I 

108TH CONGRESS 

2D SESSION H. R. 5156

To amend title II of the Social Security Act to phase out the 24-month 

waiting period for disabled individuals to become eligible for Medicare 

benefits, to eliminate the waiting period for individuals with life-threatening conditions, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 28, 2004

Mr. GREEN of Texas introduced the following bill; which was referred to the 

Committee on Ways and Means 

A BILL

To amend title II of the Social Security Act to phase out 

the 24-month waiting period for disabled individuals to 

become eligible for Medicare benefits, to eliminate the 

waiting period for individuals with life-threatening conditions, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Ending the Medicare Disability Waiting Period Act of 

6 2004’’. 
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1 (b) TABLE OF CONTENTS.—The table of contents of 

2 this Act is as follows:

Sec. 1. Short title; table of contents. 

Sec. 2. Phase out of waiting period for medicare disability benefits. 

Sec. 3. Elimination of waiting period for individuals with life-threatening conditions. 

Sec. 4. Institute of medicine study and report on delay and prevention of disability conditions.

3 SEC. 2. PHASE OUT OF WAITING PERIOD FOR MEDICARE 

4 DISABILITY BENEFITS. 

5 (a) IN GENERAL.—Section 226(b) of the Social Secu6 rity Act (42 U.S.C. 426(b)) is amended—

7 (1) in paragraph (2)(A), by striking ‘‘, and has 

8 for 24 calendar months been entitled to,’’ and insert9 ing ‘‘, and for the waiting period (as defined in sub10 section (k)) has been entitled to,’’; 

11 (2) in paragraph (2)(B), by striking ‘‘, and has 

12 been for not less than 24 months,’’ and inserting ‘‘, 

13 and has been for the waiting period (as defined in 

14 subsection (k)),’’; 

15 (3) in paragraph (2)(C)(ii), by striking ‘‘, in16 cluding the requirement that he has been entitled to 

17 the specified benefits for 24 months,’’ and inserting 

18 ‘‘, including the requirement that the individual has 

19 been entitled to the specified benefits for the waiting 

20 period (as defined in subsection (k)),’’; and 

21 (4) in the flush matter following paragraph 

22 (2)(C)(ii)(II)—
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1 (A) in the first sentence, by striking ‘‘for 

2 each month beginning with the later of (I) July 

3 1973 or (II) the twenty-fifth month of his enti4 tlement or status as a qualified railroad retire5 ment beneficiary described in paragraph (2), 

6 and’’ and inserting ‘‘for each month beginning 

7 after the waiting period (as so defined) for 

8 which the individual satisfies paragraph (2) 

9 and’’; 

10 (B) in the second sentence, by striking 

11 ‘‘the ‘twenty-fifth month of his entitlement’ re12 fers to the first month after the twenty-fourth 

13 month of entitlement to specified benefits re14 ferred to in paragraph (2)(C) and’’; and 

15 (C) in the third sentence, by striking ‘‘, 

16 but not in excess of 78 such months’’. 

17 (b) SCHEDULE FOR PHASE OUT OF WAITING PE18 RIOD.—Section 226 of the Social Security Act (42 U.S.C. 

19 426) is amended by adding at the end the following new 

20 subsection: 

21 ‘‘(k) For purposes of subsection (b) (and for purposes 

22 of section 1837(g)(1) of this Act and section 7(d)(2)(ii) 

23 of the Railroad Retirement Act of 1974), the term ‘waiting 

24 period’ means—

25 ‘‘(1) for 2005, 18 months; 
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1 ‘‘(2) for 2006, 16 months; 

2 ‘‘(3) for 2007, 14 months; 

3 ‘‘(4) for 2008, 12 months; 

4 ‘‘(5) for 2009, 10 months; 

5 ‘‘(6) for 2010, 8 months; 

6 ‘‘(7) for 2011, 6 months; 

7 ‘‘(8) for 2012, 4 months; 

8 ‘‘(9) for 2013, 2 months; and 

9 ‘‘(10) for 2014 and each subsequent year, 0 

10 months.’’. 

11 (c) CONFORMING AMENDMENTS.—

12 (1) SUNSET.—Effective January 1, 2014, sub13 section (f) of section 226 of the Social Security Act 

14 (42 U.S.C. 426) is repealed. 

15 (2) MEDICARE DESCRIPTION.—Section 1811(2) 

16 of such Act (42 U.S.C. 1395c(2)) is amended by 

17 striking ‘‘entitled for not less than 24 months’’ and 

18 inserting ‘‘entitled for the waiting period (as defined 

19 in section 226(k))’’. 

20 (3) MEDICARE COVERAGE.—Section 1837(g)(1) 

21 of such Act (42 U.S.C. 1395p(g)(1)) is amended by 

22 striking ‘‘of the later of (A) April 1973 or (B) the 

23 third month before the 25th month of such entitle24 ment’’ and inserting ‘‘of the third month before the 
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1 first month following the waiting period (as defined 

2 in section 226(k)) applicable under section 226(b)’’. 

3 (4) RAILROAD RETIREMENT SYSTEM.—Section 

4 7(d)(2)(ii) of the Railroad Retirement Act of 1974 

5 (45 U.S.C. 231f(d)(2)(ii)) is amended—

6 (A) by striking ‘‘, for not less than 24 

7 months’’ and inserting ‘‘, for the waiting period 

8 (as defined in section 226(k) of the Social Secu9 rity Act); and 

10 ‘‘(B) by striking ‘could have been entitled 

11 for 24 calendar months, and’ and inserting 

12 ‘could have been entitled for the waiting period 

13 (as defined is section 226(k) of the Social Secu14 rity Act), and’. 

15 ‘‘(d) EFFECTIVE DATE.—Except as provided in sub16 section (c)(1), the amendments made by this section shall 

17 apply to insurance benefits under title XVIII of the Social 

18 Security Act with respect to items and services furnished 

19 in months beginning at least 90 days after the date of 

20 the enactment of this Act.’’

21 SEC. 3. ELIMINATION OF WAITING PERIOD FOR INDIVID22 UALS WITH LIFE-THREATENING CONDITIONS. 

23 (a) IN GENERAL.—Section 226(h) of the Social Secu24 rity Act (42 U.S.C. 426(h)) is amended—
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1 (1) by redesignating paragraphs (1), (2), and 

2 (3) as subparagraphs (A), (B), and (C), respectively; 

3 (2) in the matter preceding subparagraph (A) 

4 (as redesignated by paragraph (1)), by inserting 

5 ‘‘(1)’’ after ‘‘(h)’’; 

6 (3) in paragraph (1) (as designated by para7 graph (2))—

8 (A) in the matter preceding subparagraph 

9 (A) (as redesignated by paragraph (1)), by in10 serting ‘‘or any other life-threatening condition 

11 identified by the Secretary’’ after ‘‘amyotrophic 

12 lateral sclerosis (ALS)’’; and 

13 (4) in subparagraph (B) (as redesignated by 

14 paragraph (1)), by striking ‘‘(rather than twenty15 fifth month)’’; and 

16 (5) by adding at the end the following new 

17 paragraph: 

18 ‘‘(2) For purposes of identifying life-threatening con19 ditions under paragraph (1), the Secretary shall compile 

20 a list of conditions that are fatal without medical treat21 ment. In compiling such list, the Secretary shall consult 

22 with the Director of the National Institutes of Health (in23 cluding the Office of Rare Diseases), the Director of the 

24 Centers for Disease Control and Prevention, the Director 
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1 of the National Science Foundation, and the Institute of 

2 Medicine of the National Academy of Sciences.’’. 

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

4 this section shall apply to insurance benefits under title 

5 XVIII of the Social Security Act with respect to items and 

6 services furnished in months beginning at least 90 days 

7 after the date of the enactment of this Act. 

8 SEC. 4. INSTITUTE OF MEDICINE STUDY AND REPORT ON 

9 DELAY AND PREVENTION OF DISABILITY 

10 CONDITIONS. 

11 (a) STUDY.—The Secretary of Health and Human 

12 Services (in this section referred to as the ‘‘Secretary’’) 

13 shall request that the Institute of Medicine of the National 

14 Academy of Sciences conduct a study on the range of dis15 ability conditions that can be delayed or prevented if indi16 viduals receive access to health care services and coverage 

17 before the condition reaches disability levels. 

18 (b) REPORT.—Not later than the date that is 2 years 

19 after the date of enactment of this Act, the Secretary shall 

20 submit to Congress a report containing the results of the 

21 Institute of Medicine study authorized under this section. 

22 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

23 authorized to be appropriated to carry out this section 

24 $750,000 for the period of fiscal years 2005 and 2006.

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