I 

116TH CONGRESS 

1ST SESSION H. R. 4666 

To amend title XVIII of the Social Security Act to provide certain lowincome territorial residents with automatic eligibility for premium and 

cost-sharing subsidies under the Medicare program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 11, 2019 

Ms. SHALALA (for herself and Mr. SOTO) 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 title XVIII of the Social Security Act to provide 

certain low-income territorial residents with automatic 

eligibility for premium and cost-sharing subsidies under 

the Medicare program, 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, 


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•HR 4666 IH

1 SECTION 1. AUTOMATIC ELIGIBILITY OF CERTAIN LOW-IN2 COME TERRITORIAL RESIDENTS FOR PRE3 MIUM AND COST-SHARING SUBSIDIES UNDER 

4 THE MEDICARE PROGRAM; SUNSET OF EN5 HANCED ALLOTMENT PROGRAM. 

6 (a) AUTOMATIC ELIGIBILITY OF CERTAIN LOW-IN7 COME TERRITORIAL RESIDENTS FOR PREMIUM AND

8 COST-SHARING SUBSIDIES UNDER THE MEDICARE PRO9 GRAM.— 

10 (1) IN GENERAL.—Section 1860D–14(a)(3) of 

11 the Social Security Act (42 U.S.C. 1395w– 

12 114(a)(3)) is amended— 

13 (A) in subparagraph (B)(v)— 

14 (i) in subclause (I), by striking ‘‘and’’ 

15 at the end; 

16 (ii) in subclause (II), by striking the 

17 period and inserting ‘‘; and’’; and 

18 (iii) by inserting after subclause (II) 

19 the following new subclause: 

20 ‘‘(III) with respect to plan years 

21 beginning on or after January 1, 

22 2021, shall provide that any part D 

23 eligible individual who is enrolled for 

24 medical assistance under the State 

25 Medicaid plan of a territory (as de26 fined in section 1935(f)) under title 


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1 XIX (or a waiver of such a plan) shall 

2 be treated as a subsidy eligible indi3 vidual described in paragraph (1).’’; 

4 and 

5 (B) in subparagraph (F), by adding at the 

6 end the following new sentence: ‘‘The previous 

7 sentence shall not apply with respect to eligi8 bility determinations for premium and cost9 sharing subsidies under this section made on or 

10 after January 1, 2021.’’. 

11 (2) CONFORMING AMENDMENT.—Section 

12 1860D–31(j)(2)(D) of the Social Security Act (42 

13 U.S.C. 1395w–141(j)(2)(D)) is amended by adding 

14 at the end the following new sentence: ‘‘The previous 

15 sentence shall not apply with respect to amounts 

16 made available to a State under this paragraph on 

17 or after January 1, 2021.’’. 

18 (b) SUNSET OF ENHANCED ALLOTMENT PRO19 GRAM.— 

20 (1) IN GENERAL.—Section 1935(e) of the So21 cial Security Act (42 U.S.C. 1396u–5(e)) is amend22 ed— 

23 (A) in paragraph (1)(A), by inserting after 

24 ‘‘such State’’ the following: ‘‘before January 1, 

25 2021’’; and 


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1 (B) in paragraph (3)— 

2 (i) in subparagraph (A), in the matter 

3 preceding clause (i), by inserting after ‘‘a 

4 year’’ the following: ‘‘(before 2021)’’; and 

5 (ii) in subparagraph (B)(iii), by strik6 ing ‘‘a subsequent year’’ and inserting 

7 ‘‘each of fiscal years 2008 through 2020’’. 

8 (2) TERRITORY DEFINED.—Section 1935 of the 

9 Social Security Act (42 U.S.C. 1396u–5) is amended 

10 by adding at the end the following new subsection: 

11 ‘‘(f) TERRITORY DEFINED.—In this section, the term 

12 ‘territory’ means Puerto Rico, the Virgin Islands, Guam, 

13 the Northern Mariana Islands, and American Samoa.’’. 

Æ 


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