month of the individual’s coverage period and ending 
with the month in which the individual’s coverage 
under this title terminates. 
‘‘(b) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of section 1840 (other than subsection (h)) 
shall apply to premiums collected under this section in the 
same manner as they apply to premiums collected under 
part B, except that any reference in such section to the 
Federal Supplementary Medical Insurance Trust Fund is 
deemed a reference to the Trust Fund established under 
section 1860E–6. 
‘‘SEC. 1860E–5. PROVISIONS RELATING TO EMPLOYMENT- 
BASED RETIREE HEALTH COVERAGE. 
‘‘(a) IN GENERAL.—In the case of an individual who 
would be eligible to enroll under this part but for the pro-
vision of employment-based retiree health coverage by an 
employer to the individual, notwithstanding the limitation 
under section 1860E–1(b)(1)(C), the individual is eligible 
to enroll under this part. 
‘‘(b) MAINTENANCE OF EFFORT.—In the case of an 
employer that offers employment-based retiree health cov-
erage to an individual who enrolls under this part, upon 
enrollment of the individual under this part, the employer 
may modify such coverage to provide for the following ben-
efits:
‘‘(1) Payment is made by the employer under 
such coverage for items and services for which pay-
ment may not be made under this title. 
‘‘(2) Payment is made by the employer spon-
soring such coverage of 25 percent of the monthly 
premium under section 1860E–3 applicable to the 
individual after enrollment under this part. 
‘‘(c) EMPLOYMENT-BASED RETIREE HEALTH COV-
ERAGE.—The term ‘employment-based retiree health cov-
erage’ has the meaning given that term in section 1860D– 
22(c)(1), except that, for purposes of this part, any ref-
erence in such section to ‘part D’ is deemed to be a ref-
erence to ‘part E’. 
‘‘SEC. 1860E–6. MEDICARE EARLY ACCESS TRUST FUND. 
‘‘(a) ESTABLISHMENT OF TRUST FUND.— 
‘‘(1) IN GENERAL.—There is hereby created on 
the books of the Treasury of the United States a 
trust fund to be known as the ‘Medicare Early Ac-
cess Trust Fund’ (in this section referred to as the 
‘Trust Fund’). The Trust Fund shall consist of such 
gifts and bequests as may be made as provided in 
section 201(i)(1) and such amounts as may be de-
posited in, or appropriated to, such fund as provided 
in this title.
‘‘(2) PREMIUMS.—Premiums collected under 
section 1860E–3 and payable under section 1860E– 
5(a)(2) shall be transferred to the Trust Fund. 
‘‘(b) INCORPORATION OF PROVISIONS.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
subsections (b) through (i) of section 1841 shall 
apply with respect to the Trust Fund and this title 
in the same manner as they apply with respect to 
the Federal Supplementary Medical Insurance Trust 
Fund and part B, respectively. 
‘‘(2) MISCELLANEOUS REFERENCES.—In apply-
ing provisions of section 1841 under paragraph 
(1)— 
‘‘(A) any reference in such section to ‘this 
part’ is construed to refer to this part E; 
‘‘(B) any reference in section 1841(h) to 
section 1840(d) and in section 1841(i) to sec-
tions 1840(b)(1) and 1842(g) are deemed ref-
erences to comparable authority exercised under 
this part; and 
‘‘(C) payments may be made under section 
1841(g) to the Trust Funds under sections 
1817 and 1841 as reimbursement to such funds 
for payments they made for benefits provided 
under this part.
‘‘SEC. 1860E–7. OVERSIGHT AND ACCOUNTABILITY. 
‘‘(a) THROUGH ANNUAL REPORTS OF TRUSTEES.— 
The Board of Trustees of the Medicare Early Access 
Trust Fund under section 1860E–6(b)(1) shall report on 
an annual basis to Congress concerning the status of the 
Trust Fund and the need for adjustments in the program 
under this part to maintain financial solvency of the pro-
gram under this part. 
‘‘(b) PERIODIC GAO REPORTS.—The Comptroller 
General of the United States shall periodically submit to 
Congress reports on the adequacy of the financing of cov-
erage provided under this part. The Comptroller General 
shall include in such report such recommendations for ad-
justments in such financing and coverage as the Comp-
troller General deems appropriate in order to maintain fi-
nancial solvency of the program under this part. 
‘‘SEC. 1860E–8. ADMINISTRATION AND MISCELLANEOUS. 
‘‘(a) TREATMENT FOR PURPOSES OF TITLE.—Ex-
cept as otherwise provided in this part— 
‘‘(1) individuals enrolled under this part shall 
be treated for purposes of this title as though the in-
dividual were entitled to benefits and enrolled under 
any part of this title; and 
‘‘(2) benefits described in section 1860E–1 
shall be payable under this title to such individuals
in the same manner as if such individuals were so 
entitled and enrolled. 
‘‘(b) NOT TREATED AS MEDICARE PROGRAM FOR 
PURPOSES OF MEDICAID PROGRAM.—For purposes of ap-
plying title XIX (including the provision of medicare cost- 
sharing assistance under such title), an individual who is 
enrolled under this part shall not be treated as being enti-
tled to benefits under this title. 
‘‘(c) NOT TREATED AS MEDICARE PROGRAM FOR 
PURPOSES OF COBRA CONTINUATION PROVISIONS.—In 
applying a COBRA continuation provision (as defined in 
section 2791(d)(4) of the Public Health Service Act), any 
reference to an entitlement to benefits under this title 
shall not be construed to include entitlement to benefits 
under this title pursuant to the operation of this part.’’. 
(b) CONFORMING AMENDMENTS TO SOCIAL SECU-
RITY ACT PROVISIONS.—(1) Section 201(i)(1) of the So-
cial Security Act (42 U.S.C. 401(i)(1)) is amended by 
striking ‘‘or the Federal Supplementary Medical Insur-
ance Trust Fund’’ and inserting ‘‘the Federal Supple-
mentary Medical Insurance Trust Fund, and the Medicare 
Early Access Trust Fund’’. 
(2) Section 201(g)(1)(A) of such Act (42 U.S.C. 
401(g)(1)(A)) is amended by striking ‘‘and the Federal 
Supplementary Medical Insurance Trust Fund established
by title XVIII’’ and inserting ‘‘, the Federal Supple-
mentary Medical Insurance Trust Fund, and the Medicare 
Early Access Trust Fund established by title XVIII’’. 
(3) Section 1820(i) of such Act (42 U.S.C. 1395i– 
4(i)) is amended by striking ‘‘part D’’ and inserting ‘‘part 
F’’. 
(4) Section 1853 of such Act (42 U.S.C. 1395w–23) 
is amended by adding at the end the following new sub-
section: 
‘‘(k) ADJUSTMENT FOR EARLY ACCESS.—In apply-
ing this section with respect to individuals entitled to bene-
fits under part E, the Secretary shall provide for an appro-
priate adjustment in, for 2006, the annual MA capitation 
rate, and for years beginning with 2007, the payment 
amount determined under this section or section 1858, as 
may be appropriate to reflect differences between the pop-
ulation served under such part and the population under 
parts A and B.’’. 
(5) Section 1860D–15(c)(1) of such Act (42 U.S.C. 
1395w–115(c)(1)) is amended by adding at the end the 
following new subparagraph: 
‘‘(E) ADJUSTMENT FOR EARLY ACCESS.— 
In applying this section with respect to individ-
uals entitled to benefits under part E, the Sec-
retary shall provide for an appropriate adjust-