II

106TH CONGRESS

1ST SESSION S. 1837

To amend title XIX of the Social Security Act to provide low-income medicare

beneficiaries with medical assistance for out-of-pocket expenditures for

outpatient prescription drugs.

IN THE SENATE OF THE UNITED STATES

NOVEMBER 1, 1999

Mr. BAUCUS introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To amend title XIX of the Social Security Act to provide

low-income medicare beneficiaries with medical assistance

for out-of-pocket expenditures for outpatient prescription

drugs.

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 ‘‘Healthy Seniors Act

5 of 1999’’.
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1 SEC. 2. PRESCRIPTION DRUG ASSISTANCE UNDER THE

2 MEDICAID PROGRAM.

3 (a) ELIGIBILITY.—Section 1902(a)(10) of the Social

4 Security Act (42 U.S.C. 1396a(a)(10)) is amended—

5 (1) in subparagraph (E)(iv)(II), by striking

6 ‘‘and’’ at the end;

7 (2) in subparagraph (F), by adding ‘‘and’’ at

8 the end; and

9 (3) by inserting after subparagraph (F) the fol10 lowing:

11 ‘‘(G) for making medical assistance de12 scribed in section 1905(v) available (but only

13 for prescribed drugs available under the State

14 plan furnished during fiscal year 2000 and each

15 fiscal year thereafter), for individuals who—

16 ‘‘(i) are not otherwise eligible for med17 ical assistance for prescribed drugs under

18 the State plan;

19 ‘‘(ii) are enrolled in part B of title

20 XVIII; and

21 ‘‘(iii) whose income does not exceed

22 175 percent of the official poverty line (as

23 defined by the Office of Management and

24 Budget, and revised annually in accord25 ance with section 673(2) of the Omnibus
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1 Budget Reconciliation Act of 1981) for a

2 family of the size involved;’’.

3 (b) BENEFIT.—Section 1905 of the Social Security

4 Act (42 U.S.C. 1396d) is amended by adding at the end

5 the following:

6 ‘‘(v)(1) For purposes of section 1902(a)(10)(G), the

7 medical assistance described in this subsection is the ap8 plicable percentage (determined under paragraph (2)) of

9 a low-income medicare beneficiary’s out-of-pocket expendi10 tures for prescribed drugs available under the State plan.

11 ‘‘(2) For purposes of paragraph (1), the applicable

12 percentage is—

13 ‘‘(A) in the case of a low-income medicare

14 beneficiary whose income does not exceed 100

15 percent of the official poverty line (as defined

16 by the Office of Management and Budget, and

17 revised annually in accordance with section

18 673(2) of the Omnibus Budget Reconciliation

19 Act of 1981 for a family of the size involved),

20 100 percent;

21 ‘‘(B) in the case of a low-income medicare

22 beneficiary whose income exceeds 100 but does

23 not exceed 125 percent of such poverty line, 75

24 percent;
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1 ‘‘(C) in the case of a low-income medicare

2 beneficiary whose income exceeds 125 but does

3 not exceed 150 percent of such poverty line, 50

4 percent; and

5 ‘‘(D) in the case of a low-income medicare

6 beneficiary whose income exceeds 150 but does

7 not exceed 175 percent of such poverty line, 25

8 percent.

9 ‘‘(3) In this subsection, the term ‘low-income medi10 care beneficiary’ means an individual described in section

11 1902(a)(10)(G).’’.

12 (c) CONFORMING AMENDMENT.—Section 1903(f)(4)

13 of the Social Security Act (42 U.S.C. 1396b(f)(4)) is

14 amended by striking ‘‘or 1905(u)’’ and inserting

15 ‘‘1905(u), or 1902(a)(10)(G)’’.

16 (d) EFFECTIVE DATE.—The amendments made by

17 this section shall apply to medical assistance provided be18 ginning with fiscal year 2000.

19 SEC. 3. PAYMENTS TO STATES FOR COSTS AT A FEDERAL

20 MATCHING RATE OF 100 PERCENT.

21 (a) IN GENERAL.—Section 1903 of the Social Secu22 rity Act (42 U.S.C. 1396b) is amended—

23 (1) in the first sentence of subsection (b), by in24 serting ‘‘and 1903(x)’’ after ‘‘1933(d)’’; and

25 (2) by adding at the end the following:
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1 ‘‘(x) With respect to medical assistance described in

2 section 1905(v) for individuals described in section

3 1902(a)(10)(G), and amounts expended for the proper

4 and efficient administration of such sections, the Federal

5 medical assistance percentage for such medical assistance

6 and amounts is equal to 100 percent.’’.

7 (b) EFFECTIVE DATE.—The amendments made by

8 subsection (a) shall apply to medical assistance provided

9 beginning with fiscal year 2000.

10 SEC. 4. ON-GOING STATE MAINTENANCE OF EFFORT.

11 Notwithstanding any other provision of law, the Sec12 retary of Health and Human Services shall reduce pay13 ments to a State under section 1903(a) of the Social Secu14 rity Act (42 U.S.C. 1396b(a)) for a calendar quarter in

15 a fiscal year to the extent that the Secretary determines

16 that, for a quarter beginning on or after January 1,

17 2000—

18 (1) the level of State expenditures for medicare

19 beneficiaries under any State-funded prescription

20 drug program for such quarter is less than the level

21 of such expenditures under such program during fis22 cal year 1999; or

23 (2) the level of State expenditures for medical

24 assistance provided to medicare beneficiaries under

25 title XIX of such Act (42 U.S.C. 1396 et seq.) for
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1 such quarter is less than the level of such expendi2 tures under such title during fiscal year 1999.

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