[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 1742 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  1st Session
                                S. 1742

   To amend title XVIII of the Social Security Act to provide for an 
 option for any citizen or permanent resident of the United States age 
                     55 to 64 to buy into Medicare.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 3, 2017

Ms. Stabenow (for herself, Mr. Brown, Ms. Baldwin, Mr. Whitehouse, Mr. 
 Leahy, Mr. Merkley, Mr. Reed, Mr. Franken, and Mr. Booker) introduced 
the following bill; which was read twice and referred to the Committee 
                               on Finance

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to provide for an 
 option for any citizen or permanent resident of the United States age 
                     55 to 64 to buy into Medicare.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare at 55 Act''.

SEC. 2. MEDICARE BUY-IN OPTION FOR INDIVIDUALS 55 TO 64 YEARS OF AGE.

    (a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 
1395c et seq.) is amended by adding at the end the following new 
section:

     ``medicare buy-in option for individuals 55 to 64 years of age

    ``Sec. 1899C.  (a) Option.--
            ``(1) In general.--Every individual who meets the 
        requirements described in paragraph (3) shall be eligible to 
        enroll under this section.
            ``(2) Part a, b, and d benefits.--An individual enrolled 
        under this section is entitled to the same benefits (and shall 
        receive the same protections) under this title as an individual 
        who is entitled to benefits under part A and enrolled under 
        parts B and D, including the ability to enroll in a Medicare 
        Advantage plan that provides qualified prescription drug 
        coverage (an MA-PD plan).
            ``(3) Requirements for eligibility.--The requirements 
        described in this paragraph are the following:
                    ``(A) The individual is a resident of the United 
                States.
                    ``(B) The individual is--
                            ``(i) a citizen or national of the United 
                        States; or
                            ``(ii) an alien lawfully admitted for 
                        permanent residence.
                    ``(C) The individual is not otherwise entitled to 
                benefits under part A or eligible to enroll under part 
                A or part B.
                    ``(D) The individual has attained 55 years of age 
                but has not attained 65 years of age.
    ``(b) Enrollment; Coverage.--The Secretary shall establish 
enrollment periods and coverage under this section consistent with the 
principles for establishment of enrollment periods and coverage for 
individuals under other provisions of this title. The Secretary shall 
establish such periods so that coverage under this section shall first 
begin on January 1, 2019.
    ``(c) Premium.--
            ``(1) Amount of monthly premiums.--The Secretary shall, 
        during September of each year (beginning with 2018), determine 
        a monthly premium for all individuals enrolled under this 
        section. Such monthly premium shall be equal to \1/12\ of the 
        annual premium computed under paragraph (2)(B), which shall 
        apply with respect to coverage provided under this section for 
        any month in the succeeding year.
            ``(2) Annual premium.--
                    ``(A) Combined per capita average for all medicare 
                benefits.--The Secretary shall estimate the average, 
                annual per capita amount for benefits and 
                administrative expenses that will be payable under 
                parts A, B, and D (including, as applicable, under part 
                C) in the year for all individuals enrolled under this 
                section.
                    ``(B) Annual premium.--The annual premium under 
                this subsection for months in a year is equal to the 
                average, annual per capita amount estimated under 
                subparagraph (A) for the year.
            ``(3) Increased premium for certain part c and d plans.--
        Nothing in this section shall preclude an individual from 
        choosing a Medicare Advantage plan or a prescription drug plan 
        which requires the individual to pay an additional amount 
        (because of supplemental benefits or because it is a more 
        expensive plan). In such case the individual would be 
        responsible for the increased monthly premium.
    ``(d) Payment of Premiums.--
            ``(1) In general.--Premiums for enrollment under this 
        section shall be paid to the Secretary at such times, and in 
        such manner, as the Secretary determines appropriate.
            ``(2) Deposit.--Amounts collected by the Secretary under 
        this section shall be deposited in the Federal Hospital 
        Insurance Trust Fund and the Federal Supplementary Medical 
        Insurance Trust Fund (including the Medicare Prescription Drug 
        Account within such Trust Fund) in such proportion as the 
        Secretary determines appropriate.
    ``(e) Not Eligible for Medicare Cost-Sharing Assistance.--An 
individual enrolled under this section shall not be treated as enrolled 
under any part of this title for purposes of obtaining medical 
assistance for Medicare cost-sharing or otherwise under title XIX.
    ``(f) Treatment in Relation to the Affordable Care Act.--
            ``(1) Satisfaction of individual mandate.--For purposes of 
        applying section 5000A of the Internal Revenue Code of 1986, 
        the coverage provided under this section constitutes minimum 
        essential coverage under subsection (f)(1)(A)(i) of such 
        section 5000A.
            ``(2) Eligibility for premium assistance.--Coverage 
        provided under this section--
                    ``(A) shall be treated as coverage under a 
                qualified health plan in the individual market enrolled 
                in through the Exchange where the individual resides 
                for all purposes of section 36B of the Internal Revenue 
                Code of 1986 other than subsection (c)(2)(B) thereof; 
                and
                    ``(B) shall not be treated as eligibility for other 
                minimum essential coverage for purposes of subsection 
                (c)(2)(B) of such section 36B.
        The Secretary shall determine the applicable second lowest cost 
        silver plan which shall apply to coverage under this section 
        for purposes of section 36B of such Code.
            ``(3) Eligibility for cost-sharing subsidies.--For purposes 
        of applying section 1402 of the Patient Protection and 
        Affordable Care Act (42 U.S.C. 18071)--
                    ``(A) coverage provided under this section shall be 
                treated as coverage under a qualified health plan in 
                the silver level of coverage in the individual market 
                offered through an Exchange; and
                    ``(B) the Secretary shall be treated as the issuer 
                of such plan.
    ``(g) Guaranteed Issue of Medigap Policies Upon First Enrollment 
and Each Subsequent Enrollment.--In the case of an individual who 
enrolls under this section (including an individual who was previously 
enrolled under this section), paragraphs (2)(A), (2)(D), (3)(B)(ii), 
and (3)(B)(vi) of section 1882(s)--
            ``(1) shall be applied by substituting `55' for `65';
            ``(2) if the individual was enrolled under this section and 
        subsequently disenrolls, shall apply each time the individual 
        subsequently reenrolls under this section as if the individual 
        had attained 55 years of age on the date of such reenrollment 
        (and as if the individual had never previously enrolled in a 
        Medicare supplemental policy); and
            ``(3) shall be applied as if this section had not been 
        enacted (and as if the individual had never previously enrolled 
        in a Medicare supplemental policy) when the individual attains 
        65 years of age.
    ``(h) No Effect on Benefits for Individuals Otherwise Eligible or 
on Trust Funds.--The Secretary shall implement the provisions of this 
section in such a manner to ensure that such provisions--
            ``(1) have no effect on the benefits under this title for 
        individuals who are entitled to, or enrolled for, such benefits 
        other than through this section; and
            ``(2) have no negative impact on the Federal Hospital 
        Insurance Trust Fund or the Federal Supplementary Medical 
        Insurance Trust Fund (including the Medicare Prescription Drug 
        Account within such Trust Fund).
    ``(i) Consultation.--In promulgating regulations to implement this 
section, the Secretary shall consult with interested parties, including 
groups representing beneficiaries, health care providers, employers, 
and insurance companies.''.
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