[Congressional Record Volume 149, Number 116 (Thursday, July 31, 2003)]
[Senate]
[Pages S10643-S10644]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Ms. Landrieu, Mrs. Lincoln, Mr. 
        Kerry, Mrs. Clinton, Mrs. Murray, Mr. Lautenberg, and Ms. 
        Mikulski):
  S. 1519. A bill to amend title XIX of the Social Security Act to 
extend medicare cost-sharing for qualifying individuals through 2004; 
to the Committee on Finance.
  Mr. BINGAMAN. Mr. President, I am introducing today emergency 
legislation with Senators Landrieu, Lincoln, Kerry, Clinton, Murray, 
Lautenberg, and Mikulski that would extend a critical Federal-State 
program that assists low-income Medicare beneficiaries in paying their 
health premiums costs through the Medicaid program. This specific 
program, for low-income senior and disabled citizens, was enacted as 
part of the Balanced Budget Act of 1997 and is slated for expiration at 
the end of fiscal year 2003. The program was extended and is slated for 
expiration at the end of fiscal year 2003. The program was extended by 
the two continuing resolutions and the final appropriations bill 
through September 30, 2003. This legislation would simply further 
extend it for another year--through the end of 2004.
  This program, known as the Qualifying Individual Program, or QI-1, 
within Medicaid is a block grant payment to states to pay the Medicare 
Part B premium of $58.70 per month in 2003 for individuals with monthly 
incomes between $887 and $997 for individuals and between $1,194 and 
$1,344 for couples. This covers Medicare beneficiaries with income 
between 120 and 135 percent of the Federal Poverty Level.
  This amounts to a benefit of over $700 annually that many older and 
disabled Americans depend upon to pay for a portion of their health 
care costs, such as prescription drugs and supplemental coverage. Well 
over 120,000 people nationwide currently rely on the QI-1 and will be 
hard pressed to afford Medicare coverage without this assistance. In 
short, to prevent the erosion of existing low-income protections, 
Congress must extend the QI-1 program this year.
  This is a bipartisan issue as well. President Bush had included QI-1 
reauthorization in his fiscal year 2003 budget. Moreover, an extension 
has been included in S. 1, the ``Prescription Drug and Medicare 
Improvement Act of 2003,'' but the conference is certainly not going to 
be completed, passed by both the House and Senate, and signed into law 
by the President in time before the need for States to send out notices 
to beneficiaries alerting them to their forthcoming loss of cost 
sharing protections at the end of September.
  As Ron Pollack, Executive Director at Families, USA notes in his 
letter of support for this legislation, ``Without an extension, over 
120,000 low-income Medicare beneficiaries will have to be sent notices 
that the program is expiring. The result will be confusion, fear, and 
uncertainty among this population. This disruption can all be avoided 
by the quick and early passage of your extension bill.''
  At the Federal level, the Congress and Administration are often 
criticized for failure to understand what are or are not the 
implications to real people. One hundred and twenty thousand low-income 
beneficiaries face the prospect of their cost sharing increasing by 
over $700 per year at the end of September. They cannot be assured that 
an extension will be passed or done so in a timely fashion. How are 
they supposed to plan and budget?

  When we return in September, we will have just a few legislative days 
to pass an extension in the Senate, the House, and be signed by the 
President to stop the process of States having to send out 
disenrollment letters. We all know this can be very difficult to get 
through the Congress, as it requires unanimous consent, and may not 
occur in a timely fashion. If not, States will be forced to send out 
disenrollment letters to the 120,000 low-income seniors and the 
disabled that rely on the cost-sharing protections provided by the QI-1 
program and begin to shut down their programs.
  Again, this is emergency legislation that simply provisions a one-
year extension of QI-1 program to prevent the cut-off of cost-sharing 
protections for 120,000 low-income Medicare beneficiaries. We should be 
engaging in improving health coverage for low-income elderly and 
disabled citizens rather than leaving these vulnerable Americans facing 
fear, uncertainty, disruption, and increasing costs.
  I urge immediate passage of this legislation and ask unanimous 
consent that the text of the bill to be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1519

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

     SECTION 1. EXTENSION OF MEDICARE COST-SHARING FOR QUALIFYING 
                   INDIVIDUALS THROUGH FISCAL YEAR 2004.

       (a) In General.--Section 1902(a)(10)(E)(iv) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended to 
     read as follows:
       ``(iv) subject to sections 1933 and 1905(p)(4), for making 
     medical assistance available (but only for premiums payable 
     with respect to months during the period beginning with 
     January 1998, and ending with December 2004) for medicare 
     cost-sharing described in section 1905(p)(3)(A)(ii) for 
     individuals who would be qualified medicare beneficiaries 
     described in section 1905(p)(1) but for the fact that their 
     income exceeds the income level established by the State 
     under section 1905(p)(2) and is at least 120 percent, but 
     less than 135 percent, of the official poverty line (referred 
     to in such section) for a family of the size involved and who 
     are not otherwise eligible for medical assistance under the 
     State plan;''.
       (b) State Allocations.--Section 1933(c) of the Social 
     Security Act (42 U.S.C. 1396u-3(c)) is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (D), by striking ``and'' at the end;
       (B) in subparagraph (E)--

[[Page S10644]]

       (i) by striking ``fiscal year 2002'' and inserting ``each 
     of fiscal years 2002 through 2004''; and
       (ii) by striking the period and inserting ``; and''; and
       (C) by adding at the end the following:
       ``(F) the first quarter of fiscal year 2005 is 
     $100,000,000.''; and
       (2) in paragraph (2)(A), by striking ``the sum of'' and all 
     that follows through ``1902(a)(10)(E)(iv)(II) in the State; 
     to'' and inserting ``twice the total number of individuals 
     described in section 1902(a)(10)(E)(iv) in the State; to''.
                                 ______