Reducing expansion FMAP for certain States providing payments for health care furnished to certain individuals

Section 1905 of the Social Security Act (42 U.S.C. 1395d) is amended— (1) in subsection (y)— (A) in paragraph (1)(E), by inserting (or, for calendar quarters beginning on or after October 1, 2027, in the case such State is a specified State with respect to such calendar quarter, 80 percent) after thereafter; and (B) in paragraph (2), by adding at the end the following new subparagraph: (C) Specified State The term specified State means, with respect to a quarter, a State that— (i) provides any form of financial assistance during such quarter, in whole or in part, whether or not made under a State plan (or waiver of such plan) under this title or under another program established by the State, and regardless of the source of funding for such assistance, to or on behalf of an alien who is not a qualified alien and is not a child or pregnant woman who is lawfully residing in the United States and receiving medical assistance pursuant to section 1903(v)(4), for the purchasing of health insurance coverage (as defined in section 2791(b)(1) of the Public Health Service Act) for an alien who is not a qualified alien and is not such a child or pregnant woman; or (ii) provides any form of comprehensive health benefits coverage during such quarter, whether or not under a State plan (or wavier of such plan) under this title or under another program established by the State, and regardless of the source of funding for such coverage, to an alien who is not a qualified alien and is not such a child or pregnant woman. (D) Immigration terms (i) Alien The term alien has the meaning given such term in section 101(a) of the Immigration and Nationality Act. (ii) Qualified alien The term qualified alien has the meaning given such term in section 431 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, except that— (I) such term does not include an alien described in subsection (b)(4) of such section (other than a qualified alien under section 402(b)(2) of such Act); (II) the reference to at the time the alien applies for, receives, or attempts to receive a Federal public benefit in subsection (b) of such section 431 shall be treated as a reference to at the time the alien is provided comprehensive health benefits coverage described in clause (ii) of section 1905(y)(C) of the Social Security Act or is provided with financial assistance described in clause (i) of such section, as applicable; and (III) the references to (in the opinion of the agency providing such benefits) in subsection (c) of such section 431 shall be treated as references to (in the opinion of the State in which such comprehensive health benefits coverage or such financial assistance is provided, as applicable).; and (2) in subsection (z)(2)— (A) in subparagraph (A), by striking for such year and inserting for such quarter; and (B) in subparagraph (B)(i)— (i) in the matter preceding subclause (I), by striking for a year and inserting for a calendar quarter in a year; and (ii) in subclause (II), by striking for the year and inserting for the quarter for the State.