1
 So in original. The period probably should be a semicolon.
2
 So in original. Probably should be “Child Enrollment Contingency Fund”.
payment under subsection (n); and
3
 So in original.
as approved by the Secretary.
4
 So in original. The comma probably should not appear.
is at least equal to 200 percent of the total projected expenditures under this subchapter for the State for fiscal year 2007.
5
 See References in Text note below.
from the amount made available under paragraphs (13) through (15) of subsection (a) for each of fiscal years 2010 through 2012, respectively, the Secretary shall compute a State allotment for each State (including the District of Columbia and each commonwealth and territory) for each such fiscal year as follows:
Editorial Notes
References in Text

Paragraphs (4) and (6), referred to in introductory provisions of subsec. (m)(2)(A), were redesignated (5) and (7), respectively, by Pub. L. 114–10, title III, § 301(b)(1)(F), Apr. 16, 2015, 129 Stat. 156.

Section 108 of the Children’s Health Insurance Program Reauthorization Act of 2009, referred to in subsec. (m)(3)(A), (D)(i)(II), is section 108 of title I of Pub. L. 111–3, Feb. 4, 2009, 123 Stat. 25, which is not classified to the Code.

Section 301(b)(3) of the Medicare Access and CHIP Reauthorization Act of 2015, referred to in subsec. (m)(4)(A), (D)(i)(II), is section 301(b)(3) of Pub. L. 114–10, title III, Apr. 16, 2015, 129 Stat. 157, which relates to a one-time appropriation for fiscal year 2017 and is not classified to the Code.

Section 3002(b)(2) of the HEALTHY KIDS Act, referred to in subsec. (m)(10)(A), (D)(i)(II), is section 3002(b)(2) of Pub. L. 115–120, div. C, Jan. 22, 2018, 132 Stat. 33, which relates to a one-time appropriation for fiscal year 2023 and is not classified to the Code.

Section 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, Pub. L. 115–123, div. E, title I, Feb. 9, 2018, 132 Stat. 173, which relates to a one-time appropriation for fiscal year 2027 and is not classified to the Code.

Amendments

2022—Subsec. (a)(27). Pub. L. 117–328, § 5111(a)(1), substituted “through 2028” for “through 2026”.

Subsec. (a)(28). Pub. L. 117–328, § 5111(a)(2)(A), substituted “for fiscal year 2029” for “for fiscal year 2027” in introductory provisions.

Subsec. (a)(28)(A). Pub. L. 117–328, § 5111(a)(2)(B), substituted “beginning on October 1, 2028, and ending on March 31, 2029” for “beginning on October 1, 2026, and ending on March 31, 2027”.

Subsec. (a)(28)(B). Pub. L. 117–328, § 5111(a)(2)(C), substituted “beginning on April 1, 2029, and ending on September 30, 2029” for “beginning on April 1, 2027, and ending on September 30, 2027”.

Subsec. (m)(2)(B)(i). Pub. L. 117–328, § 5111(b)(1)(A), substituted “2023, and 2029” for “, 2023, and 2027”.

Subsec. (m)(5). Pub. L. 117–328, § 5111(b)(1)(B), substituted “or 2029” for “or 2027”.

Subsec. (m)(7). Pub. L. 117–328, § 5111(b)(1)(C)(ii), substituted “fiscal year 2026, or fiscal year 2028.” for “or fiscal year 2026.” in concluding provisions.

Subsec. (m)(7)(A). Pub. L. 117–328, § 5111(b)(1)(C)(i), substituted “fiscal year 2029” for “fiscal year 2027,”.

Subsec. (m)(9). Pub. L. 117–328, § 5111(b)(1)(D), substituted “or 2029” for “or 2027”.

Subsec. (m)(11). Pub. L. 117–328, § 5111(b)(1)(E)(i), substituted “fiscal year 2029” for “fiscal year 2027” in heading.

Subsec. (m)(11)(C). Pub. L. 117–328, § 5111(b)(1)(E)(ii), substituted “fiscal year 2028” for “fiscal year 2026” wherever appearing and “fiscal year 2029” for “fiscal year 2027”.

Subsec. (n)(2)(A)(ii). Pub. L. 117–328, § 5111(c)(5), substituted “2024 through 2028” for “2024 through 2026” and “2023, and 2029” for “2023, and 2027”.

Subsec. (n)(2)(B). Pub. L. 117–328, § 5111(c)(5), substituted “2024 through 2028” for “2024 through 2026” and “2023, and 2029” for “2023, and 2027”.

Subsec. (n)(3)(A). Pub. L. 117–328, § 5111(c)(5)(A), substituted “2024 through 2028” for “2024 through 2026” in introductory provisions.

2021—Subsec. (m)(2)(B). Pub. L. 117–2, § 9821(c)(1), substituted “paragraphs (5), (7), and (12)” for “paragraphs (5) and (7)” in introductory provisions.

Subsec. (m)(12). Pub. L. 117–2, § 9821(c)(2), added par. (12).

2018—Subsec. (a)(21) to (26). Pub. L. 115–120, § 3002(a)(1), added pars. (21) to (26) and struck out former par. (21) which related to semi-annual allotment for fiscal year 2018 ending on March 31, 2018.

Subsec. (a)(27), (28). Pub. L. 115–123, § 50101(a), added pars. (27) and (28).

Subsec. (f)(2)(B)(ii)(I). Pub. L. 115–120, § 3002(d)(2)(A), substituted “(as defined in subclause (II)) for the month” for “for the month (as defined in subclause (II))”.

Subsec. (f)(2)(B)(ii)(II). Pub. L. 115–120, § 3002(d)(2)(B), inserted “, as in effect on the day before January 22, 2018,” after “section 1397ee(g)(4)(A) of this title”.

Subsec. (f)(2)(B)(ii)(VI). Pub. L. 115–120, § 3002(d)(2)(C), inserted “, as in effect on the day before January 22, 2018,” after “, section 1397ee(g)(4) of this title” and “, as so in effect” after “under section 1397ee(g)(4) of this title”.

Subsec. (m)(2)(B). Pub. L. 115–123, § 50101(b)(1)(A)(i), substituted “(27)” for “(25)” in introductory provisions.

Pub. L. 115–120, § 3002(b)(1)(A)(i), substituted “(25)” for “(19)” in introductory provisions.

Subsec. (m)(2)(B)(i). Pub. L. 115–123, § 50101(b)(1)(A)(ii), substituted “, 2023, and 2027” for “and 2023”.

Pub. L. 115–120, § 3002(b)(1)(A)(ii), substituted “, 2017, and 2023” for “and 2017”.

Subsec. (m)(2)(B)(ii). Pub. L. 115–120, § 3002(b)(1)(A)(iii)(I), struck out “and paragraph (10)” after “clauses (iii) and (iv)” in introductory provisions.

Subsec. (m)(2)(B)(ii)(I). Pub. L. 115–123, § 50101(b)(1)(A)(iii), 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)”.

Subsec. (m)(5). Pub. L. 115–123, § 50101(b)(1)(B), 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”.

Subsec. (m)(7). Pub. L. 115–123, § 50101(b)(1)(C)(ii), 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.

Subsec. (m)(7)(A). Pub. L. 115–123, § 50101(b)(1)(C)(i), substituted “2027,” for “2023”.

Pub. L. 115–120, § 3002(b)(1)(C)(i), substituted “2023” for “2017”.

Subsec. (m)(7)(B). Pub. L. 115–120, § 3002(b)(1)(C)(ii), inserted “(or, in the case of fiscal year 2018, by not later than the date that is 60 days after January 22, 2018)” after “before the August 31 preceding the beginning of the fiscal year” in introductory provisions.

Subsec. (m)(9). Pub. L. 115–123, § 50101(b)(1)(D)(ii), 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”.

Subsec. (m)(10). Pub. L. 115–120, § 3002(b)(1)(E), amended par. (10) generally. Prior to amendment, par. (10) related to State allotments for fiscal year 2018.

Subsec. (m)(11). Pub. L. 115–123, § 50101(b)(1)(E), added par. (11).

Subsec. (n)(2)(A)(ii). Pub. L. 115–123, § 50101(c)(1)(A), 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”.

Subsec. (n)(2)(B). Pub. L. 115–123, § 50101(c)(1)(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”.

Subsec. (n)(3)(A). Pub. L. 115–123, § 50101(c)(2), 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.

2017—Subsec. (a)(21). Pub. L. 115–96, § 3201(a), added par. (21).

Subsec. (f)(2)(B). Pub. L. 115–90, § 201(1), 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.”

Subsec. (f)(2)(B)(ii). Pub. L. 115–96, § 3201(c)(1)(A), substituted “first half” for “first quarter” in heading.

Subsec. (f)(2)(B)(ii)(I) to (VI). Pub. L. 115–96, § 3201(c)(1)(B), (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.

Subsec. (f)(2)(D). Pub. L. 115–90, § 201(2), added subpar. (D).

Subsec. (m)(2). Pub. L. 115–96, § 3201(b)(2)(B), substituted “the allotment increase factor under paragraph (6)” for “the allotment increase factor under paragraph (5)” wherever appearing. Amendment by Pub. L. 114–10, §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.

Subsec. (m)(2)(B)(ii). Pub. L. 115–96, § 3201(b)(1)(A), inserted “and paragraph (10)” after “clauses (iii) and (iv)” in introductory provisions.

Subsec. (m)(5). Pub. L. 115–96, § 3201(b)(1)(B), substituted “(4), or (10)” for “or (4)” and “, 2017, or 2018” for “or 2017”.

Subsec. (m)(9). Pub. L. 115–96, § 3201(b)(1)(C), 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”.

Subsec. (m)(10). Pub. L. 115–96, § 3201(b)(1)(D), added par. (10).

2015—Subsec. (a)(19), (20). Pub. L. 114–10, § 301(a), added pars. (19) and (20).

Subsec. (c)(1). Pub. L. 114–10, § 301(b)(2)(A), substituted “(m)(5)” for “(m)(4)”.

Subsec. (m). Pub. L. 114–10, § 301(b)(1)(A), substituted “and thereafter” for “through 2015” in heading.

Subsec. (m)(1). Pub. L. 114–10, § 301(b)(2)(B)(i)(II), substituted “the allotment increase factor determined under paragraph (6)” for “the allotment increase factor determined under paragraph (5)” wherever appearing.

Subsec. (m)(1)(A), (B). Pub. L. 114–10, § 301(b)(2)(B)(i)(I), substituted “and paragraph (5)” for “and paragraph (4)”.

Subsec. (m)(2). Pub. L. 114–10, § 301(b)(1)(B)(i), substituted “2016” for “2014” in heading.

Subsec. (m)(2)(A). Pub. L. 114–10, § 301(b)(2)(B)(ii), 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.

Subsec. (m)(2)(B). Pub. L. 114–10, § 301(b)(1)(B)(ii), added subpar. (B) and struck out former subpar. (B) which related to State allotments for fiscal years 2013 and 2014.

Subsec. (m)(3). Pub. L. 114–10, § 301(b)(2)(B)(iii), 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).

Subsec. (m)(4). Pub. L. 114–10, § 301(b)(1)(G), added par. (4). Former par. (4) redesignated (5).

Pub. L. 114–10, § 301(b)(1)(C), inserted “or 2017” after “2015”.

Subsec. (m)(5). Pub. L. 114–10, § 301(b)(2)(B)(iv), 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).

Subsec. (m)(6). Pub. L. 114–10, § 301(b)(1)(F), 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.

Subsec. (m)(6)(A). Pub. L. 114–10, § 301(b)(1)(D)(i), substituted “2017” for “2015”.

Subsec. (m)(7). Pub. L. 114–10, § 301(b)(2)(B)(v), 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).

Subsec. (m)(8). Pub. L. 114–10, § 301(b)(1)(F), 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.

Subsec. (m)(9). Pub. L. 114–10, § 301(b)(2)(B)(vi), substituted “paragraph (3) or (4)” for “paragraph (3)”.

Pub. L. 114–10, § 301(b)(1)(F), redesignated par. (8) as (9).

Subsec. (n)(2)(A)(ii). Pub. L. 114–10, § 301(d)(1)(A)(i), substituted “2010, 2011, 2012, 2013, 2014, and 2016” for “2010 through 2014” and inserted “and fiscal year 2017” after “2015”.

Subsec. (n)(2)(B). Pub. L. 114–10, § 301(d)(1)(A)(ii), substituted “2010, 2011, 2012, 2013, 2014, and 2016” for “2010 through 2014” and inserted “and fiscal year 2017” after “2015”.

Subsec. (n)(3)(A). Pub. L. 114–10, § 301(d)(1)(B), 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.

Subsec. (n)(3)(B)(ii). Pub. L. 114–10, § 301(b)(2)(C), substituted “subsection (m)(6)(B)” for “subsection (m)(5)(B)”.

2010—Subsec. (a)(16) to (18). Pub. L. 111–148, § 10203(d)(1), 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 October 1, 2012, and ending on March 31, 2013, and

“(B) $2,850,000,000 for the period beginning on April 1, 2013, and ending on September 30, 2013.”

Subsec. (m). Pub. L. 111–148, § 10203(d)(2)(A)(i), substituted “2015” for “2013” in heading.

Subsec. (m)(2). Pub. L. 111–148, § 10203(d)(2)(A)(ii), substituted “2014” for “2012” in heading and added subpar. (B).

Subsec. (m)(3). Pub. L. 111–148, § 10203(d)(2)(A)(iii)(I), substituted “2015” for “2013” in heading.

Subsec. (m)(3)(A), (B). Pub. L. 111–148, § 10203(d)(2)(A)(iii)(II), substituted “paragraph (18)” for “paragraph (16)”.

Subsec. (m)(3)(C). Pub. L. 111–148, § 10203(d)(2)(A)(iii)(III), substituted “2014” for “2012” wherever appearing and “2015” for “2013”.

Subsec. (m)(3)(D)(i)(I). Pub. L. 111–148, § 10203(d)(2)(A)(iii)(IV)(aa), substituted “subsection (a)(18)(A)” for “subsection (a)(16)(A)”.

Subsec. (m)(3)(D)(ii)(II). Pub. L. 111–148, § 10203(d)(2)(A)(iii)(IV)(bb), substituted “subsection (a)(18)(B)” for “subsection (a)(16)(B)”.

Subsec. (m)(4). Pub. L. 111–148, § 10203(d)(2)(A)(iv), substituted “2015” for “2013”.

Subsec. (m)(6). Pub. L. 111–148, § 10203(d)(2)(A)(v)(II), substituted “, fiscal year 2012, or fiscal year 2014” for “or fiscal year 2012” in concluding provisions.

Subsec. (m)(6)(A). Pub. L. 111–148, § 10203(d)(2)(A)(v)(I), substituted “2015” for “2013”.

Subsec. (m)(7). Pub. L. 111–148, § 2102(a)(1)(B), added par. (7). Former par. (7) redesignated (8).

Subsec. (m)(8). Pub. L. 111–148, § 10203(d)(2)(A)(vi), substituted “2015” for “2013” in heading and text.

Pub. L. 111–148, § 2102(a)(1)(A), redesignated par. (7) as (8).

Subsec. (n)(2)(A)(ii), (B). Pub. L. 111–148, § 10203(d)(2)(B)(i), substituted “2014” for “2012” and “2015” for “2013”.

Subsec. (n)(3)(A). Pub. L. 111–148, § 10203(d)(2)(B)(ii), 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”.

2009—Subsec. (a)(11). Pub. L. 111–3, § 101(2), substituted “fiscal year 2008” for “each of fiscal years 2008 and 2009”.

Subsec. (a)(12) to (16). Pub. L. 111–3, § 101(1), (3), added pars. (12) to (16).

Subsec. (b)(1). Pub. L. 111–3, § 102(1), substituted “subsections (d) and (m)” for “subsection (d)” in introductory provisions.

Subsec. (c)(1). Pub. L. 111–3, § 102(2), substituted “subsections (d) and (m)(4)” for “subsection (d)”.

Subsec. (e). Pub. L. 111–3, § 105, 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.”

Subsec. (f). Pub. L. 111–3, § 106(a)(1), 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).

Subsec. (k). Pub. L. 111–3, § 106(b)(1), struck out “the first 2 quarters of” before “fiscal year 2009” in heading.

Subsec. (k)(1). Pub. L. 111–3, § 106(b)(2), struck out “the first 2 quarters of” before “fiscal year 2009,”.

Subsec. (k)(6). Pub. L. 111–3, § 106(b)(3), struck out “the first 2 quarters of” before “fiscal year 2009” and substituted “September 30” for “March 31”.

Subsecs. (m), (n). Pub. L. 111–3, §§ 102(3), 103, added subsecs. (m) and (n).

2007—Subsec. (a)(11). Pub. L. 110–173, § 201(a)(1)(A), added par. (11).

Subsec. (c)(4)(B). Pub. L. 110–173, § 201(a)(1)(B), substituted “for each of fiscal years 2007 through 2009” for “for fiscal year 2007”.

Subsec. (h). Pub. L. 109–482 added subsec. (h).

Subsec. (h)(1)(B). Pub. L. 110–28, § 7001(b)(1), struck out “subject to paragraph (4)(B) and” after “estimates,” in introductory provisions.

Subsec. (h)(2). Pub. L. 110–28, § 7001(a)(1), (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).

Subsec. (h)(4). Pub. L. 110–28, § 7001(a)(2), added par. (4) and struck out former par. (4). Former text read as follows:

“(A) Expenditures limited to coverage for populations eligible on october 1, 2006.—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 October 1, 2006.

“(B) Regular fmap for expenditures for coverage of nonchild populations.—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 section 1396d(b) of this title) 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 section 1397ee of this title from such amounts.”

Subsec. (h)(5)(A). Pub. L. 110–28, § 7001(b)(3), substituted “(3), and (4)” for “and (3)”.

Subsec. (h)(6). Pub. L. 110–28, § 7001(b)(4), inserted “or allotted” after “redistributed” and “or allotments” after “redistributions” in first sentence and substituted “(3), and (4)” for “and (3)” in second sentence.

Subsec. (i). Pub. L. 110–92 added subsec. (i).

Subsec. (j) to (l). Pub. L. 110–173, § 201(c)(1), added subsecs. (j) to (l).

2006—Subsec. (a). Pub. L. 109–171, § 6101(b)(1), inserted “subject to subsection (d),” after “under this section,” in introductory provisions.

Subsec. (b)(1). Pub. L. 109–171, § 6101(b)(2), inserted “and subsection (d)” after “Subject to paragraph (4)” in introductory provisions.

Subsec. (c)(1). Pub. L. 109–171, § 6101(b)(3), inserted “subject to subsection (d),” after “for a fiscal year,”.

Subsec. (d). Pub. L. 109–171, § 6101(a), added subsec. (d).

2003—Subsec. (g). Pub. L. 108–74, § 1(a)(2)(C)(i), (3)(C)(i), substituted “, 1999, 2000, and 2001” for “and 1999” in heading.

Subsec. (g)(1)(A). Pub. L. 108–74, § 1(a)(3)(B)(i), (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”.

Subsec. (g)(1)(A)(i)(III). Pub. L. 108–74, § 1(a)(2)(B)(iii), added subclause (III).

Subsec. (g)(1)(A)(i)(IV). Pub. L. 108–74, § 1(a)(3)(B)(iii), added subcl. (IV).

Subsec. (g)(1)(A)(ii). Pub. L. 108–74, § 1(a)(3)(B)(iv), substituted “2000, or 2001” for “or 2000”.

Pub. L. 108–74, § 1(a)(2)(B)(iv), substituted “, 1999, or 2000” for “or 1999”.

Subsec. (g)(1)(B). Pub. L. 108–74, § 1(a)(2)(B)(v), struck out “with respect to fiscal year 1998 or 1999” after “paragraph” in introductory provisions.

Subsec. (g)(1)(B)(ii). Pub. L. 108–74, § 1(a)(2)(B)(vi), inserted “with respect to fiscal year 1998, 1999, or 2000” after “subsection (e),” and substituted “2004” for “2002”.

Subsec. (g)(1)(B)(iii), (iv). Pub. L. 108–74, § 1(a)(3)(B)(v), added clause (iii) and redesignated former cl. (iii) as (iv).

Subsec. (g)(1)(C). Pub. L. 108–74, § 1(a)(2)(B)(vii), added subpar. (C).

Subsec. (g)(1)(D). Pub. L. 108–74, § 1(a)(3)(B)(vi), added subpar. (D).

Subsec. (g)(2). Pub. L. 108–74, § 1(a)(2)(A)(i), (3)(A)(i), substituted “through 2001” for “and 1999” in heading.

Subsec. (g)(2)(A)(i), (ii). Pub. L. 108–74, § 1(a)(1), substituted “fiscal year 2004” for “fiscal year 2002”.

Subsec. (g)(2)(A)(iii). Pub. L. 108–74, § 1(a)(2)(A)(ii), added cl. (iii).

Subsec. (g)(2)(A)(iv). Pub. L. 108–74, § 1(a)(3)(A)(ii), added cl. (iv).

Subsec. (g)(3). Pub. L. 108–173 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 “November 30, 2002, or November 30, 2003,” for “or November 30, 2002,”.

Pub. L. 108–74, § 1(a)(2)(C)(ii), substituted “, fiscal year 1999, or fiscal year 2000” for “or fiscal year 1999” and “November 30, 2001, or November 30, 2002” for “or November 30, 2001”.

2000—Subsec. (b)(1). Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(d)(3)(A)], in introductory provisions, struck out “and subsection (d) of this section” after “Subject to paragraph (4)”.

Subsec. (c)(1). Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(d)(3)(B)], struck out “subject to subsection (d) of this section,” after “for a fiscal year,”.

Subsec. (d). Pub. L. 106–554, § 1(a)(6) [title VIII, § 802(b)], 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—

“(1) the amount (if any) of the payments made to that State under section 1396b(a) of this title 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 section 1396r–1a of this title, and

“(2) the amount (if any) of the payments made to that State under section 1396b(a) of this title 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 section 1396b(a)(1) of this title on the basis of an enhanced FMAP under the fourth sentence of section 1396d(b) of this title.”

Subsec. (g). Pub. L. 106–554, § 1(a)(6) [title VIII, § 801(a)], added subsec. (g).

1999—Subsec. (b)(2)(A)(i). Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(1)(A)], substituted “and 1999” for “through 2000”.

Subsec. (b)(2)(A)(ii). Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(1)(B)], substituted “2000” for “2001” in introductory provisions.

Subsec. (b)(2)(B). Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(3)], substituted “the calendar year in which such fiscal year begins” for “the fiscal year”.

Subsec. (b)(3)(B). Pub. L. 106–113, § 1000(a)(6) [title VII, § 705(a)], 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”.

Subsec. (b)(4). Pub. L. 106–113, § 1000(a)(6) [title VII, § 701(a)(2)], 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.”

Subsec. (c)(4)(B). Pub. L. 106–113, § 1000(a)(6) [title VII, § 702], 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”.

1998—Subsec. (b)(1). Pub. L. 105–277, § 101(f) [title VII, § 706(b)], inserted “(determined without regard to paragraph (4) thereof)” after “subsection (c)”.

Subsec. (c)(4). Pub. L. 105–277, § 101(f) [title VII, § 706(a)], added par. (4).

1997—Subsec. (a)(1). Pub. L. 105–100, § 162(8)(A), substituted “$4,295,000,000” for “$4,275,000,000”.

Subsec. (b)(4). Pub. L. 105–100, § 162(8)(B), substituted “In” for “Subject to paragraph (5), in”.

Subsec. (c)(2)(C). Pub. L. 105–100, § 162(8)(C), inserted “the” before “Virgin Islands”.

Subsec. (c)(3)(C), (E). Pub. L. 105–100, § 162(8)(C), substituted “The” for “the”.

Subsec. (d)(1). Pub. L. 105–100, § 162(6)(A), substituted “for expenditures claimed by the State” for “for calendar quarters”.

Subsec. (d)(2). Pub. L. 105–100, § 162(6)(B), 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 section 1396b(a)(1) of this title on the basis of an enhanced FMAP under section 1396d(b) of this title.”

Statutory Notes and Related Subsidiaries
Effective Date of 2010 Amendment

Pub. L. 111–148, title II, § 2102(a), Mar. 23, 2010, 124 Stat. 288, provided that the amendment made by section 2102(a)(1) of Pub. L. 111–148 is effective as if included in the enactment of the Children’s Health Insurance Program Reauthorization Act of 2009 (Pub. L. 111–3).

Effective Date of 2009 Amendment

Amendment by sections 101–103, 105, and 106(b) of Pub. L. 111–3 effective Apr. 1, 2009, and applicable to child health assistance and medical assistance provided on or after that date, with certain exceptions, see section 3 of Pub. L. 111–3, set out as an Effective Date note under section 1396 of this title.

Pub. L. 111–3, title I, § 106(a)(2), Feb. 4, 2009, 123 Stat. 24, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to redistribution of allotments made for fiscal year 2007 and subsequent fiscal years.”

Termination Date of 2007 Amendment

Pub. L. 110–92, § 136(e), Sept. 29, 2007, 121 Stat. 995, which provided that the amendments made by subsecs. (c) and (d) of section 136, amending this section and section 1397ee of this title, were effective through Dec. 31, 2007, 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 Pub. L. 110–173, title II, § 201(b)(3), Dec. 29, 2007, 121 Stat. 2510.

Effective Date of 2006 Amendment

Pub. L. 109–171, title VI, § 6101(c), Feb. 8, 2006, 120 Stat. 131, provided that: “The amendments made by this section [amending this section] apply to items and services furnished on or after October 1, 2005, without regard to whether or not regulations implementing such amendments have been issued.”

Effective Date of 2003 Amendment

Pub. L. 108–74, § 1(a)(4), Aug. 15, 2003, 117 Stat. 895, provided that: “This subsection [amending this section], and the amendments made by this subsection, shall be effective as if this subsection had been enacted on September 30, 2002, and amounts under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) from allotments for fiscal years 1998 through 2000 are available for expenditure on and after October 1, 2002, under the amendments made by this subsection as if this subsection had been enacted on September 30, 2002.”

Effective Date of 2000 Amendment

Pub. L. 106–554, § 1(a)(6) [title VIII, § 801(b)], Dec. 21, 2000, 114 Stat. 2763, 2763A–580, provided that: “The amendments made by this section [amending this section] shall take effect as if included in the enactment of section 4901 of BBA [Pub. L. 105–33] (111 Stat. 552).”

Amendment by section 802(b), (d)(3) of Pub. L. 106–554 effective as if included in the enactment of section 4901 of Pub. L. 105–33, see section 1(a)(6) [title VIII, § 802(f)] of Pub. L. 106–554, set out as a note under section 1396d of this title.

Effective Date of 1999 Amendment

Pub. L. 106–113, div. B, § 1000(a)(6) [title VII, § 701(b)], Nov. 29, 1999, 113 Stat. 1536, 1501A–400, provided that: “The amendments made by this section [amending this section] apply to allotments determined under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) for fiscal year 2000 and each fiscal year thereafter.”

Effective Date of 1997 Amendment

Pub. L. 105–100, title I, § 162, Nov. 19, 1997, 111 Stat. 2188, 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, Pub. L. 105–33.

Construction of 2017 Amendment

Pub. L. 115–96, div. C, title II, § 3201(c)(2), Dec. 22, 2017, 131 Stat. 2052, provided that: “Nothing in the amendments made by paragraph (1) [amending this section] shall be construed as authorizing the Secretary of Health and Human Services to de-obligate any funds redistributed under clause (ii) of section 2104(f)(2)(B) of the Social Security Act (42 U.S.C. 1397dd(f)(2)(B)) that have been obligated for amounts expended by an emergency shortfall State described in such clause as of January 1, 2018.”

Application of Regular Expenditure Rules

Pub. L. 115–96, div. C, title II, § 3201(b)(3), Dec. 22, 2017, 131 Stat. 2051, provided that: “Amounts allotted to a State under section 2104(m)(10)(A) of the Social Security Act (42 U.S.C. 1397dd(m)(10)(A)) (as added by paragraph (1)) shall be subject to the same requirements of title XXI of such Act [42 U.S.C. 1397aa et seq.] and applicable regulations of the Secretary of Health and Human Services as apply to other allotments made to States for a fiscal year under section 2104 of such Act [42 U.S.C. 1397dd].”

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)], Dec. 21, 2000, 114 Stat. 2763, 2763A–581, provided that: “Notwithstanding any other provision of law, all amounts appropriated under title XXI [of the Social Security Act, 42 U.S.C. 1397aa et seq.] and allotted to a State pursuant to subsection (b) or (c) of section 2104 of the Social Security Act (42 U.S.C. 1397dd) for fiscal years 1998 through 2000 (including any amounts that, but for this provision, would be considered to have expired) and not expended in providing child health assistance or related services for which payment may be made pursuant to subparagraph (C) or (D) of section 2105(a)(1) of such Act (42 U.S.C. 1397ee(a)(1)) (as amended by subsection (a)), shall be available to reimburse the Grants to States for Medicaid account in an amount equal to the total payments made to such State under section 1903(a) of such Act (42 U.S.C. 1396b(a)) for expenditures in such years for medical assistance described in subparagraphs (A) and (B) of section 2105(a)(1) of such Act (42 U.S.C. 1397ee(a)(1)) (as so amended).”

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], Oct. 21, 1998, 112 Stat. 2681–337, 2681–389, provided that: “Notwithstanding any other provision of law, for purposes of determining the product under section 2104(b)(1)(A) of the Social Security Act (42 U.S.C. 1397dd(b)(1)(A)) for a State for each of fiscal years 1998 and 1999—

“(1)
the number of children under clause (i) of such section shall be the number of low-income children specified for the State in Column B of the table on pages 48101–48102 of the Federal Register published on September 12, 1997, adjusted by the Census Bureau as necessary to treat children as being without health insurance if they have access to health care funded by the Indian Health Service but do not have health insurance; and
“(2)
the State cost factor under clause (ii) of such section shall be the State cost factor specified for the State in Column C of such table.”