I 

109TH CONGRESS 

1ST SESSION H. R. 2072 

To amend title XVIII of the Social Security Act and the Employee Retirement 

Income Security Act of 1974 to provide access to Medicare benefits 

for individuals ages 55 to 65, to amend the Internal Revenue Code 

of 1986 to allow a refundable and advanceable credit against income 

tax for payment of such premiums, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 4, 2005 

Mr. STARK (for himself, Mr. BROWN of Ohio, Mr. RANGEL, Mr. DINGELL, 

Mr. WAXMAN, Ms. PELOSI, Mr. GEORGE MILLER of California, Mr. 

PALLONE, Mr. ALLEN, Mr. ANDREWS, Mr. BACA, Ms. BALDWIN, Ms. 

BERKLEY, Mr. BERRY, Ms. CORRINE BROWN of Florida, Mr. 

BUTTERFIELD, Mr. CARNAHAN, Mrs. CAPPS, Mr. CARDIN, Ms. CARSON, 

Mrs. CHRISTENSEN, Mr. CLEAVER, Mr. CROWLEY, Mr. CUELLAR, Mr. 

CUMMINGS, Mrs. DAVIS of California, Ms. DELAURO, Mr. DOGGETT, Mr. 

EMANUEL, Mr. ENGEL, Mr. EVANS, Mr. FARR, Mr. GONZALEZ, Mr. 

GORDON, Mr. AL GREEN of Texas, Mr. GENE GREEN of Texas, Mr. 

GRIJALVA, Mr. GUTIERREZ, Mr. HASTINGS of Florida, Mr. HIGGINS, Mr. 

HINCHEY, Mr. HINOJOSA, Ms. NORTON, Mr. HOLT, Mr. HONDA, Mr. 

HOYER, Mr. ISRAEL, Mr. JACKSON of Illinois, Ms. JACKSON-LEE of 

Texas, Mr. KILDEE, Ms. KILPATRICK of Michigan, Mr. KUCINICH, Mr. 

LANGEVIN, Mr. LANTOS, Mr. LARSON of Connecticut, Ms. LEE, Mr. 

LEWIS of Georgia, Mr. LYNCH, Mrs. MALONEY, Ms. MATSUI, Mrs. 

MCCARTHY, Ms. MCCOLLUM of Minnesota, Mr. MCDERMOTT, Mr. 

MCGOVERN, Mr. MCNULTY, Mr. MEEHAN, Mr. MENENDEZ, Mr. 

MICHAUD, Ms. MILLENDER-MCDONALD, Mr. MURTHA, Mr. NADLER, Mr. 

OBERSTAR, Mr. OLVER, Mr. ORTIZ, Mr. OWENS, Mr. PASCRELL, Mr. 

PASTOR, Mr. REYES, Mr. ROSS, Ms. ROYBAL-ALLARD, Mr. 

RUPPERSBERGER, Mr. RYAN of Ohio, Mr. SALAZAR, Ms. LINDA T. 

SA ́NCHEZ of California, Ms. SCHAKOWSKY, Ms. SCHWARTZ of Pennsylvania, Mr. SCOTT of Georgia, Mr. SCOTT of Virginia, Mr. SERRANO, Ms. 

SOLIS, Mr. STRICKLAND, Mr. STUPAK, Mr. TIERNEY, Mr. VAN HOLLEN, 

Ms. WASSERMAN SCHULTZ, Mr. WEXLER, Mr. JEFFERSON, and Mr. 

SANDERS) 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 Education and the Workforce, 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 
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A BILL 

To amend title XVIII of the Social Security Act and the 

Employee Retirement Income Security Act of 1974 to 

provide access to Medicare benefits for individuals ages 

55 to 65, to amend the Internal Revenue Code of 1986 

to allow a refundable and advanceable credit against 

income tax for payment of such premiums, 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, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Medicare Early Access Act of 2005’’. 

6 (b) TABLE OF CONTENTS.— 

Sec. 1. Short title; table of contents. 

TITLE I—ACCESS TO MEDICARE BENEFITS FOR INDIVIDUALS 55 

TO 65 YEARS OF AGE 

Sec. 101. Access to Medicare benefits for individuals 55 to 65 years of age. 

‘‘PART E—PURCHASE OF MEDICARE BENEFITS BY CERTAIN INDIVIDUALS 55 

TO 65 YEARS OF AGE

‘‘Sec. 1860E–1. Program benefits; eligibility. 

‘‘Sec. 1860E–2. Enrollment process; coverage. 

‘‘Sec. 1860E–3. Premiums. 

‘‘Sec. 1860E–4. Payment of premiums. 

‘‘Sec. 1860E–5. Provisions relating to Employment-Based retiree health 

coverage. 

‘‘Sec. 1860E–6. Medicare Early Access Trust Fund. 

‘‘Sec. 1860E–7. Oversight and accountability. 

‘‘Sec. 1860E–8. Administration and miscellaneous. 

TITLE II—REFUNDABLE AND ADVANCEABLE CREDIT AGAINST 

INCOME TAX FOR MEDICARE EARLY ACCESS PREMIUMS 

Sec. 201. Refundable and advanceable income tax credit for Medicare early access premiums. 
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1 TITLE I—ACCESS TO MEDICARE 

2 BENEFITS FOR INDIVIDUALS 

3 55 TO 65 YEARS OF AGE 

4 SEC. 101. ACCESS TO MEDICARE BENEFITS FOR INDIVID5 UALS 55 TO 65 YEARS OF AGE. 

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

7 Act is amended— 

8 (1) by redesignating part E as part F; and 

9 (2) by inserting after part D the following new 

10 part: 

11 ‘‘PART E—PURCHASE OF MEDICARE BENEFITS 

12 BY CERTAIN INDIVIDUALS 55 TO 65 YEARS OF 

13 AGE 

14 ‘‘SEC. 1860E–1. PROGRAM BENEFITS; ELIGIBILITY. 

15 ‘‘(a) ENTITLEMENT TO MEDICARE BENEFITS FOR

16 ENROLLED INDIVIDUALS.— 

17 ‘‘(1) IN GENERAL.—An individual enrolled 

18 under this part is entitled to the same benefits 

19 under this title as an individual entitled to benefits 

20 or enrolled under any part of this title. 

21 ‘‘(2) DEFINITIONS.—For purposes of this part: 

22 ‘‘(A) FEDERAL OR STATE COBRA CONTINU23 ATION PROVISION.—The term ‘Federal or State 

24 COBRA continuation provision’ has the mean25 ing given the term ‘COBRA continuation provi-
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1 sion’ in section 2791(d)(4) of the Public Health 

2 Service Act and includes a comparable State 

3 program, as determined by the Secretary. 

4 ‘‘(B) FEDERAL HEALTH INSURANCE PRO5 GRAM DEFINED.—The term ‘Federal health in6 surance program’ means any of the following: 

7 ‘‘(i) MEDICARE.—Any part of this 

8 title (other than by reason of this part). 

9 ‘‘(ii) MEDICAID.—A State plan under 

10 title XIX. 

11 ‘‘(iii) FEHBP.—The Federal employ12 ees health benefit program under chapter 

13 89 of title 5, United States Code. 

14 ‘‘(iv) TRICARE.—The TRICARE 

15 program (as defined in section 1072(7) of 

16 title 10, United States Code). 

17 ‘‘(v) ACTIVE DUTY MILITARY.—Health 

18 benefits under title 10, United States 

19 Code, to an individual as a member of the 

20 uniformed services of the United States. 

21 ‘‘(C) GROUP HEALTH PLAN.—The term 

22 ‘group health plan’ has the meaning given such 

23 term in section 2791(a)(1) of the Public Health 

24 Service Act. 
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1 ‘‘(b) ELIGIBILITY OF INDIVIDUALS AGE 55 TO 65 

2 YEARS OF AGE.— 

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

4 an individual who meets the following requirements 

5 with respect to a month is eligible to enroll under 

6 this part with respect to such month: 

7 ‘‘(A) AGE.—As of the last day of the 

8 month, the individual has attained 55 years of 

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

10 ‘‘(B) MEDICARE ELIGIBILITY (BUT FOR

11 AGE).—The individual would be eligible for ben12 efits under part A or part B for the month if 

13 the individual were 65 years of age. 

14 ‘‘(C) NOT ELIGIBLE FOR COVERAGE

15 UNDER GROUP HEALTH PLANS OR FEDERAL

16 HEALTH INSURANCE PROGRAMS.—The indi17 vidual is not eligible for benefits or coverage 

18 under a Federal health insurance program (as 

19 defined in subsection (a)(2)(B)) or under a 

20 group health plan (other than such eligibility 

21 merely through a Federal or State COBRA con22 tinuation provision) as of the last day of the 

23 month involved. 

24 ‘‘(2) LIMITATION ON ELIGIBILITY IF TERMI25 NATED ENROLLMENT.—If an individual described in 
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1 paragraph (1) enrolls under this part and coverage 

2 of the individual is terminated under section 1860E– 

3 2(d) (other than because of age), the individual is 

4 not again eligible to enroll under this subsection un5 less the following requirements are met: 

6 ‘‘(A) NEW COVERAGE UNDER GROUP

7 HEALTH PLAN OR FEDERAL HEALTH INSUR8 ANCE PROGRAM.—After the date of termination 

9 of coverage under such section, the individual 

10 obtains coverage under a group health plan or 

11 under a Federal health insurance program. 

12 ‘‘(B) SUBSEQUENT LOSS OF NEW COV13 ERAGE.—The individual subsequently loses eli14 gibility for the coverage described in subpara15 graph (A) without regard to whether the indi16 vidual has exhausted any eligibility the indi17 vidual may subsequently have for coverage 

18 under a Federal or State COBRA continuation 

19 provision. 

20 ‘‘(3) CHANGE IN HEALTH PLAN ELIGIBILITY

21 DOES NOT AFFECT COVERAGE.—In the case of an 

22 individual who is eligible for and enrolls under this 

23 part under this subsection, the individual’s continued 

24 entitlement to benefits under this part shall not be 

25 affected by the individual’s subsequent eligibility for 
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1 benefits or coverage described in paragraph (1)(C), 

2 or entitlement to such benefits or coverage. 

3 ‘‘SEC. 1860E–2. ENROLLMENT PROCESS; COVERAGE. 

4 ‘‘(a) IN GENERAL.—An individual may enroll in the 

5 program established under this part only in such manner 

6 and form as may be prescribed by regulations, and only 

7 during an enrollment period prescribed by the Secretary 

8 consistent with the provisions of this section. Such regula9 tions shall provide a process under which individuals eligi10 ble to enroll as of a month are permitted to pre-enroll dur11 ing a prior month within an enrollment period described 

12 in subsection (b). 

13 ‘‘(b) ENROLLMENT PERIODS.— 

14 ‘‘(1) INDIVIDUALS 55 TO 65 YEARS OF AGE.—In 

15 the case of individuals eligible to enroll under this 

16 part under section 1860E–1(b)— 

17 ‘‘(A) INITIAL ENROLLMENT PERIOD.—If 

18 the individual is eligible to enroll under such 

19 section for January 2006, the enrollment period 

20 shall begin on November 1, 2005, and shall end 

21 on February 28, 2006. Any such enrollment be22 fore January 1, 2006, is conditioned upon com23 pliance with the conditions of eligibility for Jan24 uary 2006. 
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1 ‘‘(B) SUBSEQUENT PERIODS.—If the indi2 vidual is eligible to enroll under such section for 

3 a month after January 2006, the enrollment pe4 riod shall begin on the first day of the second 

5 month before the month in which the individual 

6 first is eligible to so enroll and shall end four 

7 months later. Any such enrollment before the 

8 first day of the third month of such enrollment 

9 period is conditioned upon compliance with the 

10 conditions of eligibility for such third month. 

11 ‘‘(2) AUTHORITY TO CORRECT FOR GOVERN12 MENT ERRORS.—The provisions of section 1837(h) 

13 apply with respect to enrollment under this part in 

14 the same manner as they apply to enrollment under 

15 part B. 

16 ‘‘(c) DATE COVERAGE BEGINS.— 

17 ‘‘(1) IN GENERAL.—The period during which 

18 an individual is entitled to benefits under this part 

19 shall begin as follows, but in no case earlier than 

20 January 1, 2006: 

21 ‘‘(A) In the case of an individual who en22 rolls (including pre-enrolls) before the month in 

23 which the individual satisfies eligibility for en24 rollment under section 1860E–1, the first day 

25 of such month of eligibility. 
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1 ‘‘(B) In the case of an individual who en2 rolls during or after the month in which the in3 dividual first satisfies eligibility for enrollment 

4 under such section, the first day of the fol5 lowing month. 

6 ‘‘(2) AUTHORITY TO PROVIDE FOR PARTIAL

7 MONTHS OF COVERAGE.—Under regulations, the 

8 Secretary may, in the Secretary’s discretion, provide 

9 for coverage periods that include portions of a 

10 month in order to avoid lapses of coverage. 

11 ‘‘(3) LIMITATION ON PAYMENTS.—No payments 

12 may be made under this title with respect to the ex13 penses of an individual enrolled under this part un14 less such expenses were incurred by such individual 

15 during a period which, with respect to the individual, 

16 is a coverage period under this section. 

17 ‘‘(d) TERMINATION OF COVERAGE.— 

18 ‘‘(1) IN GENERAL.—An individual’s coverage 

19 period under this part shall continue until the indi20 vidual’s enrollment has been terminated at the ear21 liest of the following: 

22 ‘‘(A) GENERAL PROVISIONS.— 

23 ‘‘(i) NOTICE.—The individual files no24 tice (in a form and manner prescribed by 

25 the Secretary) that the individual no 
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1 longer wishes to participate in the insur2 ance program under this part. 

3 ‘‘(ii) NONPAYMENT OF PREMIUMS.— 

4 The individual fails to make payment of 

5 premiums required for enrollment under 

6 this part. 

7 ‘‘(iii) MEDICARE ELIGIBILITY.—The 

8 individual becomes entitled to benefits or 

9 enrolled under any other part of this title 

10 (other than by reason of this part). 

11 ‘‘(B) TERMINATION BASED ON AGE.—The 

12 individual attains 65 years of age. 

13 ‘‘(2) EFFECTIVE DATE OF TERMINATION.— 

14 ‘‘(A) NOTICE.—The termination of a cov15 erage period under paragraph (1)(A)(i) shall 

16 take effect at the close of the month following 

17 for which the notice is filed. 

18 ‘‘(B) NONPAYMENT OF PREMIUM.—The 

19 termination of a coverage period under para20 graph (1)(A)(ii) shall take effect on a date de21 termined under regulations, which may be de22 termined so as to provide a grace period in 

23 which overdue premiums may be paid and cov24 erage continued. The grace period determined 

25 under the preceding sentence shall not exceed 
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1 60 days; except that it may be extended for an 

2 additional 30 days in any case where the Sec3 retary determines that there was good cause for 

4 failure to pay the overdue premiums within 

5 such 60-day period. 

6 ‘‘(C) AGE OR MEDICARE ELIGIBILITY.— 

7 The termination of a coverage period under 

8 paragraph (1)(A)(iii) or (1)(B) shall take effect 

9 as of the first day of the month in which the 

10 individual attains 65 years of age or becomes 

11 entitled to benefits or enrolled in any other part 

12 of this title (other than by reason of this part). 

13 ‘‘SEC. 1860E–3. PREMIUMS. 

14 ‘‘(a) AMOUNT OF MONTHLY PREMIUMS.—The Sec15 retary shall, during September of each year (beginning 

16 with 2005), determine a monthly premium for individuals 

55 years of age or older, equal to 1 17 ⁄12 of the annual pre18 mium computed under subsection (b)(2), which shall apply 

19 with respect to coverage provided under this title for any 

20 month in the succeeding year. 

21 ‘‘(b) ANNUAL PREMIUM.— 

22 ‘‘(1) NATIONAL, PER CAPITA AVERAGE.—The 

23 Secretary shall estimate the average, annual per 

24 capita amount that would be payable under this title 

25 with respect to individuals residing in the United 
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1 States who meet the requirement of section 1860E– 

2 1(b)(1)(A) as if all such individuals were eligible for 

3 (and enrolled) under this title during the entire year 

4 (and assuming that section 1862(b)(2)(A)(i) did not 

5 apply). 

6 ‘‘(2) ANNUAL PREMIUM.—The annual premium 

7 under this subsection for months in a year is equal 

8 to the average, annual per capita amount estimated 

9 under paragraph (1) for the year. 

10 ‘‘SEC. 1860E–4. PAYMENT OF PREMIUMS. 

11 ‘‘(a) PAYMENT OF MONTHLY PREMIUM.— 

12 ‘‘(1) IN GENERAL.—The Secretary shall provide 

13 for payment and collection of the monthly premium, 

14 determined under section 1860E–3(a) for the age of 

15 the individual involved, in the same manner as for 

16 payment of monthly premiums under section 1840, 

17 except that, for purposes of applying this section, 

18 any reference in such section to the Federal Supple19 mentary Medical Insurance Trust Fund is deemed a 

20 reference to the Trust Fund established under sec21 tion 1860E–6. 

22 ‘‘(2) PERIOD OF PAYMENT.—In the case of an 

23 individual who participates in the program estab24 lished by this title, the monthly premium shall be 

25 payable for the period commencing with the first 
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1 month of the individual’s coverage period and ending 

2 with the month in which the individual’s coverage 

3 under this title terminates. 

4 ‘‘(b) APPLICATION OF CERTAIN PROVISIONS.—The 

5 provisions of section 1840 (other than subsection (h)) 

6 shall apply to premiums collected under this section in the 

7 same manner as they apply to premiums collected under 

8 part B, except that any reference in such section to the 

9 Federal Supplementary Medical Insurance Trust Fund is 

10 deemed a reference to the Trust Fund established under 

11 section 1860E–6. 

12 ‘‘SEC. 1860E–5. PROVISIONS RELATING TO EMPLOYMENT13 BASED RETIREE HEALTH COVERAGE. 

14 ‘‘(a) IN GENERAL.—In the case of an individual who 

15 would be eligible to enroll under this part but for the pro16 vision of employment-based retiree health coverage by an 

17 employer to the individual, notwithstanding the limitation 

18 under section 1860E–1(b)(1)(C), the individual is eligible 

19 to enroll under this part. 

20 ‘‘(b) MAINTENANCE OF EFFORT.—In the case of an 

21 employer that offers employment-based retiree health cov22 erage to an individual who enrolls under this part, upon 

23 enrollment of the individual under this part, the employer 

24 may modify such coverage to provide for the following ben25 efits: 
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1 ‘‘(1) Payment is made by the employer under 

2 such coverage for items and services for which pay3 ment may not be made under this title. 

4 ‘‘(2) Payment is made by the employer spon5 soring such coverage of 25 percent of the monthly 

6 premium under section 1860E–3 applicable to the 

7 individual after enrollment under this part. 

8 ‘‘(c) EMPLOYMENT-BASED RETIREE HEALTH COV9 ERAGE.—The term ‘employment-based retiree health cov10 erage’ has the meaning given that term in section 1860D– 

11 22(c)(1), except that, for purposes of this part, any ref12 erence in such section to ‘part D’ is deemed to be a ref13 erence to ‘part E’. 

14 ‘‘SEC. 1860E–6. MEDICARE EARLY ACCESS TRUST FUND. 

15 ‘‘(a) ESTABLISHMENT OF TRUST FUND.— 

16 ‘‘(1) IN GENERAL.—There is hereby created on 

17 the books of the Treasury of the United States a 

18 trust fund to be known as the ‘Medicare Early Ac19 cess Trust Fund’ (in this section referred to as the 

20 ‘Trust Fund’). The Trust Fund shall consist of such 

21 gifts and bequests as may be made as provided in 

22 section 201(i)(1) and such amounts as may be de23 posited in, or appropriated to, such fund as provided 

24 in this title. 
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1 ‘‘(2) PREMIUMS.—Premiums collected under 

2 section 1860E–3 and payable under section 1860E– 

3 5(a)(2) shall be transferred to the Trust Fund. 

4 ‘‘(b) INCORPORATION OF PROVISIONS.— 

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

6 subsections (b) through (i) of section 1841 shall 

7 apply with respect to the Trust Fund and this title 

8 in the same manner as they apply with respect to 

9 the Federal Supplementary Medical Insurance Trust 

10 Fund and part B, respectively. 

11 ‘‘(2) MISCELLANEOUS REFERENCES.—In apply12 ing provisions of section 1841 under paragraph 

13 (1)— 

14 ‘‘(A) any reference in such section to ‘this 

15 part’ is construed to refer to this part E; 

16 ‘‘(B) any reference in section 1841(h) to 

17 section 1840(d) and in section 1841(i) to sec18 tions 1840(b)(1) and 1842(g) are deemed ref19 erences to comparable authority exercised under 

20 this part; and 

21 ‘‘(C) payments may be made under section 

22 1841(g) to the Trust Funds under sections 

23 1817 and 1841 as reimbursement to such funds 

24 for payments they made for benefits provided 

25 under this part. 
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1 ‘‘SEC. 1860E–7. OVERSIGHT AND ACCOUNTABILITY. 

2 ‘‘(a) THROUGH ANNUAL REPORTS OF TRUSTEES.— 

3 The Board of Trustees of the Medicare Early Access 

4 Trust Fund under section 1860E–6(b)(1) shall report on 

5 an annual basis to Congress concerning the status of the 

6 Trust Fund and the need for adjustments in the program 

7 under this part to maintain financial solvency of the pro8 gram under this part. 

9 ‘‘(b) PERIODIC GAO REPORTS.—The Comptroller 

10 General of the United States shall periodically submit to 

11 Congress reports on the adequacy of the financing of cov12 erage provided under this part. The Comptroller General 

13 shall include in such report such recommendations for ad14 justments in such financing and coverage as the Comp15 troller General deems appropriate in order to maintain fi16 nancial solvency of the program under this part. 

17 ‘‘SEC. 1860E–8. ADMINISTRATION AND MISCELLANEOUS. 

18 ‘‘(a) TREATMENT FOR PURPOSES OF TITLE.—Ex19 cept as otherwise provided in this part— 

20 ‘‘(1) individuals enrolled under this part shall 

21 be treated for purposes of this title as though the in22 dividual were entitled to benefits and enrolled under 

23 any part of this title; and 

24 ‘‘(2) benefits described in section 1860E–1 

25 shall be payable under this title to such individuals 
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1 in the same manner as if such individuals were so 

2 entitled and enrolled. 

3 ‘‘(b) NOT TREATED AS MEDICARE PROGRAM FOR

4 PURPOSES OF MEDICAID PROGRAM.—For purposes of ap5 plying title XIX (including the provision of medicare cost6 sharing assistance under such title), an individual who is 

7 enrolled under this part shall not be treated as being enti8 tled to benefits under this title. 

9 ‘‘(c) NOT TREATED AS MEDICARE PROGRAM FOR

10 PURPOSES OF COBRA CONTINUATION PROVISIONS.—In 

11 applying a COBRA continuation provision (as defined in 

12 section 2791(d)(4) of the Public Health Service Act), any 

13 reference to an entitlement to benefits under this title 

14 shall not be construed to include entitlement to benefits 

15 under this title pursuant to the operation of this part.’’. 

16 (b) CONFORMING AMENDMENTS TO SOCIAL SECU17 RITY ACT PROVISIONS.—(1) Section 201(i)(1) of the So18 cial Security Act (42 U.S.C. 401(i)(1)) is amended by 

19 striking ‘‘or the Federal Supplementary Medical Insur20 ance Trust Fund’’ and inserting ‘‘the Federal Supple21 mentary Medical Insurance Trust Fund, and the Medicare 

22 Early Access Trust Fund’’. 

23 (2) Section 201(g)(1)(A) of such Act (42 U.S.C. 

24 401(g)(1)(A)) is amended by striking ‘‘and the Federal 

25 Supplementary Medical Insurance Trust Fund established 
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1 by title XVIII’’ and inserting ‘‘, the Federal Supple2 mentary Medical Insurance Trust Fund, and the Medicare 

3 Early Access Trust Fund established by title XVIII’’. 

4 (3) Section 1820(i) of such Act (42 U.S.C. 1395i– 

5 4(i)) is amended by striking ‘‘part D’’ and inserting ‘‘part 

6 F’’. 

7 (4) Section 1853 of such Act (42 U.S.C. 1395w–23) 

8 is amended by adding at the end the following new sub9 section: 

10 ‘‘(k) ADJUSTMENT FOR EARLY ACCESS.—In apply11 ing this section with respect to individuals entitled to bene12 fits under part E, the Secretary shall provide for an appro13 priate adjustment in, for 2006, the annual MA capitation 

14 rate, and for years beginning with 2007, the payment 

15 amount determined under this section or section 1858, as 

16 may be appropriate to reflect differences between the pop17 ulation served under such part and the population under 

18 parts A and B.’’. 

19 (5) Section 1860D–15(c)(1) of such Act (42 U.S.C. 

20 1395w–115(c)(1)) is amended by adding at the end the 

21 following new subparagraph: 

22 ‘‘(E) ADJUSTMENT FOR EARLY ACCESS.— 

23 In applying this section with respect to individ24 uals entitled to benefits under part E, the Sec25 retary shall provide for an appropriate adjust-
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1 ment in the payment amount determined under 

2 this section as may be appropriate to reflect dif3 ferences between the population served under 

4 such part and the population under parts A and 

5 B.’’. 

6 (c) OTHER CONFORMING AMENDMENTS.—(1) Sec7 tion 602(2)(D)(ii) of the Employee Retirement Income Se8 curity Act of 1974 (29 U.S.C. 1162(2)) is amended by 

9 inserting ‘‘(not including an individual who is so entitled 

10 pursuant to enrollment under section 1860E–1)’’ after 

11 ‘‘Social Security Act’’. 

12 (2) Section 2202(2)(D)(ii) of the Public Health Serv13 ice Act (42 U.S.C. 300bb–2(2)(D)(ii)) is amended by in14 serting ‘‘(not including an individual who is so entitled 

15 pursuant to enrollment under section 1860E–1)’’ after 

16 ‘‘Social Security Act’’. 

17 (3) Section 4980B(f)(2)(B)(i)(V) of the Internal Rev18 enue Code of 1986 is amended by inserting ‘‘(not includ19 ing an individual who is so entitled pursuant to enrollment 

20 under section 1860E–1)’’ after ‘‘Social Security Act’’. 
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1 TITLE II—REFUNDABLE AND 

2 ADVANCEABLE CREDIT 

3 AGAINST INCOME TAX FOR 

4 MEDICARE EARLY ACCESS 

5 PREMIUMS 

6 SEC. 201. REFUNDABLE AND ADVANCEABLE INCOME TAX 

7 CREDIT FOR MEDICARE EARLY ACCESS PRE8 MIUMS. 

9 (a) IN GENERAL.—Subpart C of part IV of sub10 chapter A of chapter 1 of the Internal Revenue Code of 

11 1986 (relating to refundable personal credits) is amended 

12 by redesignating section 36 as section 37 and by inserting 

13 after section 35 the following new section: 

14 ‘‘SEC. 36. MEDICARE EARLY ACCESS PREMIUMS. 

15 ‘‘(a) IN GENERAL.—In the case of an individual, 

16 there shall be allowed as a credit against the tax imposed 

17 by this chapter for the taxable year an amount equal to 

18 75 percent of the amount paid during such year as medi19 care early access coverage premiums. 

20 ‘‘(b) DEFINITIONS.—For purposes of this section the 

21 term ‘medicare early access coverage premiums’ means 

22 premiums paid under part E of title XVIII of the Social 

23 Security Act. 

24 ‘‘(c) COORDINATION WITH ADVANCE PAYMENT.— 

25 With respect to any taxable year, the amount which would 
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1 (but for this subsection) be allowed as a credit under sub2 section (a) shall be reduced (but not below zero) by the 

3 aggregate amount paid on behalf of such taxpayer under 

4 section 7528 for such taxable year.’’. 

5 (b) ADVANCE PAYMENT OF CREDIT.—Chapter 77 of 

6 such Code (relating to miscellaneous provisions) is amend7 ed by adding at the end the following new section: 

8 ‘‘SEC. 7528. ADVANCE PAYMENT OF CREDIT FOR MEDICARE 

9 EARLY ACCESS PREMIUMS. 

10 ‘‘(a) GENERAL RULE.—The Secretary shall establish 

11 a program for making payments on behalf of individuals 

12 enrolled under part E of title XVIII of the Social Security 

13 Act to the Secretary of Health and Human Services for 

14 premiums payable by such individuals under such part. 

15 ‘‘(b) LIMITATION ON ADVANCE PAYMENTS DURING

16 ANY TAXABLE YEAR.—The Secretary may make pay17 ments under subsection (a) only to the extent that the 

18 total amount of such payments made on behalf of any indi19 vidual during the taxable year does not exceed the amount 

20 allowable as a credit to such individual for such year under 

21 section 36 (determined without regard to subsection (c) 

22 thereof).’’. 

23 (c) CONFORMING AMENDMENTS.— 
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1 (1) Paragraph (2) of section 1324(b) of title 

2 31, United States Code, is amended by inserting ‘‘or 

3 36’’ after ‘‘section 35’’. 

4 (2) The table of sections for subpart C of part 

5 IV of subchapter A of chapter 1 of the Internal Rev6 enue Code of 1986 is amended by striking the item 

7 relating to section 36 and inserting the following 

8 new items: 

‘‘36. Medicare early access premiums. 

‘‘37. Overpayments of tax.’’. 

9 (3) The table of sections for chapter 77 of such 

10 Code is amended by adding at the end the following 

11 new item: 

‘‘7528. Advance payment of credit for medicare early access premiums.’’. 

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

13 this section shall apply to taxable years beginning after 

14 December 31, 2005. 

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