Sec. 1012. Reduction in Medicare part D annual out-of-pocket threshold and elimination of cost-sharing above that threshold

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Section 1860D–2(b)(4)(B) of the Social Security Act ( 42 U.S.C. 1395w–102(b)(4)(B) ) is amended— in clause (i), by striking For purposes and inserting Subject to clause (iii), for purposes ; and by adding at the end the following new clause: Subject to subclause (II), for plan years beginning on or after January 1 following the date of enactment of the Medicare for All Act of 2019 and before January 1 of the year that is 4 years following such date of enactment, notwithstanding clauses

(i)and (ii), the annual out-of-pocket threshold specified in this subparagraph is equal to $305. In applying subclause (I), the Secretary may exempt costs incurred for a covered part D drug that is an applicable drug under section 1860D–14A(g)(2) if the Secretary determines that a generic version of that drug is available. . Section 1860D–2(b)(4)(A) of the Social Security Act ( 42 U.S.C. 1395w–102(b)(4)(A) ) is amended— in clause (i)— by redesignating subclauses

(I)and

(II)as items

(aa)and (bb), respectively; by striking subparagraph (B), with cost-sharing and inserting the following: “subparagraph (B)— for plan years 2006 through the plan year ending December 31 following the date of enactment of the Medicare for All Act of 2019 , with cost-sharing ; in item (bb), as redesignated by subparagraph (A), by striking the period at the end and inserting ; and ; and by adding at the end the following new subclause: for the plan year beginning January 1 following the date of enactment of the Medicare for All Act of 2019 and the two subsequent plan years, without any cost-sharing. ; and in clause (ii)— by striking clause (i)(I) and inserting clause (i)(I)(aa) ; and by adding at the end the following new sentence: The Secretary shall continue to calculate the dollar amounts specified in clause (i)(I)(aa), including with the adjustment under this clause, after plan year 2018 for purposes of 1860D–14(a)(1)(D)(iii). . Section 1860D–14(a) of the Social Security Act ( 42 U.S.C. 1395w–114(a) ) is amended— in paragraph (1)— in subparagraph (D)(iii), by striking 1860D–2(b)(4)(A)(i)(I) and inserting 1860D–2(b)(4)(A)(i)(I)(aa) ; and in subparagraph (E)— in the heading, by inserting after prior to the elimination of such cost-sharing for all individuals ; and threshold by striking The elimination and inserting For plan years 2006 through the plan year ending December 31 following the date of enactment of the ; and Medicare for All Act of 2019 , the elimination in paragraph (2)(E)— in the heading, by inserting after prior to the elimination of such cost-sharing for all individuals ; threshold by striking Subject to and inserting For plan years 2006 through the plan year ending December 31 following the date of enactment of the ; and Medicare for All Act of 2019 , subject to by striking 1860D–2(b)(4)(A)(i)(I) and inserting 1860D–2(b)(4)(A)(i)(I)(aa) .

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42 USC 1395w–102(b)(4)(B)
42 USC 1395w–102(b)(4)(A)
42 USC 1395w–114(a)

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Sec. 1012

Reduction in Medicare part D annual out-of-pocket threshold and elimination of cost-sharing above that threshold

Cite42 USC 1395w–102(b)(4)(B)

Cite42 USC 1395w–102(b)(4)(A)

Cite42 USC 1395w–114(a)

Cites 3Cited by 0 across 0 sources