,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #edc  ,,in ,,the ,,house ,,of   
,,representatives  ,january #ac1        
#bjag,mr4 ,collins of ,new ,york 7for   
himself1 ,mr4 ,mullin1 ,mr4 ,guthrie1   
,mrs4 ,blackburn1 ,mr4 ,bucshon1 and    
,mr4 ,flores7 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 for purposes of  
prioritizing the most vulnerable        
,medicaid patients4  #a4 ,short title   
,this ,act may be cited as the          
,prioritizing the ,most ,vulnerable     
,americans ,act4  #b4 ,prioritizing the 
most vulnerable ,medicaid patients  7a7 
,in general ,section #aaae of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acae7 is amended by adding at the end  
the following new subsection3  7g7 ,in  
making a determination using the        
authority under paragraph 7#b77;,a7 of  
subsection 7a7 7relating to treating    
costs that would not otherwise be       

included as expenditures under section  
#aijc and which are not included as part
 of the costs of projects under section 
#aaaj as expenditures under the ,state  
plan or plans approved under title      
,,xix7 to approve an application or     
renewal of any experimental1 pilot1 or  
demonstration project undertaken under  
such subsection to promote the          
objectives of title ,,xix 7referred to  
in this subsection as a ,medicaid       
demonstration project71 the ,secretary  
shall--  7#a7 give priority to ,medicaid
 demonstration projects that have been  
proven to be effective in improving the 
medical care and health outcomes of     
individuals who are uninsured1          
individuals eligible to receive medical 
assistance under a ,state plan under    
title ,,xix1 or individuals whose       
household income does not exceed #aej   
percent of the poverty line 7as defined 
in section #baaj7;c77#e77 applicable to 
a family of the size involved2  7#b7    
require that the ,state submitting such 

application or renewal submit to the    
,secretary1 and make publicly available1
 any available data or metrics regarding
 the health outcomes for the individuals
 to be served by such ,medicaid         
demonstration project2  7#c7 ensure that
 such ,medicaid demonstration project is
 not duplicative of any ,federal program
 or funding opportunity2 and  7#d7      
require that the ,state submitting such 
application or renewal submit to the    
,secretary1 and make publicly available1
 an analysis of the degree to which such
 ,medicaid demonstration project1 if at 
all1 precludes efforts undertaken by    
private sector and charitable sector    
entities to improve medical care and    
health outcomes for the individuals     
described in paragraph 7#a74  4  7b7    
,effective date ,the amendment made by  
subsection 7a7 shall apply with respect 
to applications or renewals submitted on
 or after ,january #a1 #bjah4