I 
108TH CONGRESS 
2D SESSION 
H. R. 5156
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 
SEPTEMBER 28, 2004
Mr. GREEN of Texas introduced the following bill; which was referred to the 
Committee on Ways and Means 
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, 
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 
2004’’.
(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 
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)—
‘‘(2) for 2006, 16 months; 
‘‘(3) for 2007, 14 months; 
‘‘(4) for 2008, 12 months; 
‘‘(5) for 2009, 10 months; 
‘‘(6) for 2010, 8 months; 
‘‘(7) for 2011, 6 months; 
‘‘(8) for 2012, 4 months; 
‘‘(9) for 2013, 2 months; and 
‘‘(10) for 2014 and each subsequent year, 0 
months.’’. 
(c) CONFORMING AMENDMENTS.—
(1) SUNSET.—Effective January 1, 2014, 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))’’. 
(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 
the enactment of this Act.’’
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 
identified by the Secretary’’ after ‘‘amyotrophic 
lateral sclerosis (ALS)’’; and 
(4) in subparagraph (B) (as redesignated by 
paragraph (1)), by striking ‘‘(rather than twenty-
fifth month)’’; and 
(5) 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 
a list of conditions that are fatal without medical treat-
ment. In compiling such list, the Secretary shall consult 
with the Director of the National Institutes of Health (in-
cluding 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.’’. 
(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. 
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-
viduals receive access to health care services and coverage 
before the condition reaches disability levels. 
(b) REPORT.—Not later than the date that is 2 years 
after the date of enactment of this Act, the Secretary shall 
submit to Congress a report containing the results of the 
Institute of Medicine study authorized under this section. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$750,000 for the period of fiscal years 2005 and 2006.
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