I
105TH CONGRESS
2D SESSION
H. R. 4662
To direct the Commissioner of Social Security to establish a demonstration
project to conduct outreach efforts to increase awareness of the availabil-
ity of Medicare cost-sharing assistance to eligible low-income Medicare
beneficiaries.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 1, 1998
Mr. BUNNING introduced the following bill; which was referred to the Commit-
tee on Ways and Means, and in addition to the Committee on Commerce,
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 direct the Commissioner of Social Security to establish
a demonstration project to conduct outreach efforts to
increase awareness of the availability of Medicare cost-
sharing assistance to eligible low-income Medicare bene-
ficiaries.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. FINDINGS.
Congress makes the following findings:
(1) Since 1988, three cost-sharing payment pro-
grams to provide certain low-income elderly and dis-
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abled individuals with financial assistance in cover-
ing Medicare beneficiary costs have been established
by law.
(2) While eligibility for Medicare cost-sharing
assistance has expanded, and while the Social Secu-
rity Administration, the Health Care Financing Ad-
ministration, and State agencies are working coop-
eratively to identify and implement reforms to cure
the chronic deficiencies associated with the programs
described in paragraph (1), reports have shown that
gaps in beneficiary knowledge and deficiencies in
program administration by Federal and State agen-
cies present persistent barriers to enrolling eligible
beneficiaries in such programs.
(3) The financial plight of Social Security and
Medicare beneficiaries who experience critical income
shifts due to the death of a spouse is of particular
concern. Statistics furnished by the Social Security
Administration show that 40 percent of nonmarried
women (a category that includes widows) rely on So-
cial Security benefits for 90 percent of their income
in comparison to only 18 percent of married couples.
Further, nearly one quarter of nonmarried women
rely on Social Security retirement benefits as their
sole source of income.
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(4) While current reform proposals concentrate
on reaching potential eligible beneficiaries upon ini-
tial enrollment in Social Security or the Medicare
program, the financial vulnerability of widowed
spouses may arise at any time after a senior has
begun to receive retirement benefits.
SEC. 2. DEMONSTRATION PROJECT.
(a) ESTABLISHMENT.—
(1) OUTREACH.—The Commissioner shall es-
tablish a demonstration project to conduct outreach
efforts to identify individuals entitled to benefits
under the Medicare program who may be eligible for
medical assistance for payment of the cost of Medi-
care cost-sharing under the Medicaid program under
section 1902(a)(10)(E) and section 1933 of the So-
cial Security Act (42 U.S.C. 1396a(a)(10)(E);
1396u–3) and to notify such individuals of the avail-
ability of such medical assistance under such sec-
tions.
(2) CONTENT
OF
NOTICE.—Any notice fur-
nished under paragraph (1) shall state that eligi-
bility for Medicare cost-sharing assistance under
such sections is conditioned upon the individual pro-
viding an accurate statement as to whether or not
the individual has tax-except income, and, if so, the
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amount of such income and, in the case of an indi-
vidual residing in a State that imposes an asset test
for such eligibility, the amount of countable assets
the individual has.
(b) COORDINATION WITH STATES AND OTHER FED-
ERAL AGENCIES.—
(1) FURNISHING INFORMATION TO STATES.—In
conducting the demonstration project established
under subsection (a), the Commissioner shall furnish
the appropriate agency of each State information
consisting of the identity of individuals residing in
the State that the Commissioner determines are or
may be eligible for medical assistance for payment of
the cost of Medicare cost-sharing under the Medic-
aid program under section 1902(a)(10)(E) and sec-
tion 1933 of such Act, and shall periodically update
any such information as appropriate.
(2) COORDINATION WITH IRS AND HCFA.—Ex-
cept as otherwise prohibited by law, in conducting
such demonstration project the Commissioner, in co-
operation with the Commissioner of the Internal
Revenue Service and the Administrator of the
Health Care Financing Administration, shall furnish
the appropriate agency of each State available in-
come and asset information of individuals residing
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in the State who are or may be eligible for the medi-
cal assistance described in paragraph (1).
(c) DURATION.—The Commissioner shall conduct the
demonstration project during the 1-year period beginning
on October 1, 1998.
(d) REPORT.—Not later than six months after the
completion of the demonstration project, the Commis-
sioner, after consultation with the Commissioner of the In-
ternal Revenue Service and the Administrator of the
Health Care Financing Administration, shall submit to
Congress a report on the outreach efforts and results of
such efforts under the project. The report may include any
recommendations for legislative or administrative actions
to further carry out the purpose of the project.
(e) DEFINITIONS.—In this Act:
(1) 
COMMISSIONER.—The 
term 
‘‘Commis-
sioner’’ means the Commissioner of Social Security.
(2) MEDICAID PROGRAM.—The term ‘‘Medicaid
program’’ means the program of medical assistance
established under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.).
(3) MEDICARE PROGRAM.—The term ‘‘Medicare
program’’ means the health insurance program es-
tablished under title XVIII of such Act (42 U.S.C.
1395 et seq.).
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(f) AUTHORIZATION
OF APPROPRIATIONS.—From
sums made available to the Social Security Administration
for fiscal year 1999 to carry out research and demonstra-
tions activities, not more than $5,000,000 may be obli-
gated to carry out the demonstration project under this
Act.
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