Protecting Medicare Beneficiaries with Pre-Existing Conditions Act
Bill: H.R.599 | Sponsor: Rep. Schneider, Bradley Scott (D-IL)
Policy area: Health

Summary:
Protecting Medicare Beneficiaries with Pre-Existing Conditions Act
This bill expands guaranteed issue rights with respect to Medigap policies (Medicare supplemental health insurance policies) to all beneficiaries regardless of age. (Guaranteed issue rights require that a policy be offered to any eligible applicant without regard to health status.) The bill provides for a phased implementation over a five-year period, with full implementation by January 1, 2028.

To amend title XVIII of the Social Security Act to provide for the 
 guaranteed issue of Medigap policies to all Medigap-eligible Medicare 
beneficiaries and Medicare Advantage enrollees, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Protecting Medicare Beneficiaries 
with Pre-Existing Conditions Act''.

SEC. 2. GUARANTEED ISSUE.

    (a) Guaranteed Issue of Medigap Policies to All Medigap-Eligible 
Medicare Beneficiaries.--
            (1) In general.--Section 1882(s) of the Social Security Act 
        (42 U.S.C. 1395ss(s)) is amended--
                    (A) in paragraph (2)(A), by striking ``65 years of 
                age or older and is enrolled for benefits under part 
                B'' and inserting ``entitled to, or enrolled for, 
                benefits under part A and enrolled for benefits under 
                part B'';
                    (B) in paragraph (2)(D), by striking ``who is 65 
                years of age or older as of the date of issuance and'';
                    (C) in paragraph (3)(B)(ii), by striking ``is 65 
                years of age or older and''; and
                    (D) in paragraph (3)(B)(vi), by striking ``at age 
                65''.
            (2) Effective date; phase-in authority.--
                    (A) Effective date.--Subject to subparagraph (B), 
                the amendments made by paragraph (1) shall apply to 
                medicare supplemental policies effective on or after 
                January 1, 2023.
                    (B) Phase-in authority.--
                            (i) In general.--Subject to clause (ii), 
                        the Secretary of Health and Human Services may 
                        phase in the implementation of the amendments 
                        made under paragraph (1) (with such phase-in 
                        beginning on or after January 1, 2023) in such 
                        manner as the Secretary determines appropriate 
                        in order to minimize any adverse impact on 
                        individuals enrolled under a medicare 
                        supplemental policy.
                            (ii) Phase-in period may not exceed 5 
                        years.--The Secretary of Health and Human 
                        Services shall ensure that the amendments made 
                        by paragraph (1) are fully implemented by not 
                        later than January 1, 2028.
            (3) Additional enrollment period for certain individuals.--
                    (A) One-time enrollment period.--
                            (i) In general.--In the case of an 
                        individual described in subparagraph (B), the 
                        Secretary shall establish a one-time enrollment 
                        period during which such an individual may 
                        enroll in any medicare supplemental policy of 
                        the individual's choosing.
                            (ii) Period.--The enrollment period 
                        established under clause (i) shall begin on the 
                        date on which the phase-in period under 
                        paragraph (2) is completed and end 6 months 
                        after such date.
                    (B) Individual described.--An individual described 
                in this paragraph is an individual who--
                            (i) is entitled to hospital insurance 
                        benefits under part A of title XVIII of the 
                        Social Security Act (42 U.S.C. 1395c et seq.) 
                        pursuant to section 226(b) or section 226A of 
                        such Act (42 U.S.C. 426(b); 426-1);
                            (ii) is enrolled for benefits under part B 
                        of such Act (42 U.S.C. 1395j et seq.); and
                            (iii) would not, but for the provisions of 
                        and amendments made by paragraphs (1) and (2), 
                        be eligible 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)).
                    (C) Outreach plan.--
                            (i) In general.--The Secretary shall 
                        develop an outreach plan to notify individuals 
                        described in subparagraph (B) of the one-time 
                        enrollment period established under 
                        subparagraph (A).
                            (ii) Consultation.--In implementing the 
                        outreach plan developed under clause (i), the 
                        Secretary shall consult with consumer 
                        advocates, brokers, insurers, the National 
                        Association of Insurance Commissioners, and 
                        State Health Insurance Assistance Programs.
    (b) Guaranteed Issue of Medigap Policies for Medicare Advantage 
Enrollees.--
            (1) In general.--Section 1882(s)(3) of the Social Security 
        Act (42 U.S.C. 1395ss(s)(3)), as amended by subsection (a), is 
        further amended--
                    (A) in subparagraph (B), by adding at the end the 
                following new clause:
            ``(vii) The individual was enrolled in a Medicare Advantage 
        plan under part C for not less than 12 months and subsequently 
        disenrolled from such plan and elects to receive benefits under 
        this title through the original Medicare fee-for-service 
        program under parts A and B.'';
                    (B) by striking subparagraph (C)(iii) and inserting 
                the following:
    ``(iii) Subject to subsection (v)(1), for purposes of an individual 
described in clause (vi) or (vii) of subparagraph (B), a medicare 
supplemental policy described in this subparagraph shall include any 
medicare supplemental policy.''; and
                    (C) in subparagraph (E)--
                            (i) in clause (iv), by striking ``and'' at 
                        the end;
                            (ii) in clause (v), by striking the period 
                        at the end and inserting ``; and''; and
                            (iii) by adding at the end the following 
                        new clause--
            ``(vi) in the case of an individual described in 
        subparagraph (B)(vii), the annual, coordinated election period 
        (as defined in section 1851(e)(3)(B)) or a continuous open 
        enrollment period (as defined in section 1851(e)(2)) during 
        which the individual disenrolls from a Medicare Advantage plan 
        under part C.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply to medicare supplemental policies effective on or 
        after January 1, 2023.
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