[Congressional Record Volume 145, Number 158 (Wednesday, November 10, 1999)]
[Senate]
[Pages S14567-S14568]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. BOXER:
  S. 1918. A bill to waive the 24-month waiting period for disabled 
individuals to qualify for Medicare benefits in the case of individuals 
suffering from terminal illness with not more than 2 years to live; to 
the Committee on Finance.


           medicare for individuals with terminal illness act

  Mrs. BOXER. Mr. President, today I am introducing legislation to 
correct a weakness in the Medicare law for those who develop a terminal 
illness.
  Under current law, individuals under age 65 who are unable to work 
because of a disability can qualify for Medicare after a two-year 
waiting period. That is, two years after developing a disability, 
individuals can start to receive Medicare benefits to help pay for 
their health care.
  There are reasons for this two-year waiting period, and this 
legislation would not change that. What I am concerned about, Mr. 
President, is the fact that thousands of individuals develop a 
disability that is terminal within two years.
  I am talking about people with cancer, people with AIDS, people with 
Lou Gehrig's Disease, to name to just a few examples. In some cases, 
when these individuals are diagnosed and can no longer work, they have 
less than two years to live. That means they will die before the end of 
the waiting period, before they become eligible for Medicare, before 
they qualify to receive health care benefits. That is not right and not 
fair.
  The Medicare for Individuals with Terminal Illness Act would change 
this. My bill would say that for people whose doctors expect them to 
live less than two years because of their disability or illness, there 
will be no waiting period. They would qualify for Medicare immediately 
and could get the health care they need.
  Mr. President, to date, 10 individuals and 44 organizations--groups 
involved with AIDS, cerebral palsy, Alzheimer's Disease, hospice care, 
and diabetes, among others--have endorsed this legislation.
  Mr. President, I encourage my colleagues to look at this list of 
supporters, look at the bill, and join me in correcting a problem that 
is denying health care benefits to thousands of Americans.
  Mr. President, I ask unanimous consent that the text of the bill and 
a list of endorsements be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1918

       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 for Individuals 
     With Terminal Illnesses Act of 1999''.

     SEC. 2. ELIMINATION OF MEDICARE WAITING PERIOD FOR 
                   INDIVIDUALS WITH A TERMINAL ILLNESS.

       (a) In General.--Section 226 of the Social Security Act (42 
     U.S.C. 426) is amended by adding at the end the following:
       ``(j)(1) Notwithstanding subsection (f), each individual 
     with a terminal illness (as defined in paragraph (2)) who 
     would be described in subsection (b) but for the requirement 
     that the individual has been entitled to the specified 
     benefits for 24 months shall be entitled to hospital 
     insurance benefits under part A of title XVIII for each month 
     beginning with the latest of--
       ``(A) the first month after the expiration of the 24-month 
     period,
       ``(B) in the case of a qualified railroad retirement 
     beneficiary (as defined in subsection (d)), the first month 
     of the individual's entitlement or status as such a 
     beneficiary, or
       ``(C) the date of enactment of the Medicare for Individuals 
     With Terminal Illnesses Act of 1999.
       ``(2) As used in this subsection, the term `terminal 
     illness' means a medically determinable physical impairment 
     which is expected to result in the death of such individual 
     within the next 24 months.''.
       (b) Conforming Amendments.--
       (1) Amendments to the railroad retirement act of1974.--
     Section 7(d)(2) of the Railroad Retirement Act of 1974 (45 
     U.S.C. 231f(d)(2)) is amended--
       (A) in clause (i), by striking ``or'' at the end;
       (B) in clause (ii), by striking the comma at the end and 
     inserting ``; or''; and
       (C) by inserting after clause (ii) the following:
       ``(iii)(I) has not attained age 65;
       ``(II) has a terminal illness (as defined in section 
     226(j)(2) of the Social Security Act); and
       ``(III) is entitled to an annuity under section 2 of this 
     Act, or under the Railroad Retirement Act of 1937 and section 
     2 of this Act, or could have been includable in the 
     computation of an annuity under section 3(f)(3) of this Act, 
     and could currently be entitled to monthly insurance benefits 
     under section 223 of the Social Security Act or under section 
     202 of that Act on the basis of disability if service as an 
     employee after December 31, 1936, had been included in the 
     term `employment' as defined in that Act and if an 
     application for disability benefits had been filed,''.
       (2) Amendments to the social security act.--
       (A) Description of program.--Section 1811 of the Social 
     Security Act (42 U.S.C. 1395c) is amended by striking ``and 
     (3)'' and inserting ``(3) individuals under age 65 who have a 
     terminal illness (as defined in section 226(j)(2)) and who 
     are eligible for benefits under title II of this Act (or 
     would have been so entitled to such benefits if certain 
     government employment were covered under such title) or under 
     the railroad retirement system on the basis of a disability, 
     and (4)''.
       (B) Hospital insurance benefits for disabled individuals 
     who have exhausted their entitlement.--Section 1818A of the 
     Social Security Act (42 U.S.C. 1395i-2a) is amended--
       (i) in subsection (a)(2)(A), by striking ``section 226(b)'' 
     and inserting ``subsection (b) or (j) of section 226'';
       (ii) in subsection (a)(2)(C), by striking ``section 
     226(b)'' and inserting ``subsection (b) or (j) of section 
     226'';
       (iii) in subsection (b)(2), by striking ``section 226(b)'' 
     and inserting ``subsection (b) or (j) of section 226''; and
       (iv) in subsection (d)(1)(B)(ii), by striking ``section 
     226(b)'' and inserting ``subsection (b) or (j) of section 
     226''.
       (C) Enrollment periods.--Section 1837 of the Social 
     Security Act (42 U.S.C. 1395p) is amended--
       (i) in subsection (g)(1), by inserting ``but does not 
     satisfy the requirements of section 226(j)'' after ``section 
     226(b)''; and
       (ii) in subsection (i)(4)(A), by striking ``section 
     226(b)'' and inserting ``subsection (b) or (j) of section 
     226''.
       (D) Exclusions from coverage and medicare as secondary 
     payer.--Section 1862(b)(1)(B)(i) of the Social Security Act 
     (42 U.S.C. 1395y(b)(1)(B)(i)) is amended by striking 
     ``section 226(b)'' and inserting ``subsection (b) or (j) of 
     section 226''.
       (c) Effective Date.--The amendments made by this Act shall 
     apply with respect to any application for hospital insurance 
     benefits submitted to the Secretary of Health and Human 
     Services on or after the date of enactment of this Act.

     Medicare for Individuals With Terminal Illnesses Act--List of 
                              Endorsements


                           Organizations (44)

       AIDS Legal Referral Panel--San Francisco, Altamed Health 
     Services--Los Angeles, Alzheimer's Aid Society--Sacramento, 
     American Diabetes Association, African American Chapter--Los 
     Angeles, American Lung Association of California--Sacramento, 
     Asian American Drug Abuse Program, Inc. (AADAP)--Los Angeles, 
     California Prevention and Education Project (CALPEP)--
     Oakland, California Hospice and Palliative Care Association 
     (CHAPCA)--Sacramento, California Coalition of United Cerebral 
     Palsy Associations--Sacramento, Camarillo Hospice--Camarillo, 
     Caring for Babies with AIDS--Los Angeles, City of Los 
     Angeles, Common Ground Community Center--Santa Monica, County 
     of Sacramento, Covenant House California--Hollywood, Dolores 
     Street Community Services--San Francisco, Families First--
     Davis, The Family Link--San Francisco, Feedback Foundation--
     Anaheim, Friends of Chelation Society--Palm Springs, 
     Homeowner Options for Massachusetts Elders--Boston, 
     Massachusetts, and Hospice Education Institute--Essex, 
     Connecticut.
       Hospice of Marin--Corte Madera, Lambda Letters Project--
     Carmichael, Legal Center for the Elderly and Disabled--
     Sacramento, Mental Health Association of Sacramento, Mission 
     Neighborhood Health Center--San Francisco, National 
     Organization for Rare Disorders--New Fairfield, Connecticut, 
     National Health Federation--Monrovia, California, Neptune 
     Society--San Francisco,

[[Page S14568]]

     New Village Project--Los Angeles, Ohlhoff Recovery Programs--
     San Francisco, Parkinson's Disease Association of the 
     Sacramento Valley, Retired Senior Volunteer Program--Santa 
     Barbara, Sacramento AIDS Foundation, San Francisco 
     Community Clinic Consortium, Serra Project--Los Angeles, 
     Shascade Community Services--Redding, Vital Options--
     Sherman Oaks, Westside Community Mental Health Center, 
     Inc.--San Francisco, Women and Children's Family Services, 
     Yolo Hospice--Davis, YMCA of Greater Sacramento, and YWCA 
     of Sacramento.


                            individuals (10)

       Barbara Kaufman--Member, SFBOS, Sue Bierman--Member, SFBOS, 
     Ricardo Hernandez--Public Administrator/Public Guardian, City 
     & County of SF, Steve Cohn--Member, Sacramento City Council, 
     Eve Meyer--Executive Director, San Francisco Suicide 
     Prevention, Mike McGowan--Member, Yolo County Board of 
     Supervisors, Rev. Gwyneth MacKenzie Murphy--Associate Pastor, 
     Grace Cathedral, Teresa Brown--Program Coordinator, HIV 
     Services Division, Alameda County Medical Ctr., Lois Wolk--
     Yolo County Supervisor, Sarah Bennett--Executive Director, Ad 
     Hoc Committee to Defend Health Care--Cambridge, MA.
                                 ______