I 
111TH CONGRESS 
1ST SESSION H. R. 1708 
To amend title II of the Social Security Act to phase out the 24-month 
waiting period for disabled individuals to become eligible for Medicare 
benefits, to eliminate the waiting period for individuals with life-threat-
ening conditions, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 25, 2009 
Mr. GENE GREEN of Texas (for himself and Mr. TERRY) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committees on Energy and Commerce and Trans-
portation and Infrastructure, for a period to be subsequently 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 II of the Social Security Act to phase out 
the 24-month waiting period for disabled individuals to 
become eligible for Medicare benefits, to eliminate the 
waiting period for individuals with life-threatening condi-
tions, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Ending the Medicare Disability Waiting Period Act of 
2009’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Phase-out of waiting period for Medicare disability benefits. 
Sec. 3. Elimination of waiting period for individuals with life-threatening condi-
tions. 
Sec. 4. Institute of Medicine study and report on delay and prevention of dis-
ability conditions. 
SEC. 2. PHASE-OUT OF WAITING PERIOD FOR MEDICARE 
DISABILITY BENEFITS. 
(a) IN GENERAL.—Section 226(b) of the Social Secu-
rity Act (42 U.S.C. 426(b)) is amended— 
(1) in paragraph (2)(A), by striking ‘‘, and has 
for 24 calendar months been entitled to,’’ and insert-
ing ‘‘, and for the waiting period (as defined in sub-
section (k)) has been entitled to,’’; 
(2) in paragraph (2)(B), by striking ‘‘, and has 
been for not less than 24 months,’’ and inserting ‘‘, 
and has been for the waiting period (as defined in 
subsection (k)),’’; 
(3) in paragraph (2)(C)(ii), by striking ‘‘, in-
cluding the requirement that he has been entitled to 
the specified benefits for 24 months,’’ and inserting 
‘‘, including the requirement that the individual has 
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been entitled to the specified benefits for the waiting 
period (as defined in subsection (k)),’’; and 
(4) in the flush matter following paragraph 
(2)(C)(ii)(II)— 
(A) in the first sentence, by striking ‘‘for 
each month beginning with the later of (I) July 
1973 or (II) the twenty-fifth month of his enti-
tlement or status as a qualified railroad retire-
ment beneficiary described in paragraph (2), 
and’’ and inserting ‘‘for each month beginning 
after the waiting period (as so defined) for 
which the individual satisfies paragraph (2) 
and’’; 
(B) in the second sentence, by striking 
‘‘the ‘twenty-fifth month of his entitlement’ re-
fers to the first month after the twenty-fourth 
month of entitlement to specified benefits re-
ferred to in paragraph (2)(C) and’’; and 
(C) in the third sentence, by striking ‘‘, 
but not in excess of 78 such months’’. 
(b) SCHEDULE FOR PHASE-OUT OF WAITING PE-
RIOD.—Section 226 of the Social Security Act (42 U.S.C. 
426) is amended by adding at the end the following new 
subsection: 
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‘‘(k) For purposes of subsection (b) (and for purposes 
of section 1837(g)(1) of this Act and section 7(d)(2)(ii) 
of the Railroad Retirement Act of 1974), the term ‘waiting 
period’ means— 
‘‘(1) for 2010, 18 months; 
‘‘(2) for 2011, 16 months; 
‘‘(3) for 2012, 14 months; 
‘‘(4) for 2013, 12 months; 
‘‘(5) for 2014, 10 months; 
‘‘(6) for 2015, 8 months; 
‘‘(7) for 2016, 6 months; 
‘‘(8) for 2017, 4 months; 
‘‘(9) for 2018, 2 months; and 
‘‘(10) for 2019 and each subsequent year, 0 
months.’’. 
(c) CONFORMING AMENDMENTS.— 
(1) SUNSET.—Effective January 1, 2019, sub-
section (f) of section 226 of the Social Security Act 
(42 U.S.C. 426) is repealed. 
(2) MEDICARE DESCRIPTION.—Section 1811(2) 
of such Act (42 U.S.C. 1395c(2)) is amended by 
striking ‘‘entitled for not less than 24 months’’ and 
inserting ‘‘entitled for the waiting period (as defined 
in section 226(k))’’. 
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(3) MEDICARE COVERAGE.—Section 1837(g)(1) 
of such Act (42 U.S.C. 1395p(g)(1)) is amended by 
striking ‘‘of the later of (A) April 1973 or (B) the 
third month before the 25th month of such entitle-
ment’’ and inserting ‘‘of the third month before the 
first month following the waiting period (as defined 
in section 226(k)) applicable under section 226(b)’’. 
(4) RAILROAD RETIREMENT SYSTEM.—Section 
7(d)(2)(ii) of the Railroad Retirement Act of 1974 
(45 U.S.C. 231f(d)(2)(ii)) is amended— 
(A) by striking ‘‘, for not less than 24 
months’’ and inserting ‘‘, for the waiting period 
(as defined in section 226(k) of the Social Secu-
rity Act); and 
(B) by striking ‘‘could have been entitled 
for 24 calendar months, and’’ and inserting 
‘‘could have been entitled for the waiting period 
(as defined is section 226(k) of the Social Secu-
rity Act), and’’. 
(d) EFFECTIVE DATE.—Except as provided in sub-
section (c)(1), the amendments made by this section shall 
apply to insurance benefits under title XVIII of the Social 
Security Act with respect to items and services furnished 
in months beginning at least 90 days after the date of 
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the enactment of this Act (but in no case earlier than Jan-
uary 1, 2010). 
SEC. 3. ELIMINATION OF WAITING PERIOD FOR INDIVID-
UALS WITH LIFE-THREATENING CONDITIONS. 
(a) IN GENERAL.—Section 226(h) of the Social Secu-
rity Act (42 U.S.C. 426(h)) is amended— 
(1) by redesignating paragraphs (1), (2), and 
(3) as subparagraphs (A), (B), and (C), respectively; 
(2) in the matter preceding subparagraph (A) 
(as redesignated by paragraph (1)), by inserting 
‘‘(1)’’ after ‘‘(h)’’; 
(3) in paragraph (1) (as designated by para-
graph (2))— 
(A) in the matter preceding subparagraph 
(A) (as redesignated by paragraph (1)), by in-
serting ‘‘or any other life-threatening condition’’ 
after ‘‘amyotrophic lateral sclerosis (ALS)’’; 
and 
(B) in subparagraph (B) (as redesignated 
by paragraph (1)), by striking ‘‘(rather than 
twenty-fifth month)’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(2) For purposes of identifying life-threatening con-
ditions under paragraph (1), the Secretary shall compile 
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a list of conditions that are fatal without medical treat-
ment. In compiling such list, the Secretary shall— 
‘‘(A) consult with the Director of the National 
Institutes of Health (including the Office of Rare 
Diseases), the Director of the Centers for Disease 
Control and Prevention, the Director of the National 
Science Foundation, and the Institute of Medicine of 
the National Academy of Sciences; and 
‘‘(B) annually review the compassionate allow-
ances list of conditions of the Social Security Admin-
istration.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to insurance benefits under title 
XVIII of the Social Security Act with respect to items and 
services furnished in months beginning at least 90 days 
after the date of the enactment of this Act (but in no case 
earlier than January 1, 2010). 
SEC. 4. INSTITUTE OF MEDICINE STUDY AND REPORT ON 
DELAY AND PREVENTION OF DISABILITY 
CONDITIONS. 
(a) STUDY.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) 
shall request that the Institute of Medicine of the National 
Academy of Sciences conduct a study on the range of dis-
ability conditions that can be delayed or prevented if indi-
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