II 

116TH CONGRESS 

1ST SESSION S. 691 

To amend title XVIII of the Social Security Act to enhance prescription 

drug affordability by expanding access to assistance with out-of-pocket 

costs under Medicare part D for low-income seniors and individuals 

with disabilities. 

IN THE SENATE OF THE UNITED STATES 

MARCH 7, 2019 

Mr. CASEY (for himself, Mr. BLUMENTHAL, Mrs. GILLIBRAND, and Ms. 

BALDWIN) introduced the following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to enhance 

prescription drug affordability by expanding access to 

assistance with out-of-pocket costs under Medicare part 

D for low-income seniors and individuals with disabilities. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Extra Rx 

5 Higher Eligibility Limits in Part D Act of 2019’’ or the 

6 ‘‘Medicare Extra Rx HELP Act of 2019’’. 


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•S 691 IS

1 SEC. 2. ENHANCING PRESCRIPTION DRUG AFFORDABILITY 

2 BY EXPANDING ACCESS TO ASSISTANCE WITH 

3 OUT-OF-POCKET COSTS UNDER MEDICARE 

4 PART D FOR LOW-INCOME SENIORS AND IN5 DIVIDUALS WITH DISABILITIES. 

6 (a) IN GENERAL.—Section 1860D–14 of the Social 

7 Security Act (42 U.S.C. 1395w–114) is amended— 

8 (1) in subsection (a)— 

9 (A) in the heading, by striking ‘‘150 PER10 CENT’’ and inserting ‘‘200 PERCENT’’; 

11 (B) in paragraph (1)— 

12 (i) in the heading, by striking ‘‘135

13 PERCENT’’ and inserting ‘‘200 PERCENT’’; 

14 and 

15 (ii) in the matter preceding subpara16 graph (A)— 

17 (I) by striking ‘‘135 percent’’ and 

18 inserting ‘‘200 percent’’; and 

19 (II) by striking ‘‘and who meets 

20 the resources requirement described in 

21 paragraph (3)(D) or who is covered 

22 under this paragraph under para23 graph (3)(B)(i)’’ and inserting ‘‘or 

24 who is covered under this paragraph 

25 under paragraph (3)(B)(v)’’; 

26 (C) by striking paragraph (2); 


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•S 691 IS

1 (D) in paragraph (3)— 

2 (i) in subparagraph (A)— 

3 (I) in clause (i), by adding ‘‘and’’ 

4 at the end; 

5 (II) in clause (ii)— 

6 (aa) by striking ‘‘150 per7 cent’’ and inserting ‘‘200 per8 cent’’; and 

9 (bb) by striking ‘‘; and’’ at 

10 the end and inserting a period; 

11 and 

12 (III) by striking clause (iii); and 

13 (ii) by striking subparagraphs (D), 

14 (E), and (G); and 

15 (E) in paragraph (4), by striking subpara16 graph (B); and 

17 (2) in subsection (c)(1), in the second sentence, 

18 by striking ‘‘subsections (a)(1)(D) and (a)(2)(E)’’ 

19 and inserting ‘‘subsection (a)(1)(D)’’. 

20 (b) CONFORMING AMENDMENT.—Section 1905(p)(1) 

21 of the Social Security Act (42 U.S.C. 1396d(p)(1)) is 

22 amended by adding at the end the following flush matter: 

23 ‘‘The Secretary shall apply subparagraph (C) as if the 

24 amendments made by section 2(a) of the Medicare Extra 

25 Rx Higher Eligibility Limits in Part D Act of 2019 had 


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•S 691 IS

1 not been enacted and shall continue to calculate the max2 imum resource level applied for a year under section 

3 1860D–14(a)(3)(D) (as in effect on the day before the 

4 date of enactment of such Act) without regard to such 

5 amendments.’’. 

6 (c) EFFECTIVE DATE.—The amendments made by 

7 subsection (a) shall apply to plan year 2020 and subse8 quent plan years. 

Æ 


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