123STA T . 3 0PUBLIC LA W 111 – 3 —FE B. 4, 200 920 0 9,an a p p lic a t i o ntot heS ec r etar yf ora w ai v er u n d er s ection 1 11 5 of the State plan under title XI X to provide m edical assistance to a nonpre g nant childless adult whose coverage is so terminated ( in this su b section referred to asa ‘M edicaid nonpregnant childless adults waiver ’). ‘‘( B ) DEADLIN E FOR A P PRO V AL. —T he Secretary shall ma k e a decision to approve or deny an application for a Medicaid nonpregnant childless adults waiver submitted under subparagraph ( A ) within 90 days of the date of the submission of the application. If no decision has been made by the Secretary as of December 3 1, 2009, on the application of a State for a Medicaid nonpregnant childless adults waiver that was submitted to the Secretary by Sep - tember 30, 2009, the application shall be deemed approved. ‘‘( C )S T ANDARD FOR BU D G ET NEUTRALIT Y .—The budget neutrality re q uirement applicable with respect to e x pendi- tures for medical assistance under a Medicaid nonpregnant childless adults waiver shall— ‘‘(i) in the case of fiscal year 2010, allow expendi- tures for medical assistance under title XIX for all such adults to not exceed the total amount of payments made to the State under paragraph (2)(B) for fiscal year 2009, increased by the percentage increase (if any) in the pro j ected nominal per capita amount of N ational H ealth E xpenditures for 2010 over 2009, as most recently published by the Secretary
and ‘‘(ii) in the case of any succeeding fiscal year, allow such expenditures to not exceed the amount in effect under this subparagraph for the preceding fiscal year, increased by the percentage increase (if any) in the projected nominal per capita amount of National Health Expenditures for the calendar year that begins during the year involved over the preceding calendar year, as most recently published by the Secretary. ‘‘(b) R ULE S AND CONDITIONS FOR COVERAGE OF P ARENTS OF TARGETED L O W -IN C O M EC H ILDREN.— ‘‘(1) TWO-YEAR PERIOD; AUTOMATIC E X TENSION AT STATE OPTION THROUGH FISCAL YEAR 201 1.— ‘‘(A) NO NEW CHIP WAIVERS.—Notwithstanding section 1115 or any other provision of this title, except as provided in this subsection— ‘‘(i) the Secretary shall not on or after the date of the enactment of the Children’s Health Insurance Program Reauthori z ation Act of 2009 approve or renew a waiver, experimental, pilot, or demonstration project that would allow funds made available under this title to be used to provide child health assistance or other health benefits coverage to a parent of a targeted low- income child; and ‘‘(ii) notwithstanding the terms and conditions of an applicable existing waiver, the provisions of para- graphs (2) and (3) shall apply for purposes of any fiscal year beginning on or after O ctober 1, 2011, in determining the period to which the waiver applies, the individuals eligible to be covered by the waiver, and the amount of the F ederal payment under this title. Ap p licab ili ty.Ef f e cti v e d ate.
