H.R. 3631 is expected to be considered under suspension of the rules, requiring a two-thirds vote for passage. The legislation was introduced by Rep. Dina Titus (D-NV) on September 23, 2009.

H.R. 3631 would prevent any Medicare beneficiary from receiving a Part B premium increase in 2010 in light of preliminary indications that seniors may not receive an annual cost-of-living adjustment (COLA) in their Social Security benefits next year. The bill would make commensurate reallocations from the Medicare Improvement Fund to offset the higher federal share of Medicare spending.

Under current law, the annual increase in the Part B premium cannot exceed the annual COLA provided through Social Security. In years where there is no Social Security COLA-expected to be the case for 2010 and potentially in future years as well-the total annual increase in the Part B premium must be paid for by three groups: 1) new Medicare enrollees (who by definition are not subject to "hold harmless" provisions); 2) high-income individuals subject to increased premiums under the Part B means test; and 3) State Medicaid programs paying on behalf of their dual eligible beneficiaries. The bill provides that for 2010 only, these beneficiaries-and all Medicare beneficiaries-would not have to pay increased Part B premiums. Some Members may therefore note that H.R. 3631 would spend nearly $3 billion-at a time when the Medicare Hospital Insurance Trust Fund is scheduled to be exhausted in 2017-in order to prevent wealthy seniors (those making more than $85,000 in 2009) from having to pay any increase in their Part B premiums.

A formal Congressional Budget Office was not available at press time; however, a preliminary CBO estimate indicated the bill would spend approximately $2.8 billion, paid for by reallocations from the Medicare Improvement Fund.