SEC. 1701. ELIGIBILITY FOR INDIVIDUALS WITH INCOME BELOW 133 1/3 PERCENT OF THE FEDERAL POVERTY LEVEL.

[a] Eligibility for Non-traditional Individuals With Income Below 133 Percent of the Federal Poverty Level-

[1] IN GENERAL- Section- 1902[a][10][A][i] of the Social Security Act [42 U.S.C. 1396b[a][10][A][i] is amended--

[A] by striking 'or' at the end of subclause [VI];

[B] by adding 'or' at the end of subclause [VII]; and

[C] by adding at the end the following new subclause:

'[VIII] who are under 65 years of age, who are not described in a previous subclause of this clause, and who are in families whose income [determined using methodologies and procedures specified by the Secretary in consultation with the Health Choices Commissioner] does not exceed 133 1/3 percent of the income official poverty line [as defined by the Office of Management and Budget, and revised annually in accordance with section 673[2] of the Omnibus Budget Reconciliation Act of 1981] applicable to a family of the size involved;'.

[2] 100% FMAP FOR NON-TRADITIONAL MEDICAID ELIGIBLE INDIVIDUALS- Section- 1905 of such Act [42 U.S.C. 1396d] is amended--

[A] in the third sentence of subsection [b] by inserting before the period at the end the following: 'and with respect to amounts described in subsection [y]'; and

[B] by adding at the end the following new subsection:

'[y] Additional Expenditures Subject to 100% FMAP- For purposes of section 1905[b], the amounts described in this subsection are the following:

'[1] Amounts expended for medical assistance for individuals described in subclause [VIII] of section 1902[a][10][A][i].'.

[3] CONSTRUCTION- Nothing in this subsection shall be construed as not providing for coverage under subclause [VIII] of section 1902[a][10][A][i] of the Social Security Act, as added by paragraph [1] of, and an increased FMAP under the amendment made by paragraph [2] for, an individual who has been provided medical assistance under title XIX of the Act under a demonstration waiver approved under section 1115 of such Act or with State funds.

[4] CONFORMING AMENDMENT- Section- 1903[f][4] of the Social Security Act [42 U.S.C. 1396b[f][4]] is amended by inserting '1902[a][10][A][i][VIII],' after '1902[a][10][A][i][VII],'.

[b] Eligibility for Traditional Medicaid Eligible Individuals With Income Not Exceeding 133 1/3 Percent of the Federal Poverty Level-

[1] IN GENERAL- Section- 1902[a][10][A][i] of the Social Security Act [42 U.S.C. 1396b[a][10][A][i]], as amended by subsection [a], is amended--

[A] by striking 'or' at the end of subclause [VII];

[B] by adding 'or' at the end of subclause [VIII]; and

[C] by adding at the end the following new subclause:

'[IX] who are under 65 years of age, who would be eligible for medical assistance under the State plan under one of subclauses [I] through [VII] [based on the income standards, methodologies, and procedures in effect as of June 16, 2009] but for income and who are in families whose income does not exceed 133 1/3 percent of the income official poverty line [as defined by the Office of Management and Budget, and revised annually in accordance with section 673[2] of the Omnibus Budget Reconciliation Act of 1981] applicable to a family of the size involved;'.

[2] 100% FMAP FOR CERTAIN TRADITIONAL MEDICAID ELIGIBLE INDIVIDUALS- Section- 1905[y] of such Act [42 U.S.C. 1396d[b]], as added by subsection [a][2][B], is amended by inserting 'or [IX]' after '[VIII]'.

[3] CONSTRUCTION- Nothing in this subsection shall be construed as not providing for coverage under subclause [IX] of section 1902[a][10][A][i] of the Social Security Act, as added by paragraph [1] of, and an increased FMAP under the amendment made by paragraph [2] for, an individual who has been provided medical assistance under title XIX of the Act under a demonstration waiver approved under section 1115 of such Act or with State funds.

[4] CONFORMING AMENDMENT- Section- 1903[f][4] of the Social Security Act [42 U.S.C. 1396b[f][4]], as amended by subsection [a][4], is amended by inserting '1902[a][10][A][i][IX],' after '1902[a][10][A][i][VIII],'.

[c] 100% Matching Rate for Temporary Coverage of Certain Newborns- Section- 1905[y] of such Act, as added by subsection [a][2][B], is amended--

[1] in paragraph [1], by inserting before the period at the end the following: ', and who is not provided medical assistance under section 1943[b][2] of this title or section 205[d][1][B] of the America's Affordable Health Choices Act of 2009'; and

[2] by adding at the end the following:

'[2] Amounts expended for medical assistance for children described in section 203[d][1][A] of the America's Affordable Health Choices Act of 2009 during the time period specified in such section.'.

[d] Network Adequacy- Section- 1932[a][2] of the Social Security Act [42 U.S.C. 1396u-2[a][2]] is amended by adding at the end the following new subparagraph:

'[D] ENROLLMENT OF NON-TRADITIONAL MEDICAID ELIGIBLES- A State may not require under paragraph [1] the enrollment in a managed care entity of an individual described in section 1902[a][10][A][i][VIII] unless the State demonstrates, to the satisfaction of the Secretary, that the entity, through its provider network and other arrangements, has the capacity to meet the health, mental health, and substance abuse needs of such individuals.'.

[e] Effective Date- The amendments made by this section shall take effect on the first day of Y1, and shall apply with respect to items and services furnished on or after such date.