Equal Access to Medicare Options Act of 2012 - Amends title XVIII (Medicare) of the Social Security Act to provide all Medicare beneficiaries, regardless of whether they have enrolled in Medicare part B, as well as Medicare Advantage and Medicaid enrollees with the right to guaranteed issue of a supplemental insurance (Medigap) policy.
Amends part C (Medicare+Choice) of SSA title XVIII to permit enrollment of individuals with end stage renal disease (ESRD) in Medicare Advantage.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 3271 Introduced in Senate (IS)]
112th CONGRESS
2d Session
S. 3271
To provide all Medicare beneficiaries with the right to guaranteed
issue of a Medicare supplemental policy.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 7, 2012
Mr. Kerry introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To provide all Medicare beneficiaries with the right to guaranteed
issue of a Medicare supplemental policy.
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 ``Equal Access to Medicare Options Act
of 2012''.
SEC. 2. GUARANTEED ISSUE OF MEDIGAP POLICIES TO ALL MEDICARE
BENEFICIARIES.
(a) In General.--Section 1882(s) of the Social Security Act (42
U.S.C. 1395ss(s)) is amended--
(1) in paragraph (2)(A), by striking ``65 years of age or
older and is enrolled for benefits under part B'' and inserting
``entitled to, or enrolled for, benefits under part A and
enrolled for benefits under part B'';
(2) in paragraph (2)(D), by striking ``who is 65 years of
age or older as of the date of issuance and''; and
(3) in paragraph (3)(B)(vi), by striking ``at age 65''.
(b) Effective Date; Phase-In Authority.--
(1) Effective date.--Subject to paragraph (2), the
amendments made by subsection (a) shall apply to Medicare
supplemental policies effective on or after January 1, 2014.
(2) Phase-in authority.--
(A) In general.--Subject to subparagraph (B), the
Secretary of Health and Human Services may phase in the
implementation of the amendments made under subsection
(a) in such manner as the Secretary determines
appropriate in order to minimize any adverse impact on
individuals enrolled under a Medicare supplemental
policy prior to January 1, 2014.
(B) Phase-in period may not exceed 5 years.--The
Secretary of Health and Human Services shall ensure
that the amendments made by subsection (a) are fully
implemented by not later than January 1, 2019.
(c) Separate Premium Class.--
(1) In general.--Subject to paragraph (2), any individuals
enrolled under a Medicare supplemental policy pursuant to the
amendments made under subsection (a) shall be classified by the
issuer as part of a separate premium class.
(2) Limit.--The provision in paragraph (1) shall apply to
individuals that enroll under a Medicare supplemental policy
prior to January 1, 2019.
(d) Additional Enrollment Period for Certain Individuals.--
(1) One-time enrollment period.--
(A) In general.--In the case of an individual
described in paragraph (2), the Secretary shall
establish a one-time enrollment period during which
such an individual may enroll in any Medicare
supplemental policy of the individual's choosing.
(B) Period.--The enrollment period established
under subparagraph (A) shall begin on the date on which
the phase-in period under subsection (b) is completed
and end 6 months after such date.
(2) Individual described.--An individual described in this
paragraph is an individual who--
(A) is entitled to hospital insurance benefits
under part A under section 226(b) or section 226A of
the Social Security Act (42 U.S.C. 426(b); 426-1);
(B) is enrolled for benefits under part B of such
Act (42 U.S.C. 1395j et seq.); and
(C) would not, but for the provisions of and
amendments made by this section, be eligible for the
guaranteed issue of a Medicare supplemental policy
under section 1882(s)(2) of such Act (42 U.S.C.
1395ss(s)(2)).
(3) Outreach plan.--The Secretary shall develop an outreach
plan to notify individuals described in paragraph (2) of the
one-time enrollment period established under paragraph (1).
SEC. 3. GUARANTEED ISSUE OF MEDIGAP POLICIES FOR MEDICARE ADVANTAGE AND
MEDICAID ENROLLEES.
(a) In General.--Section 1882(s)(3) of the Social Security Act (42
U.S.C. 1395ss(s)(3)), as amended by section 2, is amended--
(1) in subparagraph (B), by adding at the end the following
new clauses:
``(vii) The individual was enrolled in a Medicare Advantage
plan under part C for not less than 12 months and subsequently
disenrolled from such plan and elects to receive benefits under
this title through the original Medicare fee-for-service
program under parts A and B.
``(viii) The individual--
``(I) is entitled to, or enrolled for, benefits
under part A and enrolled for benefits under part B;
``(II) was eligible for medical assistance under a
State plan or waiver under title XIX and was enrolled
in such plan or waiver; and
``(III) subsequently lost eligibility for such
medical assistance.'';
(2) by striking subparagraph (C)(iii) and inserting the
following:
``(iii) Subject to subsection (v)(1), for purposes of an
individual described in clause (vi), (vii), or (viii) of
subparagraph (B), a Medicare supplemental policy described in
this subparagraph shall include any Medicare supplemental
policy.''; and
(3) in subparagraph (E)--
(A) in clause (iv), by striking ``and'' at the end;
(B) in clause (v), by striking the period at the
end and inserting a semicolon; and
(C) by adding at the end the following new
clauses--
``(vi) in the case of an individual described in
subparagraph (B)(vii), the annual, coordinated election period
(as defined in section 1851(e)(3)(B)) or a continuous open
enrollment period (as defined in section 1851(e)(2)) during
which the individual disenrolls from a Medicare Advantage plan
under part C; and
``(vii) in the case of an individual described in
subparagraph (B)(viii), the period beginning on the date that
the individual receives a notice of cessation of such
individual's eligibility for medical assistance under the State
plan or waiver under title XIX and ending on the date that is
123 days after the individual receives such notice.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to Medicare supplemental policies effective on or after January
1, 2014.
SEC. 4. ENROLLMENT OF INDIVIDUALS WITH END STAGE RENAL DISEASE IN
MEDICARE ADVANTAGE.
(a) In General.--Section 1851(a) of the Social Security Act (42
U.S.C. 1395w-21(a)) is amended by striking paragraph (3) and inserting
the following:
``(3) Medicare advantage eligible individual.--In this
title, the term `Medicare Advantage eligible individual' means
an individual who is entitled to benefits under part A and
enrolled under part B.''.
(b) Conforming Amendments.--
(1) Section 1852(b) of the Social Security Act (42 U.S.C.
1395w-22(b)) is amended by striking paragraph (1) and inserting
the following:
``(1) Beneficiaries.--A Medicare Advantage organization may
not deny, limit, or condition the coverage or provision of
benefits under this part, for individuals permitted to be
enrolled with the organization under this part, based on any
health status-related factor described in section 2702(a)(1) of
the Public Health Service Act. The Secretary shall not approve
a plan of an organization if the Secretary determines that the
design of the plan and its benefits are likely to substantially
discourage enrollment by certain MA eligible individuals with
the organization.''.
(2) Section 1859(b)(6)(B) of such Act (42 U.S.C. 1395w-
28(b)(6)(B)) is amended in the second sentence by striking
``may waive application of section 1851(a)(3)(B) in the case of
an individual described in clause (i), (ii), or (iii) of this
subparagraph and''.
(c) Effective Date.--The amendments made by this section shall
apply to plan years beginning on or after January 1, 2014.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S3840-3841)
Read twice and referred to the Committee on Finance.
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