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[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 10 Introduced in Senate (IS)]

106th CONGRESS
  1st Session
                                 S. 10

To provide health protection and needed assistance for older Americans, 
including access to health insurance for 55 to 65 year olds, assistance 
  for individuals with long-term care needs, and social services for 
                            older Americans.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            January 19, 1999

 Mr. Daschle (for himself, Ms. Mikulski, Mr. Cleland, Mr. Harkin, Mr. 
  Sarbanes, Mr. Kennedy, Mrs. Boxer, Mr. Durbin, Mr. Rockefeller, Mr. 
Dodd, Mr. Bryan, Mr. Johnson, Mr. Kohl, Mr. Kerry, and Mr. Lautenberg) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL

 
To provide health protection and needed assistance for older Americans, 
including access to health insurance for 55 to 65 year olds, assistance 
  for individuals with long-term care needs, and social services for 
                            older Americans.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Health Protection 
and Assistance For Older Americans Act of 1999''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
      TITLE I--HEALTH CARE COVERAGE CHOICES FOR 55 TO 65 YEAR OLDS

Subtitle A--Access to Medicare Benefits for Individuals 62-to-65 Years 
                                 of Age

Sec. 101. Access to medicare benefits for individuals 62-to-65 years of 
                            age.
 ``Part D--Purchase of Medicare Benefits by Certain Individuals Age 62-
                           to-65 Years of Age

        ``Sec. 1859. Program benefits; eligibility.
        ``Sec. 1859A. Enrollment process; coverage.
        ``Sec. 1859B. Premiums.
        ``Sec. 1859C. Payment of premiums.
        ``Sec. 1859D. Medicare Early Access Trust Fund.
        ``Sec. 1859E. Oversight and accountability.
        ``Sec. 1859F. Administration and miscellaneous.''.
Subtitle B--Access to Medicare Benefits for Displaced Workers 55-to-62 
                              Years of Age

Sec. 111. Access to medicare benefits for displaced workers 55-to-62 
                            years of age.
            Subtitle C--COBRA Protection for Early Retirees

Chapter 1--Amendments to the Employee Retirement Income Security Act of 
                                  1974

Sec. 121. COBRA continuation benefits for certain retired workers who 
                            lose retiree health coverage.
         Chapter 2--Amendments to the Public Health Service Act

Sec. 125. COBRA continuation benefits for certain retired workers who 
                            lose retiree health coverage.
       Chapter 3--Amendments to the Internal Revenue Code of 1986

Sec. 131. COBRA continuation benefits for certain retired workers who 
                            lose retiree health coverage.
            TITLE II--EXPANSION OF LONG-TERM CARE PROTECTION

Sec. 201. Long-term care tax credit.
Sec. 202. Federal employees group long-term care insurance.
     TITLE III--REAUTHORIZATION OF THE OLDER AMERICANS ACT OF 1965

Sec. 301. Authorizations of appropriations.
Sec. 302. National family caregiver support program.
Sec. 303. Allotments.
Sec. 304. Availability of title III-D funds for reallotment.
Sec. 305. Conforming amendments.
Sec. 306. Effective date.

      TITLE I--HEALTH CARE COVERAGE CHOICES FOR 55 TO 65 YEAR OLDS

Subtitle A--Access to Medicare Benefits for Individuals 62-to-65 Years 
                                 of Age

SEC. 101. ACCESS TO MEDICARE BENEFITS FOR INDIVIDUALS 62-TO-65 YEARS OF 
              AGE.

    (a) In General.--Title XVIII of the Social Security Act is 
amended--
            (1) by redesignating section 1859 and part D as section 
        1858 and part E, respectively; and
            (2) by inserting after such section the following new part:

 ``Part D--Purchase of Medicare Benefits by Certain Individuals Age 62-
                           to-65 Years of Age

``SEC. 1859. PROGRAM BENEFITS; ELIGIBILITY.

    ``(a) Entitlement to Medicare Benefits for Enrolled Individuals.--
            ``(1) In general.--An individual enrolled under this part 
        is entitled to the same benefits under this title as an 
        individual entitled to benefits under part A and enrolled under 
        part B.
            ``(2) Definitions.--For purposes of this part:
                    ``(A) Federal or state cobra continuation 
                provision.--The term `Federal or State COBRA 
                continuation provision' has the meaning given the term 
                `COBRA continuation provision' in section 2791(d)(4) of 
                the Public Health Service Act and includes a comparable 
                State program, as determined by the Secretary.
                    ``(B) Federal health insurance program defined.--
                The term `Federal health insurance program' means any 
                of the following:
                            ``(i) Medicare.--Part A or part B of this 
                        title (other than by reason of this part).
                            ``(ii) Medicaid.--A State plan under title 
                        XIX.
                            ``(iii) FEHBP.--The Federal employees 
                        health benefit program under chapter 89 of 
                        title 5, United States Code.
                            ``(iv) TRICARE.--The TRICARE program (as 
                        defined in section 1072(7) of title 10, United 
                        States Code).
                            ``(v) Active duty military.--Health 
                        benefits under title 10, United States Code, to 
                        an individual as a member of the uniformed 
                        services of the United States.
                    ``(C) Group health plan.--The term `group health 
                plan' has the meaning given such term in section 
                2791(a)(1) of the Public Health Service Act.
    ``(b) Eligibility of Individuals Age 62-to-65 Years of Age.--
            ``(1) In general.--Subject to paragraph (2), an individual 
        who meets the following requirements with respect to a month is 
        eligible to enroll under this part with respect to such month:
                    ``(A) Age.--As of the last day of the month, the 
                individual has attained 62 years of age, but has not 
                attained 65 years of age.
                    ``(B) Medicare eligibility (but for age).--The 
                individual would be eligible for benefits under part A 
                or part B for the month if the individual were 65 years 
                of age.
                    ``(C) Not eligible for coverage under group health 
                plans or federal health insurance programs.--The 
                individual is not eligible for benefits or coverage 
                under a Federal health insurance program (as defined in 
                subsection (a)(2)(B)) or under a group health plan 
                (other than such eligibility merely through a Federal 
                or State COBRA continuation provision) as of the last 
                day of the month involved.
            ``(2) Limitation on eligibility if terminated enrollment.--
        If an individual described in paragraph (1) enrolls under this 
        part and coverage of the individual is terminated under section 
        1859A(d) (other than because of age), the individual is not 
        again eligible to enroll under this subsection unless the 
        following requirements are met:
                    ``(A) New coverage under group health plan or 
                federal health insurance program.--After the date of 
                termination of coverage under such section, the 
                individual obtains coverage under a group health plan 
                or under a Federal health insurance program.
                    ``(B) Subsequent loss of new coverage.--The 
                individual subsequently loses eligibility for the 
                coverage described in subparagraph (A) and exhausts any 
                eligibility the individual may subsequently have for 
                coverage under a Federal or State COBRA continuation 
                provision.
            ``(3) Change in health plan eligibility does not affect 
        coverage.--In the case of an individual who is eligible for and 
        enrolls under this part under this subsection, the individual's 
        continued entitlement to benefits under this part shall not be 
        affected by the individual's subsequent eligibility for 
        benefits or coverage described in paragraph (1)(C), or 
        entitlement to such benefits or coverage.

``SEC. 1859A. ENROLLMENT PROCESS; COVERAGE.

    ``(a) In General.--An individual may enroll in the program 
established under this part only in such manner and form as may be 
prescribed by regulations, and only during an enrollment period 
prescribed by the Secretary consistent with the provisions of this 
section. Such regulations shall provide a process under which--
            ``(1) individuals eligible to enroll as of a month are 
        permitted to pre-enroll during a prior month within an 
        enrollment period described in subsection (b); and
            ``(2) each individual seeking to enroll under section 
        1859(b) is notified, before enrolling, of the deferred monthly 
        premium amount the individual will be liable for under section 
        1859C(b) upon attaining 65 years of age as determined under 
        section 1859B(c)(3).
    ``(b) Enrollment Periods.--
            ``(1) Individuals 62-to-65 years of age.--In the case of 
        individuals eligible to enroll under this part under section 
        1859(b)--
                    ``(A) Initial enrollment period.--If the individual 
                is eligible to enroll under such section for July 2000, 
                the enrollment period shall begin on May 1, 2000, and 
                shall end on August 31, 2000. Any such enrollment 
                before July 1, 2000, is conditioned upon compliance 
                with the conditions of eligibility for July 2000.
                    ``(B) Subsequent periods.--If the individual is 
                eligible to enroll under such section for a month after 
                July 2000, the enrollment period shall begin on the 
                first day of the second month before the month in which 
                the individual first is eligible to so enroll and shall 
                end 4 months later. Any such enrollment before the 
                first day of the third month of such enrollment period 
                is conditioned upon compliance with the conditions of 
                eligibility for such third month.
            ``(2) Authority to correct for government errors.--The 
        provisions of section 1837(h) apply with respect to enrollment 
        under this part in the same manner as they apply to enrollment 
        under part B.
    ``(c) Date Coverage Begins.--
            ``(1) In general.--The period during which an individual is 
        entitled to benefits under this part shall begin as follows, 
        but in no case earlier than July 1, 2000:
                    ``(A) In the case of an individual who enrolls 
                (including pre-enrolls) before the month in which the 
                individual satisfies eligibility for enrollment under 
                section 1859, the first day of such month of 
                eligibility.
                    ``(B) In the case of an individual who enrolls 
                during or after the month in which the individual first 
                satisfies eligibility for enrollment under such 
                section, the first day of the following month.
            ``(2) Authority to provide for partial months of 
        coverage.--Under regulations, the Secretary may, in the 
        Secretary's discretion, provide for coverage periods that 
        include portions of a month in order to avoid lapses of 
        coverage.
            ``(3) Limitation on payments.--No payments may be made 
        under this title with respect to the expenses of an individual 
        enrolled under this part unless such expenses were incurred by 
        such individual during a period which, with respect to the 
        individual, is a coverage period under this section.
    ``(d) Termination of Coverage.--
            ``(1) In general.--An individual's coverage period under 
        this part shall continue until the individual's enrollment has 
        been terminated at the earliest of the following:
                    ``(A) General provisions.--
                            ``(i) Notice.--The individual files notice 
                        (in a form and manner prescribed by the 
                        Secretary) that the individual no longer wishes 
                        to participate in the insurance program under 
                        this part.
                            ``(ii) Nonpayment of premiums.--The 
                        individual fails to make payment of premiums 
                        required for enrollment under this part.
                            ``(iii) Medicare eligibility.--The 
                        individual becomes entitled to benefits under 
                        part A or enrolled under part B (other than by 
                        reason of this part).
                    ``(B) Termination based on age.--The individual 
                attains 65 years of age.
            ``(2) Effective date of termination.--
                    ``(A) Notice.--The termination of a coverage period 
                under paragraph (1)(A)(i) shall take effect at the 
                close of the month following for which the notice is 
                filed.
                    ``(B) Nonpayment of premium.--The termination of a 
                coverage period under paragraph (1)(A)(ii) shall take 
                effect on a date determined under regulations, which 
                may be determined so as to provide a grace period in 
                which overdue premiums may be paid and coverage 
                continued. The grace period determined under the 
                preceding sentence shall not exceed 60 days; except 
                that it may be extended for an additional 30 days in 
                any case where the Secretary determines that there was 
                good cause for failure to pay the overdue premiums 
                within such 60-day period.
                    ``(C) Age or medicare eligibility.--The termination 
                of a coverage period under paragraph (1)(A)(iii) or 
                (1)(B) shall take effect as of the first day of the 
                month in which the individual attains 65 years of age 
                or becomes entitled to benefits under part A or 
                enrolled for benefits under part B (other than by 
                reason of this part).

``SEC. 1859B. PREMIUMS.

    ``(a) Amount of Monthly Premiums.--
            ``(1) Base monthly premiums.--The Secretary shall, during 
        September of each year (beginning with 1999), determine the 
        following premium rates which shall apply with respect to 
        coverage provided under this title for any month in the 
        succeeding year:
                    ``(A) Base monthly premium for individuals 62 years 
                of age or older.--A base monthly premium for 
                individuals 62 years of age or older is equal to \1/12\ 
                of the base annual premium rate computed under 
                subsection (b) for each premium area.
                    ``(B) Deferred monthly premiums for individuals 62 
                years of age or older.--The Secretary shall, during 
                September of each year (beginning with 1999), determine 
                under subsection (c) the amount of deferred monthly 
                premiums that shall apply with respect to individuals 
                who first obtain coverage under this part under section 
                1859(b) in the succeeding year.
            ``(3) Establishment of premium areas.--For purposes of this 
        part, the term `premium area' means such an area as the 
        Secretary shall specify to carry out this part. The Secretary 
from time to time may change the boundaries of such premium areas. The 
Secretary shall seek to minimize the number of such areas specified 
under this paragraph.
    ``(b) Base Annual Premium for Individuals 62 Years of Age or 
Older.--
            ``(1) National, per capita average.--The Secretary shall 
        estimate the average, annual per capita amount that would be 
        payable under this title with respect to individuals residing 
        in the United States who meet the requirement of section 
        1859(b)(1)(A) as if all such individuals were eligible for (and 
        enrolled) under this title during the entire year (and assuming 
        that section 1862(b)(2)(A)(i) did not apply).
            ``(2) Geographic adjustment.--The Secretary shall reduce, 
        as determined appropriate, the amount determined under 
        paragraph (1) for a premium area (specified under subsection 
        (a)(3)) that has costs below the national average, in order to 
        assure participation in all areas throughout the United States.
            ``(3) Base annual premium.--The base annual premium under 
        this subsection for months in a year for individuals 62 years 
        of age or older residing in a premium area is equal to the 
        average, annual per capita amount estimated under paragraph (1) 
        for the year, adjusted for such area under paragraph (2).
    ``(c) Deferred Premium Rate for Individuals 62 Years of Age or 
Older.--The deferred premium rate for individuals with a group of 
individuals who obtain coverage under section 1859(b) in a year shall 
be computed by the Secretary as follows:
            ``(1) Estimation of national, per capita annual average 
        expenditures for enrollment group.--The Secretary shall 
        estimate the average, per capita annual amount that will be 
        paid under this part for individuals in such group during the 
        period of enrollment under section 1859(b). In making such 
        estimate for coverage beginning in a year before 2004, the 
        Secretary may base such estimate on the average, per capita 
        amount that would be payable if the program had been in 
        operation over a previous period of at least 4 years.
            ``(2) Difference between estimated expenditures and 
        estimated premiums.--Based on the characteristics of 
        individuals in such group, the Secretary shall estimate during 
        the period of coverage of the group under this part under 
        section 1859(b) the amount by which--
                    ``(A) the amount estimated under paragraph (1); 
                exceeds
                    ``(B) the average, annual per capita amount of 
                premiums that will be payable for months during the 
                year under section 1859C(a) for individuals in such 
                group (including premiums that would be payable if 
                there were no terminations in enrollment under clause 
                (i) or (ii) of section 1859A(d)(1)(A)).
            ``(3) Actuarial computation of deferred monthly premium 
        rates.--The Secretary shall determine deferred monthly premium 
        rates for individuals in such group in a manner so that--
                    ``(A) the estimated actuarial value of such 
                premiums payable under section 1859C(b), is equal to
                    ``(B) the estimated actuarial present value of the 
                differences described in paragraph (2).
        Such rate shall be computed for each individual in the group in 
        a manner so that the rate is based on the number of months 
        between the first month of coverage based on enrollment under 
        section 1859(b) and the month in which the individual attains 
        65 years of age.
            ``(4) Determinants of actuarial present values.--The 
        actuarial present values described in paragraph (3) shall 
        reflect--
                    ``(A) the estimated probabilities of survival at 
                ages 62 through 84 for individuals enrolled during the 
                year; and
                    ``(B) the estimated effective average interest 
                rates that would be earned on investments held in the 
                trust funds under this title during the period in 
                question.

``SEC. 1859C. PAYMENT OF PREMIUMS.

    ``(a) Payment of Base Monthly Premium.--
            ``(1) In general.--The Secretary shall provide for payment 
        and collection of the base monthly premium, determined under 
        section 1859B(a)(1) for the age (and age cohort, if applicable) 
        of the individual involved and the premium area in which the 
        individual principally resides, in the same manner as for 
        payment of monthly premiums under section 1840, except that, 
        for purposes of applying this section, any reference in such 
        section to the Federal Supplementary Medical Insurance Trust 
        Fund is deemed a reference to the Trust Fund established under 
        section 1859D.
            ``(2) Period of payment.--In the case of an individual who 
        participates in the program established by this title, the base 
        monthly premium shall be payable for the period commencing with 
        the first month of the individual's coverage period and ending 
        with the month in which the individual's coverage under this 
        title terminates.
    ``(b) Payment of Deferred Premium for Individuals Covered After 
Attaining Age 62.--
            ``(1) Rate of payment.--
                    ``(A) In general.--In the case of an individual who 
                is covered under this part for a month pursuant to an 
                enrollment under section 1859(b), subject to 
                subparagraph (B), the individual is liable for payment 
                of a deferred premium in each month during the period 
                described in paragraph (2) in an amount equal to the 
                full deferred monthly premium rate determined for the 
                individual under section 1859B(c).
                    ``(B) Special rules for those who disenroll 
                early.--
                            ``(i) In general.--If such an individual's 
                        enrollment under such section is terminated 
                        under clause (i) or (ii) of section 
                        1859A(d)(1)(A), subject to clause (ii), the 
                        amount of the deferred premium otherwise 
                        established under this paragraph shall be pro-
                        rated to reflect the number of months of 
                        coverage under this part under such enrollment 
                        compared to the maximum number of months of 
                        coverage that the individual would have had if 
                        the enrollment were not so terminated.
                            ``(ii) Rounding to 12-month minimum 
                        coverage periods.--In applying clause (i), the 
                        number of months of coverage (if not a multiple 
                        of 12) shall be rounded to the next highest 
                        multiple of 12 months, except that in no case 
                        shall this clause result in a number of months 
                        of coverage exceeding the maximum number of 
                        months of coverage that the individual would 
                        have had if the enrollment were not so 
                        terminated.
            ``(2) Period of payment.--The period described in this 
        paragraph for an individual is the period beginning with the 
        first month in which the individual has attained 65 years of 
        age and ending with the month before the month in which the 
        individual attains 85 years of age.
            ``(3) Collection.--In the case of an individual who is 
        liable for a premium under this subsection, the amount of the 
        premium shall be collected in the same manner as the premium 
        for enrollment under such part is collected under section 1840, 
        except that any reference in such section to the Federal 
        Supplementary Medical Insurance Trust Fund is deemed to be a 
        reference to the Medicare Early Access Trust Fund established 
        under section 1859D.
    ``(c) Application of Certain Provisions.--The provisions of section 
1840 (other than subsection (h)) shall apply to premiums collected 
under this section in the same manner as they apply to premiums 
collected under part B, except that any reference in such section to 
the Federal Supplementary Medical Insurance Trust Fund is deemed a 
reference to the Trust Fund established under section 1859D.

``SEC. 1859D. MEDICARE EARLY ACCESS TRUST FUND.

    ``(a) Establishment of Trust Fund.--
            ``(1) In general.--There is hereby created on the books of 
        the Treasury of the United States a trust fund to be known as 
        the `Medicare Early Access Trust Fund' (in this section 
        referred to as the `Trust Fund'). The Trust Fund shall consist 
        of such gifts and bequests as may be made as provided in 
        section 201(i)(1) and such amounts as may be deposited in, or 
        appropriated to, such fund as provided in this title.
            ``(2) Premiums.--Premiums collected under section 1859B 
        shall be transferred to the Trust Fund.
    ``(b) Incorporation of Provisions.--
            ``(1) In general.--Subject to paragraph (2), subsections 
        (b) through (i) of section 1841 shall apply with respect to the 
        Trust Fund and this title in the same manner as they apply with 
        respect to the Federal Supplementary Medical Insurance Trust 
        Fund and part B, respectively.
            ``(2) Miscellaneous references.--In applying provisions of 
        section 1841 under paragraph (1)--
                    ``(A) any reference in such section to `this part' 
                is construed to refer to this part D;
                    ``(B) any reference in section 1841(h) to section 
                1840(d) and in section 1841(i) to sections 1840(b)(1) 
                and 1842(g) are deemed references to comparable 
                authority exercised under this part; and
                    ``(C) payments may be made under section 1841(g) to 
                the trust funds under sections 1817 and 1841 as 
                reimbursement to such funds for payments they made for 
                benefits provided under this part.

``SEC. 1859E. OVERSIGHT AND ACCOUNTABILITY.

    ``(a) Through Annual Reports of Trustees.--The Board of Trustees of 
the Medicare Early Access Trust Fund under section 1859D(b)(1) shall 
report on an annual basis to Congress concerning the status of the 
Trust Fund and the need for adjustments in the program under this part 
to maintain financial solvency of the program under this part.
    ``(b) Periodic GAO Reports.--The Comptroller General of the United 
States shall periodically submit to Congress reports on the adequacy of 
the financing of coverage provided under this part. The Comptroller 
General shall include in such report such recommendations for 
adjustments in such financing and coverage as the Comptroller General 
deems appropriate in order to maintain financial solvency of the 
program under this part.

``SEC. 1859F. ADMINISTRATION AND MISCELLANEOUS.

    ``(a) Treatment for Purposes of this Title.--Except as otherwise 
provided in this part--
            ``(1) an individual enrolled under this part shall be 
        treated for purposes of this title as though the individual was 
        entitled to benefits under part A and enrolled under part B; 
        and
            ``(2) benefits described in section 1859 shall be payable 
        under this title to such an individual in the same manner as if 
        such individual was so entitled and enrolled.
    ``(b) Not Treated as Medicare Program for Purposes of Medicaid 
Program.--For purposes of applying title XIX (including the provision 
of medicare cost-sharing assistance under such title), an individual 
who is enrolled under this part shall not be treated as being entitled 
to benefits under this title.
    ``(c) Not Treated as Medicare Program for Purposes of COBRA 
Continuation Provisions.--In applying a COBRA continuation provision 
(as defined in section 2791(d)(4) of the Public Health Service Act), 
any reference to an entitlement to benefits under this title shall not 
be construed to include entitlement to benefits under this title 
pursuant to the operation of this part.''.
    (b) Conforming Amendments to Social Security Act Provisions.--
            (1) Section 201(i)(1) of the Social Security Act (42 U.S.C. 
        401(i)(1)) is amended by striking ``or the Federal 
        Supplementary Medical Insurance Trust Fund'' and inserting 
        ``the Federal Supplementary Medical Insurance Trust Fund, and 
        the Medicare Early Access Trust Fund''.
            (2) Section 201(g)(1)(A) of such Act (42 U.S.C. 
        401(g)(1)(A)) is amended by striking ``and the Federal 
        Supplementary Medical Insurance Trust Fund established by title 
        XVIII'' and inserting ``, the Federal Supplementary Medical 
        Insurance Trust Fund, and the Medicare Early Access Trust Fund 
        established by title XVIII''.
            (3) Section 1820(i) of such Act (42 U.S.C. 1395i-4(i)) is 
        amended by striking ``part D'' and inserting ``part E''.
            (4) Part C of title XVIII of such Act is amended--
                    (A) in section 1851(a)(2)(B) (42 U.S.C. 1395w-
                21(a)(2)(B)), by striking ``1859(b)(3)'' and inserting 
                ``1858(b)(3)'';
                    (B) in section 1851(a)(2)(C) (42 U.S.C. 1395w-
                21(a)(2)(C)), by striking ``1859(b)(2)'' and inserting 
                ``1858(b)(2)'';
                    (C) in section 1852(a)(1) (42 U.S.C. 1395w-
                22(a)(1)), by striking ``1859(b)(3)'' and inserting 
                ``1858(b)(3)'';
                    (D) in section 1852(a)(3)(B)(ii) (42 U.S.C. 1395w-
                22(a)(3)(B)(ii)), by striking ``1859(b)(2)(B)'' and 
                inserting ``1858(b)(2)(B)'';
                    (E) in section 1853(a)(1)(A) (42 U.S.C. 1395w-
                23(a)(1)(A)), by striking ``1859(e)(4)'' and inserting 
                ``1858(e)(4)''; and
                    (F) in section 1853(a)(3)(D) (42 U.S.C. 1395w-
                23(a)(3)(D)), by striking ``1859(e)(4)'' and inserting 
                ``1858(e)(4)''.
            (5) Section 1853(c) of such Act (42 U.S.C. 1395w-23(c)) is 
        amended--
                    (A) in paragraph (1), by striking ``or (7)'' and 
                inserting ``, (7), or (8)'', and
                    (B) by adding at the end the following:
            ``(8) Adjustment for early access.--In applying this 
        subsection with respect to individuals entitled to benefits 
        under part D, the Secretary shall provide for an appropriate 
        adjustment in the Medicare+Choice capitation rate as may be 
        appropriate to reflect differences between the population 
        served under such part and the population under parts A and 
        B.''.
    (c) Other Conforming Amendments.--
            (1) Section 138(b)(4) of the Internal Revenue Code of 1986 
        is amended by striking ``1859(b)(3)'' and inserting 
        ``1858(b)(3)''.
            (2)(A) Section 602(2)(D)(ii) of the Employee Retirement 
        Income Security Act of 1974 (29 U.S.C. 1162(2)) is amended by 
        inserting ``(not including an individual who is so entitled 
        pursuant to enrollment under section 1859A)'' after ``Social 
        Security Act''.
            (B) Section 2202(2)(D)(ii) of the Public Health Service Act 
        (42 U.S.C. 300bb-2(2)(D)(ii)) is amended by inserting ``(not 
        including an individual who is so entitled pursuant to 
        enrollment under section 1859A)'' after ``Social Security 
        Act''.
            (C) Section 4980B(f)(2)(B)(i)(V) of the Internal Revenue 
        Code of 1986 is amended by inserting ``(not including an 
        individual who is so entitled pursuant to enrollment under 
        section 1859A)'' after ``Social Security Act''.

Subtitle B--Access to Medicare Benefits for Displaced Workers 55-to-62 
                              Years of Age

SEC. 111. ACCESS TO MEDICARE BENEFITS FOR DISPLACED WORKERS 55-TO-62 
              YEARS OF AGE.

    (a) Eligibility.--Section 1859 of the Social Security Act, as 
inserted by section 101(a)(2), is amended by adding at the end the 
following new subsection:
    ``(c) Displaced Workers and Spouses.--
            ``(1) Displaced workers.--Subject to paragraph (3), an 
        individual who meets the following requirements with respect to 
        a month is eligible to enroll under this part with respect to 
        such month:
                    ``(A) Age.--As of the last day of the month, the 
                individual has attained 55 years of age, but has not 
                attained 62 years of age.
                    ``(B) Medicare eligibility (but for age).--The 
                individual would be eligible for benefits under part A 
                or B for the month if the individual were 65 years of 
                age.
                    ``(C) Loss of employment-based coverage.--
                            ``(i) Eligible for unemployment 
                        compensation.--The individual meets the 
                        requirements relating to period of covered 
                        employment and conditions of separation from 
                        employment to be eligible for unemployment 
                        compensation (as defined in section 85(b) of 
                        the Internal Revenue Code of 1986), based on a 
                        separation from employment occurring on or 
                        after January 1, 1999. The previous sentence 
                        shall not be construed as requiring the 
                        individual to be receiving such unemployment 
                        compensation.
                            ``(ii) Loss of employment-based coverage.--
                        Immediately before the time of such separation 
                        of employment, the individual was covered under 
                        a group health plan on the basis of such 
                        employment, and, because of such loss, is no 
                        longer eligible for coverage under such plan 
                        (including such eligibility based on the 
                        application of a Federal or State COBRA 
                        continuation provision) as of the last day of 
                        the month involved.
                            ``(iii) Previous creditable coverage for at 
                        least 1 year.--As of the date on which the 
                        individual loses coverage described in clause 
                        (ii), the aggregate of the periods of 
                        creditable coverage (as determined under 
                        section 2701(c) of the Public Health Service 
                        Act) is 12 months or longer.
                    ``(D) Exhaustion of available cobra continuation 
                benefits.--
                            ``(i) In general.--In the case of an 
                        individual described in clause (ii) for a month 
                        described in clause (iii)--
                                    ``(I) the individual (or spouse) 
                                elected coverage described in clause 
                                (ii); and
                                    ``(II) the individual (or spouse) 
                                has continued such coverage for all 
                                months described in clause (iii) in 
                                which the individual (or spouse) is 
                                eligible for such coverage.
                            ``(ii) Individuals to whom cobra 
                        continuation coverage made available.--An 
                        individual described in this clause is an 
                        individual--
                                    ``(I) who was offered coverage 
                                under a Federal or State COBRA 
                                continuation provision at the time of 
                                loss of coverage eligibility described 
                                in subparagraph (C)(ii); or
                                    ``(II) whose spouse was offered 
                                such coverage in a manner that 
                                permitted coverage of the individual at 
                                such time.
                            ``(iii) Months of possible cobra 
                        continuation coverage.--A month described in 
                        this clause is a month for which an individual 
                        described in clause (ii) could have had 
                        coverage described in such clause as of the 
                        last day of the month if the individual (or the 
                        spouse of the individual, as the case may be) 
                        had elected such coverage on a timely basis.
                    ``(E) Not eligible for coverage under federal 
                health insurance program or group health plans.--The 
                individual is not eligible for benefits or coverage 
                under a Federal health insurance program or under a 
                group health plan (whether on the basis of the 
                individual's employment or employment of the 
                individual's spouse) as of the last day of the month 
                involved.
            ``(2) Spouse of displaced worker.--Subject to paragraph 
        (3), an individual who meets the following requirements with 
        respect to a month is eligible to enroll under this part with 
        respect to such month:
                    ``(A) Age.--As of the last day of the month, the 
                individual has not attained 62 years of age.
                    ``(B) Married to displaced worker.--The individual 
                is the spouse of an individual at the time the 
                individual enrolls under this part under paragraph (1) 
                and loses coverage described in paragraph (1)(C)(ii) 
                because the individual's spouse lost such coverage.
                    ``(C) Medicare eligibility (but for age); 
                exhaustion of any cobra continuation coverage; and not 
                eligible for coverage under federal health insurance 
                program or group health plan.--The individual meets the 
                requirements of subparagraphs (B), (D), and (E) of 
                paragraph (1).
            ``(3) Change in health plan eligibility affects continued 
        eligibility.--For provision that terminates enrollment under 
        this section in the case of an individual who becomes eligible 
        for coverage under a group health plan or under a Federal 
        health insurance program, see section 1859A(d)(1)(C).
            ``(4) Reenrollment permitted.--Nothing in this subsection 
        shall be construed as preventing an individual who, after 
        enrolling under this subsection, terminates such enrollment 
        from subsequently reenrolling under this subsection if the 
        individual is eligible to enroll under this subsection at that 
        time.''.
    (b) Enrollment.--Section 1859A of such Act, as so inserted, is 
amended--
            (1) in subsection (a), by striking ``and'' at the end of 
        paragraph (1), by striking the period at the end of paragraph 
        (2) and inserting ``; and'', and by adding at the end the 
        following new paragraph:
            ``(3) individuals whose coverage under this part would 
        terminate because of subsection (d)(1)(B)(ii) are provided 
        notice and an opportunity to continue enrollment in accordance 
        with section 1859E(c)(1).'';
            (2) in subsection (b), by inserting after Notwithstanding 
        any other provision of law, (1) the following:
            ``(2) Displaced workers and spouses.--In the case of 
        individuals eligible to enroll under this part under section 
        1859(c), the following rules apply:
                    ``(A) Initial enrollment period.--If the individual 
                is first eligible to enroll under such section for July 
                2000, the enrollment period shall begin on May 1, 2000, 
                and shall end on August 31, 2000. Any such enrollment 
                before July 1, 2000, is conditioned upon compliance 
                with the conditions of eligibility for July 2000.
                    ``(B) Subsequent periods.--If the individual is 
                eligible to enroll under such section for a month after 
                July 2000, the enrollment period based on such 
                eligibility shall begin on the first day of the second 
                month before the month in which the individual first is 
                eligible to so enroll (or reenroll) and shall end 4 
                months later.'';
            (3) in subsection (d)(1), by amending subparagraph (B) to 
        read as follows:
                    ``(B) Termination based on age.--
                            ``(i) At age 65.--Subject to clause (ii), 
                        the individual attains 65 years of age.
                            ``(ii) At age 62 for displaced workers and 
                        spouses.--In the case of an individual enrolled 
                        under this part pursuant to section 1859(c), 
                        subject to subsection (a)(1), the individual 
                        attains 62 years of age.'';
            (4) in subsection (d)(1), by adding at the end the 
        following new subparagraph:
                    ``(C) Obtaining access to employment-based coverage 
                or federal health insurance program for individuals 
                under 62 years of age.--In the case of an individual 
                who has not attained 62 years of age, the individual is 
                covered (or eligible for coverage) as a participant or 
                beneficiary under a group health plan or under a 
                Federal health insurance program.'';
            (5) in subsection (d)(2), by amending subparagraph (C) to 
        read as follows:
                    ``(C) Age or medicare eligibility.--
                            ``(i) In general.--The termination of a 
                        coverage period under paragraph (1)(A)(iii) or 
                        (1)(B)(i) shall take effect as of the first day 
                        of the month in which the individual attains 65 
                        years of age or becomes entitled to benefits 
                        under part A or enrolled for benefits under 
                        part B.
                            ``(ii) Displaced workers.--The termination 
                        of a coverage period under paragraph (1)(B)(ii) 
                        shall take effect as of the first day of the 
                        month in which the individual attains 62 years 
                        of age, unless the individual has enrolled 
                        under this part pursuant to section 1859(b) and 
                        section 1859E(c)(1).''; and
            (6) in subsection (d)(2), by adding at the end the 
        following new subparagraph:
                    ``(D) Access to coverage.--The termination of a 
                coverage period under paragraph (1)(C) shall take 
                effect on the date on which the individual is eligible 
                to begin a period of creditable coverage (as defined in 
                section 2701(c) of the Public Health Service Act) under 
                a group health plan or under a Federal health insurance 
                program.''.
    (c) Premiums.--Section 1859B of such Act, as so inserted, is 
amended--
            (1) in subsection (a)(1), by adding at the end the 
        following:
                    ``(B) Base monthly premium for individuals under 62 
                years of age.--A base monthly premium for individuals 
                under 62 years of age, equal to \1/12\ of the base 
                annual premium rate computed under subsection (d)(3) 
                for each premium area and age cohort.''; and
            (2) by adding at the end the following new subsection:
    ``(d) Base Monthly Premium for Individuals Under 62 Years of Age.--
            ``(1) National, per capita average for age groups.--
                    ``(A) Estimate of amount.--The Secretary shall 
                estimate the average, annual per capita amount that 
                would be payable under this title with respect to 
                individuals residing in the United States who meet the 
                requirement of section 1859(c)(1)(A) within each of the 
                age cohorts established under subparagraph (B) as if 
                all such individuals within such cohort were eligible 
                for (and enrolled) under this title during the entire 
                year (and assuming that section 1862(b)(2)(A)(i) did 
                not apply).
                    ``(B) Age cohorts.--For purposes of subparagraph 
                (A), the Secretary shall establish separate age cohorts 
                in 5-year age increments for individuals who have not 
                attained 60 years of age and a separate cohort for 
                individuals who have attained 60 years of age.
            ``(2) Geographic adjustment.--The Secretary shall adjust 
        the amount determined under paragraph (1)(A) for each premium 
        area (specified under subsection (a)(3)) in the same manner and 
        to the same extent as the Secretary provides for adjustments 
        under subsection (b)(2).
            ``(3) Base annual premium.--The base annual premium under 
        this subsection for months in a year for individuals in an age 
        cohort under paragraph (1)(B) in a premium area is equal to 165 
        percent of the average, annual per capita amount estimated 
        under paragraph (1) for the age cohort and year, adjusted for 
        such area under paragraph (2).
            ``(4) Pro-ration of premiums to reflect coverage during a 
        part of a month.--If the Secretary provides for coverage of 
        portions of a month under section 1859A(c)(2), the Secretary 
        shall pro-rate the premiums attributable to such coverage under 
        this section to reflect the portion of the month so covered.''.
    (d) Administrative Provisions.--Section 1859F of such Act, as so 
inserted, is amended by adding at the end the following:
    ``(d) Additional Administrative Provisions.--
            ``(1) Process for continued enrollment of displaced workers 
        who attain 62 years of age.--The Secretary shall provide a 
        process for the continuation of enrollment of individuals whose 
        enrollment under section 1859(c) would be terminated upon 
        attaining 62 years of age. Under such process such individuals 
        shall be provided appropriate and timely notice before the date 
        of such termination and of the requirement to enroll under this 
        part pursuant to section 1859(b) in order to continue 
        entitlement to benefits under this title after attaining 62 
        years of age.
            ``(2) Arrangements with states for determinations relating 
        to unemployment compensation eligibility.--The Secretary may 
        provide for appropriate arrangements with States for the 
        determination of whether individuals in the State meet or would 
        meet the requirements of section 1859(c)(1)(C)(i).''.
    (e) Conforming Amendment to Heading to Part.--The heading of part D 
of title XVIII of the Social Security Act, as so inserted, is amended 
by striking ``62'' and inserting ``55''.

            Subtitle C--COBRA Protection for Early Retirees

CHAPTER 1--AMENDMENTS TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 
                                  1974

SEC. 121. COBRA CONTINUATION BENEFITS FOR CERTAIN RETIRED WORKERS WHO 
              LOSE RETIREE HEALTH COVERAGE.

    (a) Establishment of New Qualifying Event.--
            (1) In general.--Section 603 of the Employee Retirement 
        Income Security Act of 1974 (29 U.S.C. 1163) is amended by 
        inserting after paragraph (6) the following new paragraph:
            ``(7) The termination or substantial reduction in benefits 
        (as defined in section 607(7)) of group health plan coverage as 
        a result of plan changes or termination in the case of a 
        covered employee who is a qualified retiree.''.
            (2) Qualified retiree; qualified beneficiary; and 
        substantial reduction defined.--Section 607 of such Act (29 
        U.S.C. 1167) is amended--
                    (A) in paragraph (3)--
                            (i) in subparagraph (A), by inserting 
                        ``except as otherwise provided in this 
                        paragraph,'' after ``means,''; and
                            (ii) by adding at the end the following new 
                        subparagraph:
                    ``(D) Special rule for qualifying retirees and 
                dependents.--In the case of a qualifying event 
                described in section 603(7), the term `qualified 
                beneficiary' means a qualified retiree and any other 
                individual who, on the day before such qualifying 
                event, is a beneficiary under the plan on the basis of 
                the individual's relationship to such qualified 
                retiree.''; and
                    (B) by adding at the end the following new 
                paragraphs:
            ``(6) Qualified retiree.--The term `qualified retiree' 
        means, with respect to a qualifying event described in section 
        603(7), a covered employee who, at the time of the event--
                    ``(A) has attained 55 years of age; and
                    ``(B) was receiving group health coverage under the 
                plan by reason of the retirement of the covered 
                employee.
            ``(7) Substantial reduction.--The term `substantial 
        reduction'--
                    ``(A) means, as determined under regulations of the 
                Secretary and with respect to a qualified beneficiary, 
                a reduction in the average actuarial value of benefits 
                under the plan (through reduction or elimination of 
                benefits, an increase in premiums, deductibles, 
                copayments, and coinsurance, or any combination 
                thereof), since the date of commencement of coverage of 
                the beneficiary by reason of the retirement of the 
                covered employee (or, if later, January 6, 1999), in an 
                amount equal to at least 50 percent of the total 
                average actuarial value of the benefits under the plan 
                as of such date (taking into account an appropriate 
                adjustment to permit comparison of values over time); 
                and
                    ``(B) includes an increase in premiums required to 
                an amount that exceeds the premium level described in 
                the fourth sentence of section 602(3).''.
    (b) Duration of Coverage Through Age 65.--Section 602(2)(A) of such 
Act (29 U.S.C. 1162(2)(A)) is amended--
            (1) in clause (ii), by inserting ``or 603(7)'' after 
        ``603(6)'';
            (2) in clause (iv), by striking ``or 603(6)'' and inserting 
        ``, 603(6), or 603(7)'';
            (3) by redesignating clause (iv) as clause (vi);
            (4) by redesignating clause (v) as clause (iv) and by 
        moving such clause to immediately follow clause (iii); and
            (5) by inserting after such clause (iv) the following new 
        clause:
                            ``(v) Special rule for certain dependents 
                        in case of termination or substantial reduction 
                        of retiree health coverage.--In the case of a 
                        qualifying event described in section 603(7), 
                        in the case of a qualified beneficiary 
                        described in section 607(3)(D) who is not the 
                        qualified retiree or spouse of such retiree, 
                        the later of--
                                    ``(I) the date that is 36 months 
                                after the earlier of the date the 
                                qualified retiree becomes entitled to 
                                benefits under title XVIII of the 
                                Social Security Act, or the date of the 
                                death of the qualified retiree; or
                                    ``(II) the date that is 36 months 
                                after the date of the qualifying 
                                event.''.
    (c) Type of Coverage in Case of Termination or Substantial 
Reduction of Retiree Health Coverage.--Section 602(1) of such Act (29 
U.S.C. 1162(1)) is amended--
            (1) by striking ``The coverage'' and inserting the 
        following:
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the coverage''; and
            (2) by adding at the end the following:
                    ``(B) Certain retirees.--In the case of a 
                qualifying event described in section 603(7), in 
                applying the first sentence of subparagraph (A) and the 
                fourth sentence of paragraph (3), the coverage offered 
                that is the most prevalent coverage option (as 
                determined under regulations of the Secretary) 
                continued under the group health plan (or, if none, 
                under the most prevalent other plan offered by the same 
                plan sponsor) shall be treated as the coverage 
                described in such sentence, or (at the option of the 
                plan and qualified beneficiary) such other coverage 
                option as may be offered and elected by the qualified 
                beneficiary involved.''.
    (d) Increased Level of Premiums Permitted.--Section 602(3) of such 
Act (29 U.S.C. 1162(3)) is amended by adding at the end the following 
new sentence: ``In the case of an individual provided continuation 
coverage by reason of a qualifying event described in section 603(7), 
any reference in subparagraph (A) of this paragraph to `102 percent of 
the applicable premium' is deemed a reference to `125 percent of the 
applicable premium for employed individuals (and their dependents, if 
applicable) for the coverage option referred to in paragraph 
(1)(B)'.''.
    (e) Notice.--Section 606(a) of such Act (29 U.S.C. 1166) is 
amended--
            (1) in paragraph (4)(A), by striking ``or (6)'' and 
        inserting ``(6), or (7)''; and
            (2) by adding at the end the following:
``The notice under paragraph (4) in the case of a qualifying event 
described in section 603(7) shall be provided at least 90 days before 
the date of the qualifying event.''.
    (f) Effective Dates.--
            (1) In general.--The amendments made by this section (other 
        than subsection (e)(2)) shall apply to qualifying events 
        occurring on or after January 6, 1999. In the case of a 
        qualifying event occurring on or after such date and before the 
        date of the enactment of this Act, such event shall be deemed 
        (for purposes of such amendments) to have occurred on the date 
        of the enactment of this Act.
            (2) Advance notice of terminations and reductions.--The 
        amendment made by subsection (e)(2) shall apply to qualifying 
        events occurring after the date of the enactment of this Act, 
        except that in no case shall notice be required under such 
        amendment before such date.

         CHAPTER 2--AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT

SEC. 125. COBRA CONTINUATION BENEFITS FOR CERTAIN RETIRED WORKERS WHO 
              LOSE RETIREE HEALTH COVERAGE.

    (a) Establishment of New Qualifying Event.--
            (1) In general.--Section 2203 of the Public Health Service 
        Act (42 U.S.C. 300bb-3) is amended by inserting after paragraph 
        (5) the following new paragraph:
            ``(6) The termination or substantial reduction in benefits 
        (as defined in section 2208(6)) of group health plan coverage 
        as a result of plan changes or termination in the case of a 
        covered employee who is a qualified retiree.''.
            (2) Qualified retiree; qualified beneficiary; and 
        substantial reduction defined.--Section 2208 of such Act (42 
        U.S.C. 300bb-8) is amended--
                    (A) in paragraph (3)--
                            (i) in subparagraph (A), by inserting 
                        ``except as otherwise provided in this 
                        paragraph,'' after ``means,''; and
                            (ii) by adding at the end the following new 
                        subparagraph:
                    ``(C) Special rule for qualifying retirees and 
                dependents.--In the case of a qualifying event 
                described in section 2203(6), the term `qualified 
                beneficiary' means a qualified retiree and any other 
                individual who, on the day before such qualifying 
                event, is a beneficiary under the plan on the basis of 
                the individual's relationship to such qualified 
                retiree.''; and
                    (B) by adding at the end the following new 
                paragraphs:
            ``(5) Qualified retiree.--The term `qualified retiree' 
        means, with respect to a qualifying event described in section 
        2203(6), a covered employee who, at the time of the event--
                    ``(A) has attained 55 years of age; and
                    ``(B) was receiving group health coverage under the 
                plan by reason of the retirement of the covered 
                employee.
            ``(6) Substantial reduction.--The term `substantial 
        reduction'--
                    ``(A) means, as determined under regulations of the 
                Secretary of Labor and with respect to a qualified 
                beneficiary, a reduction in the average actuarial value 
                of benefits under the plan (through reduction or 
                elimination of benefits, an increase in premiums, 
                deductibles, copayments, and coinsurance, or any 
                combination thereof), since the date of commencement of 
                coverage of the beneficiary by reason of the retirement 
                of the covered employee (or, if later, January 6, 
                1999), in an amount equal to at least 50 percent of the 
                total average actuarial value of the benefits under the 
                plan as of such date (taking into account an 
                appropriate adjustment to permit comparison of values 
                over time); and
                    ``(B) includes an increase in premiums required to 
                an amount that exceeds the premium level described in 
                the fourth sentence of section 2202(3).''.
    (b) Duration of Coverage Through Age 65.--Section 2202(2)(A) of 
such Act (42 U.S.C. 300bb-2(2)(A)) is amended--
            (1) by redesignating clause (iii) as clause (iv); and
            (2) by inserting after clause (ii) the following new 
        clause:
                            ``(iii) Special rule for certain dependents 
                        in case of termination or substantial reduction 
                        of retiree health coverage.--In the case of a 
                        qualifying event described in section 2203(6), 
                        in the case of a qualified beneficiary 
                        described in section 2208(3)(C) who is not the 
                        qualified retiree or spouse of such retiree, 
                        the later of--
                                    ``(I) the date that is 36 months 
                                after the earlier of the date the 
                                qualified retiree becomes entitled to 
                                benefits under title XVIII of the 
                                Social Security Act, or the date of the 
                                death of the qualified retiree; or
                                    ``(II) the date that is 36 months 
                                after the date of the qualifying 
                                event.''.
    (c) Type of Coverage in Case of Termination or Substantial 
Reduction of Retiree Health Coverage.--Section 2202(1) of such Act (42 
U.S.C. 300bb-2(1)) is amended--
            (1) by striking ``The coverage'' and inserting the 
        following:
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the coverage''; and
            (2) by adding at the end the following:
                    ``(B) Certain retirees.--In the case of a 
                qualifying event described in section 2203(6), in 
                applying the first sentence of subparagraph (A) and the 
                fourth sentence of paragraph (3), the coverage offered 
                that is the most prevalent coverage option (as 
                determined under regulations of the Secretary of Labor) 
                continued under the group health plan (or, if none, 
                under the most prevalent other plan offered by the same 
                plan sponsor) shall be treated as the coverage 
                described in such sentence, or (at the option of the 
                plan and qualified beneficiary) such other coverage 
                option as may be offered and elected by the qualified 
                beneficiary involved.''.
    (d) Increased Level of Premiums Permitted.--Section 2202(3) of such 
Act (42 U.S.C. 300bb-2(3)) is amended by adding at the end the 
following new sentence: ``In the case of an individual provided 
continuation coverage by reason of a qualifying event described in 
section 2203(6), any reference in subparagraph (A) of this paragraph to 
`102 percent of the applicable premium' is deemed a reference to `125 
percent of the applicable premium for employed individuals (and their 
dependents, if applicable) for the coverage option referred to in 
paragraph (1)(B)'.''.
    (e) Notice.--Section 2206(a) of such Act (42 U.S.C. 300bb-6(a)) is 
amended--
            (1) in paragraph (4)(A), by striking ``or (4)'' and 
        inserting ``(4), or (6)''; and
            (2) by adding at the end the following:
``The notice under paragraph (4) in the case of a qualifying event 
described in section 2203(6) shall be provided at least 90 days before 
the date of the qualifying event.''.
    (f) Effective Dates.--
            (1) In general.--The amendments made by this section (other 
        than subsection (e)(2)) shall apply to qualifying events 
        occurring on or after January 6, 1999. In the case of a 
        qualifying event occurring on or after such date and before the 
        date of the enactment of this Act, such event shall be deemed 
        (for purposes of such amendments) to have occurred on the date 
        of the enactment of this Act.
            (2) Advance notice of terminations and reductions.--The 
        amendment made by subsection (e)(2) shall apply to qualifying 
        events occurring after the date of the enactment of this Act, 
        except that in no case shall notice be required under such 
        amendment before such date.

       CHAPTER 3--AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986

SEC. 131. COBRA CONTINUATION BENEFITS FOR CERTAIN RETIRED WORKERS WHO 
              LOSE RETIREE HEALTH COVERAGE.

    (a) Establishment of New Qualifying Event.--
            (1) In general.--Section 4980B(f)(3) of the Internal 
        Revenue Code of 1986 is amended by inserting after subparagraph 
        (F) the following new subparagraph:
                    ``(G) The termination or substantial reduction in 
                benefits (as defined in subsection (g)(6)) of group 
                health plan coverage as a result of plan changes or 
                termination in the case of a covered employee who is a 
                qualified retiree.''.
            (2) Qualified retiree; qualified beneficiary; and 
        substantial reduction defined.--Section 4980B(g) of such Code 
        is amended--
                    (A) in paragraph (1)--
                            (i) in subparagraph (A), by inserting 
                        ``except as otherwise provided in this 
                        paragraph,'' after ``means,''; and
                            (ii) by adding at the end the following new 
                        subparagraph:
                    ``(E) Special rule for qualifying retirees and 
                dependents.--In the case of a qualifying event 
                described in subsection (f)(3)(G), the term `qualified 
                beneficiary' means a qualified retiree and any other 
                individual who, on the day before such qualifying 
                event, is a beneficiary under the plan on the basis of 
                the individual's relationship to such qualified 
                retiree.''; and
                    (B) by adding at the end the following new 
                paragraphs:
            ``(5) Qualified retiree.--The term `qualified retiree' 
        means, with respect to a qualifying event described in 
        subsection (f)(3)(G), a covered employee who, at the time of 
        the event--
                    ``(A) has attained 55 years of age; and
                    ``(B) was receiving group health coverage under the 
                plan by reason of the retirement of the covered 
                employee.
            ``(6) Substantial reduction.--The term `substantial 
        reduction'--
                    ``(A) means, as determined under regulations of the 
                Secretary of Labor and with respect to a qualified 
                beneficiary, a reduction in the average actuarial value 
                of benefits under the plan (through reduction or 
                elimination of benefits, an increase in premiums, 
                deductibles, copayments, and coinsurance, or any 
                combination thereof), since the date of commencement of 
                coverage of the beneficiary by reason of the retirement 
                of the covered employee (or, if later, January 6, 
                1999), in an amount equal to at least 50 percent of the 
                total average actuarial value of the benefits under the 
                plan as of such date (taking into account an 
                appropriate adjustment to permit comparison of values 
                over time); and
                    ``(B) includes an increase in premiums required to 
                an amount that exceeds the premium level described in 
                the fourth sentence of subsection (f)(2)(C).''.
    (b) Duration of Coverage Through Age 65.--Section 4980B(f)(2)(B)(i) 
of such Code is amended--
            (1) in subclause (II), by inserting ``or (3)(G)'' after 
        ``(3)(F)'';
            (2) in subclause (IV), by striking ``or (3)(F)'' and 
        inserting ``, (3)(F), or (3)(G)'';
            (3) by redesignating subclause (IV) as subclause (VI);
            (4) by redesignating subclause (V) as subclause (IV) and by 
        moving such clause to immediately follow subclause (III); and
            (5) by inserting after such subclause (IV) the following 
        new subclause:
                                    ``(V) Special rule for certain 
                                dependents in case of termination or 
                                substantial reduction of retiree health 
                                coverage.--In the case of a qualifying 
                                event described in paragraph (3)(G), in 
                                the case of a qualified beneficiary 
                                described in subsection (g)(1)(E) who 
                                is not the qualified retiree or spouse 
                                of such retiree, the later of--
                                            ``(a) the date that is 36 
                                        months after the earlier of the 
                                        date the qualified retiree 
                                        becomes entitled to benefits 
                                        under title XVIII of the Social 
                                        Security Act, or the date of 
                                        the death of the qualified 
                                        retiree; or
                                            ``(b) the date that is 36 
                                        months after the date of the 
                                        qualifying event.''.
    (c) Type of Coverage in Case of Termination or Substantial 
Reduction of Retiree Health Coverage.--Section 4980B(f)(2)(A) of such 
Code is amended--
            (1) by striking ``The coverage'' and inserting the 
        following:
                            ``(i) In general.--Except as provided in 
                        clause (ii), the coverage''; and
            (2) by adding at the end the following:
                            ``(ii) Certain retirees.--In the case of a 
                        qualifying event described in paragraph (3)(G), 
                        in applying the first sentence of clause (i) 
                        and the fourth sentence of subparagraph (C), 
                        the coverage offered that is the most prevalent 
                        coverage option (as determined under 
                        regulations of the Secretary of Labor) 
                        continued under the group health plan (or, if 
                        none, under the most prevalent other plan 
                        offered by the same plan sponsor) shall be 
                        treated as the coverage described in such 
                        sentence, or (at the option of the plan and 
                        qualified beneficiary) such other coverage 
                        option as may be offered and elected by the 
                        qualified beneficiary involved.''.
    (d) Increased Level of Premiums Permitted.--Section 4980B(f)(2)(C) 
of such Code is amended by adding at the end the following new 
sentence: ``In the case of an individual provided continuation coverage 
by reason of a qualifying event described in paragraph (3)(G), any 
reference in clause (i) of this subparagraph to `102 percent of the 
applicable premium' is deemed a reference to `125 percent of the 
applicable premium for employed individuals (and their dependents, if 
applicable) for the coverage option referred to in subparagraph 
(A)(ii)'.''.
    (e) Notice.--Section 4980B(f)(6) of such Code is amended--
            (1) in subparagraph (D)(i), by striking ``or (F)'' and 
        inserting ``(F), or (G)''; and
            (2) by adding at the end the following:
``The notice under subparagraph (D)(i) in the case of a qualifying 
event described in paragraph (3)(G) shall be provided at least 90 days 
before the date of the qualifying event.''.
    (f) Effective Dates.--
            (1) In general.--The amendments made by this section (other 
        than subsection (e)(2)) shall apply to qualifying events 
        occurring on or after January 6, 1999. In the case of a 
        qualifying event occurring on or after such date and before the 
        date of the enactment of this Act, such event shall be deemed 
        (for purposes of such amendments) to have occurred on the date 
        of the enactment of this Act.
            (2) Advance notice of terminations and reductions.--The 
        amendment made by subsection (e)(2) shall apply to qualifying 
        events occurring after the date of the enactment of this Act, 
        except that in no case shall notice be required under such 
        amendment before such date.

            TITLE II--EXPANSION OF LONG-TERM CARE PROTECTION

SEC. 201. LONG-TERM CARE TAX CREDIT.

    (a) Allowance of Credit.--
            (1) In general.--Section 24(a) of the Internal Revenue Code 
        of 1986 (relating to allowance of child tax credit) is amended 
        to read as follows:
    ``(a) Allowance of Credit.--There shall be allowed as a credit 
against the tax imposed by this chapter for the taxable year an amount 
equal to the sum of--
            ``(1) $500 multiplied by the number of qualifying children 
        of the taxpayer, plus
            ``(2) $1,000 multiplied by the number of applicable 
        individuals with respect to whom the taxpayer is an eligible 
        caregiver for the taxable year.''
            (2) Additional credit for taxpayer with 3 or more separate 
        credit amounts.--So much of section 24(d) of such Code as 
        precedes paragraph (1)(A) thereof is amended to read as 
        follows:
    ``(d) Additional Credit for Taxpayers With 3 or More Separate 
Credit Amounts.--
            ``(1) In general.--If the sum of the number of qualifying 
        children of the taxpayer and the number of applicable 
        individuals with respect to which the taxpayer is an eligible 
        caregiver is 3 or more for any taxable year, the aggregate 
        credits allowed under subpart C shall be increased by the 
        lesser of--''.
            (3) Conforming amendments.--
                    (A) The heading for section 32(n) of such Code is 
                amended by striking ``Child'' and inserting ``Family 
                Care''.
                    (B) The heading for section 24 is amended to read 
                as follows:

``SEC. 24. FAMILY CARE CREDIT.''

                    (C) The table of sections for subpart A of part IV 
                of subchapter A of chapter 1 of such Code is amended by 
                striking the item relating to section 24 and inserting 
                the following new item:

``Sec. 24. Family care credit.''.
    (b) Definitions.--Section 24(c) of the Internal Revenue Code of 
1986 (defining qualifying child) is amended to read as follows:
    ``(c) Definitions.--For purposes of this section--
            ``(1) Qualifying child.--
                    ``(A) In general.--The term `qualifying child' 
                means any individual if--
                            ``(i) the taxpayer is allowed a deduction 
                        under section 151 with respect to such 
                        individual for the taxable year,
                            ``(ii) such individual has not attained the 
                        age of 17 as of the close of the calendar year 
                        in which the taxable year of the taxpayer 
                        begins, and
                            ``(iii) such individual bears a 
                        relationship to the taxpayer described in 
                        section 32(c)(3)(B).
                    ``(B) Exception for certain noncitizens.--The term 
                `qualifying child' shall not include any individual who 
                would not be a dependent if the first sentence of 
                section 152(b)(3) were applied without regard to all 
                that follows `resident of the United States'.
            ``(2) Applicable individual.--
                    ``(A) In general.--The term `applicable individual' 
                means, with respect to any taxable year, any individual 
                who has been certified, before the due date for filing 
                the return of tax for the taxable year (without 
                extensions), by a physician (as defined in section 
                1861(r)(1) of the Social Security Act) as being an 
                individual with long-term care needs described in 
                subparagraph (B) for a period--
                            ``(i) which is at least 180 consecutive 
                        days, and
                            ``(ii) a portion of which occurs within the 
                        taxable year.
                Such term shall not include any individual otherwise 
                meeting the requirements of the preceding sentence 
                unless within the 39\1/2\ month period ending on such 
                due date (or such other period as the Secretary 
                prescribes) a physician (as so defined) has certified 
                that such individual meets such requirements.
                    ``(B) Individuals with long-term care needs.--An 
                individual is described in this subparagraph if the 
                individual meets any of the following requirements:
                            ``(i) The individual is at least 6 years of 
                        age and--
                                    ``(I) is unable to perform (without 
                                substantial assistance from another 
                                individual) at least 3 activities of 
                                daily living (as defined in section 
                                7702B(c)(2)(B)) due to a loss of 
                                functional capacity, or
                                    ``(II) requires substantial 
                                supervision to protect such individual 
                                from threats to health and safety due 
                                to severe cognitive impairment and is 
                                unable to perform at least 1 activity 
                                of daily living (as so defined) or to 
                                the extent provided in regulations 
                                prescribed by the Secretary (in 
                                consultation with the Secretary of 
                                Health and Human Services), is unable 
                                to engage in age appropriate 
                                activities.
                            ``(ii) The individual is at least 2 but not 
                        6 years of age and is unable due to a loss of 
                        functional capacity to perform (without 
                        substantial assistance from another individual) 
                        at least 2 of the following activities: eating, 
                        transferring, or mobility.
                            ``(iii) The individual is under 2 years of 
                        age and requires specific durable medical 
                        equipment by reason of a severe health 
                        condition or requires a skilled practitioner 
                        trained to address the individual's condition 
                        to be available if the individual's parents or 
                        guardians are absent.
            ``(3) Eligible caregiver.--
                    ``(A) In general.--A taxpayer shall be treated as 
                an eligible caregiver for any taxable year with respect 
                to the following individuals:
                            ``(i) The taxpayer.
                            ``(ii) The taxpayer's spouse.
                            ``(iii) An individual with respect to whom 
                        the taxpayer is allowed a deduction under 
                        section 151 for the taxable year.
                            ``(iv) An individual who would be described 
                        in clause (iii) for the taxable year if section 
                        151(c)(1)(A) were applied by substituting for 
                        the exemption amount an amount equal to the sum 
                        of the exemption amount, the standard deduction 
                        under section 63(c)(2)(C), and any additional 
                        standard deduction under section 63(c)(3) which 
                        would be applicable to the individual if clause 
                        (iii) applied.
                            ``(v) An individual who would be described 
                        in clause (iii) for the taxable year if--
                                    ``(I) the requirements of clause 
                                (iv) are met with respect to the 
                                individual, and
                                    ``(II) the requirements of 
                                subparagraph (B) are met with respect 
                                to the individual in lieu of the 
                                support test of section 152(a).
                    ``(B) Residency test.--The requirements of this 
                subparagraph are met if an individual has as his 
                principal place of abode the home of the taxpayer and--
                            ``(i) in the case of an individual who is 
                        an ancestor or descendant of the taxpayer or 
                        the taxpayer's spouse, is a member of the 
                        taxpayer's household for over half the taxable 
                        year, or
                            ``(ii) in the case of any other individual, 
                        is a member of the taxpayer's household for the 
                        entire taxable year.
                    ``(C) Special rules where more than 1 eligible 
                caregiver.--
                            ``(i) In general.--If more than 1 
                        individual is an eligible caregiver with 
                        respect to the same applicable individual for 
                        taxable years ending with or within the same 
                        calendar year, a taxpayer shall be treated as 
                        the eligible caregiver if each such individual 
                        (other than the taxpayer) files a written 
                        declaration (in such form and manner as the 
                        Secretary may prescribe) that such individual 
                        will not claim such applicable individual for 
the credit under this section.
                            ``(ii) No agreement.--If each individual 
                        required under clause (i) to file a written 
                        declaration under clause (i) does not do so, 
                        the individual with the highest modified 
                        adjusted gross income (as defined in section 
                        32(c)(5)) shall be treated as the eligible 
                        caregiver.
                            ``(iii) Married individuals filing 
                        separately.--In the case of married individuals 
                        filing separately, the determination under this 
                        subparagraph as to whether the husband or wife 
                        is the eligible caregiver shall be made under 
                        the rules of clause (ii) (whether or not one of 
                        them has filed a written declaration under 
                        clause (i)).''.
    (c) Identification Requirements.--
            (1) In general.--Section 24(e) of the Internal Revenue Code 
        of 1986 is amended by adding at the end the following new 
        sentence: ``No credit shall be allowed under this section to a 
        taxpayer with respect to any applicable individual unless the 
        taxpayer includes the name and taxpayer identification number 
        of such individual, and the identification number of the 
        physician certifying such individual, on the return of tax for 
        the taxable year.''.
            (2) Assessment.--Section 6213(g)(2)(I) of such Code is 
        amended--
                    (A) by inserting ``or physician identification'' 
                after ``correct TIN'', and
                    (B) by striking ``child'' and inserting ``family 
                care''.
    (d) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 1999.

SEC. 202. FEDERAL EMPLOYEES GROUP LONG-TERM CARE INSURANCE.

    (a) In General.--Subpart G of part III of title 5, United States 
Code, is amended by adding at the end the following new chapter:

                 ``Chapter 90--Long-Term Care Insurance

``Sec.
``9001. Definitions.
``9002. Contracting authority.
``9003. Minimum standards for contractors.
``9004. Long-term care benefits.
``9005. Financing.
``9006. Preemption.
``9007. Studies, reports, and audits.
``9008. Claims for benefits.
``9009. Jurisdiction of courts.
``9010. Regulations.
``9011. Authorization of appropriations.
``Sec. 9001. Definitions
    ``For the purpose of this chapter, the term--
            ``(1) `annuitant' means an individual referred to in 
        section 8901(3);
            ``(2) `employee' means an individual referred to in 
        subparagraphs (A) through (D), and (F) through (I) of section 
        8901(1); but does not include an employee excluded by 
        regulation of the Office under section 9011;
            ``(3) `Office' means the Office of Personnel Management;
            ``(4) `other eligible individual' means the spouse, former 
        spouse, parent or parent-in-law of an employee or annuitant, or 
        other individual specified by the Office;
            ``(5) `qualified carrier' means an insurer licensed to do 
        business in each of the States and meeting the requirements of 
        a qualified insurer in each of the States;
            ``(6) `qualified contract' means a contract meeting the 
        conditions prescribed in section 9002; and
            ``(7) `State' means a State or territory or possession of 
        the United States, and includes the District of Columbia.
``Sec. 9002. Contracting authority
    ``(a) The Office may, without regard to section 3709 of the Revised 
Statutes (41 U.S.C. 5) or any other statute requiring competitive 
bidding, purchase from 1 or more qualified carriers a policy or 
policies of group long-term care insurance to provide benefits as 
specified by this chapter. The Office shall ensure that each resulting 
contract is awarded on the basis of contractor qualifications, price, 
and reasonable competition to the maximum extent practicable.
    ``(b) The Office may design a benefits package or packages and 
negotiate final offerings with qualified carriers.
    ``(c) Each contract shall be for a uniform term of 5 years, unless 
terminated earlier by the Office.
    ``(d) Premium rates charged under a contract entered into under 
this section shall reasonably reflect the cost of the benefits provided 
under that contract as determined by the Office.
    ``(e) The coverage and benefits made available to individuals under 
a contract entered into under this section are guaranteed to be 
renewable and may not be canceled by the carrier except for nonpayment 
of premium.
    ``(f) The Office may withdraw an offering under this section based 
on open season participation rates, the composition of the risk pool, 
or both.
``Sec. 9003. Minimum standards for contractors
    ``At the minimum, to be a qualified carrier under this chapter, a 
company shall--
            ``(1) be licensed as an insurance company and approved to 
        issue group long-term care insurance in all States and to do 
        business in each of the States; and
            ``(2) be in compliance with the requirements imposed on 
        issuers of qualified long-term care contracts by section 4980C 
        of the Internal Revenue Code of 1986.
``Sec. 9004. Long-term care benefits
    ``The benefits provided under this chapter shall be long-term care 
benefits which, at a minimum, shall be compliant with the most recent 
standards recommended by the National Association of Insurance 
Commissioners.
``Sec. 9005. Financing
    ``(a) The amount necessary to pay the premium for enrollment of an 
enrolled employee shall be withheld from the pay of each enrolled 
employee.
    ``(b) Except as provided under subsection (d), the amount necessary 
to pay the premium for enrollment of an enrolled annuitant shall be 
withheld from the annuity of each enrolled annuitant.
    ``(c) The amount necessary to pay the premium for enrollment of a 
spouse may be withheld from pay or annuity, as appropriate.
    ``(d) An employee, annuitant, or other eligible individual, whose 
pay or annuity is insufficient to cover the withholding required for 
enrollment, shall, at the discretion of the Office, pay the premium for 
enrollment directly to the carrier.
    ``(e) Each carrier participating in the program established under 
chapter shall maintain the funds related to this program separate and 
apart from funds related to other contracts and other lines of 
business.
    ``(f) The costs of the Office in adjudicating a claims dispute 
under section 9008, including costs related to an inquiry not 
culminating in a dispute, shall be reimbursed by the carrier involved 
in the dispute or inquiry. Such funds shall be available to the Office 
for the administration of this chapter.
``Sec. 9006. Preemption
    ``This chapter shall supersede and preempt any State or local law 
which is determined by the Office to be inconsistent with--
            ``(1) the provisions of this chapter; or
            ``(2) after consultation with the National Association of 
        Insurance Commissioners, the efficient provision of a 
        nationwide long-term care insurance program for Federal 
        employees.
``Sec. 9007. Studies, reports, and audits
    ``(a) Each qualified carrier entering into a contract under this 
chapter shall--
            ``(1) furnish such reasonable reports as the Office 
        determines to be necessary to enable the carrier to carry out 
        the functions under this chapter; and
            ``(2) permit the Office and representatives of the General 
        Accounting Office to examine such records of the carrier as may 
        be necessary to carry out the purposes of this chapter.
    ``(b) Each Federal agency shall keep such records, make such 
certifications, and furnish the Office, the carrier, or both, with such 
information and reports as the Office may require.
``Sec. 9008. Claims for benefits
    ``(a) A claim for benefits under this chapter shall be filed within 
4 years after the date on which the reimbursable cost was incurred or 
the service was provided.
    ``(b) The Office shall adjudicate a claims dispute arising under 
this chapter and shall require the contractor to pay for any benefit or 
provide any service the Office determines appropriate under the 
applicable contract.
    ``(c)(1) Except as provided under paragraph (2), benefits payable 
under this chapter for any reimbursable cost incurred or service 
provided are secondary to any other benefit payable for such cost or 
service. No payment may be made where there is no legal obligation for 
such payment.
    ``(2)(A) Benefits payable under the programs described under 
subparagraph (B) shall be secondary to benefits payable under this 
chapter.
    ``(B) The programs referred to under subparagraph (A) are--
            ``(i) the program of medical assistance under title XIX of 
        the Social Security Act (42 U.S.C. 1396); and
            ``(ii) any other Federal or State programs that the Office 
        may specify in regulations that provide health benefit coverage 
        designed to be secondary to other insurance coverage.
``Sec. 9009. Jurisdiction of courts
    ``A claimant under this chapter may file suit against the carrier 
of the long-term care insurance policy covering such claimant in the 
district courts of the United States, after exhausting all available 
administrative remedies.
``Sec. 9010. Regulations
    ``(a) The Office shall prescribe regulations necessary to carry out 
this chapter.
    ``(b) The regulations of the Office may prescribe the time at which 
and the conditions under which an eligible individual may enroll in the 
program established under this chapter.
    ``(c) The Office may not exclude--
            ``(1) an employee or group of employees solely on the basis 
        of the hazardous nature of employment; or
            ``(2) an employee who is occupying a position on a part-
        time career employment basis, as defined in section 3401(2).
    ``(d) The regulations of the Office shall provide for the beginning 
and ending dates of coverage of employees, annuitants, former spouses, 
and other eligible individuals under this chapter, and any requirements 
for continuation or conversion of coverage.
``Sec. 9011. Authorization of appropriations
    ``There are authorized to be appropriated such sums as may be 
necessary for the purposes of carrying out sections 9002 and 9010.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect on the date of enactment of this Act, except that no 
coverage may be effective until the first day of the first applicable 
pay period in October, which occurs more than 1 year after the date of 
enactment of this Act.

     TITLE III--REAUTHORIZATION OF THE OLDER AMERICANS ACT OF 1965

SEC. 301. AUTHORIZATIONS OF APPROPRIATIONS.

    (a) Federal Council on the Aging.--Section 204(g) of the Older 
Americans Act of 1965 (42 U.S.C. 3015(g)) is amended by striking 
``$300,000 for fiscal year 1992 and such sums as may be necessary for 
fiscal years 1993, 1994, and 1995'' and inserting ``such sums as may be 
necessary for fiscal years 2000 through 2002''.
    (b) Administration.--Section 215 of the Older Americans Act of 1965 
(42 U.S.C. 3020f) is amended--
            (1) in subsection (a), by striking ``fiscal years 1992, 
        1993, 1994, and 1995'' and inserting ``fiscal years 2000 
        through 2002''; and
            (2) in subsection (b), by striking paragraph (1) and 
        inserting the following:
            ``(1) such sums as may be necessary for each of fiscal 
        years 2000 through 2002; and''.
    (c) Grants for State and Community Programs on Aging.--Section 303 
of the Older Americans Act of 1965 (42 U.S.C. 3023) is amended--
            (1) in subsection (a)(1), by striking ``$461,376,000 for 
        fiscal year 1992 and such sums as may be necessary for fiscal 
        years 1993, 1994, and 1995'' and inserting ``such sums as may 
        be necessary for fiscal years 2000 through 2002'';
            (2) in subsection (b)--
                    (A) in paragraph (1), by striking ``$505,000,000 
                for fiscal year 1992 and such sums as may be necessary 
                for fiscal years 1993, 1994, and 1995'' and inserting 
                ``such sums as may be necessary for fiscal years 2000 
                through 2002'';
                    (B) in paragraph (2), by striking ``$120,000,000 
                for fiscal year 1992 and such sums as may be necessary 
                for fiscal years 1993, 1994, and 1995'' and inserting 
                ``such sums as may be necessary for fiscal years 2000 
                through 2002''; and
                    (C) in paragraph (3), by striking ``$15,000,000 for 
                fiscal year 1992 and such sums as may be necessary for 
                fiscal years 1993, 1994, and 1995'' and inserting 
                ``such sums as may be necessary for fiscal years 2000 
                through 2002'';
            (3) in subsection (d), to read as follows:
    ``(d) National Family Caregiver Program.--There are authorized to 
be appropriated $125,000,000 for fiscal year 2000, and such sums as may 
be necessary for each of the fiscal years 2001 through 2004, to carry 
out the programs under part D (relating to the national family 
caregiver program).'';
            (4) in subsection (e), by striking ``the fiscal years 1992, 
        1993, 1994, and 1995'' and inserting ``fiscal years 2000 
        through 2002''; and
            (5) in subsection (f), by striking ``$25,000,000 for fiscal 
        year 1992 and such sums as may be necessary for fiscal years 
        1993, 1994, and 1995'' and inserting ``such sums as may be 
        necessary for fiscal years 2000 through 2002''.
    (d) Availability of Surplus Commodities.--Section 311(c)(1)(A) of 
the Older Americans Act of 1965 (42 U.S.C. 3030a(c)(1)(A)) is amended 
by striking ``$250,000,000 for fiscal year 1992, $310,000,000 for 
fiscal year 1993, $380,000,000 for fiscal year 1994, and $460,000,000 
for fiscal year 1995'' and inserting ``such sums as may be necessary 
for each of fiscal years 2000 through 2002''.
    (e) Training, Research, and Discretionary Projects and Programs.--
Section 431 of the Older Americans Act of 1965 (42 U.S.C. 3037) is 
amended--
            (1) in subsection (a)(1), by striking ``$72,000,000 for 
        fiscal year 1992, and such sums as may be necessary for fiscal 
        years 1993, 1994, and 1995'' and inserting ``such sums as may 
        be necessary for fiscal years 2000 through 2002''; and
            (2) in subsection (b), by striking ``$450,000 for each of 
        fiscal years 1992, 1993, 1994, and 1995'' and inserting ``such 
        sums as may be necessary for each of fiscal years 2000 through 
        2002''.
    (f) Community Service Employment for Older Americans.--Section 
508(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 3056f(a)(1)) is 
amended by striking ``$470,671,000 for fiscal year 1992, and such sums 
as may be necessary for fiscal years 1993, 1994, and 1995'' and 
inserting ``such sums as may be necessary for fiscal years 2000 through 
2002''.
    (g) Grants for Native Americans.--Section 633(a) of the Older 
Americans Act of 1965 (42 U.S.C. 3057n(a)) is amended by striking 
``$30,000,000 for fiscal year 1992 and such sums as may be necessary 
for fiscal years 1993, 1994, and 1995'' and inserting ``such sums as 
may be necessary for fiscal years 2000 through 2002''.
    (h) Allotments for Vulnerable Elder Rights Protection Activities.--
Section 702 of the Older Americans Act of 1965 (42 U.S.C. 3058a) is 
amended--
            (1) in subsection (a), by striking ``$40,000,000 for fiscal 
        year 1992 and such sums as may be necessary for fiscal years 
        1993, 1994, and 1995'' and inserting ``such sums as may be 
        necessary for fiscal years 2000 through 2002'';
            (2) in subsection (b), by striking ``$15,000,000 for fiscal 
        year 1992 and such sums as may be necessary for fiscal years 
        1993, 1994, and 1995'' and inserting ``such sums as may be 
        necessary for fiscal years 2000 through 2002'';
            (3) in subsection (c), by striking ``$10,000,000 for fiscal 
        year 1992 and such sums as may be necessary for fiscal years 
        1993, 1994, and 1995'' and inserting ``such sums as may be 
        necessary for fiscal years 2000 through 2002''; and
            (4) in subsection (d), by striking ``$15,000,000 for fiscal 
        year 1992 and such sums as may be necessary for fiscal years 
        1993, 1994, and 1995'' and inserting ``such sums as may be 
        necessary for fiscal years 2000 through 2002''.
    (i) Native American Program.--Section 751(d) of the Older Americans 
Act of 1965 (42 U.S.C. 3058aa(d)) is amended by striking ``$5,000,000 
for fiscal year 1992, and such sums as may be necessary for fiscal 
years 1993, 1994, and 1995'' and inserting ``such sums as may be 
necessary for fiscal years 2000 through 2002''.

SEC. 302. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM.

    (a) Establishment of Program.--Part D of title III of the Older 
Americans Act of 1965 (42 U.S.C. 3030h et seq.) is amended to read as 
follows:

          ``PART D-- NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM

                    ``Subpart 1--State Grant Program

``SEC. 341. PROGRAM AUTHORIZED.

    ``(a) In General.--The Assistant Secretary shall carry out a 
program under this subpart for making grants to States under State 
plans approved under section 307 for multi-faceted systems of support 
for families and other informal providers of in-home and community care 
to older individuals.
    ``(b) Coordination with Service Providers.--In carrying out this 
subpart, each area agency on aging shall coordinate with other 
community agencies and voluntary organizations providing the types of 
services for which funding is available under this subpart.
    ``(c) Family Caregiver Support Services.--The services to be 
provided through a State program under this subpart shall include--
            ``(1) the provision of information to caregivers about 
        available services;
            ``(2) assistance to caregivers in gaining access to such 
        services;
            ``(3) individual counseling, the organization of support 
        groups, and the provision of caregiver training to help 
        families make decisions and solve problems relating to their 
        caregiving roles;
            ``(4) respite care to enable families and other informal 
        caregivers to be temporarily relieved from their caregiving 
        responsibilities; and
            ``(5) the provision of supplemental services, on a limited 
        basis, to complement the care provided by families and other 
        informal caregivers.
    ``(d) Eligibility.--In order for a caregiver or caregivers of an 
older individual to be eligible to receive services provided by a State 
program under this subpart, the State must--
            ``(1) determine that the older individual meets the 
        condition specified in either subparagraph (A)(i) or (B) of 
        section 102(28); and
            ``(2) give priority for services to older individuals and 
        families with the greatest social and economic need, consistent 
        with the requirements of section 305(a)(2)(E).
    ``(e) Requirements for Quality Standards and Accountability.--A 
State receiving assistance under this subpart shall comply with the 
following:
            ``(1) Quality standards.--A State shall have in place 
        mechanisms designed to ensure the quality of services provided 
        with assistance under this subpart.
            ``(2) Data and records.--A State shall collect data and 
        furnish records at the times and in the standardized format 
        that the Assistant Secretary may require in order to enable the 
        Assistant Secretary to monitor State program administration and 
        compliance, and to evaluate and compare the effectiveness of 
        State programs under this subpart.
            ``(3) Reporting.--A State shall report to the Assistant 
        Secretary on the data and information required under paragraph 
        (2), including the services and activities funded under this 
        subpart, and standards and methods by which the quality of 
        services shall be assured.
    ``(f) Availability of Funds.--
            ``(1) In general.--The program under this subpart shall be 
        carried out in each fiscal year using the balance of funds 
        appropriated under section 303(d) for such fiscal year and 
        remaining after the reservation of funds under sections 345 and 
        346 for carrying out subpart 2.
            ``(2) Use of funds for administration of area plans.--
        Amounts made available to a State under this subpart may be 
        used, in addition to amounts available in accordance with 
        section 303(c)(1), for the costs of the administration of area 
        plans.
            ``(3) Federal share.--
                    ``(A) In general.--Notwithstanding section 
                304(d)(1)(D), amounts made available to a State under 
                this subpart shall be available to pay not more than 75 
                percent of the costs of services provided under this 
                subpart.
                    ``(B) Limitation.--Federal funds and cost sharing 
                by recipients of services provided under this subpart 
                cannot be used for the non-Federal share of funds under 
                this subpart.

``SEC. 342. MAINTENANCE OF EFFORT.

    ``Funds made available under this subpart shall be in addition to, 
and may not be used to supplant, any funds that are or would otherwise 
be expended under any Federal, State, or local law by a State or unit 
of general purpose local government (including area agencies on aging) 
which have in their planning and service areas existing services 
equivalent to the services which may be funded under this subpart.

               ``Subpart 2--National Innovation Programs

``SEC. 345. INNOVATION GRANT PROGRAM.

    ``(a) In General.--The Assistant Secretary shall carry out a 
program for making grants on a competitive basis to foster the 
development and testing of new approaches to sustaining the efforts of 
families and other informal caregivers of older individuals, and to 
serving particular groups of caregivers of older individuals, including 
minority caregivers and distant caregivers.
    ``(b) Evaluation and Dissemination of Results.--The Assistant 
Secretary shall provide for the evaluation of the effectiveness of 
programs and activities funded with grants under this subpart, and for 
the dissemination to States of descriptions and evaluations of such 
programs and activities, to enable States to incorporate successful 
approaches into their program under this part.
    ``(c) Availability of Funds.--
            ``(1) In general.--The Assistant Secretary shall reserve up 
        to 10 percent of the amount appropriated for each fiscal year 
        under section 303(d) to carry out the program under this 
        section.
            ``(2) Native american programs.--20 percent of the amounts 
        reserved for each fiscal year under paragraph (1) shall be made 
        available for programs and activities for Native Americans.

``SEC. 346. ACTIVITIES OF NATIONAL SIGNIFICANCE.

    ``(a) In General.--The Assistant Secretary shall, directly or by 
grant or contract, carry out activities of national significance to 
promote quality and continuous improvement in the support provided to 
family and other informal caregivers of older individuals through 
program evaluation, training, technical assistance and research.
    ``(b) Availability of Funds.--The Assistant Secretary shall reserve 
up to 2 percent of the amount appropriated for each fiscal year under 
section 303(d) to carry out the program under this section.''.

SEC. 303. ALLOTMENTS.

    Section 304(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3024(a)(1)) is amended in the first sentence by inserting ``remaining 
after reservations of funds in accordance with sections 345 and 346'' 
after ``from the sums appropriated under section 303 for each fiscal 
year''.

SEC. 304. AVAILABILITY OF TITLE III-D FUNDS FOR REALLOTMENT.

    Section 304(b) of the Older Americans Act of 1965 (42 U.S.C. 
3024(b)) is amended in the first sentence by striking ``part B or C'' 
and inserting ``part B, C, or D''.

SEC. 305. CONFORMING AMENDMENTS.

    (a) Relocation of Provisions Concerning In-Home Services for Frail 
Older Individuals.--Section 321(a)(5) of the Older Americans Act of 
1965 (42 U.S.C. 3030d(a)(5)) is amended by striking ``including'' and 
all that follows and inserting ``including--
                    ``(A) client assessment, case management, and 
                development and coordination of community services;
                    ``(B) in-home services for frail older individuals 
                (including supportive services for victims of 
                Alzheimer's disease and related disorders with 
                neurological and organic brain dysfunction, and for the 
                families of such individuals);
                    ``(C) supportive activities to meet the special 
                needs of caregivers, including caretakers who provide 
                in-home services to frail older individuals;
                    ``(D) in-home and other community services, 
                including home health, homemaker, shopping, escort, 
                reader, and letter writing services, to assist older 
                individuals to live independently in a home 
                environment;''.
    (b) Repeal of Part G.--Part G of title III of the Older Americans 
Act of 1965 (42 U.S.C. 3030q et seq.) is repealed.
    (c) Elimination of Obsolete References.--Section 303 of the Older 
Americans Act of 1965 (42 U.S.C. 3023) is amended by striking 
subsection (g).

SEC. 306. EFFECTIVE DATE.

    The amendments made by this title shall take effect on October 1, 
1999.
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