,,ii  #aai? ,,congress  #b;d ,session   
,s4 #ejcg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ba1 #bjbf,mr4   
,kim 7= himself1 ,ms4 ,duckwor?1 ,mr4   
,padilla1 & ,mr4 ,book]7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xix ( ! ,social        
,security ,act to make all *ildr5       
eligible = ,m$icaid f bir? until age    
#bf1 to require ,/ates to automatically 
enroll *ildr5 & "y adults "u age #bf 9 !
 ,/ate ,m$icaid program1 & = o!r        
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,medi,kids ,act4  #b4      
,medi,kids  7a7 ,eligibility until age  
#bf  7#a7 ,9 g5]al ,section             
#aijb7;a77#aj77;,a77i7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#aj77;,a77i77 is am5d$-- 7,a7
 by /rik+ or at ! end ( subclause       
7,,viii72  7,b7 9 subclause 7,,ix77dd71 
by ins]t+ or at ! end2 &  7,c7 by add+  
at ! end ! foll[+ new subclause3  7,x7  
beg9n+ on ! date t is #b ye>s aft] !    

date ( enactm5t ( ?is subclause1 :o are 
individuals :o h n atta9$ #bf ye>s (    
age2  4  7#b7 ,effective date ,! am5dm5t
 made by ?is subsection %all take effect
 on ! date ( enactm5t ( ?is ,act4  7b7  
,automatic enrollm5t ,section #aijb7;e7 
( ! ,social ,security ,act is am5d$ by  
/rik+ p>agraph 7#d7 & ins]t+ ! foll[+3  
7#d7 ,automatic enrollm5t ( *ildr5  7,a7
 ,9 g5]al ,any *ild born 9 a ,/ate on or
 aft] ! date t is #b ye>s aft] ! date ( 
enactm5t ( ! ,medi,kids ,act %all be    
consid]$ to h appli$ = m$ical assi/ance 
"u ! ,/ate plan & %all be automatically 
enroll$ = su* assi/ance on ! date ( _!  
bir?4  7,b7 ,notification requirem5t ,! 
,/ate %all in=m ! p>5t1 gu>dian1 or     
cu/odial relative ( a *ild :o is        
automatically enroll$ 9 ! ,/ate plan "u 
subp>agraph 7,a7 ( ! s]vices t w be     
cov]$1 appropriate me?ods = us+ su*     
s]vices1 m$ical support obligations 7"u 
section #aiab7;a77 creat$ by enrollm5t  
7if applicable71 ! actions ! p>5t1      
gu>dian1 or relative mu/ take 7if any7  

to ma9ta9 enrollm5t1 & ! actions ! p>5t1
 gu>dian1 or relative may take to       
dis5roll ! *ild4  7,c7 ,opt-out if o!r  
cov]age is available ,! ,/ate %all      
e/abli% a process to all[ ! p>5t1       
gu>dian1 or cu/odial relative ( a *ild  
:o is automatically enroll$ 9 ! ,/ate   
plan "u subp>agraph 7,a7 to dis5roll !  
*ild f ! ,/ate plan ?r\gh affirmation 9 
writ+ if ! *ild is enroll$ 9 o!r heal?  
b5efits cov]age t-- 7i7 at a m9imum1    
provides ! ess5tial heal? b5efits def9$ 
by ! ,secret>y "u section #acjb7;b7 ( ! 
,pati5t ,protection & ,af=dable ,c>e    
,act2 &  7ii7 meets su* o!r requirem5ts 
z ! ,secret>y det]m9es appropriate4     
7,d7 ,special rule ,) respect to an     
individual :o is automatically enroll$ 9
 ! ,/ate plan "u subp>agraph 7,a7 z a   
*ild & has atta9$ #ah ye>s ( age1 !     
notification requirem5t describ$ 9      
subp>agraph 7,b7 & ! opt-out requirem5t 
describ$ 9 subp>agraph 7,c7 %all apply  
to su* individual 9 lieu ( ! p>5t1      
gu>dian1 or cu/odial relative ( su*     

individual4  4  7c7 ,cont9u\s           
eligibility ,section #aijb7;e77#ab7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7e77#ab77 is am5d$-- 7#a7 9 !    
head+ by ins]t+ & "y adults aft] *ildr52
  7#b7 9 ! matt] prec$+ subp>agraph     
7,a71 by /rik+ #ai & ins]t+ #bf2  7#c7  
by /rik+ subp>agraph 7,a72  7#d7 by     
r$esignat+ subp>agraphs 7,b7 & 7,c7 z   
subp>agraphs 7,a7 & 7,b72 &  7#e7 9     
subp>agraph 7,a71 z s r$esignat$1 by    
/rik+ #ai & ins]t+ #bf4  7d7 ,exclusion 
f def9ition ( m9imum ess5tial cov]age   
,section #cf;,b7c77#b7 ( ! ,int]nal     
,rev5ue ,code ( #aihf is am5d$ by add+  
at ! end ! foll[+ new subp>agraph3  7,d7
 ,treatm5t ( c]ta9 cov]age "u ! ,m$icaid
 program ,= purposes ( subp>agraph 7,b71
 an individual %all n be treat$ z       
eligible = m9imum ess5tial cov]age if-- 
7i7 su* cov]age consi/s ( eligibility = 
m$ical assi/ance "u a ,/ate ,m$icaid    
program "u section                      
#aijb7;a77#aj77;,a77i77,x7 ( ! ,social  
,security ,act2 &  7ii7 ! individual is 

n enroll$ 9 su* a program = su* m$ical  
assi/ance4  4  7e7 ,cov]age ( *ildr5 &  
"y adults )\t reg>d to immigration /atus
  7#a7 ,9 g5]al ,section #aijc7v7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif;b7v77 is am5d$-- 7,a7 9 p>agraph  
7#a71 by /rik+ & 7#e7 & ins]t+ 7#e71 &  
7#f72  7,b7 9 p>agraph 7#d77;,a77ii7--  
7i7 9 ! clause head]1 by ins]t+ & "y    
adults aft] ,*ildr52 &  7ii7 by /rik+   
#ba & ins]t+ #bf2 &  7,c7 by add+ at !  
end ! foll[+ p>agraph3  7#f7 7,a7       
,not)/&+ any o!r provision ( law1 on &  
aft] ! date t is #b ye>s aft] ! date (  
enactm5t ( ?is p>agraph1 a ,/ate %all   
provide m$ical assi/ance "u ?is title to
 any individual resid+ or pres5t 9 !    
,unit$ ,/ates :o is eligible = m$ical   
assi/ance "u section                    
#aijb7;a77#aj77;,a77i77,x71 )\t reg>d to
 :e!r ! individual is lawfully resid+ or
 lawfully pres5t 9 ! ,unit$ ,/ates4     
7,b7 ,no debt %all accrue "u an         
affidavit ( support aga9/ any sponsor ( 
an individual provid$ m$ical assi/ance 9

 accordance ) subp>agraph 7,a7 & ! co/ (
 su* assi/ance %all n be consid]$ z an  
unreimburs$ co/4  4  7#b7 ,con=m+       
am5dm5ts  7,a7 ,section #aacg7;f7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;b-#g7;f77 is am5d$ by ins]t+ or to
 individuals :o are eligible = m$ical   
assi/ance "u section                    
#aijb7;a77#aj77;,a77i77,x7 & are provid$
 su* assi/ance 9 accordance ) section   
#aijc7v77#f7 be=e ! p]iod4  7,b7        
,section #bajg7;e77#a77,q7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#acig;gg7e77#a77,q77 is am5d$ by ins]t+ 
& "y adults aft] *ildr5 ea* place x     
appe>s4  7,c7 ,section #djb7;b77#b7 ( ! 
,p]sonal ,responsibility & ,"w          
,opportunity ,reconciliation ,act (     
#aiif 7#h ,u4,s4,c4 #afab7;b77#b77 is   
am5d$ by add+ at ! end ! foll[+3  7,h7  
,m$icaid exception = *ildr5 & "y adults 
,) respect to eligibility = b5efits = ! 
program def9$ 9 p>agraph 7#c77;,c7      
7relat+ to ! ,m$icaid program71 section 
#dja7;a7 & p>agraph 7#a7 %all n apply to

 any individual :o has n atta9$ #bf ye>s
 ( age4  4  7,d7 ,section #djc7;d7 ( !  
,p]sonal ,responsibility & ,"w          
,opportunity ,reconciliation ,act (     
#aiif 7#h ,u4,s4,c4 #afac7;d77 is       
am5d$-- 7i7 by /rik+ or at ! end (      
p>agraph 7#a72  7ii7 by /rik+ ! p]iod at
 ! end ( p>agraph 7#b7 & ins]t+ 2 or2 & 
7iii7 by add+ at ! end ! foll[+3  7#c7  
an individual describ$ 9 section        
#djb7;b77#b77;,h71 b only ) respect to !
 program specifi$ 9 subsection          
7b77#c77;,c7 ( section #djb4  4  7,e7   
,section #dca7;b7 ( ! ,p]sonal          
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif 7#h        
,u4,s4,c4 #afda7;b77 is am5d$-- 7i7 by  
/rik+ or at ! end ( p>agraph 7#g72  7ii7
 by /rik+ ! p]iod at ! end ( p>agraph   
7#h7 & ins]t+ 1 or2 &  7iii7 by add+ at 
! end ! foll[+3  7#i7 an individual :o  
has n atta9$ #bf ye>s ( age1 b only )   
respect to ! designat$ ,f$]al program   
def9$ 9 section #djb7;b77#c77;,c7       
7relat+ to ! ,m$icaid program74  4  7#c7

 ,effective date ,! am5dm5ts made by ?is
 subsection %all take effect on ! date (
 enactm5t ( ?is ,act4  7f7 #ajj p]c5t   
,f$]al mat*+ paym5ts = m$ical assi/ance 
= *ildr5 & "y adults  7#a7 ,9 g5]al     
,section #aije ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;d7 is am5d$-- 
7,a7 9 subsection 7b71 by /rik+ & 7ii7 &
 ins]t+ 7ii71 & 7ll72 &  7,b7 by add+ at
 ! end ! foll[+ new subsection3  7ll7   
,enhanc$ ,,fmap = c]ta9 *ildr5 & "y     
adults ,not)/&+ subsection 7b71 beg9n+  
on ! date t is #b ye>s aft] ! date (    
enactm5t ( ?is subsection1 ! ,f$]al     
m$ical assi/ance p]c5tage %all be #ajj  
p]c5t ) respect to am\nts exp5d$ by a   
,/ate = m$ical assi/ance = individuals--
 7#a7 :o are eligible = m$ical assi/ance
 "u section #aijb7;a77#aj77;,a77i77,x72 
&  7#b7 :o w\ld n h be5 eligible =      
m$ical assi/ance = full b5efits 7z def9$
 9 subsection 7y77#b77;,b77 "u ! ,/ate  
plan "u ?is title or a waiv] ( su* plan 
z su* plan or waiv] 0 9 effect on       
,janu>y #a1 #bjbe4  4  7#b7 ,effective  

date ,! am5dm5t made by ?is subsection  
%all take effect on ! date ( enactm5t ( 
?is ,act4  7g7 ,exclusion f community   
engagem5t requirem5t  7#a7 ,m&atory     
exception = c]ta9 individuals ,section  
#aijb7xx77#c77;,a77i77,,ii7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acif;a7xx77#c77;,a77i77,,ii77 is       
am5d$-- 7,a7 9 item 7aa71 by /rik+ #ai &
 ins]t+ #bf2 &  7,b7 9 item 7cc71 by    
ins]t+ or 7,x7 aft] 7,,vii74  7#b7      
,specifi$ exclud$ individuals  7,a7 ,9  
g5]al ,section                          
#aijb7xx77#i77;,a77ii77,i7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#acif;a7xx77#i77;,a77ii77,i77 is am5d$  
to read z foll[s3  7,i7 :o is describ$ 9
 subclause 7,,ix7 or 7,x7 ( subsection  
7a77#aj77;,a77i72  4  7,b7 ,con=m+      
am5dm5t ,section                        
#aijb7xx77#i77;,a77i77,,ii77bb7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7xx77#i77;,a77i77,,ii77bb77 is   
am5d$ by /rik+ #ai & ins]t+ #bf4  7h7   
,expansion ( ,,epsdt  7#a7 ,9 g5]al     

,section #aije7;a77#d77;,b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acif;d7a77#d77;,b77 is am5d$ by /rik+  
#ba & ins]t+ #bf4  7#b7 ,con=m+ am5dm5t 
,title ,,xix ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acif et seq47 is am5d$ 9
 section #aijb7;a77#dc77;,a71 by /rik+  
#ba & ins]t+ #bf4  7i7 ,o!r con=m+      
am5dm5ts ,title ,,xix ( ! ,social       
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 is am5d$-- 7#a7 9 section         
#aije7;a7-- 7,a7 9 ! matt] prec$+       
p>agraph 7#a7-- 7i7 9 clause 7i71 by    
/rik+ #ba1 or1 at ! option ( ! ,/ate1 "u
 ! age ( #bj1 #ai1 or #ah z ! ,/ate may 
*oose & ins]t+ #bf2 &  7ii7 9 clause    
7xiv71 by /rik+ or                      
#aijb7;a77#aj77;,a77i77,,ix7 & ins]t+ 1 
#aijb7;a77#aj77;,a77i77,,ix71 or        
#aijb7;a77#aj77;,a77i77,x72 &  7,b7 9   
p>agraph 7#af77;,a71 by /rik+ #ba &     
ins]t+ #bf2  7#b7 9 section             
#aije7;h77#a7-- 7,a7 9 ! matt] prec$+   
subp>agraph 7,a71 by /rik+ #ba & ins]t+ 
#bf2 &  7,b7 9 subp>agraph 7,c7-- 7i7 by

 /rik+ #ba ea* place x appe>s & ins]t+  
#bf2 &  7ii7 by /rik+ #bb & ins]t+ #bg2 
7#c7 9 section #aiae7l77#g77;,a77ii71 by
 /rik+ #ba & ins]t+ #bf2  7#d7 9 section
 #aiaf-- 7,a7 9 subsection 7a77#b77;,a71
 by /rik+ #ah ye>s ( age 7&1 at ! option
 ( ! ,/ate1 individuals "u #ba1 #bj1 or 
#ai ye>s ( age1 or any reasonable       
category ( individuals #ah ye>s ( age or
 ov]7 & ins]t+ #bf ye>s ( age2 &  7,b7 9
 subsection 7b77#b77;,a71 by /rik+ #ah  
ye>s ( age 7&1 at ! option ( ! ,/ate1   
individuals "u #ba1 #bj1 or #ai ye>s (  
age1 or any reasonable category (       
individuals #ah ye>s ( age or ov]7 &    
ins]t+ #bf ye>s ( age2  7#e7 9 section  
#aiag-- 7,a7 9 subsection 7a77#b77;,b71 
by /rik+ #ba & ins]t+ #bf2 &  7,b7 9    
subsection 7b77#b77;,a71 by /rik+ #ba & 
ins]t+ #bf2 &  7#f7 9 section           
#aicg7;a77#b77;,b71 by add+ at ! end !  
foll[+ new clause3  7xii7 ,medi,kids ,! 
individual qualifies = m$ical assi/ance 
on ! basis ( section                    
#aijb7;a77#aj77;,a77i77,x74  4  7j7     

,effective date ,except z o!rwise       
provid$1 ! am5dm5ts made by ?is section 
%all take effect on ! date t is #b ye>s 
aft] ! date ( enactm5t ( ?is ,act4