Bill > HR608

This bill establishes a demonstration project that allows political subdivisions (like counties or cities) in states that have not expanded Medicaid to provide medical assistance to low-income adults who would be eligible under the Affordable Care Act's Medicaid expansion. Specifically, the bill enables qualifying political subdivisions to apply for a seven-year demonstration project to provide health coverage to this population, with potential extensions up to five additional years. The federal government will provide matching funds at 100% for the first three years, gradually decreasing to 90% in subsequent years, with slightly different rates for rural and non-rural areas. Participating political subdivisions must provide coverage that meets essential health benefit standards, and the bill includes protections to prevent states from penalizing subdivisions that choose to participate. The Secretary of Health and Human Services is limited to approving no more than 100 such demonstration projects, and must submit a report to Congress after four years evaluating the project's impact on beneficiary enrollment and uncompensated care costs. The bill also includes provisions to prevent states from shifting costs, reducing funding, or taking punitive actions against political subdivisions that establish these demonstration projects.

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https://www.congress.gov/bill/119th-congress/house-bill/608/all-info