,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #ejj  ,,in ,,the ,,house ,,of   
,,representatives  ,february #e1 #bjac  
,mr4 ,grayson introduced the following  
bill2 which was referred to the         
,committee on ,ways and ,means  ,a      
,,bill  ,to amend title ,,xviii of the  
,social ,security ,act to provide for an
 option for any citizen or permanent    
resident of the ,united ,states to buy  
into ,medicare4  #a4 ,short title ,this 
,act may be cited as the ,public ,option
 ,act or the ,medicare ,you ,can ,buy   
,into ,act4  #b4 ,universal ,medicare   
buy-in option  7a7 ,in general ,part ,a 
of title ,,xviii of the ,social         
,security ,act 7#db ,u4,s4,c4 #acie;c et
 seq47 is amended--  7#a7 in section    
#ahah7;a7 7#db ,u4,s4,c4                
#acie;i-#b7;a771 by striking or #ahah;,a
 and inserting 1 #ahah;,a1 or #ahah;,b2 
and  7#b7 by inserting after section    
#ahah;,a the following new section3     
#ahah;,b4 ,universal buy-in  7a7 ,in    
general 7a7 ,every individual who--     

7#a7 is a resident of the ,united       
,states2  7#b7 is either 7,a7 a citizen 
or national of the ,united ,states1 or  
7,b7 an alien lawfully admitted for     
permanent residence2 and  7#c7 is not   
otherwise entitled to benefits under    
this part or eligible to enroll under   
this part2  shall be eligible to enroll 
in the insurance program established by 
this part4 ,an individual may enroll    
under this section only in such manner  
and form as may be prescribed in        
regulations1 and only during an         
enrollment period prescribed in or under
 this section4  7b7 ,enrollment2        
coverage ,the ,secretary shall establish
 enrollment periods and coverage under  
this section consistent with the        
principles for establishment of         
enrollment periods and coverage for     
individuals under section #ahah1 except 
that no entitlement to benefits under   
this part shall be effective before the 
first day of the first calendar year    
beginning after the date of the         

enactment of this ,act4  7c7 ,premiums  
7#a7 ,in general ,the provisions of     
subsections 7d77#a71 7d77#b71 and       
7d77#c7 of section #ahah insofar as they
 apply to premiums 7including collection
 of premiums7 shall apply to premiums   
and collection of premiums under this   
section1 except that--  7,a7 paragraphs 
7#d7 and 7#e7 of section #ahah shall not
 be applicable2 and  7,b7 the estimate  
of the monthly actuarial rate under     
section #ahah7;d7 shall be computed and 
applied under this paragraph based upon 
costs incurred for individuals within   
each age cohort specified in paragraph  
7#b7 rather than for all individuals age
 #fe and older4  7#b7 ,age cohorts ,the 
age cohorts specified in this paragraph 
are as follows3  7,a7 ,individuals under
 #ai years of age4  7,b7 ,individuals at
 least #ai years of age but not more    
than #be years of age4  7,c7            
,individuals at least #bf years of age  
and not more than #ce years of age4     
7,d7 ,individuals at least #cf years of 

age and not more than #de years of age4 
7,e7 ,individuals at least #df years of 
age and not more than #ee years of age4 
7,f7 ,individuals at least #ef years of 
age and not more than #fd years of age4 
7d7 ,treatment ,an individual enrolled  
under this part pursuant to this section
 shall not be treated as enrolled under 
this part 7or any other part of this    
title7 for purposes of obtaining medical
 assistance for medicare cost-sharing or
 otherwise under title ,,xix4  4