,,ii #aaith ,,congress #ast ,session ,s4 #badi ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #bd1 #bjbe ,mr4 ,booker 7for himself1 ,mr4 ,heinrich1 ,mr4 ,padilla1 ,ms4 ,warren1 ,mrs4 ,murray1 ,ms4 ,hirono1 ,mr4 ,sanders1 ,mr4 ,blumenthal1 and ,mr4 ,markey7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to expand access to health insurance coverage for immigrants and their families by removing legal and policy barriers to health insurance coverage1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,health ,equity and ,access under the ,law for ,immigrant ,families ,act of #bjbe4 #b4 ,purpose ,it is the purpose of this ,act to-- 7#a7 ensure that all individuals who are lawfully present in the ,united ,states are eligible for all ,federally funded health care programs2 7#b7 advance the ability of undocumented individuals to obtain health insurance coverage through the health insurance exchanges established under part ,,ii of the ,patient ,protection and ,affordable ,care ,act1 ,public ,law #aaa-adh2 7#c7 eliminate the authority for ,states to restrict ,medicaid eligibility for lawful permanent residents2 and 7#d7 eliminate other barriers to accessing ,medicaid1 ,,chip1 and other medical assistance4 #c4 ,removing barriers to health coverage for lawfully residing individuals 7a7 ,medicaid ,section #aijc7v77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#d77 is amended-- 7#a7 by amending subparagraph 7,a7 to read as follows3 7,a7 ,notwithstanding sections #dja7;a71 #djb7;b71 #djc1 and #dba of the ,personal ,responsibility and ,work ,opportunity ,reconciliation ,act of #aiif1 a ,state shall provide medical assistance under this title1 to individuals who are lawfully residing in the ,united ,states 7including individuals described in paragraph 7#a71 battered individuals described in section #dca7;c7 of such ,act1 and individuals with an approved or pending application for deferred action or other ,federally authorized presence71 if they otherwise meet the eligibility requirements for medical assistance under the ,state plan approved under this title 7other than the requirement of the receipt of aid or assistance under title ,,iv1 supplemental security income benefits under title ,,xvi1 or a ,state supplementary payment74 2 7#b7 by amending subparagraph 7,b7 to read as follows3 7,b7 ,no debt shall accrue under an affidavit of support against any sponsor of an individual provided medical assistance under subparagraph 7,a7 on the basis of provision of assistance to such individual and the cost of such assistance shall not be considered as an unreimbursed cost4 2 and 7#c7 in subparagraph 7,c7-- 7,a7 by striking an election by the ,state under subparagraph 7,a7 and inserting the application of subparagraph 7,a72 7,b7 by inserting or be lawfully present after lawfully reside2 and 7,c7 by inserting or present after lawfully residing each place it appears4 7b7 ,,chip ,subparagraph 7,p7 of section #bajg7;e77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7e77#a77 is amended to read as follows3 7,p7 ,paragraph 7#d7 of section #aijc7v7 7relating to lawfully present individuals and undocumented immigrants74 4 7c7 ,effective date 7#a7 ,in general ,except as provided in paragraph 7#b71 the amendments made by this section shall take effect on the date of enactment of this ,act and shall apply to services furnished on or after the date that is #ij days after such date of enactment4 7#b7 ,exception if ,state legislation required ,in the case of a ,state plan for medical assistance under title ,,xix1 or a ,state child health plan under title ,,xxi1 of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirements imposed by the amendments made by this section1 the respective ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of such session shall be deemed to be a separate regular session of the ,state legislature4 #d4 ,consistency in health insurance coverage for individuals with ,federally authorized presence1 including deferred action 7a7 ,in general ,for purposes of eligibility under any of the provisions described in subsection 7b71 all individuals granted ,federally authorized presence in the ,united ,states shall be considered to be lawfully present in the ,united ,states4 7b7 ,provisions described ,the provisions described in this subsection are the following3 7#a7 ,exchange eligibility ,section #adaa of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca74 7#b7 ,reduced cost-sharing eligibility ,section #adjb of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjga74 7#c7 ,premium subsidy eligibility ,section #cf;,b of the ,internal ,revenue ,code of #aihf 7#bf ,u4,s4,c4 #cf;,b74 7#d7 ,medicaid and ,,chip eligibility ,titles ,,xix and ,,xxi of the ,social ,security ,act1 including under section #aijc7v7 of such ,act 7#db ,u4,s4,c4 #acif;b7v774 7c7 ,effective date 7#a7 ,in general ,subsection 7a7 shall take effect on the date of enactment of this ,act4 7#b7 ,transition through special enrollment period ,in the case of an individual described in subsection 7a7 who1 before the first day of the first annual open enrollment period under subparagraph 7,b7 of section #acaa7;c77#f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;c77#f77 beginning after the date of enactment of this ,act1 is granted ,federally authorized presence in the ,united ,states and who1 as a result of such subsection1 qualifies for a subsidy under a provision described in paragraph 7#b7 or 7#c7 of subsection 7b71 the ,secretary of ,health and ,human ,services shall establish a special enrollment period under subparagraph 7,c7 of such section #acaa7;c77#f7 during which such individual may enroll in qualified health plans through ,exchanges under title ,i of the ,patient ,protection and ,affordable ,care ,act and qualify for such a subsidy4 ,for such an individual who has been granted ,federally authorized presence in the ,united ,states as of the date of enactment of this ,act1 such special enrollment period shall begin not later than #ij days after such date of enactment4 ,nothing in this paragraph shall be construed as affecting the authority of the ,secretary to establish additional special enrollment periods under such subparagraph 7,c74 #e4 ,removing citizenship and immigration barriers to access to affordable health care under the ,,aca 7a7 ,in general 7#a7 ,premium tax credits ,section #cf;,b of the ,internal ,revenue ,code of #aihf is amended-- 7,a7 in subsection 7c77#a77;,b7-- 7i7 by amending the heading to read as follows3 ,special rule for certain individuals ineligible for medicaid due to status2 and 7ii7 by amending clause 7ii7 to read as follows3 7ii7 the taxpayer is a noncitizen who is not eligible for the ,medicaid program under title ,,xix of the ,social ,security ,act by reason of the individual's immigration status1 2 and 7,b7 by striking subsection 7e74 7#b7 ,cost-sharing reductions ,section #adjb of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjga7 is amended by striking subsection 7e7 and redesignating subsection 7f7 as subsection 7e74 7#c7 ,basic health program eligibility ,section #acca7;e77#a77;,b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjea7;e77#a77;,b77 is amended by striking lawfully present in the ,united ,states14 7#d7 ,restrictions on ,federal payments ,section #adab of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb7 is amended by striking subsection 7d7 and redesignating subsection 7e7 as subsection 7d74 7#e7 ,requirement to maintain minimum essential coverage ,subsection 7d7 of section #ejjj;,a of the ,internal ,revenue ,code of #aihf is amended by striking paragraph 7#c7 and by redesignating paragraph 7#d7 as paragraph 7#c74 7b7 ,conforming amendments 7#a7 ,establishment of program ,section #adaa7;a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;a77 is amended by striking paragraph 7#a7 and redesignating paragraphs 7#b71 7#c71 and 7#d7 as paragraphs 7#a71 7#b71 and 7#c71 respectively4 7#b7 ,qualified individuals ,section #acab7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjcb7;f77 is amended-- 7,a7 in the heading1 by striking 2 access limited to citizens and lawful residents2 and 7,b7 by striking paragraph 7#c74 7c7 ,effective date ,the amendments made by this section shall apply to years1 plan years1 and taxable years1 as applicable1 beginning after ,december #ca1 #bjbe4 #f4 ,state option to expand ,medicaid and ,,chip to individuals without lawful presence 7a7 ,medicaid 7#a7 ,in general ,section #aijb7;a77#aj77;,a77ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77ii77 is amended-- 7,a7 in subclause 7,,xxii71 by striking or at the end2 7,b7 in subclause 7,,xxiii71 by striking the semicolon and inserting 2 or2 and 7,c7 by adding at the end the following new subclause3 7,,xxiv7 who would be eligible under the ,state plan 7or waiver of such plan7 under this title if they were citizens of the ,united ,states2 4 7#b7 ,conforming amendment ,section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is amended1 in the matter preceding paragraph 7#a7-- 7,a7 in the matter designated as clause 7xvi71 by striking or at the end2 7,b7 in the matter designated as clause 7xvii71 by adding or at the end2 and 7,c7 by inserting after the matter designated as clause 7xvii7 the following3 7xviii7 individuals described in section #aijb7;a77#aj77;,a77ii77,,xxiv71 4 7b7 ,,chip ,title ,,xxi of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;aa et seq47 is amended by inserting after section #baab the following new section3 #baab;,a4 ,state option to provide coverage for individuals without lawful presence ,a ,state may elect through an amendment to its ,state child health plan under section #bajb to treat an individual as a targeted low-income child or a targeted low-income pregnant woman for purposes of this title if such individual would otherwise be included as such a child or such a pregnant woman 7as applicable7 under such plan if the individual were a citizen of the ,united ,states4 4 7c7 ,nonapplication of eligibility prohibition ,section #dja7;a7 of the ,personal ,responsibility and ,work ,opportunity ,reconciliation ,act of #aiif 7#db ,u4,s4,c4 #afaa7;a77 is amended by adding at the end the following new sentence3 ,the preceding sentence shall not apply with respect to a noncitizen's eligibility under a ,state plan 7or waiver of such plan7 under title ,,xix of the ,social ,security ,act or under a ,state child health plan 7or waiver of such plan7 under title ,,xxi of such ,act to the extent that such ,state has elected to make such individual so eligible pursuant to section #aijb7;a77#aj77;,a77ii77,,xxiv7 or #baab;,a of such ,act1 respectively44 #g4 ,preserving access to coverage 7a7 ,in general ,nothing in this ,act1 including the amendments made by this ,act1 shall prevent lawfully present noncitizens who are ineligible for full benefits under the ,medicaid program under title ,,xix of the ,social ,security ,act from securing a credit for which such lawfully present noncitizens would be eligible under section #cf;,b7c77#a77;,b7 of the ,internal ,revenue ,code of #aihf and under the ,medicaid provisions for lawfully present noncitizens1 as in effect on the date prior to the date of enactment of this ,act4 7b7 ,definition ,for purposes of subsection 7a71 the term full benefits means1 with respect to an individual and ,state1 medical assistance for all services covered under the ,state plan under title ,,xix of the ,social ,security ,act that is not less in amount1 duration1 or scope1 or is determined by the ,secretary of ,health and ,human ,services to be substantially equivalent to the medical assistance available for an individual described in section #aijb7;a77#aj77;,a77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77i774 #h4 ,removing barriers to health coverage for lawfully present individuals in ,medicare 7a7 ,part ,a ,section #ahah7;a77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#b7;a77#c77 is amended by striking an alien and all that follows through under this section and inserting an individual who is lawfully present 7as defined in section #h7;c7 of the ,health ,equity and ,access under the ,law for ,immigrant ,families ,act of #bjbe7 in the ,united ,states1 including an individual with an approved or pending application for deferred action or other ,federally authorized presence4 7b7 ,part ,b ,section #ahcf7;a77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieo7a77#b77 is amended by striking an alien and all that follows through under this part and inserting an individual who is lawfully present 7as defined in section #h7;c7 of the ,health ,equity and ,access under the ,law for ,immigrant ,families ,act of #bjbe7 in the ,united ,states1 including an individual with an approved or pending application for deferred action or other ,federally authorized presence4 7c7 ,lawfully present defined ,the term lawfully present shall include1 at a minimum1 all immigration categories that are treated as lawfully present for purposes of the title ,,xix program as amended by section #c4