I 
110TH CONGRESS 
1ST SESSION H. R. 3127 
To amend title XIX of the Social Security Act to assist low-income Medicare 
beneficiaries by improving eligibility and services under the Medicare 
Savings Program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 23, 2007 
Mr. BECERRA (for himself and Mr. GENE GREEN of Texas) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XIX of the Social Security Act to assist 
low-income Medicare beneficiaries by improving eligibility 
and services under the Medicare Savings Program, 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 
‘‘Medicare Savings Program Improvement Act of 2007’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. References to Medicare Savings Program. 
Sec. 3. Increase in income levels for eligibility. 
Sec. 4. Elimination of application of estate recovery for Medicare Savings Pro-
gram beneficiaries. 
Sec. 5. Modification of asset test. 
Sec. 6. Eligibility for other programs. 
Sec. 7. Effective date of MSP benefits. 
Sec. 8. Expediting eligibility under the Medicare Savings Program. 
Sec. 9. Treatment of qualified medicare beneficiaries, specified low-income 
medicare beneficiaries, and other dual eligibles as Medicare 
beneficiaries. 
Sec. 10. Medicaid treatment of certain medicare providers. 
Sec. 11. Monitoring and enforcement of limitation on beneficiary liability. 
Sec. 12. State provision of medical assistance to dual eligibles in MA plans. 
SEC. 2. REFERENCES TO MEDICARE SAVINGS PROGRAM. 
The low-income assistance programs for Medicare 
beneficiaries under the Medicaid program under title XIX 
of the Social Security Act now popularly referred to the 
‘‘QMB’’ and ‘‘SLMB’’ programs are to be known as the 
‘‘Medicare Savings Program’’. 
SEC. 3. INCREASE IN INCOME LEVELS FOR ELIGIBILITY. 
(a) INCREASE TO 135 PERCENT OF FPL FOR QUALI-
FIED MEDICARE BENEFICIARIES.— 
(1) IN GENERAL.—Section 1905(p)(2) of the 
Social Security Act (42 U.S.C. 1396d(p)(2)) is 
amended— 
(A) in subparagraph (A), by striking ‘‘100 
percent’’ and inserting ‘‘135 percent’’; 
(B) in subparagraph (B)— 
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(i) by striking ‘‘and’’ at the end of 
clause (ii); 
(ii) by striking the period at the end 
of clause (iii) and inserting ‘‘, and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(iv) January 1, 2008, is 135 percent.’’; and 
(C) in subparagraph (C)— 
(i) by striking ‘‘and’’ at the end of 
clause (iii); 
(ii) by striking the period at the end 
of clause (iv) and inserting ‘‘, and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(v) January 1, 2008, is 135 percent.’’. 
(2) APPLICATION OF INCOME TEST BASED ON 
FAMILY SIZE.—Section 1905(p)(2)(A) of such Act 
(42 U.S.C. 1396d(p)(2)(A)) is amended by adding 
at the end the following: ‘‘For purposes of this sub-
paragraph, family size means the applicant, the 
spouse (if any) of the applicant if living in the same 
household as the applicant, and the number of indi-
viduals who are related to the applicant (or appli-
cants), who are living in the same household as the 
applicant (or applicants), and who are dependent on 
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the applicant (or the applicant’s spouse) for at least 
one-half of their financial support.’’. 
(3) NOT
COUNTING
IN-KIND
SUPPORT
AND 
MAINTENANCE AS INCOME.—Section 1905(p)(2)(D) 
of such Act (42 U.S.C. 1396d(p)(2)(D)) is amended 
by adding at the end the following new clause: 
‘‘(iii) In determining income under this subsection, 
support and maintenance furnished in kind shall not be 
counted as income.’’. 
(b) EXPANSION OF SPECIFIED LOW-INCOME MEDI-
CARE BENEFICIARY (SLMB) PROGRAM.— 
(1) ELIGIBILITY
OF
INDIVIDUALS
WITH
IN-
COMES
BELOW
150
PERCENT
OF
FPL.—Section 
1902(a)(10)(E) of the Social Security Act (42 
U.S.C. 1396b(a)(10)(E)) is amended— 
(A) by adding ‘‘and’’ at the end of clause 
(ii); 
(B) in clause (iii)— 
(i) by striking ‘‘and 120 percent in 
1995 and years thereafter’’ and inserting 
‘‘, or 120 percent in 1995 and any suc-
ceeding year before 2008, or 150 percent 
beginning in 2008’’; and 
(ii) by striking ‘‘and’’ at the end; and 
(C) by striking clause (iv). 
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(2) PROVIDING 100 PERCENT FEDERAL FINANC-
ING.—The third sentence of section 1905(b) of such 
Act (42 U.S.C. 1396d(b)) is amended by inserting 
before the period at the end the following: ‘‘and with 
respect to medical assistance for medicare cost-shar-
ing provided under section 1902(a)(10)(E)(iii)’’. 
(3) REFERENCES.—Section 1905(p)(1) of such 
Act (42 U.S.C. 1396d(p)(1)) is amended by adding 
at and below subparagraph (C) the following: ‘‘The 
term ‘specified low-income medicare beneficiary’ 
means 
an 
individual 
described 
in 
section 
1902(a)(10)(E)(iii).’’. 
(c) EFFECTIVE DATE.— 
(1) Except as provided in paragraph (2), the 
amendments made by this section shall take effect 
on January 1, 2008, and, with respect to title XIX 
of the Social Security Act, shall apply to calendar 
quarters beginning on or after January 1, 2008. 
(2) In the case of a State plan for medical as-
sistance under title XIX of the Social Security Act 
which the Secretary of Health and Human Services 
determines requires State legislation (other than leg-
islation appropriating funds) in order for the plan to 
meet the additional requirements imposed by the 
amendments made by this section, the State plan 
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shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its 
failure to meet these additional requirements before 
the first day of the first calendar quarter beginning 
after the close of the first regular session of the 
State legislature that begins after the date of the en-
actment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
SEC. 4. ELIMINATION OF APPLICATION OF ESTATE RECOV-
ERY 
FOR 
MEDICARE 
SAVINGS 
PROGRAM 
BENEFICIARIES. 
(a) IN GENERAL.—Section 1917(b)(1)(B)(ii) of the 
Social Security Act (42 U.S.C. 1396p(b)(1)(B)(ii)) is 
amended by inserting ‘‘(but not including medical assist-
ance for medicare cost-sharing or for benefits described 
in section 1902(a)(10)(E))’’ before the period at the end. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to actions commencing on or 
after January 1, 2008. 
SEC. 5. MODIFICATION OF ASSET TEST. 
(a) FOR QMBS.—Section 1905(p) of the Social Secu-
rity Act (42 U.S.C. 1396d(p)) is amended— 
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(1) in paragraph (1), by amending subpara-
graph (C) to read as follows: 
‘‘(C) whose resources (as determined under sec-
tion 1613 for purposes of the supplemental income 
security program, except as provided in paragraph 
(6)(C)) do not exceed the amount described in para-
graph (6)(A).’’; 
(2) by redesignating paragraph (6) as para-
graph (7); and 
(3) by inserting after paragraph (5) the fol-
lowing: 
‘‘(6)(A) The resource level specified in this subpara-
graph for— 
‘‘(i) for 2008 is six times the maximum amount 
of resources that an individual may have and obtain 
benefits under the supplemental security income pro-
gram under title XVI; or 
‘‘(ii) for a subsequent year is the resource level 
specified in this subparagraph for the previous year 
increased by the annual percentage increase in the 
consumer price index (all items; U.S. city average) 
as of September of such previous year. 
Any dollar amount established under clause (ii) that is not 
a multiple of $10 shall be rounded to the nearest multiple 
of $10. 
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‘‘(C) In determining the resources of an individual 
(and their eligible spouse, if any) under section 1613 for 
purposes of paragraph (1)(C) (relating to qualified medi-
care beneficiaries) or section 1902(a)(10)(E)(iii) (relating 
to individuals popularly known as specified low-income 
medicare beneficiaries), the following additional exclusions 
shall apply— 
‘‘(i) No part of the value of any life insurance 
policy shall be taken into account. 
‘‘(ii) No balance in any pension or retirement 
plan or account shall be taken into account.’’. 
(b) FOR SLMBS.— 
(1) PERMITTING
GREATER
ASSETS.—Section 
1902(a)(10)(E)(iii) 
of 
such 
Act 
(42 
U.S.C. 
1396b(a)(10)(E)(iii)) is amended by inserting before 
the semicolon the following: ‘‘or but for the fact that 
their resources exceed the resource level specified in 
section 1905(p)(6)(A) but does not exceed the re-
source level specified in section 1905(p)(6)(B)’’. 
(2) HIGHER
RESOURCE
LEVEL
SPECIFIED.— 
Section 1905(p)(6) of such Act, as inserted by sub-
section (a)(3), is amended by inserting after sub-
paragraph (A) the following new subparagraph: 
‘‘(B) The resource level specified in this subpara-
graph for— 
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‘‘(i) for 2008, is $27,500 (or $55,000 in the 
case of the combined value of the individual’s assets 
or resources and the assets or resources of the indi-
vidual’s spouse); and 
‘‘(ii) for a subsequent year is the applicable re-
source level specified in this subparagraph for the 
previous year increased by the annual percentage in-
crease in the consumer price index (all items; U.S. 
city average) as of September of such previous year. 
Any dollar amount established under clause (ii) that is not 
a multiple of $10 shall be rounded to the nearest multiple 
of $10.’’. 
(c) EFFECTIVE DATE.— 
(1) Except as provided in paragraph (2), the 
amendments made by this section shall apply to cal-
endar quarters beginning on or after January 1, 
2008. 
(2) In the case of a State plan for medical as-
sistance under title XIX of the Social Security Act 
which the Secretary of Health and Human Services 
determines requires State legislation (other than leg-
islation appropriating funds) in order for the plan to 
meet the additional requirements imposed by the 
amendments made by this section, the State plan 
shall not be regarded as failing to comply with the 
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requirements of such title solely on the basis of its 
failure to meet these additional requirements before 
the first day of the first calendar quarter beginning 
after the close of the first regular session of the 
State legislature that begins after the date of the en-
actment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
SEC. 6. ELIGIBILITY FOR OTHER PROGRAMS. 
(a) IN GENERAL.—Section 1905(p) of the Social Se-
curity Act (42 U.S.C. 1396d(p)), as amended by section 
4(a), is amended— 
(1) by redesignating paragraph (7) as para-
graph (8); and 
(2) by inserting after paragraph (6) the fol-
lowing new paragraph: 
‘‘(7) Medical assistance for some or all medicare cost- 
sharing under this title shall not be treated as benefits 
or otherwise taken into account in determining an individ-
ual’s eligibility for, or the amount of benefits under, any 
other Federal program.’’. 
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