II 

115TH CONGRESS 

1ST SESSION S. 1742 

To amend title XVIII of the Social Security Act to provide for an option 

for any citizen or permanent resident of the United States age 55 

to 64 to buy into Medicare. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 3, 2017 

Ms. STABENOW (for herself, Mr. BROWN, Ms. BALDWIN, Mr. WHITEHOUSE, 

Mr. LEAHY, Mr. MERKLEY, Mr. REED, Mr. FRANKEN, and Mr. BOOKER) 

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 provide 

for an option for any citizen or permanent resident of 

the United States age 55 to 64 to buy into Medicare. 

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 at 55 Act’’. 


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1 SEC. 2. MEDICARE BUY-IN OPTION FOR INDIVIDUALS 55 TO 

2 64 YEARS OF AGE. 

3 (a) IN GENERAL.—Title XVIII of the Social Security 

4 Act (42 U.S.C. 1395c et seq.) is amended by adding at 

5 the end the following new section: 

6 ‘‘MEDICARE BUY-IN OPTION FOR INDIVIDUALS 55 TO 64

7 YEARS OF AGE

8 ‘‘SEC. 1899C. (a) OPTION.— 

9 ‘‘(1) IN GENERAL.—Every individual who meets 

10 the requirements described in paragraph (3) shall be 

11 eligible to enroll under this section. 

12 ‘‘(2) PART A, B, AND D BENEFITS.—An indi13 vidual enrolled under this section is entitled to the 

14 same benefits (and shall receive the same protec15 tions) under this title as an individual who is enti16 tled to benefits under part A and enrolled under 

17 parts B and D, including the ability to enroll in a 

18 Medicare Advantage plan that provides qualified pre19 scription drug coverage (an MA–PD plan). 

20 ‘‘(3) REQUIREMENTS FOR ELIGIBILITY.—The 

21 requirements described in this paragraph are the fol22 lowing: 

23 ‘‘(A) The individual is a resident of the 

24 United States. 

25 ‘‘(B) The individual is— 


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1 ‘‘(i) a citizen or national of the United 

2 States; or 

3 ‘‘(ii) an alien lawfully admitted for 

4 permanent residence. 

5 ‘‘(C) The individual is not otherwise enti6 tled to benefits under part A or eligible to en7 roll under part A or part B. 

8 ‘‘(D) The individual has attained 55 years 

9 of age but has not attained 65 years of age. 

10 ‘‘(b) ENROLLMENT; COVERAGE.—The Secretary shall 

11 establish enrollment periods and coverage under this sec12 tion consistent with the principles for establishment of en13 rollment periods and coverage for individuals under other 

14 provisions of this title. The Secretary shall establish such 

15 periods so that coverage under this section shall first begin 

16 on January 1, 2019. 

17 ‘‘(c) PREMIUM.— 

18 ‘‘(1) AMOUNT OF MONTHLY PREMIUMS.—The 

19 Secretary shall, during September of each year (be20 ginning with 2018), determine a monthly premium 

21 for all individuals enrolled under this section. Such 

monthly premium shall be equal to 1 22 ⁄12 of the annual 

23 premium computed under paragraph (2)(B), which 

24 shall apply with respect to coverage provided under 

25 this section for any month in the succeeding year. 


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1 ‘‘(2) ANNUAL PREMIUM.— 

2 ‘‘(A) COMBINED PER CAPITA AVERAGE FOR

3 ALL MEDICARE BENEFITS.—The Secretary shall 

4 estimate the average, annual per capita amount 

5 for benefits and administrative expenses that 

6 will be payable under parts A, B, and D (in7 cluding, as applicable, under part C) in the year 

8 for all individuals enrolled under this section. 

9 ‘‘(B) ANNUAL PREMIUM.—The annual pre10 mium under this subsection for months in a 

11 year is equal to the average, annual per capita 

12 amount estimated under subparagraph (A) for 

13 the year. 

14 ‘‘(3) INCREASED PREMIUM FOR CERTAIN PART

15 C AND D PLANS.—Nothing in this section shall pre16 clude an individual from choosing a Medicare Advan17 tage plan or a prescription drug plan which requires 

18 the individual to pay an additional amount (because 

19 of supplemental benefits or because it is a more ex20 pensive plan). In such case the individual would be 

21 responsible for the increased monthly premium. 

22 ‘‘(d) PAYMENT OF PREMIUMS.— 

23 ‘‘(1) IN GENERAL.—Premiums for enrollment 

24 under this section shall be paid to the Secretary at 


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1 such times, and in such manner, as the Secretary 

2 determines appropriate. 

3 ‘‘(2) DEPOSIT.—Amounts collected by the Sec4 retary under this section shall be deposited in the 

5 Federal Hospital Insurance Trust Fund and the 

6 Federal Supplementary Medical Insurance Trust 

7 Fund (including the Medicare Prescription Drug Ac8 count within such Trust Fund) in such proportion 

9 as the Secretary determines appropriate. 

10 ‘‘(e) NOT ELIGIBLE FOR MEDICARE COST-SHARING

11 ASSISTANCE.—An individual enrolled under this section 

12 shall not be treated as enrolled under any part of this title 

13 for purposes of obtaining medical assistance for Medicare 

14 cost-sharing or otherwise under title XIX. 

15 ‘‘(f) TREATMENT IN RELATION TO THE AFFORDABLE

16 CARE ACT.— 

17 ‘‘(1) SATISFACTION OF INDIVIDUAL MAN18 DATE.—For purposes of applying section 5000A of 

19 the Internal Revenue Code of 1986, the coverage 

20 provided under this section constitutes minimum es21 sential coverage under subsection (f)(1)(A)(i) of 

22 such section 5000A. 

23 ‘‘(2) ELIGIBILITY FOR PREMIUM ASSISTANCE.— 

24 Coverage provided under this section— 


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1 ‘‘(A) shall be treated as coverage under a 

2 qualified health plan in the individual market 

3 enrolled in through the Exchange where the in4 dividual resides for all purposes of section 36B 

5 of the Internal Revenue Code of 1986 other 

6 than subsection (c)(2)(B) thereof; and 

7 ‘‘(B) shall not be treated as eligibility for 

8 other minimum essential coverage for purposes 

9 of subsection (c)(2)(B) of such section 36B. 

10 The Secretary shall determine the applicable second 

11 lowest cost silver plan which shall apply to coverage 

12 under this section for purposes of section 36B of 

13 such Code. 

14 ‘‘(3) ELIGIBILITY FOR COST-SHARING SUB15 SIDIES.—For purposes of applying section 1402 of 

16 the Patient Protection and Affordable Care Act (42 

17 U.S.C. 18071)— 

18 ‘‘(A) coverage provided under this section 

19 shall be treated as coverage under a qualified 

20 health plan in the silver level of coverage in the 

21 individual market offered through an Exchange; 

22 and 

23 ‘‘(B) the Secretary shall be treated as the 

24 issuer of such plan. 


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1 ‘‘(g) GUARANTEED ISSUE OF MEDIGAP POLICIES

2 UPON FIRST ENROLLMENT AND EACH SUBSEQUENT EN3 ROLLMENT.—In the case of an individual who enrolls 

4 under this section (including an individual who was pre5 viously enrolled under this section), paragraphs (2)(A), 

6 (2)(D), (3)(B)(ii), and (3)(B)(vi) of section 1882(s)— 

7 ‘‘(1) shall be applied by substituting ‘55’ for 

8 ‘65’; 

9 ‘‘(2) if the individual was enrolled under this 

10 section and subsequently disenrolls, shall apply each 

11 time the individual subsequently reenrolls under this 

12 section as if the individual had attained 55 years of 

13 age on the date of such reenrollment (and as if the 

14 individual had never previously enrolled in a Medi15 care supplemental policy); and 

16 ‘‘(3) shall be applied as if this section had not 

17 been enacted (and as if the individual had never pre18 viously enrolled in a Medicare supplemental policy) 

19 when the individual attains 65 years of age. 

20 ‘‘(h) NO EFFECT ON BENEFITS FOR INDIVIDUALS

21 OTHERWISE ELIGIBLE OR ON TRUST FUNDS.—The Sec22 retary shall implement the provisions of this section in 

23 such a manner to ensure that such provisions— 

24 ‘‘(1) have no effect on the benefits under this 

25 title for individuals who are entitled to, or enrolled 


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1 for, such benefits other than through this section; 

2 and 

3 ‘‘(2) have no negative impact on the Federal 

4 Hospital Insurance Trust Fund or the Federal Sup5 plementary Medical Insurance Trust Fund (includ6 ing the Medicare Prescription Drug Account within 

7 such Trust Fund). 

8 ‘‘(i) CONSULTATION.—In promulgating regulations 

9 to implement this section, the Secretary shall consult with 

10 interested parties, including groups representing bene11 ficiaries, health care providers, employers, and insurance 

12 companies.’’. 

Æ 


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