,i  #aaeth ,,congress  #b;d ,session    
,h4 ,r4 #gadi  ,,in ,,the ,,house ,,of  
,,representatives  ,november #af1       
#bjah,mrs4 ,dingell 7for herself and    
,mr4 ,upton7 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 remove an     
institutional bias by making permanent  
the protection for recipients of home   
and community-based services against    
spousal impoverishment4  #a4 ,short     
title ,this ,act may be cited as the    
,protecting ,married ,seniors from      
,impoverishment ,act4  #b4 ,making      
permanent the protection under ,medicaid
 for recipients of home and             
community-based services against spousal
 impoverishment  7a7 ,in general        
,section #aibd7;h77#a77;,a7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acifr-#e7;h77#a77;,a77 is amended by   
striking 7at the option of the ,state7  
is described in section                 

#aijb7;a77#aj77;,a77ii77,,vi7 and       
inserting the following3 before ,january
 #a1 #bjai1 at the option of the ,state1
 is described in section                
#aijb7;a77#aj77;,a77ii77,,vi71 or1      
beginning ,january #a1 #bjai1 is        
eligible for medical assistance for home
 and community-based services provided  
under subsection 7c71 7d71 or 7i7 of    
section #aiae1 under a waiver approved  
under section #aaae1 or who is eligible 
for such medical assistance by reason of
 being determined eligible under section
 #aijb7;a77#aj77;,c7 or by reason of    
section #aijb7;f7 or otherwise on the   
basis of a reduction of income based on 
costs incurred for medical or other     
remedial care1 or who is eligible for   
medical assistance for home and         
community-based attendant services and  
supports under section #aiae7k74  7b7   
,construction  7#a7 ,protecting ,state  
spousal income and asset disregard      
flexibility under waivers and plan      
amendments ,nothing in section #bdjd of 

,public ,law #aaa-adh 7#db ,u4,s4,c4    
#acier-#e7 or section #aibd of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acifr-#e7 shall be construed as        
prohibiting a ,state from disregarding  
an individual's spousal income and      
assets under a ,state waiver or plan    
amendment described in paragraph 7#b7   
for purposes of making determinations of
 eligibility for home and               
community-based services or home and    
community-based attendant services and  
supports under such waiver or plan      
amendment4  7#b7 ,state waiver or plan  
amendment described ,a ,state waiver or 
plan amendment described in this        
paragraph is any of the following3 7,a7 
,a waiver or plan amendment to provide  
medical assistance for home and         
community-based services under a waiver 
or plan amendment under subsection 7c71 
7d71 or 7i7 of section #aiae of the     
,social ,security ,act 7#db ,u4,s4,c4   
#acifn7 or under section #aaae of such  
,act 7#db ,u4,s4,c4 #acae74  7,b7 ,a    

plan amendment to provide medical       
assistance for home and community-based 
services for individuals by reason of   
being determined eligible under section 
#aijb7;a77#aj77;,c7 of such ,act 7#db   
,u4,s4,c4 #acif;a7a77#aj77;,c77 or by   
reason of section #aijb7;f7 of such ,act
 7#db ,u4,s4,c4 #acif;a7f77 or otherwise
 on the basis of a reduction of income  
based on costs incurred for medical or  
other remedial care under which the     
,state disregarded the income and assets
 of the individual's spouse in          
determining the initial and ongoing     
financial eligibility of an individual  
for such services in place of the       
spousal impoverishment provisions       
applied under section #aibd of such ,act
 7#db ,u4,s4,c4 #acifr-#e74  7,c7 ,a    
plan amendment to provide medical       
assistance for home and community-based 
attendant services and supports under   
section #aiae7k7 of such ,act 7#db      
,u4,s4,c4 #acifn7k774