Page:United States Statutes at Large Volume 113 Part 3.djvu/375

 PUBLIC LAW 106-170—DEC. 17, 1999 113 STAT. 1893 (3) STATE AUTHORITY TO IMPOSE INCOME-RELATED PREMIUMS AND COST-SHARING.— Section 1916 of such Act (42 U.S.C. 1396o) is amended— (A) in subsection (a), by striking "The State plan" and inserting "Subject to subsection (g), the State plan"; and (B) by adding at the end the following new subsection: "(g) With respect to individuals provided medical assistance only under subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii)— "(1) a State may (in a uniform manner for individuals described in either such subclause)— "(A) require such individuals to pay premiums or other cost-sharing charges set on a sliding scale based on income that the State may determine; and "(B) require payment of 100 percent of such premiums ^ for such year in the case of such an individual who has income for a year that exceeds 250 percent of the income official poverty line (referred to in subsection (c)(1)) applicable to a family of the size involved, except that in the case of such an individual who has income for a year that does not exceed 450 percent of such poverty line, such requirement may only a]Dply to the extent such premiums do not exceed 7.5 percent of such income; and "(2) such State shall require payment of 100 percent of such premiums for a year by such an individual whose adjusted gross income (as defined in section 62 c»f the Internal Revenue Code of 1986) for such year exceeds $75,000, except that a State may choose to subsidize such premiums by using State funds which may not be federally matched under this title. In the case of any calendar year beginning after 2000, the dollar amount specified in paragraph (2) shall be increased in accordance with the provisions of section 215(i)(2)(A)(ii).". (4) PROHIBITION AGAINST SUPPLANTATION OF STATE FUNDS AND STATE FAILURE TO MAINTAIN EFFCtRT.—Section 1903(i) of such Act (42 U.S.C. 1396b(i)) is amended— (A) by striking the period at the end of paragraph (19) and inserting "; or"; and (B) by inserting after such paragraph the following new paragraph: "(20) with respect to amounts expended for medical assistance provided to an individual described in subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii) for a fiscal year unless the State demonstrates to the satisfaction of the Secretary that the level of State funds expended for such fiscal year for programs to enable working individuals with disabilities to work (other than for such medical assistance) is not less than the level expended for such proj^ams during the most recent State fiscal year ending before the date of the enactment of this paragraph.". (b) CONFORMING AMENDMENTS.— Section 1903(f)(4) of the Social Security Act (42 U.S.C. 1396b(f)(4) is amended in the matter preceding subparagraph (A) by inserting "1902(a)(10)(A)(ii)(XV), 1902(a)(10)(A)(ii)(XVI)," before "1905(p)(l)". (c) GAG REPORT. — Not later than 3 years after the date of Deadline. the enactment of this Act, the Comptrollei- General of the United ^2 USC 1396a States shall submit a report to the Congress regarding the amend- '^°^^' ments made by this section that examines—

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