II 

108TH CONGRESS 

2D SESSION S. 2130

To contain the costs of the medicare prescription drug program under part 

D of title XVIII of the Social Security Act, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 26, 2004

Mr. GRAHAM of South Carolina (for himself, Mr. SESSIONS, and Mr. MCCAIN) 

introduced the following bill; which was read twice and referred to the 

Committee on Finance 

A BILL

To contain the costs of the medicare prescription drug program under part D of title XVIII of the Social Security 

Act, and for other purposes.

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 Prescription 

5 Drug Cost Containment Act of 2004’’. 
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1 SEC. 2. INCLUSION IN ANNUAL REPORT OF MEDICARE 

2 TRUSTEES OF INFORMATION ON STATUS OF 

3 MEDICARE PRESCRIPTION DRUG ACCOUNT. 

4 (a) DETERMINATIONS OF EXCESS GENERAL REV5 ENUE MEDICARE PRESCRIPTION DRUG FUNDING.—

6 (1) IN GENERAL.—On the same date on which 

7 the President submits a budget to Congress, the 

8 Secretary of Health and Human Services (in this 

9 Act referred to as the ‘‘Secretary’’), shall submit to 

10 Congress a determination as to whether there is pro11 jected to be excess general revenue medicare pre12 scription drug funding (as defined in subsection (b)) 

13 for the fiscal year for which the budget is submitted. 

14 (2) MEDICARE PART D FUNDING WARNING.—

15 For purposes of section 1105(i) of title 31, United 

16 States Code, and this Act, an affirmative determina17 tion under paragraph (1) by the Secretary shall be 

18 treated as a medicare part D funding warning in the 

19 fiscal year beginning on October 1 of the year in 

20 which the determination is submitted to Congress. 

21 (b) DEFINITIONS.—For purposes of this section: 

22 (1) EXCESS GENERAL REVENUE MEDICARE

23 PRESCRIPTION DRUG FUNDING.—The term ‘‘excess 

24 general revenue medicare prescription drug funding’’ 

25 means, with respect to a fiscal year during the pe-
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1 riod beginning on the date of enactment of this Act 

2 and ending on September 30, 2013, that—

3 (A) the amounts deposited in the Medicare 

4 Prescription Drug Account under section 

5 1860D–16(c)(2) (42 U.S.C. 1395w–116(c)(2)), 

6 as added by section 101 of the Medicare Pre7 scription Drug, Improvement, and Moderniza8 tion Act of 2003 (Public Law 108–173); exceed 

9 (B) the part D target amount (as defined 

10 in paragraph (2)). 

11 (2) PART D TARGET AMOUNT.—The term ‘‘part 

12 D target amount’’ means for a year—

13 (A) for fiscal year 2005, $800,000,000; 

14 (B) for fiscal year 2006, $25,700,000,000; 

15 (C) for fiscal year 2007, $39,000,000,000; 

16 (D) for fiscal year 2008, $44,600,000,000; 

17 (E) for fiscal year 2009, $48,700,000,000; 

18 (F) for fiscal year 2010, $53,700,000,000; 

19 (G) for fiscal year 2011, $58,600,000,000; 

20 (H) for fiscal year 2012, $65,300,000,000; 

21 and 

22 (I) for fiscal year 2013, $73,100,000,000. 

23 (c) TECHNICAL AMENDMENT.—Section 1860D–

24 16(c)(3) of the Social Security Act (42 U.S.C. 1395w–

25 116(c)(3)), as added by section 101 of the Medicare Pre-
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1 scription Drug, Improvement, and Modernization Act of 

2 2003 (Public Law 108–173), is amended by striking 

3 ‘‘under paragraph (1) or subsection (a)(2)’’ and inserting 

4 ‘‘under paragraph (1), (2), or (4), gifts and bequests as 

5 may be made as provided in section 201(i)(1), or accrued 

6 interest on balances in the Account’’. 

7 SEC. 3. PRESIDENTIAL SUBMISSION OF LEGISLATION. 

8 (a) IN GENERAL.—Section 1105 of title 31, United 

9 States Code, as amended by section 802(a) of the Medi10 care Prescription Drug, Improvement, and Modernization 

11 Act of 2003 (Public Law 108–173), is amended by adding 

12 at the end the following new subsection: 

13 ‘‘(i)(1) If there is a medicare part D funding warning 

14 under section 2(a)(2) of the Medicare Prescription Drug 

15 Cost Containment Act of 2004 made in a year, the Presi16 dent shall submit to Congress, within the 15-day period 

17 beginning on the date of the budget submission to Con18 gress under subsection (a) for the succeeding year, pro19 posed legislation to respond to such warning. 

20 ‘‘(2) Paragraph (1) does not apply if, during the year 

21 in which the warning is made, legislation is enacted which 

22 eliminates excess general revenue medicare funding (as de23 fined in section 2(b) of the Medicare Prescription Drug 

24 Cost Containment Act of 2004) for the period beginning 

25 with the fiscal year for which the determination is made 
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1 and ending on September 30, 2013, as certified by the 

2 Board of Trustees of the Federal Supplementary Medicare 

3 Insurance Trust Fund not later than 30 days after the 

4 date of the enactment of such legislation.’’. 

5 (b) SENSE OF CONGRESS.—It is the sense of Con6 gress that legislation submitted pursuant to section 

7 1105(i) of title 31, United States Code, in a year should 

8 be designed to eliminate excess general revenue medicare 

9 funding (as defined in section 2(b)) for the period that 

10 begins with the fiscal year for which the determination is 

11 made and ends on September 30, 2013. 

12 SEC. 4. PROCEDURES IN THE HOUSE OF REPRESENTA13 TIVES. 

14 (a) INTRODUCTION AND REFERRAL OF PRESIDENT’S

15 LEGISLATIVE PROPOSAL.—

16 (1) INTRODUCTION.—In the case of a legislative 

17 proposal submitted by the President pursuant to sec18 tion 1105(i) of title 31, United States Code, as 

19 added by section 3(a), within the 15-day period 

20 specified in paragraph (1) of such section, the ma21 jority leader of the House of Representatives (or his 

22 designee) and the minority leader of the House of 

23 Representatives (or his designee) shall introduce 

24 such proposal (by request), the title of which is as 

25 follows: ‘‘A bill to respond to a medicare part D 
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1 funding warning.’’ Such bill shall be introduced 

2 within 3 legislative days after Congress receives such 

3 proposal.

4 (2) REFERRAL.—Any legislation introduced 

5 pursuant to paragraph (1) shall be referred to the 

6 appropriate committees of the House of Representa7 tives. 

8 (b) DIRECTION TO THE APPROPRIATE HOUSE COM9 MITTEES.—

10 (1) IN GENERAL.—In the House, in any year 

11 during which the President is required to submit 

12 proposed legislation to Congress under section 

13 1105(i) of title 31, United States Code, the appro14 priate committees shall report medicare funding leg15 islation by not later than June 30 of such year. 

16 (2) MEDICARE FUNDING LEGISLATION.—For 

17 purposes of this section, the term ‘‘medicare funding 

18 legislation’’ means—

19 (A) legislation introduced pursuant to sub20 section (a)(1), but only if the legislative pro21 posal upon which the legislation is based was 

22 submitted within the 15-day period referred to 

23 in such subsection; or 
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1 (B) any bill the title of which is as follows: 

2 ‘‘A bill to respond to a medicare part D funding 

3 warning.’’. 

4 (3) CERTIFICATION.—With respect to any 

5 medicare funding legislation or any amendment to 

6 such legislation to respond to a medicare part D 

7 funding warning, the chairman of the Committee on 

8 the Budget of the House shall certify—

9 (A) whether or not such legislation elimi10 nates excess general revenue medicare funding 

11 (as defined in section 2(c)) for each fiscal year 

12 during the period beginning with the fiscal year 

13 for which the determination is made and ending 

14 on September 30, 2013; and 

15 (B) with respect to such an amendment, 

16 whether the legislation, as amended, would 

17 eliminate excess general revenue medicare fund18 ing (as defined in section 2(c)) for each fiscal 

19 year in such period. 

20 (c) FALLBACK PROCEDURE FOR FLOOR CONSIDER21 ATION IF THE HOUSE FAILS TO VOTE ON FINAL PAS22 SAGE BY JULY 30.—

23 (1) After July 30 of any year during which the 

24 President is required to submit proposed legislation 

25 to Congress under section 1105(i) of title 31, United 
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1 States Code, unless the House of Representatives 

2 has voted on final passage of any medicare funding 

3 legislation for which there is an affirmative certifi4 cation under subsection (b)(3)(A), then, after the ex5 piration of not less than 30 calendar days (and con6 currently 5 legislative days), it is in order to move 

7 to discharge any committee to which medicare fund8 ing legislation which has such a certification and 

9 which has been referred to such committee for 30 

10 calendar days from further consideration of the leg11 islation. 

12 (2) A motion to discharge may be made only by 

13 an individual favoring the legislation, may be made 

only if supported by 1 14 ⁄5 of the total membership of 

15 the House of Representatives (a quorum being 

16 present), and is highly privileged in the House of 

17 Representatives. Debate thereon shall be limited to 

18 not more than 1 hour, the time to be divided in the 

19 House of Representatives equally between those fa20 voring and those opposing the motion. An amend21 ment to the motion is not in order, and it is not in 

22 order to move to reconsider the vote by which the 

23 motion is agreed to or disagreed to. 
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1 (3) Only 1 motion to discharge a particular 

2 committee may be adopted under this subsection in 

3 any session of Congress. 

4 (4) Notwithstanding paragraph (1), it shall not 

5 be in order to move to discharge a committee from 

6 further consideration of medicare funding legislation 

7 pursuant to this subsection during a session of Con8 gress if, during the previous session of the Congress, 

9 the House of Representatives passed medicare fund10 ing legislation for which there is an affirmative cer11 tification under subsection (b)(3)(A). 

12 (d) FLOOR CONSIDERATION IN THE HOUSE OF DIS13 CHARGED LEGISLATION.—

14 (1) In the House, not later than 3 legislative 

15 days after any committee has been discharged from 

16 further consideration of legislation under subsection 

17 (c), the Speaker shall resolve the House into the 

18 Committee of the Whole for consideration of the leg19 islation. 

20 (2) The first reading of the legislation shall be 

21 dispensed with. All points of order against consider22 ation of the legislation are waived. General debate 

23 shall be confined to the legislation and shall not ex24 ceed 5 hours, which shall be divided equally between 

25 those favoring and those opposing the legislation. 
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1 After general debate the legislation shall be consid2 ered for amendment under the 5-minute rule. Dur3 ing consideration of the legislation, no amendments 

4 shall be in order in the House of Representatives or 

5 in the Committee of the Whole except those for 

6 which there has been an affirmative certification 

7 under subsection (b)(3)(B). All points of order 

8 against consideration of any such amendment in the 

9 Committee of the Whole are waived. The legislation, 

10 together with any amendments which shall be in 

11 order, shall be considered as read. During the con12 sideration of the bill for amendment, the Chairman 

13 of the Committee of the Whole may accord priority 

14 in recognition on the basis of whether the Member 

15 offering an amendment has caused it to be printed 

16 in the portion of the Congressional Record des17 ignated for that purpose in clause 8 of Rule XVIII 

18 of the Rules of the House of Representatives. De19 bate on any amendment shall not exceed 1 hour, 

20 which shall be divided equally between those favoring 

21 and those opposing the amendment, and no pro 

22 forma amendments shall be offered during the de23 bate. The total time for debate on all amendments 

24 shall not exceed 10 hours. At the conclusion of con25 sideration of the legislation for amendment, the 
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1 Committee shall rise and report the legislation to the 

2 House of Representatives with such amendments as 

3 may have been adopted. The previous question shall 

4 be considered as ordered on the legislation and 

5 amendments thereto to final passage without inter6 vening motion except one motion to recommit with 

7 or without instructions. If the Committee of the

8 Whole rises and reports that it has come to no reso9 lution on the bill, then on the next legislative day 

10 the House of Representatives shall, immediately 

11 after the third daily order of business under clause 

12 1 of Rule XIV of the Rules of the House of Rep13 resentatives, resolve into the Committee of the 

14 Whole for further consideration of the bill. 

15 (3) All appeals from the decisions of the Chair 

16 relating to the application of the Rules of the House 

17 of Representatives to the procedure relating to any 

18 such legislation shall be decided without debate. 

19 (4) Except to the extent specifically provided in 

20 the preceding provisions of this subsection, consider21 ation of any such legislation and amendments there22 to (or any conference report thereon) shall be gov23 erned by the Rules of the House of Representatives 

24 applicable to other bills and resolutions, amend-
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1 ments, and conference reports in similar cir2 cumstances. 

3 (e) LEGISLATIVE DAY DEFINED.—As used in this 

4 section, the term ‘‘legislative day’’ means a day on which 

5 the House of Representatives is in session. 

6 (f) RESTRICTION ON WAIVER.—In the House of Rep7 resentatives, the provisions of this section may be waived 

8 only by a rule or order proposing only to waive such provi9 sions. 

10 (g) RULEMAKING POWER.—The provisions of this 

11 section are enacted by the Congress—

12 (1) as an exercise of the rulemaking power of 

13 the House of Representatives and, as such, shall be 

14 considered as part of the rules of that House of 

15 Representatives and shall supersede other rules only 

16 to the extent that they are inconsistent therewith; 

17 and 

18 (2) with full recognition of the constitutional 

19 right of that House to change the rules (so far as 

20 they relate to the procedures of that House) at any 

21 time, in the same manner, and to the same extent 

22 as in the case of any other rule of that House. 

23 SEC. 5. PROCEDURES IN THE SENATE. 

24 (a) INTRODUCTION AND REFERRAL OF PRESIDENT’S

25 LEGISLATIVE PROPOSAL.—
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1 (1) INTRODUCTION.—In the case of a legislative 

2 proposal submitted by the President pursuant to sec3 tion 1105(i) of title 31, United States Code, within 

4 the 15-day period specified in paragraph (1) of such 

5 section, the majority leader and minority leader of 

6 the Senate (or their designees) shall introduce such 

7 proposal (by request), the title of which is as follows: 

8 ‘‘A bill to respond to a medicare part D funding 

9 warning.’’ Such bill shall be introduced within 3 

10 days of session after Congress receives such pro11 posal. 

12 (2) REFERRAL.—Any legislation introduced 

13 pursuant to paragraph (1) shall be referred to the 

14 Committee on Finance. 

15 (b) MEDICARE FUNDING LEGISLATION.—For pur16 poses of this section, the term ‘‘medicare funding legisla17 tion’’ means—

18 (1) legislation introduced pursuant to sub19 section (a)(1), but only if the legislative proposal 

20 upon which the legislation is based was submitted 

21 within the 15-day period referred to in such sub22 section; or 

23 (2) any bill the title of which is as follows: ‘‘A 

24 bill to respond to a medicare part D funding warn25 ing.’’. 
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1 (c) QUALIFICATION FOR SPECIAL PROCEDURES.—

2 (1) IN GENERAL.—The special procedures set 

3 forth in subsections (d) and (e) shall apply to medi4 care funding legislation, as described in subsection 

5 (b), only if the legislation—

6 (A) is medicare funding legislation that is 

7 passed by the House of Representatives; or 

8 (B) contains matter within the jurisdiction 

9 of the Committee on Finance in the Senate. 

10 (2) FAILURE TO QUALIFY FOR SPECIAL PROCE11 DURES.—If the medicare funding legislation does 

12 not satisfy paragraph (1), then the legislation shall 

13 be considered under the ordinary procedures of the 

14 Standing Rules of the Senate. 

15 (d) DISCHARGE.—

16 (1) IN GENERAL.—If the Committee on Fi17 nance of the Senate has not reported medicare fund18 ing legislation described in subsection (c)(1) by June 

19 30 of a year in which the President is required to 

20 submit medicare funding legislation to Congress 

21 under section 1105(i) of title 31, United States 

22 Code, then any Senator may move to discharge the 

23 Committee of any single medicare funding legislation 

24 measure. Only 1 such motion shall be in order in 

25 any session of Congress. 
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1 (2) DEBATE LIMITS.—Debate in the Senate on 

2 any such motion to discharge, and all appeals in 

3 connection therewith, shall be limited to not more 

4 than 2 hours. The time shall be equally divided be5 tween, and controlled by, the maker of the motion 

6 and the majority leader, or their designees, except 

7 that in the event the majority leader is in favor of 

8 such motion, the time in opposition thereto shall be 

9 controlled by the minority leader or the minority 

10 leader’s designee. A point of order under this sub11 section may be made at any time. It is not in order 

12 to move to proceed to another measure or matter 

13 while such motion (or the motion to reconsider such 

14 motion) is pending. 

15 (3) AMENDMENTS.—No amendment to the mo16 tion to discharge shall be in order. 

17 (4) EXCEPTION IF CERTIFIED LEGISLATION EN18 ACTED.—Notwithstanding paragraph (1), it shall 

19 not be in order to discharge the Committee from 

20 further consideration of medicare funding legislation 

21 pursuant to this subsection during a session of a 

22 Congress if the chairman of the Committee on the 

23 Budget of the Senate certifies that medicare funding 

24 legislation has been enacted that eliminates excess 

25 general revenue medicare funding (as defined in sec-
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1 tion 2(c)) for each fiscal year in the period begin2 ning with the fiscal year for which the determination 

3 is made and ending on September 30, 2013. 

4 (e) CONSIDERATION.—After the date on which the 

5 Committee on Finance of the Senate has reported medi6 care funding legislation described in subsection (c)(1), or 

7 has been discharged (under subsection (d)) from further 

8 consideration of, such legislation, it is in order (even 

9 though a previous motion to the same effect has been dis10 agreed to) for any Member of the Senate to move to pro11 ceed to the consideration of such legislation. 

12 (f) RULES OF THE SENATE.—This section is enacted 

13 by the Senate—

14 (1) as an exercise of the rulemaking power of 

15 the Senate and as such it is deemed a part of the 

16 rules of the Senate, but applicable only with respect 

17 to the procedure to be followed in the Senate in the 

18 case of a bill described in this paragraph, and it su19 persedes other rules only to the extent that it is in20 consistent with such rules; and 

21 (2) with full recognition of the constitutional 

22 right of the Senate to change the rules (so far as re23 lating to the procedure of the Senate) at any time, 
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1 in the same manner, and to the same extent as in 

2 the case of any other rule of the Senate.

Æ