,i #aac? ,,congress #a/ ,session ,h4 ,r4 #efg ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,febru>y #f1 #bjac ,mr4 ,rokita 7= himself1 ,mr4 ,lamborn1 ,mr4 ,g>rett1 ,mr4 ,scalise1 ,mr4 ,mulvaney1 ,mr4 ,huelskamp1 ,mr4 ,br\n ( ,georgia1 ,mr4 ,we/morel&1 ,mr4 ,radel1 ,mr4 ,ross1 ,mr4 ,poe ( ,texas1 ,mr4 ,hold+1 ,mr4 ,h5s>l+1 ,mr4 ,duncan ( ,s\? ,c>ol9a1 ,mr4 ,cotton1 ,mr4 ,culb]son1 ,mr4 ,huiz5ga ( ,mi*igan1 ,mrs4 ,black1 ,mr4 ,buc%on1 ,mr4 ,bi%op ( ,utah1 ,mr4 ,/ew>t1 ,mr4 ,flem+1 ,mr4 ,pe>ce1 ,mr4 ,au/9 ,scott ( ,georgia1 ,mr4 ,la,malfa1 ,mr4 ,m>*ant1 ,mr4 ,roe ( ,t5nessee1 ,mr4 ,palazzo1 ,mrs4 ,lummis1 ,mrs4 ,blackburn1 ,mr4 ,flores1 ,mr4 ,gohm]t1 ,mr4 ,amodei1 ,mr4 ,mc,henry1 & ,mr4 ,s*weik]t7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committees on ,ways & ,means1 ,education & ! ,work=ce1 ! ,judici>y1 ,natural ,res\rces1 ,h\se ,adm9i/ration1 ,rules1 & ,appropriations1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d ! ,social ,security ,act to replace ! ,m$icaid program & ! ,*ildr5's ,heal? ,insurance program ) a block grant to ! ,/ates1 & = o!r purposes4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,/ate ,heal? ,flexibility ,act ( #bjac4 7b7 ,table ( cont5ts ,! table ( cont5ts ( ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4 ,sec4 #b4 ,heal? grants to ! ,/ates = heal? c>e s]vices to indig5t individuals4 ,title ,,xxii--,,block ,,grants ,,to ,,/ates ,,= ,,heal? ,,c>e ,,s]vices ,,to ,,indig5t ,,individuals ,sec4 #bbja4 ,purpose4 ,sec4 #bbjb4 ,grants to ,/ates4 ,sec4 #bbjc4 ,adm9i/rative & fiscal acc\ntability4 ,sec4 #bbjd4 ,nondiscrim9ation provisions4 ,sec4 #bbje4 ,em]g5cy assi/ance4 ,sec4 #bbjf4 ,def9itions4 ,sec4 #c4 ,repeal ( ,,ppaca1 ,,hc]a1 & ! ,f$]al requirem5ts ( ,m$icaid & ,,*ip4 ,sec4 #d4 ,sev]ability4 ,sec4 #e4 ,effective date4 #b4 ,heal? grants to ! ,/ates = heal? c>e s]vices to indig5t individuals 7a7 ,heal? c>e block grant to ,/ates ,! ,social ,security ,act is am5d$ by add+ at ! end ! foll[+ new title3 ,,xxii ,,block ,,grants ,,to ,,/ates ,,= ,,heal? ,,c>e ,,s]vices ,,to ,,indig5t ,,individuals #bbja4 ,purpose ,! purpose ( ?is title is to provide ,f$]al f9ancial assi/ance to ! ,/ates1 9 ! =m ( a s+le grant1 to all[ ! ,/ates maximum flexibility 9 provid+1 & f9anc+ ! provision (1 heal?-c>e-relat$ items & s]vices to indig5t individuals4 #bbjb4 ,grants to ,/ates 7a7 ,9 g5]al ,subject to ! requirem5ts ( ?is title1 ea* ,/ate is entitl$ to receive f ! ,secret>y ( ! ,treasury a grant = ea* qu>t] ( fiscal ye>s #bjad1 #bjae1 #bjaf1 #bjag1 #bjah1 #bjai1 #bjbj1 #bjba1 #bjbb1 & #bjbc1 9 an am\nt t is equal to #be p]c5t ( ! total am\nt receiv$ by a ,/ate "u title ,,xix & title ,,xxi = fiscal ye> #bjab4 7b7 ,appropriation ,out ( any money 9 ! ,treasury ( ! ,unit$ ,/ates n o!rwise appropriat$1 !re are appropriat$ = fiscal ye>s #bjad1 #bjae1 #bjaf1 #bjag1 #bjah1 #bjai1 #bjbj1 #bjba1 #bjbb1 & #bjbc su* sums z are necess>y = grants "u ?is section4 7c7 ,requirem5ts relat+ to int]gov]nm5tal f9anc+ ,! ,secret>y ( ! ,treasury %all make ! transf] ( funds "u grants "u subsection 7a7 directly to ea* ,/ate 9 accordance ) ! requirem5ts ( section #fejc ( title #ca1 ,unit$ ,/ates ,code4 7d7 ,exp5diture ( funds 7#a7 ,9 g5]al ,except z provid$ 9 p>agraph 7#b71 am\nts receiv$ by a ,/ate "u ?is title = any fiscal ye> %all be exp5d$ by ! ,/ate 9 su* fiscal ye> or 9 ! succe$+ fiscal ye>4 7#b7 ,use ( ra9y day fund p]mitt$ ,( ! am\nts receiv$ by a ,/ate "u ?is title1 ! ,/ate may set aside1 9 a sep>ate acc\nt1 su* am\nts z ! ,/ate deems necess>y to provide1 )\t fiscal limitation1 heal?-c>e-relat$ items & s]vices = indig5t individuals dur+-- 7,a7 p]iods ( unexpect$ly high rates ( unemploym5t2 or 7,b7 p]iods relat$ to circum/ances t are n describ$ 9 subp>agraph 7,a7 & t cause unexpect$ increases 9 ! ne$ = su* items & s]vices = su* individuals4 7#c7 ,funds rema9+ aft] fiscal ye> #bjbb ,if1 aft] fiscal ye> #bjbc1 a ,/ate has funds 9 ! acc\nt "u p>agraph 7#b71 ! ,/ate may only exp5d su* funds if su* funds are us$ 9 a mann] t is p]mitt$ "u subsection 7e71 z su* subsection is 9 effect on ,septemb] #cj1 #bjbc4 7e7 ,use ( funds ,a ,/ate may only use ! am\nts receiv$ "u subsection 7a7 z foll[s3 7#a7 ,g5]al purpose ,= ! purpose "u section #bbja1 includ+ ! provision ( heal?-c>e-relat$ items & s]vices z requir$ "u section #bbje4 ,no?+ 9 ?is title %all be con/ru$ z limit+ ! flexibility ( a ,/ate to det]m9e :i* provid]s ( su* items & s]vices qualify to receive paym5t f a grant made to ! ,/ate "u ?is title4 7#b7 ,fund+ = risk adju/m5t me*anisms ,to fund qualifi$ high risk pools1 re9surance pools1 or o!r risk-adju/m5t me*anisms us$ = ! purpose ( subsidiz+ ! pur*ase ( private heal? insurance = ! high-risk population4 7#c7 ,au?ority to use portion ( ,f$]al assi/ance = o!r welf>e-relat$ programs 7,a7 ,9 g5]al ,subject to ! limit "u subp>agraph 7,b71 to c>ry out a ,/ate program pursuant to any or all ( ! foll[+ provisions ( law3 7i7 ,"p ,a ( title ,,iv ( ?is ,act4 7ii7 ,section #afaf ( ?is ,act4 7iii7 ,! ,food & ,nutrition ,act ( #bjjh4 7,b7 ,limitation ,a ,/ate may n use m ?an #cj p]c5t ( ! am\nt receiv$ "u subsection 7a7 = a fiscal ye> to c>ry out a ,/ate program1 or programs1 "u subp>agraph 7,a74 7,c7 ,requirem5ts on funds ,any am\nts t are us$ "u subp>agraph 7,a7-- 7i7 %all n be subject to any ( ! requirem5ts ( subsection 7d71 subsection 7f71 section #bbjd1 or section #bbje2 & 7ii7 %all be subject to-- 7,i7 ! audit requirem5ts "u section #bbjc2 & 7,,ii7 any requirem5ts t apply to ,f$]al funds provid$ directly = su* ,/ate program4 7f7 ,ma9t5ance ( curr5t law re/rictions on use ( f$]al funds 7#a7 ,9 g5]al 7,a7 ,no fund+ = abortions ,none ( ! funds appropriat$ 9 ?is title %all be exp5d$ = any abortion4 7,b7 ,no funds = cov]age ( abortion ,none ( ! funds appropriat$ 9 ?is title %all be exp5d$ = heal? b5efits cov]age t includes cov]age ( abortion4 7,c7 ,heal? b5efits cov]age def9$ ,= purposes ( ?is subsection1 ! t]m heal? b5efits cov]age means ! package ( s]vices cov]$ by a manag$ c>e provid] or organization pursuant to a contract or o!r arrangem5t4 7#b7 ,exceptions ,! limitations e/abli%$ 9 p>agraph 7#a7 %all n apply to an abortion-- 7,a7 if ! pregnancy is ! result ( an act ( rape or ince/2 or 7,b7 9 ! case :]e a woman suff]s f a physical disord]1 physical injury1 or physical illness t w\ld1 z c]tifi$ by a physician1 place ! woman 9 dang] ( dea? unless an abortion is p]=m$1 includ+ a life-endang]+ physical condition caus$ by or aris+ f ! pregnancy itself4 7#c7 ,/ate funds us$ 9 conjunction ) ,f$]al funds ,! limitations e/abli%$ 9 p>agraph 7#a7 %all apply to any ,/ate funds us$ 9 conjunction ) ,f$]al funds appropriat$ "u ?is title to provide1 or f9ance ! provision (1 heal?-c>e-relat$ items & s]vices to indig5t individuals pursuant to section #bbja or subsections 7d77#b71 7e77#a71 or 7e77#b7 ( ?is section4 7#d7 ,option to pur*ase sep>ate cov]age or plan ,no?+ 9 ?is subsection %all be con/ru$ z prohibit+ a ,/ate f pur*as+ sep>ate cov]age = abortions = :i* fund+ is prohibit$ "u ?is subsection1 or a heal? plan t includes su* abortions1 s long z su* cov]age or plan is paid = entirely us+ funds n provid$ by ?is title4 7#e7 ,option to (f] cov]age or plan ,no?+ 9 ?is subsection %all re/rict any heal? insurance issu] f (f]+ sep>ate cov]age = abortions = :i* fund+ is prohibit$ "u ?is subsection1 or a heal? plan t includes su* abortions1 s long z-- 7,a7 premiums = su* sep>ate cov]age or plan are paid entirely ) funds n provid$ by ?is title2 & 7,b7 adm9i/rative co/s & all s]vices (f]$ ?r\gh su* sep>ate cov]age or plan are paid = us+ only premiums collect$ = su* cov]age or plan4 7#f7 ,consci5ce protections 7,a7 ,none ( ! funds appropriat$ 9 ?is ,act may be made available to a ,f$]al ag5cy or program1 or to a ,/ate or local gov]nm5t1 if su* ag5cy1 program1 or gov]nm5t subjects any in/itutional or individual heal? c>e entity to discrim9ation on ! basis t ! heal? c>e entity does n provide1 pay =1 provide cov]age (1 or ref] = abortions4 7,b7 ,9 ?is p>agraph1 ! t]m heal? c>e entity includes an individual physician or o!r heal? c>e pr(essional1 a hospital1 a provid]-sponsor$ organization1 a heal? ma9t5ance organization1 a heal? insurance plan1 or any o!r k9d ( heal? c>e facility1 organization1 or plan4 7g7 ,no fund+ = illegal ali5s ,except z provid$ "u ?is section & section #bbje1 no funds appropriat$ 9 ?is title may be us$ to provide heal?-c>e-relat$ items & s]vices to an ali5 :o is n lawfully admitt$ = p]man5t resid5ce or o!rwise p]man5tly resid+ 9 ! ,unit$ ,/ates "u color ( law4 7h7 ,non5titlem5t ,no?+ 9 ?is title %all be con/ru$ z provid+ an individual ) an entitlem5t to heal?-c>e-relat$ items & s]vices "u ?is title4 #bbjc4 ,adm9i/rative & fiscal acc\ntability 7a7 ,audits 7#a7 ,contract ) approv$ audit+ entity ,n lat] ?an ,octob] #a1 #bjad1 & annually !reaft]1 a ,/ate %all contract ) an approv$ audit+ entity 7z def9$ "u p>agraph 7#c77;,b77 = purposes ( conduct+ an audit "u p>agraph 7#b7 7) respect to ! fiscal ye> end+ ,septemb] #cj ( su* ye>74 7#b7 ,audit requirem5t ,"u a contract "u p>agraph 7#a71 an approv$ audit+ entity %all conduct an audit ( ! exp5ditures or transf]s made by a ,/ate f am\nts receiv$ "u a grant "u ?is title1 or f ,/ate funds describ$ 9 section #bbjb7;f77#c71 ) respect to ! fiscal ye> :i* su* audit cov]s1 to det]m9e ! ext5t to :i* su* exp5ditures & transf]s 7 exp5d$ 9 accordance ) ?is title4 7#c7 ,entity conduct+ audit 7,a7 ,9 g5]al ,) respect to a ,/ate1 ! audit "u p>agraph 7#b7 %all be conduct$ by an approv$ audit+ entity 9 accordance ) g5]ally accept$ audit+ pr9ciples4 7,b7 ,approv$ audit+ entity ,= purposes ( ?is section1 ! t]m approv$ audit+ entity means1 ) respect to a ,/ate1 an entity t is-- 7i7 approv$ by ! ,secret>y ( ! ,treasury2 7ii7 approv$ by ! *ief executive (fic] ( ! ,/ate2 & 7iii7 indep5d5t ( any ,f$]al1 ,/ate1 or local ag5cy4 7#d7 ,submission ( audit ,n lat] ?an ,decemb] #ca1 #bjad1 & annually !reaft]1 a ,/ate %all submit ! results ( ! audit "u p>agraph 7#b7 7) respect to ! fiscal ye> end+ on ,septemb] #cj ( su* ye>7 to ! ,/ate legislature & to ! ,secret>y ( ! ,treasury4 7#e7 ,additional acc\nt+ requirem5ts ,! provisions ( *apt] #ge ( title #ca1 ,unit$ ,/ates ,code1 %all apply to ! audit requirem5ts ( ?is section4 7b7 ,reimbursem5t & p5alty 7#a7 ,9 g5]al ,if1 ?r\gh an audit conduct$ "u subsection 7a71 an approv$ audit+ entity f9ds t any am\nts paid to a ,/ate "u a grant "u ?is title 7 n exp5d$ 9 accordance ) ?is title-- 7,a7 ! ,/ate %all pay to ! ,treasury ( ! ,unit$ ,/ates any su* am\nt1 plus #aj p]c5t ( su* am\nt z a p5alty2 or 7,b7 ! ,secret>y ( ! ,treasury %all (fset su* am\nt plus ! #aj p]c5t p5alty aga9/ any o!r am\nt 9 any o!r fiscal ye> t ! ,/ate may be entitl$ to receive "u a grant "u ?is title4 7#b7 ,misuse ( ,/ate funds ,if1 ?r\gh an audit conduct$ "u subsection 7a71 an approv$ audit+ entity f9ds t a ,/ate violat$ ! requirem5ts ( section #bbjb7;f77#c71 ! ,/ate %all pay to ! ,treasury ( ! ,unit$ ,/ates #ajj p]c5t ( ! am\nt ( ,/ate funds t 7 us$ 9 violation ( section #bbjb7;f77#c7 z a p5alty4 ,ins(> z a ,/ate fails to pay any su* p5alty1 ! ,secret>y ( ! ,treasury %all (fset ! am\nt n s paid aga9/ ! am\nt ( any grant o!rwise payable to ! ,/ate "u ?is title4 7c7 ,annual report+ requirem5ts 7#a7 ,9 g5]al ,n lat] ?an ,janu>y #ca1 #bjae1 & annually !reaft]1 ea* ,/ate %all submit to ! ,secret>y ( ! ,treasury & ! ,/ate legislature a report on ! activities c>ri$ out by ! ,/ate dur+ ! mo/ rec5tly complet$ fiscal ye> ) funds receiv$ by ! ,/ate "u a grant "u ?is title = su* fiscal ye>4 7#b7 ,cont5t ,a report "u p>agraph 7#a7 %all1 ) respect to a fiscal ye>-- 7,a7 conta9 ! results ( ! audit conduct$ by an approv$ audit+ entity = a ,/ate = su* fiscal ye>1 9 accordance ) ! requirem5ts ( subsection 7a7 ( ?is section2 7,b7 specify ! am\nt ( ! grant made to ! ,/ate "u ?is title t is us$ to c>ry out a program "u section #bbjb7;e77#c72 & 7,c7 be 9 su* =m & conta9 su* o!r in=mation z ! ,/ate det]m9es is necess>y to provide-- 7i7 an accurate description ( ! activities conduct$ by ! ,/ate = ! purpose describ$ "u section #bbja & any o!r use ( funds p]mitt$ "u subsections 7d7 & 7e7 ( section #bbjb2 & 7ii7 a complete record ( ! purposes = :i* am\nts 7 exp5d$ 9 accordance ) ?is title4 7#c7 ,con=mity ) acc\nt+ pr9cipals ,any f9ancial in=mation 9 ! report "u p>agraph 7#a7 %all be prep>$ & report$ 9 accordance ) g5]ally accept$ acc\nt+ pr9ciples1 includ+ ! provisions ( *apt] #ge ( title #ca1 ,unit$ ,/ates ,code4 7#d7 ,public availability ,a ,/ate %all make copies ( ! reports requir$ "u ?is section available on a public ,web site & %all make copies available 9 o!r =mats ^u reque/4 7d7 ,failure ,to comply ) requirem5ts ,! ,secret>y ( ! ,treasury %all n make any paym5t to a ,/ate "u a grant au?oriz$ by section #bbjb7;a7-- 7#a7 if an audit = a ,/ate is n submitt$ z requir$ "u subsection 7a71 dur+ ! p]iod betwe5 ! date su* audit is due & ! date on :i* su* audit is submitt$2 7#b7 if a ,/ate fails to submit a report z requir$ "u subsection 7c71 dur+ ! p]iod betwe5 ! date su* report is due & ! date on :i* su* report is submitt$2 or 7#c7 if a ,/ate violates a requirem5t ( section #bbjb7;f71 dur+ ! p]iod beg9n+ on ! date ! ,secret>y becomes aw>e ( su* violation & ! date on :i* su* violation is correct$ by ! ,/ate4 7e7 ,adm9i/rative sup]vision & ov]sight 7#a7 ,limit$ role = ,secret>y ( ,treasury & ! ,attorney g5]al 7,a7 ,treasury ,! au?ority ( ! ,secret>y ( ! ,treasury "u ?is title is limit$ to-- 7i7 promulgat+ regulations1 issu+ rules1 or publi%+ guidance docum5ts to ! ext5t necess>y = purposes ( implem5t+ subsection 7a77#c77;,b71 subsection 7b71 & subsection 7d72 7ii7 mak+ qu>t]ly paym5ts to ! ,/ates "u grants "u ?is title 9 accordance ) section #bbjb7;a72 7iii7 approv+ entities "u subsection 7a77#c77;,b7 = purposes ( ! audits requir$ "u subsection 7a72 7iv7 )hold+ paym5t to a ,/ate ( a grant "u subsection 7d7 or (fsett+ a paym5t ( su* a grant to a ,/ate "u subsection 7b72 & 7v7 ex]cis+ ! au?ority relat+ to nondiscrim9ation t is specifi$ 9 section #bbjd7;b74 7,b7 ,attorney g5]al ,! au?ority ( ! ,attorney ,g5]al to sup]vise ! am\nts receiv$ by a ,/ate "u ?is title is limit$ to ! au?ority "u section #bbjd7;c74 7#b7 ,f$]al sup]vision 7,a7 ,9 g5]al ,except z provid$ "u p>agraph 7#a71 an adm9i/rative (fic]1 employee1 dep>tm5t1 or ag5cy ( ! ,unit$ ,/ates 7includ+ ! ,secret>y ( ,heal? & ,human ,s]vices7 may n-- 7i7 sup]vise-- 7,i7 ! am\nts receiv$ by ! ,/ates "u ?is title2 or 7,,ii7 ! use ( su* am\nts by ! ,/ates2 or 7ii7 promulgate regulations or issue rules 9 accordance ) ?is title4 7,b7 ,limitation on ,secret>y ( ,heal? & ,human ,s]vices ,! ,secret>y ( ,heal? & ,human ,s]vices %all h no au?ority ov] any provision ( ?is title4 7f7 ,res]vation ( ,/ate p[]s ,no?+ 9 ?is section %all be con/ru$ to limit ! p[] ( a ,/ate1 includ+ ! p[] ( a ,/ate to pursue civil & crim9al p5alties "u ,/ate law aga9/ any individual or entity t misuses1 or engages 9 fraud or abuse relat$ to1 ! funds provid$ to a ,/ate "u ?is title4 #bbjd4 ,nondiscrim9ation provisions 7a7 ,no discrim9ation aga9/ individuals ,no individual %all be exclud$ f p>ticipation 91 d5i$ ! b5efits (1 or subject$ to discrim9ation "u1 any program or activity fund$ 9 :ole or 9 "p ) am\nts paid to a ,/ate "u ?is title on ! basis ( su* individual's-- 7#a7 disability "u section #ejd ( ! ,rehabilitation ,act ( #aigc 7#bi ,u4,s4,c4 #gid72 7#b7 sex "u title ,,ix ( ! ,education ,am5dm5ts ( #aigb 7#bj ,u4,s4,c4 #afha et seq472 or 7#c7 race1 color1 or national orig9 "u title ,,vi ( ! ,civil ,rights ,act ( #aifd 7#db ,u4,s4,c4 #bjjj;d et seq474 7b7 ,compliance 7#a7 ,if ! ,secret>y ( ! ,treasury det]m9es t a ,/ate or an entity t has receiv$ funds f am\nts paid to a ,/ate "u a grant "u ?is title has fail$ to comply ) a provision ( law ref]r$ to 9 subsection 7a71 ! ,secret>y ( ! ,treasury %all notify ! *ief executive (fic] ( ! ,/ate ( su* failure to comply & %all reque/ t su* *ief executive (fic] secure su* compliance4 7#b7 ,if1 n lat] ?an #fj days aft] receiv+ notification "u p>agraph 7#a71 ! *ief executive (fic] ( a ,/ate fails or refuses to secure compliance ) ! provision ( law ref]r$ to 9 su* notification1 ! ,secret>y ( ! ,treasury may-- 7,a7 ref] ! matt] to ! ,attorney ,g5]al ) a recomm5dation t an appropriate civil action be in/itut$2 or 7,b7 ex]cise ! p[]s & functions provid$ "u section #eje ( ! ,rehabilitation ,act ( #aigc 7#bi ,u4,s4,c4 #gid;a71 title ,,ix ( ! ,education ,am5dm5ts ( #aigb 7#bj ,u4,s4,c4 #afha et seq471 or title ,,vi ( ! ,civil ,rights ,act ( #aifd 7#db ,u4,s4,c4 #bjjj;d et seq47 7z applicable74 7c7 ,civil actions ,if a matt] is ref]r$ to ! ,attorney ,g5]al "u subsection 7b77#b77;,a71 or ! ,attorney ,g5]al has reason to believe t a ,/ate or entity has fail$ to comply ) a provision ( law ref]r$ to 9 subsection 7a71 ! ,attorney ,g5]al may br+ a civil action 9 an appropriate di/rict c\rt ( ! ,unit$ ,/ates = su* relief z may be appropriate1 includ+ injunctive relief4 #bbje4 ,em]g5cy assi/ance 7a7 ,9 g5]al ,a ,/ate t receives a grant "u ?is title = a fiscal ye> %all provide paym5t = heal?-c>e-relat$ items & s]vices provid$ to a citiz51 legal resid5t1 or an ali5 :o is n lawfully admitt$ = p]man5t resid5ce or o!rwise p]man5tly resid+ 9 ! ,unit$ ,/ates "u color ( law1 consi/5t ) ! requirem5ts ( section #ahfg1 if-- 7#a7 su* heal?-c>e-relat$ items & s]vices are-- 7,a7 necess>y = ! treatm5t ( an em]g5cy m$ical condition2 & 7,b7 heal?-c>e-relat$ items & s]vices t su* ,/ate w\ld provide paym5t = "u ?is title1 if provid$ to an indig5t individual2 7#b7 ! individual meets all necess>y eligibility requirem5ts = heal?-c>e-relat$ items & s]vices "u ! ,/ate program fund$ "u ?is title1 except = any requirem5t relat$ to immigration /atus2 & 7#c7 su* items & s]vices are n relat$ to an organ transplant proc$ure4 7b7 ,em]g5cy m$ical condition ,= purposes ( ?is section1 ! t]m em]g5cy m$ical condition means a m$ical condition 7includ+ em]g5cy labor & deliv]y7 manife/+ itself by acute symptoms ( suffici5t sev]ity 7includ+ sev]e pa97 su* t ! abs5ce ( imm$iate m$ical att5tion c\ld reasonably be expect$ to result 9-- 7#a7 plac+ ! pati5t's heal? 9 s]i\s jeop>dy2 7#b7 s]i\s impairm5t to bodily functions2 or 7#c7 s]i\s dysfunction ( any bodily organ or "p4 #bbjf4 ,def9itions ,= purposes ( ?is title3 7#a7 ,heal?-c>e-relat$ items & s]vices ,! t]m heal?-c>e-relat$ items & s]vices %all be def9$ by a ,/ate ) respect to use ( su* t]m = purposes ( ! application ( ?is title to ! ,/ate4 7#b7 ,high-,risk ,population ,! t]m high-risk population means individuals :o are describ$ 9 "o ( ! foll[+ subp>agraphs3 7,a7 ,individuals :o1 by reason ( ! exi/5ce or hi/ory ( a m$ical condition1 are able to acquire heal? cov]age only at rates :i* are at lea/ #aej p]c5t ( ! /&>d risk rates = su* cov]age4 7,b7 ,individuals :o are provid$ heal? cov]age by a qualifi$ high risk pool4 7#c7 ,indig5t individual ,! t]m indig5t individual %all be def9$ by a ,/ate ) respect to use ( su* t]m = purposes ( ! application ( ?is title to ! ,/ate4 7#d7 ,qualifi$ high risk pool ,! t]m qualifi$ high risk pool has ! mean+ giv5 su* t]m 9 section #bgde7;g77#a77;,a7 ( ! ,public ,heal? ,s]vice ,act4 7#e7 ,risk-,adju/m5t ,me*anism ,def9$ ,= purposes ( ?is section1 ! t]m risk-adju/m5t me*anism means any risk-spread+ me*anism to subsidize ! pur*ase ( private heal? insurance = ! high-risk population1 includ+ a qualifi$ high risk pool4 4 7b7 ,report on r$uction ( ,f$]al adm9i/rative exp5ditures ,beg9n+ n lat] ?an ,octob] #ca1 #bjad1 & annually !reaft] until ,octob] #ca1 #bjbc1 ! ,secret>y ( ,heal? & ,human ,s]vices1 9 consultation ) ! ,secret>y ( ! ,treasury1 %all submit a report to ! ,committee on ,en]gy & ,comm]ce 9 ! ,h\se ( ,repres5tatives & ! ,f9ance ,committee 9 ! ,s5ate conta9+ a description ( ! total r$uction 9 ,f$]al exp5ditures requir$ to adm9i/] & provide ov]sight = ! programs to provide heal?-c>e-relat$ items & s]vices to indig5t individuals "u ?is ,act1 comp>$ to ! exp5ditures requir$ to adm9i/] & provide ov]sight = ! programs "u titles ,,xix & ,,xxi ( ! ,social ,security ,act1 z 9 effect on ,septemb] #cj1 #bjab4 7c7 ,/ate def9$ ,section #aaja7;a77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acja7;a77#a77 is am5d$-- 7#a7 9 ! fir/ s5t5ce1 by /rik+ & ,,xxi & ins]t+ ,,xxi1 & ,,xxii2 & 7#b7 9 ! f\r? s5t5ce1 by /rik+ & ,,xxi & ins]t+ 1 ,,xxi1 & ,,xxii4 #c4 ,repeal ( ,,ppaca1 ,,hc]a1 & ! ,f$]al requirem5ts ( ,m$icaid & ,,*ip 7a7 ,,ppaca ,! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh7 is repeal$1 & ! provisions ( law am5d$ or repeal$ by su* ,act are re/or$ or reviv$ z if su* ,act _h n be5 enact$4 7b7 ,,hc]a ,title ,i & subtitle ,b ( title ,,ii ( ! ,heal? ,c>e & ,education ,reconciliation ,act ( #bjaj 7,public ,law #aaa-aeb7 are repeal$1 & ! provisions ( law am5d$ or repeal$ by su* title or subtitle1 respectively1 are re/or$ or reviv$ z if su* title & subtitle _h n be5 enact$4 7c7 ,m$icaid & ,,*ip ,titles ,,xix & ,,xxi ( ! ,social ,security ,act are repeal$4 #d4 ,sev]ability ,if any provision ( ?is ,act1 or ! application ( su* provision to any p]son or circum/ance1 is f\nd to be uncon/itutional1 ! rema9d] ( ?is ,act1 or ! application ( t provision to o!r p]sons or circum/ances1 %all n be affect$4 #e4 ,effective date ,?is ,act & ! am5dm5ts made by ?is ,act %all take effect ) respect to items & s]vices furni%$ on or aft] ,octob] #a1 #bjac4