I 
117TH CONGRESS 
1ST SESSION H. R. 5040 
To amend titles XVIII and XIX of the Social Security Act to reduce cost- 
sharing, align income and resource eligibility tests, simplify enrollment, 
and provide for other program improvements for low-income Medicare 
beneficiaries. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 17, 2021 
Ms. BLUNT ROCHESTER (for herself, Mr. KIM of New Jersey, and Mr. 
EVANS) introduced the following bill; which was referred to the Com-
mittee on Energy 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 jurisdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to reduce cost-sharing, align income and resource eligi-
bility tests, simplify enrollment, and provide for other 
program improvements for low-income Medicare bene-
ficiaries. 
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 ‘‘Helping Seniors Afford 
Health Care Act’’. 
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SEC. 2. REDUCING COST-SHARING, ALIGNING INCOME AND 
RESOURCE ELIGIBILITY TESTS, SIMPLIFYING 
ENROLLMENT, AND OTHER PROGRAM IM-
PROVEMENTS 
FOR 
LOW-INCOME 
BENE-
FICIARIES. 
(a) INCREASE IN INCOME ELIGIBILITY TO 135 PER-
CENT
OF
FPL FOR
QUALIFIED
MEDICARE
BENE-
FICIARIES.— 
(1) IN GENERAL.—Section 1905(p)(2)(A) of the 
Social Security Act (42 U.S.C. 1396d(p)(2)(A)) is 
amended by striking ‘‘shall be at least the percent 
provided under subparagraph (B) (but not more 
than 100 percent) of the official poverty line’’ and 
all that follows through the period at the end and 
inserting the following: ‘‘shall be— 
‘‘(i) before January 1, 2022, at least 
the percent provided under subparagraph 
(B) (but not more than 100 percent) of 
the official poverty line (as defined by the 
Office of Management and Budget, and re-
vised annually in accordance with section 
673(2) of the Omnibus Budget Reconcili-
ation Act of 1981) applicable to a family 
of the size involved; and 
‘‘(ii) on or after January 1, 2022, 
equal to 135 percent of the official poverty 
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line (as so defined and revised) applicable 
to a family of the size involved.’’. 
(2) NOT
COUNTING
IN-KIND
SUPPORT
AND 
MAINTENANCE AS INCOME.—Section 1905(p)(2)(D) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396d(p)(2)(D)) is amended by adding at the end 
the following new clause: 
‘‘(iii) In determining income under this sub-
section, support and maintenance furnished in kind 
shall not be counted as income.’’. 
(b) INCREASE IN INCOME ELIGIBILITY TO 200 PER-
CENT OF FPL FOR SPECIFIED LOW-INCOME MEDICARE 
BENEFICIARIES.— 
(1) ELIGIBILITY
OF
INDIVIDUALS
WITH
IN-
COMES
BELOW
150
PERCENT
OF
FPL.—Section 
1902(a)(10)(E) of the Social Security Act (42 
U.S.C. 1396a(a)(10)(E)) is amended— 
(A) by adding ‘‘and’’ at the end of clause 
(ii); 
(B) in clause (iii)— 
(i) by striking ‘‘and 120 percent in 
1995 and years thereafter’’ and inserting 
‘‘120 percent in 1995 and years thereafter 
before 2022, and 200 percent in 2022 and 
years thereafter’’; and 
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(ii) by striking ‘‘and’’ at the end; and 
(C) by striking clause (iv). 
(2) REFERENCES.—Section 1905(p)(1) of the 
Social Security Act (42 U.S.C. 1396d(p)(1)) is 
amended by adding at and below subparagraph (C) 
the following flush sentence: 
‘‘The term ‘specified low-income medicare beneficiary’ 
means 
an 
individual 
described 
in 
section 
1902(a)(10)(E)(iii).’’. 
(3) CONFORMING AMENDMENTS.— 
(A) The first sentence of section 1905(b) 
of such Act (42 U.S.C. 1396d(b)) is amended 
by striking ‘‘and section 1933(d)’’. 
(B) Section 1933 of such Act (42 U.S.C. 
1396u–3) is repealed. 
(c) 100 PERCENT FMAP.—Section 1905 of the So-
cial Security Act (42 U.S.C. 1396d) is amended by adding 
at the end the following new subsection: 
‘‘(jj) INCREASED FMAP FOR EXPANDED MEDICARE 
COST-SHARING POPULATIONS.— 
‘‘(1) IN GENERAL.—Notwithstanding subsection 
(b), with respect to expenditures described in para-
graph (2) the Federal medical assistance percentage 
shall be equal to 100 percent. 
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