II 

111TH CONGRESS 

1ST SESSION S. 1669 

To provide all Medicare beneficiaries with the right to guaranteed issue 

of a Medicare supplemental policy. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 15, 2009 

Mr. KERRY introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To provide all Medicare beneficiaries with the right to 

guaranteed issue of a Medicare supplemental policy. 

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 ‘‘Equal Access to Medi5 care Options Act of 2009’’. 

6 SEC. 2. GUARANTEED ISSUE OF MEDIGAP POLICIES TO ALL 

7 MEDICARE BENEFICIARIES. 

8 (a) IN GENERAL.—Section 1882(s) of the Social Se9 curity Act (42 U.S.C. 1395ss(s)) is amended— 

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1 (1) in paragraph (2)(A), by striking ‘‘65 years 

2 of age or older and is enrolled for benefits under 

3 part B’’ and inserting ‘‘entitled to, or enrolled for, 

4 benefits under part A and enrolled for benefits 

5 under part B’’; 

6 (2) in paragraph (2)(D), by striking ‘‘who is 65 

7 years of age or older as of the date of issuance and’’; 

8 and 

9 (3) in paragraph (3)(B)(vi), by striking ‘‘at age 

10 65’’. 

11 (b) PHASE-IN AUTHORITY.— 

12 (1) IN GENERAL.—Subject to paragraph (2), 

13 the Secretary of Health and Human Services may 

14 phase in the implementation of the amendments 

15 made under subsection (a) in such manner as the 

16 Secretary determines appropriate to minimize any 

17 adverse impact on individuals enrolled under a Medi18 care supplemental policy prior to the effective date 

19 of this Act. 

20 (2) LIMIT.—The phase-in period under para21 graph (1) shall not exceed 5 years. 

22 (c) SEPARATE PREMIUM CLASS.— 

23 (1) IN GENERAL.—Subject to paragraph (2), 

24 any individuals enrolled under a Medicare supple25 mental policy pursuant to the amendments made 

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1 under subsection (a) shall be classified by the issuer 

2 as part of a separate premium class. 

3 (2) LIMIT.—The provision in paragraph (1) 

4 shall apply to individuals that enroll under a Medi5 care supplemental policy prior to January 1, 2015. 

6 (d) ADDITIONAL ENROLLMENT PERIOD FOR CER7 TAIN INDIVIDUALS.— 

8 (1) ONE-TIME ENROLLMENT PERIOD.— 

9 (A) IN GENERAL.—In the case of an indi10 vidual described in paragraph (2), the Secretary 

11 shall establish a one-time enrollment period 

12 during which such an individual may enroll in 

13 any Medicare supplemental policy of the indi14 vidual’s choosing. 

15 (B) PERIOD.—The enrollment period es16 tablished under subparagraph (A) shall begin 

17 on the date on which the phase-in period under 

18 subsection (b) is completed and end 6 months 

19 after such date. 

20 (2) INDIVIDUAL DESCRIBED.—An individual de21 scribed in this paragraph is an individual who— 

22 (A) is entitled to hospital insurance bene23 fits under part A under section 226(b) or sec24 tion 226A of the Social Security Act (42 U.S.C. 

25 426(b); 426–1); 

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1 (B) is enrolled for benefits under part B of 

2 such Act (42 U.S.C. 1395j et seq.); and 

3 (C) would not, but for the provisions of 

4 and amendments made by this section, be eligi5 ble for the guaranteed issue of a Medicare sup6 plemental policy under section 1882(s)(2) of 

7 such Act (42 U.S.C. 1395ss(s)(2)). 

8 (3) OUTREACH PLAN.—The Secretary shall de9 velop an outreach plan to notify individuals de10 scribed in paragraph (2) of the one-time enrollment 

11 period established under paragraph (1). 

12 SEC. 3. GUARANTEED ISSUE OF MEDIGAP POLICIES FOR 

13 MEDICARE ADVANTAGE AND MEDICAID EN14 ROLLEES. 

15 (a) IN GENERAL.—Section 1882(s)(3) of the Social 

16 Security Act (42 U.S.C. 1395ss(s)(3)), as amended by sec17 tion 2, is amended— 

18 (1) in subparagraph (B), by adding at the end 

19 the following new clauses: 

20 ‘‘(vii) The individual was enrolled in a Medicare 

21 Advantage plan under part C for not less than 12 

22 months and subsequently disenrolled from such plan 

23 and elects to receive benefits under this title through 

24 the original Medicare fee-for-service program under 

25 parts A and B. 

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1 ‘‘(viii) The individual— 

2 ‘‘(I) is entitled to, or enrolled for, benefits 

3 under part A and enrolled for benefits under 

4 part B; 

5 ‘‘(II) was eligible for medical assistance 

6 under a State plan or waiver under title XIX 

7 and was enrolled in such plan or waiver; and 

8 ‘‘(III) subsequently lost eligibility for such 

9 medical assistance.’’; and 

10 (2) by striking subparagraph (C)(iii) and in11 serting the following: 

12 ‘‘(iii) Subject to subsection (v)(1), for purposes 

13 of an individual described in clause (vi), (vii), or 

14 (viii) of subparagraph (B), a Medicare supplemental 

15 policy described in this subparagraph shall include 

16 any Medicare supplemental policy.’’. 

17 (3) in subparagraph (E)— 

18 (A) in clause (iv), by striking ‘‘and’’ at the 

19 end; 

20 (B) in clause (v), by striking the period at 

21 the end and inserting a semicolon; and 

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

23 clauses: 

24 ‘‘(vi) in the case of an individual described in 

25 subparagraph (B)(vii), the annual, coordinated elecmstockstill on DSKH9S0YB1PROD with BILLS

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1 tion period (as defined in section 1851(e)(3)(B)) or 

2 a continuous open enrollment period (as defined in 

3 section 1851(e)(2)) during which the individual 

4 disenrolls from a Medicare Advantage plan under 

5 part C; and 

6 ‘‘(vii) in the case of an individual described in 

7 subparagraph (B)(viii), the period beginning on the 

8 date that the individual receives a notice of cessation 

9 of such individual’s eligibility for medical assistance 

10 under the State plan or waiver under title XIX and 

11 ending on the date that is 123 days after the indi12 vidual receives such notice.’’. 

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

14 subsection (a) shall apply to Medicare supplemental poli15 cies effective on or after January 1, 2010. 

16 SEC. 4. ENROLLMENT OF INDIVIDUALS WITH END STAGE 

17 RENAL DISEASE IN MEDICARE ADVANTAGE. 

18 (a) IN GENERAL.—Section 1851(a) of the Social Se19 curity Act (42 U.S.C. 1395w–21(a)) is amended by strik20 ing paragraph (3) and inserting the following: 

21 ‘‘(3) MEDICARE+CHOICE ELIGIBLE INDIVIDUAL.— 

22 In this title, the term ‘Medicare+Choice eligible indi23 vidual’ means an individual who is entitled to benefits 

24 under part A and enrolled under part B.’’. 

25 (b) CONFORMING AMENDMENTS.— 

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1 (1) Section 1852(b) of the Social Security Act 

2 (42 U.S.C. 1395w–22(b)) is amended by striking 

3 paragraph (1) and inserting the following: 

4 ‘‘(1) BENEFICIARIES.—A Medicare+Choice organi5 zation may not deny, limit, or condition the coverage or 

6 provision of benefits under this part, for individuals per7 mitted to be enrolled with the organization under this 

8 part, based on any health status-related factor described 

9 in section 2702(a)(1) of the Public Health Service Act. 

10 The Secretary shall not approve a plan of an organization 

11 if the Secretary determines that the design of the plan 

12 and its benefits are likely to substantially discourage en13 rollment by certain MA eligible individuals with the orga14 nization.’’. 

15 (2) Section 1859(b)(6)(B) of such Act (42 

16 U.S.C. 1395w–28(b)(6)(B)) is amended in the sec17 ond sentence by striking ‘‘may waive application of 

18 section 1851(a)(3)(B) in the case of an individual 

19 described in clause (i), (ii), or (iii) of this subpara20 graph and’’. 

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

22 this section shall apply to plan years beginning on or after 

23 January 1, 2010. 

Æ 

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