```

[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 483 Enrolled Bill (ENR)]

        H.R.483

                       One Hundred Fourth Congress

                                 of the

                        United States of America

                          AT THE FIRST SESSION

         Begun and held at the City of Washington on Wednesday,
  the fourth day of January, one thousand nine hundred and ninety-five

                                 An Act

 
    To amend the Omnibus Budget Reconciliation Act of 1990 to permit 
          medicare select policies to be offered in all States.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. PERMITTING MEDICARE SELECT POLICIES TO BE OFFERED IN ALL 
              STATES FOR AN EXTENDED PERIOD.

    Section 4358(c) of the Omnibus Budget Reconciliation Act of 1990, 
as amended by section 172(a) of the Social Security Act Amendments of 
1994, is amended to read as follows:
    ``(c) Effective Date.--(1) The amendments made by this section 
shall only apply--
        ``(A) in 15 States (as determined by the Secretary of Health 
    and Human Services) and such other States as elect such amendments 
    to apply to them, and
        ``(B) subject to paragraph (2), during the 6\1/2\-year period 
    beginning with 1992.
For purposes of this paragraph, the term `State' has the meaning given 
such term by section 210(h) of the Social Security Act (42 U.S.C. 
410(h)).
    ``(2)(A) The Secretary of Health and Human Services shall conduct a 
study that compares the health care costs, quality of care, and access 
to services under medicare select policies with that under other 
medicare supplemental policies. The study shall be based on surveys of 
appropriate age-adjusted sample populations. The study shall be 
completed by June 30, 1997.
    ``(B) Not later than December 31, 1997, the Secretary shall 
determine, based on the results of the study under subparagraph (A), if 
any of the following findings are true:
        ``(i) The amendments made by this section have not resulted in 
    savings of premium costs to those enrolled in medicare select 
    policies (in comparison to their enrollment in medicare 
    supplemental policies that are not medicare select policies and 
    that provide comparable coverage).
        ``(ii) There have been significant additional expenditures 
    under the medicare program as a result of such amendments.
        ``(iii) Access to and quality of care has been significantly 
    diminished as a result of such amendments.
    ``(C) The amendments made by this section shall remain in effect 
beyond the 6\1/2\-year period described in paragraph (1)(B) unless the 
Secretary determines that any of the findings described in clause (i), 
(ii), or (iii) of subparagraph (B) are true.
    ``(3) The Comptroller General shall conduct a study to determine 
the extent to which individuals who are continuously covered under a 
medicare supplemental policy are subject to medical underwriting if 
they change the policy under which they are covered, and to identify 
options, if necessary, for modifying the medicare supplemental 
insurance market to make sure that continuously insured beneficiaries 
are able to switch plans without medical underwriting. By not later 
than June 30, 1996, the Comptroller General shall submit to the 
Congress a report on the study. The report shall include a description 
of the potential impact on the cost and availability of medicare 
supplemental policies of each option identified in the study.''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
```