42 USC 1396u-1 - Assuring coverage for certain low-income families

U.S Code last checked for updates: Oct 16, 2024

§ 1396u–1.

Assuring coverage for certain low-income families

(a)

References to subchapter IV–A are references to pre-welfare-reform provisions

(b)

Application of pre-welfare-reform eligibility criteria

(1)

In general

For purposes of this subchapter, subject to paragraphs (2) and (3), in determining eligibility for medical assistance—

(A)

an individual shall be treated as receiving aid or assistance under a State plan approved under part A of subchapter IV only if the individual meets—

(i)

the income and resource standards for determining eligibility under such plan, and

(ii)

the eligibility requirements of such plan under subsections (a) through (c) of section 606 of this title and section 607(a) of this title,

as in effect as of July 16, 1996; and

(B)

the income and resource methodologies under such plan as of such date shall be used in the determination of whether any individual meets income and resource standards under such plan.

(2)

State option

For purposes of applying this section, a State—

(A)

may lower its income standards applicable with respect to part A of subchapter IV, but not below the income standards applicable under its State plan under such part on May 1, 1988;

(B)

may increase income or resource standards under the State plan referred to in paragraph (1) over a period (beginning after July 16, 1996) by a percentage that does not exceed the percentage increase in the Consumer Price Index for all urban consumers (all items; United States city average) over such period; and

(C)

may use income and resource methodologies that are less restrictive than the methodologies used under the State plan under such part as of July 16, 1996.

(3)

Option to terminate medical assistance for failure to meet work requirement

(A)

Individuals receiving cash assistance under TANF

In the case of an individual who—

(i)

is receiving cash assistance under a State program funded under part A of subchapter IV,

(ii)

is eligible for medical assistance under this subchapter on a basis not related to section 1396a(l) of this title, and

(iii)

has the cash assistance under such program terminated pursuant to section 607(e)(1)(B) of this title (as in effect on or after the welfare reform effective date) because of refusing to work,

the State may terminate such individual’s eligibility for medical assistance under this subchapter until such time as there no longer is a basis for the termination of such cash assistance because of such refusal.

(B)

Exception for children

(c)

Treatment for purposes of transitional coverage provisions

(1)

Transition in the case of child support collections

(2)

Transition in the case of earnings from employment

(d)

Waivers

(e)

State option to use 1 application form

(f)

Additional rules of construction

(1)

With respect to the reference in section 1396a(a)(5) of this title to a State plan approved under part A of subchapter IV, a State may treat such reference as a reference either to a State program funded under such part (as in effect on and after the welfare reform effective date) or to the State plan under this subchapter.

(2)

Any reference in section 1396a(a)(55) of this title to a State plan approved under part A of subchapter IV shall be deemed a reference to a State program funded under such part.

(3)

In applying section 1396b(f) of this title, the applicable income limitation otherwise determined shall be subject to increase in the same manner as income or resource standards of a State may be increased under subsection (b)(2)(B).

(g)

Relation to other provisions

(h)

Transitional increased Federal matching rate for increased administrative costs

(1)

In general

(2)

Administrative expenditures described

(3)

Limitation

(i)

Welfare reform effective date

(Aug. 14, 1935, ch. 531, title XIX, § 1931, as added Pub. L. 104–193, title I, § 114(a)(2), Aug. 22, 1996, 110 Stat. 2177; amended Pub. L. 106–113, div. B, § 1000(a)(6) [title VI, § 602(a)], Nov. 29, 1999, 113 Stat. 1536, 1501A–394.)

cite as: 42 USC 1396u-1