123STA T .6 1 PUBLIC LA W 111 – 3 —FE B. 4, 2 0 0 9‘ ‘ (L)AP P LICAT I ON TO QU ALI F I ED E M PLO Y E R-S PONSORED B ENC H MAR K CO V ERA G E .—Ifagrouphe a lt h pla n or health i n s uran c eco v erage offere d through an e m plo y er is certified b y an actuary as health benefits coverage that is e q uivalent to the benefits coverage in a benchmar k benefit package described in section 2103 (b) or benchmark-equivalent cov- erage that meets the requirements of section 2103(a)(2) , the S tate may provide premium assistance subsidies for enrollment of targeted lo w -income children in such group health plan or health insurance coverage in the same manner as such subsidies are provided under this para- graph for enrollment in qualified employer-sponsored cov- erage, but without regard to the requirement to provide supplemental coverage for benefits and cost-sharing protec- tion provided under the State child health plan under subparagraph ( E ). ‘‘( M ) SATISFACTION OF COST-EFFECTIVENESS TEST.— P re- mium assistance subsidies for qualified employer-sponsored coverage offered under this paragraph shall be deemed to meet the requirement of subparagraph (A) of paragraph (3). ‘‘( N ) C OORDINATION W ITH MEDICAID.—In the case of a targeted low-income child who receives child health assistance through a State plan under title X IX and who voluntarily elects to receive a premium assistance subsidy under this section, the provisions of section 1 9 0 6 A shall apply and shall supersede any other provisions of this paragraph that are inconsistent with such section. ’ ’. (2) D ETERMINATION OF COST-EFFECTIVENESS FOR PREMIUM ASSISTANCE OR PURCHASE OF FAMILY COVERAGE.— (A) IN GENERAL.—Section 210 5 (c)(3)(A) ( 4 2 U .S.C. 139 7 ee(c)(3)(A)) is amended by striking ‘‘relative to’’ and all that follows through the comma and inserting ‘‘relative to ‘‘(i) the amount of e x penditures under the State child health plan, including administrative expendi- tures, that the State would have made to provide com- parable coverage of the targeted low-income child involved or the family involved (as applicable)
or ‘‘(ii) the aggregate amount of expenditures that the State would have made under the State child health plan, including administrative expenditures, for providing coverage under such plan for all such chil- dren or families.’’. ( B ) NONAPPLICATION TO PREVIOUSLY APPROVED COV- ERAGE.— T he amendment made by subparagraph (A) shall not apply to coverage the purchase of which has been approved by the Secretary under section 2105(c)(3) of the Social Security Act prior to the date of enactment of this Act. (b) MEDICAID.—Title XIX is amended by inserting after section 1906 the following new section
‘‘PREMIUM ASSISTANCE OPTION FOR CHILDREN ‘‘SEC. 1906A. (a) IN G ENERAL.—A State may elect to offer a premium assistance subsidy (as defined in subsection (c)) for quali- fied employer-sponsored coverage (as defined in subsection (b)) to 42USC1396e– 1 . 42 USC 139 7 ee not e. Ap p licab ilit y .
