Page:United States Statutes at Large Volume 103 Part 3.djvu/201

 PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2269 (3) PREMIUM PAYMENTS REQUIRED FOR CERTAIN INDIVIDUALS.— Section 1916 of such Act (42 U.S.C. 1396o) is amended— (A) in subsection (a), by striking "(E)" and inserting " (E)(i)", (B) by redesignating subsections (d) and (e) as subsections (e) and (f), respectively, and (C) by inserting after subsection (c) the following new subsection: v "(d) With respect to a qualified disabled and working individual described in section 1905(s) whose income (as determined under paragraph (3) of that section) exceeds 150 percent of the official poverty line referred to in that paragraph, the State plan of a State may provide for the charging of a premium (expressed as a percent- age of the medicare cost-sharing described in section 1905(p)(3)(A)(i) provided with respect to the individual) according to a sliding scale under which such percentage increases from 0 percent to 100 per- cent, in reasonable increments (as determined by the Secretary), as the individual's income increases from 150 percent of such poverty line to 200 percent of such poverty line.". (4) (CONFORMING AMENDMENTS. — v (A) Section 1905(p)(3) of such Act (42 U.S.C. 1396d(p)(3)) is amended— (i) by amending subparagraph (A) to read as follows: "(A)(i) premiums under section 1818, and "(ii) premiums under section 1839,", and (ii) in subparagraph (A) as so amended, by striking "section 1818" and inserting "section 1818 or 1818A". (. (B) Section 1905(p)(l)(A) of such Act is amended by insert- ing ", but not including an individual entitled to such benefits only pursuant to an enrollment under section 1818A" after "1818". (C) Section 1902(f) of such Act (42 U.S.C. 1396a(f)) is amended by inserting ", except with respect to qualified disabled and working individuals (described in section 1905(s))," after "1619(b)(3)". (5) EFFECTIVE DATE. — ^^ ^^ I396a (A) The amendments made by this subsection apply "° ' (except as provided under subparagraph (B)) to paymente under title XIX of the Social Security Act for calendar quarters beginning on or after July 1, 1990, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date. (B) In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Sec- retary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional require- ments imposed by the amendments made by this subsec- tion, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additioned requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case

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