,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #dfg  ,,in ,,the ,,house ,,of   
,,representatives  ,february #d1 #bjac  
,mr4 ,connolly introduced the following 
bill2 which was referred to the         
,committee on ,energy and ,commerce  ,a 
,,bill  ,to amend title ,,xix of the    
,social ,security ,act to redistribute  
,federal funds that would otherwise be  
made available to ,states that do not   
provide for the ,medicaid expansion in  
accordance with the ,affordable ,care   
,act to those ,states electing to       
provide those ,medicaid benefits4  #a4  
,short title ,this ,act may be cited as 
the ,medicaid ,expansion ,incentive ,act
 of #bjac4  #b4 ,redistribution of      
,federal ,medicaid funds to ,states     
electing to meet ,,aca ,medicaid        
expansion requirements from ,states not 
so electing  7a7 ,in general ,section   
#aijc of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acif;b7 is amended by adding
 at the end the following new           
subsection3  7aa7 ,bonus for ,states    

electing ,to meet ,,aca ,medicaid       
expansion requirements from funds made  
available by other ,states not electing 
,to meet those requirements  7#a7 ,in   
general ,in the case of a participating 
,state for a fiscal year as determined  
under paragraph 7#b71 in accordance with
 regulations of the ,secretary1 the     
,state shall be entitled to an increase 
in payments under its ,state plan under 
this title in an amount determined under
 paragraph 7#c7 of the ,secretary's     
estimate of the net reduction in        
,federal expenditures for               
nonparticipating ,states 7including the 
amount of the additional ,federal       
financial participation under this title
 that otherwise would have been paid to 
such ,states if they were participating 
,states7 during the fiscal year as a    
result of such ,states not applying the 
,,aca ,medicaid expansion requirements4 
7#b7 ,notice regarding participation    
7,a7 ,in general ,before the beginning  
of each fiscal year 7beginning with     

fiscal year #bjad7 each of the #ej      
,states and the ,district of ,columbia  
is requested to inform the ,secretary1  
in a form and manner specified by the   
,secretary and accompanied by such      
assurances regarding ,state plan        
amendments as the ,secretary may        
specify1 if the ,state will be applying 
its ,state plan under this title for    
such fiscal year in accordance with the 
requirements specified in the amendments
 made by paragraphs 7#a7 and 7#b7 of    
section #bjja7;a7 of the ,patient       
,protection and ,affordable ,care ,act  
7in this subsection referred to as the  
,,aca ,medicaid expansion requirements71
 which include requirements described   
in--  7i7 section                       
#aijb7;a77#aj77;,a77,i77,,viii72 and    
7ii7 section #aijb7k74  ,the ,secretary 
shall not accept information submitted  
under this subparagraph for a fiscal    
year after the beginning of the fiscal  
year involved4  7,b7 ,determination of  
participating and nonparticipating      

,states ,taking into account the        
information submitted under subparagraph
 7,a7 for a fiscal year1 the ,secretary 
shall determine for the fiscal year     
which of the #ej ,states and the        
,district of ,columbia will be applying 
the ,,aca ,medicaid expansion           
requirements for the fiscal year and    
which will not4 ,for purposes of this   
subsection--  7i7 each ,state or        
,district determined to be applying such
 requirements for a fiscal year is      
referred to as a participating ,state   
for such fiscal year2 and  7ii7 each    
,state or ,district determined not to be
 applying such requirements for a fiscal
 year is referred to as a               
nonparticipating ,state for such fiscal 
year4  7#c7 ,amount of increase ,the    
,secretary shall compute the increase in
 payments under this subsection for a   
participating ,state for a fiscal year1 
to the extent of available funds1 in    
accordance with a formula specified by  
the ,secretary4 ,within the amount of   

available funds1 such formula may take  
into account elements such as--  7,a7   
increasing to #ajj percent the ,,fmap   
for newly eligible mandatory            
individuals2  7,b7 increasing the       
matching percentage for administrative  
costs attributable to application of    
,,aca ,medicaid expansion requirements2 
and  7,c7 an increase in ,,dsh          
allotments4  7#d7 ,publication of       
information on estimated impact of      
nonparticipation ,the ,secretary shall  
publish for each nonparticipating ,state
 for each fiscal year--  7,a7 the amount
 of the additional ,federal funds under 
this title for the fiscal year that the 
,secretary estimates the ,state has     
forgone as a result of its not being a  
participating ,state for such fiscal    
year2 and  7,b7 the number of additional
 beneficiaries that would have been     
covered under the ,state plan under this
 title in the fiscal year if the ,state 
had been a participating ,state for the 
fiscal year4  4