[Pages S999-S1000]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 77. Ms. MURKOWSKI (for herself, Mr. Specter, Mr. Johanns, and Ms. 
Collins) submitted an amendment intended to be proposed by her to the 
bill H.R. 2, to amend title XXI of the Social Security Act to extend 
and improve the Children's Health Insurance Program, and for other 
purposes; as follows:

       At the appropriate place, insert the following:

     SEC. __. DEVELOPMENT OF BEST PRACTICE RECOMMENDATIONS AND 
                   COVERAGE OF LOW INCOME CHILDREN.

       (a) Development of Best Practice Recommendations.--Section 
     2107 (42 U.S.C. 1397gg) is amended by adding at the end the 
     following:
       ``(g) Development of Best Practice Recommendations.--Not 
     later than 12 months after the date of enactment of this Act, 
     the Secretary, in consultation with States, including 
     Medicaid and CHIP directors in States, shall publish in the 
     Federal Register, and post on the public website for the 
     Department of Health and Human Services--
       ``(1) recommendations regarding best practices for States 
     to use to address CHIP crowd-out; and
       ``(2) uniform standards for data collection by States to 
     measure and report--
       ``(A) health benefits coverage for children with family 
     income below 200 percent of the poverty line; and
       ``(B) on CHIP crowd-out, including for children with family 
     income that exceeds 200 percent of the poverty line.

     The Secretary, in consultation with States, including 
     Medicaid and CHIP directors in States, may from time to time 
     update the best practice recommendations and uniform 
     standards set published under paragraphs (1) and (2) and 
     shall provide for publication and posting of such updated 
     recommendations and standards.''.
       (b) Limitation on Payments for States Covering Higher 
     Income Children.--
       (1) In general.--Section 2105(c) (42 U.S.C. 1397ee(c)), as 
     amended by section 601(a), is further amended by adding at 
     the end the following new paragraph:
       ``(12) Limitation on payments for states covering higher 
     income children.--
       ``(A) Determinations.--
       ``(i) In general.--The Secretary shall determine, for each 
     State that is a higher income eligibility State as of October 
     1 of 2010 and each subsequent year, whether the State meets 
     the target rate of coverage of low-income children required 
     under subparagraph (C) and shall notify the State in that 
     month of such determination.
       ``(ii) Determination of failure.--If the Secretary 
     determines in such month that a higher income eligibility 
     State does not meet such target rate of coverage, no payment 
     shall be made as of April 30 of the following year, under 
     this section for child health assistance provided for higher-
     income children (as defined in subparagraph (D)) under the 
     State child health plan unless and until the Secretary 
     establishes that the

[[Page S1000]]

     State is in compliance with such requirement, but in no case 
     more than 12 months.
       ``(B) Higher income eligibility state.--A higher income 
     eligibility State described in this clause is a State that--
       ``(i) applies under its State child health plan an 
     eligibility income standard for targeted low-income children 
     that exceeds 300 percent of the poverty line; or
       ``(ii) because of the application of a general exclusion of 
     a block of income that is not determined by type of expense 
     or type of income, applies an effective income standard under 
     the State child health plan for such children that exceeds 
     300 percent of the poverty line. 
       ``(C) Requirement for target rate of coverage of low-income 
     children.--The requirement of this subparagraph for a State 
     is that the rate of health benefits coverage (both private 
     and public) for low-income children in the State is not 
     statistically significantly (at a p=0.05 level) less than 80 
     percent of the low-income children who reside in the State 
     and are eligible for child health assistance under the State 
     child health plan.
       ``(D) Higher-income child.--For purposes of this paragraph, 
     the term `higher income child' means, with respect to a State 
     child health plan, a targeted low-income child whose family 
     income--
       ``(i) exceeds 300 percent of the poverty line; or
       ``(ii) would exceed 300 percent of the poverty line if 
     there were not taken into account any general exclusion 
     described in subparagraph (B)(ii).''.
       (2) Construction.--Nothing in the amendment made by 
     paragraph (1) or this section this shall be construed as 
     authorizing the Secretary of Health and Human Services to 
     limit payments under title XXI of the Social Security Act in 
     the case of a State that is not a higher income eligibility 
     State (as defined in section 2105(c)(12)(B) of such Act, as 
     added by paragraph (1)).
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