I 

109TH CONGRESS 

2D SESSION H. R. 4719 

To amend titles XVIII and XIX of the Social Security Act to make improvements to payments to Medicare Advantage plans and to reinstate protections in the Medicaid program for working families, their children, and 

the disabled against excessive out-of-pocket costs, inadequate benefits, 

and health care coverage loss. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 8, 2006 

Mr. DINGELL (for himself, Mr. WAXMAN, Mr. RANGEL, Mr. STARK, and Mr. 

BROWN of Ohio) 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 titles XVIII and XIX of the Social Security Act 

to make improvements to payments to Medicare Advantage plans and to reinstate protections in the Medicaid 

program for working families, their children, and the 

disabled against excessive out-of-pocket costs, inadequate 

benefits, and health care coverage loss. 

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. 

2 This Act may be cited as the ‘‘Patients Before Profits 

3 Act of 2006’’. 

4 SEC. 2. ELIMINATION OF CERTAIN MEDICARE ADVANTAGE 

5 OVERPAYMENTS. 

6 (a) IN GENERAL.—Section 1853(a)(1)(C)(ii) of the 

7 Social Security Act (42 U.S.C. 1395w–23(a)(1)(C)(ii)), as 

8 added by section 5301 of the Deficit Reduction Act of 

9 2005, is amended— 

10 (1) in the heading, by striking ‘‘DURING PHASE11 OUT OF BUDGET NEUTRALITY FACTOR’’; 

12 (2) in the matter preceding subclause (I), by 

13 striking ‘‘through 2010’’ and inserting ‘‘and subse14 quent years’’; and 

15 (3) in subclause (II), by striking ‘‘only for 

16 2008, 2009, and 2010’’ and inserting ‘‘for 2008 and 

17 subsequent years’’. 

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

19 this section shall take effect as if included in the enact20 ment of section 5301 of the Deficit Reduction Act of 2005. 

21 SEC. 3. ELIMINATION OF PRIVATE INSURANCE SLUSH 

22 FUND. 

23 (a) ELIMINATION.—Subsection (e) of section 1858 of 

24 the Social Security Act (42 U.S.C. 1395w–27a) is re25 pealed. 
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1 (b) CONFORMING AMENDMENT.—Section 1858(f)(1) 

2 of the Social Security Act (42 U.S.C. 1395w–27a(f)(1)) 

3 is amended by striking ‘‘subject to subsection (e),’’. 

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

5 this section shall take effect as if included in the enact6 ment of section 221(c) of the Medicare Prescription Drug, 

7 Improvement, and Modernization Act of 2003 (Public Law 

8 108–173; 117 Stat. 2181). 

9 SEC. 4. REINSTATING PROTECTIONS FOR ADEQUATE BENE10 FITS AND AFFORDABLE COST SHARING. 

11 (a) REPEAL OF STATE OPTION FOR ALTERNATIVE

12 PREMIUMS AND COST SHARING.— 

13 (1) REPEAL.—Section 1916A of the Social Se14 curity Act, as added by sections 6041(a), 6042(a), 

15 and 6043(a) of the Deficit Reduction Act of 2005, 

16 is repealed. 

17 (2) CONFORMING AMENDMENTS.— 

18 (A) Subsection (y) of section 1903 of the 

19 Social Security Act (42 U.S.C. 1396b), as 

20 added by section 6043(b) of the Deficit Reduc21 tion Act of 2005, is repealed. 

22 (B) Section 1916 of the Social Security 

23 Act (42 U.S.C. 1396o) is amended— 

24 (i) in subsection (f), by striking ‘‘and 

25 section 1916A’’ after ‘‘(b)(3)’’; and 
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1 (ii) by striking subsection (h). 

2 (b) REPEAL OF STATE OPTION OF PROVIDING

3 BENCHMARK BENEFIT PACKAGES.—Section 1937 of the 

4 Social Security Act, as added by section 6044(a) of the 

5 Deficit Reduction Act of 2005, is repealed. 

6 (c) REPEAL OF HEALTH OPPORTUNITY ACCOUNTS

7 DEMONSTRATION.—Section 1938 of the Social Security 

8 Act, as added by section 6082 of the Deficit Reduction 

9 Act of 2005, is repealed. 

10 (d) ADDITIONAL CONFORMING AMENDMENT.—Sec11 tion 1939 of the Social Security Act, as redesignated by 

12 section 6082 of the Deficit Reduction Act of 2005, is re13 designated as section 1937 of the Social Security Act. 

14 (e) EFFECTIVE DATE.—The repeals and amend15 ments made by subsections (a) through (d) shall take ef16 fect as if included in the enactment of the Deficit Reduc17 tion Act of 2005. 

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