I 
117TH CONGRESS 
2D SESSION 
H. R. 9655 
To amend the Social Security Act to establish a Medicare for America health 
program to provide for comprehensive health coverage for all Americans. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 21, 2022 
Ms. DELAURO (for herself, Ms. SCHAKOWSKY, Mr. DOGGETT, Ms. LOFGREN, 
and Mr. GRIJALVA) introduced the following bill; which was referred to 
the Committee on Ways and Means, and in addition to the Committees 
on Energy and Commerce, the Judiciary, Natural Resources, Education 
and Labor, and House Administration, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend the Social Security Act to establish a Medicare 
for America health program to provide for comprehensive 
health coverage for all Americans. 
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 for America Act of 2019’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
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Sec. 1. Short title; table of contents. 
TITLE I—TRANSITIONING TO AND ESTABLISHING MEDICARE FOR 
AMERICA 
Subtitle A—Transitional Public Health Option 
Sec. 101. Establishment. 
Sec. 102. Eligibility. 
Sec. 103. Benefits. 
Sec. 104. Premiums. 
Sec. 105. Providers and reimbursement rates. 
Sec. 106. Account; funding. 
Subtitle B—Medicare for America 
Sec. 111. Establishment and administration of Medicare for America. 
Sec. 112. Modifications to and coordination with existing Federal health pro-
grams. 
Subtitle C—Targeted Reforms 
Sec. 121. Limitation on removal of Medicare Advantage providers by MA orga-
nizations. 
Sec. 122. Network adequacy. 
Sec. 123. Eliminating the 24-month waiting period for Medicare coverage for 
individuals with disabilities. 
Sec. 124. Eliminating the waiting period for individuals on State Medicaid 
waiting lists. 
Sec. 125. Employer health plan options. 
Sec. 126. Prohibition on step therapy and prior authorization under group 
health plans. 
Sec. 127. Medicare outpatient observation services. 
Sec. 128. Abortion coverage. 
Sec. 129. Applicability of mental health parity. 
Sec. 130. Student loan forgiveness for health care providers participating in 
Medicare for America. 
Sec. 131. Clarification of the definition of pediatric medical necessity in quali-
fying group coverage. 
Sec. 132. Safe staffing requirements. 
Sec. 133. Enhancements for reduced cost-sharing. 
Sec. 134. Repeal of bonus payments for Medicare Advantage plans. 
TITLE II—TAX PROVISIONS 
Sec. 201. Sunset of Public Law 115–97. 
Sec. 202. Surtax. 
Sec. 203. Basis of property acquired from a decedent. 
Sec. 204. Medicare payroll tax. 
Sec. 205. Net investment income tax. 
Sec. 206. Termination of deduction for contributions to health savings ac-
counts. 
Sec. 207. Increase in excise tax on small cigars and cigarettes and other to-
bacco products. 
Sec. 208. Excise tax on alcohol. 
Sec. 209. Tax on sugared drinks. 
Sec. 210. Repeal of excise tax on high-cost employer-sponsored health coverage. 
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TITLE III—DRUG-RELATED PROVISIONS 
Sec. 301. Establishment of the Prescription Drug and Medical Device Review 
Board. 
Sec. 302. Membership; staff. 
Sec. 303. Prohibition against excessive price. 
Sec. 304. Enforcement provisions. 
Sec. 305. Authority. 
Sec. 306. Regulations. 
Sec. 307. Report to Federal agencies. 
Sec. 308. Definitions. 
Sec. 309. Moratorium on direct-to-consumer drug advertising. 
Sec. 310. Reporting on justification for drug price increases. 
TITLE IV—OUTCOMES AND REPORTING 
Sec. 401. Sense of Congress. 
Sec. 402. Evaluation of bill’s outcome. 
TITLE 
I—TRANSITIONING 
TO 
AND 
ESTABLISHING 
MEDI-
CARE FOR AMERICA 
Subtitle A—Transitional Public 
Health Option 
SEC. 101. ESTABLISHMENT. 
The Secretary of Health and Human Services (in this 
subtitle referred to as the ‘‘Secretary’’) shall establish a 
public health plan option that is offered in the individual 
market through the Federal and State Exchanges under 
title I of the Patient Protection and Affordable Care Act 
to eligible individuals for plan years 2024 and 2025 in 
accordance with this subtitle. 
SEC. 102. ELIGIBILITY. 
Subject to subsection (b), an individual is eligible to 
enroll in such public health plan option if the individual 
is otherwise eligible to purchase individual health insur-
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ance coverage through an Exchange and the individual re-
sides in a rating area in which the Secretary makes the 
public health plan option available. 
SEC. 103. BENEFITS. 
(a) IN GENERAL.—The public health plan option 
shall be a qualified health plan within the meaning of sec-
tion 1301(a) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18021(a)) that— 
(1) meets all requirements applicable to quali-
fied health plans under subtitle D of title I of the 
Patient Protection and Affordable Care Act (other 
than 
the 
requirement 
under 
section 
1301(a)(1)(C)(ii) 
of 
such 
Act 
(42 
U.S.C. 
18021(a)(1)(C)(ii))) and title XXVII of the Public 
Health Service Act; 
(2) provides coverage of the essential health 
benefits described in section 1302(b) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 
18022(b)); 
(3) provides silver and gold-level coverage de-
scribed in section 1302(d)(1)(C) of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 
18022(d)(1)(C)); and 
(4) provides coverage of comprehensive repro-
ductive health services, including abortion. 
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