,,ii  #aaeth ,,congress  #ast ,session  
,s4 #agjg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,august #b1    
#bjag ,mrs4 ,gillibrand introduced the  
following bill2 which was read twice and
 referred to the ,committee on          
,agriculture1 ,nutrition1 and ,forestry 
,a ,,bill  ,to amend the ,food and      
,nutrition ,act of #bjjh to provide for 
a standard medical expense deduction    
under the supplemental nutrition        
assistance program1 and for other       
purposes4  #a4 ,short title  ,this ,act 
may be cited as the ,,snap ,standard    
,medical ,expense ,deduction ,act of    
#bjag4  #b4 ,standard medical expense   
deduction ,section #e7;e77#e7 of the    
,food and ,nutrition ,act of #bjjh 7#g  
,u4,s4,c4 #bjad7;e77#e77 is amended--   
7#a7 in the paragraph heading1 by       
striking ,excess medical and inserting  
,medical2  7#b7 by striking subparagraph
 7,a7 and inserting the following3  7,a7
 ,standard medical deduction  7i7 ,in   
general ,subject to clause 7ii71 a      

household containing an elderly or      
disabled member shall be entitled1 with 
respect to expenses other than expenses 
paid on behalf of the household by a    
third party--  7,i7 if the amount of    
actual costs of allowable medical       
expenses incurred by the elderly or     
disabled member for a month1 exclusive  
of special diets1 is equal to or greater
 than #ce1 to a standard medical        
deduction for each month of an amount   
equal to--  7aa7 for fiscal year #bjah1 
#adj2 and  7bb7 for fiscal year #bjai   
and each subsequent fiscal year1 the    
applicable amount during the preceding  
fiscal year1 as adjusted to reflect     
changes for the #ab-month period ending 
the preceding ,june #cj in the ,consumer
 ,price ,index for ,all ,urban          
,consumers3 ,medical ,care published by 
the ,bureau of ,labor ,statistics of the
 ,department of ,labor2 or  7,,ii7 if   
the amount of actual costs of allowable 
medical expenses incurred by the elderly
 or disabled member for a month1        

exclusive of special diets1 is greater  
than the sum of the amount of that      
standard medical deduction and #ce1 to a
 deduction equal to the amount of those 
actual costs4  7ii7 ,effect on ,state   
authority to adjust standard medical    
deduction ,nothing in this subparagraph 
precludes-- 7,i7 a ,state that has an   
approved standard medical deduction as  
of the date of enactment of the ,,snap  
,standard ,medical ,expense ,deduction  
,act of #bjag in an amount that is      
greater than the amount of the standard 
medical deduction described in item 7aa7
 or 7bb7 of clause 7i77,i71 as          
applicable1 from continuing in effect   
that standard medical deduction2 or     
7,,ii7 the ,secretary from approving a  
standard medical deduction in an amount 
that is greater than the amount of the  
standard medical deduction described in 
item 7aa7 or 7bb7 of clause 7i77,i71 as 
applicable4  2 and  7#c7 in subparagraph
 7,b7-- 7,a7 in the subparagraph        
heading1 by inserting actual costs      

before deduction2 and  7,b7 in clause   
7i71 by striking excess medical expense 
deduction and inserting actual costs    
deduction described in clause 7i77,,ii7 
of that subparagraph4  #c4 ,reports and 
studies  7a7 ,state performance on      
enrolling eligible seniors and          
individuals with disabilities in        
low-,income health and nutrition        
benefits ,section #ag of the ,food and  
,nutrition ,act of #bjjh 7#g ,u4,s4,c4  
#bjbf7 is amended by adding at the end  
the following3  7m7 ,state performance  
on enrolling eligible seniors and       
individuals with disabilities in        
low-,income health and nutrition        
benefits  7#a7 ,definitions ,in this    
subsection3 7,a7 ,covered program ,the  
term covered program means--  7i7 the   
supplemental nutrition assistance       
program2  7ii7 the ,medicare part ,d    
low-income subsidy under section        
#ahfj;,d-#ad of the ,social ,security   
,act 7#db ,u4,s4,c4 #aciew-#aad72 and   
7iii7 the ,medicare ,savings ,program1  

as defined in section #aadd7;c77#g7 of  
the ,social ,security ,act 7#db         
,u4,s4,c4 #acbj;b-#ad7;c77#g774  7,b7   
,disabled individual ,the term disabled 
individual means a member of a household
 described in any of paragraphs 7#b7    
through 7#g7 of section #c7;j74  7,c7   
,elderly individual ,the term elderly   
individual means a member of a household
 who is not less than #fj years old4    
7#b7 ,reports  7,a7 ,in general ,not    
later than ,june #cj1 #bjah1 and ,june  
#cj of each year thereafter1 the        
,secretary1 in collaboration with the   
,secretary of ,health and ,human        
,services and the ,commissioner of      
,social ,security1 shall submit to the  
committees described in subparagraph    
7,b7 a report that assesses the         
effectiveness of each ,state in         
enrolling eligible elderly individuals  
and disabled individuals in each covered
 program4  7,b7 ,committees described   
,the committees referred to in          
subparagraph 7,a7 are-- 7i7 of the      

,house of ,representatives--  7,i7 the  
,committee on ,agriculture2  7,,ii7 the 
,committee on ,ways and ,means2 and     
7,,iii7 the ,committee on ,energy and   
,commerce2 and  7ii7 of the ,senate--   
7,i7 the ,committee on ,agriculture1    
,nutrition1 and ,forestry2 and  7,,ii7  
the ,committee on ,finance4  7#c7       
,specific measures ,the report submitted
 under paragraph 7#b77;,a7 shall        
include1 with respect to the previous   
fiscal year--  7,a7 an estimate of the  
number of elderly individuals and the   
number of disabled individuals1 by      
,state1 who were eligible for each      
covered program2  7,b7 an estimate of   
the number of elderly individuals and   
the number of disabled individuals1 by  
,state1 who participated in each covered
 program2  7,c7 an estimate of the      
number of elderly individuals and the   
number of disabled individuals who were 
eligible for all #c covered programs2   
7,d7 an estimate of the number of       
elderly individuals and the number of   

disabled individuals who participated in
 all #c of the covered programs2 and    
7,e7 an estimate of-- 7i7 the number of 
individuals whose eligibility for each  
covered program was initiated through an
 application with the ,social ,security 
,administration2  7ii7 the number of    
individuals described in clause 7i7 who 
qualified for each covered program2 and 
7iii7 the number of individuals         
described in clause 7i7 who participated
 in each covered program4  7#d7         
,performance innovations ,the report    
submitted under paragraph 7#b77;,a7     
shall include a description of best     
practices of one or more ,states with   
the best performances for that fiscal   
year1 or the most improved performances 
from the previous fiscal year1 under    
each of the measures described in       
paragraph 7#c74  4  7b7 ,studies on     
disability and food insecurity ,section 
#ag of the ,food and ,nutrition ,act of 
#bjjh 7#g ,u4,s4,c4 #bjbf7 7as amended  
by subsection 7a77 is amended by adding 

at the end the following3  7n7 ,studies 
on disability and food insecurity  7#a7 
,definition of disabled individual  7,a7
 ,in general ,in this subsection1 the   
term disabled individual means a member 
of a household described in any of      
paragraphs 7#b7 through 7#g7 of section 
#c7;j74  7,b7 ,inclusions ,in this      
subsection1 the term disabled individual
 includes a member of a household who1  
as determined by the ,secretary--  7i7  
is not considered disabled under        
subparagraph 7,a72 but  7ii7 has a      
physical1 mental1 or sensory condition  
that limits the daily activities of the 
individual4  7#b7 ,studies ,the         
,secretary-- 7,a7 shall carry out a     
study--  7i7 on the relationship between
 disability and food insecurity for     
disabled individuals2  7ii7 on the      
effectiveness of ,federal food          
assistance programs in responding to the
 causes of food insecurity in households
 with disabled individuals2 and  7iii7  
making recommendations for how ,federal 

food assistance programs could be       
improved to better meet the needs of    
households with disabled individuals2   
and  7,b7 in collaboration with the     
,civil ,rights ,division of the         
,department of ,justice1 shall carry out
 a study on the best practices of       
,states in complying with--  7i7 section
 #ejd of the ,rehabilitation ,act of    
#aigc 7#bi ,u4,s4,c4 #gid7 and the      
,americans with ,disabilities ,act of   
#aiij 7#db ,u4,s4,c4 #abaja et seq47    
regarding practices to avoid            
discrimination on the basis of          
disability1 such as through provision of
 reasonable accommodations1 in carrying 
out ,federal food assistance programs2  
and  7ii7 section #ejh of the           
,rehabilitation ,act of #aigc 7#bi      
,u4,s4,c4 #gid;d7 regarding the         
comprehensive use of adaptive           
technologies for disabled individuals in
 accessing ,federal food assistance     
programs4  7#c7 ,report ,not later than 
#a year after the date on which the     

studies are completed under paragraph   
7#b71 the ,secretary shall submit to the
 ,committee on ,agriculture of the      
,house of ,representatives and the      
,committee on ,agriculture1 ,nutrition1 
and ,forestry of the ,senate a report   
describing the results of the studies1  
including such recommendations as the   
,secretary considers appropriate4  4    
7c7 ,report on standard medical         
deduction ,section #ag of the ,food and 
,nutrition ,act of #bjjh 7#g ,u4,s4,c4  
#bjbf7 7as amended by subsection 7b77 is
 amended by adding at the end the       
following3  7o7 ,report on standard     
medical deduction ,not later than #b    
years after the date of enactment of the
 ,,snap ,standard ,medical ,expense     
,deduction ,act of #bjag1 the ,secretary
 shall submit to the ,committee on      
,agriculture of the ,house of           
,representatives and the ,committee on  
,agriculture1 ,nutrition1 and ,forestry 
of the ,senate a report that--  7#a7    
identifies which ,states were most      

effective at increasing the use by      
individuals in the ,state of the        
standard medical deduction authorized   
under section #e7;e77#e77;,a7 during the
 period covered by the report2 and  7#b7
 provides an assessment of which factors
 were important in increasing the use of
 the standard medical deduction by      
individuals in the ,states identified   
under paragraph 7#a74  4