I 

111TH CONGRESS 

1ST SESSION H. R. 1708 

To amend title II of the Social Security Act to phase out the 24-month 

waiting period for disabled individuals to become eligible for Medicare 

benefits, to eliminate the waiting period for individuals with life-threatening conditions, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 25, 2009 

Mr. GENE GREEN of Texas (for himself and Mr. TERRY) introduced the following bill; which was referred to the Committee on Ways and Means, 

and in addition to the Committees on Energy and Commerce and Transportation and Infrastructure, 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 II of the Social Security Act to phase out 

the 24-month waiting period for disabled individuals to 

become eligible for Medicare benefits, to eliminate the 

waiting period for individuals with life-threatening conditions, and for other purposes. 

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


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Ending the Medicare Disability Waiting Period Act of 

4 2009’’. 

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

6 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Phase-out of waiting period for Medicare disability benefits. 

Sec. 3. Elimination of waiting period for individuals with life-threatening conditions. 

Sec. 4. Institute of Medicine study and report on delay and prevention of disability conditions. 

7 SEC. 2. PHASE-OUT OF WAITING PERIOD FOR MEDICARE 

8 DISABILITY BENEFITS. 

9 (a) IN GENERAL.—Section 226(b) of the Social Secu10 rity Act (42 U.S.C. 426(b)) is amended— 

11 (1) in paragraph (2)(A), by striking ‘‘, and has 

12 for 24 calendar months been entitled to,’’ and insert13 ing ‘‘, and for the waiting period (as defined in sub14 section (k)) has been entitled to,’’; 

15 (2) in paragraph (2)(B), by striking ‘‘, and has 

16 been for not less than 24 months,’’ and inserting ‘‘, 

17 and has been for the waiting period (as defined in 

18 subsection (k)),’’; 

19 (3) in paragraph (2)(C)(ii), by striking ‘‘, in20 cluding the requirement that he has been entitled to 

21 the specified benefits for 24 months,’’ and inserting 

22 ‘‘, including the requirement that the individual has 


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1 been entitled to the specified benefits for the waiting 

2 period (as defined in subsection (k)),’’; and 

3 (4) in the flush matter following paragraph 

4 (2)(C)(ii)(II)— 

5 (A) in the first sentence, by striking ‘‘for 

6 each month beginning with the later of (I) July 

7 1973 or (II) the twenty-fifth month of his enti8 tlement or status as a qualified railroad retire9 ment beneficiary described in paragraph (2), 

10 and’’ and inserting ‘‘for each month beginning 

11 after the waiting period (as so defined) for 

12 which the individual satisfies paragraph (2) 

13 and’’; 

14 (B) in the second sentence, by striking 

15 ‘‘the ‘twenty-fifth month of his entitlement’ re16 fers to the first month after the twenty-fourth 

17 month of entitlement to specified benefits re18 ferred to in paragraph (2)(C) and’’; and 

19 (C) in the third sentence, by striking ‘‘, 

20 but not in excess of 78 such months’’. 

21 (b) SCHEDULE FOR PHASE-OUT OF WAITING PE22 RIOD.—Section 226 of the Social Security Act (42 U.S.C. 

23 426) is amended by adding at the end the following new 

24 subsection: 


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1 ‘‘(k) For purposes of subsection (b) (and for purposes 

2 of section 1837(g)(1) of this Act and section 7(d)(2)(ii) 

3 of the Railroad Retirement Act of 1974), the term ‘waiting 

4 period’ means— 

5 ‘‘(1) for 2010, 18 months; 

6 ‘‘(2) for 2011, 16 months; 

7 ‘‘(3) for 2012, 14 months; 

8 ‘‘(4) for 2013, 12 months; 

9 ‘‘(5) for 2014, 10 months; 

10 ‘‘(6) for 2015, 8 months; 

11 ‘‘(7) for 2016, 6 months; 

12 ‘‘(8) for 2017, 4 months; 

13 ‘‘(9) for 2018, 2 months; and 

14 ‘‘(10) for 2019 and each subsequent year, 0 

15 months.’’. 

16 (c) CONFORMING AMENDMENTS.— 

17 (1) SUNSET.—Effective January 1, 2019, sub18 section (f) of section 226 of the Social Security Act 

19 (42 U.S.C. 426) is repealed. 

20 (2) MEDICARE DESCRIPTION.—Section 1811(2) 

21 of such Act (42 U.S.C. 1395c(2)) is amended by 

22 striking ‘‘entitled for not less than 24 months’’ and 

23 inserting ‘‘entitled for the waiting period (as defined 

24 in section 226(k))’’. 


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1 (3) MEDICARE COVERAGE.—Section 1837(g)(1) 

2 of such Act (42 U.S.C. 1395p(g)(1)) is amended by 

3 striking ‘‘of the later of (A) April 1973 or (B) the 

4 third month before the 25th month of such entitle5 ment’’ and inserting ‘‘of the third month before the 

6 first month following the waiting period (as defined 

7 in section 226(k)) applicable under section 226(b)’’. 

8 (4) RAILROAD RETIREMENT SYSTEM.—Section 

9 7(d)(2)(ii) of the Railroad Retirement Act of 1974 

10 (45 U.S.C. 231f(d)(2)(ii)) is amended— 

11 (A) by striking ‘‘, for not less than 24 

12 months’’ and inserting ‘‘, for the waiting period 

13 (as defined in section 226(k) of the Social Secu14 rity Act); and 

15 (B) by striking ‘‘could have been entitled 

16 for 24 calendar months, and’’ and inserting 

17 ‘‘could have been entitled for the waiting period 

18 (as defined is section 226(k) of the Social Secu19 rity Act), and’’. 

20 (d) EFFECTIVE DATE.—Except as provided in sub21 section (c)(1), the amendments made by this section shall 

22 apply to insurance benefits under title XVIII of the Social 

23 Security Act with respect to items and services furnished 

24 in months beginning at least 90 days after the date of 


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1 the enactment of this Act (but in no case earlier than Jan2 uary 1, 2010). 

3 SEC. 3. ELIMINATION OF WAITING PERIOD FOR INDIVID4 UALS WITH LIFE-THREATENING CONDITIONS. 

5 (a) IN GENERAL.—Section 226(h) of the Social Secu6 rity Act (42 U.S.C. 426(h)) is amended— 

7 (1) by redesignating paragraphs (1), (2), and 

8 (3) as subparagraphs (A), (B), and (C), respectively; 

9 (2) in the matter preceding subparagraph (A) 

10 (as redesignated by paragraph (1)), by inserting 

11 ‘‘(1)’’ after ‘‘(h)’’; 

12 (3) in paragraph (1) (as designated by para13 graph (2))— 

14 (A) in the matter preceding subparagraph 

15 (A) (as redesignated by paragraph (1)), by in16 serting ‘‘or any other life-threatening condition’’ 

17 after ‘‘amyotrophic lateral sclerosis (ALS)’’; 

18 and 

19 (B) in subparagraph (B) (as redesignated 

20 by paragraph (1)), by striking ‘‘(rather than 

21 twenty-fifth month)’’; and 

22 (4) by adding at the end the following new 

23 paragraph: 

24 ‘‘(2) For purposes of identifying life-threatening con25 ditions under paragraph (1), the Secretary shall compile 


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1 a list of conditions that are fatal without medical treat2 ment. In compiling such list, the Secretary shall— 

3 ‘‘(A) consult with the Director of the National 

4 Institutes of Health (including the Office of Rare 

5 Diseases), the Director of the Centers for Disease 

6 Control and Prevention, the Director of the National 

7 Science Foundation, and the Institute of Medicine of 

8 the National Academy of Sciences; and 

9 ‘‘(B) annually review the compassionate allow10 ances list of conditions of the Social Security Admin11 istration.’’. 

12 (b) EFFECTIVE DATE.—The amendments made by 

13 this section shall apply to insurance benefits under title 

14 XVIII of the Social Security Act with respect to items and 

15 services furnished in months beginning at least 90 days 

16 after the date of the enactment of this Act (but in no case 

17 earlier than January 1, 2010). 

18 SEC. 4. INSTITUTE OF MEDICINE STUDY AND REPORT ON 

19 DELAY AND PREVENTION OF DISABILITY 

20 CONDITIONS. 

21 (a) STUDY.—The Secretary of Health and Human 

22 Services (in this section referred to as the ‘‘Secretary’’) 

23 shall request that the Institute of Medicine of the National 

24 Academy of Sciences conduct a study on the range of dis25 ability conditions that can be delayed or prevented if indiVerDate Nov 24 2008 04:11 Mar 26, 2009 Jkt 079200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1708.IH H1708

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1 viduals receive access to health care services and coverage 

2 before the condition reaches disability levels. 

3 (b) REPORT.—Not later than the date that is 2 years 

4 after the date of enactment of this Act, the Secretary shall 

5 submit to Congress a report containing the results of the 

6 Institute of Medicine study authorized under this section. 

7 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

8 authorized to be appropriated to carry out this section 

9 $750,000 for the period of fiscal years 2010 and 2011. 

Æ 


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