Page:United States Statutes at Large Volume 124.djvu/340

 124 STAT. 314 PUBLIC LAW 111–148—MAR. 23, 2010 occurs after fiscal year 2012 for which the Secretary deter- mines, on the basis of the most recent American Commu- nity Survey of the Bureau of the Census, that the percent- age of uncovered individuals residing in the State is at least 45 percent less than the percentage of such individ- uals determined for the State for fiscal year 2009. ‘‘(D) EXCLUSION OF PORTIONS DIVERTED FOR COVERAGE EXPANSIONS.—For purposes of applying the applicable percentage reduction under subparagraph (A) to the DSH allotment for a State for a fiscal year, the DSH allotment for a State that would be determined under this subsection for the State for the fiscal year without the application of this paragraph (and prior to any such reduction) shall not include any portion of the allotment for which the Secretary has approved the State’s diversion to the costs of providing medical assistance or other health benefits coverage under a waiver that is in effect on July 2009. ‘‘(E) MINIMUM ALLOTMENT.—In no event shall the DSH allotment determined for a State in accordance with this paragraph for fiscal year 2013 or any succeeding fiscal year be less than the amount equal to 35 percent of the DSH allotment determined for the State for fiscal year 2012 under this subsection (and after the application of this paragraph, if applicable), increased by the percentage change in the consumer price index for all urban consumers (all items, U.S. city average) for each previous fiscal year occurring before the fiscal year. ‘‘(F) UNCOVERED INDIVIDUALS.—In this paragraph, the term ‘uncovered individuals’ means individuals with no health insurance coverage at any time during a year (as determined by the Secretary based on the most recent data available).’’. (b) EFFECTIVE DATE.—The amendments made by subsection (a) take effect on October 1, 2011. Subtitle H—Improved Coordination for Dual Eligible Beneficiaries SEC. 2601. 5-YEAR PERIOD FOR DEMONSTRATION PROJECTS. (a) IN GENERAL.—Section 1915(h) of the Social Security Act (42 U.S.C. 1396n(h)) is amended— (1) by inserting ‘‘(1)’’ after ‘‘(h)’’; (2) by inserting ‘‘, or a waiver described in paragraph (2)’’ after ‘‘(e)’’; and (3) by adding at the end the following new paragraph: ‘‘(2)(A) Notwithstanding subsections (c)(3) and (d) (3), any waiver under subsection (b), (c), or (d), or a waiver under section 1115, that provides medical assistance for dual eligible individuals (including any such waivers under which non dual eligible individ- uals may be enrolled in addition to dual eligible individuals) may be conducted for a period of 5 years and, upon the request of the State, may be extended for additional 5-year periods unless the Secretary determines that for the previous waiver period the conditions for the waiver have not been met or it would no longer be cost-effective and efficient, or consistent with the purposes of this title, to extend the waiver. Determination. 42 USC 1396r–4 note. Definition.