II 

110TH CONGRESS 

2D SESSION S. 3710 

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 SENATE OF THE UNITED STATES 

NOVEMBER 20, 2008 

Mr. ROCKEFELLER (for himself, Mr. BROWN, Mr. MENENDEZ, Mr. KERRY, 

and Mr. CARDIN) introduced the following bill; which was read twice and 

referred to the Committee on Finance 

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, 


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Medicare Early Access Act of 2008’’. 

4 (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. 

5 TITLE I—ACCESS TO MEDICARE 

6 BENEFITS FOR INDIVIDUALS 

7 55 TO 65 YEARS OF AGE 

8 SEC. 101. ACCESS TO MEDICARE BENEFITS FOR INDIVID9 UALS 55 TO 65 YEARS OF AGE. 

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

11 Act is amended— 

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

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

14 part: 


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1 ‘‘PART E—PURCHASE OF MEDICARE BENEFITS 

2 BY CERTAIN INDIVIDUALS 55 TO 65 YEARS OF 

3 AGE 

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

5 ‘‘(a) ENTITLEMENT TO MEDICARE BENEFITS FOR

6 ENROLLED INDIVIDUALS.— 

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

8 under this part is entitled to the same benefits 

9 under this title as an individual entitled to benefits 

10 or enrolled under any part of this title. 

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

12 ‘‘(A) FEDERAL OR STATE COBRA CONTINU13 ATION PROVISION.—The term ‘Federal or State 

14 COBRA continuation provision’ has the mean15 ing given the term ‘COBRA continuation provi16 sion’ in section 2791(d)(4) of the Public Health 

17 Service Act and includes a comparable State 

18 program, as determined by the Secretary. 

19 ‘‘(B) FEDERAL HEALTH INSURANCE PRO20 GRAM DEFINED.—The term ‘Federal health in21 surance program’ means any of the following: 

22 ‘‘(i) MEDICARE.—Any part of this 

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

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

25 title XIX. 


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1 ‘‘(iii) FEHBP.—The Federal employ2 ees health benefit program under chapter 

3 89 of title 5, United States Code. 

4 ‘‘(iv) TRICARE.—The TRICARE 

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

6 title 10, United States Code). 

7 ‘‘(v) ACTIVE DUTY MILITARY.—Health 

8 benefits under title 10, United States 

9 Code, to an individual as a member of the 

10 uniformed services of the United States. 

11 ‘‘(C) GROUP HEALTH PLAN.—The term 

12 ‘group health plan’ has the meaning given such 

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

14 Service Act. 

15 ‘‘(b) ELIGIBILITY OF INDIVIDUALS AGE 55 TO 65 

16 YEARS OF AGE.— 

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

18 an individual who meets the following requirements 

19 with respect to a month is eligible to enroll under 

20 this part with respect to such month: 

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

22 month, the individual has attained 55 years of 

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

24 ‘‘(B) MEDICARE ELIGIBILITY (BUT FOR

25 AGE).—The individual would be eligible for benVerDate Aug 31 2005 02:27 Nov 22, 2008 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3710.IS S3710

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1 efits under part A or part B for the month if 

2 the individual were 65 years of age. 

3 ‘‘(C) NOT ELIGIBLE FOR COVERAGE

4 UNDER GROUP HEALTH PLANS OR FEDERAL

5 HEALTH INSURANCE PROGRAMS.—The indi6 vidual is not eligible for benefits or coverage 

7 under a Federal health insurance program (as 

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

9 group health plan (other than such eligibility 

10 merely through a Federal or State COBRA con11 tinuation provision) as of the last day of the 

12 month involved. 

13 ‘‘(2) LIMITATION ON ELIGIBILITY IF TERMI14 NATED ENROLLMENT.—If an individual described in 

15 paragraph (1) enrolls under this part and coverage 

16 of the individual is terminated under section 1860E– 

17 2(d) (other than because of age), the individual is 

18 not again eligible to enroll under this subsection un19 less the following requirements are met: 

20 ‘‘(A) NEW COVERAGE UNDER GROUP

21 HEALTH PLAN OR FEDERAL HEALTH INSUR22 ANCE PROGRAM.—After the date of termination 

23 of coverage under such section, the individual 

24 obtains coverage under a group health plan or 

25 under a Federal health insurance program. 


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1 ‘‘(B) SUBSEQUENT LOSS OF NEW COV2 ERAGE.—The individual subsequently loses eli3 gibility for the coverage described in subpara4 graph (A) without regard to whether the indi5 vidual has exhausted any eligibility the indi6 vidual may subsequently have for coverage 

7 under a Federal or State COBRA continuation 

8 provision. 

9 ‘‘(3) CHANGE IN HEALTH PLAN ELIGIBILITY

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

11 individual who is eligible for and enrolls under this 

12 part under this subsection, the individual’s continued 

13 entitlement to benefits under this part shall not be 

14 affected by the individual’s subsequent eligibility for 

15 benefits or coverage described in paragraph (1)(C), 

16 or entitlement to such benefits or coverage. 

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

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

19 program established under this part only in such manner 

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

21 during an enrollment period prescribed by the Secretary 

22 consistent with the provisions of this section. Such regula23 tions shall provide a process under which individuals eligi24 ble to enroll as of a month are permitted to pre-enroll durVerDate Aug 31 2005 02:27 Nov 22, 2008 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3710.IS S3710

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1 ing a prior month within an enrollment period described 

2 in subsection (b). 

3 ‘‘(b) ENROLLMENT PERIODS.— 

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

5 the case of individuals eligible to enroll under this 

6 part under section 1860E–1(b)— 

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

8 the individual is eligible to enroll under such 

9 section for January 2010, the enrollment period 

10 shall begin on November 1, 2009, and shall end 

11 on February 28, 2010. Any such enrollment be12 fore January 1, 2010, is conditioned upon com13 pliance with the conditions of eligibility for Jan14 uary 2010. 

15 ‘‘(B) SUBSEQUENT PERIODS.—If the indi16 vidual is eligible to enroll under such section for 

17 a month after January 2010, the enrollment pe18 riod shall begin on the first day of the second 

19 month before the month in which the individual 

20 first is eligible to so enroll and shall end four 

21 months later. Any such enrollment before the 

22 first day of the third month of such enrollment 

23 period is conditioned upon compliance with the 

24 conditions of eligibility for such third month. 


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1 ‘‘(2) AUTHORITY TO CORRECT FOR GOVERN2 MENT ERRORS.—The provisions of section 1837(h) 

3 apply with respect to enrollment under this part in 

4 the same manner as they apply to enrollment under 

5 part B. 

6 ‘‘(c) DATE COVERAGE BEGINS.— 

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

8 an individual is entitled to benefits under this part 

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

10 January 1, 2010: 

11 ‘‘(A) In the case of an individual who en12 rolls (including pre-enrolls) before the month in 

13 which the individual satisfies eligibility for en14 rollment under section 1860E–1, the first day 

15 of such month of eligibility. 

16 ‘‘(B) In the case of an individual who en17 rolls during or after the month in which the in18 dividual first satisfies eligibility for enrollment 

19 under such section, the first day of the fol20 lowing month. 

21 ‘‘(2) AUTHORITY TO PROVIDE FOR PARTIAL

22 MONTHS OF COVERAGE.—Under regulations, the 

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

24 for coverage periods that include portions of a 

25 month in order to avoid lapses of coverage. 


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

2 may be made under this title with respect to the ex3 penses of an individual enrolled under this part un4 less such expenses were incurred by such individual 

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

6 is a coverage period under this section. 

7 ‘‘(d) TERMINATION OF COVERAGE.— 

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

9 period under this part shall continue until the indi10 vidual’s enrollment has been terminated at the ear11 liest of the following: 

12 ‘‘(A) GENERAL PROVISIONS.— 

13 ‘‘(i) NOTICE.—The individual files no14 tice (in a form and manner prescribed by 

15 the Secretary) that the individual no 

16 longer wishes to participate in the insur17 ance program under this part. 

18 ‘‘(ii) NONPAYMENT OF PREMIUMS.— 

19 The individual fails to make payment of 

20 premiums required for enrollment under 

21 this part. 

22 ‘‘(iii) MEDICARE ELIGIBILITY.—The 

23 individual becomes entitled to benefits or 

24 enrolled under any other part of this title 

25 (other than by reason of this part). 


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

2 individual attains 65 years of age. 

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

4 ‘‘(A) NOTICE.—The termination of a cov5 erage period under paragraph (1)(A)(i) shall 

6 take effect at the close of the month following 

7 for which the notice is filed. 

8 ‘‘(B) NONPAYMENT OF PREMIUM.—The 

9 termination of a coverage period under para10 graph (1)(A)(ii) shall take effect on a date de11 termined under regulations, which may be de12 termined so as to provide a grace period in 

13 which overdue premiums may be paid and cov14 erage continued. The grace period determined 

15 under the preceding sentence shall not exceed 

16 60 days; except that it may be extended for an 

17 additional 30 days in any case where the Sec18 retary determines that there was good cause for 

19 failure to pay the overdue premiums within 

20 such 60-day period. 

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

22 The termination of a coverage period under 

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

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

25 individual attains 65 years of age or becomes 


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1 entitled to benefits or enrolled in any other part 

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

3 ‘‘SEC. 1860E–3. PREMIUMS. 

4 ‘‘(a) AMOUNT OF MONTHLY PREMIUMS.—The Sec5 retary shall, during September of each year (beginning 

6 with 2009), determine a monthly premium for individuals 

55 years of age or older, equal to 1 7 ⁄12 of the annual pre8 mium computed under subsection (b)(2), which shall apply 

9 with respect to coverage provided under this title for any 

10 month in the succeeding year. 

11 ‘‘(b) ANNUAL PREMIUM.— 

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

13 Secretary shall estimate the average, annual per 

14 capita amount that would be payable under this title 

15 with respect to individuals residing in the United 

16 States who meet the requirement of section 1860E– 

17 1(b)(1)(A) as if all such individuals were eligible for 

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

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

20 apply). 

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

22 under this subsection for months in a year is equal 

23 to the average, annual per capita amount estimated 

24 under paragraph (1) for the year. 


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

2 ‘‘(a) PAYMENT OF MONTHLY PREMIUM.— 

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

4 for payment and collection of the monthly premium, 

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

6 the individual involved, in the same manner as for 

7 payment of monthly premiums under section 1840, 

8 except that, for purposes of applying this section, 

9 any reference in such section to the Federal Supple10 mentary Medical Insurance Trust Fund is deemed a 

11 reference to the Trust Fund established under sec12 tion 1860E–6. 

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

14 individual who participates in the program estab15 lished by this title, the monthly premium shall be 

16 payable for the period commencing with the first 

17 month of the individual’s coverage period and ending 

18 with the month in which the individual’s coverage 

19 under this title terminates. 

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

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

22 shall apply to premiums collected under this section in the 

23 same manner as they apply to premiums collected under 

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

25 Federal Supplementary Medical Insurance Trust Fund is 


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1 deemed a reference to the Trust Fund established under 

2 section 1860E–6. 

3 ‘‘SEC. 1860E–5. PROVISIONS RELATING TO EMPLOYMENT4 BASED RETIREE HEALTH COVERAGE. 

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

6 would be eligible to enroll under this part but for the pro7 vision of employment-based retiree health coverage by an 

8 employer to the individual, notwithstanding the limitation 

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

10 to enroll under this part. 

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

12 employer that offers employment-based retiree health cov13 erage to an individual who enrolls under this part, upon 

14 enrollment of the individual under this part, the employer 

15 may modify such coverage to provide for the following ben16 efits: 

17 ‘‘(1) Payment is made by the employer under 

18 such coverage for items and services for which pay19 ment may not be made under this title. 

20 ‘‘(2) Payment is made by the employer spon21 soring such coverage of 25 percent of the monthly 

22 premium under section 1860E–3 applicable to the 

23 individual after enrollment under this part. 

24 ‘‘(c) EMPLOYMENT-BASED RETIREE HEALTH COV25 ERAGE.—The term ‘employment-based retiree health covVerDate Aug 31 2005 02:27 Nov 22, 2008 Jkt 079200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S3710.IS S3710

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1 erage’ has the meaning given that term in section 1860D– 

2 22(c)(1), except that, for purposes of this part, the ref3 erence in such section to ‘part D eligible individuals’ is 

4 deemed to be a reference to ‘individuals eligible to enroll 

5 under part E’. 

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

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

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

9 the books of the Treasury of the United States a 

10 trust fund to be known as the ‘Medicare Early Ac11 cess Trust Fund’ (in this section referred to as the 

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

13 gifts and bequests as may be made as provided in 

14 section 201(i)(1) and such amounts as may be de15 posited in, or appropriated to, such fund as provided 

16 in this title. 

17 ‘‘(2) PREMIUMS.—Premiums collected under 

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

19 5(a)(2) shall be transferred to the Trust Fund. 

20 ‘‘(b) INCORPORATION OF PROVISIONS.— 

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

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

23 apply with respect to the Trust Fund and this title 

24 in the same manner as they apply with respect to 


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1 the Federal Supplementary Medical Insurance Trust 

2 Fund and part B, respectively. 

3 ‘‘(2) MISCELLANEOUS REFERENCES.—In apply4 ing provisions of section 1841 under paragraph 

5 (1)— 

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

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

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

9 section 1840(d) and in section 1841(i) to sec10 tions 1840(b)(1) and 1842(g) are deemed ref11 erences to comparable authority exercised under 

12 this part; and 

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

14 1841(g) to the Trust Funds under sections 

15 1817 and 1841 as reimbursement to such funds 

16 for payments they made for benefits provided 

17 under this part. 

18 ‘‘SEC. 1860E–7. OVERSIGHT AND ACCOUNTABILITY. 

19 ‘‘(a) ANNUAL REPORTS OF TRUSTEES.—The Board 

20 of Trustees of the Medicare Early Access Trust Fund 

21 under section 1860E–6(b)(1) shall report on an annual 

22 basis to Congress concerning the status of the Trust Fund 

23 and the need for adjustments in the program under this 

24 part to maintain financial solvency of the program under 

25 this part. 


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

2 General of the United States shall periodically submit to 

3 Congress reports on the adequacy of the financing of cov4 erage provided under this part. The Comptroller General 

5 shall include in such report such recommendations for ad6 justments in such financing and coverage as the Comp7 troller General deems appropriate in order to maintain fi8 nancial solvency of the program under this part. 

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

10 ‘‘(a) TREATMENT FOR PURPOSES OF TITLE.—Ex11 cept as otherwise provided in this part— 

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

13 be treated for purposes of this title as though the in14 dividual were entitled to benefits and enrolled under 

15 any part of this title; and 

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

17 shall be payable under this title to such individuals 

18 in the same manner as if such individuals were so 

19 entitled and enrolled. 

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

21 PURPOSES OF MEDICAID PROGRAM.—For purposes of ap22 plying title XIX (including the provision of medicare cost23 sharing assistance under such title), an individual who is 

24 enrolled under this part shall not be treated as being enti25 tled to benefits under this title. 


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

2 PURPOSES OF COBRA CONTINUATION PROVISIONS.—In 

3 applying a COBRA continuation provision (as defined in 

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

5 reference to an entitlement to benefits under this title 

6 shall not be construed to include entitlement to benefits 

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

8 (b) CONFORMING AMENDMENTS TO SOCIAL SECU9 RITY ACT PROVISIONS.—(1) Section 201(i)(1) of the So10 cial Security Act (42 U.S.C. 401(i)(1)) is amended— 

11 (A) by striking ‘‘or the Federal Supplementary 

12 Medical Insurance Trust Fund’’ and inserting ‘‘the 

13 Federal Supplementary Medical Insurance Trust 

14 Fund’’; and 

15 (B) by inserting ‘‘, or the Medicare Early Ac16 cess Trust Fund’’ after ‘‘such Trust Fund)’’. 

17 (2) Section 201(g)(1)(A) of the Social Security Act 

18 (42 U.S.C. 401(g)(1)(A)), in the matter preceding clause 

19 (i), is amended by striking ‘‘and the Federal Supple20 mentary Medical Insurance Trust Fund established by 

21 title XVIII’’ and inserting ‘‘, the Federal Supplementary 

22 Medical Insurance Trust Fund, and the Medicare Early 

23 Access Trust Fund established by title XVIII’’. 


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1 (3) Section 1820(i) of the Social Security Act (42 

2 U.S.C. 1395i–4(i)) is amended by striking ‘‘part D’’ and 

3 inserting ‘‘part F’’. 

4 (4) Section 1853 of the Social Security Act (42 

5 U.S.C. 1395w–23) is amended by adding at the end the 

6 following new subsection: 

7 ‘‘(l) ADJUSTMENT FOR EARLY ACCESS.—For years 

8 beginning with 2010, in applying this section with respect 

9 to individuals entitled to benefits under part E, the Sec10 retary shall provide for an appropriate adjustment in the 

11 payment amount determined under this section or section 

12 1858, as may be appropriate to reflect differences between 

13 the population served under such part and the population 

14 under parts A and B.’’. 

15 (5) Section 1860D–15(c)(1) of the Social Security 

16 Act (42 U.S.C. 1395w–115(c)(1)) is amended by adding 

17 at the end the following new subparagraph: 

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

19 In applying this section with respect to individ20 uals entitled to benefits under part E, the Sec21 retary shall provide for an appropriate adjust22 ment in the payment amount determined under 

23 this section as may be appropriate to reflect dif24 ferences between the population served under 


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1 such part and the population under parts A and 

2 B.’’. 

3 (c) CONFORMING REFERENCE TO PREVIOUS PART

4 E.—Any reference in law (in effect before the date of the 

5 enactment of this Act) to part E of title XVIII of the So6 cial Security Act is deemed a reference to part F of such 

7 title (as in effect after such date). 

8 (d) OTHER CONFORMING AMENDMENTS.—(1) Sec9 tion 602(2)(D)(ii) of the Employee Retirement Income Se10 curity Act of 1974 (29 U.S.C. 1162(2)(D)(ii)) is amended 

11 by inserting ‘‘(not including benefits under section 

12 1860E–1 of such Act)’’ after ‘‘Social Security Act’’. 

13 (2) Section 2202(2)(D)(ii) of the Public Health Serv14 ice Act (42 U.S.C. 300bb–2(2)(D)(ii)) is amended by in15 serting ‘‘(not including benefits under section 1860E–1 of 

16 such Act)’’ after ‘‘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 benefits under section 1860E–1 of such Act)’’ after 

20 ‘‘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 inserting after section 36 the following new section: 

13 ‘‘SEC. 36A. MEDICARE EARLY ACCESS PREMIUMS. 

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

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

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

17 75 percent of the amount paid during such year as medi18 care early access coverage premiums. 

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

20 term ‘Medicare early access coverage premiums’ means 

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

22 Security Act. 

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

24 With respect to any taxable year, the amount which would 

25 (but for this subsection) be allowed as a credit under subVerDate Aug 31 2005 02:27 Nov 22, 2008 Jkt 079200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\S3710.IS S3710

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1 section (a) shall be reduced (but not below zero) by the 

2 aggregate amount paid on behalf of such taxpayer under 

3 section 7529 for such taxable year.’’. 

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

5 such Code (relating to miscellaneous provisions) is amend6 ed by adding at the end the following new section: 

7 ‘‘SEC. 7529. ADVANCE PAYMENT OF CREDIT FOR MEDICARE 

8 EARLY ACCESS PREMIUMS. 

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

10 a program for making payments on behalf of individuals 

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

12 Act to the Secretary of Health and Human Services for 

13 premiums payable by such individuals under such part. 

14 ‘‘(b) LIMITATION ON ADVANCE PAYMENTS DURING

15 ANY TAXABLE YEAR.—The Secretary may make pay16 ments under subsection (a) only to the extent that the 

17 total amount of such payments made on behalf of any indi18 vidual during the taxable year does not exceed the amount 

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

20 section 36A (determined without regard to subsection (c) 

21 thereof).’’. 

22 (c) CONFORMING AMENDMENTS.—(1) Section 

23 6211(b)(4)(A) of such Code is amended by inserting 

24 ‘‘36A,’’ after ‘‘36,’’. 


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1 (2) Paragraph (2) of section 1324(b) of title 31, 

2 United States Code, is amended by inserting ‘‘36A,’’ after 

3 ‘‘section 36,’’. 

4 (3) The table of sections for subpart C of part IV 

5 of subchapter A of chapter 1 of the Internal Revenue Code 

6 of 1986 is amended by inserting after the item relating 

7 to section 36 the following new item: 

‘‘36A. Medicare early access premiums.’’. 

8 (4) The table of sections for chapter 77 of such Code 

9 is amended by adding at the end the following new item: 

‘‘7529. Advance payment of credit for Medicare early access premiums.’’. 

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

11 this section shall apply to taxable years beginning after 

12 December 31, 2009. 

Æ 


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