Territories Medicare Prescription Drug Assistance Equality Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 4028 To amend titles XVIII and XIX of the Social Security Act to make premium and cost-sharing subsidies available to low-income Medicare part D bene- ficiaries who reside in Puerto Rico or another territory of the United States. IN THE HOUSE OF REPRESENTATIVES JUNE 12, 2023 Mrs. GONZA´LEZ-COLO´N introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Com- mittee on Ways and Means, 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 titles XVIII and XIX of the Social Security Act to make premium and cost-sharing subsidies available to low-income Medicare part D beneficiaries who reside in Puerto Rico or another territory of the United States. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Territories Medicare 4 Prescription Drug Assistance Equality Act of 2023’’. 5 VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 4028 IH SEC. 2. EQUAL TREATMENT OF RESIDENTS OF TERRI- 1 TORIES IN PREMIUM AND COST-SHARING 2 SUBSIDIES UNDER MEDICARE PRESCRIPTION 3 DRUG PROGRAM. 4 (a) MEDICARE ASSISTANCE.—Section 1860D– 5 14(a)(3) of the Social Security Act (42 U.S.C. 1395w– 6 114(a)(3)) is amended— 7 (1) in subparagraph (A), in the matter pre- 8 ceding clause (i), by striking ‘‘subject to subpara- 9 graph (F),’’; 10 (2) in subparagraph (B)(v), in the matter pre- 11 ceding subclause (I), by striking ‘‘Subject to sub- 12 paragraph (F), the Secretary’’ and inserting ‘‘The 13 Secretary’’; 14 (3) in subparagraph (C), by adding at the end 15 the following new sentence: ‘‘In the case of an indi- 16 vidual who is not a resident of the 50 States or the 17 District of Columbia, the poverty line (as such term 18 is defined in clause (ii)) that shall apply to such in- 19 dividual shall be the poverty line for the 48 contig- 20 uous States and the District of Columbia.’’; and 21 (4) by striking subparagraph (F). 22 (b) MEDICAID ASSISTANCE.—Section 1935 of the So- 23 cial Security Act (42 U.S.C. 1396u–5) is amended— 24 (1) in subsection (c)(1)(A)— 25 VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 4028 IH (A) by inserting ‘‘(and each other State for 1 each month beginning with January 2022)’’ 2 after ‘‘January 2006’’; and 3 (B) in clause (i), by inserting ‘‘or (2)(B) 4 (as the case may be)’’ after ‘‘paragraph 5 (2)(A)’’; 6 (2) in subsection (c)(2)— 7 (A) in subparagraph (A)— 8 (i) by amending the heading to read 9 as follows: ‘‘COMPUTATION FOR 50 STATES 10 AND THE DISTRICT OF COLUMBIA’’; and 11 (ii) by striking ‘‘a State described in 12 paragraph (1)’’ and inserting ‘‘one of the 13 50 States or the District of Columbia’’; 14 (B) in subparagraph (B)— 15 (i) by striking ‘‘subparagraph (A)’’ 16 and inserting ‘‘subparagraph (A) or (B) 17 (as the case may be)’’; and 18 (ii) by redesignating such subpara- 19 graph as subparagraph (C); and 20 (C) by inserting after subparagraph (A) 21 the following new subparagraph: 22 ‘‘(B) COMPUTATION FOR TERRITORIES.— 23 The amount computed under this paragraph for 24 a State not described in subparagraph (A) and 25 VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 4028 IH for a month in a year (beginning with 2024) is 1 equal to— 2 ‘‘(i) 1⁄12 of the product of— 3 ‘‘(I) the amount determined 4 under subsection (e) for the State for 5 2023; and 6 ‘‘(II) 100 percent minus the 7 highest possible Federal medical as- 8 sistance percentage that may be ap- 9 plied to any of the 50 States for fiscal 10 year 2022 under section 1905(b)(1); 11 and 12 ‘‘(ii) increased for each year (begin- 13 ning with 2023 up to and including the 14 year involved) by the applicable growth 15 factor specified in paragraph (4) for that 16 year.’’; and 17 (3) in subsection (e)— 18 (A) in paragraph (1)— 19 (i) in subparagraph (A), by striking 20 ‘‘of such State; and’’ and inserting ‘‘of 21 such State for years before 2022;’’; 22 (ii) in subparagraph (B)— 23 VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 4028 IH (I) by inserting ‘‘for periods be- 1 fore January 1, 2024’’ after ‘‘(B)’’; 2 and 3 (II) by striking the period at the 4 end and inserting ‘‘; and’’; and 5 (iii) by adding at the end the fol- 6 lowing new subparagraph: 7 ‘‘(C) for the first 3 quarters of fiscal year 8 2024 and for each subsequent fiscal year, the 9 amount otherwise applied under section 1108(f) 10 for the State shall be increased by the amount 11 specified in paragraph (4)(A) for such period or 12 fiscal year.’’; 13 (B) in paragraph (2), by striking ‘‘The 14 Secretary’’ and inserting ‘‘For periods before 15 January 2024, the Secretary’’; 16 (C) in paragraph (3)— 17 (i) in the heading, by inserting ‘‘BE- 18 FORE SECOND QUARTER OF FISCAL YEAR 19 2024’’ after ‘‘INCREASED AMOUNT’’; 20 (ii) in subparagraph (A)— 21 (I) in the matter before clause 22 (i), by inserting ‘‘or other fiscal pe- 23 riod’’ after ‘‘for a year’’; and 24 VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 4028 IH (II) in clause (i), by inserting 1 ‘‘for such year or period’’ after ‘‘sub- 2 paragraph (B)’’; and 3 (iii) in subparagraph (B)— 4 (I) in clause (ii), by striking ‘‘or’’ 5 at the end; 6 (II) in clause (iii), by striking ‘‘a 7 subsequent year’’ and inserting ‘‘a 8 subsequent fiscal year (before the sec- 9 ond quarter of fiscal year 2024)’’; 10 (III) in clause (iii), by striking 11 the period at the end and inserting ‘‘; 12 and’’; and 13 (IV) by adding at the end the fol- 14 lowing: 15 ‘‘(iv) for the first quarter of fiscal 16 year 2024, is equal to 25 percent of the 17 aggregate amount specified in this sub- 18 paragraph for the previous fiscal year in- 19 creased by the annual percentage increase 20 specified in section 1860D–2(b)(6) for the 21 year involved.’’; 22 (D) by striking paragraph (4); and 23 (E) by inserting after paragraph (3) the 24 following new paragraph: 25 VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 4028 IH ‘‘(4) INCREASED AMOUNT BEGINNING WITH 1 SECOND QUARTER OF FISCAL YEAR 2024.— 2 ‘‘(A) IN GENERAL.—The amount specified 3 in this paragraph for a State for the last 3 4 quarters of fiscal year 2024 or for a subsequent 5 fiscal year is equal to the product of— 6 ‘‘(i) the aggregate amount specified in 7 subparagraph (B) for such period or fiscal 8 year; and 9 ‘‘(ii) the ratio (as estimated by the 10 Secretary) of— 11 ‘‘(I) the number of individuals 12 who are entitled to benefits under 13 part A or enrolled under part B and 14 who reside in the State (as deter- 15 mined by the Secretary based on the 16 most recent available data before the 17 beginning of the period or year); to 18 ‘‘(II) the sum of such numbers 19 for all States that are subject to this 20 subsection. 21 ‘‘(B) AGGREGATE AMOUNT.—The aggre- 22 gate amount specified in this subparagraph 23 for— 24 VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 4028 IH ‘‘(i) the last 3 quarters of fiscal year 1 2024, is equal to 3 times the amount spec- 2 ified in paragraph (3)(B)(iv); 3 ‘‘(ii) fiscal year 2025, is equal to 4 4 times the amount specified in paragraph 5 (3)(B)(iv) increased by the same annual 6 percentage increase as is applied to in- 7 creases in the amounts applied for the fis- 8 cal year and State under section 1108(f); 9 or 10 ‘‘(iii) a subsequent fiscal year, is equal 11 to the aggregate amount specified in this 12 subparagraph for the previous fiscal year 13 increased by the same annual percentage 14 increase as is applied for the fiscal year 15 and State under section 1108(f).’’. 16 (c) CONFORMING AMENDMENT.—Section 1108(f) of 17 the Social Security Act (42 U.S.C. 1308(f)) is amended 18 by striking ‘‘1935(e)(1)(B)’’ and inserting ‘‘1935(e)(1)’’. 19 (d) EFFECTIVE DATES.—The amendments made by 20 subsection (a) shall take effect on January 1, 2024, and 21 the amendments made by subsections (b) and (c) shall 22 take effect on the date of the enactment of this Act. 23 Æ VerDate Sep 11 2014 01:08 Jul 12, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H4028.IH H4028 kjohnson on DSK79L0C42PROD with BILLS