I 
109TH CONGRESS 
2D SESSION 
H. R. 6400 
To amend title XVIII of the Social Security Act to provide for access to 
health benefits under the Medicare Program for certain individuals 21 
to 65 years of age, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 6, 2006 
Mr. JEFFERSON introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committees on Energy 
and Commerce and Education and the Workforce, for a period to be sub-
sequently 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 of the Social Security Act to provide 
for access to health benefits under the Medicare Program 
for certain individuals 21 to 65 years of age, 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 
‘‘Extended Access to Medicare Benefits Act of 2006’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
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Sec. 1. Short title, table of contents. 
Sec. 2. Findings. 
Sec. 3. Access to Medicare benefits for certain individuals 21 to 65 years of 
age. 
‘‘PART E—PURCHASE OF MEDICARE BENEFITS BY CERTAIN INDIVIDUALS 21 
TO 65 YEARS OF AGE 
‘‘Sec. 1860E–1. Program Benefits; eligibility. 
‘‘Sec. 1860E–2. Enrollment process; coverage. 
‘‘Sec. 1860E–3. Premiums. 
‘‘Sec. 1860E–4. Payment of premiums. 
‘‘Sec. 1860E–5. Medicare for the uninsured trust fund. 
‘‘Sec. 1860E–6. Oversight and accountability. 
‘‘Sec. 1860E–7. Administration and miscellaneous. 
Sec. 4. Refundable and advanceable income tax credit for certain Medicare pre-
miums for the uninsured. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) According to a 2006 Kaiser Family Foun-
dation report, over 46 million individuals in the 
United States who are under the age of 65 did not 
have health insurance coverage in 2005, an increase 
of 1.3 million individuals from the year before and 
an increase of over 7 million individuals since 2000. 
(2) According to a Kaiser Family Foundation 
Health Insurance Survey, in 2004, more than eight 
out of ten individual who were uninsured came from 
working families, almost 70 percent of whom were 
from families with one or more full-time workers and 
11 percent of whom were from families with part- 
time workers. Fifty-three percent of individuals with-
out health insurance who are poor (defined as hav-
ing an income of less than 100 percent of the Fed-
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eral poverty level) have at least one worker in the 
family. 
(3) According to a 2005 Kaiser Family Foun-
dation report, because of the high cost of health in-
surance, the poor and near-poor have the greatest 
risk of not have health insurance. The uninsured 
rate among the non-elderly poor, which is 36 per-
cent, is twice as high as the national average of un-
insured individuals, which is 18 percent. Were it not 
for the Medicaid program, many more of the poor 
would be uninsured. The near-poor (those with in-
comes between 100 percent and 199 percent of the 
Federal poverty level) also run a high risk of being 
uninsured, in part, because they are less likely to be 
eligible for Medicaid. Two-thirds of the uninsured 
are either poor or near-poor. 
(4) According to a 2004 Kaiser Family Foun-
dation Health Insurance Survey, adults are more 
likely to be uninsured than children. Adults make up 
about 70 percent of the nonelderly population, but 
make up 80 percent of the uninsured population. 
Most low-income children qualify for Medicaid or 
SCHIP, but low-income adults under the age of 65 
qualify for Medicaid only if they are disabled, preg-
nant, or have dependent children. 
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(5) According to a 2005 Kaiser Family Foun-
dation Health Insurance Survey, more than 60 per-
cent of non-elderly uninsured adults did not attend 
college, making them less able to get higher-skilled 
jobs that more typically provide health coverage. 
Those with less education are also more likely to be 
uninsured for longer periods of time. 
(6) According to a 2005 Kaiser Family Foun-
dation report, minorities are much more likely to be 
uninsured than Caucasians. About one-third of His-
panics and Native Americans are uninsured com-
pared to 13 percent of Caucasians are uninsured. 
The uninsured rates among African Americans, 
which is 21 percent, and among Asian Americans, 
which is 19 percent, are also much higher than that 
of Caucasians. These differences in rates are only 
partly explained by income disparities. Health insur-
ance disparities exist at both lower and higher in-
come levels. 
(7) According to a 2002 Institute of Medicine 
report, 80 percent of the uninsured in the United 
States are native or naturalized United States citi-
zens. 
(8) According to a 2006 Kaiser Family Foun-
dation Health Insurance Survey, 59 percent of unin-
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sured adults have gone without coverage for a period 
of at least two years. Because health insurance is 
primarily obtained as an employment benefit, health 
coverage can be disrupted when people change jobs. 
This, as well as other changes in income and family 
composition, can cause temporary gaps in health in-
surance. 
(9) According to a 2004 Kaiser Family Foun-
dation report, health insurance makes a difference in 
whether and when individuals get necessary medical 
care, where they get their care, and ultimately, the 
health level of individuals. Uninsured adults are far 
more likely than insured adults to postpone or forgo 
health care altogether and less able to afford pre-
scription drugs or follow through with recommended 
treatments. The consequences of reduced access to 
health care can be severe, particularly when prevent-
able conditions go undetected. 
(10) According to a 2004 Kaiser Family Foun-
dation report, anticipating high medical bills, many 
of the uninsured are not able to follow recommended 
treatment. Over one-third of uninsured adults say 
they did not fill a drug prescription in the past year 
and over one-third of uninsured adults went without 
a recommended medical test or treatment because of 
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