II 

116TH CONGRESS 

1ST SESSION S. 1928 

To amend title XVIII of the Social Security Act to improve the enrollment 

of retiring individuals in the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

JUNE 20, 2019 

Mr. PORTMAN (for himself and Mr. CASEY) 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 to improve 

the enrollment of retiring individuals in the Medicare 

program. 

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 ‘‘Enrollment Reshaping 

5 Entry For Older, Retiring Members Act’’ or the ‘‘Enroll6 ment REFORM Act’’. 


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1 SEC. 2. COORDINATION OF MEDICARE BENEFITS WITH 

2 OTHER HEALTH CARE INSURANCE. 

3 (a) IN GENERAL.—Section 1862(b)(1)(A) of the So4 cial Security Act (42 U.S.C. 1395y(b)(1)(A)) is amended 

5 by adding at the end the following new clause: 

6 ‘‘(vi) COORDINATION OF BENEFITS

7 WITH OTHER HEALTH CARE INSURANCE.— 

8 Notwithstanding any other provision of 

9 law, in the event that an individual is en10 rolled in an employer group health plan 

11 (including a multiemployer or multiple em12 ployer group health plan) by virtue of cur13 rent employment status with an employer 

14 that does not have 20 or more individuals 

15 in current employment status for each 

16 working day in each of 20 or more cal17 endar weeks in the current calendar year 

18 and the preceding calendar year and the 

19 individual is eligible but not enrolled in 

20 coverage under part B, such employer 

21 group health plan shall not reduce benefits 

22 under the plan with respect to the indi23 vidual on the basis that the individual 

24 could have been enrolled in coverage under 

25 part B. Nothing in the preceding sentence 

26 shall require such employer group health 


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1 plan to provide coverage to an individual 

2 who elects to enroll in coverage under part 

3 B or to prohibit such plan from termi4 nating such coverage or reducing benefits 

5 if such individual makes such election.’’. 

6 (b) EFFECTIVE DATE.—The amendment made by 

7 subsection (a) shall apply to items and services furnished 

8 on or after the date of the enactment of this Act. 

9 SEC. 3. LIMITATION ON DOCUMENTATION AN INDIVIDUAL 

10 IS REQUIRED TO PROVIDE IN ORDER TO 

11 DEMONSTRATE EMPLOYMENT-BASED 

12 HEALTH INSURANCE FOR PURPOSES OF 

13 AVOIDING THE PART B LATE ENROLLMENT 

14 PENALTY. 

15 (a) IN GENERAL.—Section 1839 of the Social Secu16 rity Act (42 U.S.C. 1395r) is amended— 

17 (1) in subsection (b), in the second sentence, by 

18 striking ‘‘For purposes’’ and inserting ‘‘Subject to 

19 subsection (j), for purposes’’; and 

20 (2) by adding at the end the following new sub21 section: 

22 ‘‘(j) LIMITATION ON DOCUMENTATION AN INDI23 VIDUAL IS REQUIRED TO PROVIDE IN ORDER TO DEM24 ONSTRATE EMPLOYMENT-BASED HEALTH INSURANCE


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1 FOR PURPOSES OF AVOIDING THE LATE ENROLLMENT

2 PENALTY.— 

3 ‘‘(1) LIMITATION.—Subject to paragraph (2), 

4 for purposes of demonstrating enrollment in a group 

5 health plan or a large group health plan for a period 

6 of time under the second sentence of subsection (b), 

7 the Secretary may not require an individual to pro8 vide documentation of such enrollment for more 

9 than the 36-month period immediately preceding the 

10 close of the enrollment period in which the individual 

11 enrolled (or reenrolled). 

12 ‘‘(2) LIMITATION NOT APPLICABLE IF INDI13 VIDUAL IS UNABLE TO PROVIDE DOCUMENTATION

14 FOR ENTIRE 36-MONTH PERIOD.—In the case where 

15 an individual is unable to provide documentation of 

16 enrollment described in paragraph (1) for the entire 

17 preceding 36-month period described in such para18 graph, the limitation under paragraph (1) shall not 

19 apply. 

20 ‘‘(3) INDIVIDUAL CAN PROVIDE ADDITIONAL

21 DOCUMENTATION.—Nothing in this subsection shall 

22 preclude an individual from providing the Secretary 

23 with documentation of enrollment for periods prior 

24 to the preceding 36-month period described in para25 graph (1), including in the case where the limitation 


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1 under paragraph (1) does not apply because of the 

2 application of paragraph (2).’’. 

3 (b) EFFECTIVE DATE.—The amendment made by 

4 subsection (a) shall apply to calculations of premiums 

5 under such section 1839 made on or after the date of the 

6 enactment of this Act. 

Æ 


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