Appropriation; total allotment
Allotments to 50 States and District of Columbia
In general
Number of children
In general
Determination of number of children
For purposes of subparagraph (A), a determination of the number of low-income children (and of such children who have no health insurance coverage) for a State for a fiscal year shall be made on the basis of the arithmetic average of the number of such children, as reported and defined in the 3 most recent March supplements to the Current Population Survey of the Bureau of the Census before the beginning of the calendar year in which such fiscal year begins.
Adjustment for geographic variations in health costs
In general
Annual average wages per employee
For purposes of subparagraph (A), the “annual average wages per employee” for a State, or for all the States, for a fiscal year is equal to the average of the annual wages per employee for the State or for the 50 States and the District of Columbia for employees in the health services industry (SIC code 8000), as reported by the Bureau of Labor Statistics of the Department of Labor for each of the most recent 3 years before the beginning of the calendar year in which such fiscal year begins.
Floors and ceilings in State allotments
In general
Floor of $2,000,000
A floor equal to $2,000,000 divided by the total of the amount available under this subsection for all such allotments for the fiscal year.
Annual floor of 10 percent below preceding fiscal year’s proportion
A floor of 90 percent of the proportion for the State for the preceding fiscal year.
Cumulative floor of 30 percent below the FY 1999 proportion
A floor of 70 percent of the proportion for the State for fiscal year 1999.
Cumulative ceiling of 45 percent above FY 1999 proportion
A ceiling of 145 percent of the proportion for the State for fiscal year 1999.
Reconciliation
Elimination of any deficit by establishing a percentage increase ceiling for States with highest annual percentage increases
To the extent that the application of subparagraph (A) would result in the sum of the proportions of the allotments for all subsection (b) States exceeding 1.0, the Secretary shall establish a maximum percentage increase in such proportions for all subsection (b) States for the fiscal year in a manner so that such sum equals 1.0.
Allocation of surplus through pro rata increase
To the extent that the application of subparagraph (A) would result in the sum of the proportions of the allotments for all subsection (b) States being less than 1.0, the proportions of such allotments (as computed before the application of floors under clauses (i), (ii), and (iii) of subparagraph (A)) for all subsection (b) States shall be increased in a pro rata manner (but not to exceed the ceiling established under subparagraph (A)(iv)) so that (after the application of such floors and ceiling) such sum equals 1.0.
Construction
This paragraph shall not be construed as applying to (or taking into account) amounts of allotments redistributed under subsection (f).
Definitions
Proportion of allotment
The term “proportion” means, with respect to the allotment of a subsection (b) State for a fiscal year, the amount of the allotment of such State under this subsection for the fiscal year divided by the total of the amount available under this subsection for all such allotments for the fiscal year.
Subsection (b) State
The term “subsection (b) State” means one of the 50 States or the District of Columbia.
Allotments to territories
In general
Of the amount available for allotment under subsection (a) for a fiscal year, subject to subsections (d) and (m)(5), the Secretary shall allot 0.25 percent among each of the commonwealths and territories described in paragraph (3) in the same proportion as the percentage specified in paragraph (2) for such commonwealth or territory bears to the sum of such percentages for all such commonwealths or territories so described.
Percentage
Commonwealths and territories
Additional allotment
In general
In addition to the allotment under paragraph (1), the Secretary shall allot each commonwealth and territory described in paragraph (3) the applicable percentage specified in paragraph (2) of the amount appropriated under subparagraph (B).
Appropriations
For purposes of providing allotments pursuant to subparagraph (A), there is appropriated, out of any money in the Treasury not otherwise appropriated $32,000,000 for fiscal year 1999, $34,200,000 for each of fiscal years 2000 and 2001, $25,200,000 for each of fiscal years 2002 through 2004, $32,400,000 for each of fiscal years 2005 and 2006, and $40,000,000 for each of fiscal years 2007 through 2009.
Additional allotments to eliminate funding shortfalls
Appropriation; allotment authority
For the purpose of providing additional allotments to shortfall States described in paragraph (2), there is appropriated, out of any money in the Treasury not otherwise appropriated, $283,000,000 for fiscal year 2006.
Shortfall States described
Allotments
Use of additional allotment
Additional allotments provided under this subsection are only available for amounts expended under a State plan approved under this subchapter for child health assistance for targeted low-income children.
1-year availability; no redistribution of unexpended additional allotments
Notwithstanding subsections (e) and (f), amounts allotted to a State pursuant to this subsection for fiscal year 2006 shall only remain available for expenditure by the State through . Any amounts of such allotments that remain unexpended as of such date shall not be subject to redistribution under subsection (f) and shall revert to the Treasury on .
Availability of amounts allotted
In general
Availability of amounts redistributed
Amounts redistributed to a State under subsection (f) shall be available for expenditure by the State through the end of the fiscal year in which they are redistributed.
Procedure for redistribution of unused allotments
In general
The Secretary shall determine an appropriate procedure for redistribution of allotments from States that were provided allotments under this section for a fiscal year but that do not expend all of the amount of such allotments during the period in which such allotments are available for expenditure under subsection (e), to States that the Secretary determines with respect to the fiscal year for which unused allotments are available for redistribution under this subsection, are shortfall States described in paragraph (2) for such fiscal year, but not to exceed the amount of the shortfall described in paragraph (2)(A) for each such State (as may be adjusted under paragraph (2)(C)).
Shortfall States described
In general
Determination of redistributed amounts if insufficient amounts available
Proration rule
Subject to clause (ii), if the amounts available for redistribution under paragraph (1) for a fiscal year are less than the total amounts of the estimated shortfalls determined for the year under subparagraph (A), the amount to be redistributed under such paragraph for each shortfall State shall be reduced proportionally.
Special rule for first half of fiscal year 2018
In general
For each month beginning during the period beginning on , and ending , subject to the succeeding subclauses of this clause, the Secretary shall redistribute any amounts available for redistribution under paragraph (1) for fiscal year 2018, to each State that is an emergency shortfall State (as defined in subclause (II)) for the month such amount as the Secretary determines will eliminate the estimated shortfall described in subclause (II) for such State for the month (as may be adjusted under subparagraph (C)) before the Secretary may redistribute such amounts to any shortfall State that is not an emergency shortfall State. In the case of any amounts redistributed under this subclause to a State that is not an emergency shortfall State, such amounts shall be determined in accordance with clause (i).
Emergency shortfall State defined
section 1397ee(g) of this titlesection 1397ee(g)(4)(A) of this titleFor purposes of this clause, the term “emergency shortfall State” means, with respect to a month beginning during the period beginning , and ending , a shortfall State for which the Secretary estimates, in accordance with subparagraph (A) (unless otherwise specified in this subclause) and on a monthly basis using the most recent data available to the Secretary as of such month, that the projected expenditures under the State child health plan and under (calculated as if the reference under , as in effect on the day before , to “2017” were a reference to “2018” and insofar as the allotments are available to the State under this subsection or subsection (e) or (m)) for such month will exceed the sum of the amounts described in clauses (i) through (iii) of subparagraph (A) for such month, including after application of any amount redistributed under paragraph (1) for a previous month for fiscal year 2018 in accordance with this clause, to such State. A shortfall State may be an emergency shortfall State under the previous sentence without regard to whether any amounts were redistributed to such State under paragraph (1) for a previous month in fiscal year 2018.
Funds redistributed in the order in which States realize funding shortfalls
The Secretary shall redistribute the amounts available for redistribution under paragraph (1) to emergency shortfall States described in subclause (II) in the order in which such States realize monthly funding shortfalls under this subchapter for fiscal year 2018. The Secretary shall only make redistributions under this clause to the extent that such amounts are available for such redistributions.
Proration rule
If the amounts available for redistribution under paragraph (1) for a month during the period described in subclause (I) are less than the total amounts of the estimated shortfalls determined for the month for emergency shortfall States described in subclause (II), the amount computed under subclause (I) for each emergency shortfall State shall be reduced proportionally.
Unobligated redistributed funds
The Secretary shall withhold any funds redistributed under paragraph (1) for fiscal year 2018 before , but which have not been obligated for amounts expended by a State as of that date, and shall redistribute such funds in accordance with the preceding subclauses of this clause.
Application of qualifying State option
Retrospective adjustment
The Secretary may adjust the estimates and determinations made under paragraph (1) and this paragraph with respect to a fiscal year as necessary on the basis of the amounts reported by States not later than November 30 of the succeeding fiscal year, as approved by the Secretary.
Rule of construction
Nothing in this paragraph may be construed as preventing a commonwealth or territory described in subsection (c)(3) from being treated as a shortfall State or an emergency shortfall State.
Rule for redistribution and extended availability of fiscal years 1998, 1999, 2000, and 2001 allotments
Amount redistributed
In general
State
Territory
In the case of a commonwealth or territory described in subsection (c)(3), an amount that bears the same ratio to 1.05 percent of the total amount described in paragraph (2)(B)(i)(I) as the ratio of the commonwealth’s or territory’s fiscal year 1998, 1999, 2000, or 2001 allotment under subsection (c) (as the case may be) bears to the total of all such allotments for such fiscal year under such subsection.
Expenditure rules
Amounts used in computing redistributions for fiscal year 2000
Amounts used in computing redistributions for fiscal year 2001
Extension of availability of portion of unexpended fiscal years 1998 through 2001 allotments
In general
Fiscal year 1998 allotment
Of the amounts allotted to a State pursuant to this section for fiscal year 1998 that were not expended by the State by the end of fiscal year 2000, the amount specified in subparagraph (B) for fiscal year 1998 for such State shall remain available for expenditure by the State through the end of fiscal year 2004.
Fiscal year 1999 allotment
Of the amounts allotted to a State pursuant to this subsection for fiscal year 1999 that were not expended by the State by the end of fiscal year 2001, the amount specified in subparagraph (B) for fiscal year 1999 for such State shall remain available for expenditure by the State through the end of fiscal year 2004.
Fiscal year 2000 allotment
Of the amounts allotted to a State pursuant to this section for fiscal year 2000 that were not expended by the State by the end of fiscal year 2002, 50 percent of that amount shall remain available for expenditure by the State through the end of fiscal year 2004.
Fiscal year 2001 allotment
Of the amounts allotted to a State pursuant to this section for fiscal year 2001 that were not expended by the State by the end of fiscal year 2003, 50 percent of that amount shall remain available for expenditure by the State through the end of fiscal year 2005.
Amount remaining available for expenditure
Use of up to 10 percent of retained 1998 allotments for outreach activities
section 1397ee(c)(2)(A) of this titleNotwithstanding , with respect to any State described in subparagraph (A)(i), the State may use up to 10 percent of the amount specified in subparagraph (B) for fiscal year 1998 for expenditures for outreach activities approved by the Secretary.
Determination of amounts
3
Special rules to address fiscal year 2007 shortfalls
Redistribution of unused fiscal year 2004 allotments
In general
Notwithstanding subsection (f) and subject to subparagraphs (C) and (D), with respect to months beginning during fiscal year 2007, the Secretary shall provide for a redistribution under such subsection from the allotments for fiscal year 2004 under subsection (b) that are not expended by the end of fiscal year 2006, to a shortfall State described in subparagraph (B), such amount as the Secretary determines will eliminate the estimated shortfall described in such subparagraph for such State for the month.
Shortfall State described
Funds redistributed in the order in which States realize funding shortfalls
The Secretary shall redistribute the amounts available for redistribution under subparagraph (A) to shortfall States described in subparagraph (B) in the order in which such States realize monthly funding shortfalls under this subchapter for fiscal year 2007. The Secretary shall only make redistributions under this paragraph to the extent that there are unexpended fiscal year 2004 allotments under subsection (b) available for such redistributions.
Proration rule
If the amounts available for redistribution under subparagraph (A) for a month are less than the total amounts of the estimated shortfalls determined for the month under that subparagraph, the amount computed under such subparagraph for each shortfall State shall be reduced proportionally.
Funding part of shortfall for fiscal year 2007 through redistribution of certain unused fiscal year 2005 allotments
In general
Subject to subparagraphs (C) and (D) and paragraph (5)(B), with respect to months beginning during fiscal year 2007 after , the Secretary shall provide for a redistribution under subsection (f) from amounts made available for redistribution under paragraph (3) to each shortfall State described in subparagraph (B), such amount as the Secretary determines will eliminate the estimated shortfall described in such subparagraph for such State for the month.
Shortfall State described
Funds redistributed in the order in which States realize funding shortfalls
The Secretary shall redistribute the amounts available for redistribution under subparagraph (A) to shortfall States described in subparagraph (B) in the order in which such States realize monthly funding shortfalls under this subchapter for fiscal year 2007. The Secretary shall only make redistributions under this paragraph to the extent that such amounts are available for such redistributions.
Proration rule
If the amounts available for redistribution under paragraph (3) for a month are less than the total amounts of the estimated shortfalls determined for the month under subparagraph (A), the amount computed under such subparagraph for each shortfall State shall be reduced proportionally.
Treatment of certain States with fiscal year 2005 allotments unexpended at the end of the first half of fiscal year 2007
Identification of States
States with funds in excess of 200 percent of need
4
Redistribution and limitation on availability of portion of unused allotments for certain States
In general
In the case of a State identified under subparagraph (A)(i) that is also described in subparagraph (B), notwithstanding subsection (e), the applicable amount described in clause (ii) shall not be available for expenditure by the State on or after , and shall be redistributed in accordance with paragraph (2).
Applicable amount
Additional amounts to eliminate remainder of fiscal year 2007 funding shortfalls
In general
From the amounts provided in advance in appropriations Acts, the Secretary shall allot to each remaining shortfall State described in subparagraph (B) such amount as the Secretary determines will eliminate the estimated shortfall described in such subparagraph for the State for fiscal year 2007.
Remaining shortfall State described
Retrospective adjustment
In general
The Secretary may adjust the estimates and determinations made under paragraphs (1), (2), (3), and (4) as necessary on the basis of the amounts reported by States not later than , on CMS Form 64 or CMS Form 21, as the case may be and as approved by the Secretary, but in no case may the applicable amount described in paragraph (3)(C)(ii) exceed the amount determined by the Secretary on the basis of the most recent data available to the Secretary as of .
Funding of any retrospective adjustments only from unexpended 2005 allotments
Notwithstanding subsections (e) and (f), to the extent the Secretary determines it necessary to adjust the estimates and determinations made for purposes of paragraphs (1), (2), and (3), the Secretary may use only the allotments for fiscal year 2005 under subsection (b) that remain unexpended through the end of fiscal year 2007 for providing any additional amounts to States described in paragraph (2)(B) (without regard to whether such unexpended allotments are from States described in paragraph (3)(B)).
Rules of construction
1-year availability; no further redistribution
4Notwithstanding subsections (e) and (f), amounts redistributed or allotted to a State pursuant to this subsection for fiscal year 2007 shall only remain available for expenditure by the State through , and any amounts of such redistributions or allotments that remain unexpended as of such date, shall not be subject to redistribution under subsection (f). Nothing in the preceding sentence shall be construed as limiting the ability of the Secretary to adjust the determinations made under paragraphs (1), (2), (3), and (4) in accordance with paragraph (5).
Definition of State
For purposes of this subsection, the term “State” means a State that receives an allotment for fiscal year 2007 under subsection (b).
Redistribution of unused fiscal year 2005 allotments to States with estimated funding shortfalls for fiscal year 2008
In general
Notwithstanding subsection (f) and subject to paragraphs (3) and (4), with respect to months beginning during fiscal year 2008, the Secretary shall provide for a redistribution under such subsection from the allotments for fiscal year 2005 under subsection (b) that are not expended by the end of fiscal year 2007, to a fiscal year 2008 shortfall State described in paragraph (2), such amount as the Secretary determines will eliminate the estimated shortfall described in such paragraph for such State for the month.
Fiscal year 2008 shortfall State described
Funds redistributed in the order in which States realize funding shortfalls
The Secretary shall redistribute the amounts available for redistribution under paragraph (1) to fiscal year 2008 shortfall States described in paragraph (2) in the order in which such States realize monthly funding shortfalls under this subchapter for fiscal year 2008. The Secretary shall only make redistributions under this subsection to the extent that there are unexpended fiscal year 2005 allotments under subsection (b) available for such redistributions.
Proration rule
If the amounts available for redistribution under paragraph (1) are less than the total amounts of the estimated shortfalls determined for the month under that paragraph, the amount computed under such paragraph for each fiscal year 2008 shortfall State for the month shall be reduced proportionally.
Retrospective adjustment
The Secretary may adjust the estimates and determinations made to carry out this subsection as necessary on the basis of the amounts reported by States not later than , on CMS Form 64 or CMS Form 21, as the case may be, and as approved by the Secretary.
1–year availability; no further redistribution
Notwithstanding subsections (e) and (f), amounts redistributed to a State pursuant to this subsection for fiscal year 2008 shall only remain available for expenditure by the State through , and any amounts of such redistributions that remain unexpended as of such date, shall not be subject to redistribution under subsection (f).
Additional allotments to eliminate funding shortfalls for fiscal year 2008
Appropriation; allotment authority
For the purpose of providing additional allotments described in subparagraphs (A) and (B) of paragraph (3), there is appropriated, out of any money in the Treasury not otherwise appropriated, such sums as may be necessary, not to exceed $1,600,000,000 for fiscal year 2008.
Shortfall States described
Allotments
Proration rule
If the amounts available for additional allotments under paragraph (1) are less than the total of the amounts determined under subparagraphs (A) and (B) of paragraph (3), the amounts computed under such subparagraphs shall be reduced proportionally.
Retrospective adjustment
The Secretary may adjust the estimates and determinations made to carry out this subsection as necessary on the basis of the amounts reported by States not later than , on CMS Form 64 or CMS Form 21, as the case may be, and as approved by the Secretary.
One-year availability; no redistribution of unexpended additional allotments
Notwithstanding subsections (e) and (f), amounts allotted to a State pursuant to this subsection for fiscal year 2008, subject to paragraph (5), shall only remain available for expenditure by the State through . Any amounts of such allotments that remain unexpended as of such date shall not be subject to redistribution under subsection (f).
Redistribution of unused fiscal year 2006 allotments to States with estimated funding shortfalls during fiscal year 2009
In general
Notwithstanding subsection (f) and subject to paragraphs (3) and (4), with respect to months beginning during fiscal year 2009, the Secretary shall provide for a redistribution under such subsection from the allotments for fiscal year 2006 under subsection (b) that are not expended by the end of fiscal year 2008, to a fiscal year 2009 shortfall State described in paragraph (2), such amount as the Secretary determines will eliminate the estimated shortfall described in such paragraph for such State for the month.
Fiscal year 2009 shortfall State described
Funds redistributed in the order in which States realize funding shortfalls
The Secretary shall redistribute the amounts available for redistribution under paragraph (1) to fiscal year 2009 shortfall States described in paragraph (2) in the order in which such States realize monthly funding shortfalls under this subchapter for fiscal year 2009. The Secretary shall only make redistributions under this subsection to the extent that there are unexpended fiscal year 2006 allotments under subsection (b) available for such redistributions.
Proration rule
If the amounts available for redistribution under paragraph (1) are less than the total amounts of the estimated shortfalls determined for the month under that paragraph, the amount computed under such paragraph for each fiscal year 2009 shortfall State for the month shall be reduced proportionally.
Retrospective adjustment
The Secretary may adjust the estimates and determinations made to carry out this subsection as necessary on the basis of the amounts reported by States not later than , on CMS Form 64 or CMS Form 21, as the case may be, and as approved by the Secretary.
Availability; no further redistribution
Notwithstanding subsections (e) and (f), amounts redistributed to a State pursuant to this subsection for fiscal year 2009 shall only remain available for expenditure by the State through , and any amounts of such redistributions that remain unexpended as of such date, shall not be subject to redistribution under subsection (f).
Additional allotments to eliminate funding shortfalls for the first 2 quarters of fiscal year 2009
Appropriation; allotment authority
For the purpose of providing additional allotments described in subparagraphs (A) and (B) of paragraph (3), there is appropriated, out of any money in the Treasury not otherwise appropriated, such sums as may be necessary, not to exceed $275,000,000 for the first 2 quarters of fiscal year 2009.
Shortfall States described
Allotments
Proration rule
If the amounts available for additional allotments under paragraph (1) are less than the total of the amounts determined under subparagraphs (A) and (B) of paragraph (3), the amounts computed under such subparagraphs shall be reduced proportionally.
Retrospective adjustment
The Secretary may adjust the estimates and determinations made to carry out this subsection as necessary on the basis of the amounts reported by States not later than , on CMS Form 64 or CMS Form 21, as the case may be, and as approved by the Secretary.
Availability; no redistribution of unexpended additional allotments
Notwithstanding subsections (e) and (f), amounts allotted to a State pursuant to this subsection for fiscal year 2009, subject to paragraph (5), shall only remain available for expenditure by the State through . Any amounts of such allotments that remain unexpended as of such date shall not be subject to redistribution under subsection (f).
Allotments for fiscal years 2009 and thereafter
For fiscal year 2009
For the 50 States and the District of Columbia
For the commonwealths and territories
Subject to the succeeding provisions of this paragraph and paragraph (5), the Secretary shall allot for fiscal year 2009 from the amount made available under subsection (a)(12) to each of the commonwealths and territories described in subsection (c)(3) an amount equal to the highest amount of Federal payments to the commonwealth or territory under this subchapter for any fiscal year occurring during the period of fiscal years 1999 through 2008, multiplied by the allotment increase factor determined under paragraph (6) for fiscal year 2009, except that subparagraph (B) thereof shall be applied by substituting “the United States” for “the State”.
Adjustment for qualifying States
section 1397ee(g) of this titleIn the case of a qualifying State described in paragraph (2) of , the Secretary shall permit the State to submit a revised projection described in subparagraph (A)(iii) in order to take into account changes in such projections attributable to the application of paragraph (4) of such section.
For fiscal years beginning with fiscal year 2010
In general
Growth factor update for fiscal year 2010
Rebasing in fiscal year 2011
For fiscal year 2011, the allotment of the State is equal to the Federal payments to the State that are attributable to (and countable towards) the total amount of allotments available under this section to the State in fiscal year 2010 (including payments made to the State under subsection (n) for fiscal year 2010 as well as amounts redistributed to the State in fiscal year 2010), multiplied by the allotment increase factor under paragraph (6) for fiscal year 2011.
Growth factor update for fiscal year 2012
Fiscal year 2013 and each succeeding fiscal year
Rebasing in fiscal year 2013 and each succeeding odd-numbered fiscal year
For fiscal year 2013 and each succeeding odd-numbered fiscal year (other than fiscal years 2015, 2017, 2023, and 2029), the allotment of the State is equal to the Federal payments to the State that are attributable to (and countable toward) the total amount of allotments available under this section to the State in the preceding fiscal year (including payments made to the State under subsection (n) for such preceding fiscal year as well as amounts redistributed to the State in such preceding fiscal year), multiplied by the allotment increase factor under paragraph (6) for such odd-numbered fiscal year.
Growth factor update for fiscal year 2014 and each succeeding even-numbered fiscal year
Special rule for 2016
section 1397ee(b) of this titleFor fiscal year 2016, the allotment of the State is equal to the Federal payments to the State that are attributable to (and countable toward) the total amount of allotments available under this section to the State in the preceding fiscal year (including payments made to the State under subsection (n) for such preceding fiscal year as well as amounts redistributed to the State in such preceding fiscal year), but determined as if the last two sentences of were in effect in such preceding fiscal year and then multiplying the result by the allotment increase factor under paragraph (6) for fiscal year 2016.
Reduction in 2018
For fiscal year 2018, with respect to the allotment of the State for fiscal year 2017, any amounts of such allotment that remain available for expenditure by the State in fiscal year 2018 shall be reduced by one-third.
For fiscal year 2015
First half
Subject to paragraphs (5) and (7), from the amount made available under subparagraph (A) of paragraph (18) of subsection (a) for the semi-annual period described in such paragraph, increased by the amount of the appropriation for such period under section 108 of the Children’s Health Insurance Program Reauthorization Act of 2009, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the first half ratio (described in subparagraph (D)) of the amount described in subparagraph (C).
Second half
Full year amount based on rebased amount
The amount described in this subparagraph for a State is equal to the Federal payments to the State that are attributable to (and countable towards) the total amount of allotments available under this section to the State in fiscal year 2014 (including payments made to the State under subsection (n) for fiscal year 2014 as well as amounts redistributed to the State in fiscal year 2014), multiplied by the allotment increase factor under paragraph (6) for fiscal year 2015.
First half ratio
For fiscal year 2017
First half
Subject to paragraphs (5) and (7), from the amount made available under subparagraph (A) of paragraph (20) of subsection (a) for the semi-annual period described in such paragraph, increased by the amount of the appropriation for such period under section 301(b)(3) of the Medicare Access and CHIP Reauthorization Act of 2015, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the first half ratio (described in subparagraph (D)) of the amount described in subparagraph (C).
Second half
Full year amount based on rebased amount
The amount described in this subparagraph for a State is equal to the Federal payments to the State that are attributable to (and countable towards) the total amount of allotments available under this section to the State in fiscal year 2016 (including payments made to the State under subsection (n) for fiscal year 2016 as well as amounts redistributed to the State in fiscal year 2016), multiplied by the allotment increase factor under paragraph (6) for fiscal year 2017.
First half ratio
Proration rule
If, after the application of this subsection without regard to this paragraph, the sum of the allotments determined under paragraph (1), (2), (3), (4), (10), or (11) for a fiscal year (or, in the case of fiscal year 2015, 2017, 2023, or 2029, for a semi-annual period in such fiscal year) exceeds the amount available under subsection (a) for such fiscal year or period, the Secretary shall reduce each allotment for any State under such paragraph for such fiscal year or period on a proportional basis.
Allotment increase factor
Per capita health care growth factor
1 plus the percentage increase in the projected per capita amount of National Health Expenditures from the calendar year in which the previous fiscal year ends to the calendar year in which the fiscal year involved ends, as most recently published by the Secretary before the beginning of the fiscal year.
Child population growth factor
1 plus the percentage increase (if any) in the population of children in the State from July 1 in the previous fiscal year to July 1 in the fiscal year involved, as determined by the Secretary based on the most recent published estimates of the Bureau of the Census before the beginning of the fiscal year involved, plus 1 percentage point.
Increase in allotment to account for approved program expansions
Adjustment of fiscal year 2010 allotments to account for changes in projected spending for certain previously approved expansion programs
For purposes of recalculating the fiscal year 2010 allotment, in the case of one of the 50 States or the District of Columbia that has an approved State plan amendment effective , to provide child health assistance through the provision of benefits under the State plan under subchapter XIX for children from birth through age 5 whose family income does not exceed 200 percent of the poverty line, the Secretary shall increase the allotment by an amount that would be equal to the Federal share of expenditures that would have been claimed at the enhanced FMAP rate rather than the Federal medical assistance percentage matching rate for such population.
Availability of amounts for semi-annual periods in certain fiscal years
Each semi-annual allotment made under paragraph (3), (4), (10), or (11) for a period in fiscal year 2015, 2017, 2023, or 2029, shall remain available for expenditure under this subchapter for periods after the end of such fiscal year in the same manner as if the allotment had been made available for the entire fiscal year.
For fiscal year 2023
First half
Subject to paragraphs (5) and (7), from the amount made available under subparagraph (A) of paragraph (26) of subsection (a) for the semi-annual period described in such subparagraph, increased by the amount of the appropriation for such period under section 3002(b)(2) of the HEALTHY KIDS Act, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the first half ratio (described in subparagraph (D)) of the amount described in subparagraph (C).
Second half.—
Full year amount based on rebased amount.—
The amount described in this subparagraph for a State is equal to the Federal payments to the State that are attributable to (and countable towards) the total amount of allotments available under this section to the State in fiscal year 2022 (including payments made to the State under subsection (n) for fiscal year 2022 as well as amounts redistributed to the State in fiscal year 2022), multiplied by the allotment increase factor under paragraph (6) for fiscal year 2023.
First half ratio.—
For fiscal year 2029
First half
Subject to paragraphs (5) and (7), from the amount made available under subparagraph (A) of paragraph (28) of subsection (a) for the semi-annual period described in such subparagraph, increased by the amount of the appropriation for such period under section 50101(b)(2) of the Advancing Chronic Care, Extenders, and Social Services Act, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for such semi-annual period in an amount equal to the first half ratio (described in subparagraph (D)) of the amount described in subparagraph (C).
Second half
Full year amount based on rebased amount
The amount described in this subparagraph for a State is equal to the Federal payments to the State that are attributable to (and countable towards) the total amount of allotments available under this section to the State in fiscal year 2028 (including payments made to the State under subsection (n) for fiscal year 2028 as well as amounts redistributed to the State in fiscal year 2028), multiplied by the allotment increase factor under paragraph (6) for fiscal year 2029.
First half ratio
Adjusting allotments to account for increased Federal payments for coverage and administration of COVID–19 vaccines
Child Enrollment Contingency Fund
Establishment
There is hereby established in the Treasury of the United States a fund which shall be known as the “Child Enrollment Contingency Fund” (in this subsection referred to as the “Fund”). Amounts in the Fund shall be available without further appropriations for payments under this subsection.
Deposits into Fund
Initial and subsequent appropriations
Aggregate cap
The total amount available for payment from the Fund for each of fiscal years 2010 through 2014, 2016, 2018 through 2022, and 2024 through 2028 (and for each of the semi-annual allotment periods for fiscal years 2015, 2017, 2023, and 2029), taking into account deposits made under subparagraph (C), shall not exceed 20 percent of the amount made available under subsection (a) for the fiscal year or period.
Investment of Fund
The Secretary of the Treasury shall invest, in interest bearing securities of the United States, such currently available portions of the Fund as are not immediately required for payments from the Fund. The income derived from these investments constitutes a part of the Fund.
Availability of excess funds for performance bonuses
section 1397ee(a)(3) of this titleAny amounts in excess of the aggregate cap described in subparagraph (B) for a fiscal year or period shall be made available for purposes of carrying out for any succeeding fiscal year and the Secretary of the Treasury shall reduce the amount in the Fund by the amount so made available.
Child Enrollment Contingency Fund payments
In general
Target average number of child enrollees
Projected per capita expenditures
Proration rule
If the amounts available for payment from the Fund for a fiscal year or period are less than the total amount of payments determined under subparagraph (A) for the fiscal year or period, the amount to be paid under such subparagraph to each eligible State shall be reduced proportionally.
Timely payment; reconciliation
section 1397ee of this titlePayment under this paragraph for a fiscal year or period shall be made before the end of the fiscal year or period based upon the most recent data for expenditures and enrollment and the provisions of subsection (e) of shall apply to payments under this subsection in the same manner as they apply to payments under such section.
Continued reporting
For purposes of this paragraph and subsection (f), the State shall submit to the Secretary the State’s projected Federal expenditures, even if the amount of such expenditures exceeds the total amount of allotments available to the State in such fiscal year or period.
Application to commonwealths and territories
No payment shall be made under this paragraph to a commonwealth or territory described in subsection (c)(3) until such time as the Secretary determines that there are in effect methods, satisfactory to the Secretary, for the collection and reporting of reliable data regarding the enrollment of children described in subparagraphs (A) and (B) in order to accurately determine the commonwealth’s or territory’s eligibility for, and amount of payment, under this paragraph.
Aug. 14, 1935, ch. 531Pub. L. 105–33, title IV, § 4901(a)111 Stat. 558Pub. L. 105–100, title I, § 162(6)111 Stat. 2189Pub. L. 105–277, div. A, § 101(f) [title VII, § 706]112 Stat. 2681–337Pub. L. 106–113, div. B, § 1000(a)(6) [title VII, §§ 701(a), 702, 705(a)]113 Stat. 1536Pub. L. 106–554, § 1(a)(6) [title VIII, §§ 801(a), 802(b), (d)(3)]114 Stat. 2763Pub. L. 108–74, § 1(a)(1)117 Stat. 892Pub. L. 108–173, title IX, § 900(e)(1)(M)117 Stat. 2372Pub. L. 109–171, title VI, § 6101(a)120 Stat. 130Pub. L. 109–482, title II, § 201(a)120 Stat. 3698Pub. L. 110–28, title VII, § 7001121 Stat. 186Pub. L. 110–92, § 136(c)121 Stat. 994Pub. L. 110–173, title II, § 201(a)(1)121 Stat. 2509Pub. L. 111–3, title I123 Stat. 11Pub. L. 111–148, title II, § 2102(a)(1)124 Stat. 288Pub. L. 114–10, title III, § 301(a)129 Stat. 154–158Pub. L. 115–90, div. B, § 201131 Stat. 1280Pub. L. 115–96, div. C, title II, § 3201(a)131 Stat. 2050Pub. L. 115–120, div. C, § 3002(a)(1)132 Stat. 31–34Pub. L. 115–123, div. E, title I, § 50101(a)132 Stat. 172Pub. L. 117–2, title IX, § 9821(c)135 Stat. 220Pub. L. 117–328, div. FF, title V, § 5111(a)136 Stat. 5938(, title XXI, § 2104, as added , , ; amended , (8), , , 2190; , , , 2681–389; , , , 1501A–399, 1501A–400, 1501A–402; , , , 2763A–578, 2763A–581; –(3), , , 893; , , ; , (b), , , 131; , , ; , , ; , , ; , (c)(1), , , 2510; , §§ 101–103, 105, 106(a)(1), (b), , , 15, 23, 24; , title X, § 10203(d)(1)–(2)(B), , , 928–930; –(b)(2)(C), (d)(1), , ; , , ; –(b)(2), (c)(1), , , 2051; , (b)(1), (c), (d)(2), , ; , (b)(1), (c), , , 174; , , ; , (b)(1), (c)(5), , , 5939.)
Editorial Notes
References in Text
Pub. L. 114–10, title III, § 301(b)(1)(F)129 Stat. 156Paragraphs (4) and (6), referred to in introductory provisions of subsec. (m)(2)(A), were redesignated (5) and (7), respectively, by , , .
section 108 of title I of Pub. L. 111–3123 Stat. 25Section 108 of the Children’s Health Insurance Program Reauthorization Act of 2009, referred to in subsec. (m)(3)(A), (D)(i)(II), is , , , which is not classified to the Code.
section 301(b)(3) of Pub. L. 114–10129 Stat. 157Section 301(b)(3) of the Medicare Access and CHIP Reauthorization Act of 2015, referred to in subsec. (m)(4)(A), (D)(i)(II), is , title III, , , which relates to a one-time appropriation for fiscal year 2017 and is not classified to the Code.
section 3002(b)(2) of Pub. L. 115–120132 Stat. 33Section 3002(b)(2) of the HEALTHY KIDS Act, referred to in subsec. (m)(10)(A), (D)(i)(II), is , div. C, , , which relates to a one-time appropriation for fiscal year 2023 and is not classified to the Code.
Pub. L. 115–123, div. E, title I132 Stat. 173Section 50101(b)(2) of the Advancing Chronic Care, Extenders, and Social Services Act, referred to in subsec. (m)(11)(A), (D)(i)(II), probably means section 50101(b)(2) of the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act, , , , which relates to a one-time appropriation for fiscal year 2027 and is not classified to the Code.
Amendments
Pub. L. 117–328, § 5111(a)(1)2022—Subsec. (a)(27). , substituted “through 2028” for “through 2026”.
Pub. L. 117–328, § 5111(a)(2)(A)Subsec. (a)(28). , substituted “for fiscal year 2029” for “for fiscal year 2027” in introductory provisions.
Pub. L. 117–328, § 5111(a)(2)(B)Subsec. (a)(28)(A). , substituted “beginning on , and ending on ” for “beginning on , and ending on ”.
Pub. L. 117–328, § 5111(a)(2)(C)Subsec. (a)(28)(B). , substituted “beginning on , and ending on ” for “beginning on , and ending on ”.
Pub. L. 117–328, § 5111(b)(1)(A)Subsec. (m)(2)(B)(i). , substituted “2023, and 2029” for “, 2023, and 2027”.
Pub. L. 117–328, § 5111(b)(1)(B)Subsec. (m)(5). , substituted “or 2029” for “or 2027”.
Pub. L. 117–328, § 5111(b)(1)(C)(ii)Subsec. (m)(7). , substituted “fiscal year 2026, or fiscal year 2028.” for “or fiscal year 2026.” in concluding provisions.
Pub. L. 117–328, § 5111(b)(1)(C)(i)Subsec. (m)(7)(A). , substituted “fiscal year 2029” for “fiscal year 2027,”.
Pub. L. 117–328, § 5111(b)(1)(D)Subsec. (m)(9). , substituted “or 2029” for “or 2027”.
Pub. L. 117–328, § 5111(b)(1)(E)(i)Subsec. (m)(11). , substituted “fiscal year 2029” for “fiscal year 2027” in heading.
Pub. L. 117–328, § 5111(b)(1)(E)(ii)Subsec. (m)(11)(C). , substituted “fiscal year 2028” for “fiscal year 2026” wherever appearing and “fiscal year 2029” for “fiscal year 2027”.
Pub. L. 117–328, § 5111(c)(5)Subsec. (n)(2)(A)(ii). , substituted “2024 through 2028” for “2024 through 2026” and “2023, and 2029” for “2023, and 2027”.
Pub. L. 117–328, § 5111(c)(5)Subsec. (n)(2)(B). , substituted “2024 through 2028” for “2024 through 2026” and “2023, and 2029” for “2023, and 2027”.
Pub. L. 117–328, § 5111(c)(5)(A)Subsec. (n)(3)(A). , substituted “2024 through 2028” for “2024 through 2026” in introductory provisions.
Pub. L. 117–2, § 9821(c)(1)2021—Subsec. (m)(2)(B). , substituted “paragraphs (5), (7), and (12)” for “paragraphs (5) and (7)” in introductory provisions.
Pub. L. 117–2, § 9821(c)(2)Subsec. (m)(12). , added par. (12).
Pub. L. 115–120, § 3002(a)(1)2018—Subsec. (a)(21) to (26). , added pars. (21) to (26) and struck out former par. (21) which related to semi-annual allotment for fiscal year 2018 ending on .
Pub. L. 115–123, § 50101(a)Subsec. (a)(27), (28). , added pars. (27) and (28).
Pub. L. 115–120, § 3002(d)(2)(A)Subsec. (f)(2)(B)(ii)(I). , substituted “(as defined in subclause (II)) for the month” for “for the month (as defined in subclause (II))”.
Pub. L. 115–120, § 3002(d)(2)(B)section 1397ee(g)(4)(A) of this titleSubsec. (f)(2)(B)(ii)(II). , inserted “, as in effect on the day before ,” after “”.
Pub. L. 115–120, § 3002(d)(2)(C)section 1397ee(g)(4) of this titlesection 1397ee(g)(4) of this titleSubsec. (f)(2)(B)(ii)(VI). , inserted “, as in effect on the day before ,” after “, ” and “, as so in effect” after “under ”.
Pub. L. 115–123, § 50101(b)(1)(A)(i)Subsec. (m)(2)(B). , substituted “(27)” for “(25)” in introductory provisions.
Pub. L. 115–120, § 3002(b)(1)(A)(i), substituted “(25)” for “(19)” in introductory provisions.
Pub. L. 115–123, § 50101(b)(1)(A)(ii)Subsec. (m)(2)(B)(i). , substituted “, 2023, and 2027” for “and 2023”.
Pub. L. 115–120, § 3002(b)(1)(A)(ii), substituted “, 2017, and 2023” for “and 2017”.
Pub. L. 115–120, § 3002(b)(1)(A)(iii)(I)Subsec. (m)(2)(B)(ii). , struck out “and paragraph (10)” after “clauses (iii) and (iv)” in introductory provisions.
Pub. L. 115–123, § 50101(b)(1)(A)(iii)Subsec. (m)(2)(B)(ii)(I). , substituted “(or, in the case of fiscal year 2018 or 2024, under paragraph (4) or (10), respectively)” for “(or, in the case of fiscal year 2018, under paragraph (4))”.
Pub. L. 115–120, § 3002(b)(1)(A)(iii)(II), inserted “(or, in the case of fiscal year 2018, under paragraph (4))” after “clause (i)”.
Pub. L. 115–123, § 50101(b)(1)(B)Subsec. (m)(5). , substituted “(10), or (11)” for “or (10)” and “2023, or 2027,” for “or 2023,”.
Pub. L. 115–120, § 3002(b)(1)(B), substituted “2023” for “2018”.
Pub. L. 115–123, § 50101(b)(1)(C)(ii)Subsec. (m)(7). , substituted “fiscal year 2022, fiscal year 2024, or fiscal year 2026” for “or fiscal year 2022” in concluding provisions.
Pub. L. 115–120, § 3002(b)(1)(C)(iii), substituted “fiscal year 2016, fiscal year 2018, fiscal year 2020, or fiscal year 2022” for “or fiscal year 2016” in concluding provisions.
Pub. L. 115–123, § 50101(b)(1)(C)(i)Subsec. (m)(7)(A). , substituted “2027,” for “2023”.
Pub. L. 115–120, § 3002(b)(1)(C)(i), substituted “2023” for “2017”.
Pub. L. 115–120, § 3002(b)(1)(C)(ii)Subsec. (m)(7)(B). , inserted “(or, in the case of fiscal year 2018, by not later than the date that is 60 days after )” after “before the August 31 preceding the beginning of the fiscal year” in introductory provisions.
Pub. L. 115–123, § 50101(b)(1)(D)(ii)Subsec. (m)(9). , which directed amendment of par. (9) by substituting “2023, or 2027,” for “or 2023,”, was executed by making the substitution for “or 2023” to reflect the probable intent of Congress.
Pub. L. 115–123, § 50101(b)(1)(D)(i), substituted “(10), or (11)” for “or (10)”.
Pub. L. 115–120, § 3002(b)(1)(D), substituted “2023” for “2018”.
Pub. L. 115–120, § 3002(b)(1)(E)Subsec. (m)(10). , amended par. (10) generally. Prior to amendment, par. (10) related to State allotments for fiscal year 2018.
Pub. L. 115–123, § 50101(b)(1)(E)Subsec. (m)(11). , added par. (11).
Pub. L. 115–123, § 50101(c)(1)(A)Subsec. (n)(2)(A)(ii). , substituted “2018 through 2022, and 2024 through 2026” for “and 2018 through 2022” and “2023, and 2027” for “and 2023”.
Pub. L. 115–120, § 3002(c)(1)(A), substituted “2010 through 2014, 2016, and 2018 through 2022” for “2010, 2011, 2012, 2013, 2014, and 2016” and “fiscal years 2015, 2017, and 2023” for “fiscal year 2015 and fiscal year 2017”.
Pub. L. 115–123, § 50101(c)(1)(B)Subsec. (n)(2)(B). , substituted “2018 through 2022, and 2024 through 2026” for “and 2018 through 2022” and “2023, and 2027” for “and 2023”.
Pub. L. 115–120, § 3002(c)(1)(B), substituted “2010 through 2014, 2016, and 2018 through 2022” for “2010, 2011, 2012, 2013, 2014, and 2016” and “fiscal years 2015, 2017, and 2023” for “fiscal year 2015 and fiscal year 2017”.
Pub. L. 115–123, § 50101(c)(2)Subsec. (n)(3)(A). , substituted “fiscal years 2018 through 2022, or fiscal years 2024 through 2026” for “or in any of fiscal years 2018 through 2022” and “2023, or 2027” for “or 2023” in introductory provisions.
Pub. L. 115–120, § 3002(c)(2), substituted “or in any of fiscal years 2018 through 2022 (or a semi-annual allotment period for fiscal year 2015, 2017, or 2023)” for “or a semi-annual allotment period for fiscal year 2015 or 2017” in introductory provisions.
Pub. L. 115–96, § 3201(a)2017—Subsec. (a)(21). , added par. (21).
Pub. L. 115–90, § 201(1)Subsec. (f)(2)(B). , amended subpar. (B) generally. Prior to amendment, text read as follows: “If the amounts available for redistribution under paragraph (1) for a fiscal year are less than the total amounts of the estimated shortfalls determined for the year under subparagraph (A), the amount to be redistributed under such paragraph for each shortfall State shall be reduced proportionally.”
Pub. L. 115–96, § 3201(c)(1)(A)Subsec. (f)(2)(B)(ii). , substituted “first half” for “first quarter” in heading.
Pub. L. 115–96, § 3201(c)(1)(B)Subsec. (f)(2)(B)(ii)(I) to (VI). , (C), added subcls. (I) to (V), redesignated former subcl. (III) as (VI), and struck out former subcls. (I) and (II) which related to amounts available for redistribution under paragraph (1) and definition of emergency shortfall State, respectively.
Pub. L. 115–90, § 201(2)Subsec. (f)(2)(D). , added subpar. (D).
Pub. L. 115–96, § 3201(b)(2)(B)Pub. L. 114–10Subsec. (m)(2). , substituted “the allotment increase factor under paragraph (6)” for “the allotment increase factor under paragraph (5)” wherever appearing. Amendment by , §301(b)(2)(B)(ii), which made identical substitution but did not specify where it should occur, had already been executed by making the substitution wherever appearing to reflect the probable intent of Congress. See 2015 Amendment note below.
Pub. L. 115–96, § 3201(b)(2)(A), substituted “beginning with fiscal year 2010” for “2010 through 2016” in heading.
Pub. L. 115–96, § 3201(b)(1)(A)Subsec. (m)(2)(B)(ii). , inserted “and paragraph (10)” after “clauses (iii) and (iv)” in introductory provisions.
Pub. L. 115–96, § 3201(b)(1)(B)Subsec. (m)(5). , substituted “(4), or (10)” for “or (4)” and “, 2017, or 2018” for “or 2017”.
Pub. L. 115–96, § 3201(b)(1)(C)Subsec. (m)(9). , substituted, in heading, “certain fiscal years” for “fiscal years 2015 and 2017” and, in text, “, (4), or (10)” for “or (4)” and “, 2017, or 2018” for “or fiscal year 2017”.
Pub. L. 115–96, § 3201(b)(1)(D)Subsec. (m)(10). , added par. (10).
Pub. L. 114–10, § 301(a)2015—Subsec. (a)(19), (20). , added pars. (19) and (20).
Pub. L. 114–10, § 301(b)(2)(A)Subsec. (c)(1). , substituted “(m)(5)” for “(m)(4)”.
Pub. L. 114–10, § 301(b)(1)(A)Subsec. (m). , substituted “and thereafter” for “through 2015” in heading.
Pub. L. 114–10, § 301(b)(2)(B)(i)(II)Subsec. (m)(1). , substituted “the allotment increase factor determined under paragraph (6)” for “the allotment increase factor determined under paragraph (5)” wherever appearing.
Pub. L. 114–10, § 301(b)(2)(B)(i)(I)Subsec. (m)(1)(A), (B). , substituted “and paragraph (5)” for “and paragraph (4)”.
Pub. L. 114–10, § 301(b)(1)(B)(i)Subsec. (m)(2). , substituted “2016” for “2014” in heading.
Pub. L. 114–10, § 301(b)(2)(B)(ii)Subsec. (m)(2)(A). , which directed substitution in subpar. (A) of “the allotment increase factor under paragraph (6)” for “the allotment increase factor under paragraph (5)”, was executed by making the substitution wherever appearing in subpar. (A), to reflect the probable intent of Congress.
Pub. L. 114–10, § 301(b)(1)(B)(ii)Subsec. (m)(2)(B). , added subpar. (B) and struck out former subpar. (B) which related to State allotments for fiscal years 2013 and 2014.
Pub. L. 114–10, § 301(b)(2)(B)(iii)Subsec. (m)(3). , substituted “paragraphs (5) and (7)” for “paragraphs (4) and (6)” in subpars. (A) and (B) and “the allotment increase factor under paragraph (6)” for “the allotment increase factor under paragraph (5)” in subpar. (C).
Pub. L. 114–10, § 301(b)(1)(G)Subsec. (m)(4). , added par. (4). Former par. (4) redesignated (5).
Pub. L. 114–10, § 301(b)(1)(C), inserted “or 2017” after “2015”.
Pub. L. 114–10, § 301(b)(2)(B)(iv)Subsec. (m)(5). , substituted “paragraph (1), (2), (3), or (4)” for “paragraph (1), (2), or (3)”.
Pub. L. 114–10, § 301(b)(1)(F), redesignated par. (4) as (5). Former par. (5) redesignated (6).
Pub. L. 114–10, § 301(b)(1)(F)Subsec. (m)(6). , redesignated par. (5) as (6). Former par. (6) redesignated (7).
Pub. L. 114–10, § 301(b)(1)(D)(ii), substituted “fiscal year 2014, or fiscal year 2016” for “or fiscal year 2014” in concluding provisions.
Pub. L. 114–10, § 301(b)(1)(D)(i)Subsec. (m)(6)(A). , substituted “2017” for “2015”.
Pub. L. 114–10, § 301(b)(2)(B)(v)Subsec. (m)(7). , substituted “subject to paragraph (5)” for “subject to paragraph (4)” in concluding provisions.
Pub. L. 114–10, § 301(b)(1)(F), redesignated par. (6) as (7). Former par. (7) redesignated (8).
Pub. L. 114–10, § 301(b)(1)(F)Subsec. (m)(8). , redesignated par. (7) as (8). Former par. (8) redesignated (9).
Pub. L. 114–10, § 301(b)(1)(E), substituted “fiscal years 2015 and 2017” for “fiscal year 2015” in heading and inserted “or fiscal year 2017” after “2015” in text.
Pub. L. 114–10, § 301(b)(2)(B)(vi)Subsec. (m)(9). , substituted “paragraph (3) or (4)” for “paragraph (3)”.
Pub. L. 114–10, § 301(b)(1)(F), redesignated par. (8) as (9).
Pub. L. 114–10, § 301(d)(1)(A)(i)Subsec. (n)(2)(A)(ii). , substituted “2010, 2011, 2012, 2013, 2014, and 2016” for “2010 through 2014” and inserted “and fiscal year 2017” after “2015”.
Pub. L. 114–10, § 301(d)(1)(A)(ii)Subsec. (n)(2)(B). , substituted “2010, 2011, 2012, 2013, 2014, and 2016” for “2010 through 2014” and inserted “and fiscal year 2017” after “2015”.
Pub. L. 114–10, § 301(d)(1)(B)Subsec. (n)(3)(A). , substituted “any of fiscal years 2009 through 2014, fiscal year 2016, or a semi-annual allotment period for fiscal year 2015 or 2017” for “fiscal year 2009, fiscal year 2010, fiscal year 2011, fiscal year 2012, fiscal year 2013, fiscal year 2014, or a semi-annual allotment period for fiscal year 2015” in introductory provisions.
Pub. L. 114–10, § 301(b)(2)(C)Subsec. (n)(3)(B)(ii). , substituted “subsection (m)(6)(B)” for “subsection (m)(5)(B)”.
Pub. L. 111–148, § 10203(d)(1)2010—Subsec. (a)(16) to (18). , added pars. (16) to (18) and struck out former par. (16) which read as follows: “for fiscal year 2013, for purposes of making 2 semi-annual allotments—
“(A) $2,850,000,000 for the period beginning on , and ending on , and
“(B) $2,850,000,000 for the period beginning on , and ending on .”
Pub. L. 111–148, § 10203(d)(2)(A)(i)Subsec. (m). , substituted “2015” for “2013” in heading.
Pub. L. 111–148, § 10203(d)(2)(A)(ii)Subsec. (m)(2). , substituted “2014” for “2012” in heading and added subpar. (B).
Pub. L. 111–148, § 10203(d)(2)(A)(iii)(I)Subsec. (m)(3). , substituted “2015” for “2013” in heading.
Pub. L. 111–148, § 10203(d)(2)(A)(iii)(II)Subsec. (m)(3)(A), (B). , substituted “paragraph (18)” for “paragraph (16)”.
Pub. L. 111–148, § 10203(d)(2)(A)(iii)(III)Subsec. (m)(3)(C). , substituted “2014” for “2012” wherever appearing and “2015” for “2013”.
Pub. L. 111–148, § 10203(d)(2)(A)(iii)(IV)(aa)Subsec. (m)(3)(D)(i)(I). , substituted “subsection (a)(18)(A)” for “subsection (a)(16)(A)”.
Pub. L. 111–148, § 10203(d)(2)(A)(iii)(IV)(bb)Subsec. (m)(3)(D)(ii)(II). , substituted “subsection (a)(18)(B)” for “subsection (a)(16)(B)”.
Pub. L. 111–148, § 10203(d)(2)(A)(iv)Subsec. (m)(4). , substituted “2015” for “2013”.
Pub. L. 111–148, § 10203(d)(2)(A)(v)(II)Subsec. (m)(6). , substituted “, fiscal year 2012, or fiscal year 2014” for “or fiscal year 2012” in concluding provisions.
Pub. L. 111–148, § 10203(d)(2)(A)(v)(I)Subsec. (m)(6)(A). , substituted “2015” for “2013”.
Pub. L. 111–148, § 2102(a)(1)(B)Subsec. (m)(7). , added par. (7). Former par. (7) redesignated (8).
Pub. L. 111–148, § 10203(d)(2)(A)(vi)Subsec. (m)(8). , substituted “2015” for “2013” in heading and text.
Pub. L. 111–148, § 2102(a)(1)(A), redesignated par. (7) as (8).
Pub. L. 111–148, § 10203(d)(2)(B)(i)Subsec. (n)(2)(A)(ii), (B). , substituted “2014” for “2012” and “2015” for “2013”.
Pub. L. 111–148, § 10203(d)(2)(B)(ii)Subsec. (n)(3)(A). , substituted “fiscal year 2013, fiscal year 2014, or a semi-annual allotment period for fiscal year 2015” for “or a semi-annual allotment period for fiscal year 2013”.
Pub. L. 111–3, § 101(2)2009—Subsec. (a)(11). , substituted “fiscal year 2008” for “each of fiscal years 2008 and 2009”.
Pub. L. 111–3, § 101(1)Subsec. (a)(12) to (16). , (3), added pars. (12) to (16).
Pub. L. 111–3, § 102(1)Subsec. (b)(1). , substituted “subsections (d) and (m)” for “subsection (d)” in introductory provisions.
Pub. L. 111–3, § 102(2)Subsec. (c)(1). , substituted “subsections (d) and (m)(4)” for “subsection (d)”.
Pub. L. 111–3, § 105Subsec. (e). , amended subsec. (e) generally. Prior to amendment, text read as follows: “Amounts allotted to a State pursuant to this section for a fiscal year shall remain available for expenditure by the State through the end of the second succeeding fiscal year; except that amounts reallotted to a State under subsection (f) of this section shall be available for expenditure by the State through the end of the fiscal year in which they are reallotted.”
Pub. L. 111–3, § 106(a)(1)Subsec. (f). , designated existing provisions as par. (1), inserted heading, substituted “States that the Secretary determines with respect to the fiscal year for which unused allotments are available for redistribution under this subsection, are shortfall States described in paragraph (2) for such fiscal year, but not to exceed the amount of the shortfall described in paragraph (2)(A) for each such State (as may be adjusted under paragraph (2)(C)).” for “States that have fully expended the amount of their allotments under this section.”, and added par. (2).
Pub. L. 111–3, § 106(b)(1)Subsec. (k). , struck out “the first 2 quarters of” before “fiscal year 2009” in heading.
Pub. L. 111–3, § 106(b)(2)Subsec. (k)(1). , struck out “the first 2 quarters of” before “fiscal year 2009,”.
Pub. L. 111–3, § 106(b)(3)Subsec. (k)(6). , struck out “the first 2 quarters of” before “fiscal year 2009” and substituted “September 30” for “March 31”.
Pub. L. 111–3Subsecs. (m), (n). , §§ 102(3), 103, added subsecs. (m) and (n).
Pub. L. 110–173, § 201(a)(1)(A)2007—Subsec. (a)(11). , added par. (11).
Pub. L. 110–173, § 201(a)(1)(B)Subsec. (c)(4)(B). , substituted “for each of fiscal years 2007 through 2009” for “for fiscal year 2007”.
Pub. L. 109–482Subsec. (h). added subsec. (h).
Pub. L. 110–28, § 7001(b)(1)Subsec. (h)(1)(B). , struck out “subject to paragraph (4)(B) and” after “estimates,” in introductory provisions.
Pub. L. 110–28, § 7001(a)(1)Subsec. (h)(2). , (b)(2), substituted “part” for “remainder of reduction” in heading and struck out “subject to paragraph (4)(B) and” after “estimates,” in introductory provisions of subpar. (B).
Pub. L. 110–28, § 7001(a)(2)Subsec. (h)(4). , added par. (4) and struck out former par. (4). Former text read as follows:
Expenditures limited to coverage for populations eligible on “(A) .—A State shall use amounts redistributed under this subsection only for expenditures for providing child health assistance or other health benefits coverage for populations eligible for such assistance or benefits under the State child health plan (including under a waiver of such plan) on .
Regular fmap for expenditures for coverage of nonchild populationssection 1396d(b) of this titlesection 1397ee of this title“(B) .—To the extent a State uses amounts redistributed under this subsection for expenditures for providing child health assistance or other health benefits coverage to an individual who is not a child or a pregnant woman, the Federal medical assistance percentage (as defined in the first sentence of ) applicable to the State for the fiscal year shall apply to such expenditures for purposes of making payments to the State under subsection (a) of from such amounts.”
Pub. L. 110–28, § 7001(b)(3)Subsec. (h)(5)(A). , substituted “(3), and (4)” for “and (3)”.
Pub. L. 110–28, § 7001(b)(4)Subsec. (h)(6). , inserted “or allotted” after “redistributed” and “or allotments” after “redistributions” in first sentence and substituted “(3), and (4)” for “and (3)” in second sentence.
Pub. L. 110–92Subsec. (i). added subsec. (i).
lPub. L. 110–173, § 201(c)(1)lSubsecs. (j) to (). , added subsecs. (j) to ().
Pub. L. 109–171, § 6101(b)(1)2006—Subsec. (a). , inserted “subject to subsection (d),” after “under this section,” in introductory provisions.
Pub. L. 109–171, § 6101(b)(2)Subsec. (b)(1). , inserted “and subsection (d)” after “Subject to paragraph (4)” in introductory provisions.
Pub. L. 109–171, § 6101(b)(3)Subsec. (c)(1). , inserted “subject to subsection (d),” after “for a fiscal year,”.
Pub. L. 109–171, § 6101(a)Subsec. (d). , added subsec. (d).
Pub. L. 108–74, § 1(a)(2)(C)(i)2003—Subsec. (g). , (3)(C)(i), substituted “, 1999, 2000, and 2001” for “and 1999” in heading.
Pub. L. 108–74, § 1(a)(3)(B)(i)Subsec. (g)(1)(A). , (ii), inserted “or for fiscal year 2001 by the end of fiscal year 2003,” after “fiscal year 2002,” and substituted “1999, 2000, or 2001” for “1999, or 2000”.
Pub. L. 108–74, § 1(a)(2)(B)(i), (ii), inserted “or for fiscal year 2000 by the end of fiscal year 2002,” after “fiscal year 2001,” and substituted “1998, 1999, or 2000” for “1998 or 1999”.
Pub. L. 108–74, § 1(a)(2)(B)(iii)Subsec. (g)(1)(A)(i)(III). , added subclause (III).
Pub. L. 108–74, § 1(a)(3)(B)(iii)Subsec. (g)(1)(A)(i)(IV). , added subcl. (IV).
Pub. L. 108–74, § 1(a)(3)(B)(iv)Subsec. (g)(1)(A)(ii). , substituted “2000, or 2001” for “or 2000”.
Pub. L. 108–74, § 1(a)(2)(B)(iv), substituted “, 1999, or 2000” for “or 1999”.
Pub. L. 108–74, § 1(a)(2)(B)(v)Subsec. (g)(1)(B). , struck out “with respect to fiscal year 1998 or 1999” after “paragraph” in introductory provisions.
Pub. L. 108–74, § 1(a)(2)(B)(vi)Subsec. (g)(1)(B)(ii). , inserted “with respect to fiscal year 1998, 1999, or 2000” after “subsection (e),” and substituted “2004” for “2002”.
Pub. L. 108–74, § 1(a)(3)(B)(v)Subsec. (g)(1)(B)(iii), (iv). , added clause (iii) and redesignated former cl. (iii) as (iv).
Pub. L. 108–74, § 1(a)(2)(B)(vii)Subsec. (g)(1)(C). , added subpar. (C).
Pub. L. 108–74, § 1(a)(3)(B)(vi)Subsec. (g)(1)(D). , added subpar. (D).
Pub. L. 108–74, § 1(a)(2)(A)(i)Subsec. (g)(2). , (3)(A)(i), substituted “through 2001” for “and 1999” in heading.
Pub. L. 108–74, § 1(a)(1)Subsec. (g)(2)(A)(i), (ii). , substituted “fiscal year 2004” for “fiscal year 2002”.
Pub. L. 108–74, § 1(a)(2)(A)(ii)Subsec. (g)(2)(A)(iii). , added cl. (iii).
Pub. L. 108–74, § 1(a)(3)(A)(ii)Subsec. (g)(2)(A)(iv). , added cl. (iv).
Pub. L. 108–173Subsec. (g)(3). inserted “or CMS Form 64 or CMS Form 21, as the case may be,” after “HCFA Form 64 or HCFA Form 21”.
Pub. L. 108–74, § 1(a)(3)(C)(ii), substituted “fiscal year 2000, or fiscal year 2001” for “or fiscal year 2000” and “, or ,” for “or ,”.
Pub. L. 108–74, § 1(a)(2)(C)(ii), substituted “, fiscal year 1999, or fiscal year 2000” for “or fiscal year 1999” and “, or ” for “or ”.
Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(d)(3)(A)]2000—Subsec. (b)(1). , in introductory provisions, struck out “and subsection (d) of this section” after “Subject to paragraph (4)”.
Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(d)(3)(B)]Subsec. (c)(1). , struck out “subject to subsection (d) of this section,” after “for a fiscal year,”.
Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(b)]Subsec. (d). , struck out heading and text of subsec. (d). Text read as follows: “The amount of the allotment otherwise provided to a State under subsection (b) or (c) of this section for a fiscal year shall be reduced by the sum of—
section 1396b(a) of this titlesection 1396r–1a of this title“(1) the amount (if any) of the payments made to that State under for expenditures claimed by the State during such fiscal year that is attributable to the provision of medical assistance to a child during a presumptive eligibility period under , and
section 1396b(a) of this titlesection 1396b(a)(1) of this titlesection 1396d(b) of this title“(2) the amount (if any) of the payments made to that State under for expenditures claimed by the State during such fiscal year that is attributable to the provision of medical assistance to a child for which payment is made under on the basis of an enhanced FMAP under the fourth sentence of .”
Pub. L. 106–554, § 1(a)(6) [title VIII, § 801(a)]Subsec. (g). , added subsec. (g).
Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(1)(A)]1999—Subsec. (b)(2)(A)(i). , substituted “and 1999” for “through 2000”.
Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(1)(B)]Subsec. (b)(2)(A)(ii). , substituted “2000” for “2001” in introductory provisions.
Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(3)]Subsec. (b)(2)(B). , substituted “the calendar year in which such fiscal year begins” for “the fiscal year”.
Pub. L. 106–113, § 1000(a)(6) [title VII, § 705(a)]Subsec. (b)(3)(B). , substituted “all the States,” for “all the States.”
Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(4)], substituted “the calendar year in which such fiscal year begins” for “the fiscal year involved”.
Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(2)]Subsec. (b)(4). , amended heading and text of par. (4) generally. Prior to amendment, text read as follows: “In no case shall the amount of the allotment under this subsection for one of the 50 States or the District of Columbia for a year be less than $2,000,000. To the extent that the application of the previous sentence results in an increase in the allotment to a State above the amount otherwise provided, the allotments for the other States and the District of Columbia under this subsection shall be reduced in a pro rata manner (but not below $2,000,000) so that the total of such allotments in a fiscal year does not exceed the amount otherwise provided for allotment under paragraph (1) for that fiscal year.”
Pub. L. 106–113, § 1000(a)(6) [title VII, § 702]Subsec. (c)(4)(B). , inserted before period at end “, $34,200,000 for each of fiscal years 2000 and 2001, $25,200,000 for each of fiscal years 2002 through 2004, $32,400,000 for each of fiscal years 2005 and 2006, and $40,000,000 for fiscal year 2007”.
Pub. L. 105–277, § 101(f) [title VII, § 706(b)]1998—Subsec. (b)(1). , inserted “(determined without regard to paragraph (4) thereof)” after “subsection (c)”.
Pub. L. 105–277, § 101(f) [title VII, § 706(a)]Subsec. (c)(4). , added par. (4).
Pub. L. 105–100, § 162(8)(A)1997—Subsec. (a)(1). , substituted “$4,295,000,000” for “$4,275,000,000”.
Pub. L. 105–100, § 162(8)(B)Subsec. (b)(4). , substituted “In” for “Subject to paragraph (5), in”.
Pub. L. 105–100, § 162(8)(C)Subsec. (c)(2)(C). , inserted “the” before “Virgin Islands”.
Pub. L. 105–100, § 162(8)(C)Subsec. (c)(3)(C), (E). , substituted “The” for “the”.
Pub. L. 105–100, § 162(6)(A)Subsec. (d)(1). , substituted “for expenditures claimed by the State” for “for calendar quarters”.
Pub. L. 105–100, § 162(6)(B)section 1396b(a)(1) of this titlesection 1396d(b) of this titleSubsec. (d)(2). , added par. (2) and struck out former par. (2) which read as follows: “the amount of payments under such section during such period that is attributable to the provision of medical assistance to a child for which payment is made under on the basis of an enhanced FMAP under .”
Statutory Notes and Related Subsidiaries
Effective Date of 2010 Amendment
Pub. L. 111–148, title II, § 2102(a)124 Stat. 288section 2102(a)(1) of Pub. L. 111–148Pub. L. 111–3, , , provided that the amendment made by is effective as if included in the enactment of the Children’s Health Insurance Program Reauthorization Act of 2009 ().
Effective Date of 2009 Amendment
Pub. L. 111–3section 3 of Pub. L. 111–3section 1396 of this titleAmendment by sections 101–103, 105, and 106(b) of effective , and applicable to child health assistance and medical assistance provided on or after that date, with certain exceptions, see , set out as an Effective Date note under .
Pub. L. 111–3, title I, § 106(a)(2)123 Stat. 24
Termination Date of 2007 Amendment
Pub. L. 110–92, § 136(e)121 Stat. 995section 1397ee of this titlePub. L. 110–173, title II, § 201(b)(3)121 Stat. 2510, , , which provided that the amendments made by subsecs. (c) and (d) of section 136, amending this section and , were effective through , or, if earlier, the date of the enactment of an Act that provides funding for fiscal year 2008 and for one or more subsequent fiscal years for the Children’s Health Insurance Program under this subchapter, was repealed by , , .
Effective Date of 2006 Amendment
Pub. L. 109–171, title VI, § 6101(c)120 Stat. 131
Effective Date of 2003 Amendment
Pub. L. 108–74, § 1(a)(4)117 Stat. 895
Effective Date of 2000 Amendment
Pub. L. 106–554, § 1(a)(6) [title VIII, § 801(b)]114 Stat. 2763
Pub. L. 106–554section 4901 of Pub. L. 105–33Pub. L. 106–554section 1396d of this titleAmendment by section 802(b), (d)(3) of effective as if included in the enactment of , see section 1(a)(6) [title VIII, § 802(f)] of , set out as a note under .
Effective Date of 1999 Amendment
Pub. L. 106–113, div. B, § 1000(a)(6) [title VII, § 701(b)]113 Stat. 1536
Effective Date of 1997 Amendment
Pub. L. 105–100, title I, § 162111 Stat. 2188Pub. L. 105–33, , , provided that the amendment made by that section is effective as if included in the enactment of subtitle J (§§ 4901–4923) of title IV of the Balanced Budget Act of 1997, .
Construction of 2017 Amendment
Pub. L. 115–96, div. C, title II, § 3201(c)(2)131 Stat. 2052
Application of Regular Expenditure Rules
Pub. L. 115–96, div. C, title II, § 3201(b)(3)131 Stat. 2051
Authority To Transfer Subchapter XXI Appropriations to Subchapter XIX Appropriation Account as Reimbursement for Medicaid Expenditures for Medicaid Expansion SCHIP Services
Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(c)]114 Stat. 2763
Determination of Number of Children and State Cost Factors for Fiscal Years 1998 and 1999
Pub. L. 105–277, div. A, § 101(f) [title VII, § 707]112 Stat. 2681–337