I 

113TH CONGRESS 

1ST SESSION H. R. 500 

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 

FEBRUARY 5, 2013 

Mr. GRAYSON 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 (42 U.S.C. 1395c et seq.) is amended— 


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1 (1) in section 1818(a) (42 U.S.C. 1395i–2(a)), 

2 by striking ‘‘or 1818A’’ and inserting ‘‘, 1818A, or 

3 1818B’’; and 

4 (2) by inserting after section 1818A the fol5 lowing new section: 

6 ‘‘UNIVERSAL BUY-IN

7 ‘‘SEC. 1818B. (a) IN GENERAL.—(a) Every indi8 vidual who— 

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

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

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

12 permanent residence; and 

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

14 this part or eligible to enroll under this part; 

15 shall be eligible to enroll in the insurance program estab16 lished by this part. An individual may enroll under this 

17 section only in such manner and form as may be pre18 scribed in regulations, and only during an enrollment pe19 riod prescribed in or under this section. 

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

21 establish enrollment periods and coverage under this sec22 tion consistent with the principles for establishment of en23 rollment periods and coverage for individuals under sec24 tion 1818, except that no entitlement to benefits under 

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


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1 calendar year beginning after the date of the enactment 

2 of this Act. 

3 ‘‘(c) PREMIUMS.— 

4 ‘‘(1) IN GENERAL.—The provisions of sub5 sections (d)(1), (d)(2), and (d)(3) of section 1818 

6 insofar as they apply to premiums (including collec7 tion of premiums) shall apply to premiums and col8 lection of premiums under this section, except 

9 that— 

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

11 1818 shall not be applicable; and 

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

13 rate under section 1818(d) shall be computed 

14 and applied under this paragraph based upon 

15 costs incurred for individuals within each age 

16 cohort specified in paragraph (2) rather than 

17 for all individuals age 65 and older. 

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

19 in this paragraph are as follows: 

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

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

22 but not more than 25 years of age. 

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

24 and not more than 35 years of age. 


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

2 and not more than 45 years of age. 

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

4 and not more than 55 years of age. 

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

6 and not more than 64 years of age. 

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

8 part pursuant to this section shall not be treated as en9 rolled under this part (or any other part of this title) for 

10 purposes of obtaining medical assistance for medicare 

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

Æ 


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