I 
117TH CONGRESS 
1ST SESSION H. R. 5165 
To amend titles II and XVIII of the Social Security Act to lower the 
Medicare eligibility age to 60, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 3, 2021 
Ms. JAYAPAL (for herself, Mr. LAMB, Mr. NEGUSE, Ms. WILD, Ms. STEVENS, 
Mrs. DINGELL, Ms. ADAMS, Mr. AGUILAR, Mrs. AXNE, Ms. BARRAGA´N, 
Ms. BASS, Mr. BLUMENAUER, Ms. BONAMICI, Mr. BOWMAN, Mr. 
BROWN, Ms. BROWNLEY, Ms. BUSH, Mr. CARBAJAL, Mr. CA´RDENAS, Mr. 
CARSON, Mr. CARTER of Louisiana, Mr. CASTRO of Texas, Ms. CHU, Mr. 
CICILLINE, Ms. CLARK of Massachusetts, Ms. CLARKE of New York, Mr. 
COHEN, Mr. CONNOLLY, Mr. CORREA, Mr. COURTNEY, Ms. CRAIG, Ms. 
DEAN, Mr. DEFAZIO, Ms. DEGETTE, Ms. DELAURO, Mr. DESAULNIER, 
Mr. MICHAEL F. DOYLE of Pennsylvania, Mr. ESPAILLAT, Mr. EVANS, 
Mr. GALLEGO, Mr. GARCI´A of Illinois, Ms. GARCIA of Texas, Mr. GREEN 
of Texas, Mr. GRIJALVA, Mrs. HAYES, Mr. HIGGINS of New York, Mr. 
HORSFORD, Mr. HUFFMAN, Ms. JACKSON LEE, Ms. JACOBS of Cali-
fornia, Mr. JOHNSON of Georgia, Mr. JONES, Mr. KAHELE, Ms. KAPTUR, 
Mr. KHANNA, Mr. KIM of New Jersey, Mr. KRISHNAMOORTHI, Ms. 
KUSTER, Mr. LARSEN of Washington, Mr. LARSON of Connecticut, Mrs. 
LAWRENCE, Ms. LEE of California, Ms. LEGER FERNANDEZ, Mr. LEVIN 
of Michigan, Mr. LIEU, Mr. LOWENTHAL, Mrs. CAROLYN B. MALONEY 
of New York, Ms. MANNING, Ms. MATSUI, Ms. MCCOLLUM, Mr. 
MCEACHIN, Mr. MCGOVERN, Mr. MCNERNEY, Ms. MENG, Mr. MFUME, 
Mr. MORELLE, Mr. MOULTON, Mr. NADLER, Mrs. NAPOLITANO, Ms. 
NEWMAN, Mr. NORCROSS, Ms. NORTON, Ms. OCASIO-CORTEZ, Ms. 
OMAR, Mr. PAYNE, Mr. PERLMUTTER, Mr. PHILLIPS, Ms. PINGREE, Mr. 
POCAN, Ms. PORTER, Ms. PRESSLEY, Mr. QUIGLEY, Mr. RASKIN, Mr. 
RUSH, Mr. RYAN, Ms. SA´NCHEZ, Mr. SARBANES, Ms. SCANLON, Ms. 
SCHAKOWSKY, Mr. SCHIFF, Mr. SHERMAN, Mr. SMITH of Washington, 
Mr. SOTO, Ms. STRICKLAND, Mr. SUOZZI, Mr. TAKANO, Mr. THOMPSON 
of California, Mr. THOMPSON of Mississippi, Ms. TITUS, Ms. TLAIB, Mr. 
TONKO, Mrs. TORRES of California, Mr. TORRES of New York, Mrs. 
TRAHAN, Mr. VARGAS, Ms. VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, 
Mrs. WATSON COLEMAN, Ms. WILLIAMS of Georgia, Ms. WILSON of Flor-
ida, Mr. YARMUTH, Ms. LOFGREN, Mr. MEEKS, Mr. DANNY K. DAVIS 
of Illinois, Ms. JOHNSON of Texas, Mrs. KIRKPATRICK, Mr. CROW, Mr. 
JEFFRIES, Mr. CLEAVER, and Ms. ESCOBAR) introduced the following 
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bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, 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 titles II and XVIII of the Social Security Act 
to lower the Medicare eligibility age to 60, 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. 
This Act may be cited as the ‘‘Improving Medicare 
Coverage Act’’. 
SEC. 2. MEDICARE ELIGIBILITY EXPANSION. 
(a) IN GENERAL.—Section 226 of the Social Security 
Act (42 U.S.C. 426) is amended— 
(1) by striking ‘‘65’’ each place it appears and 
inserting ‘‘60’’; and 
(2) in subsection (a)— 
(A) in paragraph (2)(A)— 
(i) by inserting ‘‘would be entitled to 
those benefits but for age,’’ after ‘‘section 
202,’’; and 
(ii) by inserting ‘‘(not including age)’’ 
after ‘‘meets all the criteria’’; and 
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(B) in the matter at the end— 
(i) by inserting ‘‘, in the case of an in-
dividual who has attained age 65 before 
the date that is 6 months after the date of 
the enactment of the Improving Medicare 
Coverage Act,’’ after ‘‘beginning with’’; 
and 
(ii) by inserting ‘‘and, in the case of 
an individual who has not attained age 65 
before the date that is 6 months after the 
date of the enactment of the Improving 
Medicare Coverage Act, the first month 
after the month that is 5 months after 
such date of enactment for which the indi-
vidual meets the conditions specified in 
paragraphs (1) and (2)’’ after ‘‘and (2)’’. 
(b) ENROLLMENT PERIODS
FOR PART B BENE-
FITS.—Section 1837(d) of the Social Security Act (42 
U.S.C. 1395p(d)) is amended— 
(1) by striking ‘‘(d) In the case of’’ and insert-
ing ‘‘(d)(1) Subject to paragraph (2), in the case 
of’’; and 
(2) by adding at the end the following new 
paragraph: 
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‘‘(2) In the case of an individual described in para-
graph (1) who has attained the age of 60 but not attained 
the age of 65 before the date that is 6 months after the 
date of the enactment of the Improving Medicare Coverage 
Act, such individual’s initial enrollment period shall begin 
on the date that is 3 months after such date of enactment, 
and shall end on the date that is 11 months after such 
date of enactment.’’. 
(c) CONFORMING AMENDMENTS.— 
(1) HOSPITAL INSURANCE BENEFITS FOR THE 
AGED.—Section 1811 of the Social Security Act (42 
U.S.C. 1395c) is amended— 
(A) by striking ‘‘65’’ each place it appears 
and inserting ‘‘60’’; and 
(B) by striking ‘‘(or would be eligible for 
such benefits if certain government employment 
were covered employment under such title)’’ 
and inserting ‘‘(or would be eligible for such 
benefits if certain government employment were 
covered employment under such title, or would 
be eligible for such benefits but for age)’’. 
(2) HOSPITAL INSURANCE BENEFITS FOR UNIN-
SURED ELDERLY INDIVIDUALS NOT OTHERWISE ELI-
GIBLE.—Section 1818 of such Act (42 U.S.C. 
1395i–2) is amended— 
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(A) in subsection (a)(1), by striking ‘‘65’’ 
and inserting ‘‘60’’; and 
(B) in subsection (d)— 
(i) in paragraph (1), by striking ‘‘65’’ 
and inserting ‘‘60’’; and 
(ii) in paragraph (3), by striking ‘‘65’’ 
and inserting ‘‘60’’. 
(3) HOSPITAL INSURANCE BENEFITS FOR DIS-
ABLED INDIVIDUALS WHO HAVE EXHAUSTED OTHER 
ENTITLEMENT.—Section 1818A(a)(1) of such Act 
(42 U.S.C. 1395i–2a(a)(1)) is amended by striking 
‘‘65’’ and inserting ‘‘60’’. 
(4) ELIGIBLE INDIVIDUALS.—Section 1836(2) 
of such Act (42 U.S.C. 1395o(2)) is amended by 
striking ‘‘65’’ and inserting ‘‘60’’. 
(5) ENROLLMENT PERIODS.—Section 1837 of 
such Act (42 U.S.C. 1395p), as amended by sub-
section (b), is further amended by striking ‘‘65’’ 
each place it appears and inserting ‘‘60’’. 
(6) COVERAGE PERIOD.—Section 1838 of the 
such Act (42 U.S.C. 1395q) is amended— 
(A) by striking ‘‘65’’ each place it appears 
and inserting ‘‘60’’; and 
(B) in subsection (a)(2)— 
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(i) by striking ‘‘subsection (d)’’ each 
place it appears and inserting ‘‘subsection 
(d)(1)’’; 
(ii) in subparagraph (D), by striking 
‘‘; or’’ and inserting ‘‘, or’’; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(E) in the case of an individual who enrolls 
pursuant to subsection (d)(2) of section 1837, on 
the date that is 6 months after the date of the en-
actment of the Improving Medicare Coverage Act; 
or’’. 
(7) AMOUNTS OF PREMIUMS.—Section 1839 of 
such Act (42 U.S.C. 1395r) is amended— 
(A) in subsection (a)(1)— 
(i) by striking the first sentence and 
inserting ‘‘The Secretary shall, during Sep-
tember of 1983 through September of 
2021, determine the monthly actuarial rate 
for enrollees age 65 and over which shall 
be applicable for the succeeding calendar 
year (including, for 2022, with respect to 
individuals who enroll pursuant to sub-
section (d)(2) of section 1837) and, during 
September of 2022 and of each year there-
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after, determine the monthly actuarial 
value for enrollees age 60 and over which 
shall be applicable for the succeeding cal-
endar year.’’; and 
(ii) by inserting ‘‘(for years before 
2023 and with respect to those enrollees 
age 50 or older (for 2023 and subsequent 
years)’’ after ‘‘age 60 and older’’; 
(B) in subsection (a)(3)— 
(i) by striking ‘‘for enrollees age 65 
and over, determined according to para-
graph (1),’’ and inserting ‘‘determined ac-
cording to paragraph (1)’’; and 
(ii) by striking ‘‘age 65 and older’’; 
(C) in subsection (a)(4)— 
(i) by striking the first sentence and 
inserting ‘‘The Secretary shall, during Sep-
tember of 1983 through September of 
2021, determine the monthly actuarial rate 
for disabled enrollees under age 65 which 
shall be applicable for the succeeding cal-
endar year and, during September of 2022 
and of each year thereafter, determine the 
monthly actuarial value for disabled enroll-
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ees under age 60 which shall be applicable 
for the succeeding calendar year.’’; and 
(ii) by inserting ‘‘(for years before 
2023) and with respect to those disabled 
enrollees under age 60 (for 2023 and sub-
sequent years)’’ after ‘‘to disabled enrollees 
under age 65’’; 
(D) in subsection (b), by inserting ‘‘(in the 
case of an individual who attained the age of 65 
before the date that is 6 months after the date 
of the enactment of the Improving Medicare 
Coverage Act) or the age of 60 (in the case of 
an individual who did not attain the age of 65 
before the date that is 6 months after such date 
of enactment)’’ after ‘‘the age of 65’’; 
(E) in subsection (d), by inserting ‘‘(in the 
case of an individual who attained the age of 65 
before the date that is 6 months after the date 
of the enactment of the Improving Medicare 
Coverage Act) or the age of 60 (in the case of 
an individual who did not attain the age of 65 
before the date that is 6 months after such date 
of enactment)’’ after ‘‘age 65’’; 
(F) in subsection (i)(3)(A), by inserting 
‘‘(for years before 2023) or for enrollees age 60 
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and older (for 2023 and subsequent years)’’ 
after ‘‘age 65 and older’’; and 
(G) in subsection (j), by inserting ‘‘(for 
years before 2023) or for enrollees age 60 and 
older (for 2023 and subsequent years)’’ after 
‘‘age 65 and older’’. 
(8) APPROPRIATIONS TO COVER GOVERNMENT 
CONTRIBUTIONS AND CONTINGENCY RESERVE.—Sec-
tion 1844(a) of such Act (42 U.S.C. 1395w(a)) is 
amended by striking ‘‘65’’ each place it appears and 
inserting ‘‘60’’. 
(9) ELIGIBILITY, 
ELECTION, 
AND
ENROLL-
MENT.—Section 1851(e)(4) of such Act (42 U.S.C. 
1395w–21(e)(4)) is amended in the matter at the 
end by striking ‘‘65’’ and inserting ‘‘60’’. 
(10) PREMIUMS; 
LATE
ENROLLMENT
PEN-
ALTY.—Section 1860D–13(b)(7)(B)(i) of such Act 
(42 U.S.C. 1395w–113(b)(7)(B)(i)) is amended by 
inserting ‘‘(in the case of an individual who attained 
the age of 65 before the date that is 6 months after 
the date of the enactment of the Improving Medicare 
Coverage Act) or age 60 (in the case of an individual 
who did not attain the age of 65 before the date that 
is 6 months after such date of enactment)’’ after 
‘‘65’’. 
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‘‘(2) FUNDING.—For purposes of carrying out 
this section, the Secretary shall make payments from 
the Federal Hospital Insurance Trust Fund under 
section 1817 and the Federal Supplementary Med-
ical Insurance Trust Fund under section 1841, in 
such proportion as the Secretary determines appro-
priate, of such amounts as the Secretary determines 
necessary to provide Medicare cost assistance under 
this section. 
‘‘(e) REFERENCES TO MEDICARE COST-SHARING.— 
Effective beginning on the date that is 6 months after the 
date of the enactment of the Improving Medicare Coverage 
Act, any reference to medicare cost-sharing described in 
section 1905(p) shall be deemed a reference to Medicare 
cost assistance under this section. 
‘‘(f) OUTREACH EFFORTS.—For provisions relating 
to outreach efforts to increase awareness of the availability 
of Medicare cost assistance, see section 1144.’’. 
(b) SPECIAL ENROLLMENT PERIOD.— 
(1) NO PREMIUM PENALTY.—Section 1839(b) 
of the Social Security Act (42 U.S.C. 1395r(b)) is 
amended, in the last sentence, by inserting the fol-
lowing before the period: ‘‘or, effective beginning on 
the date that is 6 months after the date of the en-
actment of the Improving Medicare Coverage Act, 
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