Sec. 2. Medicare Eligibility Expansion

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Section 226 of the Social Security Act ( 42 U.S.C. 426 ) is amended— by striking 65 each place it appears and inserting 60 ; and in subsection (a)— in paragraph (2)(A)— by inserting would be entitled to those benefits but for age, after section 202, ; and by inserting (not including age) after meets all the criteria ; and in the matter at the end— by inserting , in the case of an individual who has attained age 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act , beginning with ; and by inserting and, in the case of an individual who has not attained age 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act , the first month after the month that is 5 months after such date of enactment for which the individual meets the conditions specified in paragraphs

(1)and

(2)and

(2). Section 1837(d) of the Social Security Act ( 42 U.S.C. 1395p(d) ) is amended— by striking

(d)In the case of and inserting (d)(1) Subject to paragraph (2), in the case of ; and by adding at the end the following new paragraph: In the case of an individual described in paragraph

(1)who has attained the age of 60 but not attained the age of 65 before the date that is 6 months after the date of the enactment of the Improving Medicare Coverage Act , such individual’s initial enrollment period shall begin on the date that is 3 months after such date of enactment, and shall end on the date that is 11 months after such date of enactment. . Section 1811 of the Social Security Act ( 42 U.S.C. 1395c ) is amended— by striking 65 each place it appears and inserting 60 ; and by striking (or would be eligible for such benefits if certain government employment were covered employment under such title) and inserting (or would be eligible for such benefits if certain government employment were covered employment under such title, or would be eligible for such benefits but for age) . Section 1818 of such Act ( 42 U.S.C. 1395i–2 ) is amended— in subsection (a)(1), by striking 65 and inserting 60 ; and in subsection (d)— in paragraph (1), by striking 65 and inserting 60 ; and in paragraph (3), by striking 65 and inserting 60 . Section 1818A(a)(1) of such Act (42 U.S.C. 1395i–2a(a)(1)) is amended by striking 65 and inserting 60 . Section 1836(2) of such Act ( 42 U.S.C. 1395o(2) ) is amended by striking 65 and inserting 60 . Section 1837 of such Act ( 42 U.S.C. 1395p ), as amended by subsection (b), is further amended by striking 65 each place it appears and inserting 60 . Section 1838 of the such Act ( 42 U.S.C. 1395q ) is amended— by striking 65 each place it appears and inserting 60 ; and in subsection (a)(2)— by striking subsection

(d)each place it appears and inserting subsection (d)(1) ; in subparagraph (D), by striking ; or and inserting , or ; and by adding at the end the following new subparagraph: in the case of an individual who enrolls pursuant to subsection (d)(2) of section 1837, on the date that is 6 months after the date of the enactment of the Improving Medicare Coverage Act ; or . Section 1839 of such Act ( 42 U.S.C. 1395r ) is amended— in subsection (a)(1)— by striking the first sentence and inserting The Secretary shall, during September of 1983 through September of 2021, determine the monthly actuarial rate for enrollees age 65 and over which shall be applicable for the succeeding calendar year (including, for 2022, with respect to individuals who enroll pursuant to subsection (d)(2) of section 1837) and, during September of 2022 and of each year thereafter, determine the monthly actuarial value for enrollees age 60 and over which shall be applicable for the succeeding calendar year. ; and by inserting (for years before 2023 and with respect to those enrollees age 50 or older (for 2023 and subsequent years) after age 60 and older ; in subsection (a)(3)— by striking for enrollees age 65 and over, determined according to paragraph (1), and inserting determined according to paragraph

(1); and by striking age 65 and older ; in subsection (a)(4)— by striking the first sentence and inserting The Secretary shall, during September of 1983 through September of 2021, determine the monthly actuarial rate for disabled enrollees under age 65 which shall be applicable for the succeeding calendar year and, during September of 2022 and of each year thereafter, determine the monthly actuarial value for disabled enrollees under age 60 which shall be applicable for the succeeding calendar year. ; and by inserting (for years before 2023) and with respect to those disabled enrollees under age 60 (for 2023 and subsequent years) after to disabled enrollees under age 65 ; in subsection (b), by inserting (in the case of an individual who attained the age of 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act ) or the age of 60 (in the case of an individual who did not attain the age of 65 before the date that is 6 months after such date of enactment) the age of 65 ; in subsection (d), by inserting (in the case of an individual who attained the age of 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act ) or the age of 60 (in the case of an individual who did not attain the age of 65 before the date that is 6 months after such date of enactment) age 65 ; in subsection (i)(3)(A), by inserting (for years before 2023) or for enrollees age 60 and older (for 2023 and subsequent years) after age 65 and older ; and in subsection (j), by inserting (for years before 2023) or for enrollees age 60 and older (for 2023 and subsequent years) after age 65 and older . Section 1844(a) of such Act ( 42 U.S.C. 1395w(a) ) is amended by striking 65 each place it appears and inserting 60 . Section 1851(e)(4) of such Act ( 42 U.S.C. 1395w–21(e)(4) ) is amended in the matter at the end by striking 65 and inserting 60 . Section 1860D–13(b)(7)(B)(i) of such Act ( 42 U.S.C. 1395w–113(b)(7)(B)(i) ) is amended by inserting (in the case of an individual who attained the age of 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act ) or age 60 (in the case of an individual who did not attain the age of 65 before the date that is 6 months after such date of enactment) 65 . Section 1861(yy)(2)(F)(iv) of such Act ( 42 U.S.C. 1395x(yy)(2)(F)(iv) ) is amended by striking 65 and inserting 60 . Section 1862(b)(1)(A)(i)(II) of such Act ( 42 U.S.C. 1395y(b)(1)(A)(i)(II) ) is amended by striking 65 each place it appears and inserting 60 . Section 1882(s) of such Act ( 42 U.S.C. 1395ss(s) ) is amended— in paragraph (2)— in subparagraph (A), by striking 65 years of age or older and inserting entitled to benefits under part A under subsection

(a)of section 226, or would be entitled to benefits under such subsection but for paragraph

(2)of such subsection, ; and in subparagraph (D), by inserting (in the case of an individual who attained the age of 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act ) or 60 years of age or older (in the case of an individual who did not attain the age of 65 before the date that is 6 months after such date of enactment) older ; and in paragraph (3)(B)— in clause (ii), by inserting (in the case of an individual who attained the age of 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act ) or 60 years of age or older (in the case of an individual who did not attain the age of 65 before the date that is 6 months after such date of enactment) older ; and in clause (vi), by striking eligible for benefits under part A at age 65 and inserting entitled to part A benefits under section 226(a) . Section 1883(z)(2)(A) of such Act ( 42 U.S.C. 1395tt(z)(2)(A) ) is amended by inserting (in the case of an individual who attained the age of 65 before the date that is 6 months after the date of the enactment of the after Improving Medicare Coverage Act or age 60 (in the case of an individual who did not attain the age of 65 before the date that is 6 months after such date of enactment) 65 . Section 1896(a)(4) of such Act ( 42 U.S.C. 1395ggg(a)(4) ) is amended— in subparagraph (B)— in clause (i), by striking benefits under part A of this title and inserting part A benefits under section 226(a) ; and in clause (ii), by striking the semicolon at the end and inserting ; and ; in subparagraph (C), by striking ; and and inserting a period; and by striking subparagraph (D). Coverage provided under the Medicare program under title XVIII of the Social Security Act pursuant to this section (relating to coverage of individuals who have attained the age of 60 but have not attained the age of 65) shall be treated as coverage under a qualified health plan in the individual market enrolled in through an Exchange where the individual resides for purposes of section 36B of the Internal Revenue Code of 1986 other than subsection (c)(2)(B) thereof. The Secretary of Health and Human Services shall establish procedures to provide for the automatic enrollment of individuals who become entitled to benefits under part A of title XVIII of the Social Security Act as of the date that is 6 months after the date of the enactment of this Act pursuant to this section in descending order of age with enrollment of such individuals beginning not later than 3 months after such date of enactment and completed not later than 11 months after such date of enactment. Nothing in this section shall be construed to— provide coverage under the Medicare program of a dependent who is not otherwise eligible for such coverage as an individual; or affect a dependent’s eligibility under a group health plan, qualified health plan offered on an Exchange, or any other health plan for which the dependent is otherwise eligible. Nothing in this section shall affect the requirements under section 1862(b) of the Social Security Act ( 42 U.S.C. 1395y(b) ) (relating to Medicare as secondary payer). Subject to paragraph (2), the amendments made by this section shall take effect on the date that is 6 months after the date of the enactment of this Act. The amendments made by subsection

(b)and subsection (c)(1)(G) shall take effect on the date of enactment of this Act.

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