I 

108TH CONGRESS 

2D SESSION H. R. 3702

To amend title XVIII of the Social Security Act, as amended by the Medicare 

Prescription Drug, Improvement, and Modernization Act of 2003, to 

provide additional beneficiary protections. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 20, 2004

Mr. CARDIN introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL

To amend title XVIII of the Social Security Act, as amended 

by the Medicare Prescription Drug, Improvement, and 

Modernization Act of 2003, to provide additional beneficiary protections.

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Preserving Medicare for All Act of 2004’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows:
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Sec. 1. Short title; table of contents. 

Sec. 2. Authority to negotiate prices. 

Sec. 3. Guaranteed prescription drug benefits. 

Sec. 4. Full reimbursement for qualified retiree prescription drug plans. 

Sec. 5. Repeal of Comparative Cost Adjustment (CCA) program. 

Sec. 6. Repeal of MA Regional Plan Stabilization Fund. 

Sec. 7. Repeal of cost containment provisions.

1 SEC. 2. AUTHORITY TO NEGOTIATE PRICES. 

2 Subsection (i) of section 1860D–11, as added by sec3 tion 101 of the Medicare Prescription Drug, Improvement, 

4 and Modernization Act of 2003 (Public Law 108–173), 

5 is repealed. 

6 SEC. 3. GUARANTEED PRESCRIPTION DRUG BENEFITS. 

7 (a) IN GENERAL.—Section 1860D–3 of the Social 

8 Security Act, as added by section 101 of the Medicare Pre9 scription Drug, Improvement, and Modernization Act of 

10 2003 (Public Law 108–173), is amended to read as fol11 lows: 

12 ‘‘ACCESS TO A CHOICE OF QUALIFIED PRESCRIPTION

13 DRUG COVERAGE

14 ‘‘SEC. 1860D–3. (a) ASSURING ACCESS TO A CHOICE

15 OF COVERAGE.—

16 ‘‘(1) CHOICE OF AT LEAST THREE PLANS IN

17 EACH AREA.—The Secretary shall ensure that each 

18 part D eligible individual has available, consistent 

19 with paragraph (2), a choice of enrollment in—

20 ‘‘(A) a nationwide prescription drug plan 

21 offered by the Secretary in accordance with 

22 subsection (b); and 
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1 ‘‘(B) at least 2 qualifying plans (as defined 

2 in paragraph (3)) in the area in which the indi3 vidual resides, at least one of which is a pre4 scription drug plan. 

5 ‘‘(2) REQUIREMENT FOR DIFFERENT PLAN

6 SPONSORS.—The requirement in paragraph (1)(B) is 

7 not satisfied with respect to an area if only one enti8 ty offers all the qualifying plans in the area. 

9 ‘‘(3) QUALIFYING PLAN DEFINED.—For pur10 poses of this section, the term ‘qualifying plan’ 

11 means—

12 ‘‘(A) a prescription drug plan; 

13 ‘‘(B) an MA–PD plan described in section 

14 1851(a)(2)(A)(i) that provides—

15 ‘‘(i) basic prescription drug coverage; 

16 or 

17 ‘‘(ii) qualified prescription drug cov18 erage that provides supplemental prescrip19 tion drug coverage so long as there is no 

20 MA monthly supplemental beneficiary pre21 mium applied under the plan, due to the 

22 application of a credit against such pre23 mium of a rebate under section 

24 1854(b)(1)(C); or 
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1 ‘‘(C) a nationwide prescription drug plan 

2 offered by the Secretary in accordance with 

3 subsection (b). 

4 ‘‘(b) HHS AS PDP SPONSOR FOR A NATIONWIDE

5 PRESCRIPTION DRUG PLAN.—

6 ‘‘(1) IN GENERAL.—The Secretary, through the 

7 Administrator of the Centers for Medicare & Med8 icaid Services, shall take such steps as may be nec9 essary to qualify and serve as a PDP sponsor and 

10 to offer a prescription drug plan that offers basic 

11 prescription drug coverage throughout the United 

12 States. Such a plan shall be in addition to, and not 

13 in lieu of, other prescription drug plans offered 

14 under this part. 

15 ‘‘(2) PREMIUM; SOLVENCY; AUTHORITIES.—In 

16 carrying out paragraph (1), the Secretary—

17 ‘‘(A) shall establish a premium in the 

18 amount of $35 for months in 2006 and, for 

19 months in subsequent years, in the amount 

20 specified in this paragraph for months in the 

21 previous year increased by the annual percent22 age increase described in section 1860D–

23 2(b)(6) (relating to growth in medicare pre24 scription drug costs per beneficiary) for the 

25 year involved; 
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1 ‘‘(B) is deemed to have met any applicable 

2 solvency and capital adequacy standards; and 

3 ‘‘(C) shall exercise such authorities (includ4 ing the use of regional or other pharmaceutical 

5 benefit managers) as the Secretary determines 

6 necessary to offer the prescription drug plan in 

7 the same or a comparable manner as is the case 

8 for prescription drug plans offered by private 

9 PDP sponsors. 

10 ‘‘(c) FLEXIBILITY IN RISK ASSUMED.—In order to 

11 ensure access pursuant to subsection (a) in an area the 

12 Secretary may approve limited risk plans under section 

13 1860D–11(f) for the area.’’. 

14 (b) CONFORMING AMENDMENT.—Section 1860D–11 

15 of the Social Security Act, as added by section 101 of the 

16 Medicare Prescription Drug, Improvement, and Mod17 ernization Act of 2003 (Public Law 108–173), is amended 

18 by striking subsection (g). 

19 SEC. 4. FULL REIMBURSEMENT FOR QUALIFIED RETIREE 

20 PRESCRIPTION DRUG PLANS. 

21 (a) ELIMINATION OF TRUE OUT-OF-POCKET LIMI22 TATION.—Section 1860D–2(b)(4)(C)(ii) of the Social Se23 curity Act, as added by section 101(a) of the Medicare 

24 Prescription Drug, Improvement, and Modernization Act 

25 of 2003 (Public Law 108–173), is amended—
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1 (1) by inserting ‘‘under a qualified retiree pre2 scription drug plan (as defined in section 1860D–

3 22(a)(2)),’’ after ‘‘under section 1860D–14,’’; and 

4 (2) by inserting ‘‘, under such a qualified re5 tiree prescription drug plan,’’ after ‘‘(other than 

6 under such section’’ . 

7 (b) EQUALIZATION OF SUBSIDIES.—Notwithstanding 

8 any other provision of law, the Secretary of Health and 

9 Human Services shall provide for such increase in the spe10 cial subsidy payment amounts under section 1860D–

11 22(a)(3) of the Social Security Act, as added by section 

12 101(a) of the Medicare Prescription Drug, Improvement, 

13 and Modernization Act of 2003 (Public Law 108–173), 

14 as may be appropriate to provide for payments in the ag15 gregate equivalent to the payments that would have been 

16 made under section 1860D–15 of such Act if the individ17 uals were not enrolled in a qualified retiree prescription 

18 drug plan. In making such computation, the Secretary 

19 shall not take into account the application of the amend20 ments made by section 1202 of the Medicare Prescription 

21 Drug, Improvement, and Modernization Act of 2003. 

22 SEC. 5. REPEAL OF COMPARATIVE COST ADJUSTMENT 

23 (CCA) PROGRAM. 

24 Subtitle E of title II of the Medicare Prescription 

25 Drug, Improvement, and Modernization Act of 2003 (Pub-
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1 lic Law 108–173), and the amendments made by such 

2 subtitle, are repealed. 

3 SEC. 6. REPEAL OF MA REGIONAL PLAN STABILIZATION 

4 FUND. 

5 (a) IN GENERAL.—Section 1858 of the Social Secu6 rity Act, as added by section 221(c) of the Medicare Pre7 scription Drug, Improvement, and Modernization Act of 

8 2003 (Public Law 108–173), is amended—

9 (1) by striking subsection (e); 

10 (2) by redesignating subsections (f), (g), and 

11 (h) as subsections (e), (f), and (g), respectively; and 

12 (3) in subsection (e), as so redesignated, by 

13 striking ‘‘subject to subsection (e),’’. 

14 (b) CONFORMING AMENDMENT.—Section 1851(i)(2) 

15 of the Social Security Act (42 U.S.C. 1395w–21(i)(2)), as 

16 amended by section 221(d)(5) of the Medicare Prescrip17 tion Drug, Improvement, and Modernization Act of 2003 

18 (Public Law 108–173), is amended by striking ‘‘1858(h)’’ 

19 and inserting ‘‘1858(g)’’. 

20 SEC. 7. REPEAL OF COST CONTAINMENT PROVISIONS. 

21 Subtitle A of title VIII of the Medicare Prescription 

22 Drug, Improvement, and Modernization Act of 2003 (Pub23 lic Law 108–173) is repealed and any provisions of law 
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1 amended by such subtitle are restored as if such subtitle 

2 had not been enacted.

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