II 

112TH CONGRESS 

2D SESSION S. 3271 

To provide all Medicare beneficiaries with the right to guaranteed issue 

of a Medicare supplemental policy. 

IN THE SENATE OF THE UNITED STATES 

JUNE 7, 2012 

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 2012’’. 

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) EFFECTIVE DATE; PHASE-IN AUTHORITY.— 

12 (1) EFFECTIVE DATE.—Subject to paragraph 

13 (2), the amendments made by subsection (a) shall 

14 apply to Medicare supplemental policies effective on 

15 or after January 1, 2014. 

16 (2) PHASE-IN AUTHORITY.— 

17 (A) IN GENERAL.—Subject to subpara18 graph (B), the Secretary of Health and Human 

19 Services may phase in the implementation of 

20 the amendments made under subsection (a) in 

21 such manner as the Secretary determines ap22 propriate in order to minimize any adverse im23 pact on individuals enrolled under a Medicare 

24 supplemental policy prior to January 1, 2014. 


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1 (B) PHASE-IN PERIOD MAY NOT EXCEED 5

2 YEARS.—The Secretary of Health and Human 

3 Services shall ensure that the amendments 

4 made by subsection (a) are fully implemented 

5 by not later than January 1, 2019. 

6 (c) SEPARATE PREMIUM CLASS.— 

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

8 any individuals enrolled under a Medicare supple9 mental policy pursuant to the amendments made 

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

11 as part of a separate premium class. 

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

13 shall apply to individuals that enroll under a Medi14 care supplemental policy prior to January 1, 2019. 

15 (d) ADDITIONAL ENROLLMENT PERIOD FOR CER16 TAIN INDIVIDUALS.— 

17 (1) ONE-TIME ENROLLMENT PERIOD.— 

18 (A) IN GENERAL.—In the case of an indi19 vidual described in paragraph (2), the Secretary 

20 shall establish a one-time enrollment period 

21 during which such an individual may enroll in 

22 any Medicare supplemental policy of the indi23 vidual’s choosing. 

24 (B) PERIOD.—The enrollment period es25 tablished under subparagraph (A) shall begin 


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

2 subsection (b) is completed and end 6 months 

3 after such date. 

4 (2) INDIVIDUAL DESCRIBED.—An individual de5 scribed in this paragraph is an individual who— 

6 (A) is entitled to hospital insurance bene7 fits under part A under section 226(b) or sec8 tion 226A of the Social Security Act (42 U.S.C. 

9 426(b); 426–1); 

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

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

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

13 and amendments made by this section, be eligi14 ble for the guaranteed issue of a Medicare sup15 plemental policy under section 1882(s)(2) of 

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

17 (3) OUTREACH PLAN.—The Secretary shall de18 velop an outreach plan to notify individuals de19 scribed in paragraph (2) of the one-time enrollment 

20 period established under paragraph (1). 


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1 SEC. 3. GUARANTEED ISSUE OF MEDIGAP POLICIES FOR 

2 MEDICARE ADVANTAGE AND MEDICAID EN3 ROLLEES. 

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

5 Security Act (42 U.S.C. 1395ss(s)(3)), as amended by sec6 tion 2, is amended— 

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

8 the following new clauses: 

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

10 Advantage plan under part C for not less than 12 

11 months and subsequently disenrolled from such plan 

12 and elects to receive benefits under this title through 

13 the original Medicare fee-for-service program under 

14 parts A and B. 

15 ‘‘(viii) The individual— 

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

17 under part A and enrolled for benefits under 

18 part B; 

19 ‘‘(II) was eligible for medical assistance 

20 under a State plan or waiver under title XIX 

21 and was enrolled in such plan or waiver; and 

22 ‘‘(III) subsequently lost eligibility for such 

23 medical assistance.’’; 

24 (2) by striking subparagraph (C)(iii) and in25 serting the following: 


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

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

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

4 policy described in this subparagraph shall include 

5 any Medicare supplemental policy.’’; and 

6 (3) in subparagraph (E)— 

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

8 end; 

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

10 the end and inserting a semicolon; and 

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

12 clauses— 

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

14 subparagraph (B)(vii), the annual, coordinated elec15 tion period (as defined in section 1851(e)(3)(B)) or 

16 a continuous open enrollment period (as defined in 

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

18 disenrolls from a Medicare Advantage plan under 

19 part C; and 

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

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

22 date that the individual receives a notice of cessation 

23 of such individual’s eligibility for medical assistance 

24 under the State plan or waiver under title XIX and 


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1 ending on the date that is 123 days after the indi2 vidual receives such notice.’’. 

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

4 subsection (a) shall apply to Medicare supplemental poli5 cies effective on or after January 1, 2014. 

6 SEC. 4. ENROLLMENT OF INDIVIDUALS WITH END STAGE 

7 RENAL DISEASE IN MEDICARE ADVANTAGE. 

8 (a) IN GENERAL.—Section 1851(a) of the Social Se9 curity Act (42 U.S.C. 1395w–21(a)) is amended by strik10 ing paragraph (3) and inserting the following: 

11 ‘‘(3) MEDICARE ADVANTAGE ELIGIBLE INDI12 VIDUAL.—In this title, the term ‘Medicare Advan13 tage eligible individual’ means an individual who is 

14 entitled to benefits under part A and enrolled under 

15 part B.’’. 

16 (b) CONFORMING AMENDMENTS.— 

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

18 (42 U.S.C. 1395w–22(b)) is amended by striking 

19 paragraph (1) and inserting the following: 

20 ‘‘(1) BENEFICIARIES.—A Medicare Advantage 

21 organization may not deny, limit, or condition the 

22 coverage or provision of benefits under this part, for 

23 individuals permitted to be enrolled with the organi24 zation under this part, based on any health status25 related factor described in section 2702(a)(1) of the 


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1 Public Health Service Act. The Secretary shall not 

2 approve a plan of an organization if the Secretary 

3 determines that the design of the plan and its bene4 fits are likely to substantially discourage enrollment 

5 by certain MA eligible individuals with the organiza6 tion.’’. 

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

8 U.S.C. 1395w–28(b)(6)(B)) is amended in the sec9 ond sentence by striking ‘‘may waive application of 

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

11 described in clause (i), (ii), or (iii) of this subpara12 graph and’’. 

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

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

15 January 1, 2014. 

Æ 


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