---
kind: "diff"
citation: "H.R. 3253"
bill: "116-hr-3253"
heading: "Sustaining Excellence in Medicaid Act of 2019"
from: "ih"
from_label: "Introduced in House"
to: "eh"
to_label: "Engrossed in House"
sections_amended: 1
sections_added: 1
sections_removed: 0
url: "https://uscodex.org/bills/116/hr/3253/changes/eh"
---

# H.R. 3253 — what changed

H.R. 3253, Sustaining Excellence in Medicaid Act of 2019 — 1 section amended and 1 added between Introduced in House and Engrossed in House.

Edits are marked `<del>struck</del>` and `<ins>inserted</ins>`.

## Sec. 4 Extension of protection for Medicaid recipients of home and community-based services against spousal impoverishment

- (a) <ins>In general—</ins> <ins>Section 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) is amended by striking “September 30, 2019” and inserting “March 31, 2024”.</ins>
- (b) <ins>Rule of construction—</ins> <ins>Nothing in section 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note), section 1924 of the Social Security Act (42 U.S.C. 1396r–5), or section 1902(a)(17) of such Act (42 U.S.C. 1396a(a)(17)) shall be construed as prohibiting a State from applying an income or resource disregard authorized under section 1902(r)(2) of such Act (42 U.S.C. 1396a(r)(2))—</ins>
  - (1) <ins>to the income or resources of individuals described in section 1902(a)(10)(A)(ii)(VI) of such Act (42 U.S.C. 1396a(a)(10)(A)(ii)(VI)) (including a disregard of the income or resources of such individual’s spouse); or</ins>
  - (2) <ins>on the basis of an individual’s need for home and community-based services authorized under subsection (c), (d), (i), or (k) of section 1915 of such Act (42 U.S.C. 1396n) or under section 1115 of such Act (42 U.S.C. 1315).</ins>
- <del>Section 2404 of Public Law 111–148 (42 U.S.C. 1396r–5 note) is amended by striking “September 30, 2019” and inserting “March 31, 2024”.</del>

## Sec. 8 Determination of budgetary effects — added

- <ins>The budgetary effects of this Act, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled “Budgetary Effects of PAYGO Legislation” for this Act, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to the vote on passage.</ins>