I 

116TH CONGRESS 

1ST SESSION H. R. 4676 

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

issue of Medigap policies to all Medigap-eligible Medicare beneficiaries 

and Medicare Advantage enrollees, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 15, 2019 

Mr. SCHNEIDER introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, 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 title XVIII of the Social Security Act to provide 

for the guaranteed issue of Medigap policies to all 

Medigap-eligible Medicare beneficiaries and Medicare Advantage enrollees, 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. 

4 This Act may be cited as the ‘‘Protecting Medicare 

5 Beneficiaries with Pre-Existing Conditions Act’’. 


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1 SEC. 2. GUARANTEED ISSUE. 

2 (a) GUARANTEED ISSUE OF MEDIGAP POLICIES TO

3 ALL MEDIGAP-ELIGIBLE MEDICARE BENEFICIARIES.— 

4 (1) IN GENERAL.—Section 1882(s) of the So5 cial Security Act (42 U.S.C. 1395ss(s)) is amend6 ed— 

7 (A) in paragraph (2)(A), by striking ‘‘65 

8 years of age or older and is enrolled for benefits 

9 under part B’’ and inserting ‘‘entitled to, or en10 rolled for, benefits under part A and enrolled 

11 for benefits under part B’’; 

12 (B) in paragraph (2)(D), by striking ‘‘who 

13 is 65 years of age or older as of the date of 

14 issuance and’’; 

15 (C) in paragraph (3)(B)(ii), by striking ‘‘is 

16 65 years of age or older and’’; and 

17 (D) in paragraph (3)(B)(vi), by striking 

18 ‘‘at age 65’’. 

19 (2) EFFECTIVE DATE; PHASE-IN AUTHORITY.— 

20 (A) EFFECTIVE DATE.—Subject to sub21 paragraph (B), the amendments made by para22 graph (1) shall apply to medicare supplemental 

23 policies effective on or after January 1, 2023. 

24 (B) PHASE-IN AUTHORITY.— 

25 (i) IN GENERAL.—Subject to clause 

26 (ii), the Secretary of Health and Human 


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1 Services may phase in the implementation 

2 of the amendments made under paragraph 

3 (1) (with such phase-in beginning on or 

4 after January 1, 2023) in such manner as 

5 the Secretary determines appropriate in 

6 order to minimize any adverse impact on 

7 individuals enrolled under a medicare sup8 plemental policy. 

9 (ii) PHASE-IN PERIOD MAY NOT EX10 CEED 5 YEARS.—The Secretary of Health 

11 and Human Services shall ensure that the 

12 amendments made by paragraph (1) are 

13 fully implemented by not later than Janu14 ary 1, 2028. 

15 (3) ADDITIONAL ENROLLMENT PERIOD FOR

16 CERTAIN INDIVIDUALS.— 

17 (A) ONE-TIME ENROLLMENT PERIOD.— 

18 (i) IN GENERAL.—In the case of an 

19 individual described in subparagraph (B), 

20 the Secretary shall establish a one-time en21 rollment period during which such an indi22 vidual may enroll in any medicare supple23 mental policy of the individual’s choosing. 

24 (ii) PERIOD.—The enrollment period 

25 established under clause (i) shall begin on 


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1 the date on which the phase-in period 

2 under paragraph (2) is completed and end 

3 6 months after such date. 

4 (B) INDIVIDUAL DESCRIBED.—An indi5 vidual described in this paragraph is an indi6 vidual who— 

7 (i) is entitled to hospital insurance 

8 benefits under part A of title XVIII of the 

9 Social Security Act (42 U.S.C. 1395c et 

10 seq.) pursuant to section 226(b) or section 

11 226A of such Act (42 U.S.C. 426(b); 426– 

12 1); 

13 (ii) is enrolled for benefits under part 

14 B of such Act (42 U.S.C. 1395j et seq.); 

15 and 

16 (iii) would not, but for the provisions 

17 of and amendments made by paragraphs 

18 (1) and (2), be eligible for the guaranteed 

19 issue of a medicare supplemental policy 

20 under paragraph (2) or (3) of section 

21 1882(s) of such Act (42 U.S.C. 1395ss(s)). 

22 (C) OUTREACH PLAN.— 

23 (i) IN GENERAL.—The Secretary shall 

24 develop an outreach plan to notify individ25 uals described in subparagraph (B) of the 


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1 one-time enrollment period established 

2 under subparagraph (A). 

3 (ii) CONSULTATION.—In imple4 menting the outreach plan developed under 

5 clause (i), the Secretary shall consult with 

6 consumer advocates, brokers, insurers, the 

7 National Association of Insurance Commis8 sioners, and State Health Insurance As9 sistance Programs. 

10 (b) GUARANTEED ISSUE OF MEDIGAP POLICIES FOR

11 MEDICARE ADVANTAGE ENROLLEES.— 

12 (1) IN GENERAL.—Section 1882(s)(3) of the 

13 Social Security Act (42 U.S.C. 1395ss(s)(3)), as 

14 amended by subsection (a), is further amended— 

15 (A) in subparagraph (B), by adding at the 

16 end the following new clause: 

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

18 Advantage plan under part C for not less than 12 

19 months and subsequently disenrolled from such plan 

20 and elects to receive benefits under this title through 

21 the original Medicare fee-for-service program under 

22 parts A and B.’’; 

23 (B) by striking subparagraph (C)(iii) and 

24 inserting the following: 


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

2 individual described in clause (vi) or (vii) of subparagraph 

3 (B), a medicare supplemental policy described in this sub4 paragraph shall include any medicare supplemental pol5 icy.’’; and 

6 (C) in subparagraph (E)— 

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

8 the end; 

9 (ii) in clause (v), by striking the pe10 riod at the end and inserting ‘‘; and’’; and 

11 (iii) by adding at the end the fol12 lowing new clause— 

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.’’. 

20 (2) EFFECTIVE DATE.—The amendments made 

21 by paragraph (1) shall apply to medicare supple22 mental policies effective on or after January 1, 

23 2023. 

Æ 


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