I 

111TH CONGRESS 

2D SESSION H. R. 4789 

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

for any citizen or permanent resident of the United States to buy 

into Medicare. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 9, 2010 

Mr. GRAYSON (for himself, Mr. FILNER, Mr. POLIS of Colorado, Ms. PINGREE

of Maine, Ms. SHEA-PORTER, Ms. SCHAKOWSKY, Mr. FRANK of Massachusetts, Mr. KUCINICH, Ms. EDWARDS of Maryland, Ms. WATSON, and 

Ms. JACKSON LEE of Texas) introduced the following bill; which was referred to the Committee on Ways and Means 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for an option for any citizen or permanent resident of 

the United States to buy into Medicare. 

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 ‘‘Public Option Act’’ 

5 or the ‘‘Medicare You Can Buy Into Act’’. 

6 SEC. 2. UNIVERSAL MEDICARE BUY-IN OPTION. 

7 (a) IN GENERAL.—Part A of title XVIII of the Social 

8 Security Act is amended— 


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1 (1) in section 1818(a), by striking ‘‘or 1818A’’ 

2 and inserting ‘‘, 1818A, or 1818B’’; and 

3 (2) by inserting after section 1818A the fol4 lowing new section: 

5 ‘‘UNIVERSAL BUY-IN

6 ‘‘SEC. 1818B. 

7 ‘‘(a) IN GENERAL.—(a) Every individual who— 

8 ‘‘(1) is a resident of the United States; 

9 ‘‘(2) is either (A) a citizen or national of the 

10 United States, or (B) an alien lawfully admitted for 

11 permanent residence; and 

12 ‘‘(3) is not otherwise entitled to benefits under 

13 this part or eligible to enroll under this part; 

14 shall be eligible to enroll in the insurance program estab15 lished by this part. An individual may enroll under this 

16 section only in such manner and form as may be pre17 scribed in regulations, and only during an enrollment pe18 riod prescribed in or under this section. 

19 ‘‘(b) ENROLLMENT; COVERAGE.—The Secretary shall 

20 establish enrollment periods and coverage under this sec21 tion consistent with the principles for establishment of en22 rollment periods and coverage for individuals under sec23 tion 1818, except that no entitlement to benefits under 

24 this part shall be effective before the first day of the first 

25 calendar year beginning after the date of the enactment 

26 of this Act. 


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1 ‘‘(c) PREMIUMS.— 

2 ‘‘(1) IN GENERAL.—The provisions of sub3 sections (d)(1), (d)(2), and (d)(3) of section 1818 

4 insofar as they apply to premiums (including collec5 tion of premiums) shall apply to premiums and col6 lection of premiums under this section, except 

7 that— 

8 ‘‘(A) paragraphs (4) and (5) of section 

9 1818 shall not be applicable; and 

10 ‘‘(B) the estimate of the monthly actuarial 

11 rate under section 1818(d) shall be computed 

12 and applied under this paragraph based upon 

13 costs incurred for individuals within each age 

14 cohort specified in paragraph (2) rather than 

15 for all individuals age 65 and older. 

16 ‘‘(2) AGE COHORTS.—The age cohorts specified 

17 in this paragraph are as follows: 

18 ‘‘(A) Individuals under 19 years of age. 

19 ‘‘(B) Individuals at least 19 years of age 

20 but not more than 25 years of age. 

21 ‘‘(C) Individuals at least 26 years of age 

22 and not more than 35 years of age. 

23 ‘‘(D) Individuals at least 36 years of age 

24 and not more than 45 years of age. 


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1 ‘‘(E) Individuals at least 46 years of age 

2 and not more than 55 years of age. 

3 ‘‘(F) Individuals at least 56 years of age 

4 and not more than 64 years of age. 

5 ‘‘(d) TREATMENT.—An individual enrolled under this 

6 part pursuant to this section shall not be treated as en7 rolled under this part (or any other part of this title) for 

8 purposes of obtaining medical assistance for medicare 

9 cost-sharing or otherwise under title XIX.’’. 

Æ 


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