I 

109TH CONGRESS 

1ST SESSION H. R. 3511 

To amend title XIX of the Social Security Act to expand State long-term 

care partnership programs under the Medicaid Program. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 28, 2005 

Mr. BURGESS (for himself, Mr. PETERSON of Pennsylvania, Mr. POMEROY, 

Mr. JINDAL, and Mrs. JOHNSON of Connecticut) introduced the following 

bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to expand 

State long-term care partnership programs under the 

Medicaid Program. 

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 ‘‘Medicaid State Long5 Term Care Partnership Program Act of 2005’’. 

6 SEC. 2. EXPANSION OF STATE LONG-TERM CARE PARTNER7 SHIP PROGRAM. 

8 (a) IN GENERAL.—Section 1917(b) of the Social Se9 curity Act (42 U.S.C. 1396p(b)) is amended— 
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1 (1) in paragraph (1)(C)(i), by striking ‘‘shall 

2 seek adjustment’’ and inserting ‘‘may seek adjust3 ment’’; 

4 (2) in paragraph (1)(C)(ii), by inserting ‘‘or 

5 which has a State plan amendment that provides for 

6 a qualified State long-term care insurance partner7 ship (as defined in clause (iii))’’ after ‘‘1993,’’; 

8 (3) by adding at the end of paragraph (1)(C) 

9 the following new clauses: 

10 ‘‘(iii) For purposes of this paragraph, the term 

11 ‘qualified State long-term care insurance partner12 ship’ means a State plan amendment under this title 

13 that provides for the disregard of any assets or re14 sources in an amount equal to the insurance benefit 

15 payments that are made under a long-term care in16 surance policy (including a certificate issued under a 

17 group insurance contract), regardless of whether the 

18 policy was issued before the effective date of such 

19 plan amendment, if the following requirements are 

20 met: 

21 ‘‘(I) The policy covers an insured who, 

22 when coverage first became effective under the 

23 policy, was a resident of such State or of an24 other State that had such a partnership in ef25 fect or that had in effect a State plan amend-
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1 ment described in clause (ii) that was approved 

2 as of May 19, 1993. 

3 ‘‘(II) The policy meets the requirements of 

4 State law in the State in which it is issued. 

5 ‘‘(III) The policy is a qualified long-term 

6 care insurance policy (as defined in section 

7 7702B(b) of the Internal Revenue Code of 

8 1986). 

9 ‘‘(IV) Such disregard shall not apply if the 

10 policy was originally issued to the insured when 

11 the insured resided in another State, unless 

12 that other State continues to have a qualified 

13 State long-term care insurance partnership in 

14 effect. 

15 ‘‘(V) If the policy does not provide some 

16 level of inflation protection, the insured was of17 fered, before the policy was sold, a long-term 

18 care insurance policy that provides some level of 

19 inflation protection. 

20 ‘‘(VI) The State plan amendment provides 

21 for agent training for the sale of long-term care 

22 insurance policies under the partnership. 

23 ‘‘(VII) The issuer of the policy provides 

24 regular reports to the Secretary that include, in 

25 accordance with regulations of the Secretary 
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1 (promulgated after consultation with the 

2 States), notification regarding when all benefits 

3 provided under the policy have been paid and 

4 the amount of such benefits paid, when the pol5 icy otherwise terminates, and such other infor6 mation as the Secretary determines may be ap7 propriate to the administration of such partner8 ships. 

9 ‘‘(VIII) The State does not impose any re10 quirement affecting the terms or benefits of 

11 such a policy unless the State imposes such re12 quirement on long-term care insurance policies 

13 without regard to whether the policy is covered 

14 under the partnership or is offered in connec15 tion with such a partnership. 

16 In the case of a long-term care insurance policy 

17 which is exchanged for another such policy, sub18 clause (I) shall be applied based on the coverage of 

19 the first such policy that was exchanged. 

20 ‘‘(iv) The Secretary— 

21 ‘‘(I) as appropriate, shall provide copies of 

22 the reports described in clause (iii)(VII) to the 

23 State involved; and 
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1 ‘‘(II) shall promote the education of con2 sumers regarding qualified State long-term care 

3 insurance partnerships.’’; and 

4 (4) in paragraph (4)(B), by striking ‘‘(and shall 

5 include, in the case of an individual to whom para6 graph (1)(C)(i) applies)’’. 

7 (b) APPLICATION OF CERTAIN REQUIREMENTS TO

8 EXISTING PARTNERSHIP PROGRAMS.—Subparagraph (C) 

9 of such section, as amended by subsection (a), is further 

10 amended— 

11 (1) in clause (ii), by inserting ‘‘(subject to 

12 clause (v))’’ after ‘‘under a State plan of a State 

13 which’’; and 

14 (2) by adding at the end the following new 

15 clause: 

16 ‘‘(v) Clause (ii) shall continue to apply to a 

17 State plan amendment approved as of May 19, 

18 1993, only if the State plan amendment— 

19 ‘‘(I) is modified by not later than 30 days 

20 after the date of the enactment of this Act to 

21 meet the requirements of subclauses (III) and 

22 (V) of clause (iii); and 
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1 ‘‘(II) is modified by not later than 1 year 

2 after such date of enactment to meet the re3 quirement of clause (iii)(VI).’’. 

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