2) by adding at the end the following:CommentsClose CommentsPermalink





‘(4)(A) A State may elect (in a plan amendment under this title) to provide medical assistance under this title for aliens--CommentsClose CommentsPermalink





‘(i) who are lawfully residing in the United States (including battered aliens described in section 431(c) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996); andCommentsClose CommentsPermalink





‘(ii) who are otherwise eligible for such assistance, within the eligibility category of children (as defined under such plan), including optional targeted low-income children described in section 1905(u)(2)(B).CommentsClose CommentsPermalink





‘(B)(i) In the case of a State that has elected to provide medical assistance to a category of aliens under subparagraph (A), no debt shall accrue under an affidavit of support against any sponsor of such an alien on the basis of provision of assistance to such category and the cost of such assistance shall not be considered as an unreimbursed cost.CommentsClose CommentsPermalink





‘(ii) The provisions of sections 401(a), 402(b), 403, and 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 shall not apply to a State that makes an election under subparagraph (A).’.CommentsClose CommentsPermalink





(b) Title XXI- Section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)), as amended by section 201(c), is amended redesignating subparagraph (E) as subparagraph (F) and by inserting after subparagraph (D) the following:CommentsClose CommentsPermalink





‘(E) Section 1903(v)(4) (relating to optional coverage of permanent resident alien children), but only if the State has elected to apply such section to that category of children under title XIX.’.CommentsClose CommentsPermalink

SEC. 204. STATE OPTION FOR PASSIVE RENEWAL OF ELIGIBILITY FOR CHILDREN UNDER MEDICAID AND SCHIP.

(a) In General- Section 1902(l) of the Social Security Act (42 U.S.C. 1396a(l)) is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(5) Notwithstanding any other provision of this title, a State may provide that an individual who has not attained 21 years of age who has been determined eligible for medical assistance under this title shall remain eligible for medical assistance until such time as the State has information demonstrating that the individual is no longer so eligible.’.CommentsClose CommentsPermalink





(b) Application Under Title XXI- Section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)), as amended by section 201(c) and 203(b), is amended--CommentsClose CommentsPermalink





(1) by redesignating subparagraphs (C) through (F) as subparagraphs (D) through (G), respectively; andCommentsClose CommentsPermalink





(2) by inserting after subparagraph (B), the following:CommentsClose CommentsPermalink





‘(C) Section 1902(l)(5) (relating to passive renewal of eligibility for children).’.CommentsClose CommentsPermalink

TITLE III--TAX INCENTIVES FOR HEALTH INSURANCE COVERAGE OF CHILDRENCommentsClose CommentsPermalink

SEC. 301. REFUNDABLE CREDIT FOR HEALTH INSURANCE COVERAGE OF CHILDREN.

(a) In General- Subpart C of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 (relating to refundable credits) is amended by inserting after section 36 the following new section:CommentsClose CommentsPermalink

‘SEC. 36A. HEALTH INSURANCE COVERAGE OF CHILDREN.

‘(a) In General- In the case of an individual, there shall be allowed as a credit against the tax imposed by this subtitle an amount equal to so much of the amount paid during the taxable year, not compensated for by insurance or otherwise, for qualified health insurance for each dependent child of the taxpayer, as exceeds 5 percent of the adjusted gross income of such taxpayer for such taxable year.CommentsClose CommentsPermalink





‘(b) Dependent Child- For purposes of this section, the term ‘dependent child’ means any child (as defined in section 152(f)(1)) who has not attained the age of 19 as of the close of the calendar year in which the taxable year of the taxpayer begins and with respect to whom a deduction under section 151 is allowable to the taxpayer.CommentsClose CommentsPermalink





‘(c) Qualified Health Insurance- For purposes of this section--CommentsClose CommentsPermalink





‘(1) IN GENERAL- The term ‘qualified health insurance’ means insurance, either employer-provided or made available under title XIX or XXI of the Social Security Act, which constitutes medical care as defined in section 213(d) without regard to--CommentsClose CommentsPermalink





‘(A) paragraph (1)(C) thereof, andCommentsClose CommentsPermalink





‘(B) so much of paragraph (1)(D) thereof as relates to qualified long-term care insurance contracts.CommentsClose CommentsPermalink





‘(2) EXCLUSION OF CERTAIN OTHER CONTRACTS- Such term shall not include insurance if a substantial portion of its benefits are excepted benefits (as defined in section 9832(c)).CommentsClose CommentsPermalink





‘(d) Medical Savings Account and Health Savings Account Contributions-CommentsClose CommentsPermalink





‘(1) IN GENERAL- If a deduction would (but for paragraph (2)) be allowed under section 220 or 223 to the taxpayer for a payment for the taxable year to the medical savings account or health savings account of an individual, subsection (a) shall be applied by treating such payment as a payment for qualified health insurance for such individual.CommentsClose CommentsPermalink





‘(2) DENIAL OF DOUBLE BENEFIT- No deduction shall be allowed under section 220 or 223 for that portion of the payments otherwise allowable as a deduction under section 220 or 223 for the taxable year which is equal to the amount of credit allowed for such taxable year by reason of this subsection.CommentsClose CommentsPermalink





‘(e) Special Rules-CommentsClose CommentsPermalink





‘(1) DETERMINATION OF INSURANCE COSTS- The Secretary shall provide rules for the allocation of the cost of any qualified health insurance for family coverage to the coverage of any dependent child under such insurance.CommentsClose CommentsPermalink





‘(2) COORDINATION WITH DEDUCTION FOR HEALTH INSURANCE COSTS OF SELF-EMPLOYED INDIVIDUALS- In the case of a taxpayer who is eligible to deduct any amount under section 162(l) for the taxable year, this section shall apply only if the taxpayer elects not to claim any amount as a deduction under such section for such year.CommentsClose CommentsPermalink





‘(3) COORDINATION WITH MEDICAL EXPENSE AND HIGH DEDUCTIBLE HEALTH PLAN DEDUCTIONS- The amount which would (but for this paragraph) be taken into account by the taxpayer under section 213 or 223 for the taxable year shall be reduced by the credit (if any) allowed by this section to the taxpayer for such year.CommentsClose CommentsPermalink





‘(4) DENIAL OF CREDIT TO DEPENDENTS- No credit shall be allowed under this section to any individual with respect to whom a deduction under section 151 is allowable to another taxpayer for a taxable year beginning in the calendar year in which such individual’s taxable year begins.CommentsClose CommentsPermalink





‘(5) DENIAL OF DOUBLE BENEFIT- No credit shall be allowed under subsection (a) if the credit under section 35 is allowed and no credit shall be allowed under 35 if a credit is allowed under this section.CommentsClose CommentsPermalink





‘(6) ELECTION NOT TO CLAIM CREDIT- This section shall not apply to a taxpayer for any taxable year if such taxpayer elects to have this section not apply for such taxable year.’.CommentsClose CommentsPermalink





(b) Information Reporting-CommentsClose CommentsPermalink





(1) IN GENERAL- Subpart B of part III of subchapter A of chapter 61 of the Internal Revenue Code of 1986 (relating to information concerning transactions with other persons) is amended by adding at the end the following new section:CommentsClose CommentsPermalink

‘SEC. 6050X. RETURNS RELATING TO PAYMENTS FOR QUALIFIED HEALTH INSURANCE.

‘(a) In General- Any governmental unit or any person who, in connection with a trade or business conducted by such person, receives payments during any calendar year from any individual for coverage of a dependent child (as defined in section 36A(b)) of such individual under creditable health insurance, shall make the return described in subsection (b) (at such time as the Secretary may by regulations prescribe) with respect to each individual from whom such payments were received.CommentsClose CommentsPermalink





‘(b) Form and Manner of Returns- A return is described in this subsection if such return--CommentsClose CommentsPermalink





‘(1) is in such form as the Secretary may prescribe, andCommentsClose CommentsPermalink





‘(2) contains--CommentsClose CommentsPermalink





‘(A) the name, address, and TIN of the individual from whom payments described in subsection (a) were received,CommentsClose CommentsPermalink





‘(B) the name, address, and TIN of each dependent child (as so defined) who was provided by such person with coverage under creditable health insurance by reason of such payments and the period of such coverage, andCommentsClose CommentsPermalink





‘(C) such other information as the Secretary may reasonably prescribe.CommentsClose CommentsPermalink





‘(c) Creditable Health Insurance- For purposes of this section, the term ‘creditable health insurance’ means qualified health insurance (as defined in section 36A(c)).CommentsClose CommentsPermalink





‘(d) Statements To Be Furnished to Individuals With Respect to Whom Information Is Required- Every person required to make a return under subsection (a) shall furnish to each individual whose name is required under subsection (b)(2)(A) to be set forth in such return a written statement showing--CommentsClose CommentsPermalink





‘(1) the name and address of the person required to make such return and the phone number of the information contact for such person,CommentsClose CommentsPermalink





‘(2) the aggregate amount of payments described in subsection (a) received by the person required to make such return from the individual to whom the statement is required to be furnished, andCommentsClose CommentsPermalink





‘(3) the information required under subsection (b)(2)(B) with respect to such payments.CommentsClose CommentsPermalink





The written statement required under the preceding sentence shall be furnished on or before January 31 of the year following the calendar year for which the return under subsection (a) is required to be made.CommentsClose CommentsPermalink





‘(e) Returns Which Would Be Required To Be Made by 2 or More Persons- Except to the extent provided in regulations prescribed by the Secretary, in the case of any amount received by any person on behalf of another person, only the person first receiving such amount shall be required to make the return under subsection (a).’.CommentsClose CommentsPermalink





(2) ASSESSABLE PENALTIES-CommentsClose CommentsPermalink





(A) Subparagraph (B) of section 6724(d)(1) of such Code (relating to definitions) is amended by striking ‘or’ at the end of clause (xxi), by striking ‘and’ at the end of clause (xxii) and inserting ‘or’, and by inserting at the end the following new clause:CommentsClose CommentsPermalink





‘(xxiii) section 6050X (relating to returns relating to payments for qualified health insurance), and’.CommentsClose CommentsPermalink





(B) Paragraph (2) of section 6724(d) of such Code is amended by striking ‘or’ at the end of subparagraph (CC), by striking the period at the end of subparagraph (DD) and inserting ‘, or’, and by adding at the end the following new subparagraph:CommentsClose CommentsPermalink





‘(EE) section 6050X(d) (relating to returns relating to payments for qualified health insurance).’.CommentsClose CommentsPermalink





(3) CLERICAL AMENDMENT- The table of sections for subpart B of part III of subchapter A of chapter 61 of such Code is amended by inserting after the item relating to section 6050W the following new item:CommentsClose CommentsPermalink





‘Sec. 6050X. Returns relating to payments for qualified health insurance.’.CommentsClose CommentsPermalink





(c) Conforming Amendments-CommentsClose CommentsPermalink





(1) Paragraph (2) of section 1324(b) of title 31, United States Code, is amended by inserting before the period ‘, or from section 36A of such Code’.CommentsClose CommentsPermalink





(2) The table of sections for subpart C of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by inserting after the item relating to section 36 the following new items:CommentsClose CommentsPermalink





‘Sec. 36A. Health insurance coverage of children.’.CommentsClose CommentsPermalink





(d) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008.CommentsClose CommentsPermalink

SEC. 302. FORFEITURE OF PERSONAL EXEMPTION FOR ANY CHILD NOT COVERED BY HEALTH INSURANCE.

(a) In General- Section 151(d) of the Internal Revenue Code of 1986 (relating to exemption amount) is amended by adding at the end the following new paragraph:CommentsClose CommentsPermalink





‘(5) REDUCTION OF EXEMPTION AMOUNT FOR ANY CHILD NOT COVERED BY HEALTH INSURANCE-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Except as otherwise provided in this paragraph, the exemption amount otherwise determined under this subsection for any dependent child (as defined in section 36A(b)) for any taxable year shall be reduced by the same percentage as the percentage of such taxable year during which such dependent child was not covered by qualified health insurance (as defined in section 36A(c)).CommentsClose CommentsPermalink





‘(B) FULL REDUCTION IF NO PROOF OF COVERAGE IS PROVIDED- For purposes of subparagraph (A), in the case of any taxpayer who fails to attach to the return of tax for any taxable year a copy of the statement furnished to such taxpayer under section 6050X, the percentage reduction under such subparagraph shall be deemed to be 100 percent.CommentsClose CommentsPermalink





‘(C) NONAPPLICATION OF PARAGRAPH TO TAXPAYERS IN LOWEST TAX BRACKET- This paragraph shall not apply to any taxpayer whose taxable income for the taxable year does not exceed the initial bracket amount determined under section 1(i)(1)(B).’.CommentsClose CommentsPermalink





(b) Effective Date- The amendment made by this section shall apply to taxable years beginning after December 31, 2008.CommentsClose CommentsPermalink

TITLE IV--SMALL BUSINESS CHILDREN’S HEALTH EDUCATION TASK FORCECommentsClose CommentsPermalink

SEC. 401. DEFINITIONS.

In this title:CommentsClose CommentsPermalink





(1) The terms ‘Administration’ and ‘Administrator’ means the Small Business Administration and the Administrator thereof, respectively.CommentsClose CommentsPermalink





(2) The term ‘certified development company’ means a development company participating in the program under title V of the Small Business Investment Act of 1958 (15 U.S.C. 695 et seq.).CommentsClose CommentsPermalink





(3) The term ‘Medicaid program’ means the program established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).CommentsClose CommentsPermalink





(4) The term ‘Service Corps of Retired Executives’ means the Service Corps of Retired Executives authorized by section 8(b)(1) of the Small Business Act (15 U.S.C. 637(b)(1)).CommentsClose CommentsPermalink





(5) The term ‘small business concern’ has the meaning given that term in section 3 of the Small Business Act (15 U.S.C. 632).CommentsClose CommentsPermalink





(6) The term ‘small business development center’ means a small business development center described in section 21 of the Small Business Act (15 U.S.C. 648).CommentsClose CommentsPermalink





(7) The term ‘State’ has the meaning given that term for purposes of title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.).CommentsClose CommentsPermalink





(8) The term ‘State Children’s Health Insurance Program’ means the State Children’s Health Insurance Program established under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.).CommentsClose CommentsPermalink





(9) The term ‘task force’ means the task force established under section 402(a).CommentsClose CommentsPermalink





(10) The term ‘women’s business center’ means a women’s business center described in section 29 of the Small Business Act (15 U.S.C. 656).CommentsClose CommentsPermalink

SEC. 402. ESTABLISHMENT OF TASK FORCE.

(a) Establishment- There is established a task force to conduct a nationwide campaign of education and outreach for small business concerns regarding the availability of coverage for children through private insurance options, the Medicaid program, and the State Children’s Health Insurance Program.CommentsClose CommentsPermalink





(b) Membership- The task force shall consist of the Administrator, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury.CommentsClose CommentsPermalink





(c) Responsibilities- The campaign conducted under this section shall include--CommentsClose CommentsPermalink





(1) efforts to educate the owners of small business concerns about the value of health coverage for children;CommentsClose CommentsPermalink





(2) information regarding options available to the owners and employees of small business concerns to make insurance more affordable, including Federal and State tax deductions and credits for health care-related expenses and health insurance expenses and Federal tax exclusion for health insurance options available under employer-sponsored cafeteria plans under section 125 of the Internal Revenue Code of 1986;CommentsClose CommentsPermalink





(3) efforts to educate the owners of small business concerns about assistance available through public programs; andCommentsClose CommentsPermalink





(4) efforts to educate the owners and employees of small business concerns regarding the availability of the hotline operated as part of the Insure Kids Now program of the Department of Health and Human Services.CommentsClose CommentsPermalink





(d) Implementation- In carrying out this section, the task force may--CommentsClose CommentsPermalink





(1) use any business partner of the Administration, including--CommentsClose CommentsPermalink





(A) a small business development center;CommentsClose CommentsPermalink





(B) a certified development company;CommentsClose CommentsPermalink





(C) a women’s business center; andCommentsClose CommentsPermalink





(D) the Service Corps of Retired Executives;CommentsClose CommentsPermalink





(2) enter into--CommentsClose CommentsPermalink





(A) a memorandum of understanding with a chamber of commerce; andCommentsClose CommentsPermalink





(B) a partnership with any appropriate small business concern or health advocacy group; andCommentsClose CommentsPermalink





(3) designate outreach programs at regional offices of the Department of Health and Human Services to work with district offices of the Administration.CommentsClose CommentsPermalink





(e) Website- The Administrator shall ensure that links to information on the eligibility and enrollment requirements for the Medicaid program and State Children’s Health Insurance Program of each State are prominently displayed on the website of the Administration.CommentsClose CommentsPermalink





(f) Report-CommentsClose CommentsPermalink





(1) IN GENERAL- Not later than 2 years after the date of enactment of this Act, and every 2 years thereafter, the Administrator shall submit to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives a report on the status of the nationwide campaign conducted under subsection (a).CommentsClose CommentsPermalink





(2) CONTENTS- Each report submitted under paragraph (1) shall include a status update on all efforts made to educate owners and employees of small business concerns on options for providing health insurance for children through public and private alternatives.CommentsClose CommentsPermalink

TITLE V--MISCELLANEOUSCommentsClose CommentsPermalink

SEC. 501. REQUIREMENT FOR GROUP MARKET HEALTH INSURERS TO OFFER DEPENDENT COVERAGE OPTION FOR WORKERS WITH CHILDREN.

(a) ERISA-CommentsClose CommentsPermalink





(1) IN GENERAL- Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 714. REQUIREMENT TO OFFER OPTION TO PURCHASE DEPENDENT COVERAGE FOR CHILDREN.

‘(a) Requirements for Coverage- A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, shall offer an individual who is enrolled in such coverage the option to purchase dependent coverage for a child of the individual.CommentsClose CommentsPermalink





‘(b) No Employer Contribution Required- An employer shall not be required to contribute to the cost of purchasing dependent coverage for a child by an individual who is an employee of such employer.CommentsClose CommentsPermalink





‘(c) Definition of Child- In this section, the term ‘child’ means an individual who has not attained 21 years of age.’.CommentsClose CommentsPermalink





(2) CLERICAL AMENDMENT- The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001) is amended by inserting after the item relating to section 713 the following:CommentsClose CommentsPermalink





‘Sec. 714. Requirement to offer option to purchase dependent coverage for children.’.CommentsClose CommentsPermalink





(b) Public Health Service Act- Subpart 2 of part A of title XXVII of the Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 2708. REQUIREMENT TO OFFER OPTION TO PURCHASE DEPENDENT COVERAGE FOR CHILDREN.

‘(a) Requirements for Coverage- A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, shall offer an individual who is enrolled in such coverage the option to purchase dependent coverage for a child of the individual.CommentsClose CommentsPermalink





‘(b) No Employer Contribution Required- An employer shall not be required to contribute to the cost of purchasing dependent coverage for a child by an individual who is an employee of such employer.CommentsClose CommentsPermalink





‘(c) Definition of Child- In this section, the term ‘child’ means an individual who has not attained 21 years of age.’.CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply with respect to plan years beginning on or after January 1, 2009.CommentsClose CommentsPermalink

TITLE VI--REVENUE PROVISIONCommentsClose CommentsPermalink

SEC. 601. PARTIAL REPEAL OF RATE REDUCTION IN THE HIGHEST INCOME TAX BRACKET.

Section 1(i)(2) of the Internal Revenue Code of 1986 is amended by adding at the end the following flush sentence:CommentsClose CommentsPermalink





‘In the case of taxable years beginning during calendar year 2009 and thereafter, the final item in the fourth column in the preceding table shall be applied by substituting for ‘35.0%’ a rate equal to the lesser of 39.6% or the rate the Secretary determines is necessary to provide sufficient revenues to offset the Federal outlays required to implement the provisions of, and amendments made by, the Kids Come First Act of 2009.’.CommentsClose CommentsPermalink