Page:United States Statutes at Large Volume 104 Part 2.djvu/609

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PUBLIC LAW 101-508—NOV. 5, 1990 104 STAT. 1388-201 (1) NONE FOR THOSE WITH INCOME BELOW THE POVERTY UNE. — Under a project, there shall be no premiums, coinsurance, or other cost-sharing for individuals whose family income level does not exceed 100 percent of the income official poverty line (as defined in subsection (g)(1)) applicable to a family of the size involved. (2) LIMIT FOR THOSE WITH INCOME ABOVE THE POVERTY UNE. — Under a project, for individuals whose family income level exceeds 100 percent, but is less than 150 percent, of the income official poverty line applicable to a family of the size involved, the monthly average amount of premiums, coinsurance, and other cost-sharing for covered items and services shall not exceed 3 percent of the family's average gross monthly earnings. (3) INCOME DETERMINATION. —Each project shall provide for determinations of income in a manner consistent with the methodology used for determinations of income under title XIX of the Social Security Act for individuals entitled to benefits under part A of title IV of such Act. (d) DURATION.— Each project under this section shall commence not later than July 1, 1991 and shall be conducted for a 3-year period; except that the Secretary may terminate such a project if the Secretary determines that the project is not in substantial compliance with the requirements of this section. (e) LIMITS ON EXPENDITURES AND FUNDING.— (1) IN GENERAL. —(A) The Secretary in conducting projects shall limit the total amount of the Federal share of benefits paid and expenses incurred under title XIX of the Social Security Act to no more than $12,000,000 in each of fiscal years 1991, 1992, and 1993, and to no more than $4,000,000 in fiscal year 1994. (B) Of the amounts appropriated under subparagraph (A), the Secretary shall provide that no more than one-third of such amounts shall be used to carry out the projects described in paragraph (I)(B) of subsection (a) (for which the statewideness requirement has been waived). (2) No FUNDING OF CURRENT BENEFICIARIES.— No funding shall be available under a project with respect to medical assistance provided to individuals who are otherwise eligible for medical assistance under the plan without regard to the project. (3) No INCREASE IN FEDERAL MEDICAL ASSISTANCE PERCENT- AGE.— Pajnnents to a State under a project with respect to expenditures made for medical assistance made available under the project may not exceed the Federal medical assistance percentage (as defined in section 19050)) of the Social Security Act) of such expenditures. (f) EVALUATION AND REPORT.— (1) EVALUATIONS. — For each project the Secretary shall provide for an evaluation to determine the effect of the project with respect to— (A) access to, and costs of, health care, (B) private health care insurance coverage, and (C) premiums and cost-sharing. (2) REPORTS.—The Secretary shall prepare and submit to Congress an interim report on the status of the projects not later than January 1, 1993, and a final report containing such summary together with such further recommendations as the Sec- -194O-91-20:QL3Part2