1.Short title; table of
contents
(a)This Act may be cited as the Medicare Early Access Act of
2009
.
(b)
Sec. 1. Short title; table of contents.
TITLE I—Access to Medicare benefits for individuals 55 to 65
years of age
Sec. 101. Access to Medicare benefits for individuals 55 to 65
years of age.
PART E—Purchase of Medicare benefits by certain individuals 55 to
65 years of age
Sec. 1860E–1. Program benefits;
eligibility.
Sec. 1860E–2. Enrollment process;
coverage.
Sec. 1860E–3.
Premiums.
Sec. 1860E–4. Payment of
premiums.
Sec. 1860E–5. Provisions relating to employment-based retiree
health coverage.
Sec. 1860E–6. Medicare Early Access Trust
Fund.
Sec. 1860E–7. Oversight and
accountability.
Sec. 1860E–8. Administration and
miscellaneous.
TITLE II—Refundable and advanceable credit against income tax for
Medicare early access premiums
Sec. 201. Refundable and advanceable income tax credit for
Medicare early access premiums.
<enum>I</enum><header>Access to
Medicare benefits for individuals 55 to 65 years of age</header>
<section id="H52527C9DFCA84F9682ADE848C3E9CC"><enum>101.</enum><header>Access to
Medicare benefits for individuals 55 to 65 years of age</header>
<subsection id="H856B6AD5EACE416ABEE731B1999B974C"><enum>(a)</enum><header>In
general</header><text>Title XVIII of the <act-name parsable-cite="SSA">Social
Security Act</act-name> is amended—</text>
<paragraph id="HE3D7B45FF69F452C995D3E37F2023004"><enum>(1)</enum><text>by redesignating
part E as part F; and</text>
</paragraph><paragraph id="H56D28AF3F0B84AB5B0CC4C90077B7CD8"><enum>(2)</enum><text>by inserting after
part D the following new part:</text>
<quoted-block id="H816364E574B64A5E8E7DC20021F15D1D">
<part id="HB029950D299A44C2A29EF6B52EB8387"><enum>E</enum><header>Purchase of
Medicare benefits by certain individuals 55 to 65 years of age</header>
<section id="HAA0AF50AE9FD47EC82364733C010B086"><enum>1860E–1.</enum><header>Program
benefits; eligibility</header>
<subsection id="H74FD1FF8FFF142E69C3B36DE81947D1E"><enum>(a)</enum><header>Entitlement to
Medicare benefits for enrolled individuals</header>
<paragraph id="H8A73BD51786845B382E4BAC5866CED7F"><enum>(1)</enum><header>In
general</header><text>An individual enrolled under this part is entitled to the
same benefits under this title as an individual entitled to benefits or
enrolled under any part of this title.</text>
</paragraph><paragraph id="HD39E2E0812D94D26B9C32D6DCB4D352C"><enum>(2)</enum><header>Definitions</header><text>For
purposes of this part:</text>
<subparagraph id="HD8448DB3E2F34903AF275183D7D733C0"><enum>(A)</enum><header>Federal or State
COBRA continuation provision</header><text>The term <term>Federal or State
COBRA continuation provision</term> has the meaning given the term <term>COBRA
continuation provision</term> in section 2791(d)(4) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> and
includes a comparable State program, as determined by the Secretary.</text>
</subparagraph><subparagraph id="H4833086C3584435CADC54703D5913DE4"><enum>(B)</enum><header>Federal health
insurance program defined</header><text>The term <term>Federal health insurance
program</term> means any of the following:</text>
<clause id="H91444AD745FE40B1B0D09EE747ABAEED"><enum>(i)</enum><header>Medicare</header><text>Any
part of this title (other than by reason of this part).</text>
</clause><clause id="HAE34B468D6774E1C954DFD194997B507"><enum>(ii)</enum><header>Medicaid</header><text>A
State plan under title XIX.</text>
</clause><clause id="HDEF062F8EBC141F5937612007164FE33"><enum>(iii)</enum><header>FEHBP</header><text>The
Federal employees health benefit program under chapter 89 of title 5, United
States Code.</text>
</clause><clause id="HD0A70BC90B454B5A913F00EE2EF246D7"><enum>(iv)</enum><header>TRICARE</header><text>The
TRICARE program (as defined in section 1072(7) of title 10, United States
Code).</text>
</clause><clause id="H438583B793554AA385FD024CB4B15E61"><enum>(v)</enum><header>Active duty
military</header><text>Health benefits under title 10, United States Code, to
an individual as a member of the uniformed services of the United
States.</text>
</clause></subparagraph><subparagraph id="H9252CF9B46BE491FB801F7101690C15C"><enum>(C)</enum><header>Group health
plan</header><text>The term <term>group health plan</term> has the meaning
given such term in section 2791(a)(1) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>.</text>
</subparagraph></paragraph></subsection><subsection id="H92716E9B66B5495F86A3602DB8007EE5"><enum>(b)</enum><header>Eligibility of
individuals age 55 to 65 years of age</header>
<paragraph id="HBE44E1F9B53C43ABBF7EB1FBBBCEB84"><enum>(1)</enum><header>In
general</header><text>Subject to paragraph (2), an individual who meets the
following requirements with respect to a month is eligible to enroll under this
part with respect to such month:</text>
<subparagraph id="H68439DF08D0341A7B8AD3900389C058E"><enum>(A)</enum><header>Age</header><text>As
of the last day of the month, the individual has attained 55 years of age, but
has not attained 65 years of age.</text>
</subparagraph><subparagraph id="HD940DB94D60E45AEB5B1D6CE973DB4FB"><enum>(B)</enum><header>Medicare
eligibility (but for age)</header><text>The individual would be eligible for
benefits under part A or part B for the month if the individual were 65 years
of age.</text>
</subparagraph><subparagraph id="H6B6CDE183E334126BB19EADDAEA7B690"><enum>(C)</enum><header>Not eligible for
coverage under group health plans or Federal health insurance
programs</header><text>The individual is not eligible for benefits or coverage
under a Federal health insurance program (as defined in subsection (a)(2)(B))
or under a group health plan (other than such eligibility merely through a
Federal or State COBRA continuation provision) as of the last day of the month
involved.</text>
</subparagraph></paragraph><paragraph id="HEF6CF4919EEE4D3C9E9BF0B61E000068"><enum>(2)</enum><header>Limitation on
eligibility if terminated enrollment</header><text>If an individual described
in paragraph (1) enrolls under this part and coverage of the individual is
terminated under section 1860E–2(d) (other than because of age), the individual
is not again eligible to enroll under this subsection unless the following
requirements are met:</text>
<subparagraph id="H346A830DA5854A7A948B5D65E600CBA0"><enum>(A)</enum><header>New coverage
under group health plan or Federal health insurance program</header><text>After
the date of termination of coverage under such section, the individual obtains
coverage under a group health plan or under a Federal health insurance
program.</text>
</subparagraph><subparagraph id="H8541DF2603C249B48B2700ECDD5733B"><enum>(B)</enum><header>Subsequent loss
of new coverage</header><text>The individual subsequently loses eligibility for
the coverage described in subparagraph (A) without regard to whether the
individual has exhausted any eligibility the individual may subsequently have
for coverage under a Federal or State COBRA continuation provision.</text>
</subparagraph></paragraph><paragraph id="HE79B76E461B647B600EA45BBDFCE3769"><enum>(3)</enum><header>Change in health
plan eligibility does not affect coverage</header><text>In the case of an
individual who is eligible for and enrolls under this part under this
subsection, the individual’s continued entitlement to benefits under this part
shall not be affected by the individual’s subsequent eligibility for benefits
or coverage described in paragraph (1)(C), or entitlement to such benefits or
coverage.</text>
</paragraph></subsection></section><section id="HD5ADBBA77D2F4A348500EFCC38E1996"><enum>1860E–2.</enum><header>Enrollment
process; coverage</header>
<subsection id="H5C49CA3F83434708953C8B6222DCD76B"><enum>(a)</enum><header>In
general</header><text>An individual may enroll in the program established under
this part only in such manner and form as may be prescribed by regulations, and
only during an enrollment period prescribed by the Secretary consistent with
the provisions of this section. Such regulations shall provide a process under
which individuals eligible to enroll as of a month are permitted to pre-enroll
during a prior month within an enrollment period described in subsection
(b).</text>
</subsection><subsection id="H989CF8787BF0400ABC67ED2B56E73559"><enum>(b)</enum><header>Enrollment
periods</header>
<paragraph id="H22F12408194346FF8E908507FF6F9BF2"><enum>(1)</enum><header>Individuals 55
to 65 years of age</header><text>In the case of individuals eligible to enroll
under this part under section 1860E–1(b)—</text>
<subparagraph id="H85D27E826672405EB9F7DB106D76058"><enum>(A)</enum><header>Initial
enrollment period</header><text>If the individual is eligible to enroll under
such section for January 2011, the enrollment period shall begin on November 1,
2010, and shall end on February 28, 2011. Any such enrollment before January 1,
2011, is conditioned upon compliance with the conditions of eligibility for
January 2011.</text>
</subparagraph><subparagraph id="H70AB32D6CC30445084ADC679C53E298E"><enum>(B)</enum><header>Subsequent
periods</header><text>If the individual is eligible to enroll under such
section for a month after January 2011, the enrollment period shall begin on
the first day of the second month before the month in which the individual
first is eligible to so enroll and shall end four months later. Any such
enrollment before the first day of the third month of such enrollment period is
conditioned upon compliance with the conditions of eligibility for such third
month.</text>
</subparagraph></paragraph><paragraph id="H76AB48BE68A34EA9BD5150B55F4C1C7D"><enum>(2)</enum><header>Authority to
correct for government errors</header><text>The provisions of section 1837(h)
apply with respect to enrollment under this part in the same manner as they
apply to enrollment under part B.</text>
</paragraph></subsection><subsection id="HC4FBA812226B429C9BC2B01103B4D52"><enum>(c)</enum><header>Date coverage
begins</header>
<paragraph id="H9F409A6E05BE4DD6B54BC5B43FD4222C"><enum>(1)</enum><header>In
general</header><text>The period during which an individual is entitled to
benefits under this part shall begin as follows, but in no case earlier than
January 1, 2011:</text>
<subparagraph id="HBFA266E2F81E467CBB1FA5BD00E29C71"><enum>(A)</enum><text>In the case of an
individual who enrolls (including pre-enrolls) before the month in which the
individual satisfies eligibility for enrollment under section 1860E–1, the
first day of such month of eligibility.</text>
</subparagraph><subparagraph id="HEAA504AB51C94ABF9D5B2951B6B1F8FB"><enum>(B)</enum><text>In the case of an
individual who enrolls during or after the month in which the individual first
satisfies eligibility for enrollment under such section, the first day of the
following month.</text>
</subparagraph></paragraph><paragraph id="HA2C8E74FF44C4EAAACE16E66D2D0D9E5"><enum>(2)</enum><header>Authority to
provide for partial months of coverage</header><text>Under regulations, the
Secretary may, in the Secretary’s discretion, provide for coverage periods that
include portions of a month in order to avoid lapses of coverage.</text>
</paragraph><paragraph id="H472EB92F5DE74AA682778B9F71DBF000"><enum>(3)</enum><header>Limitation on
payments</header><text>No payments may be made under this title with respect to
the expenses of an individual enrolled under this part unless such expenses
were incurred by such individual during a period which, with respect to the
individual, is a coverage period under this section.</text>
</paragraph></subsection><subsection id="HC1FAA01DDE284483B0001450E232ACF"><enum>(d)</enum><header>Termination of
coverage</header>
<paragraph id="HD59608BC57D84BAAB37E039D78B55445"><enum>(1)</enum><header>In
general</header><text>An individual’s coverage period under this part shall
continue until the individual’s enrollment has been terminated at the earliest
of the following:</text>
<subparagraph id="HA6A9C87579784D8382C4F09044CD103"><enum>(A)</enum><header>General
provisions</header>
<clause id="HAF9F4FCB65C946F8A849C23FEF3251CE"><enum>(i)</enum><header>Notice</header><text>The
individual files notice (in a form and manner prescribed by the Secretary) that
the individual no longer wishes to participate in the insurance program under
this part.</text>
</clause><clause id="H6BD779B7075F4272B04E2734A8F8D152"><enum>(ii)</enum><header>Nonpayment of
premiums</header><text>The individual fails to make payment of premiums
required for enrollment under this part.</text>
</clause><clause id="H9C191A5F7ECF4CB89BA2A195EFC795DC"><enum>(iii)</enum><header>Medicare
eligibility</header><text>The individual becomes entitled to benefits or
enrolled under any other part of this title (other than by reason of this
part).</text>
</clause></subparagraph><subparagraph id="HA815B0ADF7B443F2B3923E3875A207D7"><enum>(B)</enum><header>Termination
based on age</header><text>The individual attains 65 years of age.</text>
</subparagraph></paragraph><paragraph id="HE40E0474C0D4414CBC7C00EF002B00E8"><enum>(2)</enum><header>Effective date
of termination</header>
<subparagraph id="H7FFBE1014C1A42E3B3BAFB895901BA2D"><enum>(A)</enum><header>Notice</header><text>The
termination of a coverage period under paragraph (1)(A)(i) shall take effect at
the close of the month following for which the notice is filed.</text>
</subparagraph><subparagraph id="H99AED1CDD1974BBCB49C596E3561BC9E"><enum>(B)</enum><header>Nonpayment of
premium</header><text>The termination of a coverage period under paragraph
(1)(A)(ii) shall take effect on a date determined under regulations, which may
be determined so as to provide a grace period in which overdue premiums may be
paid and coverage continued. The grace period determined under the preceding
sentence shall not exceed 60 days; except that it may be extended for an
additional 30 days in any case where the Secretary determines that there was
good cause for failure to pay the overdue premiums within such 60-day
period.</text>
</subparagraph><subparagraph id="HB10D3CC56A384D0E87944493299600E0"><enum>(C)</enum><header>Medicare
eligibility or age</header><text>The termination of a coverage period under
paragraph (1)(A)(iii) or (1)(B) shall take effect as of the first day of the
month in which the individual—</text>
<clause id="id5B92EA874E3549579293155376F35F1A"><enum>(i)</enum><text>becomes entitled
to benefits or enrolled in any other part of this title (other than by reason
of this part); or</text>
</clause><clause id="idFE947A93D81E47C8ABBA1F297F26C4E5"><enum>(ii)</enum><text>attains 65 years
of age.</text>
</clause></subparagraph></paragraph></subsection></section><section id="HEC3EE3763F0C46B48D1DC0E817008D06"><enum>1860E–3.</enum><header>Premiums</header>
<subsection id="H89831D276DE4492AA7BF53AB28B249ED"><enum>(a)</enum><header>Amount of
monthly premiums</header><text>The Secretary shall, during September of each
year (beginning with 2010), determine a monthly premium for individuals 55
years of age or older, equal to <fraction>1/12</fraction> of the annual premium
computed under subsection (b)(2), which shall apply with respect to coverage
provided under this title for any month in the succeeding year.</text>
</subsection><subsection id="HDD50FF204E7840EB95FBC93BF8EC2E44"><enum>(b)</enum><header>Annual
premium</header>
<paragraph id="H323EA48A03CF43579578873E6E7CE3FF"><enum>(1)</enum><header>National, per
capita average</header><text>The Secretary shall estimate the average, annual
per capita amount that would be payable under this title with respect to
individuals residing in the United States who meet the requirement of section
1860E–1(b)(1)(A) as if all such individuals were eligible for (and enrolled)
under this title during the entire year (and assuming that section
1862(b)(2)(A)(i) did not apply).</text>
</paragraph><paragraph id="H6F3A14D0D5844612A5D43549AE4D13CF"><enum>(2)</enum><header>Annual
premium</header><text>The annual premium under this subsection for months in a
year is equal to the average, annual per capita amount estimated under
paragraph (1) for the year.</text>
</paragraph></subsection></section><section id="HE5BE7F04CE8A42C1ACF31078EF73E700"><enum>1860E–4.</enum><header>Payment of
premiums</header>
<subsection id="HDC2A90628750475FB9000000A1DE5E89"><enum>(a)</enum><header>Payment of
monthly premium</header>
<paragraph id="H4A09E05E451F46CFA67C7DEF79D3FF44"><enum>(1)</enum><header>In
general</header><text>The Secretary shall provide for payment and collection of
the monthly premium, determined under section 1860E–3(a) for the the individual
involved, in the same manner as for payment of monthly premiums under section
1840, except that, for purposes of applying this section, any reference in such
section to the Federal Supplementary Medical Insurance Trust Fund is deemed a
reference to the Trust Fund established under section 1860E–6.</text>
</paragraph><paragraph id="H40895BCBF0B2493F9E6080211BA5EEDD"><enum>(2)</enum><header>Period of
payment</header><text>In the case of an individual who participates in the
program established by this title pursuant to enrollment under this part, the
monthly premium shall be payable for the period commencing with the first month
of the individual’s coverage period and ending with the month in which the
individual’s coverage under this part terminates.</text>
</paragraph></subsection><subsection id="H3083C084485A4252BF51D075588F8BDF"><enum>(b)</enum><header>Application of
certain provisions</header><text>The provisions of section 1840 (other than
subsection (h)) shall apply to premiums collected under this section in the
same manner as they apply to premiums collected under part B, except that any
reference in such section to the Federal Supplementary Medical Insurance Trust
Fund is deemed a reference to the Trust Fund established under section
1860E–6.</text>
</subsection></section><section id="H83329583509E45BCB5A4C78200C1F600"><enum>1860E–5.</enum><header>Provisions
relating to employment-based retiree health coverage</header>
<subsection id="HEA23C876753C40FC90F363AB5F76451C"><enum>(a)</enum><header>In
general</header><text>In the case of an individual who would be eligible to
enroll under this part but for the provision of employment-based retiree health
coverage by an employer to the individual, notwithstanding the limitation under
section 1860E–1(b)(1)(C), the individual is eligible to enroll under this
part.</text>
</subsection><subsection id="H35C97379A59C4577AEAD3F36B81BEC54"><enum>(b)</enum><header>Maintenance of
effort</header><text>In the case of an employer that offers employment-based
retiree health coverage to an individual who enrolls under this part, upon
enrollment of the individual under this part, the employer may modify such
coverage to provide for the following benefits:</text>
<paragraph id="HBB16EA92A8004C8F90ADFD08AADB2CED"><enum>(1)</enum><text>Payment is made by
the employer under such coverage for items and services for which payment may
not be made under this title.</text>
</paragraph><paragraph id="HDFDA500B9D194915A5E17B08B77498F"><enum>(2)</enum><text>Payment is made by
the employer sponsoring such coverage of 25 percent of the monthly premium
under section 1860E–3 applicable to the individual after enrollment under this
part.</text>
</paragraph></subsection><subsection id="HE82981A962EC41B6A61C3EADD3AE1EB9"><enum>(c)</enum><header>Employment-Based
retiree health coverage</header><text>The term <term>employment-based retiree
health coverage</term> has the meaning given that term in section
1860D–22(c)(1), except that, for purposes of this part, the reference in such
section to <quote>part D eligible individuals</quote> is deemed to be a
reference to <quote>individuals eligible to enroll under part E</quote>.</text>
</subsection></section><section id="HACF42940D46044928428FC6C9705A6D9"><enum>1860E–6.</enum><header>Medicare
Early Access Trust Fund</header>
<subsection id="H05A1EFD13A984CDE8B760096B0B473AF"><enum>(a)</enum><header>Establishment of
Trust Fund</header>
<paragraph id="H713498A87E0A4299B7E5F207E000C8F7"><enum>(1)</enum><header>In
general</header><text>There is hereby created on the books of the Treasury of
the United States a trust fund to be known as the <quote>Medicare Early Access
Trust Fund</quote> (in this section referred to as the <quote>Trust
Fund</quote>). The Trust Fund shall consist of such gifts and bequests as may
be made as provided in section 201(i)(1) and such amounts as may be deposited
in, or appropriated to, such fund as provided in this title.</text>
</paragraph><paragraph id="H4F0DD3F3500D4D75AC7F6073A0FFFC00"><enum>(2)</enum><header>Premiums</header><text>Premiums
collected under section 1860E–3 and payable under section 1860E–5(a)(2) shall
be transferred to the Trust Fund.</text>
</paragraph></subsection><subsection id="HF56546644DCD4C52809441BECF63130"><enum>(b)</enum><header>Incorporation of
provisions</header>
<paragraph id="HCF3B5E05A3F644139297999C9421AE81"><enum>(1)</enum><header>In
general</header><text>Subject to paragraph (2), subsections (b) through (i) of
section 1841 shall apply with respect to the Trust Fund and this title in the
same manner as they apply with respect to the Federal Supplementary Medical
Insurance Trust Fund and part B, respectively.</text>
</paragraph><paragraph id="H2F872803A2134EB68D621100491797A2"><enum>(2)</enum><header>Miscellaneous
references</header><text>In applying provisions of section 1841 under paragraph
(1)—</text>
<subparagraph id="HF16307C22CE64B7D83F5211124992651"><enum>(A)</enum><text>any reference in
such section to <quote>this part</quote> is construed to refer to this part
E;</text>
</subparagraph><subparagraph id="H88E4A63BA3D444769726BF7725E828CE"><enum>(B)</enum><text>any reference in
section 1841(h) to section 1840(d) and in section 1841(i) to sections
1840(b)(1) and 1842(g) are deemed references to comparable authority exercised
under this part; and</text>
</subparagraph><subparagraph id="HBAF9DE3AA5DC476CBDD30008027B7E3F"><enum>(C)</enum><text>payments may be
made under section 1841(g) to the Trust Funds under sections 1817 and 1841 as
reimbursement to such funds for payments they made for benefits provided under
this part.</text>
</subparagraph></paragraph></subsection></section><section id="H3D512E0587A1481D9B5D140840AB7471"><enum>1860E–7.</enum><header>Oversight
and accountability</header>
<subsection id="H1F10A5E388A24619B24FBBD8D23C033"><enum>(a)</enum><header>Annual reports of
trustees</header><text>The Board of Trustees of the Medicare Early Access Trust
Fund under section 1860E–6(b)(1) shall report on an annual basis to Congress
concerning the status of the Trust Fund and the need for adjustments in the
program under this part to maintain financial solvency of the program under
this part.</text>
</subsection><subsection id="H61D59CB240F648749BB0482BC810E9E0"><enum>(b)</enum><header>Periodic GAO
reports</header><text>The Comptroller General of the United States shall
periodically submit to Congress reports on the adequacy of the financing of
coverage provided under this part. The Comptroller General shall include in
such report such recommendations for adjustments in such financing and coverage
as the Comptroller General deems appropriate in order to maintain financial
solvency of the program under this part.</text>
</subsection></section><section id="HFE203F9474894487ACB3E5EBEF565D75"><enum>1860E–8.</enum><header>Administration
and miscellaneous</header>
<subsection id="H1D641FA79E7041FBB3ABFE3572BAED56"><enum>(a)</enum><header>Treatment for
purposes of title</header><text>Except as otherwise provided in this
part—</text>
<paragraph id="HC1D24459A2614AD48B5706FDEBF7FA"><enum>(1)</enum><text>individuals enrolled
under this part shall be treated for purposes of this title as though the
individual were entitled to benefits and enrolled under any part of this title;
and</text>
</paragraph><paragraph id="HF2B8A336C1B74853BE00A06F84B71906"><enum>(2)</enum><text>benefits described
in section 1860E–1 shall be payable under this title to such individuals in the
same manner as if such individuals were so entitled and enrolled.</text>
</paragraph></subsection><subsection id="H67819EC1CA6F4A2C8FAEB5B5AB16D800"><enum>(b)</enum><header>Not treated as
Medicare program for purposes of medicaid program</header><text>For purposes of
applying title XIX (including the provision of medicare cost-sharing assistance
under such title), an individual who is enrolled under this part shall not be
treated as being entitled to benefits under this title.</text>
</subsection><subsection id="H996527A719264693A302C534700BF23"><enum>(c)</enum><header>Not treated as
Medicare program for purposes of COBRA continuation provisions</header><text>In
applying a COBRA continuation provision (as defined in section 2791(d)(4) of
the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>), any
reference to an entitlement to benefits under this title shall not be construed
to include entitlement to benefits under this title pursuant to the operation
of this
part.</text>
</subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H605C98790E844D3B0036FEEB2CB1C64"><enum>(b)</enum><header>Conforming
amendments to <act-name parsable-cite="SSA">Social Security Act</act-name>
provisions</header><paragraph commented="no" display-inline="yes-display-inline" id="HA4454628EE744EFEA3A25E4185EA898"><enum>(1)</enum><text>Section 201(i)(1) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
401(i)(1)) is amended—</text>
<subparagraph id="idCFC1C587C44045C29858F736225EE552" indent="up1"><enum>(A)</enum><text>by striking <quote>or the Federal
Supplementary Medical Insurance Trust Fund</quote> and inserting <quote>the
Federal Supplementary Medical Insurance Trust Fund</quote>; and</text>
</subparagraph><subparagraph id="idF074E80E29384239A89834BF3ACAAB17" indent="up1"><enum>(B)</enum><text>by inserting <quote>, or the Medicare
Early Access Trust Fund</quote> after <quote>such Trust Fund)</quote>.</text>
</subparagraph></paragraph><paragraph id="HD995AC0EE42845FB8614C5EA88779715" indent="up1"><enum>(2)</enum><text>Section 201(g)(1)(A) of the Social
Security Act (42 U.S.C. 401(g)(1)(A)), in the matter preceding clause (i), is
amended by striking <quote>and the Federal Supplementary Medical Insurance
Trust Fund established by title XVIII</quote> and inserting <quote>, the
Federal Supplementary Medical Insurance Trust Fund, and the Medicare Early
Access Trust Fund established by title XVIII</quote>.</text>
</paragraph><paragraph id="H850994A77DA34B71A0CDE1753643594" indent="up1"><enum>(3)</enum><text>Section 1820(i) of the Social
Security Act (42 U.S.C. 1395i–4(i)) is amended by striking <quote>part
D</quote> and inserting <quote>part F</quote>.</text>
</paragraph><paragraph id="H4A6C07666E4147378C59FF226301F8E0" indent="up1"><enum>(4)</enum><text>Section 1853 of the Social Security
Act (42 U.S.C. 1395w–23), as amended by sections 401 and 402 of the HITECH Act
(Public Law 111–5), is amended by adding at the end the following new
subsection:</text>
<quoted-block id="H54216D637642427D938794B0D1BBEE9">
<subsection id="H1C9718621A9C480C9DDB522B00BB98C7"><enum>(n)</enum><header>Adjustment for
early access</header><text>For years beginning with 2011, in applying this
section with respect to individuals entitled to benefits under part E, the
Secretary shall provide for an appropriate adjustment in the payment amount
determined under this section or section 1858, as may be appropriate to reflect
differences between the population served under such part and the population
under parts A and
B.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HF9E7A2C138A84F8EAA128EE847AE9E83" indent="up1"><enum>(5)</enum><text>Section 1860D–15(c)(1) of the Social
Security Act (42 U.S.C. 1395w–115(c)(1)) is amended by adding at the end the
following new subparagraph:</text>
<quoted-block id="H6196277A6ECB4A2C922D19014CF1DE1">
<subparagraph id="H3C6CAFB118124FEB8E59FF09546CB361"><enum>(E)</enum><header>Adjustment for
early access</header><text>In applying this section with respect to individuals
entitled to benefits under part E, the Secretary shall provide for an
appropriate adjustment in the payment amount determined under this section as
may be appropriate to reflect differences between the population served under
such part and the population under parts A and
B.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="idDFA5BAC8C46A43F8986BB2A168208AEE"><enum>(c)</enum><header>Conforming
reference to previous part E</header><text>Any reference in law (in effect
before the date of the enactment of this Act) to part E of title XVIII of the
Social Security Act is deemed a reference to part F of such title (as in effect
after such date).</text>
</subsection><subsection id="H8FCDCEDC7BC148CBB800EE68AAA484EF"><enum>(d)</enum><header>Other conforming
amendments</header><paragraph commented="no" display-inline="yes-display-inline" id="H7769925DE52446458523F6C1C016FCEA"><enum>(1)</enum><text>Section 602(2)(D)(ii) of
the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of
1974</act-name> (29 U.S.C. 1162(2)(D)(ii)) is amended by inserting <quote>(not
including benefits under section 1860E–1 of such Act)</quote> after
<quote><act-name parsable-cite="SSA">Social Security
Act</act-name></quote>.</text>
</paragraph><paragraph id="H36FBFCCF182E43BC9BEE4DC36D4F4CF" indent="up1"><enum>(2)</enum><text>Section 2202(2)(D)(ii) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
300bb–2(2)(D)(ii)) is amended by inserting <quote>(not including benefits under
section 1860E–1 of such Act)</quote> after <quote><act-name parsable-cite="SSA">Social Security Act</act-name></quote>.</text>
</paragraph><paragraph id="HF839713720C942CAA9ECF2C5C24EBA1C" indent="up1"><enum>(3)</enum><text>Section 4980B(f)(2)(B)(i)(V) of the
Internal Revenue Code of 1986 is amended by inserting <quote>(not including
benefits under section 1860E–1 of such Act)</quote> after <quote><act-name parsable-cite="SSA">Social Security Act</act-name></quote>.</text>
</paragraph></subsection></section><enum>II</enum><header>Refundable and
advanceable credit against income tax for Medicare early access
premiums</header>
<section id="H1C3A0F96776D4FA9986B61F08200A5B3"><enum>201.</enum><header>Refundable and
advanceable income tax credit for Medicare early access premiums</header>
<subsection id="H6AA666FB3E034E9D9E4FF3617821F26"><enum>(a)</enum><header>In
general</header><text>Subpart C of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to refundable personal credits) is
amended by inserting after section 36A the following new section:</text>
<quoted-block id="H3D36CFA506A4450A9E1388F220A6604F">
<section id="H186EDB5C6BC74A709870562E11E98354"><enum>36B.</enum><header>Medicare early
access premiums</header>
<subsection id="H81B9BDE3EA654F15966134CB495052E7"><enum>(a)</enum><header>In
general</header><text>In the case of an individual, there shall be allowed as a
credit against the tax imposed by this chapter for the taxable year an amount
equal to 75 percent of the amount paid during such year as Medicare early
access coverage premiums.</text>
</subsection><subsection id="H13246F0036E84A29A7FEA02920E74056"><enum>(b)</enum><header>Definitions</header><text>For
purposes of this section the term <term>Medicare early access coverage
premiums</term> means premiums paid under part E of title XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
</subsection><subsection id="HD0BD7B42D3504D9FA206F8A953147512"><enum>(c)</enum><header>Coordination
with advance payment</header><text>With respect to any taxable year, the amount
which would (but for this subsection) be allowed as a credit under subsection
(a) shall be reduced (but not below zero) by the aggregate amount paid on
behalf of such taxpayer under section 7529 for such taxable
year.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HD8CA3059D9964490962BD916226DA600"><enum>(b)</enum><header>Advance payment
of credit</header><text>Chapter 77 of such Code (relating to miscellaneous
provisions) is amended by adding at the end the following new section:</text>
<quoted-block id="H5B5CE30F3D9249899FA9AC3941788920">
<section id="H7C02B185CAAB4817AA80E16328B800F"><enum>7529.</enum><header>Advance payment
of credit for Medicare early access premiums</header>
<subsection id="H0B9AD3C236CD4047B99DF58C4129C6DE"><enum>(a)</enum><header>General
rule</header><text>The Secretary shall establish a program for making payments
on behalf of individuals enrolled under part E of title XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name> to the Secretary
of Health and Human Services for premiums payable by such individuals under
such part.</text>
</subsection><subsection id="H367C867579B54E3DA4874082CA9C4408"><enum>(b)</enum><header>Limitation on
advance payments during any taxable year</header><text>The Secretary may make
payments under subsection (a) only to the extent that the total amount of such
payments made on behalf of any individual during the taxable year does not
exceed the amount allowable as a credit to such individual for such year under
section 36B (determined without regard to subsection (c)
thereof).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H10D9FBA0302C4FD897B300C703008F3"><enum>(c)</enum><header>Conforming
amendments</header><paragraph commented="no" display-inline="yes-display-inline" id="id63F1F570258F4BF3A6EEEAE624F79E50"><enum>(1)</enum><text>Section 6211(b)(4)(A)
of such Code is amended by inserting <quote>36B,</quote> after
<quote>36A,</quote>.</text>
</paragraph><paragraph id="H41D5E89559584BFABD112CDBC55D6CFC" indent="up1"><enum>(2)</enum><text>Paragraph (2) of section 1324(b) of
title 31, United States Code, is amended by inserting <quote>36B,</quote> after
<quote>section 36A,</quote>.</text>
</paragraph><paragraph id="H7B78A695F17643CFB6735800EA8BED69" indent="up1"><enum>(3)</enum><text>The table of sections for subpart C
of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is
amended by inserting after the item relating to section 36A the following new
item:</text>
<quoted-block id="HA7A9DA33A9274F5AA8902DF5B5FFBDD1" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">36B. Medicare early access
premiums.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H6A17BC176DCD46BD8D5F21CF88101EDC" indent="up1"><enum>(4)</enum><text>The table of sections for chapter 77
of such Code is amended by adding at the end the following new item:</text>
<quoted-block id="HFBA814117E184D0BACBA509BACD795A3" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">7529. Advance payment of credit for
Medicare early access
premiums.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HC2A5F3DAA7624E588950798E4F27BACC"><enum>(d)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2010.</text>
</subsection></section>