An Act to amend the Omnibus Budget Reconciliation Act of 1990 to permit medicare select policies to be offered in all States.
PL 104-18 (H.R.483), enacted 07/07/1995

109 STAT. 192 
PUBLIC LAW 104-18-^JULY 7, 1995 
Public Law 104-18 
104th Congress 
An Act 
July 7, 1995 
To amend the Omnibus Budget Reconciliation Act of 1990 to permit medicare 
[H.R. 483] 
select policies to be offered in all States. 
Be it enacted by the Senate and House of Representatives 
of 
the United States of America in Congress assembled, 
SECTION 1. PERMITTING MEDICARE SELECT POLICIES TO BE 
OFFERED IN ALL STATES FOR AN EXTENDED PERIOD. 
Section 4358(c) of the Omnibus Budget Reconciliation Act of 
1990, as amended by section 172(a) of the Social Security Act 
42 use 1320C-3 
Amendments of 1994, is amended to read as follows: 
note- 
"(c) EFFECTIVE DATE.—(1) The amendments made by this sec-
tion shall only apply— 
"(A) in 15 States (as determined by the Secretary of Health 
and Human Services) and such other States as elect such 
amendments to apply to them, and 
"(B) subject to paragraph (2), during the 6y2-year period 
beginning with 1992. 
For purposes of this paragraph, the term 'State' has the meaning 
given such term by section 210(h) of the Social Security Act (42 
U.S.C. 410(h)). 
"(2)(A) The Secretary of Health and Human Services shall 
conduct a study that compares the health care costs, quality of 
care, and access to services under medicare select policies with 
that under other medicare supplemental policies. The study shall 
be based on surveys of appropriate age-adjusted sample populations. 
The study shall be completed by June 30, 1997. 
"(B) Not later than December 31, 1997, the Secretary shall 
determine, based on the results of the study under subparagraph 
(A), if any of the following findings are true: 
"(i) The amendments made by this section have not resulted 
in savings of premium costs to those enrolled in medicare 
select policies (in comparison to their enrollment in medicare 
supplemental policies that are not medicare select policies and 
that provide comparable coverage). 
"(ii) There have been significant additional expenditures 
under the medicare program as a result of such amendments. 
"(iii) Access to and quality of care has been significantly 
diminished as a result of such amendments. 
"(C) The amendments made by this section shall remain in 
effect beyond the 6y2-year period described in paragraph (1)(B) 
unless the Secretary determines that any of the findings described 
in clause (i), (ii), or (iii) of subparagraph (B) are true. 
"(3) The Comptroller (General shall conduct a study to determine 
the extent to which individuals who are continuously covered under 
PUBLIC LAW 104-18-JULY 7, 1995 
109 STAT. 193 
a medicare supplemental policy are subject to medical underwriting 
if they change the policy under which they are covered, and to 
identify options, if necessary, for modifying the medicare supple-
mental insurance market to make sure that continuously insured 
beneficiaries are able to switch plans without medical underwriting. 
By not later than June 30, 1996, the Comptroller General shall Reports, 
submit to the Congress a report on the study. The report shall 
include a description of the potential impact on the cost and avail-
ability of medicare supplemental policies of each option identified 
in the study.". 
Approved July 7, 1995. 
LEGISLATIVE HISTORY—H.R. 483: 
HOUSE REPORTS: Nos. 104-79, Pt. 1 (Comm. on Ways and Means) and Pt. 
(Comm. on Commerce), and 104-157 (Comm. of Conference). 
CONGRESSIONAL RECORD, Vol. 141 (1995): 
Apr. 6, considered and passed House. 
May 17, considered and passed Senate, amended. 
June 26, Senate agreed to conference report. 
June 30, House agreed to conference report. 
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