To provide for a 5-year SCHIP reauthorization for coverage of low-income children, an expansion of child health care insurance coverage through tax fairness, and a health care Federalism initiative, and for other purposes.


More Children, More Choices Act of 2009 - Amends title XXI (State Children's Health Insurance) (SCHIP) of the Social Security Act (SSA) to require a state SCHIP plan to specify how it will achieve coverage for 90% of targeted low-income children.

Prohibits SCHIP payment for children with family income above 250% of the applicable poverty line.

Sets forth special rules for SCHIP payment for children with family income above 200% of the applicable poverty line.

Provides for standardization of income determinations.

Applies citizenship documentation requirements to SCHIP beneficiaries, and increases the federal matching rate for citizenship documentation enforcement under SSA title XIX (Medicaid) and SCHIP.

Places limitations on SCHIP eligibility based on substantial net assets.

Requires state SCHIP plans to describe how they will provide for targeted low-income children covered under a group health plan.

Revises federal financial participation requirements for employer-sponsored insurance.

Requires the offering of alternative coverage options under SCHIP.

Changes the allotment distribution formula for allotments to the states and the District of Columbia, particularly for targeted low-income children and pregnant women. Prohibits redistribution of unused allotments.

Reauthorizes the SCHIP program through FY2014 at increased levels.

Directs the Secretary of Health and Human Services to make grants to eligible entities to improve outreach to and enrollment of eligible children.

Amends the Internal Revenue Code to allow: (1) a limited tax credit for qualified health insurance for any dependent child; and (2) advance payment to insurance providers of health insurance credit for purchasers of such insurance.

Directs the Secretary to establish a State Health Coverage Innovation Commission to make grants to states for innovative health reform projects.

Directs the Secretary to implement administrative reforms with respect to the Medicare and Medicaid programs sufficient to result in projected reductions in the Medicare and Medicaid federal budget baselines for FY2010-2015 that exceed the projected revenue loss for the same period attributable to the tax credit provided for, and the increase in the federal budget baseline for SCHIP resulting from, this Act.

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