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As revised by sections 1204(b)(1)(B), 1204(b)(2)(A), and 1204(b)(2)(B) of the HCERA, effective July 1, 2011 through September 30, 2019, increases by $6.3 billion the amount of federal Medicaid funding available to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. Effective July 1, 2011, increases territories’ regular Medicaid FMAP from 50% to 55%.
On December 10, 2012, HHS issued a letter to governors in which it provided a more thorough overview of the impact of the ACA on the territories. Though the letter largely focused on the territories’ requirements relative to Exchange implementation, it did address key ACA Medicaid provisions, including the increased FMAP.
SEC. 2005. PAYMENTS TO TERRITORIES. (a) INCREASE IN LIMIT ON PAYMENTS.—Section 1108(g) of the Social Security Act (42 U.S.C. 1308(g)) is amended— (1) in paragraph (2), in the matter preceding subparagraph (A), by striking ‘‘paragraph (3)’’ and inserting ‘‘paragraphs (3) and (5)’’; (2) in paragraph (4), by striking ‘‘and (3)’’ and inserting ‘‘(3), and (4)’’; and (3) by adding at the end the following paragraph: ‘‘(5) ADDITIONAL INCREASE.—[Replaced by section 1204(b)(1)(B) of HCERA] The Secretary shall increase the amounts otherwise determined under this subsection for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa (after the application of subsection (f) and the preceding paragraphs of this subsection) for the period beginning July 1, 2011, and ending on September 30, 2019, by such amounts that the total additional payments under title XIX to such territories equals $6,300,000,000 for such period. The Secretary shall increase such amounts in proportion to the amounts applicable to such territories under this subsection and subsection (f) on the date of enactment of this paragraph.’’. [Subsection (b) repealed by section 1204(b)(2)(A) of HCERA] (c) INCREASED FMAP.— (1) IN GENERAL.—The first sentence of section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is amended by striking ‘‘shall be 50 per centum’’ and inserting ‘‘shall be 55 percent’’. (2) EFFECTIVE DATE.—The amendment made by paragraph (1) takes effect on July 1, 2011. [As revised by section 1204(b)(2)(B)of HCERA]
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