[Congressional Record Volume 152, Number 10 (Wednesday, February 1, 2006)]
[Senate]
[Pages S454-S458]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           TEXT OF AMENDMENTS

  SA 2697. Mr. NELSON of Florida (for himself, Mr. Durbin, Mr. 
Bingaman, Mr. Lautenberg, Mrs. Murray, Mr. Schumer, Mrs. Clinton, Mr. 
Kohl, Mr. Leahy, Mr. Dayton, Mr. Feingold, Mr. Lieberman, Mr. Nelson of 
Nebraska, and Mr. Sarbanes) submitted an amendment intended to be 
proposed by him to the bill H.R. 4297, to provide for reconciliation 
pursuant to section 201(b) of the concurrent resolution on the budget 
for fiscal year 2006; which was ordered to lie on the table; as 
follows:

       At the appropriate place, insert the following:

     SEC. __. PROTECTION FOR MEDICARE BENEFICIARIES WHO ENROLL IN 
                   THE PRESCRIPTION DRUG BENEFIT DURING 2006.

       (a) Extended Period of Open Enrollment During All of 2006 
     Without Late Enrollment Penalty.--Section 1851(e)(3)(B) of 
     the Social Security Act (42 U.S.C. 1395w-21(e)(3)(B)) is 
     amended--
       (1) in clause (iii), by striking ``May 15, 2006'' and 
     inserting ``December 31, 2006''; and
       (2) by adding at the end the following new sentence:

     ``An individual making an election during the period 
     beginning on November 15, 2006, and ending on December 15, 
     2006, shall specify whether the election is to be effective 
     with respect to 2006 or with respect to 2007 (or both).''.
       (b) One-Time Change of Plan Enrollment for Medicare 
     Prescription Drug Benefit During All of 2006.--
       (1) In general.--Section 1851(e) of the Social Security Act 
     (42 U.S.C. 1395w-21(e)) is amended--
       (A) in paragraph (2)(B)--
       (i) in the heading, by striking ``for first 6 months'';
       (ii) in clause (i), by striking ``the first 6 months of 
     2006,'' and all that follows through ``is a Medicare+Choice 
     eligible individual,'' and inserting ``2006,''; and
       (iii) in clause (ii), by inserting ``(other than during 
     2006)'' after ``paragraph (3)''; and
       (B) in paragraph (4), by striking ``2006'' and inserting 
     ``2007'' each place it appears.
       (2) Conforming amendment.--Section 1860D-1(b)(1)(B)(iii) of 
     the Social Security Act (42 U.S.C. 1395w-101(b)(1)(B)(iii)) 
     is amended by striking ``subparagraphs (B) and (C) of 
     paragraph (2)'' and inserting ``paragraph (2)(C)''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect as if included in the enactment of the 
     Medicare Prescription Drug, Improvement, and Modernization 
     Act of 2003 (Public Law 108-173).
                                 ______
                                 
  SA 2698. Mr. BINGAMAN (for himself, Mr. Rockefeller, Mrs. Murray, Ms. 
Cantwell, Mrs. Clinton, Mr. Kennedy, Mr. Kohl, Mr. Lieberman, Mr. 
Schumer, Mr. Menendez, Mr. Kerry, Mr. Leahy, Mr. Durbin, Mr. Dayton, 
Mr. Feinstein, and Mr. Bayh) submitted an amendment intended to be 
proposed by him to the bill H.R. 4297, to provide for reconciliation 
pursuant to section 201(b) of the concurrent resolution on the budget 
for fiscal year 2006; which was ordered to lie on the table; as 
follows:

       At the appropriate place, insert the following:

     SEC. ___. TRANSITION REQUIREMENTS.

       (a) Requirement.--
       (1) In general.--Section 1860D-4(b) of the Social Security 
     Act (42 U.S.C. 1395w-104(b)) is amended by adding at the end 
     the following new paragraph:
       ``(4) Formulary transition.--The sponsor of a prescription 
     drug plan is required to provide at least a 30-day supply of 
     any drug that a new enrollee in the plan was taking prior to 
     enrolling in such plan. For individuals residing in a long-
     term care setting, the sponsor of a prescription drug plan is 
     required to

[[Page S455]]

     provide at least a 90-day supply of any drug such individual 
     was taking prior to enrolling in such plan. A formulary 
     transition supply provided under this section shall be made 
     by the sponsor of a prescription drug plan without imposing 
     any prior authorization requirements or other access 
     restrictions for individuals stabilized on a course of 
     treatment and at the dosage previously prescribed by a 
     physician or recommended by a physician going forward.
       ``(5) Customer service.--The sponsor of a prescription drug 
     plan is required to provide--
       ``(A) accessible and trained customer service 
     representatives available for full business hours from coast 
     to coast to provide knowledgeable assistance to individuals 
     seeking help with Medicare Part D including, but not limited 
     to, beneficiaries, caseworkers, SHIP counselors, pharmacists, 
     doctors, and caregivers;
       ``(B) at least one dedicated phone line for pharmacists 
     with sufficient staff to reduce wait times for pharmacists 
     seeking Medicare Part D assistance to no more than 20 
     minutes; and
       ``(C) sufficient staff to reduce wait times for all 
     Medicare Part D-related calls to plan phone lines to no more 
     than 20 minutes.''.
       (2) Application.--The requirements under paragraphs (4) and 
     (5) of section 1860D-4(b) of the Social Security Act (42 
     U.S.C. 1395w-104(b)), as added by subsection (a), shall apply 
     to the plan serving as the national point of sale contractor 
     under part D of title XVIII of such Act.
       (b) Effective Date and Enforcement.--
       (1) Effective date.--The amendment made by subsection (a) 
     shall take effect on the date of enactment of this Act.
       (2) Enforcement.--The Secretary may impose a civil monetary 
     penalty in an amount not to exceed $15,000 for conduct that a 
     sponsor of a prescription drug plan or an organization 
     offering an MA-PD plan knows or should know is a violation of 
     the provisions of paragraph (4) or (5) of section 1860D-4(b) 
     of the Social Security Act (42 U.S.C. 1395w-104(b)), as added 
     by subsection (a). The provisions of section 1128A of the 
     Social Security Act (42 U.S.C. a-7a), other than subsections 
     (a) and (b) and the second sentence of subsection (f), shall 
     apply to a civil monetary penalty under the previous sentence 
     in the same manner as such provisions apply to a penalty or 
     proceeding under subsection (a) of such section 1128A(a).

     SEC. ___. FEDERAL FALLBACK FOR FULL-BENEFIT DUAL ELIGIBLE 
                   INDIVIDUALS FOR 2006.

       (a) In General.--
       (1) In general.--If a full-benefit dual eligible individual 
     (as defined in section 1935(c)(6) of the Social Security Act 
     (42 U.S.C. 1396u-5(c)(6))), or an individual who is presumed 
     to be such an individual pursuant to subsection (b), presents 
     a prescription for a covered part D drug (as defined in 
     section 1860D-2(e) of such Act (42 U.S.C. 1395w-102(e))) at a 
     pharmacy in 2006 and the pharmacy is unable to locate or 
     verify the individual's enrollment through a reasonable 
     effort, including the use of the pharmacy billing system or 
     by calling an official Medicare hotline, or to bill for the 
     prescription through the plan serving as the national point 
     of sale contractor, the pharmacy may provide a 30-day supply 
     of the drug to the individual.
       (2) Refill.--The pharmacy may provide an additional 30-day 
     supply of a drug if the pharmacy continues to be unable to 
     locate the individual's enrollment through such reasonable 
     efforts or to bill for the prescription through the plan 
     serving as the national point of sale contractor when a 
     prescription is presented on or after the date that a 
     prescription refill is appropriate, but in no case after 
     December 31, 2006.
       (3) Cost-sharing.--The cost-sharing for a prescription 
     filled pursuant to this subsection shall be cost-sharing 
     provided for under section 1860D-14(a) of the Social Security 
     Act (42 U.S.C. 1395w-114(a)).
       (b) Presumptive Eligibility.--An individual shall be 
     presumed to be a full-benefit dual eligible individual (as so 
     defined) if the individual presents at the pharmacy with--
       (1) a government issued picture identification card;
       (2) reliable evidence of Medicaid enrollment, such as a 
     Medicaid card, recent history of Medicaid billing in the 
     pharmacy patient profile, or a copy of a current Medicaid 
     award letter; and
       (3) reliable evidence of Medicare enrollment, such as a 
     Medicare identification card, a Medicare enrollment approval 
     letter, a Medicare Summary Notice, or confirmation from an 
     official Medicare hotline.
       (c) Payments to Pharmacists.--
       (1) In general.--The Secretary of Health and Human Services 
     shall reimburse pharmacists, to the extent that such 
     pharmacists are not otherwise reimbursed by States or plans, 
     for the costs incurred in complying with the requirements 
     under subsection (a), including acquisition costs, dispensing 
     costs, and other overhead costs. Such payments shall be made 
     in a timely manner from the Medicare Prescription Drug 
     Account under section 1860D-16 of the Social Security Act (42 
     U.S.C. 1395w-116) and shall be deemed to be payments from 
     such Account under subsection (b) of such section.
       (2) Retroactive application to beginning of 2006.--The 
     costs incurred by a pharmacy which may be reimbursed under 
     paragraph (1) shall include costs incurred during the period 
     beginning on January 1, 2006, and before the date of 
     enactment of this Act.
       (d) Recovery of Costs From Plans by Secretary Not 
     Pharmacies.--The Secretary of Health and Human Services shall 
     establish a process for recovering the costs described in 
     subsection (c)(1) from prescription drug plans (as defined in 
     section 1860D-1(a)(3)(C) of the Social Security Act (42 
     U.S.C. 1394w-101(a)(3)(C))) and MA-PD plans (as defined in 
     section 1860D-41(a)(14) of such Act (42 U.S.C. 1395w-
     151(a)(14))) if the Secretary determines that such plans 
     should have incurred such costs. Amounts recovered pursuant 
     to the preceding sentence shall be deposited in the Medicare 
     Prescription Drug Account described in subsection (c)(1).

     SEC. ___. ENSURING THAT FULL-BENEFIT DUAL ELIGIBLE 
                   INDIVIDUALS ARE NOT OVERCHARGED.

       (a) In General.--Section 1860D-14 of the Social Security 
     Act (42 U.S.C. 1395w-114) is amended--
       (1) by redesignating subsection (d) as subsection (e); and
       (2) by inserting after subsection (c) the following new 
     subsection:
       ``(d) Ensuring Full-Benefit Dual Eligible Individuals Are 
     Not Overcharged.--
       ``(1) In general.--The Secretary shall, as soon a possible 
     after the date of enactment of this subsection, establish 
     processes for the following:
       ``(A) Tracking inappropriate payments.--The Secretary shall 
     track full-benefit dual eligible individuals enrolled in a 
     prescription drug plan or an MA-PD plan to determine whether 
     such individuals were inappropriately subject under the plan 
     to a deductible or cost-sharing that is greater than is 
     required under section 1860D-14.
       ``(B) Reduction in payments to plans and refunds to 
     individuals.--If the Secretary determines under subparagraph 
     (A) that an individual was overcharged, the Secretary shall--
       ``(i) reduce payments to the sponsor of the prescription 
     drug plan under section 1860D-15 or to the organization 
     offering the MA-PD plan under section 1853 that 
     inappropriately charged the individual by an amount equal to 
     the inappropriate charges; and
       ``(ii) refund such amount to the individual within 60 days 
     of the determination that the individual was inappropriately 
     charged.

     If the Secretary does not provide for the refund under clause 
     (i) within the 60 days provided for under such clause, 
     interest at the rate established under section 6621(a)(1) of 
     the Internal Revenue Code of 1986 shall be payable from the 
     end of such 60-day period until the date of the refund.
       ``(2) Requirement.--The processes established under 
     paragraph (1) shall provide for the ability of an individual 
     to notify the Secretary if the individual believes that they 
     were inappropriately subject under the plan to a deductible 
     or cost-sharing that is greater than is required under 
     section 1860D-14.''.
       (b) Report to Congress.--Not later than January 1, 2007, 
     the Secretary of Health and Human Services shall submit a 
     report to Congress on the implementation of the processes 
     established under subsection (d) of section 1860D-14 of the 
     Social Security Act (42 U.S.C. 1395w-114), as added by 
     subsection (a).

     SEC. ___. REIMBURSEMENT OF STATES FOR 2006 TRANSITION COSTS.

       (a) Reimbursement.--
       (1) In general.--Notwithstanding section 1935(d) of the 
     Social Security Act (42 U.S.C. 1396u-5(d) or any other 
     provision of law, the Secretary of Health and Human Services 
     shall reimburse States for 100 percent of the costs incurred 
     by the State during 2006 for covered part D drugs (as defined 
     in section 1860D-2(e) of such Act (42 U.S.C. 1395w-102(e))) 
     for part D eligible individuals (as defined in section 1860D-
     1(a)(3)(A) of the Social Security Act (42 U.S.C. 1394w-
     101(a)(3)(A))) which the State reasonably expected would have 
     been covered under such part but were not because the 
     individual was unable to access on a timely basis 
     prescription drug benefits to which they were entitled under 
     such part. Such payments shall be made from the Medicare 
     Prescription Drug Account under section 1860D-16 of the 
     Social Security Act (42 U.S.C. 1395w-116) and shall be deemed 
     to be payments from such Account under subsection (b) of such 
     section.
       (2) Retroactive application to beginning of 2006.--The 
     costs incurred by a State which may be reimbursed under 
     paragraph (1) shall include costs incurred during the period 
     beginning on January 1, 2006, and before the date of 
     enactment of this Act.
       (b) Recovery of Costs From Plans by Secretary Not States.--
     The Secretary of Health and Human Services shall establish a 
     process for recovering the costs described in subsection 
     (a)(1) from prescription drug plans (as defined in section 
     1860D-1(a)(3)(C) of the Social Security Act (42 U.S.C. 1394w-
     101(a)(3)(C))) and MA-PD plans (as defined in section 1860D-
     41(a)(14) of such Act (42 U.S.C. 1395w-151(a)(14))) if the 
     Secretary determines that such plans should have incurred 
     such costs. Amounts recovered pursuant to the preceding 
     sentence shall be deposited in the Medicare Prescription Drug 
     Account described in subsection (a)(1).
       (c) State.--For purposes of this section, the term 
     ``State'' includes the District of Columbia.

     SEC. ___. FACILITATION OF IDENTIFICATION AND ENROLLMENT 
                   THROUGH PHARMACIES OF FULL-BENEFIT DUAL 
                   ELIGIBLE INDIVIDUALS IN THE MEDICARE PART D 
                   DRUG PROGRAM.

       (a) In General.--The Secretary of Health and Human Services 
     shall provide for outreach and education to every pharmacy 
     that has participated in the Medicaid program

[[Page S456]]

     under title XIV of the Social Security Act, particularly 
     independent pharmacies, on the following:
       (1) The needs of full-benefit dual eligible individuals and 
     the challenges of meeting those needs.
       (2) The processes for the transition from Medicaid 
     prescription drug coverage to coverage under such part D for 
     such individuals.
       (3) The processes established by the Secretary to 
     facilitate, at point of sale, identification of drug plan 
     assignment of such population or enrollment of previously 
     unidentified or new full-benefit dual eligible individuals 
     into Medicare part D prescription drug coverage, including 
     how pharmacies can use such processes to help ensure that 
     such population makes a successful transition to Medicare 
     part D without a lapse in prescription drug coverage.
       (b) Holding Pharmacies Harmless for Certain Costs.--
       (1) In general.--The Secretary of Health and Human Services 
     shall provide for such payments to pharmacies as may be 
     necessary to reimburse pharmacies fully for--
       (A) transaction fees associated with the point-of-sale 
     facilitated identification and enrollment processes referred 
     to in subsection (a)(3); and
       (B) costs associated with technology or software upgrades 
     necessary to make any identification and enrollment inquiries 
     as part of the processes under subsection (a)(3).
       (2) Time.--Payments under paragraph (1) shall be made with 
     respect to fees and costs incurred during the period 
     beginning on December 1, 2005, and ending on June 1, 2006.
       (3) Payments from account.--Payments under paragraph (1) 
     shall be made from the Medicare Prescription Drug Account 
     under section 1860D-16 of the Social Security Act (42 U.S.C. 
     1395w-116) and shall be deemed to be payments from such 
     Account under subsection (b) of such section.

     SEC. ___. STATE COVERAGE OF NON-FORMULARY PRESCRIPTION DRUGS 
                   FOR FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS 
                   DURING 2006.

       (a) State Coverage of Non-Formulary Prescription Drugs for 
     Full-Benefit Dual Eligible Individuals During 2006.--For 
     prescriptions filled during 2006, notwithstanding section 
     1935(d) of the Social Security Act (42 U.S.C. 1396v(d)), a 
     State (as defined for purposes of title XIX of such Act) may 
     provide (and receive Federal financial participation for) 
     medical assistance under such title with respect to 
     prescription drugs provided to a full-benefit dual eligible 
     individual (as defined in section 1935(c)(6) of such Act (42 
     U.S.C. 1396v(c)(6)) that are not on the formulary of the 
     prescription drug plan under part D or the MA-PD plan under 
     part C of title XVIII of such Act in which such individual is 
     enrolled.
       (b) Application.--
       (1) Medicare as primary payer.--Nothing in subsection (a) 
     shall be construed as changing or affecting the primary payer 
     status of a prescription drug plan under part D or an MA-PD 
     plan under part C of title XVIII of the Social Security Act 
     with respect to prescription drugs furnished to any full-
     benefit dual eligible individual (as defined in section 
     1935(c)(6) of such Act (42 U.S.C. 1396v(c)(6)) during 2006.
       (2) Third party liability.--Nothing in subsection (a) shall 
     be construed as limiting the authority or responsibility of a 
     State under section 1902(a)(25) of the Social Security Act 
     (42 U.S.C. 1396a(a)(25)) to seek reimbursement from a 
     prescription drug plan, an MA-PD plan, or any other third 
     party, of the costs incurred by the State in providing 
     prescription drug coverage during 2006.
                                 ______
                                 
  SA 2699. Mr. LAUTENBERG submitted an amendment intended to be 
proposed by him to the bill H.R. 4297, to provide for reconciliation 
pursuant to section 201(b) of the concurrent resolution on the budget 
for fiscal year 2006; which was ordered to lie on the table; as 
follows:

       At the appropriate place, insert the following:

     SEC. __. REQUIREMENT OF SIGNED CERTIFICATION PRIOR TO PLAN 
                   ENROLLMENT UNDER PART D.

       (a) In General.--Section 1860D-1(b)(1) of the Social 
     Security Act (42 U.S.C. 1395w-101) is amended by adding at 
     the end the following new subparagraph:
       ``(D) Special rule for plans with an initial coverage 
     limit.--
       ``(i) In general.--The process for enrollment established 
     under subparagraph (A) shall include, in the case of a 
     prescription drug plan or an MA-PD plan that has an initial 
     coverage limit (as described in section 1860D-2(b)(3)), a 
     requirement that, prior to enrolling a part D eligible 
     individual in the plan, the plan must obtain a certification 
     signed by the enrollee or the legal guardian of the enrollee 
     that meets the requirements described in clause (ii) and 
     includes the following text: `I understand that the Medicare 
     Prescription Drug Plan or MA-PD Plan that I am signing up for 
     may result in a gap in coverage during a given year. I 
     understand that if subject to this gap in coverage, I will be 
     responsible for paying 100 percent of the cost of my 
     prescription drugs and will continue to be responsible for 
     paying the plan's monthly premium while subject to this gap 
     in coverage. For specific information on the potential 
     coverage gap under this plan, I understand that I should 
     contact (insert name of the sponsor of the prescription drug 
     plan or the sponsor of the MA-PD plan) at (insert toll free 
     phone number for such sponsor of such plan).'.
       ``(ii) Certification requirements described.--The 
     certification required under clause (i) shall meet the 
     following requirements:

       ``(I) The certification shall be printed in a typeface of 
     not less than 18 points.
       ``(II) The certification shall be printed on a single piece 
     of paper separate from any matter not related to the 
     certification.
       ``(III) The certification shall have a heading printed at 
     the top of the page in all capital letters and bold face type 
     that states the following: `WARNING: POTENTIAL MEDICARE 
     PRESCRIPTION DRUG COVERAGE GAP'.''.

       (b) Effective Date.--The amendment made by this section 
     shall take effect on the date of enactment of this Act.
                                 ______
                                 
  SA 2700. Mr. KENNEDY (for himself and Mr. Harkin) submitted an 
amendment intended to be proposed by him to the bill H.R. 4297, to 
provide for reconciliation pursuant to section 201(b) of the concurrent 
resolution on the budget for fiscal year 2006; which was ordered to lie 
on the table; as follows:

       At the end, add the following:

     SEC. __. REPEAL OF STATE OPTIONS FOR ALTERNATIVE PREMIUMS AND 
                   COST SHARING AND FLEXIBILITY IN BENEFIT 
                   PACKAGES UNDER THE MEDICAID PROGRAM.

       (a) Repeal of State Option for Alternative Premiums and 
     Cost Sharing.--
       (1) Repeal.--Section 1916A of the Social Security Act, as 
     added by sections 6041(a), 6042(a), and 6043(a) of the 
     Deficit Reduction Act of 2005, is repealed.
       (2) Conforming amendments.--
       (A) Subsection (y) of section 1903 of the Social Security 
     Act (42 U.S.C. 1396b), as added by section 6043(b) of the 
     Deficit Reduction Act of 2005, is repealed.
       (B) Section 1916 of the Social Security Act (42 U.S.C. 
     1396o) is amended--
       (i) in subsection (f), by striking ``and section 1916A'' 
     after ``(b)(3)''; and
       (ii) by striking subsection (h).
       (C) Section 1938(c) of the Social Security Act, as added by 
     section 6082 of the Deficit Reduction Act of 2005, is 
     amended--
       (i) in paragraph (3), by striking ``and 1916A''; and
       (ii) in paragraph (5), by striking ``sections 1916 and 
     1916A'' and inserting ``section 1916''.
       (b) Repeal of State Option of Providing Benchmark Benefit 
     Packages.--
       (1) Repeal.--Section 1937 of the Social Security Act, as 
     added by section 6044(a) of the Deficit Reduction Act of 
     2005, is repealed.
       (2) Conforming amendments.--
       (A) Sections 1938 and 1939 of the Social Security Act, as 
     added and redesignated, respectively, by section 6082 of the 
     Deficit Reduction Act of 2005, are redesignated as sections 
     1937 and 1938, respectively, of the Social Security Act.
       (B) 1937(b)(3) of the Social Security Act, as redesignated 
     by subparagraph (A), is amended by inserting ``(as added by 
     section 6044(a) of S. 1932 of the 109th Congress, as passed 
     by the Senate on December 21, 2005)''.
       (c) Effective Date.--The repeals and amendments made by 
     subsections (a) and (b) shall take effect as if included in 
     the enactment of the Deficit Reduction Act of 2005.

     SEC. __. ADDITIONAL FUNDING FOR THE STATE CHILDREN'S HEALTH 
                   INSURANCE PROGRAM.

       (a) In General.--Section 2104(a) of the Social Security Act 
     (42 U.S.C. 1397dd(a)) is amended--
       (1) in paragraph (9), by striking ``$4,050,000,000'' and 
     inserting ``$6,550,000,000''; and
       (2) in paragraph (10), by striking ``$5,000,000,000'' and 
     inserting ``$7,500,000,000''.
       (b) Funds in Addition to Funds Provided to Eliminate Fiscal 
     Year 2006 Shortfalls.--The Secretary of Health and Human 
     Services shall carry out subsection (d) of section 2104 of 
     the Social Security Act (42 U.S.C. 1397dd(d)), as added by 
     section 6101(a) of the Deficit Reduction Act of 2005, 
     (including the determination of a State's allotment for 
     fiscal year 2006 under paragraph (2)(C) of that subsection), 
     without regard to the amendment made by subsection (a)(1) 
     providing increased funding for State allotments for fiscal 
     year 2006.

     SEC. __. REPEAL OF THE SCHEDULED PHASEOUT OF THE LIMITATIONS 
                   ON PERSONAL EXEMPTIONS AND ITEMIZED DEDUCTIONS.

       (a) In General.--The Internal Revenue Code of 1986 is 
     amended--
       (1) by striking subparagraphs (E) and (F) of section 
     151(d)(3), and
       (2) by striking subsections (f) and (g) of section 68.
       (b) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2005.
       (c) Application of EGTRRA Sunset.--The amendments made by 
     this section shall be subject to title IX of the Economic 
     Growth and Tax Relief Reconciliation Act of 2001 to the same 
     extent and in the same manner as the provision of such Act to 
     which such amendment relates.
                                 ______
                                 
  SA 2701. Mr. DURBIN submitted an amendment intended to be proposed by 
him to the bill H.R. 4297, to provide for reconciliation pursuant to 
section 201(b) of the concurrent resolution on the budget for fiscal 
year 2006; which was ordered to lie on the table; as follows:


[[Page S457]]


       On page 19, strike lines 19 through 22 and insert the 
     following:

     SEC. 203. ELIGIBILITY OF ALL UNINSURED CHILDREN FOR SCHIP.

       (a) In General.--Section 2110(b) of the Social Security Act 
     (42 U.S.C. 1397jj(b)) is amended--
       (1) in paragraph (1)--
       (A) by striking subparagraph (B); and
       (B) by redesignating subparagraph (C) as subparagraph (B);
       (2) in paragraph (2)--
       (A) by striking ``include'' and all that follows through 
     ``a child who is an'' and inserting ``include a child who is 
     an''; and
       (B) by striking the semicolon and all that follows through 
     the period and inserting a period; and
       (3) by striking paragraph (4).
       (b) No Exclusion of Children With Access to High-Cost 
     Coverage.--Section 2110(b)(3) of the Social Security Act (42 
     U.S.C. 1397jj(b)(3)) is amended--
       (1) in the paragraph heading, by striking ``rule'' and 
     inserting ``rules'';
       (2) by striking ``A child shall not be considered to be 
     described in paragraph (1)(C)'' and inserting the following:
       ``(A) Certain non federally funded coverage.--A child shall 
     not be considered to be described in paragraph (1)(C)''; and
       (3) by adding at the end the following:
       ``(B) No exclusion of children with access to high-cost 
     coverage.--A State may include a child as a targeted 
     vulnerable child if the child has access to coverage under a 
     group health plan or health insurance coverage and the total 
     annual aggregate cost for premiums, deductibles, cost 
     sharing, and similar charges imposed under the group health 
     plan or health insurance coverage with respect to all 
     targeted vulnerable children in the child's family exceeds 5 
     percent of such family's income for the year involved.''.
       (c) Conforming Amendments.--
       (1) Titles XIX and XXI of the Social Security Act (42 
     U.S.C. 1396 et seq.; 1397aa et. seq.) are amended by striking 
     ``targeted low-income'' each place it appears and inserting 
     ``targeted vulnerable''.
       (2) Section 2101(a) of such Act (42 U.S.C. 1397aa(a)) is 
     amended by striking ``uninsured, low-income'' and inserting 
     ``low-income''.
       (3) Section 2102(b)(3)(C) of such Act (42 U.S.C. 
     1397bb(b)(3)(C)) is amended by inserting ``, particularly 
     with respect to children whose family income exceeds 200 
     percent of the poverty line'' before the semicolon.
       (4) Section 2102(b)(3)(E), section 2105(a)(1)(D)(ii), 
     paragraphs (1)(C) and (2) of section 2107, and subsections 
     (a)(1) and (d)(1)(B) of section 2108 of such Act (42 U.S.C. 
     1397bb(b)(3)(E); 1397ee(a)(1)(D)(ii); 1397gg; 1397hh) are 
     amended by striking ``low-income'' each place it appears.
       (5) Section 2110(a)(27) of such Act (42 U.S.C. 
     1397jj(a)(27)) is amended by striking ``eligible low-income 
     individuals'' and inserting ``targeted vulnerable 
     individuals''.
       (d) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.

     SEC. 203A. INCREASE IN FEDERAL FINANCIAL PARTICIPATION UNDER 
                   SCHIP AND MEDICAID FOR STATES WITH SIMPLIFIED 
                   ENROLLMENT AND RENEWAL PROCEDURES FOR CHILDREN.

       (a) SCHIP.--Section 2105(c)(2) of the Social Security Act 
     (42 U.S.C. 1397ee(c)(2)) is amended by adding at the end the 
     following:
       ``(C) Nonapplication of limitation and increase in federal 
     payment for states with simplified enrollment and renewal 
     procedures.--
       ``(i) In general.--Notwithstanding subsection (a)(1) and 
     subparagraph (A)--

       ``(I) the limitation under subparagraph (A) on expenditures 
     for items described in subsection (a)(1)(D) shall not apply 
     with respect to expenditures incurred to carry out any of the 
     outreach strategies described in clause (ii), but only if the 
     State carries out the same outreach strategies for children 
     under title XIX; and
       ``(II) the enhanced FMAP for a State for a fiscal year 
     otherwise determined under subsection (b) shall be increased 
     by 5 percentage points (without regard to the application of 
     the 85 percent limitation under that subsection) with respect 
     to such expenditures.

       ``(ii) Outreach strategies described.--For purposes of 
     clause (i), the outreach strategies described in this clause 
     are the following:

       ``(I) Presumptive eligibility.--The State provides for 
     presumptive eligibility for children under this title and 
     under title XIX.
       ``(II) Adoption of 12-month continuous eligibility.--The 
     State provides that eligibility for children shall not be 
     redetermined more often than once every year under this title 
     or under title XIX.
       ``(III) Elimination of asset test.--The State does not 
     apply any asset test for eligibility under this title or 
     title XIX with respect to children.
       ``(IV) Passive renewal.--The State provides for the 
     automatic renewal of the eligibility of children for 
     assistance under this title and under title XIX if the family 
     of which such a child is a member does not report any changes 
     to family income or other relevant circumstances, subject to 
     verification of information from State databases.''.

       (b) Medicaid.--
       (1) In general.--Section 1902(l) of the Social Security Act 
     (42 U.S.C. 1396a(l)) is amended--
       (A) in paragraph (3), by inserting ``subject to paragraph 
     (5)'', after ``Notwithstanding subsection (a)(17),''; and
       (B) by adding at the end the following:
       ``(5)(A) Notwithstanding the first sentence of section 
     1905(b), with respect to expenditures incurred to carry out 
     any of the outreach strategies described in subparagraph (B) 
     for individuals under 19 years of age who are eligible for 
     medical assistance under subsection (a)(10)(A), the Federal 
     medical assistance percentage is equal to the enhanced FMAP 
     described in section 2105(b) and increased under section 
     2105(c)(2)(C)(i)(II), but only if the State carries out the 
     same outreach strategies for children under title XXI.
       ``(B) For purposes of subparagraph (A), the outreach 
     strategies described in this subparagraph are the following:
       ``(i) Presumptive eligibility.--The State provides for 
     presumptive eligibility for such individuals under this title 
     and title XXI.
       ``(ii) Adoption of 12-month continuous eligibility.--The 
     State provides that eligibility for such individuals shall 
     not be redetermined more often than once every year under 
     this title or under title XXI.
       ``(iii) Elimination of asset test.--The State does not 
     apply any asset test for eligibility under this title or 
     title XXI with respect to such individuals.
       ``(iv) Passive renewal.--The State provides for the 
     automatic renewal of the eligibility of such individuals for 
     assistance under this title and under title XXI if the family 
     of which such an individual is a member does not report any 
     changes to family income or other relevant circumstances, 
     subject to verification of information from State 
     databases.''.
       (2) Conforming amendment.--The first sentence of section 
     1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is 
     amended by striking ``section 1933(d)'' and inserting 
     ``sections 1902(l)(5) and 1933(d)''.
       (c) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.

     SEC. 203B. LIMITATION ON PAYMENTS TO STATES THAT HAVE AN 
                   ENROLLMENT CAP BUT HAVE NOT EXHAUSTED THE 
                   STATE'S AVAILABLE ALLOTMENTS.

       (a) In General.--Section 2105 of the Social Security Act 
     (42 U.S.C. 1397ee) is amended by adding at the end the 
     following:
       ``(h) Limitation on Payments to States That Have an 
     Enrollment Cap but Have Not Exhausted the State's Available 
     Allotments.--
       ``(1) In general.--Notwithstanding any other provision of 
     this section, payment shall not be made to a State under this 
     section if the State has an enrollment freeze, enrollment 
     cap, procedures to delay consideration of, or not to 
     consider, submitted applications for child health assistance, 
     or a waiting list for the submission or consideration of such 
     applications or for such assistance, and the State has not 
     fully expended the amount of all allotments available with 
     respect to a fiscal year for expenditure by the State, 
     including allotments for prior fiscal years that remain 
     available for expenditure during the fiscal year under 
     subsection (c) or (g) of section 2104 or that were 
     redistributed to the State under subsection (f) or (g) of 
     section 2104.
       ``(2) Rule of construction.--Paragraph (1) shall not be 
     construed as prohibiting a State from establishing regular 
     open enrollment periods for the submission of applications 
     for child health assistance.''.
       (b) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.

     SEC. 203C. ADDITIONAL ENHANCEMENT TO FMAP TO PROMOTE 
                   EXPANSION OF COVERAGE TO ALL UNINSURED CHILDREN 
                   UNDER MEDICAID AND SCHIP.

       (a) In General.--Title XXI (42 U.S.C. 1397aa et seq.) is 
     amended by adding at the end the following:

     ``SEC. 2111. ADDITIONAL ENHANCEMENT TO FMAP TO PROMOTE 
                   EXPANSION OF COVERAGE TO ALL UNINSURED CHILDREN 
                   UNDER MEDICAID AND SCHIP.

       ``(a) In General.--Notwithstanding subsection (b) of 
     section 2105 (and without regard to the application of the 85 
     percent limitation under that subsection), the enhanced FMAP 
     with respect to expenditures in a quarter for providing child 
     health assistance to uninsured children whose family income 
     exceeds 200 percent of the poverty line, shall be increased 
     by 5 percentage points.
       ``(b) Uninsured Child Defined.--
       ``(1) In general.--For purposes of subsection (a), subject 
     to paragraph (2), the term `uninsured child' means an 
     uncovered child who has been without creditable coverage for 
     a period determined by the Secretary, except that such period 
     shall not be less than 6 months.
       ``(2) Special rule for newborn children.--In the case of a 
     child 12 months old or younger, the period determined under 
     paragraph (1) shall be 0 months and such child shall be 
     considered uninsured upon birth.
       ``(3) Special rule for children losing medicaid or schip 
     coverage due to increased family income.--In the case of a 
     child who, due to an increase in family income, becomes 
     ineligible for coverage under title XIX or this title during 
     the period beginning on the date that is 12 months prior to 
     the date of enactment of the All Kids Health Insurance 
     Coverage Act of 2005 and ending on the date of enactment of 
     such Act, the period determined under paragraph (1) shall be 
     0 months and such child shall be considered uninsured upon 
     the date of enactment of the All Kids Health Insurance 
     Coverage Act of 2005.

[[Page S458]]

       ``(4) Monitoring and adjustment of period required to be 
     uninsured.--The Secretary shall--
       ``(A) monitor the availability and retention of employer-
     sponsored health insurance coverage of dependent children; 
     and
       ``(B) adjust the period determined under paragraph (1) as 
     needed for the purpose of promoting the retention of private 
     or employer-sponsored health insurance coverage of dependent 
     children and timely access to health care services for such 
     children.''.
       (b) Cost-Sharing for Children in Families With High Family 
     Income.--Section 2103(e)(3) of the Social Security Act (42 
     U.S.C. 1397cc(e)(3)) is amended by adding at the end the 
     following new subparagraph:
       ``(C) Children in families with high family income.--
       ``(i) In general.--For children not described in 
     subparagraph (A) whose family income exceeds 400 percent of 
     the poverty line for a family of the size involved, subject 
     to paragraphs (1)(B) and (2), the State shall impose a 
     premium that is not less than the cost of providing child 
     health assistance to children in such families, and 
     deductibles, cost sharing, or similar charges shall be 
     imposed under the State child health plan (without regard to 
     a sliding scale based on income), except that the total 
     annual aggregate cost-sharing with respect to all such 
     children in a family under this title may not exceed 5 
     percent of such family's income for the year involved.
       ``(ii) Inflation adjustment.--The dollar amount specified 
     in clause (i) shall be increased, beginning with fiscal year 
     2008, from year to year based on the percentage increase in 
     the consumer price index for all urban consumers (all items; 
     United States city average). Any dollar amount established 
     under this clause that is not a multiple of $100 shall be 
     rounded to the nearest multiple of $100.''.
       (c) Additional Allotments for States Providing Coverage to 
     All Uninsured Children in the State.--
       (1) In general.--Section 2104 of the Social Security Act 
     (42 U.S.C. 1397dd) is amended by inserting after subsection 
     (c) the following:
       ``(d) Additional Allotments for States Providing Coverage 
     to All Uninsured Children in the State.--
       ``(1) Appropriation; total allotment.--For the purpose of 
     providing additional allotments to States to provide coverage 
     of all uninsured children (as defined in section 2111(b)) in 
     the State under the State child health plan, there is 
     appropriated, out of any money in the Treasury not otherwise 
     appropriated--
       ``(A) for fiscal years 2007, 2008, and 2009, 
     $3,000,000,000;
       ``(B) for fiscal year 2010, $5,000,000,000; and
       ``(C) for fiscal year 2011, $7,000,000,000.
       ``(2) State and territorial allotments.--
       ``(A) In general.--In addition to the allotments provided 
     under subsections (b) and (c), subject to subparagraph (B) 
     and paragraphs (3) and (4), of the amount available for the 
     additional allotments under paragraph (1) for a fiscal year, 
     the Secretary shall allot to each State with a State child 
     health plan that provides coverage of all uninsured children 
     (as so defined) in the State approved under this title--
       ``(i) in the case of such a State other than a commonwealth 
     or territory described in subsection (ii), the same 
     proportion as the proportion of the State's allotment under 
     subsection (b) (determined without regard to subsection (f)) 
     to 98.95 percent of the total amount of the allotments under 
     such section for such States eligible for an allotment under 
     this subparagraph for such fiscal year; and
       ``(ii) in the case of a commonwealth or territory described 
     in subsection (c)(3), the same proportion as the proportion 
     of the commonwealth's or territory's allotment under 
     subsection (c) (determined without regard to subsection (f)) 
     to 1.05 percent of the total amount of the allotments under 
     such section for commonwealths and territories eligible for 
     an allotment under this subparagraph for such fiscal year.
       ``(B) Minimum allotment.--
       ``(i) In general.--No allotment to a State for a fiscal 
     year under this subsection shall be less than 50 percent of 
     the amount of the allotment to the State determined under 
     subsections (b) and (c) for the preceding fiscal year.
       ``(ii) Pro rata reductions.--The Secretary shall make such 
     pro rata reductions to the allotments determined under this 
     subsection as are necessary to comply with the requirements 
     of clause (i).
       ``(C) Availability and redistribution of unused 
     allotments.--In applying subsections (e) and (f) with respect 
     to additional allotments made available under this 
     subsection, the procedures established under such subsections 
     shall ensure such additional allotments are only made 
     available to States which have elected to provide coverage 
     under section 2111.
       ``(3) Use of additional allotment.--Additional allotments 
     provided under this subsection are not available for amounts 
     expended before October 1, 2005. Such amounts are available 
     for amounts expended on or after such date for child health 
     assistance for uninsured children (as defined in section 
     2111(b)).
       ``(4) Requiring election to provide coverage.--No payments 
     may be made to a State under this title from an allotment 
     provided under this subsection unless the State has made an 
     election to provide child health assistance for all uninsured 
     children (as so defined) in the State, including such 
     children whose family income exceeds 200 percent of the 
     poverty line.''.
       (2) Conforming amendments.--Section 2104 of the Social 
     Security Act (42 U.S.C. 1397dd) is amended--
       (A) in subsection (a), by inserting ``subject to subsection 
     (d),'' after ``under this section,'';
       (B) in subsection (b)(1), by inserting ``and subsection 
     (d)'' after ``Subject to paragraph (4)''; and
       (C) in subsection (c)(1), by inserting ``subject to 
     subsection (d),'' after ``for a fiscal year,''.
       (d) Effective Date.--The amendments made by this section 
     take effect on October 1, 2006.
                                 ______
                                 
  SA 2702. Mr. KENNEDY submitted an amendment intended to be proposed 
by him to the bill H.R. 4297, to provide for reconciliation pursuant to 
section 201(b) of the concurrent resolution on the budget for fiscal 
year 2006; which was ordered to lie on the table; as follows:

       On page 19, strike lines 19 through 22 and insert the 
     following:

     SEC. 203. EXTENSION OF RESEARCH CREDIT.

       (a) Extension.--
       (1) In general.--Subparagraph (B) of section 41(h)(1) 
     (relating to termination), as amended by section 113 of this 
     Act, is amended by striking ``December 31, 2006'' and 
     inserting ``December 31, 2008''.
       (2) Conforming amendment.--Subparagraph (D) of section 
     45C(b)(1) (relating to special rule), as amended by section 
     113 of this Act, is amended by striking ``December 31, 2006'' 
     and inserting ``December 31, 2008''.
       (3) Effective date.--The amendments made by this subsection 
     shall apply to amounts paid or incurred after December 31, 
     2005.
       (b) Expansion of Credit to Expenses of General 
     Collaborative Research Consortia.--
       (1) In general.--Section 41 is amended--
       (A) by striking ``an energy research consortium'' in 
     subsections (a)(3) and (b)(3)(C)(i) and inserting ``a 
     research consortium'',
       (B) by striking ``energy'' each place it appears in 
     subsection (f)(6)(A),
       (C) by inserting ``or 501(c)(6)'' after ``section 
     501(c)(3)'' in subsection (f)(6)(A)(i)(I), and
       (D) by striking ``Energy research'' in the heading for 
     subsection (f)(6) and inserting ``Research''.
       (2) Effective date.--The amendments made by this subsection 
     shall apply to taxable years ending after December 31, 2005.

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