,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #fhb  ,,in ,,the ,,house ,,of   
,,representatives  ,january #bd1        
#bjag,mr4 ,mullin 7for himself1 ,mr4    
,russell1 and ,mr4 ,grothman7 introduced
 the following bill2 which was referred 
to the ,committee on ,energy and        
,commerce  ,a ,,bill  ,to amend titles  
,,xix and ,,xxi of the ,social ,security
 ,act to eliminate the ,,chip           
maintenance of effort requirement and to
 eliminate ,,dsh cuts for ,states not   
implementing the ,,aca ,medicaid        
expansion4  #a4 ,short title ,this ,act 
may be cited as the ,preserving ,access 
to ,medicaid for ,americans ,act of     
#bjag4  #b4 ,elimination of ,,moe       
requirement for ,,chip eligibility      
,section #baje7;d77#c7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#acig;ee7d77#c77 is amended by striking 
,september #cj1 #bjai and inserting the 
date of the enactment of the ,preserving
 ,access to ,medicaid for ,americans    
,act of #bjag4  #c4 ,elimination of     

,,dsh cuts for ,states not implementing 
,,aca expansion  7a7 ,in general        
,section #aibc7;f77#g7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#acifr-#d7;f77#g77 is amended-- 7#a7 in 
subparagraph 7,a7--  7,a7 in clause     
7i7-- 7i7 in the matter preceding       
subclause 7,i71 by striking each of     
fiscal years #bjah through #bjbe and    
inserting each of fiscal years #bjai    
through #bjbh2 and  7ii7 in subclause   
7,i7-- 7,i7 by striking the amount      
specified under the ,,dsh health reform 
methodology under subparagraph 7,b7 and 
inserting the amount of the aggregate   
reduction target2 and  7,,ii7 by        
striking ,,dsh allotments to ,states and
 inserting the ,,dsh allotment to each  
expansion ,state each place it appears2 
7,b7 in clause 7ii7--  7i7 in the matter
 preceding subclause 7,i71 by striking  
,the aggregate reductions and inserting 
,in applying subparagraph 7,b71 the     
aggregate reduction targets2  7ii7 by   
striking subclause 7,i72  7iii7 by      

redesignating subclauses 7,,ii7 through 
7,,viii7 as subclauses 7,i7 through     
7,,vii71 respectively2  7iv7 in         
subclause 7,,vi7 7as so redesignated71  
by striking and at the end2  7v7 in     
subclause 7,,vii7 7as so redesignated71 
by striking the period at the end and   
inserting 2 and2 and  7vi7 by adding at 
the end the following new subclause3    
7,,viii7 #h1jjj1jjj1jjj for fiscal years
 #bjbg and #bjbh4  2  7,c7 by amending  
clause 7iv7 to read as follows3  7iv7   
,definitions ,for purposes of this      
paragraph3 7,i7 ,the term expansion     
,state means1 for a fiscal year1 a      
,state that1 as of the date that is #ahj
 days before the start of such fiscal   
year1 provides for eligibility under    
clause 7i77,,viii7 or 7ii77,,xx7 of     
section #aijb7;a77#aj77;,a7 for medical 
assistance under this title 7or a waiver
 of the ,state plan approved under      
section #aaae74  7,,ii7 ,the term       
non-expansion ,state means1 for a fiscal
 year1 a ,state that is not an expansion

 ,state for such fiscal year4  7,,iii7  
,the term ,state means the #ej ,states  
and the ,district of ,columbia4  2 and  
7,d7 in clause 7v71 by striking         
,distribution of aggregate              
reductions4--,the ,secretary shall      
distribute the aggregate reductions     
under clause 7ii7 among ,states and     
inserting ,distribution of aggregate    
reduction targets4--,the ,secretary     
shall distribute the aggregate reduction
 targets under clause 7ii7 among all the
 ,states 7including non-expansion       
,states72 and  7#b7 in subparagraph     
7,b71 by adding at the end the following
 new clause3  7iv7 ,the methodology     
imposes reduction targets as if the     
reductions under subparagraph 7,a7 were 
applied to all ,states1 including       
non-expansion ,states4  4  7b7          
,conforming amendment ,section          
#aibc7;f77#h7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #acifr-#d7;f77#h77  
is amended by striking fiscal year #bjbe
 and inserting fiscal year #bjbh4