II 109th CONGRESS 2d Session S. 2260 IN THE SENATE OF THE UNITED STATES February 8, 2006 Mrs. Clinton introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend titles XVIII and XIX of the Social Security Act to make improvements to payments to Medicare Advantage plans and to reinstate protections in the Medicaid program for working families, their children, and the disabled against excessive out-of-pocket costs, inadequate benefits, and health care coverage loss.

1.

Short title

This Act may be cited as the Patients Before Profits Act of 2006.

2.

Elimination of certain Medicare Advantage overpayments

(a)

In general

Section 1853(a)(1)(C)(ii) of the Social Security Act (42 U.S.C. 1395w–23(a)(1)(C)(ii)), as added by section 5301 of the Deficit Reduction Act of 2005, is amended— (1)in the heading, by striking during phase-out of budget neutrality factor; (2)in the matter preceding subclause (I), by striking through 2010 and inserting and subsequent years; and (3)in subclause (II), by striking only for 2008, 2009, and 2010 and inserting for 2008 and subsequent years. (b)

Effective date

The amendments made by this section shall take effect as if included in the enactment of section 5301 of the Deficit Reduction Act of 2005.

3.

Elimination of private insurance slush fund

(a)

Elimination

Subsection (e) of section 1858 of the Social Security Act (42 U.S.C. 1395w–27a) is repealed. (b)

Conforming Amendment

Section 1858(f)(1) of the Social Security Act (42 U.S.C. 1395w–27a(f)(1)) is amended by striking subject to subsection (e),. (c)

Effective Date

The amendments made by this section shall take effect as if included in the enactment of section 221(c) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2181).

4.

Reinstating protections for adequate benefits and affordable cost sharing

(a)

Repeal of state option for alternative premiums and cost sharing

(1)

Repeal

Section 1916A of the Social Security Act, as added by sections 6041(a), 6042(a), and 6043(a) of the Deficit Reduction Act of 2005, is repealed. (2)

Conforming amendments

(A)Subsection (y) of section 1903 of the Social Security Act (42 U.S.C. 1396b), as added by section 6043(b) of the Deficit Reduction Act of 2005, is repealed. (B)Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended— (i)in subsection (f), by striking and section 1916A after (b)(3); and (ii)by striking subsection (h). (b)

Repeal of state option of providing benchmark benefit packages

Section 1937 of the Social Security Act, as added by section 6044(a) of the Deficit Reduction Act of 2005, is repealed. (c)

Repeal of health opportunity accounts demonstration

Section 1938 of the Social Security Act, as added by section 6082 of the Deficit Reduction Act of 2005, is repealed. (d)

Additional conforming amendment

Section 1939 of the Social Security Act, as redesignated by section 6082 of the Deficit Reduction Act of 2005, is redesignated as section 1937 of the Social Security Act. (e)

Effective date

The repeals and amendments made by this subsections (a) through (d) shall take effect as if included in the enactment of the Deficit Reduction Act of 2005.