,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #fadi  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #i1 #bjbj,mr4    
,cunn+ham introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,en]gy &     
,comm]ce  ,a ,,bill  ,to am5d title     
,,xix ( ! ,social ,security ,act to     
enhance report+ requirem5ts =           
nonexpansion ,/ates1 & = o!r purposes4  
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,m$icaid ,report on ,expansion (      
,access to ,cov]age = ,heal? ,act or    
,m$icaid ,,rea* ,act4  #b4 ,enhanc$     
report+ requirem5ts = nonexpansion      
,/ates ,section #aijc ( ! ,social       
,security ,act 7#db ,u4,s4,c4 #acif;b7  
is am5d$-- 7#a7 9 subsection 7a77#g71 by
 ins]t+ subsection 7bb7 & be=e section  
#aiai7;g77#c77;,b72 &  7#b7 by add+ at !
 end ! foll[+ new subsection3  7bb7     
,r$uction ( ,f$]al paym5ts = c]ta9      
adm9i/rative co/s ( nonexpansion ,/ates 
t d n satisfy report+ requirem5ts  7#a7 
,9 g5]al  7,a7 ,r$uction ,9 ! case ( a  
nonexpansion ,/ate1 ) respect to a      

fiscal ye> 7beg9n+ ) fiscal ye> #bjbb7 t
 does n satisfy ! report+ requirem5t "u 
p>agraph 7#b7 = su* fiscal ye>1 !       
p]c5tage specifi$ 9 subsection 7a77#g7 =
 am\nts describ$ 9 su* subsection exp5d$
 by su* ,/ate dur+ a cal5d> qu>t]       
describ$ 9 p>agraph 7#d7 ) respect to   
su* fiscal ye>1 subject to subp>agraph  
7,b71 %all be r$uc$ by ! numb] (        
p]c5tage po9ts specifi$ 9 p>agraph 7#d7 
= ! respective cal5d> qu>t]4  7,b7      
,exception ,9 ! case ( a nonexpansion   
,/ate t is subject to a r$uction "u     
subp>agraph 7,a7 = ! cal5d> qu>t]       
describ$ 9 p>agraph 7#d77;,a7 ) respect 
to a fiscal ye>1 if ! ,/ate satisfies ! 
crit]ia describ$ 9 subp>agraphs 7,a71   
7,b71 & 7,c7 ( p>agraph 7#b7 7)\t reg>d 
to ! dates specifi$ 9 su* subp>agraph   
7,a7 & 7,c77 be=e ! beg9n+ ( a subsequ5t
 cal5d> qu>t] describ$ 9 p>agraph 7#d7 )
 respect to su* fiscal ye>1 !n su* ,/ate
 %all n be subject to a r$uction "u     
subp>agraph 7,a7 = su* subsequ5t cal5d> 
qu>t]4  7#b7 ,report+ requirem5t ,=     

purposes ( p>agraph 7#a71 a nonexpansion
 ,/ate satisfies ! report+ requirem5t "u
 ?is p>agraph = a fiscal ye>1 if !      
nonexpansion ,/ate-- 7,a7 by n lat] ?an 
,janu>y #a ( su* ye>1 po/s on ! public  
website ( ! ,/ate ag5cy adm9i/]+ ! ,/ate
 plan1 ! in=mation describ$ 9 p>agraph  
7#c7 ) respect to su* ,/ate = ! previ\s 
ye>2  7,b7 provides = at lea/ a #cj-;day
 p]iod = notice & comm5t on su*         
in=mation2 &  7,c7 by n lat] ?an ,m>* #a
 ( su* ye>1 submits to ! ,secret>y a    
complete report includ+ su* in=mation1  
comm5ts submitt$ pursuant to subp>agraph
 7,b71 & a response by ! ,/ate to ea*   
su* comm5t4  7#c7 ,in=mation describ$ ,!
 in=mation describ$ 9 ?is p>agraph1 )   
respect to a ,/ate & ye>1 is ! foll[+3  
7,a7 ,! e/imat$ numb] ( individuals :o 7
 un9sur$ = at lea/ #f mon?s1 %[n by     
age-gr\ps ( #j to #ah ye>s ( age & ( #ai
 ye>s ( age to #fd ye>s ( age1 z well z 
a detail$ description ( ! basis = !     
e/imates4  7,b7 ,! e/imat$ numb] ( !    
individuals e/imat$ "u subp>agraph 7,a7 

9 ! ,/ate :o w\ld be eligible = m$ical  
assi/ance "u ! ,/ate plan if ! ,/ate 7  
to make m$ical assi/ance "u ! ,/ate plan
 available 9 accordance ) section       
#aijb7k77#a7 to all individuals describ$
 9 section #aijb7;a77#aj77;i77,,viii71 &
 a detail$ description ( ! basis = !    
e/imates4  7,c7 ,a compreh5sive li/+ (  
,/ate income eligibility crit]ia = all  
m&atory & optional ,m$icaid eligibility 
gr\ps = :i* ! ,/ate plan provides m$ical
 assi/ance 7o!r ?an ) respect to        
individuals describ$ 9 clause 7i77,,ii71
 7ii77,,vi71 or 7ii77,,xxii7 ( section  
#aijb7;a77#aj77;,a774  7,d7 ,! total    
am\nt ( hospital uncomp5sat$-c>e co/s & 
a breakd[n ( ! s\rce ( su* co/s1 z well 
z a breakd[n = rural & non-rural        
hospitals4  7#d7 ,p]c5tage describ$ ,=  
purposes ( p>agraph 7#a71 a cal5d> qu>t]
 describ$ 9 ?is p>agraph1 ) respect to a
 fiscal ye>1 & ! p]c5tage po9ts describ$
 9 ?is p>agraph = su* qu>t]1 ) respect  
to a ,/ate1 are-- 7,a7 = ! cal5d> qu>t] 
beg9n+ on ! ,april #a occurr+ dur+ su*  

fiscal ye>1 #j4e p]c5tage po9ts2  7,b7 =
 ! cal5d> qu>t] beg9n+ on ! ,july #a    
occurr+ dur+ su* fiscal ye>1 #a4j       
p]c5tage po9t2 &  7,c7 = ! cal5d> qu>t] 
beg9n+ on ! ,octob] #a occurr+ dur+ !   
subsequ5t fiscal ye>1 #a4e p]c5tage     
po9ts4  7#e7 ,paym5t 9 case ( report+   
,/ate ,! exp5ses incurr$ by a           
non-expansion ,/ate1 ) respect to any   
cal5d> qu>t] ) respect to a fiscal ye>  
7beg9n+ ) #bjba71 = c>ry+ out           
subp>agraphs 7,a7 ?r\gh 7,c7 ( p>agraph 
7#b7 %all1 = purposes ( section         
#aijc7;a77#g71 be consid]$ to be exp5ses
 necess>y = ! prop] & effici5t          
adm9i/ration ( ! ,/ate plan "u ?is      
title4  7#f7 ,nonexpanion ,/ate def9$ ,=
 purposes ( ?is subsection1 ! t]m       
nonexpansion ,/ate means1 ) respect to a
 fiscal ye>1 a ,/ate t z ( ! fir/ qu>t] 
( su* fiscal ye> does n provide "u !    
,/ate plan ( su* ,/ate 7or waiv] ( su*  
plan7 = mak+ m$ical assi/ance available 
9 accordance ) section #aijb7k77#a7 to  
all individuals describ$ 9 section      

#aijb7;a77#aj77;i77,,viii74  4