I 
110TH CONGRESS 
1ST SESSION H. R. 4295 
To amend title XVIII of the Social Security Act to require wealthy bene-
ficiaries to pay a greater share of their premiums under the Medicare 
prescription drug program. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 5, 2007 
Mr. RYAN of Wisconsin (for himself, Mr. HENSARLING, and Mr. FLAKE) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to require 
wealthy beneficiaries to pay a greater share of their 
premiums under the Medicare prescription drug program. 
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 ‘‘Reforming an Entitle-
ment through Premium Adjustments based on Income Re-
sources (REPAIR) Act of 2007’’. 
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SEC. 2. INCOME-RELATED REDUCTION IN PART D PREMIUM 
SUBSIDY. 
(a) INCOME-RELATED REDUCTION IN PART D PRE-
MIUM SUBSIDY.— 
(1) IN GENERAL.—Section 1860D–13(a) of the 
Social Security Act (42 U.S.C. 1395w–113(a)) is 
amended by adding at the end the following new 
paragraph: 
‘‘(7) REDUCTION IN PREMIUM SUBSIDY BASED 
ON INCOME.— 
‘‘(A) IN GENERAL.—In the case of an indi-
vidual whose modified adjusted gross income 
exceeds the threshold amount applicable under 
paragraph (2) of section 1839(i) (including ap-
plication of paragraph (5) of such section) for 
the calendar year, the monthly amount of the 
premium subsidy applicable to the premium 
under this section for a month after December 
2008 shall be reduced (and the monthly bene-
ficiary premium shall be increased) by the 
monthly adjustment amount specified in sub-
paragraph (B). 
‘‘(B) MONTHLY ADJUSTMENT AMOUNT.— 
The monthly adjustment amount specified in 
this subparagraph for an individual for a month 
in a year is equal to the product of— 
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‘‘(i) the quotient obtained by divid-
ing— 
‘‘(I) the applicable percentage de-
termined under paragraph (3)(C) of 
section 1839(i) (including application 
of paragraph (5) of such section) for 
the individual for the calendar year 
reduced by 25.5 percent; by 
‘‘(II) 25.5 percent; and 
‘‘(ii) the base beneficiary premium (as 
computed under paragraph (2)). 
‘‘(C) MODIFIED
ADJUSTED
GROSS
IN-
COME.—For purposes of this paragraph, the 
term ‘modified adjusted gross income’ has the 
meaning given such term in subparagraph (A) 
of section 1839(i)(4), determined for the tax-
able year applicable under subparagraphs (B) 
and (C) of such section. 
‘‘(D) DETERMINATION BY COMMISSIONER 
OF
SOCIAL
SECURITY.—The Commissioner of 
Social Security shall make any determination 
necessary to carry out the income-related reduc-
tion in premium subsidy under this paragraph. 
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‘‘(E) PROCEDURES TO ASSURE CORRECT 
INCOME-RELATED
REDUCTION
IN
PREMIUM 
SUBSIDY.— 
‘‘(i) DISCLOSURE
OF
BASE
BENE-
FICIARY
PREMIUM.—Not later than Sep-
tember 15 of each year beginning with 
2008, the Secretary shall disclose to the 
Commissioner 
of 
Social 
Security 
the 
amount of the base beneficiary premium 
(as computed under paragraph (2)) for the 
purpose of carrying out the income-related 
reduction in premium subsidy under this 
paragraph with respect to the following 
year. 
‘‘(ii) ADDITIONAL DISCLOSURE.—Not 
later than October 15 of each year begin-
ning with 2008, the Secretary shall dis-
close to the Commissioner of Social Secu-
rity the following information for the pur-
pose of carrying out the income-related re-
duction in premium subsidy under this 
paragraph with respect to the following 
year: 
‘‘(I) The modified adjusted gross 
income threshold applicable under 
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paragraph (2) of section 1839(i) (in-
cluding application of paragraph (5) 
of such section). 
‘‘(II) The applicable percentage 
determined under paragraph (3)(C) of 
section 1839(i) (including application 
of paragraph (5) of such section). 
‘‘(III) The monthly adjustment 
amount specified in subparagraph 
(B). 
‘‘(IV) Any other information the 
Commissioner of Social Security de-
termines necessary to carry out the 
income-related reduction in premium 
subsidy under this paragraph. 
‘‘(F) RULE OF CONSTRUCTION.—The for-
mula used to determine the monthly adjustment 
amount specified under subparagraph (B) shall 
only be used for the purpose of determining 
such monthly adjustment amount under such 
subparagraph.’’. 
(2) COLLECTION
OF
MONTHLY
ADJUSTMENT 
AMOUNT.—Section 1860D–13(c) of the Social Secu-
rity Act (42 U.S.C. 1395w–113(c)) is amended— 
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(A) in paragraph (1), by striking ‘‘(2) and 
(3)’’ and inserting ‘‘(2), (3), and (4)’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(4) COLLECTION OF MONTHLY ADJUSTMENT 
AMOUNT.— 
‘‘(A) IN GENERAL.—Notwithstanding any 
other provision of this subsection or section 
1854(d)(2), subject to subparagraph (B), the 
amount of the income-related reduction in pre-
mium subsidy for an individual for a month (as 
determined under subsection (a)(7)) shall be 
paid through withholding from benefit pay-
ments in the manner provided under section 
1840. 
‘‘(B) AGREEMENTS.—In the case where 
the monthly benefit payments of an individual 
that are withheld under subparagraph (A) are 
insufficient to pay the amount described in such 
subparagraph, the Commissioner of Social Se-
curity shall enter into agreements with the Sec-
retary, the Director of the Office of Personnel 
Management, and the Railroad Retirement 
Board as necessary in order to allow other 
agencies to collect the amount described in sub-
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paragraph (A) that was not withheld under 
such subparagraph.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) MEDICARE.—Part D of title XVIII of the 
Social Security Act (42 U.S.C. 1395w–101 et seq.) 
is amended— 
(A) in section 1860D–13(a)(1)— 
(i) by redesignating subparagraph (F) 
as subparagraph (G); 
(ii) in subparagraph (G), as redesig-
nated by clause (i), by striking ‘‘(D) and 
(E)’’ and inserting ‘‘(D), (E), and (F)’’; 
and 
(iii) by inserting after subparagraph 
(E) the following new subparagraph: 
‘‘(F) INCREASE BASED ON INCOME.—The 
monthly beneficiary premium shall be increased 
pursuant to paragraph (7).’’; and 
(B) in section 1860D–15(a)(1)(B), by 
striking ‘‘paragraph (1)(B)’’ and inserting 
‘‘paragraphs (1)(B) and (1)(F)’’. 
(2) 
INTERNAL
REVENUE
CODE.—Section 
6103(l)(20) of the Internal Revenue Code of 1986 
(relating to disclosure of return information to carry 
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out Medicare part B premium subsidy adjustment) 
is amended— 
(A) in the heading, by striking ‘‘PART B 
PREMIUM SUBSIDY ADJUSTMENT’’ and inserting 
‘‘PARTS B AND D PREMIUM SUBSIDY ADJUST-
MENTS’’; 
(B) in subparagraph (A)— 
(i) in the matter preceding clause (i), 
by inserting ‘‘or 1860D–13(a)(7)’’ after 
‘‘1839(i)’’; and 
(ii) in clause (vii), by inserting after 
‘‘subsection (i) of such section’’ the fol-
lowing: ‘‘or under section 1860D–13(a)(7) 
of such Act’’; 
(C) in subparagraph (B)— 
(i) by inserting ‘‘or such section 
1860D–13(a)(7)’’ before the period at the 
end; 
(ii) as amended by clause (i), by in-
serting ‘‘or for the purpose of resolving tax 
payer appeals with respect to any such pre-
mium adjustment’’ before the period at the 
end; and 
(iii) by adding at the end the fol-
lowing new sentence: ‘‘Officers, employees, 
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and contractors of the Social Security Ad-
ministration may disclose such return in-
formation to officers, employees, and con-
tractors of the Department of Health and 
Human Services, the Office of Personnel 
Management, the Railroad Retirement 
Board, the Department of Justice, and the 
courts of the United States to the extent 
necessary to carry out the purposes de-
scribed in the preceding sentence.’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(C) TIMING OF DISCLOSURE.—Return in-
formation shall be disclosed to officers, employ-
ees, and contractors of the Social Security Ad-
ministration under subparagraph (A) not later 
than the date that is 90 days prior to the date 
on which the taxpayer first becomes entitled to 
benefits under part A of title XVIII of the So-
cial Security Act or eligible to enroll for benefits 
under part B of such title.’’. 
Æ 
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