Page:United States Statutes at Large Volume 124.djvu/305

124 STAT. 279 PUBLIC LAW 111–148—MAR. 23, 2010 the term ‘parent’ includes an individual treated as a caretaker relative for purposes of carrying out section 1931.’’. (2) CONFORMING AMENDMENTS.— (A) Section 1905(a) of such Act (42 U.S.C. 1396d(a)), as amended by subsection (a)(5)(C), is amended in the matter preceding paragraph (1)— (i) by striking ‘‘or’’ at the end of clause (xiii); (ii) by inserting ‘‘or’’ at the end of clause (xiv); and (iii) by inserting after clause (xiv) the following: ‘‘(xv) individuals described in section 1902(a)(10)(A)(ii)(XX),’’. (B) Section 1903(f)(4) of such Act (42 U.S.C. 1396b(f)(4)) is amended by inserting ‘‘1902(a)(10)(A)(ii)(XX),’’ after ‘‘1902(a)(10)(A)(ii)(XIX),’’. (C) Section 1920(e) of such Act (42 U.S.C. 1396r–1(e)), as added by subsection (a)(4)(B), is amended by inserting ‘‘or clause (ii)(XX)’’ after ‘‘clause (i)(VIII)’’. SEC. 2002. INCOME ELIGIBILITY FOR NONELDERLY DETERMINED USING MODIFIED GROSS INCOME. (a) IN GENERAL.—Section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) is amended by adding at the end the following: ‘‘(14) INCOME DETERMINED USING MODIFIED GROSS INCOME.— ‘‘(A) IN GENERAL.—Notwithstanding subsection (r) or any other provision of this title, except as provided in subparagraph (D), for purposes of determining income eligi- bility for medical assistance under the State plan or under any waiver of such plan and for any other purpose applicable under the plan or waiver for which a determina- tion of income is required, including with respect to the imposition of premiums and cost-sharing, a State shall use the modified gross income of an individual and, in the case of an individual in a family greater than 1, the household income of such family. A State shall establish income eligibility thresholds for populations to be eligible for medical assistance under the State plan or a waiver of the plan using modified gross income and household income that are not less than the effective income eligibility levels that applied under the State plan or waiver on the date of enactment of the Patient Protection and Afford- able Care Act. For purposes of complying with the mainte- nance of effort requirements under subsection (gg) during the transition to modified gross income and household income, a State shall, working with the Secretary, establish an equivalent income test that ensures individuals eligible for medical assistance under the State plan or under a waiver of the plan on the date of enactment of the Patient Protection and Affordable Care Act, do not lose coverage under the State plan or under a waiver of the plan. The Secretary may waive such provisions of this title and title XXI as are necessary to ensure that States establish income and eligibility determination systems that protect bene- ficiaries. ‘‘(B) NO INCOME OR EXPENSE DISREGARDS.—No type of expense, block, or other income disregard shall be applied Waiver authority.