II 

109TH CONGRESS 

1ST SESSION S. 581 

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 

MARCH 9, 2005 

Mr. GRAHAM (for himself and Mr. SESSIONS) 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 2005’’. 

6 SEC. 2. INCLUSION IN ANNUAL REPORT OF MEDICARE 

7 TRUSTEES OF INFORMATION ON STATUS OF 

8 MEDICARE PRESCRIPTION DRUG ACCOUNT. 

9 (a) DETERMINATIONS OF EXCESS GENERAL REV10 ENUE MEDICARE PRESCRIPTION DRUG FUNDING.— 
2 

•S 581 IS

1 (1) IN GENERAL.—Beginning in 2006, on the 

2 same date on which the President submits a budget 

3 to Congress, the Secretary of Health and Human 

4 Services (in this Act referred to as the ‘‘Secretary’’), 

5 shall submit to Congress a determination on the fol6 lowing: 

7 (A) PROJECTION.—Whether there is pro8 jected to be excess general revenue medicare 

9 prescription drug funding (as defined in sub10 section (b)) for the fiscal year for which the 

11 budget is submitted. 

12 (B) LOOK BACK.—Whether there was ex13 cess general revenue medicare prescription drug 

14 funding (as defined in subsection (b)) in the fis15 cal year ending September 30 of the year prior 

16 to the year in which such budget is submitted. 

17 (2) MEDICARE PART D FUNDING WARNING.— 

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

19 States Code, and this Act, an affirmative determina20 tion by the Secretary under either subparagraph (A) 

21 or (B) of paragraph (1) shall be treated as a medi22 care part D funding warning in the fiscal year be23 ginning on October 1 of the year in which the deter24 mination is submitted to Congress. 

25 (b) DEFINITIONS.—For purposes of this section: 
3 

•S 581 IS

1 (1) EXCESS GENERAL REVENUE MEDICARE

2 PRESCRIPTION DRUG FUNDING.—The term ‘‘excess 

3 general revenue medicare prescription drug funding’’ 

4 means, with respect to a fiscal year during the pe5 riod beginning on the date of enactment of this Act 

6 and ending on September 30, 2013, that— 

7 (A) the amounts deposited in the Medicare 

8 Prescription Drug Account under section 

9 1860D–16(c)(2) (42 U.S.C. 1395w–116(c)(2)), 

10 as added by section 101 of the Medicare Pre11 scription Drug, Improvement, and Moderniza12 tion Act of 2003 (Public Law 108–173); exceed 

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

14 in paragraph (2)). 

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

16 D target amount’’ means for a year— 

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

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

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

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

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

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

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

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

25 and 
4 

•S 581 IS

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

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

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

4 116(c)(3)), as added by section 101 of the Medicare Pre5 scription Drug, Improvement, and Modernization Act of 

6 2003 (Public Law 108–173), is amended by striking 

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

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

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

10 interest on balances in the Account’’. 

11 SEC. 3. PRESIDENTIAL SUBMISSION OF LEGISLATION. 

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

13 States Code, as amended by section 802(a) of the Medi14 care Prescription Drug, Improvement, and Modernization 

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

16 at the end the following new subsection: 

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

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

19 Cost Containment Act of 2005 made in a year, the Presi20 dent shall submit to Congress, within the 15-day period 

21 beginning on the date of the budget submission to Con22 gress under subsection (a) for the succeeding year, pro23 posed legislation to respond to such warning. 

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

25 in which the warning is made, legislation is enacted which 
5 

•S 581 IS

1 eliminates excess general revenue medicare funding (as de2 fined in section 2(b) of the Medicare Prescription Drug 

3 Cost Containment Act of 2005) for the period beginning 

4 with the fiscal year for which the determination is made 

5 and ending on September 30, 2013, as certified by the 

6 Board of Trustees of the Federal Supplementary Medicare 

7 Insurance Trust Fund not later than 30 days after the 

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

9 (b) SENSE OF CONGRESS.—It is the sense of Con10 gress that legislation submitted pursuant to section 

11 1105(i) of title 31, United States Code, as added by sub12 section (a), in a year should be designed to eliminate ex13 cess general revenue medicare funding (as defined in sec14 tion 2(b)) for the period that begins with the fiscal year 

15 for which the determination is made and ends on Sep16 tember 30, 2013. 

17 SEC. 4. PROCEDURES IN THE HOUSE OF REPRESENTA18 TIVES. 

19 (a) INTRODUCTION AND REFERRAL OF PRESIDENT’S

20 LEGISLATIVE PROPOSAL.— 

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

22 proposal submitted by the President pursuant to sec23 tion 1105(i) of title 31, United States Code, as 

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

25 specified in paragraph (1) of such section, the ma-
6 

•S 581 IS

1 jority leader of the House of Representatives (or his 

2 designee) and the minority leader of the House of 

3 Representatives (or his designee) shall introduce 

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

5 follows: ‘‘A bill to respond to a medicare part D 

6 funding warning.’’ Such bill shall be introduced 

7 within 3 legislative days after Congress receives such 

8 proposal. 

9 (2) REFERRAL.—Any legislation introduced 

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

11 appropriate committees of the House of Representa12 tives. 

13 (b) DIRECTION TO THE APPROPRIATE HOUSE COM14 MITTEES.— 

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

16 during which the President is required to submit 

17 proposed legislation to Congress under section 

18 1105(i) of title 31, United States Code, as added by 

19 section 3(a), the appropriate committees shall report 

20 medicare funding legislation by not later than June 

21 30 of such year. 

22 (2) MEDICARE FUNDING LEGISLATION.—For 

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

24 legislation’’ means— 
7 

•S 581 IS

1 (A) legislation introduced pursuant to sub2 section (a)(1), but only if the legislative pro3 posal upon which the legislation is based was 

4 submitted within the 15-day period referred to 

5 in such subsection; or 

6 (B) any bill the title of which is as follows: 

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

8 warning.’’. 

9 (3) CERTIFICATION.—With respect to any 

10 medicare funding legislation or any amendment to 

11 such legislation to respond to a medicare part D 

12 funding warning, the chairman of the Committee on 

13 the Budget of the House shall certify— 

14 (A) whether or not such legislation elimi15 nates excess general revenue medicare funding 

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

17 during the period beginning with the fiscal year 

18 for which the determination is made and ending 

19 on September 30, 2013; and 

20 (B) with respect to such an amendment, 

21 whether the legislation, as amended, would 

22 eliminate excess general revenue medicare fund23 ing (as defined in section 2(b)) for each fiscal 

24 year in such period. 
8 

•S 581 IS

1 (c) FALLBACK PROCEDURE FOR FLOOR CONSIDER2 ATION IF THE HOUSE FAILS TO VOTE ON FINAL PASSAGE

3 BY JULY 30.— 

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

5 President is required to submit proposed legislation 

6 to Congress under section 1105(i) of title 31, United 

7 States Code, as added by section 3(a), unless the 

8 House of Representatives has voted on final passage 

9 of any medicare funding legislation for which there 

10 is an affirmative certification under subsection 

11 (b)(3)(A), then, after the expiration of not less than 

12 30 calendar days (and concurrently 5 legislative 

13 days), it is in order to move to discharge any com14 mittee to which medicare funding legislation which 

15 has such a certification and which has been referred 

16 to such committee for 30 calendar days from further 

17 consideration of the legislation. 

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

19 an individual favoring the legislation, may be made 

only if supported by 1 20 ⁄5 of the total membership of 

21 the House of Representatives (a quorum being 

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

23 Representatives. Debate thereon shall be limited to 

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

25 House of Representatives equally between those fa-
9 

•S 581 IS

1 voring and those opposing the motion. An amend2 ment to the motion is not in order, and it is not in 

3 order to move to reconsider the vote by which the 

4 motion is agreed to or disagreed to. 

5 (3) Only 1 motion to discharge a particular 

6 committee may be adopted under this subsection in 

7 any session of Congress. 

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

9 be in order to move to discharge a committee from 

10 further consideration of medicare funding legislation 

11 pursuant to this subsection during a session of Con12 gress if, during the previous session of the Congress, 

13 the House of Representatives passed medicare fund14 ing legislation for which there is an affirmative cer15 tification under subsection (b)(3)(A). 

16 (d) FLOOR CONSIDERATION IN THE HOUSE OF DIS17 CHARGED LEGISLATION.— 

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

19 days after any committee has been discharged from 

20 further consideration of legislation under subsection 

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

22 Committee of the Whole for consideration of the leg23 islation. 

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

25 dispensed with. All points of order against consider-
10 

•S 581 IS

1 ation of the legislation are waived. General debate 

2 shall be confined to the legislation and shall not ex3 ceed 5 hours, which shall be divided equally between 

4 those favoring and those opposing the legislation. 

5 After general debate, the legislation shall be consid6 ered for amendment under the 5-minute rule. Dur7 ing consideration of the legislation, no amendments 

8 shall be in order in the House of Representatives or 

9 in the Committee of the Whole except those for 

10 which there has been an affirmative certification 

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

12 against consideration of any such amendment in the 

13 Committee of the Whole are waived. The legislation, 

14 together with any amendments which shall be in 

15 order, shall be considered as read. During the con16 sideration of the bill for amendment, the Chairman 

17 of the Committee of the Whole may accord priority 

18 in recognition on the basis of whether the Member 

19 offering an amendment has caused it to be printed 

20 in the portion of the Congressional Record des21 ignated for that purpose in clause 8 of Rule XVIII 

22 of the Rules of the House of Representatives. De23 bate on any amendment shall not exceed 1 hour, 

24 which shall be divided equally between those favoring 

25 and those opposing the amendment, and no pro 
11 

•S 581 IS

1 forma amendments shall be offered during the de2 bate. The total time for debate on all amendments 

3 shall not exceed 10 hours. At the conclusion of con4 sideration of the legislation for amendment, the 

5 Committee shall rise and report the legislation to the 

6 House of Representatives with such amendments as 

7 may have been adopted. The previous question shall 

8 be considered as ordered on the legislation and 

9 amendments thereto to final passage without inter10 vening motion except 1 motion to recommit with or 

11 without instructions. If the Committee of the Whole 

12 rises and reports that it has come to no resolution 

13 on the bill, then on the next legislative day the 

14 House of Representatives shall, immediately after 

15 the third daily order of business under clause 1 of 

16 Rule XIV of the Rules of the House of Representa17 tives, resolve into the Committee of the Whole for 

18 further consideration of the bill. 

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

20 relating to the application of the Rules of the House 

21 of Representatives to the procedure relating to any 

22 such legislation shall be decided without debate. 

23 (4) Except to the extent specifically provided in 

24 the preceding provisions of this subsection, consider25 ation of any such legislation and amendments there-
12 

•S 581 IS

1 to (or any conference report thereon) shall be gov2 erned by the Rules of the House of Representatives 

3 applicable to other bills and resolutions, amend4 ments, and conference reports in similar cir5 cumstances. 

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

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

8 the House of Representatives is in session. 

9 (f) RESTRICTION ON WAIVER.—In the House of Rep10 resentatives, the provisions of this section may be waived 

11 only by a rule or order proposing only to waive such provi12 sions. 

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

14 section are enacted by Congress— 

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

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

17 considered as part of the rules of the House of Rep18 resentatives and shall supersede other rules only to 

19 the extent that they are inconsistent therewith; and 

20 (2) with full recognition of the constitutional 

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

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

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

24 as in the case of any other rule of that House. 
13 

•S 581 IS

1 SEC. 5. PROCEDURES IN THE SENATE. 

2 (a) INTRODUCTION AND REFERRAL OF PRESIDENT’S

3 LEGISLATIVE PROPOSAL.— 

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

5 proposal submitted by the President pursuant to sec6 tion 1105(i) of title 31, United States Code, as 

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

8 specified in paragraph (1) of such section, the ma9 jority leader and minority leader of the Senate (or 

10 their designees) shall introduce such proposal (by re11 quest), the title of which is as follows: ‘‘A bill to re12 spond to a medicare part D funding warning.’’ Such 

13 bill shall be introduced within 3 days of session after 

14 Congress receives such proposal. 

15 (2) REFERRAL.—Any legislation introduced 

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

17 Committee on Finance. 

18 (b) MEDICARE FUNDING LEGISLATION.—For pur19 poses of this section, the term ‘‘medicare funding legisla20 tion’’ means— 

21 (1) legislation introduced pursuant to sub22 section (a)(1), but only if the legislative proposal 

23 upon which the legislation is based was submitted 

24 within the 15-day period referred to in such sub25 section; or 
14 

•S 581 IS

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

2 bill to respond to a medicare part D funding warn3 ing.’’. 

4 (c) QUALIFICATION FOR SPECIAL PROCEDURES.— 

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

6 forth in subsections (d) and (e) shall apply to medi7 care funding legislation, as described in subsection 

8 (b), only if the legislation— 

9 (A) is medicare funding legislation that is 

10 passed by the House of Representatives; or 

11 (B) contains matter within the jurisdiction 

12 of the Committee on Finance in the Senate. 

13 (2) FAILURE TO QUALIFY FOR SPECIAL PROCE14 DURES.—If the medicare funding legislation does 

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

16 be considered under the ordinary procedures of the 

17 Standing Rules of the Senate. 

18 (d) DISCHARGE.— 

19 (1) IN GENERAL.—If the Committee on Fi20 nance of the Senate has not reported medicare fund21 ing legislation described in subsection (c)(1) by June 

22 30 of a year in which the President is required to 

23 submit medicare funding legislation to Congress 

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

25 Code, as added by section 3(a), then any Senator 
15 

•S 581 IS

1 may move to discharge the Committee of any single 

2 medicare funding legislation measure. Only 1 such 

3 motion shall be in order in any session of Congress. 

4 (2) DEBATE LIMITS.—Debate in the Senate on 

5 any such motion to discharge, and all appeals in 

6 connection therewith, shall be limited to not more 

7 than 2 hours. The time shall be equally divided be8 tween, and controlled by, the maker of the motion 

9 and the majority leader, or their designees, except 

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

11 such motion, the time in opposition thereto shall be 

12 controlled by the minority leader or the minority 

13 leader’s designee. A point of order under this sub14 section may be made at any time. It is not in order 

15 to move to proceed to another measure or matter 

16 while such motion (or the motion to reconsider such 

17 motion) is pending. 

18 (3) AMENDMENT.—No amendment to the mo19 tion to discharge shall be in order. 

20 (4) EXCEPTION IF CERTIFIED LEGISLATION EN21 ACTED.—Notwithstanding paragraph (1), it shall 

22 not be in order to discharge the Committee from 

23 further consideration of medicare funding legislation 

24 pursuant to this subsection during a session of Con25 gress if the chairman of the Committee on the 
16 

•S 581 IS

1 Budget of the Senate certifies that medicare funding 

2 legislation has been enacted that eliminates excess 

3 general revenue medicare funding (as defined in sec4 tion 2(c)) for each fiscal year in the period begin5 ning with the fiscal year for which the determination 

6 is made and ending on September 30, 2013. 

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

8 Committee on Finance of the Senate has reported medi9 care funding legislation described in subsection (c)(1), or 

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

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

12 though a previous motion to the same effect has been dis13 agreed to) for any Member of the Senate to move to pro14 ceed to the consideration of such legislation. 

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

16 by the Senate— 

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

18 the Senate, and as such, it is deemed a part of the 

19 rules of the Senate, but applicable only with respect 

20 to the procedure to be followed in the Senate in the 

21 case of a bill described in this paragraph, and it su22 persedes other rules only to the extent that it is in23 consistent with such rules; and 

24 (2) with full recognition of the constitutional 

25 right of the Senate to change the rules (so far as re-
17 

•S 581 IS

1 lating to the procedure of the Senate) at any time, 

2 in the same manner, and to the same extent as in 

3 the case of any other rule of the Senate. 

Æ