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.
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.
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