I 
117TH CONGRESS 
1ST SESSION H. R. 1676 
To amend title XVIII to provide for certain Medigap coverage for Medicare 
beneficiaries with end-stage renal disease, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 9, 2021 
Mrs. AXNE (for herself, Ms. HERRERA BEUTLER, and Mr. CARSON) intro-
duced the following bill; which was referred to the Committee on Ways 
and Means, and in addition to the Committee on Energy and 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 amend title XVIII to provide for certain Medigap cov-
erage for Medicare beneficiaries with end-stage renal dis-
ease, 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 ‘‘Jack Reynolds Memory 
Medigap Expansion Act’’. 
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SEC. 2. MEDIGAP COVERAGE FOR BENEFICIARIES WITH 
END-STAGE RENAL DISEASE. 
(a) GUARANTEED AVAILABILITY OF MEDIGAP POLI-
CIES TO ALL ESRD MEDICARE BENEFICIARIES.— 
(1) IN GENERAL.—Section 1882(s) of the So-
cial Security Act (42 U.S.C. 1395ss(s)) is amend-
ed— 
(A) in paragraph (2)— 
(i) in subparagraph (A), by striking 
‘‘is 65’’ and all that follows through the 
period at the end and inserting the fol-
lowing: ‘‘is— 
‘‘(i) 65 years of age or older and is 
enrolled for benefits under part B; or 
‘‘(ii) is entitled to benefits under 
226A(b) and is enrolled for benefits under 
part B.’’; and 
(ii) in subparagraph (D), in the mat-
ter preceding clause (i), by inserting ‘‘(or 
is entitled to benefits under 226A(b))’’ 
after ‘‘is 65 years of age or older’’; and 
(B) in paragraph (3)(B)— 
(i) in clause (ii), by inserting ‘‘(or is 
entitled to benefits under 226A(b))’’ after 
‘‘is 65 years of age or older’’; and 
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(ii) in clause (vi), by inserting ‘‘(or 
under 226A(b))’’ after ‘‘at age 65’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to Medicare supple-
mental policies effective on or after January 1, 
2022. 
(b) ADDITIONAL ENROLLMENT PERIOD FOR CER-
TAIN INDIVIDUALS.— 
(1) ONE-TIME ENROLLMENT PERIOD.— 
(A) IN GENERAL.—In the case of an indi-
vidual described in paragraph (2), the Secretary 
of Health and Human Services shall establish a 
one-time enrollment period during which such 
an individual may enroll in any Medicare sup-
plemental policy under section 1882 of the So-
cial Security Act (42 U.S.C. 1395ss) of the in-
dividual’s choosing. 
(B) ENROLLMENT
PERIOD.—The enroll-
ment period established under subparagraph 
(A) shall begin on January 1, 2022, and shall 
end June 30, 2022. 
(2) INDIVIDUAL DESCRIBED.—An individual de-
scribed in this paragraph is an individual who— 
(A) is entitled to hospital insurance bene-
fits under part A of title XVIII of the Social 
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Security Act under section 226A(b) of such Act 
(42 U.S.C. 426–1(b)); 
(B) is enrolled for benefits under part B of 
such title XVIII; and 
(C) would not, but for the provisions of, 
and amendments made by, subsection (a) be eli-
gible for the guaranteed issue of a Medicare 
supplemental policy under paragraph (2) or (3) 
of section 1882(s) of such Act (42 U.S.C. 
1395ss(s)). 
SEC. 3. ALLOWING INDIVIDUALS WITH KIDNEY FAILURE TO 
RETAIN ACCESS TO PRIVATE INSURANCE. 
(a) IN GENERAL.—Section 1862(b)(1)(C) of the So-
cial Security Act (42 U.S.C. 1395y(b)(1)(C)) is amend-
ed— 
(1) in the last sentence, by inserting ‘‘and be-
fore January 1, 2021’’ after ‘‘prior to such date’’; 
and 
(2) by adding at the end the following new sen-
tence: ‘‘Effective for items and services furnished on 
or after January 1, 2021 (with respect to periods 
beginning on or after the date that is 42 months 
prior to such date), clauses (i) and (ii) shall be ap-
plied by substituting ‘42-month’ for ‘12-month’ each 
place it appears.’’. 
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(b) EFFECTIVE DATE.—The amendments made by 
this subsection shall take effect on the date of enactment 
of this Act. For purposes of determining an individual’s 
status under section 1862(b)(1)(C) of the Social Security 
Act (42 U.S.C. 1395y(b)(1)(C)), as amended by sub-
section (a), an individual who is within the coordinating 
period as of the date of enactment of this Act shall have 
that period extended to the full 42 months described in 
the last sentence of such section, as added by the amend-
ment made by subsection (a)(2). 
Æ 
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