I 
108TH CONGRESS 
2D SESSION 
H. R. 3854
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 HOUSE OF REPRESENTATIVES 
FEBRUARY 26, 2004
Mr. FLAKE (for himself, Mr. PENCE, Mr. SMITH of Michigan, Mr. KING of 
Iowa, Mr. AKIN, Mr. TANCREDO, Mr. NORWOOD, Mr. JONES of North 
Carolina, Mr. BARTLETT of Maryland, Mr. MILLER of Florida, Mr. 
FRANKS of Arizona, Mr. BRADY of Texas, Mr. HENSARLING, Mrs. 
MUSGRAVE, Mr. BARRETT of South Carolina, Mr. DEMINT, Mr. GUT-
KNECHT, and Mr. FEENEY) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committees on Ways and Means, and Rules, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To contain the costs of the Medicare prescription drug pro-
gram under part D of title XVIII of the Social Security 
Act, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Prescription 
Drug Cost Containment Act of 2004’’.
SEC. 2. INCLUSION IN ANNUAL REPORT OF MEDICARE 
TRUSTEES OF INFORMATION ON STATUS OF 
MEDICARE PRESCRIPTION DRUG ACCOUNT. 
(a) DETERMINATIONS OF EXCESS GENERAL REV-
ENUE MEDICARE PRESCRIPTION DRUG FUNDING.— 
(1) IN GENERAL.—On the same date on which 
the President submits a budget to Congress, the 
Secretary of Health and Human Services (in this 
Act referred to as the ‘‘Secretary’’), shall submit to 
Congress a determination as to whether there is pro-
jected to be excess general revenue medicare pre-
scription drug funding (as defined in subsection (b)) 
for the fiscal year for which the budget is submitted. 
(2) MEDICARE PART D FUNDING WARNING.— 
For purposes of section 1105(i) of title 31, United 
States Code, and this Act, an affirmative determina-
tion under paragraph (1) by the Secretary shall be 
treated as a medicare part D funding warning in the 
fiscal year beginning on October 1 of the year in 
which the determination is submitted to Congress. 
(b) DEFINITIONS.—For purposes of this section: 
(1) EXCESS
GENERAL
REVENUE
MEDICARE 
PRESCRIPTION DRUG FUNDING.—The term ‘‘excess 
general revenue medicare prescription drug funding’’ 
means, with respect to a fiscal year during the pe-
riod beginning on the date of enactment of this Act 
and ending on September 30, 2013, that— 
(A) the amounts deposited in the Medicare 
Prescription 
Drug 
Account 
under 
section 
1860D–16(c)(2) (42 U.S.C. 1395w–116(c)(2)), 
as added by section 101 of the Medicare Pre-
scription Drug, Improvement, and Moderniza-
tion Act of 2003 (Public Law 108–173); exceed 
(B) the part D target amount (as defined 
in paragraph (2)). 
(2) PART D TARGET AMOUNT.—The term ‘‘part 
D target amount’’ means for a year— 
(A) for fiscal year 2005, $800,000,000; 
(B) for fiscal year 2006, $25,700,000,000; 
(C) for fiscal year 2007, $39,000,000,000; 
(D) for fiscal year 2008, $44,600,000,000; 
(E) for fiscal year 2009, $48,700,000,000; 
(F) for fiscal year 2010, $53,700,000,000; 
(G) for fiscal year 2011, $58,600,000,000; 
(H) for fiscal year 2012, $65,300,000,000; 
and 
(I) for fiscal year 2013, $73,100,000,000. 
(c) TECHNICAL
AMENDMENT.—Section 1860D– 
16(c)(3) of the Social Security Act (42 U.S.C. 1395w– 
116(c)(3)), as added by section 101 of the Medicare Pre-
scription Drug, Improvement, and Modernization Act of 
2003 (Public Law 108–173), is amended by striking 
‘‘under paragraph (1) or subsection (a)(2)’’ and inserting 
‘‘under paragraph (1), (2), or (4), gifts and bequests as 
may be made as provided in section 201(i)(1), or accrued 
interest on balances in the Account’’. 
SEC. 3. PRESIDENTIAL SUBMISSION OF LEGISLATION. 
(a) IN GENERAL.—Section 1105 of title 31, United 
States Code, as amended by section 802(a) of the Medi-
care Prescription Drug, Improvement, and Modernization 
Act of 2003 (Public Law 108–173), is amended by adding 
at the end the following new subsection: 
‘‘(i)(1) If there is a medicare part D funding warning 
under section 2(a)(2) of the Medicare Prescription Drug 
Cost Containment Act of 2004 made in a year, the Presi-
dent shall submit to Congress, within the 15-day period 
beginning on the date of the budget submission to Con-
gress under subsection (a) for the succeeding year, pro-
posed legislation to respond to such warning. 
‘‘(2) Paragraph (1) does not apply if, during the year 
in which the warning is made, legislation is enacted which 
eliminates excess general revenue medicare funding (as de-
fined in section 2(b) of the Medicare Prescription Drug 
Cost Containment Act of 2004) for the period beginning 
with the fiscal year for which the determination is made
and ending on September 30, 2013, as certified by the 
Board of Trustees of the Federal Supplementary Medicare 
Insurance Trust Fund not later than 30 days after the 
date of the enactment of such legislation.’’. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that legislation submitted pursuant to section 
1105(i) of title 31, United States Code, in a year should 
be designed to eliminate excess general revenue medicare 
funding (as defined in section 2(b)) for the period that 
begins with the fiscal year for which the determination is 
made and ends on September 30, 2013. 
SEC. 4. PROCEDURES IN THE HOUSE OF REPRESENTA-
TIVES. 
(a) INTRODUCTION AND REFERRAL OF PRESIDENT’S 
LEGISLATIVE PROPOSAL.— 
(1) INTRODUCTION.—In the case of a legislative 
proposal submitted by the President pursuant to sec-
tion 1105(i) of title 31, United States Code, as 
added by section 3(a), within the 15-day period 
specified in paragraph (1) of such section, the ma-
jority leader of the House of Representatives (or his 
designee) and the minority leader of the House of 
Representatives (or his designee) shall introduce 
such proposal (by request), the title of which is as 
follows: ‘‘A bill to respond to a medicare part D
funding warning.’’ Such bill shall be introduced 
within 3 legislative days after Congress receives such 
proposal. 
(2) REFERRAL.—Any legislation introduced 
pursuant to paragraph (1) shall be referred to the 
appropriate committees of the House of Representa-
tives. 
(b) DIRECTION TO THE APPROPRIATE HOUSE COM-
MITTEES.— 
(1) IN GENERAL.—In the House, in any year 
during which the President is required to submit 
proposed legislation to Congress under section 
1105(i) of title 31, United States Code, the appro-
priate committees shall report medicare funding leg-
islation by not later than June 30 of such year. 
(2) MEDICARE
FUNDING
LEGISLATION.—For 
purposes of this section, the term ‘‘medicare funding 
legislation’’ means— 
(A) legislation introduced pursuant to sub-
section (a)(1), but only if the legislative pro-
posal upon which the legislation is based was 
submitted within the 15-day period referred to 
in such subsection; or
(B) any bill the title of which is as follows: 
‘‘A bill to respond to a medicare part D funding 
warning.’’. 
(3) CERTIFICATION.—With respect to any 
medicare funding legislation or any amendment to 
such legislation to respond to a medicare part D 
funding warning, the chairman of the Committee on 
the Budget of the House shall certify—
(A) whether or not such legislation elimi-
nates excess general revenue medicare funding 
(as defined in section 2(c)) for each fiscal year 
during the period beginning with the fiscal year 
for which the determination is made and ending 
on September 30, 2013; and 
(B) with respect to such an amendment, 
whether the legislation, as amended, would 
eliminate excess general revenue medicare fund-
ing (as defined in section 2(c)) for each fiscal 
year in such period. 
(c) FALLBACK PROCEDURE FOR FLOOR CONSIDER-
ATION IF THE HOUSE FAILS TO VOTE ON FINAL PASSAGE 
BY JULY 30.—
(1) After July 30 of any year during which the 
President is required to submit proposed legislation 
to Congress under section 1105(i) of title 31, United
States Code, unless the House of Representatives 
has voted on final passage of any medicare funding 
legislation for which there is an affirmative certifi-
cation under subsection (b)(3)(A), then, after the ex-
piration of not less than 30 calendar days (and con-
currently 5 legislative days), it is in order to move 
to discharge any committee to which medicare fund-
ing legislation which has such a certification and 
which has been referred to such committee for 30 
calendar days from further consideration of the leg-
islation. 
(2) A motion to discharge may be made only by 
an individual favoring the legislation, may be made 
only if supported by 1⁄5 of the total membership of 
the House of Representatives (a quorum being 
present), and is highly privileged in the House of 
Representatives. Debate thereon shall be limited to 
not more than 1 hour, the time to be divided in the 
House of Representatives equally between those fa-
voring and those opposing the motion. An amend-
ment to the motion is not in order, and it is not in 
order to move to reconsider the vote by which the 
motion is agreed to or disagreed to.
(3) Only 1 motion to discharge a particular 
committee may be adopted under this subsection in 
any session of Congress. 
(4) Notwithstanding paragraph (1), it shall not 
be in order to move to discharge a committee from 
further consideration of medicare funding legislation 
pursuant to this subsection during a session of Con-
gress if, during the previous session of the Congress, 
the House of Representatives passed medicare fund-
ing legislation for which there is an affirmative cer-
tification under subsection (b)(3)(A). 
(d) FLOOR CONSIDERATION IN THE HOUSE OF DIS-
CHARGED LEGISLATION.— 
(1) In the House, not later than 3 legislative 
days after any committee has been discharged from 
further consideration of legislation under subsection 
(c), the Speaker shall resolve the House into the 
Committee of the Whole for consideration of the leg-
islation. 
(2) The first reading of the legislation shall be 
dispensed with. All points of order against consider-
ation of the legislation are waived. General debate 
shall be confined to the legislation and shall not ex-
ceed 5 hours, which shall be divided equally between 
those favoring and those opposing the legislation.
After general debate the legislation shall be consid-
ered for amendment under the 5-minute rule. Dur-
ing consideration of the legislation, no amendments 
shall be in order in the House of Representatives or 
in the Committee of the Whole except those for 
which there has been an affirmative certification 
under subsection (b)(3)(B). All points of order 
against consideration of any such amendment in the 
Committee of the Whole are waived. The legislation, 
together with any amendments which shall be in 
order, shall be considered as read. During the con-
sideration of the bill for amendment, the Chairman 
of the Committee of the Whole may accord priority 
in recognition on the basis of whether the Member 
offering an amendment has caused it to be printed 
in the portion of the Congressional Record des-
ignated for that purpose in clause 8 of Rule XVIII 
of the Rules of the House of Representatives. De-
bate on any amendment shall not exceed 1 hour, 
which shall be divided equally between those favoring 
and those opposing the amendment, and no pro 
forma amendments shall be offered during the de-
bate. The total time for debate on all amendments 
shall not exceed 10 hours. At the conclusion of con-
sideration of the legislation for amendment, the
Committee shall rise and report the legislation to the 
House of Representatives with such amendments as 
may have been adopted. The previous question shall 
be considered as ordered on the legislation and 
amendments thereto to final passage without inter-
vening motion except one motion to recommit with 
or without instructions. If the Committee of the 
Whole rises and reports that it has come to no reso-
lution on the bill, then on the next legislative day the 
House of Representatives shall, immediately after 
the third daily order of business under clause 1 of 
Rule XIV of the Rules of the House of Representa-
tives, resolve into the Committee of the Whole for 
further consideration of the bill. 
(3) All appeals from the decisions of the Chair 
relating to the application of the Rules of the House 
of Representatives to the procedure relating to any 
such legislation shall be decided without debate. 
(4) Except to the extent specifically provided in 
the preceding provisions of this subsection, consider-
ation of any such legislation and amendments there-
to (or any conference report thereon) shall be gov-
erned by the Rules of the House of Representatives 
applicable to other bills and resolutions, amend-
ments, and conference reports in similar cir-
cumstances. 
(e) LEGISLATIVE DAY DEFINED.—As used in this 
section, the term ‘‘legislative day’’ means a day on which 
the House of Representatives is in session. 
(f) RESTRICTION ON WAIVER.—In the House of Rep-
resentatives, the provisions of this section may be waived 
only by a rule or order proposing only to waive such provi-
sions. 
(g) RULEMAKING POWER.—The provisions of this 
section are enacted by the Congress— 
(1) as an exercise of the rulemaking power of 
the House of Representatives and, as such, shall be 
considered as part of the rules of that House of 
Representatives and shall supersede other rules only 
to the extent that they are inconsistent therewith; 
and 
(2) with full recognition of the constitutional 
right of that House to change the rules (so far as 
they relate to the procedures of that House) at any 
time, in the same manner, and to the same extent 
as in the case of any other rule of that House. 
SEC. 5. PROCEDURES IN THE SENATE. 
(a) INTRODUCTION AND REFERRAL OF PRESIDENT’S 
LEGISLATIVE PROPOSAL.—
(c) QUALIFICATION FOR SPECIAL PROCEDURES.— 
(1) IN GENERAL.—The special procedures set 
forth in subsections (d) and (e) shall apply to medi-
care funding legislation, as described in subsection 
(b), only if the legislation— 
(A) is medicare funding legislation that is 
passed by the House of Representatives; or 
(B) contains matter within the jurisdiction 
of the Committee on Finance in the Senate. 
(2) FAILURE TO QUALIFY FOR SPECIAL PROCE-
DURES.—If the medicare funding legislation does 
not satisfy paragraph (1), then the legislation shall 
be considered under the ordinary procedures of the 
Standing Rules of the Senate. 
(d) DISCHARGE.— 
(1) IN
GENERAL.—If the Committee on Fi-
nance of the Senate has not reported medicare fund-
ing legislation described in subsection (c)(1) by June 
30 of a year in which the President is required to 
submit medicare funding legislation to Congress 
under section 1105(i) of title 31, United States 
Code, then any Senator may move to discharge the 
Committee of any single medicare funding legislation 
measure. Only 1 such motion shall be in order in 
any session of Congress.
(2) DEBATE LIMITS.—Debate in the Senate on 
any such motion to discharge, and all appeals in 
connection therewith, shall be limited to not more 
than 2 hours. The time shall be equally divided be-
tween, and controlled by, the maker of the motion 
and the majority leader, or their designees, except 
that in the event the majority leader is in favor of 
such motion, the time in opposition thereto shall be 
controlled by the minority leader or the minority 
leader’s designee. A point of order under this sub-
section may be made at any time. It is not in order 
to move to proceed to another measure or matter 
while such motion (or the motion to reconsider such 
motion) is pending. 
(3) AMENDMENTS.—No amendment to the mo-
tion to discharge shall be in order. 
(4) EXCEPTION IF CERTIFIED LEGISLATION EN-
ACTED.—Notwithstanding paragraph (1), it shall 
not be in order to discharge the Committee from 
further consideration of medicare funding legislation 
pursuant to this subsection during a session of a 
Congress if the chairman of the Committee on the 
Budget of the Senate certifies that medicare funding 
legislation has been enacted that eliminates excess 
general revenue medicare funding (as defined in sec-
tion 2(c)) for each fiscal year in the period begin-
ning with the fiscal year for which the determination 
is made and ending on September 30, 2013. 
(e) CONSIDERATION.—After the date on which the 
Committee on Finance of the Senate has reported medi-
care funding legislation described in subsection (c)(1), or 
has been discharged (under subsection (d)) from further 
consideration of, such legislation, it is in order (even 
though a previous motion to the same effect has been dis-
agreed to) for any Member of the Senate to move to pro-
ceed to the consideration of such legislation. 
(f) RULES OF THE SENATE.—This section is enacted 
by the Senate— 
(1) as an exercise of the rulemaking power of 
the Senate and as such it is deemed a part of the 
rules of the Senate, but applicable only with respect 
to the procedure to be followed in the Senate in the 
case of a bill described in this paragraph, and it su-
persedes other rules only to the extent that it is in-
consistent with such rules; and 
(2) with full recognition of the constitutional 
right of the Senate to change the rules (so far as re-
lating to the procedure of the Senate) at any time,
in the same manner, and to the same extent as in 
the case of any other rule of the Senate. 
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