[Congressional Record Volume 151, Number 106 (Friday, July 29, 2005)]
[Senate]
[Pages S9509-S9510]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Mr. Rockefeller, Mr. Feingold, Mr. 
        Corzine, Mr. Kohl, Ms. Mikulski, Mr. Durbin, and Mr. Harkin):
  S. 1589. A bill to amend title XVIII of the Social Security Act to 
provide for reductions in the medicare part B premium through 
elimination of certain overpayments to Medicare Advantage 
organizations; to the Committee on Finance.

                                S. 1589

  Mr. BINGAMAN. Mr. President, I am introducing legislation today with 
Senators Rockefeller and Feingold that is similar to S. 2906 in the 
108th Congress and will have more to say about this legislation when we 
return in September.

[[Page S9510]]

  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1589

       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 ``Affordability in Medicare 
     Premiums Act of 2005''.

     SEC. 2. REDUCTION OF MEDICARE PART B PREMIUM FOR INDIVIDUALS 
                   NOT ENROLLED IN A MEDICARE ADVANTAGE PLAN.

       Section 1839(a) of the Social Security Act (42 U.S.C. 
     1395r(a)) is amended--
       (1) in paragraph (3), in the first sentence, by striking 
     ``The Secretary'' and inserting ``Subject to paragraph (5), 
     the Secretary''; and
       (2) by adding at the end the following new paragraph:
       ``(5)(A) For each year (beginning with 2006), the Secretary 
     shall reduce the monthly premium rate determined under 
     paragraph (3) for each month in the year for individuals who 
     are not enrolled in a Medicare Advantage plan (including such 
     individuals subject to an increased premium under subsection 
     (b) or (i)) so that the aggregate amount of such reductions 
     in the year is equal to the aggregate amount of reduced 
     expenditures from the Federal Supplementary Medicare 
     Insurance Trust Fund that the Secretary estimates would 
     result in the year if the annual Medicare+Choice capitation 
     rate for the year was equal to the amount specified under 
     subparagraph (D) of section 1853(c)(1), and not subparagraph 
     (A), (B), or (C) of such section.
       ``(B) In order to carry out subsections (a)(1) and (b)(1) 
     of section 1840, the Secretary shall transmit to the 
     Commissioner of Social Security and the Railroad Retirement 
     Board by the beginning of each year (beginning with 2006), 
     such information determined appropriate by the Secretary, in 
     consultation with the Commissioner of Social Security and the 
     Railroad Retirement Board, regarding the amount of the 
     monthly premium rate determined under paragraph (3) for 
     individuals after the application of subparagraph (A).''.

     SEC. 3. FUNDING REDUCTIONS IN THE MEDICARE PART B PREMIUM 
                   THROUGH REDUCTIONS IN PAYMENTS TO MEDICARE 
                   ADVANTAGE ORGANIZATIONS.

       Section 1839(a) of the Social Security Act (42 U.S.C. 
     1395r(a)), as amended by section 2, is amended--
       (1) in paragraph (3), in the first sentence, by striking 
     ``paragraph (5)'' and inserting ``paragraphs (5) and (6)''; 
     and
       (2) by adding at the end the following new paragraph:
       ``(6) For each year (beginning with 2006), the Secretary 
     shall reduce the monthly premium rate determined under 
     paragraph (3) for each month in the year for each individual 
     enrolled under this part (including such an individual 
     subject to an increased premium under subsection (b) or (i)) 
     so that the aggregate amount of such reductions in the year 
     is equal to an amount equal to--
       ``(A) the aggregate amount of reduced expenditures from the 
     Federal Supplementary Medicare Insurance Trust Fund in the 
     year that the Secretary estimates will result from the 
     provisions of, and the amendments made by, sections 4 and 5 
     of the Affordability in Medicare Premiums Act of 2005; minus
       ``(B) the aggregate amount of reductions in the monthly 
     premium rate in the year pursuant to paragraph (5)(A).''.

     SEC. 4. APPLICATION OF RISK ADJUSTMENT REFLECTING 
                   CHARACTERISTICS FOR THE ENTIRE MEDICARE 
                   POPULATION IN PAYMENTS TO MEDICARE ADVANTAGE 
                   ORGANIZATIONS.

       Effective January 1, 2006, in applying risk adjustment 
     factors to payments to organizations under section 1853 of 
     the Social Security Act (42 U.S.C. 1395w-23), the Secretary 
     of Health and Human Services shall ensure that payments to 
     such organizations are adjusted based on such factors to 
     ensure that the health status of the enrollee is reflected in 
     such adjusted payments, including adjusting for the 
     difference between the health status of the enrollee and 
     individuals enrolled under the original medicare fee-for-
     service program under parts A and B of title XVIII of such 
     Act. Payments to such organizations must, in aggregate, 
     reflect such differences.

     SEC. 5. ELIMINATION OF MA REGIONAL PLAN STABILIZATION FUND 
                   (SLUSH FUND).

       (a) In General.--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).
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