Modifying retroactive coverage under the Medicaid and CHIP programs

(a) In general Section 1902(a)(34) of the Social Security Act (42 U.S.C. 1396a(a)(34)) is amended— (1) by striking him and inserting the individual; (2) by striking the third month and inserting the month; (3) by striking he and inserting the individual; and (4) by striking his and inserting the individual’s. (b) Definition of medical assistance Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended by striking in or after the third month before the month in which the recipient makes application for assistance and inserting in or after the month before the month in which the recipient makes application for assistance. (c) CHIP Section 2102(b)(1)(B) of the Social Security Act (42 U.S.C. 1397bb(b)(1)(B)) is amended— (1) in clause (iv), by striking and at the end; (2) in clause (v), by striking the period and inserting; and; and (3) by adding at the end the following new clause: (vi) shall, in the case that the State elects to provide child health or pregnancy-related assistance to an individual for any period prior to the month in which the individual made application for such assistance (or application was made on behalf of the individual), provide that such assistance is not made available to such individual for items and services included under the State child health plan (or waiver of such plan) that are furnished before the month preceding the month in which such individual made application (or application was made on behalf of such individual) for such assistance.. (d) Effective date The amendments made by this section shall apply to medical assistance and child health and pregnancy-related assistance with respect to individuals whose eligibility for such medical assistance or child health assistance is based on an application made on or after October 1, 2026.

(a) In general Section 1902(a)(34) of the Social Security Act (42 U.S.C. 1396a(a)(34)) is amended— (1) by striking him and inserting the individual; (2) by striking the third month and inserting the month; (3) by striking he and inserting the individual; and (4) by striking his and inserting the individual’s. (b) Definition of medical assistance Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended by striking in or after the third month before the month in which the recipient makes application for assistance and inserting in or after the month before the month in which the recipient makes application for assistance. (c) CHIP Section 2102(b)(1)(B) of the Social Security Act (42 U.S.C. 1397bb(b)(1)(B)) is amended— (1) in clause (iv), by striking and at the end; (2) in clause (v), by striking the period and inserting; and; and (3) by adding at the end the following new clause: (vi) shall, in the case that the State elects to provide child health or pregnancy-related assistance to an individual for any period prior to the month in which the individual made application for such assistance (or application was made on behalf of the individual), provide that such assistance is not made available to such individual for items and services included under the State child health plan (or waiver of such plan) that are furnished before the month preceding the month in which such individual made application (or application was made on behalf of such individual) for such assistance.. (d) Effective date The amendments made by this section shall apply to medical assistance and child health assistance, and pregnancy-related assistance with respect to individuals whose eligibility for such medical assistance, child health assistance, or pregnancy-related assistance is based on an application made on or after December 31, 2026.