datamatters24/research-document-archive huggingface dataset:
V 
108TH CONGRESS 
1ST SESSION H. R. 2487
For the relief of Esther Karinge. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 16, 2003
Mr. MARKEY introduced the following bill; which was referred to the 
Committee on the Judiciary 
A BILL 
For the relief of Esther Karinge.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. PERMANENT RESIDENT STATUS FOR ESTHER 
KARINGE. 
(a) IN GENERAL.—Notwithstanding subsections (a) 
and (b) of section 201 of the Immigration and Nationality 
Act, Esther Karinge shall be eligible for issuance of an 
immigrant visa or for adjustment of status to that of an 
alien lawfully admitted for permanent residence upon fil-
ing an application for issuance of an immigrant visa under 
section 204 of such Act or for adjustment of status to 
lawful permanent resident.
(b) ADJUSTMENT OF STATUS.—If Esther Karinge 
enters the United States before the filing deadline speci-
fied in subsection (c), she shall be considered to have en-
tered and remained lawfully and shall, if otherwise eligible, 
be eligible for adjustment of status under section 245 of 
the Immigration and Nationality Act as of the date of the 
enactment of this Act. 
(c) DEADLINE FOR APPLICATION AND PAYMENT OF 
FEES.—Subsections (a) and (b) shall apply only if the ap-
plication for issuance of an immigrant visa or the applica-
tion for adjustment of status is filed with appropriate fees 
within 2 years after the date of the enactment of this Act. 
(d) REDUCTION OF IMMIGRANT VISA NUMBER.—
Upon the granting of an immigrant visa or permanent res-
idence to Esther Karinge, the Secretary of State shall in-
struct the proper officer to reduce by 1, during the current 
or next following fiscal year, the total number of immi-
grant visas that are made available to natives of the coun-
try of the alien’s birth under section 203(a) of the Immi-
gration and Nationality Act or, if applicable, the total 
number of immigrant visas that are made available to na-
tives of the country of the alien’s birth under section 
202(e) of such Act. 
(e) 
DENIAL
OF
PREFERENTIAL
IMMIGRATION 
TREATMENT
FOR CERTAIN RELATIVES.—The natural
parents, brothers, and sisters of Esther Karinge shall not, 
by virtue of such relationship, be accorded any right, privi-
lege, or status under the Immigration and Nationality Act.
Æ
I 
108TH CONGRESS 
1ST SESSION H. R. 2488
To provide for the protection of the tropical forests of the Karst Region 
of the Commonwealth of Puerto Rico and the aquifers and watersheds 
of this region that constitute a principal water source for much of 
Puerto Rico, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 17, 2003
Mr. ACEVEDO-VILA´ (for himself, Mr. DUNCAN, Mrs. CHRISTENSEN, Mr. 
UDALL of Colorado, Mr. GONZALEZ, Mr. TOWNS, Mr. GRIJALVA, and Ms. 
BORDALLO) introduced the following bill; which was referred to the Com-
mittee on Resources 
A BILL 
To provide for the protection of the tropical forests of the 
Karst Region of the Commonwealth of Puerto Rico and 
the aquifers and watersheds of this region that constitute 
a principal water source for much of Puerto Rico, 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 ‘‘Puerto Rico Karst 
Conservation Act of 2003’’.
HR 253 RFS 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the Director may not provide assistance 
under this section to a State or community in an 
amount exceeding 3 times the amount that the State 
or community certifies, as the Director shall require, 
that the State or community will contribute from 
non-Federal funds for carrying out the eligible ac-
tivities to be funded with such assistance amounts. 
‘‘(2) WAIVER.—
‘‘(A) AUTHORITY.—Subject to subpara-
graph (B), the Director may waive the limita-
tion under paragraph (1) for any State, and for 
the communities located in that State, with re-
spect to a year, if, for such year—
‘‘(i) 5 percent or more of the total 
number of severe repetitive loss properties 
in the United States are located in such 
State; and 
‘‘(ii) the State submits a plan to the 
Director specifying how the State intends 
to reduce the number of severe repetitive 
loss properties and the Director deter-
mines, after consultation with State and 
technical experts, that the State has taken
determined by the tribe), for the construction and mainte-
nance of tribal and cultural centers. Beginning the second 
year after the date of the enactment of this Act, interest 
earned on such sum shall be disbursed annually in a lump 
sum to the tribe’s governing body and shall be used for 
the following, with 21.45 percent of the initial interest 
available upon the date of the enactment of this Act to 
fund the program for the first year after the date of the 
enactment of this Act: 
(1) Property acquisition for business or other 
activities which are likely to benefit the tribe eco-
nomically or provide employment for tribal members. 
(2) Business development for the tribe, includ-
ing collateralization of loans for the purchase or op-
eration of businesses, matching funds for economic 
development grants, joint venture partnerships, and 
other similar ventures, which are likely to produce 
profits for the tribe. All business loans shall pay 
principal and interest back to the Economic Devel-
opment program for reinvestments and business 
profits shall go to the tribe’s general fund for uses 
to be determined by the tribe’s governing body. 
(3) Design, construction, maintenance, and op-
eration of tribal and cultural centers.
(4) Section 7 of the Indian Tribal Judgment
Funds Use or Distribution Act (25 U.S.C. 1407)
shall apply to funds available under this Act.
(5) Any tribal member who feels he or she has
been unfairly denied the right to take part in any
program under this Act may appeal to the tribal sec-
retary. The tribal secretary shall bring the appeal to
the tribe’s governing body for resolution. The resolu-
tion shall be made in a timely manner and the tribal
secretary at that time shall respond to the tribal
member.
Passed the House of Representatives March 23,
2004.
Attest:
Clerk.
multi-faceted law, combining public health, social 
service, and law enforcement approaches. 
(7) For over 20 years, Congress has been pre-
sented with facts and testimony calling for a coordi-
nated Federal effort to combat elder abuse, neglect, 
and exploitation. 
(8) The Federal Government has been slow to 
respond to the needs of victims of elder abuse, ne-
glect, and exploitation or to undertake prevention ef-
forts. 
(9) No Federal law has been enacted that ade-
quately and comprehensively addresses the issues of 
elder abuse, neglect, and exploitation and there are 
very limited resources available to those in the field 
directly dealing with these issues. 
(10) Differences in State laws and practices in 
the areas of elder abuse, neglect, and exploitation 
lead to significant disparities in prevention, protec-
tive and social services, treatment systems, and law 
enforcement, and lead to other inequities. 
(11) The Federal Government has played an 
important role in promoting research, training, pub-
lic safety, data collection, the identification, develop-
ment, and dissemination of promising health care, 
social, and protective services, and law enforcement
I 
108TH CONGRESS 
1ST SESSION 
H. R. 248
To amend the Public Health Service Act and the Homeland Security Act 
of 2002 to strike unrelated provisions concerning changes to the National 
Vaccine Injury Compensation Program and liability for vaccine manufac-
turers. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 8, 2003
Mr. ALLEN (for himself, Mr. STARK, Mr. PALLONE, Mr. BROWN of Ohio, Mr. 
MICHAUD, Mr. SANDERS, Mr. BERRY, Mr. DAVIS of Florida, Mr. 
KUCINICH, and Mrs. CAPPS) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act and the Homeland 
Security Act of 2002 to strike unrelated provisions con-
cerning changes to the National Vaccine Injury Com-
pensation Program and liability for vaccine manufactur-
ers.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. REPEAL OF CERTAIN AMENDMENTS TO NA-
TIONAL VACCINE INJURY COMPENSATION 
PROGRAM. 
(a) IN GENERAL.—Section 2133 of the Public Health 
Service Act (42 U.S.C. 300aa–33) is amended to read as 
if sections 1714 through 1716 of Public Law 107–296 had 
not been enacted. Section 1717 of Public Law 107–296 
is repealed. 
(b) EFFECTIVE DATE.—Subsection (a) is deemed to 
have taken effect instantly upon the enactment of Public 
Law 107–296. 
(c) RULE OF CONSTRUCTION.—This Act and sections 
1714 through 1717 of Public Law 107–296 may not be 
construed as having any legal effect on any court pro-
ceeding or decision involving any issue with which such 
sections were concerned.
Æ
(b) DEDUCTION
ALLOWED
IN
COMPUTING
AD-
JUSTED GROSS INCOME.—Subsection (a) of section 62 of 
such Code is amended by inserting after paragraph (18) 
the following new paragraph: 
‘‘(19) MEDICAL CARE.—The deduction allowed 
by section 213.’’. 
(c) CONFORMING AMENDMENTS.—
(1) Section 56(b)(1) of such Code is amended 
by striking subparagraph (B). 
(2) Section 67(b) is amended by striking para-
graph (5). 
(3) Section 72(t)(B) of such Code is amended 
by striking ‘‘to the extent such distributions do not 
exceed the amount’’ and inserting ‘‘which are’’. 
(4) Sections 104(a) and 105(b) of such Code 
are both amended by striking ‘‘(and not in excess 
of)’’. 
(d) EFFECTIVE DATE.— The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2003.
SEC. 103. MEDICAL CHECKING ACCOUNTS. 
(a) IN GENERAL.—Subchapter F of chapter 1 of the 
Internal Revenue Code of 1986 (relating to exempt organi-
zations) is amended by adding at the end the following:
tion shall be allowed for a taxable year for any 
amount contributed to a medical checking ac-
count if the sum of such amount plus the bal-
ance in the account determined as the end of 
the taxable year would exceed $2,000 ($4,000 
in the case of married individuals filing a joint 
return, a surviving spouse, and a head of house-
hold). 
‘‘(c) CREDIT FOR CONTRIBUTIONS.—
‘‘(1) IN
GENERAL.—In the case of an indi-
vidual, there shall be allowed as a credit against the 
tax imposed by this chapter for the taxable year an 
amount equal to the credit amount with respect to 
contributions made during the taxable year to the 
medical checking account of the taxpayer. 
‘‘(2) CREDIT AMOUNT.—For purposes of para-
graph (1), the credit amount is the lesser of—
‘‘(A) the total amount of contributions to 
the medical checking account for the taxable 
year reduced by the amount of contributions al-
lowed as a deduction under subsection (b), and 
‘‘(B) $1,000. 
‘‘(d) DEFINITIONS AND SPECIAL RULES.—For pur-
poses of this section—
‘‘(i) there is no long-term mission require-
ment for the property, but the Federal Govern-
ment is not permitted to dispose of it; or
‘‘(ii)(I) there is a continuing, long-term 
mission requirement of the landholding agency 
for the property to remain in Government own-
ership; and 
‘‘(II) the use of the real property by the 
lessee will not be inconsistent with such mis-
sion; and 
‘‘(B) in the case of an outlease to a non-Fed-
eral entity, the outlease is conducted competitively. 
If the agency head makes a finding under subparagraph 
(A)(ii), the agency head shall include a written rationale 
for the finding of a continuing Federal need for the prop-
erty in the business plan submitted under section 
623(b)(3) of this title. 
‘‘(2) To reduce vacant space and realize the equity 
value of Government-owned real property assets, provide 
Federal agencies with modern functional work environ-
ments, and work cooperatively with the commercial real 
estate community, the landholding agency may enter into 
an agreement with a non-Federal entity. Any agreement 
under this subsection—
than a petition to the Supreme 
Court for a writ of certiorari 
holding that the patent that is 
the subject of the certification is 
invalid or not infringed; or 
‘‘(bb) the date of a settle-
ment order or consent decree 
signed by a Federal judge that 
enters a final judgment and in-
cludes a finding that the patent 
that is the subject of the certifi-
cation is invalid or not otherwise 
infringed;’’; and 
(2) by inserting after subparagraph (C) the fol-
lowing: 
‘‘(D) FORFEITURE
OF
180-DAY
EXCLU-
SIVITY PERIOD.—
‘‘(i) DEFINITION
OF
FORFEITURE 
EVENT.—In this subparagraph, the term 
‘forfeiture event’, with respect to an appli-
cation under this subsection, means the oc-
currence of any of the following: 
‘‘(I) FAILURE TO MARKET.—The 
applicant fails to market the drug by 
the later of—
154
under this subsection by a preponderance of the 
evidence. 
(D) CIVIL INVESTIGATIVE DEMAND PROCE-
DURES.—The civil investigative demand proce-
dures set forth in The Antitrust Civil Process 
Act (15 U.S.C. 1511 et seq.) may be used in 
investigations and actions pursued under this 
subsection. 
(d) RELATIONSHIP TO OTHER LAWS.—This section 
is not intended to supplant or otherwise bar any existing 
equitable, common law, or criminal or civil statutory rem-
edies possessed by the United States, including under the 
False Claims Act (31 U.S.C. 33729–3733). The Federal 
Rules of Civil Procedure shall apply to actions brought 
under subsection (b). 
(e) NO PRIVATE CAUSE OF ACTION.—Nothing in this 
title creates a private cause of action or in any other way 
increases the liability of any person under any other law. 
TITLE III—TAX PROVISIONS 
SEC. 301. LONG-TERM CARE FACILITY WORKER EMPLOY-
MENT TAX CREDIT. 
(a) WORK OPPORTUNITY TAX CREDIT.—
(1) IN GENERAL.—Section 51(d)(1) of the In-
ternal Revenue code of 1986 (relating to members of 
targeted groups) is amended by striking ‘‘or’’ at the
155
end of subparagraph (G), by striking the period at 
the end of subparagraph (H) and inserting ‘‘, or’’, 
and by adding at the end the following: 
‘‘(I) a qualified long-term care facility 
worker.’’. 
(2) QUALIFIED
LONG-TERM
CAR
FACILITY 
WORKER.—Section 51(d) of such Code is amended 
by redesignating paragraphs (10) through (12) as 
paragraphs (11) through (13), respectively, and by 
inserting after paragraph (9) the following: 
‘‘(10) QUALIFIED LONG-TERM CARE FACILITY 
WORKER.—The term ‘qualified long-term care facil-
ity worker’ means any individual who—
‘‘(A) is hired by a long-term care facility 
(as defined in section 2201 of the Social Secu-
rity Act; and 
‘‘(B) is certified by the designated local 
agency as being qualified to provide long-term 
care (as defined in section 2201 of such Act) at 
such facility.’’
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to individuals who begin work for 
the employer after the date of enactment of this Act.
Æ
I 
108TH CONGRESS 
1ST SESSION H. R. 2492
To ensure that recreation benefits are accorded the same weight as hurricane 
and storm damage reduction benefits and environmental restoration benefits. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 17, 2003
Mr. LAMPSON introduced the following bill; which was referred to the 
Committee on Transportation and Infrastructure 
A BILL 
To ensure that recreation benefits are accorded the same 
weight as hurricane and storm damage reduction benefits 
and environmental restoration benefits.
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 ‘‘National Beach Recre-
ation Act’’. 
SEC. 2. GIVING RECREATIONAL BENEFITS THE SAME STA-
TUS AS OTHER BEACH RESTORATION BENE-
FITS. 
Subsection (e)(2)(B)(i) of the 1st section of the Act 
entitled ‘‘An Act authorizing Federal participation in the
cost of protecting the shores of publicly owned property’’, 
approved August 13, 1946 (33 U.S.C. 426e), is amended 
by adding at the end the following: ‘‘In making such rec-
ommendations, the Secretary shall develop and implement 
procedures that treat recreational, hurricane and storm 
damage reduction, and environmental restoration benefits 
equally.’’.
Æ
tically sampled and tested for authenticity and 
degradation. 
‘‘(K) Certification from the importer or 
manufacturer of the prescription drug that the 
prescription drug—
‘‘(i) is approved for marketing in the 
United States; and 
‘‘(ii) meets all labeling requirements 
under this Act. 
‘‘(L) Laboratory records, including com-
plete data derived from all tests necessary to 
ensure that the prescription drug is in compli-
ance with established specifications and stand-
ards. 
‘‘(M) Documentation demonstrating that 
the testing required by subparagraphs (J) and 
(L) was conducted at a qualifying laboratory. 
‘‘(N) Any other information that the Sec-
retary determines is necessary to ensure the 
protection of the public health. 
‘‘(2) MAINTENANCE BY THE SECRETARY.—The 
Secretary shall maintain information and docu-
mentation submitted under paragraph (1) for such 
period of time as the Secretary determines to be nec-
essary.
I 
108TH CONGRESS 
1ST SESSION H. R. 2496
To authorize a national museum, including a research center and related 
visitor facilities, in the city of El Paso, Texas, to commemorate migration 
at the United States southern border. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 17, 2003
Mr. REYES introduced the following bill; which was referred to the Committee 
on Education and the Workforce, and in addition to the Committee on 
the Judiciary, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To authorize a national museum, including a research center 
and related visitor facilities, in the city of El Paso, 
Texas, to commemorate migration at the United States 
southern border.
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 ‘‘Paso al Norte National 
Museum of Immigration History Act’’. 
SEC. 2. FINDINGS. 
Congress finds that—
name in which a designated national has an interest, 
including any such trade name issued by a des-
ignated national. 
(3) BLOCKED
FOREIGN
TRADEMARK.—The 
term ‘‘blocked foreign trademark’’ has the meaning 
given that term in section 515.528(c) of title 31, 
Code of Federal Regulations, as in effect on April 
28, 2003. 
(4) DESIGNATED NATIONAL.—The term ‘‘des-
ignated national’’ has the meaning given that term 
in subpart C of part 515 of title 31, Code of Federal 
Regulations, as in effect on April 28, 2003. 
(5) DIRECTOR OF THE PATENT AND TRADE-
MARK OFFICE.—The term ‘‘Director of the Patent 
and Trademark Office’’ means the Under Secretary 
of Commerce for Intellectual Property and Director 
of the United States Patent and Trademark Office. 
(6) DOMAIN NAME; MARK; TRADEMARK.—The 
terms ‘‘domain name’’, ‘‘mark’’, and ‘‘trademark’’ 
have the meanings given those terms in section 45 
of the Trademark Act of 1946. 
(7) INTEREST.—The term ‘‘interest’’ has the 
meaning given that term in section 515.312 of title 
31, Code of Federal Regulations, as in effect on 
April 28, 2003.
(8) TRADEMARK
ACT
OF
1946.—The term 
‘‘Trademark Act of 1946’’ means the Act entitled 
‘‘An Act to provide for the registration and protec-
tion of trademarks used in commerce, to carry out 
the provisions of certain international conventions, 
and for other purposes’’, approved July 5, 1946 (15 
U.S.C. 1051 et seq.). 
(9) TRADE
NAME.—The term ‘‘trade name’’ 
means a trade name or commercial name as those 
terms are defined in section 45 of the Trademark 
Act of 1946. 
(10) UNITED
STATES
NATIONAL.—The term 
‘‘United States national’’ means—
(A) any United States citizen; or 
(B) any other legal entity which is orga-
nized under the laws of the United States, or 
of any State, the District of Columbia, or any 
commonwealth, territory, or possession of the 
United States, and which has its principal place 
of business in the United States.
Æ
I 
108TH CONGRESS 
1ST SESSION H. R. 2495
To amend the Ysleta del Sur Pueblo and Alabama and Coushatta Indian 
Tribes of Texas Restoration Act to decrease the requisite blood quantum 
required for membership in the Ysleta del Sur Pueblo tribe. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 17, 2003
Mr. REYES introduced the following bill; which was referred to the Committee 
on Resources 
A BILL 
To amend the Ysleta del Sur Pueblo and Alabama and 
Coushatta Indian Tribes of Texas Restoration Act to 
decrease the requisite blood quantum required for mem-
bership in the Ysleta del Sur Pueblo tribe.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. BLOOD QUANTUM REQUIRED FOR TRIBAL 
MEMBERSHIP DECREASED. 
Section 108(a)(2)(i) of the Ysleta del Sur Pueblo and 
Alabama and Coushatta Indian Tribes of Texas Restora-
tion Act (25 U.S.C. 1300g–7) is amended by striking ‘‘1⁄8’’ 
and inserting ‘‘1⁄16’’.
Æ
I 
108TH CONGRESS 
1ST SESSION H. R. 2498
To amend title XVIII of the Social Security Act to provide a prescription 
benefit program for all Medicare beneficiaries. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 17, 2003
Mr. SANDERS (for himself, Mr. KUCINICH, Ms. LEE, Mr. HINCHEY, Mr. 
FRANK of Massachusetts, Mr. DEFAZIO, Mr. PAYNE, Mr. SERRANO, Mr. 
WEINER, Mr. OLVER, Mr. FILNER, Mr. CONYERS, Mr. NADLER, Ms. 
CORRINE BROWN of Florida, Ms. WATSON, Ms. BALDWIN, Ms. WOOL-
SEY, and Mr. DAVIS of Illinois) introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined 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 of the Social Security Act to provide 
a prescription benefit program for all Medicare beneficiaries.
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 Extension of Drugs to Seniors (MEDS) Act of 
2003’’.
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows:
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Prescription medicine benefit program. 
‘‘PART D—PRESCRIPTION MEDICINE BENEFIT FOR THE AGED AND 
DISABLED 
‘‘Sec. 1860. Establishment of prescription medicine benefit program for 
the aged and disabled. 
‘‘Sec. 1860A. Scope of benefits. 
‘‘Sec. 1860B. Payment of benefits; benefit limits. 
‘‘Sec. 1860C. Eligibility and enrollment. 
‘‘Sec. 1860D. Premiums. 
‘‘Sec. 1860E. Special eligibility, enrollment, and copayment rules for low-
income individuals. 
‘‘Sec. 1860F. Prescription Medicine Insurance Account. 
‘‘Sec. 1860G. Administration of benefits. 
‘‘Sec. 1860H. Employer Incentive Program for employment-based retiree 
medicine coverage. 
‘‘Sec. 1860I. Promotion of pharmaceutical research on break-through medi-
cines while providing program cost containment. 
‘‘Sec. 1860J. Appropriations to cover Government contributions. 
‘‘Sec. 1860K. Prescription medicine defined. 
Sec. 4. Substantial reductions in the price of prescription drugs for medicare 
beneficiaries. 
Sec. 5. Amendments to program for importation of certain prescription drugs 
by pharmacists and wholesalers. 
Sec. 6. Reasonable price agreement for federally funded research. 
Sec. 7. GAO ongoing studies and reports on program; miscellaneous reports. 
Sec. 8. Medigap transition provisions.
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Prescription medicine coverage was not a 
standard part of health insurance when the medicare 
program under title XVIII of the Social Security Act 
was enacted in 1965. Since 1965, however, medicine 
coverage has become a key component of most pri-
vate and public health insurance coverage, except for 
the medicare program.