I 
108TH CONGRESS 
2D SESSION 
H. R. 5189 
To amend title XIX of the Social Security Act to extend Medicare cost- 
sharing for the Medicare part B premium for qualifying individuals 
through September 2005. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 30, 2004 
Mr. ISRAEL (for himself, Mr. ACKERMAN, Mr. BISHOP of New York, Mrs. 
MCCARTHY of New York, Mr. KING of New York, and Mrs. LOWEY) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to extend 
Medicare cost-sharing for the Medicare part B premium 
for qualifying individuals through September 2005. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. EXTENSION OF MEDICARE COST-SHARING FOR 
THE 
MEDICARE 
PART 
B 
PREMIUM 
FOR 
QUALIFYING INDIVIDUALS. 
(a) IN GENERAL.—Section 1902(a)(10)(E)(iv) of the 
Social Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is 
amended by striking ‘‘2004’’ and inserting ‘‘2005’’.
(b) TOTAL AMOUNT AVAILABLE FOR ALLOCATION.— 
Section 1933(g) of such Act (42 U.S.C. 1396u–3(g)) is 
amended to read as follows: 
‘‘(g) SPECIAL RULES.— 
‘‘(1) IN GENERAL.—With respect to each period 
described in paragraph (2), a State shall select 
qualifying individuals, subject to paragraph (3), and 
provide such individuals with assistance, in accord-
ance with the provisions of this section as in effect 
with respect to calendar year 2003, except that for 
such purpose— 
‘‘(A) references in the preceding sub-
sections of this section to a year, whether fiscal 
or calendar, shall be deemed to be references to 
such period; and 
‘‘(B) the total allocation amount under 
subsection (c) for such period shall be the 
amount described in paragraph (2) for that pe-
riod. 
‘‘(2) 
PERIODS
AND
TOTAL
ALLOCATION 
AMOUNTS DESCRIBED.—For purposes of this sub-
section— 
‘‘(A) for the period that begins on January 
1, 2004, and ends on September 30, 2004, the 
total allocation amount is $300,000,000;
‘‘(B) for the period that begins on October 
1, 2004, and ends on December 31, 2004, the 
total allocation amount is $100,000,000; and 
‘‘(C) for the period that begins on January 
1, 2005, and ends on September 30, 2005, the 
total allocation amount is $300,000,000. 
‘‘(3) RULES FOR PERIODS THAT BEGIN AFTER 
JANUARY 1.—For any specific period described in 
subparagraph (B) of paragraph (2), the following 
applies: 
‘‘(A) The specific period shall be treated as 
a continuation of the immediately preceding pe-
riod in that calendar year for purposes of apply-
ing subsection (b)(2) and qualifying individuals 
who received assistance in the last month of 
such immediately preceding period shall be 
deemed to be selected for the specific period 
(without the need to complete an application for 
assistance for such period). 
‘‘(B) The limit to be applied under sub-
section (b)(3) for the specific period shall be the 
same as the limit applied under such subsection 
for the immediately preceding period. 
‘‘(C) The ratio to be applied under sub-
section (c)(2) for the specific period shall be the
same as the ratio applied under such subsection 
for the immediately preceding period.’’. 
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