119-hr3321

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3321 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 3321

To amend title XIX of the Social Security Act to phase out the enhanced 
 Federal match applicable to medical assistance provided to low-income 
 adults.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 May 9, 2025

 Mr. Roy (for himself, Mr. Fitzgerald, Mr. Gill of Texas, Mr. Ogles, 
 Mrs. Spartz, Mr. Donalds, Mr. Cloud, Mr. Harris of Maryland, Ms. 
 Boebert, Mr. Self, Mr. Higgins of Louisiana, Mr. Brecheen, Mr. Perry, 
 Mr. Gosar, Mr. Tiffany, and Mr. Biggs of Arizona) introduced the 
 following bill; which was referred to the Committee on Energy and 
 Commerce

_______________________________________________________________________

 A BILL

To amend title XIX of the Social Security Act to phase out the enhanced 
 Federal match applicable to medical assistance provided to low-income 
 adults.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Ending Medicaid Discrimination 
Against the Most Vulnerable Act''.

SEC. 2. PHASE-OUT OF ENHANCED FEDERAL MATCH FOR MEDICAL ASSISTANCE 
 PROVIDED TO LOW-INCOME INDIVIDUALS UNDER MEDICAID.

    (a) In General.--

Section 1905

    (y) of the Social Security Act (42 
U.S.C. 1396d

    (y) ) is amended--

    (1) in paragraph

    (1) --
        (A) in subparagraph
        (A) , by inserting ``and subject 
 to paragraph

    (4) '' after ``Notwithstanding subsection

    (b) '';
        (B) in subparagraph
            (D) , by striking ``; and'' and 
 inserting a semicolon;
            (C) in subparagraph
        (E) , by striking ``and each 
 year thereafter.'' and inserting ``through 2026;''; and
            (D) by adding at the end the following new 
 subparagraphs:
 ``
        (F) for calendar quarters in each of calendar 
 years 2027 through 2034, the percentage that applied 
 under this subsection for calendar quarters in the 
 preceding calendar year minus the applicable number of 
 percentage points determined for the State under 
 paragraph

    (3) or, if higher, the Federal medical 
 assistance percentage otherwise determined for the 
 State and year under subsection

    (b) (without regard to 
 this subsection); and
 ``
        (G) for calendar quarters in 2035 and each year 
 thereafter, the Federal medical assistance percentage 
 otherwise determined for the State and year under 
 subsection

    (b) (without regard to this subsection).''; 
 and

    (2) by adding at the end the following new paragraphs:
 ``

    (3) Applicable number of percentage points.--For purposes 
 of paragraph

    (1)
        (F) , the applicable number of percentage points 
 for a State is the number of percentage points equal to--
 ``
        (A) the percentage points difference between--
 ``
            (i) 90 percent; and
 ``
            (ii) the Federal medical assistance 
 percentage determined for the State under 
 subsection

    (b) (without regard to this 
 subsection) for fiscal year 2026; divided by
 ``
        (B) 8.
 ``

    (4) Rules of application for calendar years after 2024.--
 ``
        (A) In general.--Notwithstanding any other 
 provision of law, for calendar years after 2024--
 ``
            (i) paragraph

    (1) shall not apply to a 
 non-expansion State (as defined in subparagraph
        (B) );
 ``
            (ii) if a non-expansion State elects on 
 or after the date of enactment of this 
 paragraph to expend amounts for all or any 
 individuals described in 

section 1902

    (a)

    (10)
        (A)
            (i) 
            (VIII) , the Federal medical 
 assistance percentage otherwise determined for 
 the State and year under subsection

    (b) (without regard to this subsection) shall apply 
 to amounts expended by such State for medical 
 assistance for such individuals; and
 ``
            (iii) an expansion State (as defined in 
 such subparagraph) may, at the option of the 
 State, elect to only expend amounts for medical 
 assistance for newly eligible individuals 
 described in 

section 1902

    (a)

    (10)
        (A)
            (i) 
            (VIII) whose income does not exceed 100 percent of the 
 Federal poverty line (as defined for purposes 
 of such section) and continue to receive the 
 Federal medical assistance percentage specified 
 under paragraph

    (1) for such amounts.
 ``
        (B) === Definitions. ===
-In this paragraph:
 ``
            (i) Expansion state.--The term `expansion 
 State' means a State that is not a non-
 expansion State.
 ``
            (ii) Non-expansion state.--The term `non-
 expansion State' means a State that has not 
 expended amounts for all individuals described 
 in 

section 1902

    (a)

    (10)
        (A)
            (i) 
            (VIII) before the 
 date of the enactment of this paragraph.''.

    (b) Eliminating Temporary FMAP Increase for States That Begin To 
Provide Medical Assistance for Low-Income Adults.--

Section 1905 of the 
Social Security Act (42 U.S.C. 1396d) is amended by striking subsection
            (ii) .
 <all>