PUBLIC LAW 101-508—NOV. 5, 1990 104 STAT. 1388-191 (D) in the matter following subparagraph (E), by striking "and" before "(X)" and by inserting before the semicolon at the end the following:, and (XI) the medical assistance made available to an individual described in subsection (u)(l) who is eligible for medical assistance only because of subparagraph (F) shall be limited to medical assistance for COBRA continuation premiums (as defined in subsection (u)(2))"; and (2) by adding after the subsections added by section 4604 and 4701(b) the following new subsection: "(u)(l) Individuals described in this paragraph are individuals— "(A) who are entitled to elect COBRA continuation coverage (as defined in paragraph (3)), "(B) whose income (as determined under section 1612 for purposes of the supplemental security income program) does not exceed 100 percent of the 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, "(C) whose resources (as determined under section 1613 for purposes of the supplemental security income program) do not exceed twice the maximum amount of resources that an individual may have and obtain benefits under that program, and "(D) with respect to whose enrollment for COBRA continuation coverage the State has determined that the savings in expenditures under this title resulting from such enrollment is likely to exceed the amount of payments for COBRA premiums made. "(2) For purposes of subsection (a)(10)(F) and this subsection, the term 'COBRA premiums' means the applicable premium imposed with respect to COBRA continuation coverage. "(3) In this subsection, the term 'COBRA continuation coverage' means coverage under a group health plan provided by an employer with 75 or more employees provided pursuant to title XXII of the Public Health Service Act, section 4980B of the Internal Revenue Code of 1986, or title VI of the Employee Retirement Income Security Act of 1974. "(4) Notwithstanding subsection (a)(17), for individuals described in paragraph (1) who are covered under the State plan by virtue of subsection (a)(10)(A)(ii)(XI)— "(A) the income standard to be applied is the income standard described in paragraph (I)(B), and "(B) except as provided in section 1612(b)(4)(B)(ii), costs incurred for medical care or for any other type of remedial care shall not be taken into account in determining income. Any different treatment provided under this paragraph for such individuals shall not, because of subsection (a)(10)(B) or (a)(17), require or permit such treatment for other individuals.". (h) CONFORMING AMENDMENT.— Section 1905(a) (42 U.S.C. 1396d(a)) is amended— (1) by striking "or" at the end of clause (viii), (2) by adding "or" at the end of clause (ix), and (3) by inserting after clause (ix) the following new clause: " (x) individuals described in section 1902(u)(l),". (c) EFFECTIVE DATE. —The amendments made by this section shall 42 USC 1396a apply to medical assistance furnished on or after January 1, 1991. note.