120 STAT. 98
PUBLIC LAW 109–171—FEB. 8, 2006 an amount that reasonably reflects the premium contribution made by the parent for private coverage on behalf of a child with a disability; and ‘‘(II) treat such coverage as a third party liability under subsection (a)(25). ‘‘(B) In the case of a parent to which subparagraph (A) applies, a State, notwithstanding section 1906 but subject to paragraph (1)(C)(ii), may provide for payment of any portion of the annual premium for such family coverage that the parent is required to pay. Any payments made by the State under this subparagraph shall be considered, for purposes of section 1903(a), to be payments for medical assistance.’’. (b) STATE OPTION TO IMPOSE INCOME-RELATED PREMIUMS.— Section 1916 of such Act (42 U.S.C. 1396o) is amended— (1) in subsection (a), by striking ‘‘subsection (g)’’ and inserting ‘‘subsections (g) and (i)’’; and (2) by adding at the end, as amended by section 6041(b)(2), the following new subsection: ‘‘(i)(1) With respect to disabled children provided medical assistance under section 1902(a)(10)(A)(ii)(XIX), subject to paragraph (2), a State may (in a uniform manner for such children) require the families of such children to pay monthly premiums set on a sliding scale based on family income. ‘‘(2) A premium requirement imposed under paragraph (1) may only apply to the extent that— ‘‘(A) in the case of a disabled child described in that paragraph whose family income— ‘‘(i) does not exceed 200 percent of the poverty line, the aggregate amount of such premium and any premium that the parent is required to pay for family coverage under section 1902(cc)(2)(A)(i) and other cost-sharing charges do not exceed 5 percent of the family’s income; and ‘‘(ii) exceeds 200, but does not exceed 300, percent of the poverty line, the aggregate amount of such premium and any premium that the parent is required to pay for family coverage under section 1902(cc)(2)(A)(i) and other cost-sharing charges do not exceed 7.5 percent of the family’s income; and ‘‘(B) the requirement is imposed consistent with section 1902(cc)(2)(A)(ii)(I). ‘‘(3) A State shall not require prepayment of a premium imposed pursuant to paragraph (1) and shall not terminate eligibility of a child under section 1902(a)(10)(A)(ii)(XIX) for medical assistance under this title on the basis of failure to pay any such premium until such failure continues for a period of at least 60 days from the date on which the premium became past due. The State may waive payment of any such premium in any case where the State determines that requiring such payment would create an undue hardship.’’. (c) CONFORMING AMENDMENTS.—(1) Section 1903(f)(4) of such Act (42 U.S.C. 1396b(f)(4)) is amended in the matter preceding subparagraph (A), by inserting ‘‘1902(a)(10)(A)(ii)(XIX),’’ after ‘‘1902(a)(10)(A)(ii)(XVIII),’’. (2) Section 1905(u)(2)(B) of such Act (42 U.S.C. 1396d(u)(2)(B)) is amended by adding at the end the following sentence: ‘‘Such
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