I 

113TH CONGRESS 

2D SESSION H. R. 3966 

To amend titles XVIII and XIX of the Social Security Act to provide for 

equitable treatment of residents of the territories with respect to lowincome subsidies under the Medicare prescription drug benefit program, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 29, 2014 

Mr. PIERLUISI (for himself, Mrs. CHRISTENSEN, Ms. BORDALLO, Mr. 

SABLAN, Mr. FALEOMAVAEGA, Mr. GRAYSON, and Mr. RANGEL) 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 titles XVIII and XIX of the Social Security Act 

to provide for equitable treatment of residents of the 

territories with respect to low-income subsidies under 

the Medicare prescription drug benefit 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, 

3 SECTION 1. SHORT TITLE. 

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

5 Prescription Drug Assistance Equity Act of 2014’’. 


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1 SEC. 2. EQUITABLE TREATMENT OF RESIDENTS OF TERRI2 TORIES IN PREMIUM AND COST-SHARING 

3 SUBSIDIES UNDER MEDICARE PRESCRIPTION 

4 DRUG PROGRAM. 

5 (a) MEDICARE ASSISTANCE.—Section 1860D– 

6 14(a)(3) of the Social Security Act (42 U.S.C. 1395w– 

7 114(a)(3)) is amended by striking subparagraph (F). 

8 (b) MEDICAID ASSISTANCE.—Section 1935 of the So9 cial Security Act (42 U.S.C. 1396v) is amended— 

10 (1) in subsection (c)(1)(A)— 

11 (A) by inserting ‘‘(and each other State for 

12 each month beginning with January 2016)’’ 

13 after ‘‘January 2006’’; and 

14 (B) in clause (i), by inserting ‘‘or (2)(B) 

15 (as the case may be)’’ after ‘‘paragraph 

16 (2)(A)’’; 

17 (2) in subsection (c)(2)— 

18 (A) in subparagraph (A)— 

19 (i) by amending the heading to read 

20 as follows: ‘‘COMPUTATION FOR 50 STATES

21 AND THE DISTRICT OF COLUMBIA’’; and 

22 (ii) by striking ‘‘a State described in 

23 paragraph (1)’’ and inserting ‘‘one of the 

24 50 States or the District of Columbia’’; 

25 (B) in subparagraph (B)— 


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1 (i) by striking ‘‘subparagraph (A)’’ 

2 and inserting ‘‘subparagraph (A) or (B) 

3 (as the case may be)’’; and 

4 (ii) by redesignating such subpara5 graph as subparagraph (C); and 

6 (C) by inserting after subparagraph (A) 

7 the following new subparagraph: 

8 ‘‘(B) COMPUTATION FOR TERRITORIES.— 

9 The amount computed under this paragraph for 

10 a State not described in subparagraph (A) and 

11 for a month in a year (beginning with 2016) is 

12 equal to— 

‘‘(i) 1 13 ⁄12 of the product of— 

14 ‘‘(I) the amount determined 

15 under subsection (e) for the State for 

16 2015; and 

17 ‘‘(II) 100 percent minus the 

18 highest possible Federal medical as19 sistance percentage that may be ap20 plied to any of the 50 States for fiscal 

21 year 2014 under section 1905(b)(1); 

22 and 

23 ‘‘(ii) increased for each year ((begin24 ning with 2016) up to and including the 

25 year involved) by the applicable growth 


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1 factor specified in paragraph (4) for that 

2 year.’’; and 

3 (3) in subsection (e)— 

4 (A) in paragraph (1)— 

5 (i) in subparagraph (A), by striking 

6 ‘‘of such State; and’’ and inserting ‘‘of 

7 such State for years before 2016;’’; 

8 (ii) in subparagraph (B)— 

9 (I) by inserting ‘‘for periods be10 fore January 1, 2016’’ after ‘‘(B)’’; 

11 and 

12 (II) by striking the period at the 

13 end and inserting ‘‘; and’’; and 

14 (iii) by adding at the end the fol15 lowing new subparagraph: 

16 ‘‘(C) for the first 3 quarters of fiscal year 

17 2016 and for each subsequent fiscal year, the 

18 amount otherwise applied under section 1108(f) 

19 for the State shall be increased by the amount 

20 specified in paragraph (4)(A) for such period or 

21 fiscal year.’’; 

22 (B) in paragraph (2), by striking ‘‘The 

23 Secretary’’ and inserting ‘‘For periods before 

24 January 2016, the Secretary’’; 

25 (C) in paragraph (3)— 


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1 (i) in the heading, by inserting ‘‘BE2 FORE SECOND QUARTER OF FISCAL YEAR

3 2016’’ after ‘‘INCREASED AMOUNT’’; 

4 (ii) in subparagraph (A)— 

5 (I) in the matter before clause 

6 (i), by inserting ‘‘or other fiscal pe7 riod’’ after ‘‘for a year’’; and 

8 (II) in clause (i), by inserting 

9 ‘‘for such year or period’’ after ‘‘sub10 paragraph (B)’’; and 

11 (iii) in subparagraph (B)— 

12 (I) in clause (ii), by striking ‘‘or’’ 

13 at the end; 

14 (II) in clause (iii), by striking ‘‘in 

15 a subsequent year’’ and inserting ‘‘in 

16 a subsequent fiscal year (before the 

17 second quarter of fiscal year 2016)’’ 

18 and by striking the period at the end 

19 and inserting ‘‘; and’’; and 

20 (III) by adding at the end the 

21 following: 

22 ‘‘(iv) for the first quarter of fiscal 

23 year 2016, is equal to 25 percent of the 

24 aggregate amount specified in this sub25 paragraph for the previous fiscal year inVerDate Mar 15 2010 04:38 Feb 01, 2014 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3966.IH H3966

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1 creased by the annual percentage increase 

2 specified in section 1860D–2(b)(6) for the 

3 year involved.’’; 

4 (D) by striking paragraph (4); and 

5 (E) by inserting after paragraph (3) the 

6 following new paragraph: 

7 ‘‘(4) INCREASED AMOUNT BEGINNING WITH

8 SECOND QUARTER OF FISCAL YEAR 2016.— 

9 ‘‘(A) IN GENERAL.—The amount specified 

10 in this paragraph for a State for the last 3 

11 quarters of fiscal year 2016 or for a subsequent 

12 fiscal year is equal to the product of— 

13 ‘‘(i) the aggregate amount specified in 

14 subparagraph (B) for such period or fiscal 

15 year; and 

16 ‘‘(ii) the ratio (as estimated by the 

17 Secretary) of— 

18 ‘‘(I) the number of individuals 

19 who are entitled to benefits under 

20 part A or enrolled under part B and 

21 who reside in the State (as deter22 mined by the Secretary based on the 

23 most recent available data before the 

24 beginning of the period or year); to 


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1 ‘‘(II) the sum of such numbers 

2 for all States that are subject to this 

3 subsection. 

4 ‘‘(B) AGGREGATE AMOUNT.—The aggre5 gate amount specified in this subparagraph 

6 for— 

7 ‘‘(i) the last 3 quarters of fiscal year 

8 2016, is equal to 3 times the amount spec9 ified in paragraph (3)(B)(iv); 

10 ‘‘(ii) fiscal year 2017, is equal to 4 

11 times the amount specified in paragraph 

12 (3)(B)(iv) increased by the same annual 

13 percentage increase as is applied to in14 creases in the amounts applied for the fis15 cal year and State under section 1108(f); 

16 or 

17 ‘‘(iii) a subsequent fiscal year, is equal 

18 to the aggregate amount specified in this 

19 subparagraph for the previous fiscal year 

20 increased by the same annual percentage 

21 increase as is applied for the fiscal year 

22 and State under section 1108(f).’’. 

23 (c) CONFORMING AMENDMENTS.— 


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1 (1) Section 1108(f) of the Social Security Act 

2 (42 U.S.C. 1308(f)) is amended by striking 

3 ‘‘1935(e)(1)(B)’’ and inserting ‘‘1935(e)(1)’’. 

4 (2) Section 1860D–14(a)(3)(C) of the Social 

5 Security Act (42 U.S.C. 1395w–114(a)(3)(C)) is 

6 amended by adding at the end the following: ‘‘The 

7 poverty line to be applied in the territories shall be 

8 the same as the poverty line applied to States in the 

9 continental United States.’’. 

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

11 subsections (a) and (c)(2) shall be effective as of January 

12 1, 2016, and the amendments made by subsections (b) and 

13 (c)(1) shall take effect on the date of the enactment of 

14 this Act. 

Æ 


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