Territories Medicare Prescription Drug Assistance Equality Act of 2023
This bill makes certain income-based subsidies under the Medicare prescription drug benefit available to individuals who reside in Puerto Rico or another U.S. territory and are otherwise eligible.
Current law makes such individuals ineligible for premium and cost-sharing subsidies, but establishes a process for U.S. territories to apply for financial assistance with respect to the provision of Medicare prescription drugs. The bill retains a process for U.S. territories to apply for such assistance, but alters the formula by which the amount of assistance is calculated. Specifically, the bill phases in modifications to the formula that more closely align how assistance is calculated for U.S. territories with how it is calculated for the 50 states and the District of Columbia.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4028 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 4028
To amend titles XVIII and XIX of the Social Security Act to make
premium and cost-sharing subsidies available to low-income Medicare
part D beneficiaries who reside in Puerto Rico or another territory of
the United States.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 12, 2023
Mrs. Gonzalez-Colon introduced the following bill; which was referred
to the Committee on Energy and Commerce, and in addition to the
Committee on Ways and Means, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions as
fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend titles XVIII and XIX of the Social Security Act to make
premium and cost-sharing subsidies available to low-income Medicare
part D beneficiaries who reside in Puerto Rico or another territory of
the United States.
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 ``Territories Medicare Prescription
Drug Assistance Equality Act of 2023''.
SEC. 2. EQUAL TREATMENT OF RESIDENTS OF TERRITORIES IN PREMIUM AND
COST-SHARING SUBSIDIES UNDER MEDICARE PRESCRIPTION DRUG
PROGRAM.
(a) Medicare Assistance.--Section 1860D-14(a)(3) of the Social
Security Act (42 U.S.C. 1395w-114(a)(3)) is amended--
(1) in subparagraph (A), in the matter preceding clause
(i), by striking ``subject to subparagraph (F),'';
(2) in subparagraph (B)(v), in the matter preceding
subclause (I), by striking ``Subject to subparagraph (F), the
Secretary'' and inserting ``The Secretary'';
(3) in subparagraph (C), by adding at the end the following
new sentence: ``In the case of an individual who is not a
resident of the 50 States or the District of Columbia, the
poverty line (as such term is defined in clause (ii)) that
shall apply to such individual shall be the poverty line for
the 48 contiguous States and the District of Columbia.''; and
(4) by striking subparagraph (F).
(b) Medicaid Assistance.--Section 1935 of the Social Security Act
(42 U.S.C. 1396u-5) is amended--
(1) in subsection (c)(1)(A)--
(A) by inserting ``(and each other State for each
month beginning with January 2022)'' after ``January
2006''; and
(B) in clause (i), by inserting ``or (2)(B) (as the
case may be)'' after ``paragraph (2)(A)'';
(2) in subsection (c)(2)--
(A) in subparagraph (A)--
(i) by amending the heading to read as
follows: ``Computation for 50 states and the
district of columbia''; and
(ii) by striking ``a State described in
paragraph (1)'' and inserting ``one of the 50
States or the District of Columbia'';
(B) in subparagraph (B)--
(i) by striking ``subparagraph (A)'' and
inserting ``subparagraph (A) or (B) (as the
case may be)''; and
(ii) by redesignating such subparagraph as
subparagraph (C); and
(C) by inserting after subparagraph (A) the
following new subparagraph:
``(B) Computation for territories.--The amount
computed under this paragraph for a State not described
in subparagraph (A) and for a month in a year
(beginning with 2024) is equal to--
``(i) \1/12\ of the product of--
``(I) the amount determined under
subsection (e) for the State for 2023;
and
``(II) 100 percent minus the
highest possible Federal medical
assistance percentage that may be
applied to any of the 50 States for
fiscal year 2022 under section
1905(b)(1); and
``(ii) increased for each year (beginning
with 2023 up to and including the year
involved) by the applicable growth factor
specified in paragraph (4) for that year.'';
and
(3) in subsection (e)--
(A) in paragraph (1)--
(i) in subparagraph (A), by striking ``of
such State; and'' and inserting ``of such State
for years before 2022;'';
(ii) in subparagraph (B)--
(I) by inserting ``for periods
before January 1, 2024'' after ``(B)'';
and
(II) by striking the period at the
end and inserting ``; and''; and
(iii) by adding at the end the following
new subparagraph:
``(C) for the first 3 quarters of fiscal year 2024
and for each subsequent fiscal year, the amount
otherwise applied under section 1108(f) for the State
shall be increased by the amount specified in paragraph
(4)(A) for such period or fiscal year.'';
(B) in paragraph (2), by striking ``The Secretary''
and inserting ``For periods before January 2024, the
Secretary'';
(C) in paragraph (3)--
(i) in the heading, by inserting ``before
second quarter of fiscal year 2024'' after
``Increased amount'';
(ii) in subparagraph (A)--
(I) in the matter before clause
(i), by inserting ``or other fiscal
period'' after ``for a year''; and
(II) in clause (i), by inserting
``for such year or period'' after
``subparagraph (B)''; and
(iii) in subparagraph (B)--
(I) in clause (ii), by striking
``or'' at the end;
(II) in clause (iii), by striking
``a subsequent year'' and inserting ``a
subsequent fiscal year (before the
second quarter of fiscal year 2024)'';
(III) in clause (iii), by striking
the period at the end and inserting ``;
and''; and
(IV) by adding at the end the
following:
``(iv) for the first quarter of fiscal year
2024, is equal to 25 percent of the aggregate
amount specified in this subparagraph for the
previous fiscal year increased by the annual
percentage increase specified in section 1860D-
2(b)(6) for the year involved.'';
(D) by striking paragraph (4); and
(E) by inserting after paragraph (3) the following
new paragraph:
``(4) Increased amount beginning with second quarter of
fiscal year 2024.--
``(A) In general.--The amount specified in this
paragraph for a State for the last 3 quarters of fiscal
year 2024 or for a subsequent fiscal year is equal to
the product of--
``(i) the aggregate amount specified in
subparagraph (B) for such period or fiscal
year; and
``(ii) the ratio (as estimated by the
Secretary) of--
``(I) the number of individuals who
are entitled to benefits under part A
or enrolled under part B and who reside
in the State (as determined by the
Secretary based on the most recent
available data before the beginning of
the period or year); to
``(II) the sum of such numbers for
all States that are subject to this
subsection.
``(B) Aggregate amount.--The aggregate amount
specified in this subparagraph for--
``(i) the last 3 quarters of fiscal year
2024, is equal to 3 times the amount specified
in paragraph (3)(B)(iv);
``(ii) fiscal year 2025, is equal to 4
times the amount specified in paragraph
(3)(B)(iv) increased by the same annual
percentage increase as is applied to increases
in the amounts applied for the fiscal year and
State under section 1108(f); or
``(iii) a subsequent fiscal year, is equal
to the aggregate amount specified in this
subparagraph for the previous fiscal year
increased by the same annual percentage
increase as is applied for the fiscal year and
State under section 1108(f).''.
(c) Conforming Amendment.--Section 1108(f) of the Social Security
Act (42 U.S.C. 1308(f)) is amended by striking ``1935(e)(1)(B)'' and
inserting ``1935(e)(1)''.
(d) Effective Dates.--The amendments made by subsection (a) shall
take effect on January 1, 2024, and the amendments made by subsections
(b) and (c) shall take effect on the date of the enactment of this Act.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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