I 
109TH CONGRESS 
1ST SESSION H. R. 2072 
To amend title XVIII of the Social Security Act and the Employee Retirement 
Income Security Act of 1974 to provide access to Medicare benefits 
for individuals ages 55 to 65, to amend the Internal Revenue Code 
of 1986 to allow a refundable and advanceable credit against income 
tax for payment of such premiums, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 4, 2005 
Mr. STARK (for himself, Mr. BROWN of Ohio, Mr. RANGEL, Mr. DINGELL, 
Mr. WAXMAN, Ms. PELOSI, Mr. GEORGE MILLER of California, Mr. 
PALLONE, Mr. ALLEN, Mr. ANDREWS, Mr. BACA, Ms. BALDWIN, Ms. 
BERKLEY, Mr. BERRY, Ms. CORRINE
BROWN
of Florida, Mr. 
BUTTERFIELD, Mr. CARNAHAN, Mrs. CAPPS, Mr. CARDIN, Ms. CARSON, 
Mrs. CHRISTENSEN, Mr. CLEAVER, Mr. CROWLEY, Mr. CUELLAR, Mr. 
CUMMINGS, Mrs. DAVIS of California, Ms. DELAURO, Mr. DOGGETT, Mr. 
EMANUEL, Mr. ENGEL, Mr. EVANS, Mr. FARR, Mr. GONZALEZ, Mr. 
GORDON, Mr. AL GREEN of Texas, Mr. GENE GREEN of Texas, Mr. 
GRIJALVA, Mr. GUTIERREZ, Mr. HASTINGS of Florida, Mr. HIGGINS, Mr. 
HINCHEY, Mr. HINOJOSA, Ms. NORTON, Mr. HOLT, Mr. HONDA, Mr. 
HOYER, Mr. ISRAEL, Mr. JACKSON of Illinois, Ms. JACKSON-LEE of 
Texas, Mr. KILDEE, Ms. KILPATRICK of Michigan, Mr. KUCINICH, Mr. 
LANGEVIN, Mr. LANTOS, Mr. LARSON of Connecticut, Ms. LEE, Mr. 
LEWIS of Georgia, Mr. LYNCH, Mrs. MALONEY, Ms. MATSUI, Mrs. 
MCCARTHY, Ms. MCCOLLUM of Minnesota, Mr. MCDERMOTT, Mr. 
MCGOVERN, Mr. MCNULTY, Mr. MEEHAN, Mr. MENENDEZ, Mr. 
MICHAUD, Ms. MILLENDER-MCDONALD, Mr. MURTHA, Mr. NADLER, Mr. 
OBERSTAR, Mr. OLVER, Mr. ORTIZ, Mr. OWENS, Mr. PASCRELL, Mr. 
PASTOR, 
Mr. 
REYES, 
Mr. 
ROSS, 
Ms. 
ROYBAL-ALLARD, 
Mr. 
RUPPERSBERGER, Mr. RYAN of Ohio, Mr. SALAZAR, Ms. LINDA T. 
SA´NCHEZ of California, Ms. SCHAKOWSKY, Ms. SCHWARTZ of Pennsyl-
vania, Mr. SCOTT of Georgia, Mr. SCOTT of Virginia, Mr. SERRANO, Ms. 
SOLIS, Mr. STRICKLAND, Mr. STUPAK, Mr. TIERNEY, Mr. VAN HOLLEN, 
Ms. WASSERMAN SCHULTZ, Mr. WEXLER, Mr. JEFFERSON, and Mr. 
SANDERS) introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committees on Energy 
and Commerce and Education and the Workforce, for a period to be sub-
sequently 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 title XVIII of the Social Security Act and the 
Employee Retirement Income Security Act of 1974 to 
provide access to Medicare benefits for individuals ages 
55 to 65, to amend the Internal Revenue Code of 1986 
to allow a refundable and advanceable credit against 
income tax for payment of such premiums, 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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Medicare Early Access Act of 2005’’. 
(b) TABLE OF CONTENTS.— 
Sec. 1. Short title; table of contents. 
TITLE I—ACCESS TO MEDICARE BENEFITS FOR INDIVIDUALS 55 
TO 65 YEARS OF AGE 
Sec. 101. Access to Medicare benefits for individuals 55 to 65 years of age. 
‘‘PART E—PURCHASE OF MEDICARE BENEFITS BY CERTAIN INDIVIDUALS 55 
TO 65 YEARS OF AGE 
‘‘Sec. 1860E–1. Program benefits; eligibility. 
‘‘Sec. 1860E–2. Enrollment process; coverage. 
‘‘Sec. 1860E–3. Premiums. 
‘‘Sec. 1860E–4. Payment of premiums. 
‘‘Sec. 1860E–5. Provisions relating to Employment-Based retiree health 
coverage. 
‘‘Sec. 1860E–6. Medicare Early Access Trust Fund. 
‘‘Sec. 1860E–7. Oversight and accountability. 
‘‘Sec. 1860E–8. Administration and miscellaneous. 
TITLE II—REFUNDABLE AND ADVANCEABLE CREDIT AGAINST 
INCOME TAX FOR MEDICARE EARLY ACCESS PREMIUMS 
Sec. 201. Refundable and advanceable income tax credit for Medicare early ac-
cess premiums.
TITLE I—ACCESS TO MEDICARE 
BENEFITS FOR INDIVIDUALS 
55 TO 65 YEARS OF AGE 
SEC. 101. ACCESS TO MEDICARE BENEFITS FOR INDIVID-
UALS 55 TO 65 YEARS OF AGE. 
(a) IN GENERAL.—Title XVIII of the Social Security 
Act is amended— 
(1) by redesignating part E as part F; and 
(2) by inserting after part D the following new 
part: 
‘‘PART E—PURCHASE OF MEDICARE BENEFITS 
BY CERTAIN INDIVIDUALS 55 TO 65 YEARS OF 
AGE 
‘‘SEC. 1860E–1. PROGRAM BENEFITS; ELIGIBILITY. 
‘‘(a) ENTITLEMENT TO MEDICARE BENEFITS FOR 
ENROLLED INDIVIDUALS.— 
‘‘(1) IN
GENERAL.—An individual enrolled 
under this part is entitled to the same benefits 
under this title as an individual entitled to benefits 
or enrolled under any part of this title. 
‘‘(2) DEFINITIONS.—For purposes of this part: 
‘‘(A) FEDERAL OR STATE COBRA CONTINU-
ATION PROVISION.—The term ‘Federal or State 
COBRA continuation provision’ has the mean-
ing given the term ‘COBRA continuation provi-
sion’ in section 2791(d)(4) of the Public Health 
Service Act and includes a comparable State 
program, as determined by the Secretary. 
‘‘(B) FEDERAL HEALTH INSURANCE PRO-
GRAM DEFINED.—The term ‘Federal health in-
surance program’ means any of the following: 
‘‘(i) MEDICARE.—Any part of this 
title (other than by reason of this part). 
‘‘(ii) MEDICAID.—A State plan under 
title XIX. 
‘‘(iii) FEHBP.—The Federal employ-
ees health benefit program under chapter 
89 of title 5, United States Code. 
‘‘(iv) 
TRICARE.—The 
TRICARE 
program (as defined in section 1072(7) of 
title 10, United States Code). 
‘‘(v) ACTIVE DUTY MILITARY.—Health 
benefits under title 10, United States 
Code, to an individual as a member of the 
uniformed services of the United States. 
‘‘(C) GROUP
HEALTH
PLAN.—The term 
‘group health plan’ has the meaning given such 
term in section 2791(a)(1) of the Public Health 
Service Act.
‘‘(b) ELIGIBILITY OF INDIVIDUALS AGE 55 TO 65 
YEARS OF AGE.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
an individual who meets the following requirements 
with respect to a month is eligible to enroll under 
this part with respect to such month: 
‘‘(A) AGE.—As of the last day of the 
month, the individual has attained 55 years of 
age, but has not attained 65 years of age. 
‘‘(B) MEDICARE
ELIGIBILITY
(BUT
FOR 
AGE).—The individual would be eligible for ben-
efits under part A or part B for the month if 
the individual were 65 years of age. 
‘‘(C) 
NOT
ELIGIBLE
FOR
COVERAGE 
UNDER
GROUP
HEALTH
PLANS
OR
FEDERAL 
HEALTH
INSURANCE
PROGRAMS.—The indi-
vidual is not eligible for benefits or coverage 
under a Federal health insurance program (as 
defined in subsection (a)(2)(B)) or under a 
group health plan (other than such eligibility 
merely through a Federal or State COBRA con-
tinuation provision) as of the last day of the 
month involved. 
‘‘(2) LIMITATION
ON
ELIGIBILITY
IF
TERMI-
NATED ENROLLMENT.—If an individual described in
paragraph (1) enrolls under this part and coverage 
of the individual is terminated under section 1860E– 
2(d) (other than because of age), the individual is 
not again eligible to enroll under this subsection un-
less the following requirements are met: 
‘‘(A) NEW
COVERAGE
UNDER
GROUP 
HEALTH
PLAN
OR
FEDERAL
HEALTH
INSUR-
ANCE PROGRAM.—After the date of termination 
of coverage under such section, the individual 
obtains coverage under a group health plan or 
under a Federal health insurance program. 
‘‘(B) SUBSEQUENT
LOSS
OF
NEW
COV-
ERAGE.—The individual subsequently loses eli-
gibility for the coverage described in subpara-
graph (A) without regard to whether the indi-
vidual has exhausted any eligibility the indi-
vidual may subsequently have for coverage 
under a Federal or State COBRA continuation 
provision. 
‘‘(3) CHANGE
IN
HEALTH
PLAN
ELIGIBILITY 
DOES NOT AFFECT COVERAGE.—In the case of an 
individual who is eligible for and enrolls under this 
part under this subsection, the individual’s continued 
entitlement to benefits under this part shall not be 
affected by the individual’s subsequent eligibility for
benefits or coverage described in paragraph (1)(C), 
or entitlement to such benefits or coverage. 
‘‘SEC. 1860E–2. ENROLLMENT PROCESS; COVERAGE. 
‘‘(a) IN GENERAL.—An individual may enroll in the 
program established under this part only in such manner 
and form as may be prescribed by regulations, and only 
during an enrollment period prescribed by the Secretary 
consistent with the provisions of this section. Such regula-
tions shall provide a process under which individuals eligi-
ble to enroll as of a month are permitted to pre-enroll dur-
ing a prior month within an enrollment period described 
in subsection (b). 
‘‘(b) ENROLLMENT PERIODS.— 
‘‘(1) INDIVIDUALS 55 TO 65 YEARS OF AGE.—In 
the case of individuals eligible to enroll under this 
part under section 1860E–1(b)— 
‘‘(A) INITIAL
ENROLLMENT
PERIOD.—If 
the individual is eligible to enroll under such 
section for January 2006, the enrollment period 
shall begin on November 1, 2005, and shall end 
on February 28, 2006. Any such enrollment be-
fore January 1, 2006, is conditioned upon com-
pliance with the conditions of eligibility for Jan-
uary 2006.
‘‘(B) SUBSEQUENT PERIODS.—If the indi-
vidual is eligible to enroll under such section for 
a month after January 2006, the enrollment pe-
riod shall begin on the first day of the second 
month before the month in which the individual 
first is eligible to so enroll and shall end four 
months later. Any such enrollment before the 
first day of the third month of such enrollment 
period is conditioned upon compliance with the 
conditions of eligibility for such third month. 
‘‘(2) AUTHORITY
TO
CORRECT
FOR
GOVERN-
MENT ERRORS.—The provisions of section 1837(h) 
apply with respect to enrollment under this part in 
the same manner as they apply to enrollment under 
part B. 
‘‘(c) DATE COVERAGE BEGINS.— 
‘‘(1) IN GENERAL.—The period during which 
an individual is entitled to benefits under this part 
shall begin as follows, but in no case earlier than 
January 1, 2006: 
‘‘(A) In the case of an individual who en-
rolls (including pre-enrolls) before the month in 
which the individual satisfies eligibility for en-
rollment under section 1860E–1, the first day 
of such month of eligibility.
‘‘(B) In the case of an individual who en-
rolls during or after the month in which the in-
dividual first satisfies eligibility for enrollment 
under such section, the first day of the fol-
lowing month. 
‘‘(2) AUTHORITY
TO
PROVIDE
FOR
PARTIAL 
MONTHS
OF
COVERAGE.—Under regulations, the 
Secretary may, in the Secretary’s discretion, provide 
for coverage periods that include portions of a 
month in order to avoid lapses of coverage. 
‘‘(3) LIMITATION ON PAYMENTS.—No payments 
may be made under this title with respect to the ex-
penses of an individual enrolled under this part un-
less such expenses were incurred by such individual 
during a period which, with respect to the individual, 
is a coverage period under this section. 
‘‘(d) TERMINATION OF COVERAGE.— 
‘‘(1) IN
GENERAL.—An individual’s coverage 
period under this part shall continue until the indi-
vidual’s enrollment has been terminated at the ear-
liest of the following: 
‘‘(A) GENERAL PROVISIONS.— 
‘‘(i) NOTICE.—The individual files no-
tice (in a form and manner prescribed by 
the Secretary) that the individual no
longer wishes to participate in the insur-
ance program under this part. 
‘‘(ii) NONPAYMENT OF PREMIUMS.— 
The individual fails to make payment of 
premiums required for enrollment under 
this part. 
‘‘(iii) MEDICARE
ELIGIBILITY.—The 
individual becomes entitled to benefits or 
enrolled under any other part of this title 
(other than by reason of this part). 
‘‘(B) TERMINATION BASED ON AGE.—The 
individual attains 65 years of age. 
‘‘(2) EFFECTIVE DATE OF TERMINATION.— 
‘‘(A) NOTICE.—The termination of a cov-
erage period under paragraph (1)(A)(i) shall 
take effect at the close of the month following 
for which the notice is filed. 
‘‘(B) NONPAYMENT
OF
PREMIUM.—The 
termination of a coverage period under para-
graph (1)(A)(ii) shall take effect on a date de-
termined under regulations, which may be de-
termined so as to provide a grace period in 
which overdue premiums may be paid and cov-
erage continued. The grace period determined 
under the preceding sentence shall not exceed
60 days; except that it may be extended for an 
additional 30 days in any case where the Sec-
retary determines that there was good cause for 
failure to pay the overdue premiums within 
such 60-day period. 
‘‘(C) AGE
OR
MEDICARE
ELIGIBILITY.— 
The termination of a coverage period under 
paragraph (1)(A)(iii) or (1)(B) shall take effect 
as of the first day of the month in which the 
individual attains 65 years of age or becomes 
entitled to benefits or enrolled in any other part 
of this title (other than by reason of this part). 
‘‘SEC. 1860E–3. PREMIUMS. 
‘‘(a) AMOUNT OF MONTHLY PREMIUMS.—The Sec-
retary shall, during September of each year (beginning 
with 2005), determine a monthly premium for individuals 
55 years of age or older, equal to 1⁄12 of the annual pre-
mium computed under subsection (b)(2), which shall apply 
with respect to coverage provided under this title for any 
month in the succeeding year. 
‘‘(b) ANNUAL PREMIUM.— 
‘‘(1) NATIONAL, PER
CAPITA
AVERAGE.—The 
Secretary shall estimate the average, annual per 
capita amount that would be payable under this title 
with respect to individuals residing in the United
States who meet the requirement of section 1860E– 
1(b)(1)(A) as if all such individuals were eligible for 
(and enrolled) under this title during the entire year 
(and assuming that section 1862(b)(2)(A)(i) did not 
apply). 
‘‘(2) ANNUAL PREMIUM.—The annual premium 
under this subsection for months in a year is equal 
to the average, annual per capita amount estimated 
under paragraph (1) for the year. 
‘‘SEC. 1860E–4. PAYMENT OF PREMIUMS. 
‘‘(a) PAYMENT OF MONTHLY PREMIUM.— 
‘‘(1) IN GENERAL.—The Secretary shall provide 
for payment and collection of the monthly premium, 
determined under section 1860E–3(a) for the age of 
the individual involved, in the same manner as for 
payment of monthly premiums under section 1840, 
except that, for purposes of applying this section, 
any reference in such section to the Federal Supple-
mentary Medical Insurance Trust Fund is deemed a 
reference to the Trust Fund established under sec-
tion 1860E–6. 
‘‘(2) PERIOD OF PAYMENT.—In the case of an 
individual who participates in the program estab-
lished by this title, the monthly premium shall be 
payable for the period commencing with the first