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