S. Amdt. 46 - To Reinstate the Crowd out Policy Agreed to in Section 116 of H.R. 3963 (CHIPRA II), As Agreed to and Passed by the House and Senate.

Children's Health Insurance Program Reauthorization Act of 2009

H.R. 2 — 111^th Congress (2009–2010)

Keywords

SCHIP

Summary

To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. (by CRS)

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Title

To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes.

Other Titles

• Children's Health Insurance Program Reauthorization Act of 2009
• Children's Health Insurance Program Reauthorization Act of 2009
• Children's Health Insurance Program Reauthorization Act of 2009
• Children's Health Insurance Program Reauthorization Act of 2009

Sponsor

Frank Pallone

Co-Sponsors

• Doris Matsui
• Edward Markey
• Fortney Stark
• Zachary Space
• Daniel Maffei
• Gerald Connolly
• Henry Johnson
• Neil Abercrombie
• John Dingell
• Raymond Green
• Jane Harman
• Henry Cuellar
• Steve Kagen
• Anthony Weiner
• Eliot Engel
• Janice Schakowsky
• Charles Rangel
• Debbie Wasserman Schultz
• Peter Welch
• Kathy Castor
• Thomas Edwards
• John Barrow
• Mary Jo Kilroy
• Niki Tsongas
• Brad Sherman
• Betty Sutton
• Anna Eshoo
• Frederick Boucher
• Bill Foster
• Bart Stupak
• Michael McMahon
• Jerry McNerney
• Ben Luján
• Eric Massa
• Edolphus Towns
• Diana DeGette
• Kathleen Dahlkemper
• Bruce Braley
• Lois Capps
• Christopher Murphy
• Henry Waxman
• Rubén Hinojosa
• William Pascrell

Subjects

• Health
• Administrative law and regulatory procedures
• American Samoa
• Appropriations
• Border security and unlawful immigration
• Child health
• Citizenship and naturalization
• Congressional oversight
• Dental care
• Department of Health and Human Services
• Drug, alcohol, tobacco use
• Emergency medical services and trauma care
• Employee benefits and pensions
• Fraud offenses and financial crimes
• Government information and archives
• Government investigations
• Government trust funds
• Guam
• Hawaii
• Health care costs and insurance
• Health care coverage and access
• Health care quality
• Health facilities and institutions
• Health information and medical records
• Health promotion and preventive care
• Immigrant health and welfare
• Indian social and development programs
• Intergovernmental relations
• Licensing and registrations
• Medicaid
• Medical tests and diagnostic methods
• Mental health
• Northern Mariana Islands
• Nutrition and diet
• Performance measurement
• Poverty and welfare assistance
• Puerto Rico
• Rural conditions and development
• Sales and excise taxes
• Small business
• Smuggling and trafficking
• State and local finance
• State and local government operations
• Surgery and anesthesia
• Tax administration and collection, taxpayers
• Tennessee
• Virgin Islands
• Women's health

Related Bills

• H.Res. 52 (111^th) : Providing for Consideration of 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.
• H.Res. 107 (111^th) : Providing for Consideration of the Senate Amendment to the Bill (H.R. 2) to Amend Title XXI of the Social Security Act to Extend and Improve the Childrens's Health Insurance Program, and for Other Purposes.
• S. 275 (111^th) : Children's Health Insurance Program Reauthorization Act of 2009
• S. 275 (111^th) : Children's Health Insurance Program Reauthorization Act of 2009
• S. 275 (111^th) : Children's Health Insurance Program Reauthorization Act of 2009

Major Actions

Introduced	1/13/2009
Referred to Committee
Amendments (60 proposed)
Passed House	1/14/2009
Passed Senate	1/30/2009
Signed by President	2/04/2009

Bill History

• All Votes
• All Actions
• Amendments

	Chamber/Committee	Motion	Date	Result
select this vote	House	On Motion to Recommit with Instructions: H.R. 2 Children’s Health Insurance Program Reauthorization Act of 2009	1/14/2009	This motion DID NOT PASS the House 179 voted YES 247 voted NO 7 voted present/not voting
select this vote	House	On Passage - House - H.R. 2 Children’s Health Insurance Program Reauthorization Act of 2009	1/14/2009	This bill PASSED the House 289 voted YES 139 voted NO 6 voted present/not voting
select this vote	Senate	Amendment SA 39 agreed to in Senate by Unanimous Consent.	1/27/2009	PASSED by voice vote
select this vote	Senate	Amendment SA 45 not agreed to in Senate by Voice Vote.	1/27/2009	DID NOT PASS by voice vote
select this vote	Senate	On the Motion to Table (Motion to Table Demint Amdt. No. 43)	1/27/2009	This amendment PASSED the Senate 60 voted YES 37 voted NO 2 voted present/not voting
select this vote	Senate	Amendment SA 41 not agreed to in Senate by Voice Vote.	1/28/2009	DID NOT PASS by voice vote
select this vote	Senate	McConnell Amdt. No. 40	1/28/2009	This amendment DID NOT PASS the Senate 32 voted YES 65 voted NO 2 voted present/not voting
select this vote	Senate	Martinez Amdt. No. 65	1/28/2009	This amendment DID NOT PASS the Senate 37 voted YES 60 voted NO 2 voted present/not voting
select this vote	Senate	On the Motion to Table (Motion to Table Cornyn Amdt. No. 67)	1/28/2009	This amendment PASSED the Senate 64 voted YES 33 voted NO 2 voted present/not voting
select this vote	Senate	Roberts Amdt. No. 75	1/28/2009	This amendment DID NOT PASS the Senate 36 voted YES 60 voted NO 3 voted present/not voting
currently selected	Senate	Kyl Amdt. No. 46	1/28/2009	This amendment DID NOT PASS the Senate 42 voted YES 56 voted NO 1 voted present/not voting
select this vote	Senate	Murkowski Amdt. No. 77	1/28/2009	This amendment DID NOT PASS the Senate 47 voted YES 51 voted NO 1 voted present/not voting
select this vote	Senate	Amendment SA 49 not agreed to in Senate by Voice Vote.	1/29/2009	DID NOT PASS by voice vote
select this vote	Senate	Amendment SA 50 agreed to in Senate by Voice Vote.	1/29/2009	PASSED by voice vote
select this vote	Senate	Amendment SA 71 not agreed to in Senate by Voice Vote.	1/29/2009	DID NOT PASS by voice vote
select this vote	Senate	Amendment SA 83 not agreed to in Senate by Voice Vote.	1/29/2009	DID NOT PASS by voice vote
select this vote	Senate	Amendment SA 94 agreed to in Senate by Unanimous Consent.	1/29/2009	PASSED by voice vote
select this vote	Senate	Amendment SA 95 agreed to in Senate by Unanimous Consent.	1/29/2009	PASSED by voice vote
select this vote	Senate	Amendment SA 96 agreed to in Senate by Unanimous Consent.	1/29/2009	PASSED by voice vote
select this vote	Senate	Amendment SA 97 agreed to in Senate by Unanimous Consent.	1/29/2009	PASSED by voice vote
select this vote	Senate	Coburn Amdt. No. 47	1/29/2009	This amendment DID NOT PASS the Senate 36 voted YES 62 voted NO 1 voted present/not voting
select this vote	Senate	On the Motion to Table (Motion to Table Bunning Amdt. No. 74 as Modified)	1/29/2009	This amendment PASSED the Senate 54 voted YES 44 voted NO 1 voted present/not voting
select this vote	Senate	Hatch Amdt. No. 80	1/29/2009	This amendment DID NOT PASS the Senate 39 voted YES 59 voted NO 1 voted present/not voting
select this vote	Senate	DeMint Amdt. No. 85	1/30/2009	This amendment DID NOT PASS the Senate 40 voted YES 58 voted NO 1 voted present/not voting
select this vote	Senate	Coburn Amdt. No. 86	1/30/2009	This amendment DID NOT PASS the Senate 36 voted YES 62 voted NO 1 voted present/not voting
select this vote	Senate	Bingaman Amdt. No. 63 as Modified	1/30/2009	This amendment PASSED the Senate 55 voted YES 43 voted NO 1 voted present/not voting
select this vote	Senate	Hutchison Amdt. No. 93	1/30/2009	This amendment DID NOT PASS the Senate 17 voted YES 81 voted NO 1 voted present/not voting
select this vote	Senate	On Passage - Senate - H.R. 2 as Amended	1/30/2009	This bill PASSED the Senate 66 voted YES 32 voted NO 1 voted present/not voting
select this vote	House	On Motion to Concur in the Senate Amendment: H.R. 2 Children’s Health Insurance Program Reauthorization Act of 2009	2/04/2009	This motion PASSED the House 290 voted YES 135 voted NO 8 voted present/not voting

	Action	Date	Description
	Introduced	1/13/2009
		1/13/2009	Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
		1/13/2009	Referred to House Energy and Commerce
		1/13/2009	Referred to House Ways and Means
		1/13/2009	Referred to House Education and Labor
		1/14/2009	Rules Committee Resolution H. Res. 52 Reported to House. Rule provides for consideration of H.R. 2 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. Bill is closed to amendments. The Resolution waives all points of order against consideration of the bill except those arising under clause 9 or 10 of rule XXI.
		1/14/2009	Received in the Senate.
		1/14/2009	Rule H. Res. 52 passed House.
		1/14/2009	Considered under the provisions of rule H. Res. 52.
		1/14/2009	Rule provides for consideration of H.R. 2 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. Bill is closed to amendments. The Resolution waives all points of order against consideration of the bill except those arising under clause 9 or 10 of rule XXI.
		1/14/2009	DEBATE - The House proceeded with one hour of debate on H.R. 2.
		1/14/2009	The previous question was ordered pursuant to the rule.
		1/14/2009	Mr. Deal (GA) moved to recommit with instructions to Energy and Commerce.
		1/14/2009	DEBATE - The House proceeded with 10 minutes of debate on the Deal (GA) motion to recommit with instructions. The instructions in the motion seek to report the same back to the House forthwith with amendments to determine the use of funds for the Children's Health Insurance Program.
		1/14/2009	The previous question on the motion to recommit with instructions was ordered without objection.
select this vote	Vote	1/14/2009	On Motion to Recommit with Instructions: H.R. 2 Children’s Health Insurance Program Reauthorization Act of 2009
select this vote	House Vote on Passage	1/14/2009	On Passage - House - H.R. 2 Children’s Health Insurance Program Reauthorization Act of 2009
	Put on a legislative calendar	1/16/2009	Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 18.
		1/26/2009	Measure laid before Senate by unanimous consent.
		1/27/2009	Considered by Senate.
		1/27/2009	Amendment SA 39 proposed by Senator Reid for Senator Baucus.
select this vote	Vote	1/27/2009	Amendment SA 39 agreed to in Senate by Unanimous Consent.
		1/27/2009	Amendment SA 40 proposed by Senator McConnell.
		1/27/2009	Amendment SA 41 proposed by Senator Grassley.
		1/27/2009	Amendment SA 43 proposed by Senator DeMint to Amendment SA 39.
		1/27/2009	Amendment SA 45 proposed by Senator Hatch to Amendment SA 39.
select this vote	Vote	1/27/2009	Amendment SA 45 not agreed to in Senate by Voice Vote.
		1/27/2009	Amendment SA 40 proposed by Senator McConnell to Amendment SA 39.
		1/27/2009	Amendment SA 40 modified to reflect a first degree status by Unanimous Consent.
		1/27/2009	Amendment SA 41 proposed by Senator Grassley to Amendment SA 39.
		1/27/2009	Amendment SA 41 modified to reflect a first degree status by Unanimous Consent.
select this vote	Vote	1/27/2009	On the Motion to Table (Motion to Table Demint Amdt. No. 43)
		1/28/2009	Considered by Senate.
		1/28/2009	Considered by Senate.
		1/28/2009	Considered by Senate.
select this vote	Vote	1/28/2009	Amendment SA 41 not agreed to in Senate by Voice Vote.
		1/28/2009	Amendment SA 46 proposed by Senator Kyl.
		1/28/2009	Amendment SA 49 proposed by Senator Coburn.
		1/28/2009	Amendment SA 50 proposed by Senator Coburn.
		1/28/2009	Amendment SA 58 proposed by Senator Webb.
		1/28/2009	Proposed amendment SA 58 withdrawn in Senate.
		1/28/2009	Amendment SA 65 proposed by Senator Martinez.
		1/28/2009	Amendment SA 67 proposed by Senator Cornyn.
		1/28/2009	Amendment SA 75 proposed by Senator Roberts.
		1/28/2009	Amendment SA 77 proposed by Senator Murkowski.
		1/28/2009	Amendment SA 79 proposed by Senator Brown.
		1/28/2009	Proposed amendment SA 79 withdrawn in Senate.
select this vote	Vote	1/28/2009	McConnell Amdt. No. 40
select this vote	Vote	1/28/2009	Martinez Amdt. No. 65
select this vote	Vote	1/28/2009	On the Motion to Table (Motion to Table Cornyn Amdt. No. 67)
select this vote	Vote	1/28/2009	Roberts Amdt. No. 75
currently selected	Vote	1/28/2009	Kyl Amdt. No. 46
select this vote	Vote	1/28/2009	Murkowski Amdt. No. 77
		1/29/2009	Considered by Senate.
		1/29/2009	Senate insists on its amendment, asks for a conference, appoints conferees Baucus; Rockefeller; Conrad; Grassley; Hatch.
		1/29/2009	Amendment SA 47 proposed by Senator Baucus for Senator Coburn.
		1/29/2009	Considered by Senate.
select this vote	Vote	1/29/2009	Amendment SA 49 not agreed to in Senate by Voice Vote.
		1/29/2009	Considered by Senate.
select this vote	Vote	1/29/2009	Amendment SA 50 agreed to in Senate by Voice Vote.
		1/29/2009	Amendment SA 63 proposed by Senator Bingaman.
		1/29/2009	Amendment SA 71 proposed by Senator Grassley.
select this vote	Vote	1/29/2009	Amendment SA 71 not agreed to in Senate by Voice Vote.
		1/29/2009	Amendment SA 74 proposed by Senator Bunning.
		1/29/2009	Amendment SA 80 proposed by Senator Hatch.
		1/29/2009	Amendment SA 83 proposed by Senator Grassley.
select this vote	Vote	1/29/2009	Amendment SA 83 not agreed to in Senate by Voice Vote.
		1/29/2009	Amendment SA 85 proposed by Senator DeMint.
		1/29/2009	Amendment SA 86 proposed by Senator Coburn.
		1/29/2009	Amendment SA 93 proposed by Senator Hutchison.
		1/29/2009	Amendment SA 94 proposed by Senator Baucus.
select this vote	Vote	1/29/2009	Amendment SA 94 agreed to in Senate by Unanimous Consent.
		1/29/2009	Amendment SA 95 proposed by Senator Baucus.
select this vote	Vote	1/29/2009	Amendment SA 95 agreed to in Senate by Unanimous Consent.
		1/29/2009	Amendment SA 96 proposed by Senator Baucus.
select this vote	Vote	1/29/2009	Amendment SA 96 agreed to in Senate by Unanimous Consent.
		1/29/2009	Amendment SA 97 proposed by Senator Rockefeller for Senator Baucus.
select this vote	Vote	1/29/2009	Amendment SA 97 agreed to in Senate by Unanimous Consent.
select this vote	Vote	1/29/2009	Coburn Amdt. No. 47
select this vote	Vote	1/29/2009	On the Motion to Table (Motion to Table Bunning Amdt. No. 74 as Modified)
select this vote	Vote	1/29/2009	Hatch Amdt. No. 80
select this vote	Vote	1/30/2009	DeMint Amdt. No. 85
select this vote	Vote	1/30/2009	Coburn Amdt. No. 86
select this vote	Vote	1/30/2009	Bingaman Amdt. No. 63 as Modified
select this vote	Vote	1/30/2009	Hutchison Amdt. No. 93
select this vote	Senate Vote on Passage	1/30/2009	On Passage - Senate - H.R. 2 as Amended
		1/30/2009	Message on Senate action sent to the House.
		1/30/2009	SA 63 previously adopted was further modified by Unanimous Consent.
		2/04/2009	Rules Committee Resolution H. Res. 107 Reported to House. Upon the adoption of H. Res. 107, it shall be in order to take from the Speaker's table the bill H.R. 2 with the Senate amendment thereto, and for the Chair to entertain a motion to concur in the Senate amendment. The Senate amendment and the motion shall be considered as read. The motion shall be debatable for one hour.
	Presented to President	2/04/2009	Cleared for White House.
	Presented to President	2/04/2009	Presented to President.
	Signed	2/04/2009	Signed by President.
	Enacted	2/04/2009	Became Public Law No: 111-3.
		2/04/2009	Rule H. Res. 107 passed House.
		2/04/2009	Pursuant to the provisions of H. Res. 107, Mr. Waxman moved to agree to the Senate amendment.
		2/04/2009	DEBATE - The House proceeded with one hour of debate on the motion to agree to the Senate amendment to H.R. 2.
		2/04/2009	The previous question was ordered pursuant to the rule.
		2/04/2009	On motion that the House agree to the Senate amendment Agreed to by the Yeas and Nays: 290 - 135 (Roll No. 50).
select this vote	Vote	2/04/2009	On Motion to Concur in the Senate Amendment: H.R. 2 Children’s Health Insurance Program Reauthorization Act of 2009
		3/06/2009	Referred to the Subcommittee on Health, Employment, Labor, and Pensions.

	Number	Sponsor	Date Offered	Status
select this vote	S. Amdt. 39	Baucus, Max [D-MT]	January 27, 2009	Passed by voice vote on January 26, 2009.
	In the nature of a substitute. Show amendment details
select this vote	S. Amdt. 40	McConnell, Mitch [R-KY]	January 27, 2009	Failed by roll call vote on January 27, 2009.
	In the nature of a substitute. Show amendment details
select this vote	S. Amdt. 41	Grassley, Charles [R-IA]	January 27, 2009	Failed by voice vote on January 27, 2009.
	To strike the option to provide coverage to legal immigrants and increase the enrollment of uninsured low income American children. Show amendment details
	S. Amdt. 42	DeMint, Jim [R-SC]	January 27, 2009	Offered on January 26, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 43	DeMint, Jim [R-SC]	January 27, 2009	Failed by roll call vote on January 26, 2009.
	To require States to impose cost-sharing for any individual enrolled in a State child health plan whose income exceeds 200 percent of the poverty line. Show amendment details
	S. Amdt. 44	DeMint, Jim [R-SC]	January 27, 2009	Offered on January 26, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 45	Hatch, Orrin [R-UT]	January 27, 2009	Failed by voice vote on January 26, 2009.
	To prohibit any Federal matching payment for Medicaid or CHIP coverage of noncitizen children or pregnant women until a State demonstrates that it has enrolled 95 percent of the children eligible for Medicaid or CHIP who reside in the State and whose family income does not exceed 200 percent of the poverty line. Show amendment details
currently selected	S. Amdt. 46	Kyl, Jon [R-AZ]	January 27, 2009	Failed by roll call vote on January 28, 2009.
	To reinstate the crowd out policy agreed to in section 116 of H.R. 3963 (CHIPRA II), as agreed to and passed by the House and Senate. Actions January 28, 2009, 12:00 am ET - Amendment SA 46 proposed by Senator Kyl. January 28, 2009, 5:46 pm ET - Kyl Amdt. No. 46 Full Text of this Amendment SA 46. Mr. KYL submitted an amendment intended to be proposed by him 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; which was ordered to lie on the table; as follows: On page 76, after line 23, add the following: SEC. 116. PREVENTING SUBSTITUTION OF CHIP COVERAGE FOR PRIVATE COVERAGE. (a) Findings.-- (1) Congress agrees with the President that low-income children should be the first priority of all States in providing child health assistance under CHIP. (2) Congress agrees with the President and the Congressional Budget Office that the substitution of CHIP coverage for private coverage occurs more frequently for children in families at higher income levels. (3) Congress agrees with the President that it is appropriate that States that expand CHIP eligibility to children at higher income levels should have achieved a high level of health benefits coverage for low-income children and should implement strategies to address such substitution. (4) Congress concludes that the policies specified in this section (and the amendments made by this section) are the appropriate policies to address these issues. (b) Analyses of Best Practices and Methodology in Addressing Crowd-Out.-- (1) GAO REPORT.--Not later than 18 months after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Finance of the Senate and the Committee on Energy and Commerce of the House of Representatives and the Secretary a report describing the best practices by States in addressing the issue of CHIP crowd-out. Such report shall include analyses of-- (A) the impact of different geographic areas, including urban and rural areas, on CHIP crowd-out; (B) the impact of different State labor markets on CHIP crowd-out; (C) the impact of different strategies for addressing CHIP crowd-out; (D) the incidence of crowd-out for children with different levels of family income; and (E) the relationship (if any) between changes in the availability and affordability of dependent coverage under employer-sponsored health insurance and CHIP crowd-out. (2) IOM REPORT ON METHODOLOGY.--The Secretary shall enter into an arrangement with the Institute of Medicine under which the Institute submits to the Committee on Finance of the Senate and the Committee on Energy and Commerce of the House of Representatives and the Secretary, not later than 18 months after the date of the enactment of this Act, a report on-- (A) the most accurate, reliable, and timely way to measure-- (i) on a State-by-State basis, the rate of public and private health benefits coverage among low-income children with family income that does not exceed 200 percent of the poverty line; and (ii) CHIP crowd-out, including in the case of children with family income that exceeds 200 percent of the poverty line; and (B) the least burdensome way to gather the necessary data to conduct the measurements described in subparagraph (A). Out of any money in the Treasury not otherwise appropriated, there are hereby appropriated $2,000,000 to carry out this paragraph for the period ending September 30, 2010. (3) INCORPORATION OF DEFINITIONS.--In this section, the terms ``CHIP crowd-out'', ``children'', ``poverty line'', and ``State'' have the meanings given such terms for purposes of CHIP. (4) DEFINITION OF CHIP CROWD-OUT.--Section 2110(c) (42 U.S.C. 1397jj(c)) is amended by adding at the end the following: ``(9) CHIP CROWD-OUT.--The term `CHIP crowd-out' means the substitution of-- ``(A) health benefits coverage for a child under this title, for ``(B) health benefits coverage for the child other than under this title or title XIX.''. (c) 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.--Within 6 months after the date of receipt of the reports under subsections (a) and (b) of section 116 of the Children's Health Insurance Program Reauthorization Act of 2009, 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.''. (d) Requirement To Address CHIP Crowd-Out; Secretarial Review.--Section 2106 (42 U.S.C. 1397ff) is amended by adding at the end the following: ``(f) Requirement To Address CHIP Crowd-Out; Secretarial Review.-- ``(1) IN GENERAL.--Not later than 6 months after the best practice application date described in paragraph (2), each State that has a State child health plan shall submit to the Secretary a State plan amendment describing how the State-- ``(A) will address CHIP crowd-out; and ``(B) will incorporate recommended best practices referred to in such paragraph. ``(2) BEST PRACTICE APPLICATION DATE.--The best practice application date described in this paragraph is the date that is 6 months after the date of publication of recommendations regarding best practices under section 2107(g)(1). ``(3) SECRETARIAL REVIEW.--The Secretary shall-- ``(A) review each State plan amendment submitted under paragraph (1); ``(B) determine whether the amendment incorporates recommended best practices referred to in paragraph (2); ``(C) in the case of a higher income eligibility State (as defined in section 2105(c)(9)(B)), determine whether the State meets the enrollment targets required under reference section 2105(c)(9)(C); and ``(D) notify the State of such determinations.''. (e) 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 114(a), is amended by adding at the end the following new paragraph: ``(9) 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 April 1 of 2011 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, subject to subparagraph (E), no payment shall be made as of October 1 of such year on or after October 1, 2011, 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 State establishes it is in compliance with such requirement. ``(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.-- ``(i) IN GENERAL.--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 the target rate of coverage specified in clause (ii). ``(ii) TARGET RATE.--The target rate of coverage specified in this clause is the average rate (determined by the Secretary) of health benefits coverage (both private and public) as of January 1, 2011, among the 10 of the 50 States and the District of Columbia with the highest percentage of health benefits coverage (both private and public) for low-income children. ``(iii) STANDARDS FOR DATA.--In applying this subparagraph, rates of health benefits coverage for States shall be determined using the uniform standards identified by the Secretary under section 2107(g)(2). ``(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). ``(E) NOTICE AND OPPORTUNITY TO COMPLY WITH TARGET RATE.--If the Secretary makes a determination described in subparagraph (A)(ii) in April of a year, the Secretary-- ``(i) shall provide the State with the opportunity to submit and implement a corrective action plan for the State to come into compliance with the requirement of subparagraph (C) before October 1 of such year; ``(ii) shall not effect a denial of payment under subparagraph (A) on the basis of such determination before October 1 of such year; and ``(iii) shall not effect such a denial if the Secretary determines that there is a reasonable likelihood that the implementation of such a correction action plan will bring the State into compliance with the requirement of subparagraph (C).''. (2) CONSTRUCTION.--Nothing in the amendment made by paragraph (1) or this section this shall be construed as authorizing the Secretary 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)(9)(B) of such Act, as added by paragraph (1)). (f) Treatment of Medical Support Orders.--Section 2102(b) (42 U.S.C. 1397bb(c)) is amended by adding at the end the following: ``(5) TREATMENT OF MEDICAL SUPPORT ORDERS.-- ``(A) IN GENERAL.--Nothing in this title shall be construed to allow the Secretary to require that a State deny eligibility for child health assistance to a child who is otherwise eligible on the basis of the existence of a valid medical support order being in effect. ``(B) STATE ELECTION.--A State may elect to limit eligibility for child health assistance to a targeted low-income child on the basis of the existence of a valid medical support order on the child's behalf, but only if the State does not deny such eligibility for a child on such basis if the child asserts that the order is not being complied with for any of the reasons described in subparagraph (C) unless the State demonstrates that none of such reasons applies in the case involved. ``(C) REASONS FOR NONCOMPLIANCE.--The reasons described in this subparagraph for noncompliance with a medical support order with respect to a child are that the child is not being provided health benefits coverage pursuant to such order because-- ``(i) of failure of the noncustodial parent to comply with the order; ``(ii) of the failure of an employer, group health plan or health insurance issuer to comply with such order; or ``(iii) the child resides in a geographic area in which benefits under the health benefits coverage are generally unavailable.''. (g) Effective Date of Amendments; Consistency of Policies.--The amendments made by this section shall take effect as if enacted on August 16, 2007. The Secretary may not impose (or continue in effect) any requirement, prevent the implementation of any provision, or condition the approval of any provision under any State child health plan, State plan amendment, or waiver request on the basis of any policy or interpretation relating to CHIP crowd-out, coordination with other sources of coverage, target rate of coverage, or medical support order other than under the amendments made by this section. In the case of a State plan amendment which was denied on or after August 16, 2007, on the basis of any such policy or interpretation in effect before the date of the enactment of this Act, if the State submits a modification of such State plan amendment that complies with title XXI of the Social Security Act as amended by this Act, such submitted State plan amendment, as so modified, shall be considered as if it had been submitted (as so modified) as of the date of its original submission, but such State plan amendment shall not be effective before the date of the enactment of this Act. (As printed in the Congressional Record for the Senate on Jan 27, 2009.)
select this vote	S. Amdt. 47	Coburn, Thomas [R-OK]	January 27, 2009	Failed by roll call vote on January 29, 2009.
	To ensure that children do not lose their private insurance and that uninsured children can get access to private insurance. Show amendment details
	S. Amdt. 48	Coburn, Thomas [R-OK]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 49	Coburn, Thomas [R-OK]	January 27, 2009	Failed by voice vote on January 29, 2009.
	To prevent fraud and restore fiscal accountability to the Medicaid and SCHIP programs. Show amendment details
select this vote	S. Amdt. 50	Coburn, Thomas [R-OK]	January 27, 2009	Passed by voice vote on January 29, 2009.
	To restore fiscal discipline by making the Medicaid and SCHIP programs more accountable and efficient. Show amendment details
	S. Amdt. 51	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 52	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 53	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 54	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 55	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 56	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 57	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 58	Webb, Jim [D-VA]	January 27, 2009	Withdrawn on January 28, 2009.
	To amend the Internal Revenue Code of 1986 to provide a revenue source through the treatment of income of partners for performing investment management services as ordinary income received for performance of services and reduce accordingly the tobacco tax increase as a revenue source. Show amendment details
	S. Amdt. 59	Vitter, David [R-LA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 60	Wicker, Roger [R-MS]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 61	Bingaman, Jeff [D-NM]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 62	Bingaman, Jeff [D-NM]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 63	Bingaman, Jeff [D-NM]	January 27, 2009	Passed by roll call vote on January 29, 2009.
	To clarify that new paperwork and enrollment barriers are not created in the Express Lane Enrollment option and that income may be determined by Express Lane agencies based on State income tax records or returns. Show amendment details
	S. Amdt. 64	Bingaman, Jeff [D-NM]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 65	Martinez, Mel [R-FL]	January 27, 2009	Failed by roll call vote on January 28, 2009.
	To restore the prohibition on funding of nongovernmental organizations that promote abortion as a method of birth control (the "Mexico City Policy"). Show amendment details
	S. Amdt. 66	Cornyn, John [R-TX]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 67	Cornyn, John [R-TX]	January 27, 2009	Failed by roll call vote on January 28, 2009.
	To ensure redistributed funds go towards coverage of low-income children or outreach and enrollment of low-income children, rather than to States that will use the funds to cover children from higher income families. Show amendment details
	S. Amdt. 68	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 69	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 70	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 71	Grassley, Charles [R-IA]	January 27, 2009	Failed by voice vote on January 29, 2009.
	To extend the State Children's Health Insurance Program for 6 quarters in order to enact bipartisan, comprehensive health care reform. Show amendment details
	S. Amdt. 72	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 73	Grassley, Charles [R-IA]	January 27, 2009	Offered on January 27, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 74	Bunning, Jim [R-KY]	January 28, 2009	Failed by roll call vote on January 29, 2009.
	To eliminate any exceptions to the prohibition on States receiving an enhanced Federal matching rate for providing coverage to children whose family income exceeds 300 percent of the poverty line. Show amendment details
select this vote	S. Amdt. 75	Roberts, Pat [R-KS]	January 28, 2009	Failed by roll call vote on January 28, 2009.
	To prohibit CHIP coverage for higher income children and to prohibit any payments to a State from its CHIP allotments for any fiscal year quarter in which the State Medicaid income eligibility level for children is greater than the income eligibility level for children under CHIP. Show amendment details
	S. Amdt. 76	Roberts, Pat [R-KS]	January 28, 2009	Offered on January 28, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 77	Murkowski, Lisa [R-AK]	January 28, 2009	Failed by roll call vote on January 28, 2009.
	To provide for the development of best practice recommendations and to ensure coverage of low income children. Show amendment details
	S. Amdt. 78	Martinez, Mel [R-FL]	January 28, 2009	Offered on January 28, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 79	Brown, Sherrod [D-OH]	January 28, 2009	Withdrawn on January 28, 2009.
	To strengthen and protect health care access, and to benefit children in need of cancer care or other acute care services. Show amendment details
select this vote	S. Amdt. 80	Hatch, Orrin [R-UT]	January 28, 2009	Failed by roll call vote on January 29, 2009.
	To codify regulations specifying that an unborn child is eligible for child health assistance. Show amendment details
	S. Amdt. 81	Bunning, Jim [R-KY]	January 28, 2009	Offered on January 28, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 82	Coburn, Thomas [R-OK]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 83	Grassley, Charles [R-IA]	January 29, 2009	Failed by voice vote on January 29, 2009.
	In the nature of a substitute. Show amendment details
	S. Amdt. 84	Coburn, Thomas [R-OK]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 85	DeMint, Jim [R-SC]	January 29, 2009	Failed by roll call vote on January 29, 2009.
	To provide an above-the-line Federal income tax deduction for health care costs of certain children in an amount comparable to the average federal share of the benefit provided to any non-citizen child for medical assistance or child health assistance. Show amendment details
select this vote	S. Amdt. 86	Coburn, Thomas [R-OK]	January 29, 2009	Failed by roll call vote on January 29, 2009.
	To ensure that American children have high-quality health coverage that fits their individual needs. Show amendment details
	S. Amdt. 87	Stabenow, Debbie Ann [D-MI]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 88	Stabenow, Debbie Ann [D-MI]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 89	Stabenow, Debbie Ann [D-MI]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 90	Stabenow, Debbie Ann [D-MI]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 91	Stabenow, Debbie Ann [D-MI]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
	S. Amdt. 92	Coburn, Thomas [R-OK]	January 29, 2009	Offered on January 29, 2009.
	Amendment information not available. Show amendment details
select this vote	S. Amdt. 93	Hutchison, Kay [R-TX]	January 29, 2009	Failed by roll call vote on January 29, 2009.
	To provide assistance for States with percentages of children with no health insurance coverage above the national average. Show amendment details
select this vote	S. Amdt. 94	Baucus, Max [D-MT]	January 29, 2009	Passed by voice vote on January 29, 2009.
	To make a technical correction to the option to cover legal immigrant children and pregnant women. Show amendment details
select this vote	S. Amdt. 95	Baucus, Max [D-MT]	January 29, 2009	Passed by voice vote on January 29, 2009.
	To make technical corrections to the State option to provide dental-only supplemental coverage. Show amendment details
select this vote	S. Amdt. 96	Baucus, Max [D-MT]	January 29, 2009	Passed by voice vote on January 29, 2009.
	To clarify that no eligible entity that receives an outreach and enrollment grant is required to provide matching funds. Show amendment details
select this vote	S. Amdt. 97	Baucus, Max [D-MT]	January 29, 2009	Passed by voice vote on January 29, 2009.
	Of a technical nature. Show amendment details
	S. Amdt. 244	Cornyn, John [R-TX]	February 4, 2009	Offered on February 4, 2009.
	Amendment information not available. Show amendment details