To amend title XVIII of the Social Security Act, as amended by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, to provide additional beneficiary protections.

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Preserving 
Medicare for All 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. Authority to negotiate prices.
Sec. 3. Guaranteed prescription drug benefits.
Sec. 4. Full reimbursement for qualified retiree prescription drug 
                            plans.
Sec. 5. Repeal of Comparative Cost Adjustment (CCA) program.
Sec. 6. Repeal of MA Regional Plan Stabilization Fund.
Sec. 7. Repeal of cost containment provisions.

SEC. 2. AUTHORITY TO NEGOTIATE PRICES.

    Subsection (i) of section 1860D-11, as added by section 101 of the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(Public Law 108-173), is repealed.

SEC. 3. GUARANTEED PRESCRIPTION DRUG BENEFITS.

    (a) In General.--Section 1860D-3 of the Social Security Act, as 
added by section 101 of the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 (Public Law 108-173), is amended to read 
as follows:

      ``access to a choice of qualified prescription drug coverage

    ``Sec. 1860D-3. (a) Assuring Access to a Choice of Coverage.--
            ``(1) Choice of at least three plans in each area.--The 
        Secretary shall ensure that each part D eligible individual has 
        available, consistent with paragraph (2), a choice of 
        enrollment in--
                    ``(A) a nationwide prescription drug plan offered 
                by the Secretary in accordance with subsection (b); and
                    ``(B) at least 2 qualifying plans (as defined in 
                paragraph (3)) in the area in which the individual 
                resides, at least one of which is a prescription drug 
                plan.
            ``(2) Requirement for different plan sponsors.--The 
        requirement in paragraph (1)(B) is not satisfied with respect 
        to an area if only one entity offers all the qualifying plans 
        in the area.
            ``(3) Qualifying plan defined.--For purposes of this 
        section, the term `qualifying plan' means--
                    ``(A) a prescription drug plan;
                    ``(B) an MA-PD plan described in section 
                1851(a)(2)(A)(i) that provides--
                            ``(i) basic prescription drug coverage; or
                            ``(ii) qualified prescription drug coverage 
                        that provides supplemental prescription drug 
                        coverage so long as there is no MA monthly 
                        supplemental beneficiary premium applied under 
                        the plan, due to the application of a credit 
                        against such premium of a rebate under section 
                        1854(b)(1)(C); or
                    ``(C) a nationwide prescription drug plan offered 
                by the Secretary in accordance with subsection (b).
    ``(b) HHS as PDP Sponsor for a Nationwide Prescription Drug Plan.--
            ``(1) In general.--The Secretary, through the Administrator 
        of the Centers for Medicare & Medicaid Services, shall take 
        such steps as may be necessary to qualify and serve as a PDP 
        sponsor and to offer a prescription drug plan that offers basic 
        prescription drug coverage throughout the United States. Such a 
        plan shall be in addition to, and not in lieu of, other 
        prescription drug plans offered under this part.
            ``(2) Premium; solvency; authorities.--In carrying out 
        paragraph (1), the Secretary--
                    ``(A) shall establish a premium in the amount of 
                $35 for months in 2006 and, for months in subsequent 
                years, in the amount specified in this paragraph for 
                months in the previous year increased by the annual 
                percentage increase described in section 1860D-2(b)(6) 
                (relating to growth in medicare prescription drug costs 
                per beneficiary) for the year involved;
                    ``(B) is deemed to have met any applicable solvency 
                and capital adequacy standards; and
                    ``(C) shall exercise such authorities (including 
                the use of regional or other pharmaceutical benefit 
                managers) as the Secretary determines necessary to 
                offer the prescription drug plan in the same or a 
                comparable manner as is the case for prescription drug 
                plans offered by private PDP sponsors.
    ``(c) Flexibility in Risk Assumed.--In order to ensure access 
pursuant to subsection (a) in an area the Secretary may approve limited 
risk plans under section 1860D-11(f) for the area.''.
    (b) Conforming Amendment.--Section 1860D-11 of the Social Security 
Act, as added by section 101 of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173), is 
amended by striking subsection (g).

SEC. 4. FULL REIMBURSEMENT FOR QUALIFIED RETIREE PRESCRIPTION DRUG 
              PLANS.

    (a) Elimination of True Out-Of-Pocket Limitation.--Section 1860D-
2(b)(4)(C)(ii) of the Social Security Act, as added by section 101(a) 
of the Medicare Prescription Drug, Improvement, and Modernization Act 
of 2003 (Public Law 108-173), is amended--
            (1) by inserting ``under a qualified retiree prescription 
        drug plan (as defined in section 1860D-22(a)(2)),'' after 
        ``under section 1860D-14,''; and
            (2) by inserting ``, under such a qualified retiree 
        prescription drug plan,'' after ``(other than under such 
        section'' .
    (b) Equalization of Subsidies.--Notwithstanding any other provision 
of law, the Secretary of Health and Human Services shall provide for 
such increase in the special subsidy payment amounts under section 
1860D-22(a)(3) of the Social Security Act, as added by section 101(a) 
of the Medicare Prescription Drug, Improvement, and Modernization Act 
of 2003 (Public Law 108-173), as may be appropriate to provide for 
payments in the aggregate equivalent to the payments that would have 
been made under section 1860D-15 of such Act if the individuals were 
not enrolled in a qualified retiree prescription drug plan. In making 
such computation, the Secretary shall not take into account the 
application of the amendments made by section 1202 of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003.

SEC. 5. REPEAL OF COMPARATIVE COST ADJUSTMENT (CCA) PROGRAM.

    Subtitle E of title II of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173), and 
the amendments made by such subtitle, are repealed.

SEC. 6. REPEAL OF MA REGIONAL PLAN STABILIZATION FUND.

    (a) In General.--Section 1858 of the Social Security Act, as added 
by section 221(c) of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (Public Law 108-173), is amended--
            (1) by striking subsection (e);
            (2) by redesignating subsections (f), (g), and (h) as 
        subsections (e), (f), and (g), respectively; and
            (3) in subsection (e), as so redesignated, by striking 
        ``subject to subsection (e),''.
    (b) Conforming Amendment.--Section 1851(i)(2) of the Social 
Security Act (42 U.S.C. 1395w-21(i)(2)), as amended by section 
221(d)(5) of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (Public Law 108-173), is amended by striking 
``1858(h)'' and inserting ``1858(g)''.

SEC. 7. REPEAL OF COST CONTAINMENT PROVISIONS.

    Subtitle A of title VIII of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173) is 
repealed and any provisions of law amended by such subtitle are 
restored as if such subtitle had not been enacted.

Summary: Preserving Medicare for All Act of 2004 - Amends title XVIII (Medicare) of the Social Security Act, as amended by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, to repeal provisions prohibiting the Secretary of Health and Human Services from interfering with the negotiations between drug manufacturers and pharmacies and prescription drug plan sponsors and from requiring a particular formulary to institute a price structure for the reimbursement of covered Medicare part D drugs.

Includes for the Medicare part D (Voluntary Prescription Drug Benefit Program) eligible individual as a choice of coverage, in addition to the current choice of coverage in at least two qualifying plans in the area in which the individual resides, a choice of enrollment in a nationwide prescription drug plan offered by the Secretary (to replace enrollment in a fallback prescription drug plan in any case in which such plans are not available).

Directs the Secretary, through the Administrator of the Centers for Medicare & Medicaid Services, to take such steps as may be necessary to qualify and serve as a prescription drug plan sponsor and to offer a prescription drug plan that offers basic prescription drug coverage throughout the United States and has a premium of $35 for 2006.

Requires such a plan to be in addition to, and not in lieu of, other prescription drug plans offered.

Provides for full reimbursement for employers for the cost of qualified retiree drug coverage and permits their costs to count towards senior's catastrophic limits.

Abolishes the comparative cost adjustment program.

Eliminates the MA Regional Plan Stabilization Fund.

Repeals cost containment provisions.