PHASED-IN EXTENSION OF MEDICAID PAYMENTS FOR MEDICARE PREMIUMS FOR CERTAIN INDIVIDUALS WITH INCOME BELOW 120 PERCENT OF THE OFFICIAL POVERTY LINE.

SEC. 4501. PHASED-IN EXTENSION OF MEDICAID PAYMENTS FOR MEDICARE PREMIUMS FOR CERTAIN INDIVIDUALS WITH INCOME BELOW 120 PERCENT OF THE OFFICIAL POVERTY LINE. (a) 1-Year Acceleration of Buy-en of Premiums and Cost Sharing for Qualified Medicare Beneficiaries up to 100 Percent of Poverty Line.— Section 1905(p)(2) (42 U.S.C. 1396d(p)(2)) is further amended— (1) in subparagraph (B)— (A) by adding “and” at the end of clause (ii); (B) in clause (iii), by striking “95 percent, and” and inserting “100 percent.”; and (C) by striking clause (iv); and (2) in subparagraph (C)— (A) in clause (iii), by striking “90” and inserting “95”; (B) by adding “and” at the end of clause (iii); (C) in clause (iv), by striking “95 percent, and” and inserting “100 percent.”; and (D) by striking clause (v). (b) Entitlement.—Section 1902(a)(10)(E) (42 U.S.C. 1395b(a)(10)(E)(ii)) is amended— 104 STAT. 1388–165 (1) by striking “, and” at the end of clause (i) and inserting a semicolon; (2) by adding “and” at the end of clause (ii); and (3) by adding at the end the following new clause: “(iii) for making medical assistance available for medicare cost sharing described in section 1905(p)(3)(A)(ii) subject to section 1905(p)(4), for individuals who would be qualified medicare beneficiaries described in section 1905(p)(l) but for the fact that their income exceeds the income level established by the State under section 1905(p)(2) but is less than 110 percent in 1993 and 1994, and 120 percent in 1995 and years thereafter of the official poverty line (referred to in such section) for a family of the size involved;”. (c) Application in Certain States and Territories.— Section 1905(p)(4) (42 U.S.C. 1396d(p)(4)) is amended— (1) in subparagraph (B), by inserting “or 1902(a)(10)(E)(iii)” after “subparagraph (B)”, and (2) by adding at the end the following: “In the case of any State which is providing medical assistance to its residents under a waiver granted under section 1115, the Secretary shall require the State to meet the requirement of section 1902(a)(10)(E) in the same manner as the State would be required to meet such requirement if the State had in effect a plan approved under this title.” (d) Conforming Amendment.— Section 1843(h) (42 U.S.C. 1395v(h)) is amended by adding at the end the following new paragraph: “(3) In this subsection, the term ‘qualified medicare beneficiary’ also includes an individual described in section 1902(a)(10)(E)(iii)”. (e) Delay in Counting Social Security COLA Increases Until New Poverty Guidelines Published.— (1) In general.— Section 1905(p) is amended— (A) in paragraph (1)(B), by inserting “, except as provided in paragraph (2)(D)” after “supplementary social security income program”, and (B) by adding at the end of paragraph (2) the following new subparagraph: “(D) (i) In determining under this subsection the income of an individual who is entitled to monthly insurance benefits under title II for a transition month (as defined in clause (ii)) in a year, such income shall not include any amounts attributable to an increase in the level of monthly insurance benefits payable under such title which have occurred pursuant to section 215(i) for benefits payable for months beginning with December of the previous year. “(ii) For purposes of clause (i), the term ‘transition month’ means each month in a year through the month following the month in which the annual revision of the official poverty line, referred to in subparagraph (A), is published.”. (2) Conforming amendments.— Section 1902(m) (42 U.S.C. 1396a(m)) is amended— (A) in paragraph (1)(B), by inserting “, except as provided in paragraph (2)(C)” after “supplemental security income program”, and (B) by adding at the end of paragraph (2) the following new subparagraph: 104 STAT. 1388–166 “(C) The provisions of section 1905(p)(2)(D) shall apply to determinations of income under this subsection in the same manner as they apply to determinations of income under section 1905(p).”. (f) Effective Date.—The amendments made by this section shall apply to calendar quarters beginning on or after January 1, 1991, without regard to whether or not regulations to implement such amendments are promulgated by such date; except that the amendments made by subsection (e) shall apply to determinations of income for months beginning with January 1991.