II

106TH CONGRESS

1ST SESSION S. 1918

To waive the 24-month waiting period for disabled individuals to qualify

for Medicare benefits in the case of individuals suffering from terminal

illnesses with not more than 2 years to live.

IN THE SENATE OF THE UNITED STATES

NOVEMBER 10, 1999

Mrs. BOXER introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To waive the 24-month waiting period for disabled individuals to qualify for Medicare benefits in the case of individuals suffering from terminal illnesses with not more

than 2 years to live.

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 for Individ5 uals With Terminal Illnesses Act of 1999’’.
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1 SEC. 2. ELIMINATION OF MEDICARE WAITING PERIOD FOR

2 INDIVIDUALS WITH A TERMINAL ILLNESS.

3 (a) IN GENERAL.—Section 226 of the Social Security

4 Act (42 U.S.C. 426) is amended by adding at the end the

5 following:

6 ‘‘(j)(1) Notwithstanding subsection (f), each indi7 vidual with a terminal illness (as defined in paragraph (2))

8 who would be described in subsection (b) but for the re9 quirement that the individual has been entitled to the

10 specified benefits for 24 months shall be entitled to hos11 pital insurance benefits under part A of title XVIII for

12 each month beginning with the latest of—

13 ‘‘(A) the first month after the expiration of the

14 24-month period,

15 ‘‘(B) in the case of a qualified railroad retire16 ment beneficiary (as defined in subsection (d)), the

17 first month of the individual’s entitlement or status

18 as such a beneficiary, or

19 ‘‘(C) the date of enactment of the Medicare for

20 Individuals With Terminal Illnesses Act of 1999.

21 ‘‘(2) As used in this subsection, the term ‘terminal

22 illness’ means a medically determinable physical impair23 ment which is expected to result in the death of such indi24 vidual within the next 24 months.’’.

25 (b) CONFORMING AMENDMENTS.—
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1 (1) AMENDMENTS TO THE RAILROAD RETIRE2 MENT ACT OF 1974.—Section 7(d)(2) of the Rail3 road Retirement Act of 1974 (45 U.S.C. 231f(d)(2))

4 is amended—

5 (A) in clause (i), by striking ‘‘or’’ at the

6 end;

7 (B) in clause (ii), by striking the comma at

8 the end and inserting ‘‘; or’’; and

9 (C) by inserting after clause (ii) the fol10 lowing:

11 ‘‘(iii)(I) has not attained age 65;

12 ‘‘(II) has a terminal illness (as defined in sec13 tion 226(j)(2) of the Social Security Act); and

14 ‘‘(III) is entitled to an annuity under section 2

15 of this Act, or under the Railroad Retirement Act of

16 1937 and section 2 of this Act, or could have been

17 includable in the computation of an annuity under

18 section 3(f)(3) of this Act, and could currently be

19 entitled to monthly insurance benefits under section

20 223 of the Social Security Act or under section 202

21 of that Act on the basis of disability if service as an

22 employee after December 31, 1936, had been in23 cluded in the term ‘employment’ as defined in that

24 Act and if an application for disability benefits had

25 been filed,’’.
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1 (2) AMENDMENTS TO THE SOCIAL SECURITY

2 ACT.—

3 (A) DESCRIPTION OF PROGRAM.—Section

4 1811 of the Social Security Act (42 U.S.C.

5 1395c) is amended by striking ‘‘and (3)’’ and

6 inserting ‘‘(3) individuals under age 65 who

7 have a terminal illness (as defined in section

8 226(j)(2)) and who are eligible for benefits

9 under title II of this Act (or would have been

10 so entitled to such benefits if certain govern11 ment employment were covered under such

12 title) or under the railroad retirement system

13 on the basis of a disability, and (4)’’.

14 (B) HOSPITAL INSURANCE BENEFITS FOR

15 DISABLED INDIVIDUALS WHO HAVE EXHAUSTED

16 THEIR ENTITLEMENT.—Section 1818A of the

17 Social Security Act (42 U.S.C. 1395i–2a) is

18 amended—

19 (i) in subsection (a)(2)(A), by striking

20 ‘‘section 226(b)’’ and inserting ‘‘subsection

21 (b) or (j) of section 226’’;

22 (ii) in subsection (a)(2)(C), by strik23 ing ‘‘section 226(b)’’ and inserting ‘‘sub24 section (b) or (j) of section 226’’;
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1 (iii) in subsection (b)(2), by striking

2 ‘‘section 226(b)’’ and inserting ‘‘subsection

3 (b) or (j) of section 226’’; and

4 (iv) in subsection (d)(1)(B)(ii), by

5 striking ‘‘section 226(b)’’ and inserting

6 ‘‘subsection (b) or (j) of section 226’’.

7 (C) ENROLLMENT PERIODS.—Section

8 1837 of the Social Security Act (42 U.S.C.

9 1395p) is amended—

10 (i) in subsection (g)(1), by inserting

11 ‘‘but does not satisfy the requirements of

12 section 226(j)’’ after ‘‘section 226(b)’’; and

13 (ii) in subsection (i)(4)(A), by striking

14 ‘‘section 226(b)’’ and inserting ‘‘subsection

15 (b) or (j) of section 226’’.

16 (D) EXCLUSIONS FROM COVERAGE AND

17 MEDICARE AS SECONDARY PAYER.—Section

18 1862(b)(1)(B)(i) of the Social Security Act (42

19 U.S.C. 1395y(b)(1)(B)(i)) is amended by strik20 ing ‘‘section 226(b)’’ and inserting ‘‘subsection

21 (b) or (j) of section 226’’.

22 (c) EFFECTIVE DATE.—The amendments made by

23 this Act shall apply with respect to any application for

24 hospital insurance benefits submitted to the Secretary of
6

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1 Health and Human Services on or after the date of enact2 ment of this Act.

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