[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 506 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 506
To provide for innovation in health care through State initiatives that
expand coverage and access.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 17, 2007
Ms. Baldwin (for herself, Mr. Price of Georgia, Mr. Tierney, Mr.
Fortuno, Mr. Stark, Mr. Linder, Mr. Conyers, Mr. Westmoreland, Mrs.
Capps, Mr. Souder, Mr. Allen, Mr. Marchant, Mr. Gene Green of Texas,
Mr. Gohmert, Mr. Larson of Connecticut, Mr. Burton of Indiana, Mr.
Welch of Vermont, Mr. Gingrey, Mr. Holt, Mr. Wamp, Mr. Cooper, Mr.
Cantor, Mr. Payne, Mr. Carter, Ms. Jackson-Lee of Texas, Mr. Akin, Ms.
Moore of Wisconsin, Mr. Wu, and Mr. Langevin) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committee on Rules, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To provide for innovation in health care through State initiatives that
expand coverage and access.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Partnership Through Creative
Federalism Act''.
SEC. 2. STATE HEALTH REFORM PROJECTS.
(a) Purposes; Establishment of State Health Care Expansion and
Improvement Program.--
(1) Purposes.--The purposes of the programs approved under
this section shall include, but not be limited to--
(A) achieving the goals of increased health
coverage and access; and
(B) testing alternative reforms, such as building
on the public or private health systems, or creating
new systems, to achieve the objectives of this Act.
(2) Intent of congress.--It is the intent of Congress
that--
(A) the programs approved under this Act each
comprise significant coverage expansions;
(B) taken as a whole, such programs should be
diverse and balanced in their approaches to covering
the uninsured; and
(C) each such program should be rigorously and
objectively evaluated, so that the State programs
developed pursuant to this Act may guide the
development of future State and national policy.
(b) Applications by States and Local Governments.--
(1) Entities that may apply.--
(A) In general.--A State may apply for a State
health care expansion and improvement program for the
entire State (or for regions of the State) under
paragraph (2).
(B) Regional and sub-state groups.--A regional
entity consisting of more than one State or one or more
local governments within a State may apply for a multi-
State or a sub-state health care expansion and
improvement program for the region or area involved.
(C) Definition.--In this Act, the term ``State''
means the 50 States, the District of Columbia, and the
Commonwealth of Puerto Rico. Such term shall include a
regional entity described in subparagraph (B).
(2) Submission of application.--In accordance with this
section, each State or regional entity desiring to implement a
State health care expansion and improvement program may submit
an application to the State Health Coverage Innovation
Commission under subsection (c) (referred to in this section as
the ``Commission'') for approval.
(3) Local government applications.--Where a State fails to
submit an application under this section, a unit of local
government of such State, or a consortium of such units of
local governments, may submit an application directly to the
Commission for programs or projects under this subsection. Such
an application shall be subject to the requirements of this
section.
(c) State Health Coverage Innovation Commission.--
(1) In general.--Within 90 days after the date of the
enactment of this Act, the Secretary of Health and Human
Services (in this section referred to as the ``Secretary'')
shall establish a State Health Coverage Innovation Commission
that--
(A) shall be comprised of--
(i) the Secretary;
(ii) four State governors to be appointed
by the National Governors Association on a
bipartisan basis;
(iii) two members of a State legislature to
be appointed, on a joint and bipartisan basis,
by the National Conference of State Legislators
and the American Legislative Exchange Council;
(iv) two county officials to be appointed
by the National Association of Counties on a
bipartisan basis;
(v) two mayors to be appointed, on a joint
and bipartisan basis, by the National League of
Cities and by the United States Conference of
Mayors;
(vi) two individuals to be appointed by the
Speaker of the House of Representatives;
(vii) two individuals to be appointed by
the Minority Leader of the House of
Representatives;
(viii) two individuals to be appointed by
the Majority Leader of the Senate; and
(ix) two individuals to be appointed by the
Minority Leader of the Senate;
(B) shall request States to submit proposals, which
may include a variety of reform options such as tax
credit approaches, expansions of public programs such
as Medicaid and the State Children's Health Insurance
Program, the creation of purchasing pooling
arrangements similar to the Federal Employees Health
Benefits Program, individual market purchasing options,
single risk pool or single payer systems, health
savings accounts, a combination of the options
described in this subparagraph, or other alternatives
determined appropriate by the Commission, including
options suggested by States or the public, and nothing
in this subparagraph shall be construed to prevent the
Commission from approving a reform proposal not
included in this subparagraph;
(C) shall conduct a thorough review of the grant
application from a State and carry on a dialogue with
all State applicants concerning possible modifications
and adjustments;
(D) shall submit the recommendations and
legislative proposal described in subsection (d)(4)(C);
(E) shall be responsible for receiving information
to determine the status and progress achieved under
program or projects granted under this section;
(F) shall report to the public concerning progress
made by States with respect to the performance measures
and goals established under this Act, the periodic
progress of the State relative to its State performance
measures and goals, and the State program application
procedures, by region and State jurisdiction;
(G) shall promote information exchange between
States and the Federal Government;
(H) shall be responsible for making recommendations
to the Secretary and the Congress, using equivalency or
minimum standards, for minimizing the negative effect
of State program on national employer groups, provider
organizations, and insurers because of differing State
requirements under the programs; and
(I) may require States to submit additional
information or reports concerning the status and
progress achieved under health care expansion and
improvement programs granted under this section, as
needed.
(2) Period of appointment; representation requirements;
vacancies.--Members shall be appointed for a term of 5 years.
In appointing such members under paragraph (1)(A), the
designated appointing individuals shall ensure the
representation of urban and rural areas and an appropriate
geographic distribution of such members. Any vacancy in the
Commission shall not affect its powers, but shall be filled in
the same manner as the original appointment.
(3) Chairperson, meetings.--
(A) Chairperson.--The Commission shall select a
Chairperson from among its members.
(B) Quorum.--Two-thirds of the members of the
Commission shall constitute a quorum, but a lesser
number of members may hold hearings.
(C) Meetings.--Not later than 30 days after the
date on which all members of the Commission have been
appointed, the Commission shall hold its first meeting.
The Commission shall meet at the call of the
Chairperson.
(4) Powers of the commission.--
(A) Negotiations with states.--The Commission may
conduct detailed discussions and negotiations with
States submitting applications under this section,
either individually or in groups, to facilitate a final
set of recommendations for purposes of subsection
(d)(4)(C).
(B) Hearings.--The Commission may hold such
hearings, sit and act at such times and places, take
such testimony, and receive such evidence as the
Commission considers advisable to carry out the
purposes of this subsection.
(C) Meetings.--In addition to other meetings the
Commission may hold, the Commission shall hold an
annual meeting with the participating States under this
section for the purpose of having States report
progress toward the purposes in subsection (a) and for
an exchange of information.
(D) Information.--The Commission may secure
directly from any Federal department or agency such
information as the Commission considers necessary to
carry out the provisions of this subsection. Upon
request of the Chairperson of the Commission, the head
of such department or agency shall furnish such
information to the Commission if the head of the
department or agency involved determines it
appropriate.
(E) Postal services.--The Commission may use the
United States mails in the same manner and under the
same conditions as other departments and agencies of
the Federal Government.
(5) Personnel matters.--
(A) Compensation.--Each member of the Commission
who is not an officer or employee of the Federal
Government or of a State or local government shall be
compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of
the Executive Schedule under section 5315 of title 5,
United States Code, for each day (including travel
time) during which such member is engaged in the
performance of the duties of the Commission. All
members of the Commission who are officers or employees
of the United States shall serve without compensation
in addition to that received for their services as
officers or employees of the United States.
(B) Travel expenses.--The members of the Commission
shall be allowed travel expenses, including per diem in
lieu of subsistence, at rates authorized for employees
of agencies under subchapter I of chapter 57 of title
5, United States Code, while away from their homes or
regular places of business in the performance of
services for the Commission.
(C) Staff.--The Chairperson of the Commission may,
without regard to the civil service laws and
regulations, appoint and terminate an executive
director and such other additional personnel as may be
necessary to enable the Commission to perform its
duties. The employment of an executive director shall
be subject to confirmation by the Commission.
(D) Detail of government employees.--Any Federal
Government employee may be detailed to the Commission
without reimbursement, and such detail shall be without
interruption or loss of civil service status or
privilege.
(E) Temporary and intermittent services.--The
Chairperson of the Commission may procure temporary and
intermittent services under section 3109(b) of title 5,
United States Code, at rates for individuals which do
not exceed the daily equivalent of the annual rate of
basic pay prescribed for level V of the Executive
Schedule under section 5316 of such title.
(6) Funding.--For the purpose of carrying out this
subsection, there are authorized to be appropriated $3,000,000
for fiscal year 2008 and each fiscal year thereafter.
(d) Requirements for Programs.--
(1) State plan.--A State that seeks to operate a program
under this section shall prepare and submit to the Commission,
as part of the application under subsection (b), a State health
care plan that shall have as its goal increased coverage, and
in service of that goal such additional goals as improvements
in quality, efficiency, cost-effectiveness, and the appropriate
use of information technology. To achieve such goal, the State
plan shall comply with the following:
(A) Coverage.--
(i) In general.--With respect to coverage,
the State plan shall--
(I) provide and describe the manner
in which the State will ensure that an
increased number of individuals
residing within the State will have
expanded access to health care coverage
with a specific 5-year target for
reduction in the number or proportion
of uninsured individuals through either
private or public program expansion, or
both, in accordance with or in addition
to the options established by the
Commission;
(II) describe the number and
percentage of current uninsured
individuals who will achieve coverage
under a State health program;
(III) describe the coverage that
will be provided to beneficiaries under
a State health program;
(IV) identify Federal, State, or
local and private programs that
currently provide health care services
in the State and describe how such
programs could be coordinated with a
State health program, to the extent
practicable; and
(V) provide for improvements in the
availability of appropriate health care
coverage that will increase access to
care in urban, suburban, rural, and
frontier areas of the State with
medically underserved populations or
where there may be an inadequate supply
of health care providers.
(ii) Coverage options.--The coverage under
the State plan may be--
(I) health insurance coverage that
meets the aggregate actuarial value
requirement of section 2103(a)(2)(B) of
the Social Security Act (42 U.S.C.
1397cc(a)(2)(B));
(II) a combination of health
insurance coverage and a consumer-
directed health care spending account,
if the actuarial value of such coverage
plus the amount of annual deposits into
such account from sources other than
the beneficiary is not less than the
actuarial value amount described in
subclause (I); or
(III) health care access not less
on average than that provided through
coverage described in subclause (I).
(iii) Construction.--Nothing in this clause
shall be construed to limit in any way the
authority of the Secretary of Health and Human
Services to issue waivers under section 1115 of
the Social Security Act.
(B) Quality.--With respect to quality, the State
plan may describe efforts to improve health care
quality in the State, including an explanation of how
such efforts would change (if at all) under the State
plan.
(C) Costs.--With respect to costs, the State plan
shall--
(i) describe such steps as the State may
undertake to improve the efficiency of health
care;
(ii) describe the public and private sector
financing to be provided for the State health
program;
(iii) estimate the amount of Federal,
State, and local expenditures, as well as, the
costs to business and individuals under the
State health program; and
(iv) describe how the State plan will
ensure the financial solvency of the State
health program.
(D) Health information technology.--With respect to
health information technology, the State plan may
describe efforts to improve the appropriate use of
health information technology, including an explanation
of how such efforts would change (if at all) under the
State plan.
(E) Exceptions to federal policies.--The State plan
shall describe the exceptions to otherwise applicable
Federal statutes, regulations, and policies that would
apply within the geographic area and time period
governed by the plan.
(2) Technical assistance.--The Secretary shall, if
requested, provide technical assistance to States to assist
such States in developing applications and plans under this
section, including technical assistance by private sector
entities if determined appropriate by the Commission.
(3) Initial review.--With respect to a State application
under subsection (b), the Secretary and the Commission shall
complete an initial review of such State application within 60
days of the receipt of such application, analyze the scope of
the proposal, and determine whether additional information is
needed from the State. The Commission shall advise the State
within such period of the need to submit additional
information.
(4) Final determination.--
(A) In general.--In a timely manner consistent with
subparagraph (C), the Commission shall determine
whether to submit a State proposal to Congress for
approval.
(B) Voting.--
(i) In general.--The determination to
submit a State proposal to Congress under
subparagraph (A) shall be approved by \2/3\ of
the members of the Commission who are present
and eligible to vote and a majority of the
entire Commission.
(ii) Eligibility.--A member of the
Commission shall not participate in a
determination under subparagraph (A) if--
(I) in the case of a member who is
a Governor, such determination relates
to the State of which the member is the
Governor; or
(II) in the case of member not
described in subclause (I), such
determination relates to the geographic
area of a State of which such member
serves as a State or local official or
as a Member of Congress.
(C) Submission.--Not later than 90 days prior to
October 1 of each fiscal year, the Commission may
submit to Congress a list, in the form of a legislative
proposal, of the State applications that the Commission
recommends for approval under this section.
(5) Program or project period.--A State program or project
may be approved for a period of 5 years and may be extended for
a subsequent period of time upon approval by the Commission,
based upon achievement of targets.
(e) Expedited Congressional Consideration.--
(1) Introduction and expedited consideration in the house
of representatives.--
(A) Introduction in house of representatives.--The
legislative proposal submitted pursuant to subsection
(d)(4)(C) shall be in the form of a joint resolution
(in this subsection referred to as the ``resolution'').
Such resolution shall be introduced in the House of
Representatives by the Speaker immediately upon receipt
of the language and shall be referred non-sequentially
to the appropriate committee (or committees) of House
of Representatives. If the resolution is not introduced
in accordance with the preceding sentence, the
resolution may be introduced by any member of the House
of Representatives.
(B) Committee consideration.--Not later than 15
calendar days after the introduction of the resolution
described in subparagraph (A), each committee of House
of Representatives to which the resolution was referred
shall report the resolution. The report may include, at
the committee's discretion, a recommendation for action
by the House. If a committee has not reported such
resolution (or an identical resolution) at the end of
15 calendar days after its introduction or at the end
of the first day after there has been reported to the
House a resolution, whichever is earlier, such
committee shall be deemed to be discharged from further
consideration of such resolution and such resolution
shall be placed on the appropriate calendar of the
House of Representatives.
(C) Expedited procedure in house.--Not later than 5
legislative days after the date on which all committees
have been discharged from consideration of a
resolution, the Speaker of the House of
Representatives, or the Speaker's designee, shall move
to proceed to the consideration of the resolution. It
shall also be in order for any member of the House of
Representatives to move to proceed to the consideration
of the resolution at any time after the conclusion of
such 5-day period. All points of order against the
resolution (and against consideration of the
resolution) are waived. A motion to proceed to the
consideration of the resolution is highly privileged in
the House of Representatives and is not debatable. The
motion is not subject to amendment, to a motion to
postpone consideration of the resolution, or to a
motion to proceed to the consideration of other
business. A motion to reconsider the vote by which the
motion to proceed is agreed to or not agreed to shall
not be in order. If the motion to proceed is agreed to,
the House of Representatives shall immediately proceed
to consideration of the resolution without intervening
motion, order, or other business, and the resolution
shall remain the unfinished business of the House of
Representatives until disposed of. A motion to recommit
the resolution shall not be in order. Upon its passage
in the House, the clerk of the House shall provide for
its immediate transmittal to the Senate.
(2) Expedited consideration in the senate.--
(A) Referral to committee.--If the resolution is
agreed to by the House of Representatives, upon its
receipt in the Senate the Majority Leader of the
Senate, or the Leader's designee, the resolution shall
be referred to the appropriate committee of Senate.
(B) Committee consideration.--Not later than 15
calendar days after the referral of the resolution
under subparagraph (A), the committee of the Senate to
which the resolution was referred shall report the
resolution. The report may include, at the committee's
discretion, a recommendation for action by the Senate.
If a committee has not reported such resolution (or an
identical resolution) at the end of 15 calendar days
after its referral or at the end of the first day after
there has been reported to the Senate a resolution,
whichever is earlier, such committee shall be deemed to
be discharged from further consideration of such
resolution and such resolution shall be placed on the
appropriate calendar of the Senate.
(C) Expedited floor consideration.--Not later than
5 legislative days after the date on which all
committees have been discharged from consideration of a
resolution, the Majority Leader of the Senate, or the
Majority Leader's designee, shall move to proceed to
the consideration of the resolution. It shall also be
in order for any member of the Senate to move to
proceed to the consideration of the resolution at any
time after the conclusion of such 5-day period. All
points of order against the resolution (and against
consideration of the resolution) are waived. A motion
to proceed to the consideration of the resolution in
the Senate is privileged and is not debatable. The
motion is not subject to amendment, to a motion to
postpone consideration of the resolution, or to a
motion to proceed to the consideration of other
business. A motion to reconsider the vote by which the
motion to proceed is agreed to or not agreed to shall
not be in order. If the motion to proceed is agreed to,
the Senate shall immediately proceed to consideration
of the resolution without intervening motion, order, or
other business, and the resolution shall remain the
unfinished business of the Senate until disposed of.
(3) Rules of the senate and house of representatives.--This
subsection is enacted by Congress--
(A) as an exercise of the rulemaking power of the
Senate and House of Representatives, respectively, and
is deemed to be part of the rules of each House,
respectively, but applicable only with respect to the
procedure to be followed in that House in the case of a
resolution under this subsection, and it supersedes
other rules only to the extent that it is inconsistent
with such rules; and
(B) with full recognition of the constitutional
right of either House to change the rules (so far as
they relate to the procedure of that House) at any
time, in the same manner, and to the same extent as in
the case of any other rule of that House.
(4) Federal budget neutrality.--Except insofar as it allots
appropriations made pursuant to subsection (k), the legislative
proposal submitted pursuant to subsection (d)(4)(C) may not
increase the cumulative, net Federal budget deficit during the
multi-year operation of all the State applications contained
therein, taking into account such applications' impact on
Federal mandatory and discretionary spending, Federal revenue,
and Federal tax expenditures.
(f) Funding.--
(1) In general.--The Secretary shall provide a grant to a
State that has an application approved under subsection (e) to
enable such State to carry out an innovative State health
program in the State, to the extent that such a grant is
included in the recommendation of the Commission.
(2) Amount of grant.--The amount of a grant provided to a
State under paragraph (1) shall be determined based upon the
recommendations of the Commission, subject to the amount
appropriated under subsection (k).
(3) Performance-based funding allocation.--In awarding
grants under paragraph (1), the Commission shall direct the
Secretary to--
(A) fund a balanced diversity of approaches as
provided for by the Commission in subsection (c)(1)(B);
and
(B) link allocations to the State to the meeting of
the goals and performance measures relating to health
care coverage and health care costs established under
this Act through the State project application process.
(4) Report.--One year prior to the end of the 5-year period
beginning on the date on which the first State begins to
implement a plan approved under subsection (e), the Commission
shall prepare and submit to the appropriate committees of
Congress, a report on the progress made by States in meeting
the goals of expanded coverage and cost containment through
performance measures established during the 5-year period of
the State plan. Such report may contain the recommendation of
the Commission concerning any future action that Congress
should take concerning health care reform, including whether or
not to extend the program established under this subsection.
(g) Monitoring and Evaluation.--
(1) Annual reports and participation by states.--Each State
that has received a program approval shall--
(A) submit to the Commission an annual report based
on the period representing the respective State's
fiscal year, detailing compliance with the requirements
established by the Commission and the Secretary in the
approval and in this section; and
(B) participate in the annual meeting under
subsection (c)(4)(C).
(2) Evaluations by commission.--The Commission shall
prepare and submit to the Congress annual reports that shall
contain--
(A) a description of the effects of the reforms
undertaken in States receiving approvals under this
section;
(B) a description of the recommendations of the
Commission and actions taken based on these
recommendations;
(C) an independent evaluation of the effectiveness
of such reforms in--
(i) expanding health care coverage for
State residents; and
(ii) reducing or containing health care
costs in the States,
as well as other relevant or significant findings;
(D) recommendations regarding the advisability of
increasing Federal financial assistance for State
ongoing or future health program initiatives, including
the amount and source of such assistance; and
(E) as required by the Commission or the Secretary
under this section, a periodic, independent evaluation
of the program.
(h) Noncompliance.--
(1) Corrective action plans.--If a State is not in
compliance with a requirement of this section, the Commission,
on recommendation of the Secretary, shall develop a corrective
action plan for such State.
(2) Termination.--The Commission, on recommendation of the
Secretary, may revoke any program granted under this section.
Such decisions shall be subject to a petition for
reconsideration and appeal pursuant to regulations established
by the Secretary.
(i) Relationship to Federal Programs.--
(1) In general.--Nothing in this Act, or in section 1115 of
the Social Security Act (42 U.S.C. 1315) shall be construed as
authorizing the Secretary, the Commission, a State, or any
other person or entity to alter or affect in any way the
provisions of title XIX of such Act (42 U.S.C. 1396 et seq.) or
the regulations implementing such title.
(2) Maintenance of effort.--No payment may be made under
subsection (f)(1) if the State adopts criteria for benefits or
criteria for standards and methodologies for purposes of
determining an individual's eligibility for medical assistance
under the State plan under title XIX that are more restrictive
than those required under Federal law and applied as of the
date of enactment of this Act.
(j) Miscellaneous Provisions.--
(1) Application of certain requirements.--
(A) Restriction on application of preexisting
condition exclusions.--
(i) In general.--Subject to subparagraph
(B), a State shall not permit the imposition of
any preexisting condition exclusion for covered
benefits under a program or project under this
section.
(ii) Group health plans and group health
insurance coverage.--If the State program or
project provides for benefits through payment
for, or a contract with, a group health plan or
group health insurance coverage, the program or
project may permit the imposition of a
preexisting condition exclusion but only
insofar and to the extent that such exclusion
is permitted under the applicable provisions of
part 7 of subtitle B of title I of the Employee
Retirement Income Security Act of 1974 and
title XXVII of the Public Health Service Act.
(B) Compliance with other requirements.--Coverage
offered under the program or project shall comply with
the requirements of subpart 2 of part A of title XXVII
of the Public Health Service Act insofar as such
requirements apply with respect to a health insurance
issuer that offers group health insurance coverage.
(2) Prevention of duplicative payments.--
(A) Other health plans.--No payment shall be made
to a State under subsection (f)(1) for expenditures for
health assistance provided for an individual to the
extent that a private insurer (as defined by the
Secretary by regulation and including a group health
plan (as defined in section 607(1) of the Employee
Retirement Income Security Act of 1974), a service
benefit plan, and a health maintenance organization)
would have been obligated to provide such assistance
but for a provision of its insurance contract which has
the effect of limiting or excluding such obligation
because the individual is eligible for or is provided
health assistance under the plan.
(B) Other federal governmental programs.--Except as
provided in any other provision of law, no payment
shall be made to a State under subsection (f)(1) for
expenditures for health assistance provided for an
individual to the extent that payment has been made or
can reasonably be expected to be made promptly (as
determined in accordance with regulations) under any
other federally operated or financed health care
insurance program. For purposes of this paragraph,
rules similar to the rules for overpayments under
section 1903(d)(2) of the Social Security Act shall
apply.
(3) Application of certain general provisions.--The
following provisions of the Social Security Act shall apply to
States under subsection (f)(1) in the same manner as they apply
to a State under such title XIX:
(A) Title xix provisions.--
(i) Section 1902(a)(4)(C) (relating to
conflict of interest standards).
(ii) Paragraphs (2), (16), and (17) of
section 1903(i) (relating to limitations on
payment).
(iii) Section 1903(w) (relating to
limitations on provider taxes and donations).
(iv) Section 1920A (relating to presumptive
eligibility for children).
(B) Title xi provisions.--
(i) Section 1116 (relating to
administrative and judicial review), but only
insofar as consistent with this title.
(ii) Section 1124 (relating to disclosure
of ownership and related information).
(iii) Section 1126 (relating to disclosure
of information about certain convicted
individuals).
(iv) Section 1128A (relating to civil
monetary penalties).
(v) Section 1128B(d) (relating to criminal
penalties for certain additional charges).
(vi) Section 1132 (relating to periods
within which claims must be filed).
(4) Relation to hipaa.--Health benefits coverage provided
under a State program or project under this section shall be
treated as creditable coverage for purposes of part 7 of
subtitle B of title I of the Employee Retirement Income
Security Act of 1974, title XXVII of the Public Health Service
Act, and subtitle K of the Internal Revenue Code of 1986.
(k) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
in each fiscal year. Amounts appropriated for a fiscal year under this
subsection and not expended may be used in subsequent fiscal years to
carry out this section.
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