I 
117TH CONGRESS 
2D SESSION 
H. R. 9594 
To amend title XVIII of the Social Security Act to provide benefits under 
the Medicare program for first responders at the age of 57. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 15, 2022 
Mr. PANETTA (for himself and Ms. CONWAY) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addi-
tion to the Committee on Energy and Commerce, 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 to provide 
benefits under the Medicare program for first responders 
at the age of 57. 
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 ‘‘First Responders’ Care 
Expansion Act of 2022’’. 
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS
SEC. 2. PROVIDING BENEFITS UNDER THE MEDICARE PRO-
GRAM FOR FIRST RESPONDERS AT THE AGE 
OF 57. 
(a) IN GENERAL.—Title XVIII of the Social Security 
Act (42 U.S.C. 1395c et seq.) is amended by adding at 
the end the following new section: 
‘‘MEDICARE FOR FIRST RESPONDERS AT AGE 57 
‘‘SEC. 1899C. (a) OPTION.— 
‘‘(1) IN GENERAL.—Every individual who meets 
the requirements described in paragraph (2) shall be 
eligible to enroll under this section. 
‘‘(2) ELIGIBILITY.—The requirements described 
in this paragraph are the following: 
‘‘(A) AGE.—The individual has attained 57 
years of age, but has not attained 65 years of 
age. 
‘‘(B) FIRST RESPONDER.—The individual 
has worked for a total of 10 years or longer in 
any occupation (or a combination of occupa-
tions) identified by any of the following codes 
(or successor codes) under the Standard Occu-
pations Classification System established by the 
Bureau of Labor Statistics: 
‘‘(i) 33–1010. 
‘‘(ii) 33–1020. 
‘‘(iii) 33–2000. 
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(iv) 33–3000 (other than any occu-
pations identified under code 33–3040). 
‘‘(v) 33–9092. 
‘‘(C) MEDICARE
ELIGIBILITY
(BUT
FOR 
AGE).—The individual is not otherwise entitled 
to benefits under part A or eligible to enroll 
under part A or part B but would be so entitled 
(or so eligible) if the individual were 65 years 
of age. 
‘‘(3) PART A, B, AND D BENEFITS AND PROTEC-
TIONS.—An individual enrolled under this section is 
entitled to the same benefits (and shall receive the 
same protections) under this title as an individual 
who is entitled to benefits under part A and enrolled 
under part B, including the ability to enroll in a pre-
scription drug plan under part D or a Medicare Ad-
vantage plan (including such a plan that provides 
qualified prescription drug coverage (an MA–PD 
plan)) and including access to the Medicare Bene-
ficiary Ombudsman under section 1808(c). 
‘‘(b) ENROLLMENT AND COVERAGE PERIODS.— 
‘‘(1) ENROLLMENT.—An individual eligible to 
enroll under this section may so enroll— 
‘‘(A) during the 1-month period prior to 
the individual becoming so eligible; or 
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(B) at any time while such individual is 
so eligible. 
‘‘(2) COVERAGE.—An individual enrolled under 
this section shall be eligible for benefits provided 
under this section beginning with the first day of the 
first month beginning after the date such individual 
so enrolls and ending on the earlier of the following: 
‘‘(A) The date on which such individual 
elects to terminate enrollment under this sec-
tion. 
‘‘(B) The date on which such individual 
becomes entitled to benefits under part A or eli-
gible to enroll for benefits under part B. 
‘‘(c) PREMIUM.— 
‘‘(1) AMOUNT OF MONTHLY PREMIUMS.—The 
monthly premium payable for coverage for a month 
under this section for an individual is equal to— 
‘‘(A) the monthly premium that would 
apply to such individual for such month under 
section 1839 if such individual were enrolled 
under part B; plus 
‘‘(B) in the case of an individual who 
would not be entitled to benefits under part A 
for such month pursuant to section 226 if the 
individual were 65 years of age, the monthly 
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS
premium that would apply to such individual 
for such month under section 1818 if such indi-
vidual were enrolled under part A. 
‘‘(2) ADDITIONAL PREMIUMS.—In the case of 
an individual enrolled under this section who elects 
to enroll in a Medicare Advantage plan under part 
C or a prescription drug plan under part D, the pro-
visions of such part C or such part D, as applicable, 
relating to payment of premiums for individuals so 
enrolled shall apply to individuals enrolled under this 
section. 
‘‘(d) PAYMENT OF PREMIUMS.— 
‘‘(1) 
PAYMENT.—Premiums 
for 
enrollment 
under this section shall be paid to the Secretary at 
such times, and in such manner, as the Secretary 
determines appropriate. 
‘‘(2) DEPOSIT.—Amounts collected by the Sec-
retary under this section shall be deposited in the 
Medicare First Responder Trust Fund established 
under subsection (e). 
‘‘(e) MEDICARE FIRST RESPONDER 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 First Re-
sponder Trust Fund’ (in this subsection referred to 
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(g) TREATMENT IN RELATION TO THE AFFORD-
ABLE CARE ACT.— 
‘‘(1) TREATMENT AS MINIMUM ESSENTIAL COV-
ERAGE.—For purposes of applying section 5000A of 
the Internal Revenue Code of 1986, the coverage 
provided through enrollment under this section con-
stitutes minimum essential coverage under sub-
section (f)(1)(A)(i) of such section. 
‘‘(2) MEDICAID
MANAGED
CARE.—States are 
prohibited from buying their Medicaid beneficiaries 
ages 57 to 64 who are eligible to enroll under this 
section into Medicare under this section, and individ-
uals otherwise eligible for enrollment under a State 
plan under title XIX are prohibited from coverage 
under this title pursuant to enrollment under this 
section. The preceding sentence shall not apply to 
Medicaid beneficiaries whose Medicaid coverage or 
eligibility does not meet the definition of minimum 
essential coverage under a government-sponsored 
program under section 1.5000A–2 of title 26, Code 
of Federal Regulations (or any successor regulation). 
‘‘(3) ACCESS TO MEDIGAP.—Coverage provided 
through medicare supplemental policies certified 
under section 1882 shall be made available to indi-
viduals eligible for enrollment pursuant to this sec-
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS
tion for enrollment, information, comparison, and 
otherwise as such a policy through any internet 
website described in paragraph (2).’’. 
(b) MEDIGAP.—Section 1882 of the Social Security 
Act is amended by adding at the end the following new 
subsection: 
‘‘(aa) DEVELOPMENT OF NEW STANDARDS FOR CER-
TAIN MEDICARE SUPPLEMENTAL POLICIES RELATING TO 
FIRST RESPONDER COVERAGE.—The Secretary shall re-
quest the National Association of Insurance Commis-
sioners to review and revise the standards for benefit pack-
ages described in subsection (p)(1), to otherwise update 
standards to include requirements for each medicare sup-
plemental policy that offers such a policy in a State, with 
respect to each year, to accept every individual in the 
State who is eligible for enrollment pursuant to section 
1899C and who applies for such coverage for such year 
if the individual applies for enrollment in such policy dur-
ing the 30-day period following the date of enrollment pur-
suant to section 1899C and to accept every such individual 
during a period of transition from enrollment pursuant to 
such section to enrollment under this title pursuant to eli-
gibility other than under such section. Such revisions shall 
be made consistent with the rules applicable under sub-
section (p)(1)(E) with the reference to the ‘1991 NAIC 
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS
Model Regulation’ deemed a reference to the NAIC Model 
Regulation as published in the Federal Register on De-
cember 4, 1998, and as subsequently updated by the Na-
tional Association of Insurance Commissioners to reflect 
previous changes in law and the reference to ‘date of en-
actment of this subsection’ deemed a reference to the date 
of enactment of this subsection (aa).’’. 
Æ 
VerDate Sep 11 2014 
15:49 Dec 29, 2022
Jkt 039200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6301
E:\BILLS\H9594.IH
H9594
pamtmann on DSKBC07HB2PROD with BILLS