,,ii  #aaeth ,,congress  #ast ,session  
,s4 #bbji  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #g1  
#bjag,mr4 ,cornyn 7for himself1 ,mr4    
,cassidy1 and ,mr4 ,toomey7 introduced  
the following bill2 which was read twice
 and referred to the ,committee on      
,finance  ,a ,,bill  ,to amend title    
,,xix of the ,social ,security ,act to  
require ,states to count monetary       
winnings from lotteries and other       
lump-sum income of #hj1jjj or more as if
 they were obtained over multiple months
 for purposes of determining income     
eligibility for medical assistance4  #a4
 ,short title ,this ,act may be cited as
 the ,prioritizing the ,most ,vulnerable
 ,over ,lottery ,winners ,act of #bjag4 
#b4 ,treatment of lottery winnings and  
other lump-sum income for purposes of   
income eligibility under ,medicaid  7a7 
,in general ,section #aijb of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7 is amended--  7#a7 in          
subsection 7a77#ag71 by striking        

7e77#ad71 7e77#ad7 and inserting        
7e77#ad71 7e77#ae72 and  7#b7 in        
subsection 7e7--  7,a7 in paragraph     
7#ad7 7relating to modified adjusted    
gross income71 by adding at the end the 
following new subparagraph3  7,j7       
,treatment of certain lottery winnings  
and income received as a lump sum  7i7  
,in general ,in the case of an          
individual who is the recipient of      
qualified lottery winnings 7pursuant to 
lotteries occurring on or after ,january
 #a1 #bjah7 or qualified lump sum income
 7received on or after such date7 and   
whose eligibility for medical assistance
 is determined based on the application 
of modified adjusted gross income under 
subparagraph 7,a71 a ,state shall1 in   
determining such eligibility1 include   
such winnings or income 7as applicable7 
as income received--  7,i7 in the month 
in which such winnings or income 7as    
applicable7 is received if the amount of
 such winnings or income is less than   
#hj1jjj2  7,,ii7 over a period of #b    

months if the amount of such winnings or
 income 7as applicable7 is greater than 
or equal to #hj1jjj but less than       
#ij1jjj2  7,,iii7 over a period of #c   
months if the amount of such winnings or
 income 7as applicable7 is greater than 
or equal to #ij1jjj but less than       
#ajj1jjj2 and  7,,iv7 over a period of  
#c months plus #a additional month for  
each increment of #aj1jjj of such       
winnings or income 7as applicable7      
received1 not to exceed a period of #abj
 months 7for winnings or income of      
#a1bfj1jjj or more71 if the amount of   
such winnings or income is greater than 
or equal to #ajj1jjj4  7ii7 ,counting in
 equal installments ,for purposes of    
subclauses 7,,ii71 7,,iii71 and 7,,iv7  
of clause 7i71 winnings or income to    
which such subclause applies shall be   
counted in equal monthly installments   
over the period of months specified     
under such subclause4  7iii7 ,hardship  
exemption ,an individual whose income1  
by application of clause 7i71 exceeds   

the applicable eligibility threshold    
established by the ,state1 shall        
continue to be eligible for medical     
assistance to the extent that the ,state
 determines1 under procedures           
established by the ,state 7in accordance
 with standards specified by the        
,secretary71 that the denial of         
eligibility of the individual would     
cause an undue medical or financial     
hardship as determined on the basis of  
criteria established by the ,secretary4 
7iv7 ,notifications and assistance      
required in case of loss of eligibility 
,a ,state shall1 with respect to an     
individual who loses eligibility for    
medical assistance under the ,state plan
 7or a waiver of such plan7 by reason of
 clause 7i7--  7,i7 before the date on  
which the individual loses such         
eligibility1 inform the individual--    
7aa7 of the individual's opportunity to 
enroll in a qualified health plan       
offered through an ,exchange established
 under title ,i of the ,patient         

,protection and ,affordable ,care ,act  
during the special enrollment period    
specified in section #ihja7;f77#c7 of   
the ,internal ,revenue ,code of #aihf   
7relating to loss of ,medicaid or ,,chip
 coverage72 and  7bb7 of the date on    
which the individual would no longer be 
considered ineligible by reason of      
clause 7i7 to receive medical assistance
 under the ,state plan or under any     
waiver of such plan and be eligible to  
reapply to receive such medical         
assistance2 and  7,,ii7 provide         
technical assistance to the individual  
seeking to enroll in such a qualified   
health plan4  7v7 ,qualified lottery    
winnings defined ,in this subparagraph1 
the term qualified lottery winnings     
means winnings from a sweepstakes1      
lottery1 or pool described in paragraph 
7#c7 of section #ddjb of the ,internal  
,revenue ,code of #aihf or a lottery    
operated by a multistate or             
multijurisdictional lottery association1
 including amounts awarded as a lump sum

 payment4  7vi7 ,qualified lump sum     
income defined ,in this subparagraph1   
the term qualified lump sum income means
 income that is received as a lump sum  
from one of the following sources3 7,i7 
,monetary winnings from gambling 7as    
defined by the ,secretary and including 
gambling activities described in section
 #aiee7;b77#d7 of title #ah1 ,united    
,states ,code74  7,,ii7 ,damages        
received1 whether by suit or agreement  
and whether as lump sums or as periodic 
payments 7other than monthly payments71 
on account of causes of action other    
than causes of action arising from      
personal physical injuries or physical  
sickness4  7,,iii7 ,income received as  
liquid assets from the estate 7as       
defined in section #aiag7;b77#d77 of a  
deceased individual4  2 and  7,b7 by    
striking 7#ad7 ,exclusion and inserting 
7#ae7 ,exclusion4  7b7 ,rules of        
construction  7#a7 ,interception of     
lottery winnings allowed ,nothing in the
 amendment made by subsection 7a77#b7   

shall be construed as preventing a      
,state from intercepting the ,state     
lottery winnings awarded to an          
individual in the ,state to recover     
amounts paid by the ,state under the    
,state ,medicaid plan under title ,,xix 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acif et seq47 for medical    
assistance furnished to the individual4 
7#b7 ,applicability limited to          
eligibility of recipient of lottery     
winnings or lump sum income ,nothing in 
the amendment made by subsection        
7a77#b77;,a7 shall be construed1 with   
respect to a determination of household 
income for purposes of a determination  
of eligibility for medical assistance   
under the ,state plan under title ,,xix 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acif et seq47 7or a waiver of
 such plan7 made by applying modified   
adjusted gross income under subparagraph
 7,a7 of section #aijb7;e77#ad7 of such 
,act 7#db ,u4,s4,c4 #acif;a7e77#ad771 as
 limiting the eligibility for such      

medical assistance of any individual    
that is a member of the household other 
than the individual who received        
qualified lottery winnings or qualified 
lump-sum income 7as defined in          
subparagraph 7,j7 of such section       
#aijb7;e77#ad71 as added by subsection  
7a77#b77;,a7 of this section74