text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Equal Access to Medicare Options Act 
  of 2009''.
  
  SEC. 2. GUARANTEED ISSUE OF MEDIGAP POLICIES TO ALL MEDICARE 
                BENEFICIARIES.
  
      (a) In General.--Section 1882(s) of the Social Security Act (42 
  U.S.C. 1395ss(s)) is amended--
              (1) in paragraph (2)(A), by striking ``65 years of age or 
          older and is enrolled for benefits under part B'' and inserting 
          ``entitled to, or enrolled for, benefits under part A and 
          enrolled for benefits under part B'';
              (2) in paragraph (2)(D), by striking ``who is 65 years of 
          age or older as of the date of issuance and''; and
              (3) in paragraph (3)(B)(vi), by striking ``at age 65''.
      (b) Phase-In Authority.--
              (1) In general.--Subject to paragraph (2), the Secretary of 
          Health and Human Services may phase in the implementation of 
          the amendments made under subsection (a) in such manner as the 
          Secretary determines appropriate to minimize any adverse impact 
          on individuals enrolled under a Medicare supplemental policy 
          prior to the effective date of this Act.
              (2) Limit.--The phase-in period under paragraph (1) shall 
          not exceed 5 years.
      (c) Separate Premium Class.--
              (1) In general.--Subject to paragraph (2), any individuals 
          enrolled under a Medicare supplemental policy pursuant to the 
          amendments made under subsection (a) shall be classified by the 
          issuer as part of a separate premium class.
              (2) Limit.--The provision in paragraph (1) shall apply to 
          individuals that enroll under a Medicare supplemental policy 
          prior to January 1, 2015.
      (d) Additional Enrollment Period for Certain Individuals.--
              (1) One-time enrollment period.--
                      (A) In general.--In the case of an individual 
                  described in paragraph (2), the Secretary shall 
                  establish a one-time enrollment period during which 
                  such an individual may enroll in any Medicare 
                  supplemental policy of the individual's choosing.
                      (B) Period.--The enrollment period established 
                  under subparagraph (A) shall begin on the date on which 
                  the phase-in period under subsection (b) is completed 
                  and end 6 months after such date.
              (2) Individual described.--An individual described in this 
          paragraph is an individual who--
                      (A) is entitled to hospital insurance benefits 
                  under part A under section 226(b) or section 226A of 
                  the Social Security Act (42 U.S.C. 426(b); 426-1);
                      (B) is enrolled for benefits under part B of such 
                  Act (42 U.S.C. 1395j et seq.); and
                      (C) would not, but for the provisions of and 
                  amendments made by this section, be eligible for the 
                  guaranteed issue of a Medicare supplemental policy 
                  under section 1882(s)(2) of such Act (42 U.S.C. 
                  1395ss(s)(2)).
              (3) Outreach plan.--The Secretary shall develop an outreach 
          plan to notify individuals described in paragraph (2) of the 
          one-time enrollment period established under paragraph (1).
  
  SEC. 3. GUARANTEED ISSUE OF MEDIGAP POLICIES FOR MEDICARE ADVANTAGE AND 
                MEDICAID ENROLLEES.
  
      (a) In General.--Section 1882(s)(3) of the Social Security Act (42 
  U.S.C. 1395ss(s)(3)), as amended by section 2, is amended--
              (1) in subparagraph (B), by adding at the end the following 
          new clauses:
              ``(vii) The individual was enrolled in a Medicare Advantage 
          plan under part C for not less than 12 months and subsequently 
          disenrolled from such plan and elects to receive benefits under 
          this title through the original Medicare fee-for-service 
          program under parts A and B.
              ``(viii) The individual--
                      ``(I) is entitled to, or enrolled for, benefits 
                  under part A and enrolled for benefits under part B;
                      ``(II) was eligible for medical assistance under a 
                  State plan or waiver under title XIX and was enrolled 
                  in such plan or waiver; and
                      ``(III) subsequently lost eligibility for such 
                  medical assistance.''; and
              (2) by striking subparagraph (C)(iii) and inserting the 
          following:
              ``(iii) Subject to subsection (v)(1), for purposes of an 
          individual described in clause (vi), (vii), or (viii) of 
          subparagraph (B), a Medicare supplemental policy described in 
          this subparagraph shall include any Medicare supplemental 
          policy.''.
              (3) in subparagraph (E)--
                      (A) in clause (iv), by striking ``and'' at the end;
                      (B) in clause (v), by striking the period at the 
                  end and inserting a semicolon; and
                      (C) by adding at the end the following new clauses:
              ``(vi) in the case of an individual described in 
          subparagraph (B)(vii), the annual, coordinated election period 
          (as defined in section 1851(e)(3)(B)) or a continuous open 
          enrollment period (as defined in section 1851(e)(2)) during 
          which the individual disenrolls from a Medicare Advantage plan 
          under part C; and
              ``(vii) in the case of an individual described in 
          subparagraph (B)(viii), the period beginning on the date that 
          the individual receives a notice of cessation of such 
          individual's eligibility for medical assistance under the State 
          plan or waiver under title XIX and ending on the date that is 
          123 days after the individual receives such notice.''.
      (b) Effective Date.--The amendments made by subsection (a) shall 
  apply to Medicare supplemental policies effective on or after January 
  1, 2010.
  
  SEC. 4. ENROLLMENT OF INDIVIDUALS WITH END STAGE RENAL DISEASE IN 
                MEDICARE ADVANTAGE.
  
      (a) In General.--Section 1851(a) of the Social Security Act (42 
  U.S.C. 1395w-21(a)) is amended by striking paragraph (3) and inserting 
  the following:
      ``(3) Medicare+Choice Eligible Individual.--In this title, the term 
  `Medicare+Choice eligible individual' means an individual who is 
  entitled to benefits under part A and enrolled under part B.''.
      (b) Conforming Amendments.--
              (1) Section 1852(b) of the Social Security Act (42 U.S.C. 
          1395w-22(b)) is amended by striking paragraph (1) and inserting 
          the following:
      ``(1) Beneficiaries.--A Medicare+Choice organization may not deny, 
  limit, or condition the coverage or provision of benefits under this 
  part, for individuals permitted to be enrolled with the organization 
  under this part, based on any health status-related factor described in 
  section 2702(a)(1) of the Public Health Service Act. The Secretary 
  shall not approve a plan of an organization if the Secretary determines 
  that the design of the plan and its benefits are likely to 
  substantially discourage enrollment by certain MA eligible individuals 
  with the organization.''.
              (2) Section 1859(b)(6)(B) of such Act (42 U.S.C. 1395w-
          28(b)(6)(B)) is amended in the second sentence by striking 
          ``may waive application of section 1851(a)(3)(B) in the case of 
          an individual described in clause (i), (ii), or (iii) of this 
          subparagraph and''.
      (c) Effective Date.--The amendments made by this section shall 
  apply to plan years beginning on or after January 1, 2010.
target: Equal Access to Medicare Options Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to provide all Medicare beneficiaries, regardless of whether they have enrolled in Medicare part B, as well as Medicare Advantage and Medicaid enrollees with the right to guaranteed issue of a supplemental insurance (Medigap) policy.
  
  Amends part C (Medicare+Choice) of SSA title XVIII to permit enrollment of individuals with end stage renal disease (ESRD) in Medicare Advantage.
feat_title: A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy.