
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC1396u-1]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
    SUBCHAPTER XIX--GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
 
Sec. 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).

(Aug. 14, 1935, ch. 531, title XIX, Sec. 1931, as added Pub. L. 104-193, 
title I, Sec. 114(a)(2), Aug. 22, 1996, 110 Stat. 2177; amended Pub. L. 
106-113, div. B, Sec. 1000(a)(6) [title VI, Sec. 602(a)], Nov. 29, 1999, 
113 Stat. 1536, 1501A-394.)

                       References in Text

    Parts A and D of subchapter IV of this chapter, referred to in text, 
are classified to sections 601 et seq. and 651 et seq., respectively, of 
this title.
    For 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), referred to in subsec. (i), 
see section 116 of Pub. L. 104-193, set out as an Effective Date note 
under section 601 of this title.


                            Prior Provisions

    A prior section 1931 of act Aug. 14, 1935, was renumbered section 
1935, and is classified to section 1396v of this title.


                               Amendments

    1999--Subsec. (h)(3). Pub. L. 106-113, Sec. 1000(a)(6) [title VI, 
Sec. 602(a)(1)], struck out ``and ending with fiscal year 2000'' after 
``fiscal year 1997''.
    Subsec. (h)(4). Pub. L. 106-113, Sec. 1000(a)(6) [title VI, 
Sec. 602(a)(2)], struck out heading and text of par. (4). Prior to 
amendment, text read as follows: ``This subsection shall only apply with 
respect to a State for expenditures incurred during the first 12 
calendar quarters in which the State program funded under part A of 
subchapter IV of this chapter (as in effect on and after the welfare 
reform effective date) is in effect.''


                    Effective Date of 1999 Amendment

    Pub. L. 106-113, div. B, Sec. 1000(a)(6) [title VI, Sec. 602(b)], 
Nov. 29, 1999, 113 Stat. 1536, 1501A-394, provided that: ``The 
amendments made by this section [amending this section] shall take 
effect as if included in the enactment of section 114 of the Personal 
Responsibility and Work Opportunity Reconciliation Act of 1996 (Public 
Law 104-193; 110 Stat. 2177).''


                             Effective Date

    Section effective July 1, 1997, with transition rules relating to 
State options to accelerate such date, rules relating to claims, 
actions, and proceedings commenced before such date, rules relating to 
closing out of accounts for terminated or substantially modified 
programs and continuance in office of Assistant Secretary for Family 
Support, and provisions relating to termination of entitlement under 
AFDC program, see section 116 of Pub. L. 104-193, as amended, set out as 
a note under section 601 of this title.

                  Section Referred to in Other Sections

    This section is referred to in sections 608, 1396a, 1396d of this 
title.
