127 
(b) INDIVIDUALS WITH INCOME BETWEEN 135 AND 
150 PERCENT OF POVERTY LINE.—Paragraph (2)(A) of 
such section is amended— 
(1) by inserting ‘‘equal to (i) an amount’’ after 
‘‘premium subsidy’’; 
(2) by striking ‘‘paragraph (1)(A)’’ and insert-
ing ‘‘clause (i) of paragraph (1)(A)’’; and 
(3) by adding at the end before the period the fol-
lowing: ‘‘, plus (ii) 100 percent of the amount de-
scribed in clause (ii) of such paragraph for such indi-
vidual’’. 
(c) EFFECTIVE DATE.—The amendments made by this 
section shall apply to subsidies for months beginning with 
January 2008. 
SEC. 227. SPECIAL ENROLLMENT PERIOD FOR SUBSIDY ELI-
GIBLE INDIVIDUALS. 
(a) IN GENERAL.—Section 1860D–1(b)(3) of the So-
cial Security Act (42 U.S.C. 1395w–101(b)(3)), as amended 
by section 222(a), is further amended by adding at the end 
the following new subparagraph: 
‘‘(G) ELIGIBILITY
FOR
LOW-INCOME
SUB-
SIDY.— 
‘‘(i) IN GENERAL.—In the case of an 
applicable subsidy eligible individual (as 
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128 
defined in clause (ii)), the special enroll-
ment period described in clause (iii). 
‘‘(ii) APPLICABLE
SUBSIDY
ELIGIBLE 
INDIVIDUAL DEFINED.—For purposes of this 
subparagraph, the term ‘applicable subsidy 
eligible individual’ means a part D eligible 
individual who is determined under sub-
paragraph (B) of section 1860D–14(a)(3) to 
be a subsidy eligible individual (as defined 
in subparagraph (A) of such section), and 
includes such an individual who was en-
rolled in a prescription drug plan or an 
MA–PD plan on the date of such deter-
mination. 
‘‘(iii) SPECIAL
ENROLLMENT
PERIOD 
DESCRIBED.—The special enrollment period 
described in this clause, with respect to an 
applicable subsidy eligible individual, is the 
90-day period beginning on the date the in-
dividual receives notification that such in-
dividual has been determined under section 
1860D–14(a)(3)(B) to be a subsidy eligible 
individual (as so defined).’’. 
(b) AUTOMATIC ENROLLMENT PROCESS FOR CERTAIN 
SUBSIDY ELIGIBLE INDIVIDUALS.—Section 1860D–1(b)(1) 
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129 
of the Social Security Act (42 U.S.C. 1395w–101(b)(1)), as 
amended by section 218(a)(2), is further amended by add-
ing at the end the following new subparagraph: 
‘‘(E) SPECIAL RULE FOR SUBSIDY ELIGIBLE 
INDIVIDUALS.—The process established under 
subparagraph (A) shall include, in the case of an 
applicable subsidy eligible individual (as defined 
in clause (ii) of paragraph (3)(F)) who fails to 
enroll in a prescription drug plan or an MA–PD 
plan during the special enrollment period de-
scribed in clause (iii) of such paragraph applica-
ble to such individual, a process for the facili-
tated enrollment of the individual in the pre-
scription drug plan or MA–PD plan that is most 
appropriate for such individual (as determined 
by the Secretary). Nothing in the previous sen-
tence shall prevent an individual described in 
such sentence from declining enrollment in a 
plan determined appropriate by the Secretary 
(or in the program under this part) or from 
changing such enrollment.’’. 
(c) EFFECTIVE DATE.—The amendments made by this 
section shall apply to subsidy determinations made for 
months beginning with January 2008. 
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130 
Subtitle D—Reducing Health 
Disparities 
SEC. 231. MEDICARE DATA ON RACE, ETHNICITY, AND PRI-
MARY LANGUAGE. 
(a) REQUIREMENTS.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this subtitle referred to as the 
‘‘Secretary’’) shall— 
(A) collect data on the race, ethnicity, and 
primary language of each applicant for and re-
cipient of benefits under title XVIII of the Social 
Security Act— 
(i) using, at a minimum, the cat-
egories for race and ethnicity described in 
the 1997 Office of Management and Budget 
Standards for Maintaining, Collecting, and 
Presenting Federal Data on Race and Eth-
nicity; 
(ii) using the standards developed 
under subsection (e) for the collection of lan-
guage data; 
(iii) where practicable, collecting data 
for additional population groups if such 
groups can be aggregated into the minimum 
race and ethnicity categories; and 
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131 
(iv) where practicable, through self-re-
porting; 
(B) with respect to the collection of the data 
described in subparagraph (A) for applicants 
and recipients who are minors or otherwise le-
gally incapacitated, require that— 
(i) such data be collected from the par-
ent or legal guardian of such an applicant 
or recipient; and 
(ii) the preferred language of the par-
ent or legal guardian of such an applicant 
or recipient be collected; 
(C) systematically analyze at least annually 
such data using the smallest appropriate units of 
analysis feasible to detect racial and ethnic dis-
parities in health and health care and when ap-
propriate, for men and women separately; 
(D) report the results of analysis annually 
to the Director of the Office for Civil Rights, the 
Committee on Health, Education, Labor, and 
Pensions and the Committee on Finance of the 
Senate, and the Committee on Energy and Com-
merce and the Committee on Ways and Means of 
the House of Representatives; and 
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132 
(E) ensure that the provision of assistance 
to an applicant or recipient of assistance is not 
denied or otherwise adversely affected because of 
the failure of the applicant or recipient to pro-
vide race, ethnicity, and primary language data. 
(2) RULES OF CONSTRUCTION.—Nothing in this 
subsection shall be construed— 
(A) to permit the use of information col-
lected under this subsection in a manner that 
would adversely affect any individual providing 
any such information; and 
(B) to require health care providers to col-
lect data. 
(b) PROTECTION OF DATA.—The Secretary shall en-
sure (through the promulgation of regulations or otherwise) 
that all data collected pursuant to subsection (a) is pro-
tected— 
(1) under the same privacy protections as the 
Secretary applies to other health data under the regu-
lations promulgated under section 264(c) of the 
Health Insurance Portability and Accountability Act 
of 1996 (Public Law 104–191; 110 Stat. 2033) relat-
ing to the privacy of individually identifiable health 
information and other protections; and 
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(2) from all inappropriate internal use by any 
entity that collects, stores, or receives the data, includ-
ing use of such data in determinations of eligibility 
(or continued eligibility) in health plans, and from 
other inappropriate uses, as defined by the Secretary. 
(c) COLLECTION PLAN.—In carrying out the duties 
specified in subsection (a), the Secretary shall develop and 
implement a plan to improve the collection, analysis, and 
reporting of racial, ethnic, and primary language data 
within the programs administered under title XVIII of the 
Social Security Act, and, in consultation with the National 
Committee on Vital Health Statistics, the Office of Minority 
Health, and other appropriate public and private entities, 
shall make recommendations on how to— 
(1) implement subsection (a) while minimizing 
the cost and administrative burdens of data collection 
and reporting; 
(2) expand awareness that data collection, anal-
ysis, and reporting by race, ethnicity, and primary 
language is legal and necessary to assure equity and 
non-discrimination in the quality of health care serv-
ices; 
(3) ensure that future patient record systems 
have data code sets for racial, ethnic, and primary 
language identifiers and that such identifiers can be 
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134 
retrieved from clinical records, including records 
transmitted electronically; 
(4) improve health and health care data collec-
tion and analysis for more population groups if such 
groups can be aggregated into the minimum race and 
ethnicity categories; 
(5) provide researchers with greater access to ra-
cial, ethnic, and primary language data, subject to 
privacy and confidentiality regulations; and 
(6) safeguard and prevent the misuse of data col-
lected under subsection (a). 
(d) COMPLIANCE WITH STANDARDS.—Data collected 
under subsection (a) shall be obtained, maintained, and 
presented (including for reporting purposes and at a min-
imum) in accordance with the 1997 Office of Management 
and Budget Standards for Maintaining, Collecting, and 
Presenting Federal Data on Race and Ethnicity. 
(e) LANGUAGE COLLECTION STANDARDS.—Not later 
than 1 year after the date of enactment of this Act, the Di-
rector of the Office of Minority Health, in consultation with 
the Office for Civil Rights of the Department of Health and 
Human Services, shall develop and disseminate Standards 
for the Classification of Federal Data on Preferred Written 
and Spoken Language. 
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