[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 749 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 749
To amend the Social Security Act to improve choices available to
Medicare eligible seniors by permitting them to elect (instead of
regular Medicare benefits) to receive a voucher for a health savings
account, for premiums for a high deductible health insurance plan, or
both and by suspending Medicare late enrollment penalties between ages
65 and 70.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 31, 2007
Mrs. Blackburn (for herself, Mr. Sam Johnson of Texas, Mr.
Westmoreland, Mr. Wilson of South Carolina, Mr. Franks of Arizona, and
Mr. Sessions) introduced the following bill; which was referred to the
Committee on Ways and Means, and in addition to the Committee on Energy
and Commerce, for a period to be subsequently 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 the Social Security Act to improve choices available to
Medicare eligible seniors by permitting them to elect (instead of
regular Medicare benefits) to receive a voucher for a health savings
account, for premiums for a high deductible health insurance plan, or
both and by suspending Medicare late enrollment penalties between ages
65 and 70.
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 ``Health Care Choices for Seniors
Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The Social Security Administration's Program Operations
Manual System section HI 00801.002, titled ``Waiver of Hospital
Insurance Entitlement by Monthly Beneficiary'', provides that
an individual who does not sign up for part A of the medicare
program when the individual signs up for social security
benefits will lose such benefits, regardless of the desire of
the individual to not participate in the medicare program
because of religious or philosophical reasons or a preference
to have private health insurance.
(2) Congress recently increased health insurance options by
authorizing health savings accounts into which individuals may
make annual contributions that are allowable as deductions for
income tax purposes. Seniors are not allowed to deduct
contributions to their health savings account after the date of
the entitlement of such seniors to Medicare benefits.
(3) Section 1802(b) of the Social Security Act (42 U.S.C.
1395a(b)), added by section 4507 of the Balanced Budget Act of
1997, states that a Medicare beneficiary may only enter into a
private contract with a physician for an item or service if no
claim for payment under title XVIII of such Act will be
submitted. In the case of such contract, the physician must
sign an affidavit that acknowledges such contract and that
provides that the physician will not submit a claim, and will
forgo reimbursement, under such title for an item or service
provided to any Medicare beneficiary for a period of two years.
SEC. 3. AUTHORITY TO ELECT VOUCHER PROGRAM INSTEAD OF MEDICARE PART A
ENTITLEMENT.
(a) In General.--Section 226 of the Social Security Act (42 U.S.C.
426) is amended by adding at the end the following new subsections:
``(k) Waiver of Entitlement and Election of Voucher Program.--
``(1) In general.--Notwithstanding the previous provisions
of this section, the Secretary shall establish a procedure
under which an individual otherwise entitled under subsection
(a) to benefits under part A of title XVIII may waive such
entitlement and be automatically enrolled in the Medicare
Alternative Voucher Program established under subsection (l)
if--
``(A) at the time such waiver is made the
individual--
``(i) has a health savings account
described in subsection (d) of section 223 of
the Internal Revenue Code of 1986 (26 U.S.C.
223); and
``(ii) is enrolled under a high deductible
health plan, as defined in subsection (c)(1) of
such section; and
``(B) the individual makes such waiver during the
initial enrollment period described in section 1837(d).
``(2) Treatment under the internal revenue code of 1986.--
An individual who waives entitlement under paragraph (1) shall
not be treated as entitled to benefits under title XVIII for
purposes of section 223(b)(7) of the Internal Revenue Code of
1986.
``(3) Ineligibility for part b or d benefits.--An
individual shall not be eligible for benefits under part B or D
of title XVIII during the period for which the individual
waives entitlement under part A of such title under paragraph
(1).
``(4) Termination of waiver and reenrollment under medicare
program.--The Secretary shall establish a procedure under which
an individual who waives entitlement under paragraph (1) may
terminate such waiver during an annual period that shall be the
same as the annual general enrollment period described in
section 1837(e). For purposes of applying parts B and D of
title XVIII, such individual shall be treated as if the
individual were entitled to benefits under part A of such title
as of the date such individual terminates the waiver under this
paragraph. An individual who has terminated such a waiver may
not subsequently make such a waiver.
``(l) Medicare Alternative Voucher Program.--
``(1) Establishment of program.--The Secretary shall
establish a program to be known as the Medicare Alternative
Voucher Program (in this subsection referred to as the `voucher
program') consistent with this subsection.
``(2) Automatic enrollment.--An individual who waives
entitlement under subsection (k)(1) shall be enrolled in the
voucher program for the period during which such waiver is in
effect.
``(3) Amount of voucher.--
``(A) Amount based on age cohort.--
``(i) In general.--Subject to clause (ii),
for each month that an individual within an age
cohort is enrolled in the voucher program, the
Secretary shall provide a voucher to such
individual in an amount that is equal to the
monthly actuarial rate for that month computed
under section 1818(d)(1) multiplied by the age
cohort adjustment factor for such age cohort
under subparagraph (B).
``(ii) Monthly limit.--The amount of a
voucher provided to an individual for a month
may not exceed $200.
``(B) Age cohort adjustment factor.--For each age
cohort the Secretary shall determine an age cohort
adjustment factor equal to the ratio of--
``(i) the monthly actuarial rate described
in section 1818(d)(1) as determined by the
Secretary for individuals in such age cohort,
to
``(ii) the monthly actuarial rate described
in such section.
``(C) Age cohort defined.--For purposes of this
paragraph, an `age cohort' means a group of individuals
whose age falls within a span of five consecutive
years, consistent with the following:
``(i) The first such span begins at age 65.
``(ii) Other spans follow consecutively.
``(4) Permissible use of voucher.--A voucher under
paragraph (3) may be used only for the following purposes:
``(A) As a contribution into a health savings
account established by such individual, as described in
subsection (k)(1)(A).
``(B) For payment of premiums for enrollment of
such individual under a high deductible health plan
described in such subsection.
``(5) Effect of subsequent termination of waiver.--If an
individual terminates a waiver under subsection (k)(4), the
enrollment of such individual in the voucher program shall be
terminated on the date on which the termination becomes
effective.''.
(b) Amendment of Internal Revenue Code of 1986.--Paragraph (7) of
section 223(b) of the Internal Revenue Code of 1986 (relating to
medicare eligible individuals) is amended to read as follows:
``(7) Medicare eligible individuals.--
``(A) In general.--The limitation under this
subsection for any month with respect to an individual
shall be zero for any month such individual is entitled
to benefits under title XVIII of the Social Security
Act.
``(B) Medicare alternative voucher program.--In the
case of an individual who is enrolled in the Medicare
Alternative Voucher Program under section 226(l) of the
Social Security Act, the applicable limitation under
subparagraphs (A) and (B) of paragraph (2) shall be
increased by the amount of the voucher described in
paragraph (3) of such section which is contributed to a
health savings account of such individual.''.
(c) Effective Date.--
(1) In general.--The amendment made by subsection (a) shall
take effect on the date that is six months after the date of
the enactment of this Act and shall apply to an individual who
becomes entitled to benefits under part A of title XVIII of the
Social Security Act on or after such date of the enactment.
(2) Amendment of internal revenue code of 1986.--The
amendment made by subsection (b) shall apply to months ending
after the date referred to in paragraph (1), in taxable years
ending after such date.
SEC. 4. SUSPENSION OF MEDICARE LATE ENROLLMENT PENALTIES BETWEEN AGES
65 AND 70 IF THE INDIVIDUAL IS ENROLLED IN THE MEDICARE
ALTERNATIVE VOUCHER PROGRAM.
(a) Part B.--The second sentence of section 1839(b) of the Social
Security Act (42 U.S.C. 1395r(b)) is amended by inserting before the
period the following: ``and there shall not be taken into account (for
individuals not entitled to benefits under section 226A) any month
during any part of which the individual attained age 65 and had not
attained age 70 and was enrolled in the Medicare Alternative Voucher
Program under section 226(l)''.
(b) Part D.--
(1) In general.--Section 1860D-13(b)(2) of such Act (42
U.S.C. 1395w-113(b)(2)) is amended by adding at the end the
following sentence: ``For purposes of the preceding sentence,
in the case of an individual not entitled to benefits under
part A under section 226A, a continuous period of eligibility
shall not include any month during any part of which the
individual attained age 65 and had not attained age 70 and was
enrolled in the Medicare Alternative Voucher Program under
section 226(l).''.
(2) Conforming amendment.--Section 1860D-1(b)(6)(A) of such
Act (42 U.S.C. 1395w-101(b)(6)(A)) is amended by inserting
after ``paragraph (2)'' the following: ``, but excluding the
period between 65 and 70 years of age if the individual was
enrolled in the Medicare Alternative Voucher Program under
section 226(l)''.
(c) Effective Date.--The amendments made by this section shall
apply to individuals who attain 65 years of age in a month after the
month in which this Act is enacted.
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