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U.S. Code as of:
01/19/04
Section 1396u-1. Assuring coverage for certain low-income families
(a) References to subchapter IV-A are references to
pre-welfare-reform provisions
Subject to the succeeding provisions of this section, with
respect to a State any reference in this subchapter (or any other
provision of law in relation to the operation of this subchapter)
to a provision of part A of subchapter IV of this chapter, or a
State plan under such part (or a provision of such a plan),
including income and resource standards and income and resource
methodologies under such part or plan, shall be considered a
reference to such a provision or plan as in effect as of July 16,
1996, with respect to the State.
(b) Application of pre-welfare-reform eligibility criteria
(1) In general
For purposes of this subchapter, subject to paragraphs (2) and
(3), in determining eligibility for medical assistance -
(A) an individual shall be treated as receiving aid or
assistance under a State plan approved under part A of
subchapter IV of this chapter only if the individual meets -
(i) the income and resource standards for determining
eligibility under such plan, and
(ii) the eligibility requirements of such plan under
subsections (a) through (c) of section 606 of this title and
section 607(a) of this title,
as in effect as of July 16, 1996; and
(B) the income and resource methodologies under such plan as
of such date shall be used in the determination of whether any
individual meets income and resource standards under such plan.
(2) State option
For purposes of applying this section, a State -
(A) may lower its income standards applicable with respect to
part A of subchapter IV of this chapter, but not below the
income standards applicable under its State plan under such
part on May 1, 1988;
(B) may increase income or resource standards under the State
plan referred to in paragraph (1) over a period (beginning
after July 16, 1996) by a percentage that does not exceed the
percentage increase in the Consumer Price Index for all urban
consumers (all items; United States city average) over such
period; and
(C) may use income and resource methodologies that are less
restrictive than the methodologies used under the State plan
under such part as of July 16, 1996.
(3) Option to terminate medical assistance for failure to meet
work requirement
(A) Individuals receiving cash assistance under TANF
In the case of an individual who -
(i) is receiving cash assistance under a State program
funded under part A of subchapter IV of this chapter,
(ii) is eligible for medical assistance under this
subchapter on a basis not related to section 1396a(l) of this
title, and
(iii) has the cash assistance under such program terminated
pursuant to section 607(e)(1)(B) of this title (as in effect
on or after the welfare reform effective date) because of
refusing to work,
the State may terminate such individual's eligibility for
medical assistance under this subchapter until such time as
there no longer is a basis for the termination of such cash
assistance because of such refusal.
(B) Exception for children
Subparagraph (A) shall not be construed as permitting a State
to terminate medical assistance for a minor child who is not
the head of a household receiving assistance under a State
program funded under part A of subchapter IV of this chapter.
(c) Treatment for purposes of transitional coverage provisions
(1) Transition in the case of child support collections
The provisions of section 606(h) of this title (as in effect on
July 16, 1996) shall apply, in relation to this subchapter, with
respect to individuals (and families composed of individuals) who
are described in subsection (b)(1)(A) of this section, in the
same manner as they applied before such date with respect to
individuals who became ineligible for aid to families with
dependent children as a result (wholly or partly) of the
collection of child or spousal support under part D of subchapter
IV of this chapter.
(2) Transition in the case of earnings from employment
For continued medical assistance in the case of individuals
(and families composed of individuals) described in subsection
(b)(1)(A) of this section who would otherwise become ineligible
because of hours or income from employment, see sections 1396r-6
and 1396a(e)(1) of this title.
(d) Waivers
In the case of a waiver of a provision of part A of subchapter IV
of this chapter in effect with respect to a State as of July 16,
1996, or which is submitted to the Secretary before August 22,
1996, and approved by the Secretary on or before July 1, 1997, if
the waiver affects eligibility of individuals for medical
assistance under this subchapter, such waiver may (but need not)
continue to be applied, at the option of the State, in relation to
this subchapter after the date the waiver would otherwise expire.
(e) State option to use 1 application form
Nothing in this section, or part A of subchapter IV of this
chapter, shall be construed as preventing a State from providing
for the same application form for assistance under a State program
funded under part A of subchapter IV of this chapter (on or after
the welfare reform effective date) and for medical assistance under
this subchapter.
(f) Additional rules of construction
(1) With respect to the reference in section 1396a(a)(5) of this
title to a State plan approved under part A of subchapter IV of
this chapter, a State may treat such reference as a reference
either to a State program funded under such part (as in effect on
and after the welfare reform effective date) or to the State plan
under this subchapter.
(2) Any reference in section 1396a(a)(55) of this title to a
State plan approved under part A of subchapter IV of this chapter
shall be deemed a reference to a State program funded under such
part.
(3) In applying section 1396b(f) of this title, the applicable
income limitation otherwise determined shall be subject to increase
in the same manner as income or resource standards of a State may
be increased under subsection (b)(2)(B) of this section.
(g) Relation to other provisions
The provisions of this section shall apply notwithstanding any
other provision of this chapter.
(h) Transitional increased Federal matching rate for increased
administrative costs
(1) In general
Subject to the succeeding provisions of this subsection, the
Secretary shall provide that with respect to administrative
expenditures described in paragraph (2) the per centum specified
in section 1396b(a)(7) of this title shall be increased to such
percentage as the Secretary specifies.
(2) Administrative expenditures described
The administrative expenditures described in this paragraph are
expenditures described in section 1396b(a)(7) of this title that
a State demonstrates to the satisfaction of the Secretary are
attributable to administrative costs of eligibility
determinations that (but for the enactment of this section) would
not be incurred.
(3) Limitation
The total amount of additional Federal funds that are expended
as a result of the application of this subsection for the period
beginning with fiscal year 1997 shall not exceed $500,000,000. In
applying this paragraph, the Secretary shall ensure the equitable
distribution of additional funds among the States.
(i) Welfare reform effective date
In this section, the term "welfare reform effective date" means
the effective date, with respect to a State, of title I of the
Personal Responsibility and Work Opportunity Reconciliation Act of
1996 (as specified in section 116 of such Act).
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