I 

111TH CONGRESS 

2D SESSION H. R. 5588 

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

opportunities to enroll under part B of the Medicare Program, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 23, 2010 

Mr. SCHRADER (for himself, Ms. SCHAKOWSKY, Ms. MATSUI, and Mr. 

LARSON of Connecticut) 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 

for additional opportunities to enroll under part B of 

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, 

3 SECTION 1. SHORT TITLE. 

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

5 Protection Act of 2010’’. 


smartinez on DSKB9S0YB1PROD with BILLS
2 

•HR 5588 IH

1 SEC. 2. MEDICARE PART B SPECIAL ENROLLMENT PERIOD 

2 FOR INDIVIDUALS ENROLLED IN COBRA CON3 TINUATION COVERAGE. 

4 (a) SPECIAL ENROLLMENT PERIOD.—Section 

5 1837(i) of the Social Security Act (42 U.S.C. 1395p(i)) 

6 is amended by adding at the end the following new para7 graph: 

8 ‘‘(5)(A) In the case of an individual who— 

9 ‘‘(i) at the time the individual first satisfies 

10 paragraph (1) or (2) of section 1836, is enrolled in 

11 COBRA continuation coverage, and 

12 ‘‘(ii) has elected not to enroll (or to be deemed 

13 enrolled) under this section during the individual’s 

14 initial enrollment period, 

15 there shall be a special enrollment period described 

16 in subparagraph (B). 

17 ‘‘(B) The special enrollment period referred to in sub18 paragraph (A) is the period including each month during 

19 any part of which the individual is enrolled in COBRA 

20 continuation coverage ending with the last day of the 

21 eighth consecutive month in which the individual is at no 

22 time so enrolled. 

23 ‘‘(C) An individual may only enroll during the special 

24 enrollment period provided under subparagraph (B) one 

25 time during the individual’s lifetime. 


smartinez on DSKB9S0YB1PROD with BILLS
3 

•HR 5588 IH

1 ‘‘(D) For purposes of this paragraph, the term 

2 ‘COBRA continuation coverage’ means continuation cov3 erage provided pursuant to part 6 of subtitle B of title 

4 I of the Employee Retirement Income Security Act of 

5 1974 (other than under section 609), title XXII of the 

6 Public Health Service Act, section 4980B of the Internal 

7 Revenue Code of 1986 (other than subsection (f)(1) of 

8 such section insofar as it relates to pediatric vaccines), or 

9 section 8905a of title 5, United States Code, or under a 

10 State program that provides comparable continuation cov11 erage. Such term does not include coverage under a health 

12 flexible spending arrangement under a cafeteria plan with13 in the meaning of section 125 of the Internal Revenue 

14 Code of 1986.’’. 

15 (b) COVERAGE PERIOD.—Section 1838(a)(2) of such 

16 Act (42 U.S.C. 1395q(a)(2)) is amended— 

17 (1) in subparagraph (E), by striking the semi18 colon and inserting a comma; and 

19 (2) by adding at the end the following new sub20 paragraph: 

21 ‘‘(F) in the case of an individual who enrolls 

22 pursuant to subsection (i)(5) of section 1837, the 

23 first day of the month following the month in which 

24 the individual so enrolls; or’’. 


smartinez on DSKB9S0YB1PROD with BILLS
4 

•HR 5588 IH

1 (c) NO INCREASE IN PREMIUM.—Section 1839(b) of 

2 such Act (42 U.S.C. 1395r(b)) is amended— 

3 (1) in the first sentence, by inserting ‘‘, (i)(5),’’ 

4 after ‘‘subsection (i)(4)’’; and 

5 (2) in the second sentence, by inserting before 

6 the period at the end the following: ‘‘or months for 

7 which the individual can demonstrate that the indi8 vidual was enrolled in COBRA continuation coverage 

9 (as such term is defined in section 1837(i)(5)(D)).’’. 

10 (d) EFFECTIVE DATE.— 

11 (1) IN GENERAL.—The amendments made by 

12 this section shall take effect on the date of the en13 actment of this Act and shall apply to periods of 

14 COBRA continuation coverage before, on, or after 

15 such date. 

16 (2) SPECIAL ENROLLMENT PERIOD.—No spe17 cial enrollment period under section 1837(i)(5)(B) of 

18 the Social Security Act (42 U.S.C. 1395p(i)(5)(B)) 

19 shall begin before the first day of the first month 

20 that begins at least 45 days after the date of the en21 actment of this Act. 

22 (3) PREMIUMS.—The amendment made by sub23 section (c)(2) shall apply to premiums for months 

24 beginning with the first month that begins at least 

25 45 days after the date of the enactment of this Act. 


smartinez on DSKB9S0YB1PROD with BILLS
5 

•HR 5588 IH

1 SEC. 3. CONTINUOUS OPEN MEDICARE PART B ENROLL2 MENT. 

3 (a) CONTINUOUS OPEN ENROLLMENT PERIOD.— 

4 Section 1837 of the Social Security Act (42 U.S.C. 1395p) 

5 is amended by adding at the end the following new sub6 section: 

7 ‘‘(m)(1) There shall be a continuous open enrollment 

8 period beginning on the first day of the first month in 

9 which an individual first satisfies paragraph (1) or (2) of 

10 section 1836, except that such continuous open enrollment 

11 period shall not be available during the individual’s initial 

12 enrollment period or a special enrollment period available 

13 to the individual. 

14 ‘‘(2) In the case of an individual seeking enrollment 

15 under paragraph (1) during a general enrollment period 

16 under subsection (e), the individual shall be enrolled under 

17 such subsection and not under paragraph (1), unless the 

18 individual specifies otherwise.’’. 

19 (b) COVERAGE PERIOD.—Section 1838(a)(2) of such 

20 Act (42 U.S.C. 1395q(a)(2)) is amended— 

21 (1) in subparagraph (F), as added by section 

22 2(b)(2), by striking the semicolon and inserting a 

23 comma; and 

24 (2) by adding at the end the following new sub25 paragraph: 


smartinez on DSKB9S0YB1PROD with BILLS
6 

•HR 5588 IH

1 ‘‘(G) in the case of an individual who enrolls 

2 pursuant to subsection (m) of section 1837, the first 

3 day of the month following the month in which such 

4 individual so enrolls; or’’. 

5 (c) PREMIUM INCREASE.—Section 1839 of such Act 

6 (42 U.S.C. 1395r) is amended by adding at the end the 

7 following new subsection: 

8 ‘‘(j) INCREASE IN PREMIUM BASED ON ENROLL9 MENT PURSUANT TO CONTINUOUS OPEN ENROLLMENT

10 PERIOD.—In the case of an individual whose coverage pe11 riod began pursuant to a continuous open enrollment pe12 riod under section 1837(m), the monthly premium deter13 mined under subsection (a), adjusted in accordance with 

14 subsection (i), shall, in addition to the increase required 

15 by subsection (b), be increased by such amount as the Sec16 retary considers appropriate, taking into account any ad17 ditional actuarial cost to the insurance program estab18 lished under this part due to enrollment under such sec19 tion. Any increase under this subsection shall apply to all 

20 premiums paid by the individual after enrollment pursuant 

21 to such continuous open enrollment period.’’. 

22 (d) REPORT TO CONGRESS.—Not later than 180 days 

23 after the date of the enactment of this Act, the Secretary 

24 of Health and Human Services shall submit to Congress 

25 a report describing— 


smartinez on DSKB9S0YB1PROD with BILLS
7 

•HR 5588 IH

1 (1) the average increase in premiums based on 

2 enrollment in the insurance program established 

3 under part B of title XVIII of the Social Security 

4 Act pursuant to a continuous open enrollment period 

5 under section 1837(m) of such Act, as added by sub6 section (a); 

7 (2) any other regulations promulgated by the 

8 Secretary with respect to such enrollment; 

9 (3) the number and characteristics of individ10 uals choosing such enrollment; and 

11 (4) any costs of such enrollment to such insur12 ance program that were not covered by the increases 

13 in premiums described in the amendment made by 

14 subsection (c). 

15 (e) EFFECTIVE DATE.—The amendments made by 

16 this section shall take effect on the date of the enactment 

17 of this Act, except that no individual may enroll pursuant 

18 to a continuous open enrollment period under the amend19 ment made by subsection (a) before the first day of the 

20 first month that begins at least 45 days after the date 

21 of the enactment of this Act. 


smartinez on DSKB9S0YB1PROD with BILLS
8 

•HR 5588 IH

1 SEC. 4. SPECIAL ENROLLMENT PERIODS TO CORRECT 

2 ERROR, MISREPRESENTATION, OR INACTION 

3 OF FEDERAL GOVERNMENT, GROUP HEALTH 

4 PLAN, OR PLAN SPONSOR. 

5 Section 1837(h) of the Social Security Act (42 U.S.C. 

6 1395p(h)) is amended by inserting ‘‘or by an officer, em7 ployee, or agent of a group health plan, or of a plan spon8 sor (as such term is defined in section 3(16)(B) of the 

9 Employee Retirement Income Security Act of 1974 (29 

10 U.S.C. 1002(16)(B))) of a group health plan,’’ after ‘‘in11 strumentalities,’’. 

12 SEC. 5. COORDINATION OF MEDICARE PART B WITH AMER13 ICAN HEALTH BENEFIT EXCHANGES. 

14 Section 1837 of the Social Security Act (42 U.S.C. 

15 1395p), as amended by section 3(a), is further amended 

16 by adding at the end the following new subsection: 

17 ‘‘(n) The Secretary shall ensure appropriate coordi18 nation between the insurance program established under 

19 this part and American Health Benefit Exchanges estab20 lished under section 1311(b) of the Patient Protection and 

21 Affordable Care Act (Public Law 111–148), including en22 suring a smooth transition in enrollment from enrollment 

23 in qualified health plans offered through Exchanges to en24 rollment under this part.’’. 


smartinez on DSKB9S0YB1PROD with BILLS
9 

•HR 5588 IH

1 SEC. 6. GAO STUDY AND REPORT ON MEDICARE PART B EN2 ROLLMENT. 

3 Not later than 2 years after the date of the enact4 ment of this Act, the Comptroller General of the United 

5 States shall submit to Congress a report on enrollment 

6 in the insurance program established under part B of title 

7 XVIII of the Social Security Act (in this section referred 

8 to as ‘‘Medicare part B’’). The report shall include— 

9 (1) a comprehensive evaluation of problems ex10 perienced by individuals with respect to enrollment 

11 in Medicare part B, including the causes of such 

12 problems and any geographic trends in the mani13 festation of such problems; 

14 (2) an assessment of the number of people who 

15 lack health insurance coverage because of such prob16 lems; 

17 (3) an evaluation of efforts by the Centers for 

18 Medicare & Medicaid Services and the Social Secu19 rity Administration to educate employers regarding 

20 the transition of employees from group health plans 

21 to Medicare part B; 

22 (4) an evaluation of coordination of coverage 

23 for individuals with private health insurance who are 

24 also eligible for Medicare part B and ways to im25 prove such coordination; 


smartinez on DSKB9S0YB1PROD with BILLS
10 

•HR 5588 IH

1 (5) an evaluation of the coordination between 

2 Medicare part B and American Health Benefit Ex3 changes required by the amendment made by section 

4 5; 

5 (6) an evaluation of the differences in regula6 tions applicable to individuals who are eligible for 

7 Medicare part B based on age and individuals who 

8 are eligible based on disability, and ways to improve 

9 parity in the treatment of each such group of indi10 viduals that may be implemented in regulations and 

11 guidance; and 

12 (7) an evaluation of efforts by the Centers for 

13 Medicare & Medicaid Services to provide equitable 

14 relief to individuals who suffered adverse con15 sequences due to misinformation or a lack of infor16 mation on enrollment in Medicare part B, and ways 

17 to improve the provision of such equitable relief. 

Æ 


smartinez on DSKB9S0YB1PROD with BILLS