Congress · Laws

An Act to amend the Omnibus Budget Reconciliation Act of 1990 to permit medicare select policies to be offered in all States.

Public Law 104-18 · H.R. 483 · 104th Congress · began in the House

Signed by Bill Clinton (D) on Jul 7, 1995 · Health

Sponsor: Rep. Nancy Johnson (R-CT-6)

Cosponsors (132): Rep. Earl Pomeroy, Rep. Bill Thomas,

Passage votesYeaNay

HouseRecorded vote: 350 yea, 68 nay350–68
SenateVoice vote

Data notes

The final version of the law, as each chamber passed it. A chamber that passed it by voice vote or unanimous consent has no count. “Method not stated” means the record does not say how the chamber voted. Where the record has a member-by-member vote, the “Who voted for it” section shows who voted yea.

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Summary

The Congressional Research Service’s plain-language summary of what the law does.

Amends the Omnibus Budget Reconciliation Act of 1990, as amended by the Social Security Act Amendments of 1994, to: (1) extend the current 15-State Medicare Select demonstration program under which insurers can market Medicare supplemental (Medigap) policies that are the same as other Medigap policies except that supplemental benefits are paid only if services are provided through designated providers; and (2) permit Medicare Select policies to be offered in all States, at State option, until June 30, 1998.

Directs the Secretary of Health and Human Services to conduct a study that compares the health care costs, quality of care, and access to services under Medicare Select policies with those under other Medigap policies.

Declares that such amendments shall remain in effect beyond the extended period unless the Secretary determines by December 31, 1997, based on the study, that as a result of such amendments: (1) there have been no savings in premium costs to Select enrollees as compared to their enrollment in Medigap policies with comparable coverage which are not Medicare Select policies; (2) there have been significant additional expenditures under the Medicare program; or (3) access to and quality of care have been significantly diminished.

Directs the Comptroller General to study and report, by June 30, 1996, to the Congress on: (1) the extent to which individuals who are continuously covered under a Medigap policy are subject to medical underwriting if they change the policy under which they are covered; and (2) the options, if necessary, for modifying the Medigap insurance market to make sure that continuously insured beneficiaries are able to switch plans without medical underwriting. Requires such report to describe the potential impact on the cost and availability of Medigap policies of each option identified.

Who voted for it

Every House member of the 104th Congress on the ideology compass. Highlighted: the 350 who voted yea on final passage. Faded: everyone else, including those who voted nay, did not vote, or had not yet taken office.

350 yea68 nay16 present or did not vote

Dimension 2

Economic left–right

More liberalMore conservative

Democrats who voted yea(124)

Rep. Xavier BecerraD-CA-30
Rep. Lucille Roybal-AllardD-CA-33
Rep. Kweisi MfumeD-MD-7
Rep. José SerranoD-NY-16
Rep. Eddie JohnsonD-TX-30
Rep. James OberstarD-MN-8
Rep. Martin SaboD-MN-5
Rep. Luis GutiérrezD-IL-4
Rep. Bruce VentoD-MN-4
Rep. Norman MinetaD-CA-15
Rep. Lynn WoolseyD-CA-6
Rep. Eliot EngelD-NY-17
Rep. Eva ClaytonD-NC-1
Rep. Corrine BrownD-FL-3
Rep. Dick GephardtD-MO-3
Rep. Floyd FlakeD-NY-6
Rep. Bobby ScottD-VA-3
Rep. Julian DixonD-CA-32
Rep. Albert WynnD-MD-4
Rep. Harry JohnstonD-FL-19
Rep. Sam GejdensonD-CT-2
Rep. Ed PastorD-AZ-2
Rep. Sheila Jackson LeeD-TX-18
Rep. Tom LantosD-CA-12
Rep. Anthony BeilensonD-CA-24
Rep. Victor FazioD-CA-3
Rep. Carolyn MaloneyD-NY-14
Rep. Zoe LofgrenD-CA-16
Rep. Joseph KennedyD-MA-8
Rep. Howard BermanD-CA-26
Rep. Gary AckermanD-NY-5
Rep. Richard DurbinD-IL-20
Rep. Robert MatsuiD-CA-5
Rep. Nita LoweyD-NY-18
Rep. Elizabeth FurseD-OR-1
Rep. Richard NealD-MA-2
Rep. Sam FarrD-CA-17
Rep. Sherrod BrownD-OH-13
Rep. Rosa DeLauroD-CT-3
Rep. Sander LevinD-MI-12
Rep. Harold VolkmerD-MO-9
Rep. Anna EshooD-CA-14
Rep. Lynn RiversD-MI-13
Rep. Dave ObeyD-WI-7
Rep. Gene GreenD-TX-29
Rep. Robert WiseD-WV-2
Rep. Jack ReedD-RI-2
Rep. Thomas SawyerD-OH-14
Rep. Michael WardD-KY-3
Rep. Steny HoyerD-MD-5
Rep. William RichardsonD-NM-3
Rep. Martin FrostD-TX-24
Rep. Norm DicksD-WA-6
Rep. Bob MenendezD-NJ-13
Rep. Sanford BishopD-GA-2
Rep. Frank PalloneD-NJ-6
Rep. Lloyd DoggettD-TX-10
Rep. Marty MeehanD-MA-5
Rep. Marcy KapturD-OH-9
Rep. Thomas BarrettD-WI-5
Rep. Barbara KennellyD-CT-1
Rep. Alan MollohanD-WV-1
Rep. Chuck SchumerD-NY-9
Rep. Bill HefnerD-NC-8
Rep. Tony HallD-OH-3
Rep. John BaldacciD-ME-2
Rep. Ken BentsenD-TX-25
Rep. Earl PomeroyD-ND
Rep. Frank MascaraD-PA-20
Rep. Peter DeutschD-FL-20
Rep. Nick RahallD-WV-3
Rep. Ray ThorntonD-AR-2
Rep. Karen McCarthyD-MO-5
Rep. Jerry CostelloD-IL-12
Rep. Benjamin CardinD-MD-3
Rep. Kika de la GarzaD-TX-15
Rep. Karen ThurmanD-FL-5
Rep. William LutherD-MN-6
Rep. Charles RoseD-NC-7
Rep. Jerry KleczkaD-WI-4
Rep. Tim JohnsonD-SD
Rep. Jim MoranD-VA-8
Rep. Pete PetersonD-FL-2
Rep. Paul McHaleD-PA-15
Rep. Frank TejedaD-TX-28
Rep. Solomon OrtizD-TX-27
Rep. John SprattD-SC-5
Rep. James BarciaD-MI-5
Rep. Michael DoyleD-PA-18
Rep. Michael McNultyD-NY-21
Rep. Tim HoldenD-PA-6
Rep. Chet EdwardsD-TX-11
Rep. Glenn PoshardD-IL-19
Rep. David MingeD-MN-2
Rep. Jim ChapmanD-TX-1
Rep. Pat DannerD-MO-6
Rep. William LipinskiD-IL-3
Rep. Rob AndrewsD-NJ-1
Rep. Jane HarmanD-CA-36
Rep. Tom BevillD-AL-4
Rep. Andrew JacobsD-IN-10
Rep. Charles WilsonD-TX-2
Rep. Bart GordonD-TN-6
Rep. William OrtonD-UT-3
Rep. Cal DooleyD-CA-20
Rep. Lee HamiltonD-IN-9
Rep. Blanche LincolnD-AR-1
Rep. Lewis PayneD-VA-5
Rep. Timothy RoemerD-IN-3
Rep. John TannerD-TN-8
Rep. John BrowderD-AL-3
Rep. Bud CramerD-AL-5
Rep. Scotty BaeslerD-KY-6
Rep. Owen PickettD-VA-2
Rep. Ike SkeltonD-MO-4
Rep. Collin PetersonD-MN-7
Rep. Norman SisiskyD-VA-4
Rep. James TraficantD-OH-17
Rep. Gary ConditD-CA-18
Rep. Gene TaylorD-MS-5
Rep. William BrewsterD-OK-3
Rep. Pete GerenD-TX-12
Rep. Sonny MontgomeryD-MS-3
Rep. Ralph HallD-TX-4

Republicans who voted yea(226)

Rep. Constance MorellaR-MD-8
Rep. Sherry BoehlertR-NY-23
Rep. Benjamin GilmanR-NY-20
Rep. Marge RoukemaR-NJ-5
Rep. Peter TorkildsenR-MA-6
Rep. Christopher ShaysR-CT-4
Rep. Jim LeachR-IA-1
Rep. Michael ForbesR-NY-1
Rep. Jack QuinnR-NY-30
Rep. Tom DavisR-VA-11
Rep. Amo HoughtonR-NY-31
Rep. Nancy JohnsonR-CT-6
Rep. Lincoln Diaz-BalartR-FL-21
Rep. Chris SmithR-NJ-4
Rep. Jim BunnR-OR-5
Rep. Steven SchiffR-NM-1
Rep. Peter BluteR-MA-3
Rep. Stephen HornR-CA-38
Rep. William MartiniR-NJ-8
Rep. Ileana Ros-LehtinenR-FL-18
Rep. Jon FoxR-PA-13
Rep. Joseph McDadeR-PA-10
Rep. Steven GundersonR-WI-3
Rep. Michael CastleR-DE
Rep. Doug BereuterR-NE-1
Rep. Jimmy DuncanR-TN-2
Rep. John McHughR-NY-24
Rep. Phil EnglishR-PA-21
Rep. Ed WhitfieldR-KY-1
Rep. Steven LaTouretteR-OH-19
Rep. Wayne GilchrestR-MD-1
Rep. Richard ZimmerR-NJ-12
Rep. Rick LazioR-NY-2
Rep. Frank LoBiondoR-NJ-2
Rep. Jim GreenwoodR-PA-8
Rep. Curt WeldonR-PA-7
Rep. Jan MeyersR-KS-3
Rep. Pete KingR-NY-3
Rep. Ralph RegulaR-OH-16
Rep. Sue KellyR-NY-19
Rep. William ClingerR-PA-5
Rep. Gary FranksR-CT-5
Rep. Bob FranksR-NJ-7
Rep. Frank WolfR-VA-10
Rep. Bob NeyR-OH-18
Rep. Michael FlanaganR-IL-5
Rep. Dan FrisaR-NY-4
Rep. James LongleyR-ME-1
Rep. Herbert BatemanR-VA-1
Rep. Vernon EhlersR-MI-3
Rep. Jerry LewisR-CA-40
Rep. John PorterR-IL-10
Rep. Fred UptonR-MI-6
Rep. Ray LaHoodR-IL-18
Rep. Frank RiggsR-CA-1
Rep. Joseph SkeenR-NM-2
Rep. William GoodlingR-PA-19
Rep. Jim SaxtonR-NJ-3
Rep. Rodney FrelinghuysenR-NJ-11
Rep. Dave HobsonR-OH-7
Rep. Fred HeinemanR-NC-4
Rep. John EnsignR-NV-1
Rep. Brian BilbrayR-CA-49
Rep. Paul GillmorR-OH-5
Rep. James QuillenR-TN-1
Rep. Susan MolinariR-NY-13
Rep. Bill ThomasR-CA-21
Rep. Tillie FowlerR-FL-4
Rep. Billy TauzinD-LA-3
Rep. Robert EhrlichR-MD-2
Rep. Hal RogersR-KY-5
Rep. James LightfootR-IA-3
Rep. Pat RobertsR-KS-1
Rep. Deborah PryceR-OH-15
Rep. W. Bill YoungR-FL-10
Rep. Jerry WellerR-IL-11
Rep. Robert LivingstonR-LA-1
Rep. Greg GanskeR-IA-4
Rep. James HayesD-LA-7
Rep. Joe KnollenbergR-MI-11
Rep. Clay ShawR-FL-22
Rep. Harris FawellR-IL-13
Rep. Jim RamstadR-MN-3
Rep. Scott KlugR-WI-2
Rep. Jim McCreryR-LA-5
Rep. Michael BilirakisR-FL-9
Rep. Bill BarrettR-NE-3
Rep. Richard BakerR-LA-6
Rep. Charles CanadyR-FL-12
Rep. John MyersR-IN-7
Rep. Michael OxleyR-OH-4
Rep. Henry HydeR-IL-6
Rep. Mark FoleyR-FL-16
Rep. George GekasR-PA-17
Rep. Ken CalvertR-CA-43
Rep. Bill McCollumR-FL-8
Rep. Nathan DealD-GA-9
Rep. Henry BonillaR-TX-23
Rep. H. CallahanR-AL-1
Rep. Barbara VucanovichR-NV-2
Rep. George NethercuttR-WA-5
Rep. Jim KolbeR-AZ-5
Rep. Steve BuyerR-IN-5
Rep. Bill EmersonR-MO-8
Rep. Floyd SpenceR-SC-2
Rep. Jack KingstonR-GA-1
Rep. Rob PortmanR-OH-2
Rep. Sonny BonoR-CA-44
Rep. Spencer BachusR-AL-6
Rep. Ron PackardR-CA-48
Rep. Bob GoodlatteR-VA-6
Rep. Dave CampR-MI-4
Rep. Charlie BassR-NH-2
Rep. Jack MetcalfR-WA-2
Rep. Tom BlileyR-VA-7
Rep. Jennifer DunnR-WA-8
Rep. Martin HokeR-OH-10
Rep. Lamar SmithR-TX-21
Rep. Mike ParkerD-MS-4
Rep. Frank CremeansR-OH-6
Rep. Frank LucasR-OK-6
Rep. Thomas EwingR-IL-15
Rep. Zach WampR-TN-3
Rep. Bud ShusterR-PA-9
Rep. Tom LathamR-IA-5
Rep. Saxby ChamblissR-GA-8
Rep. Roger WickerR-MS-1
Rep. Tim HutchinsonR-AR-3
Rep. Rick WhiteR-WA-1
Rep. Terry EverettR-AL-2
Rep. Lindsey GrahamR-SC-3
Rep. Jay DickeyR-AR-4
Rep. Dave WeldonR-FL-15
Rep. Richard BurrR-NC-5
Rep. Porter GossR-FL-14
Rep. Enid Greene WaldholtzR-UT-2
Rep. Charles TaylorR-NC-11
Rep. Duke CunninghamR-CA-51
Rep. Linda SmithR-WA-3
Rep. Walter JonesR-NC-3
Rep. William ZeliffR-NH-1
Rep. Cass BallengerR-NC-10
Rep. Buck McKeonR-CA-25
Rep. Dan MillerR-FL-13
Rep. Jim NussleR-IA-2
Rep. Ron LewisR-KY-2
Rep. Carlos MoorheadR-CA-27
Rep. Duncan HunterR-CA-52
Rep. John LinderR-GA-4
Rep. Roscoe BartlettR-MD-6
Rep. Denny HastertR-IL-14
Rep. James HansenR-UT-1
Rep. Scott McInnisR-CO-3
Rep. Jay KimR-CA-41
Rep. Doc HastingsR-WA-4
Rep. John MicaR-FL-7
Rep. Gregory LaughlinD-TX-14
Rep. Toby RothR-WI-8
Rep. Ed BryantR-TN-7
Rep. Gerald SolomonR-NY-22
Rep. John KasichR-OH-12
Rep. Randy TateR-WA-9
Rep. David DreierR-CA-28
Rep. Dick ChryslerR-MI-8
Rep. Jim TalentR-MO-2
Rep. Sam BrownbackR-KS-2
Rep. William PaxonR-NY-27
Rep. George RadanovichR-CA-19
Rep. Howard CobleR-NC-6
Rep. Barbara CubinR-WY
Rep. Nick SmithR-MI-7
Rep. Mike CrapoR-ID-2
Rep. Donald ManzulloR-IL-16
Rep. Mac CollinsR-GA-3
Rep. Robert DornanR-CA-46
Rep. Larry CombestR-TX-19
Rep. Jim BunningR-KY-4
Rep. Robert WalkerR-PA-16
Rep. Bill ArcherR-TX-7
Rep. Van HillearyR-TN-4
Rep. Andrea SeastrandR-CA-22
Rep. Tom DeLayR-TX-22
Rep. Dan SchaeferR-CO-6
Rep. David FunderburkR-NC-2
Rep. J.D. HayworthR-AZ-6
Rep. Tom PetriR-WI-6
Rep. Ernest IstookR-OK-5
Rep. Bob BarrR-GA-7
Rep. Dan BurtonR-IN-6
Rep. David McIntoshR-IN-2
Rep. Mac ThornberryR-TX-13
Rep. Sue MyrickR-NC-9
Rep. Wayne AllardR-CO-4
Rep. Richard ArmeyR-TX-26
Rep. Jon ChristensenR-NE-2
Rep. Wally HergerR-CA-2
Rep. John DoolittleR-CA-4
Rep. Joe BartonR-TX-6
Rep. Bob InglisR-SC-4
Rep. Steve ChabotR-OH-1
Rep. Pete HoekstraR-MI-2
Rep. Christopher CoxR-CA-47
Rep. William BakerR-CA-10
Rep. Mark SanfordR-SC-1
Rep. Matt SalmonR-AZ-1
Rep. Gil GutknechtR-MN-1
Rep. Cliff StearnsR-FL-6
Rep. Sam JohnsonR-TX-3
Rep. Todd TiahrtR-KS-4
Rep. Richard PomboR-CA-11
Rep. Steve LargentR-OK-1
Rep. Phil CraneR-IL-8
Rep. John HostettlerR-IN-8
Rep. Dana RohrabacherR-CA-45
Rep. Mark NeumannR-WI-1
Rep. Mark SouderR-IN-4
Rep. James SensenbrennerR-WI-9
Rep. John ShadeggR-AZ-4
Rep. Robert StumpR-AZ-3
Rep. Helen Chenoweth-HageR-ID-1
Rep. Ed RoyceR-CA-39
Rep. Mel HancockR-MO-7
Rep. Wes CooleyR-OR-2
Rep. Joe ScarboroughR-FL-1
Rep. Joel HefleyR-CO-5
Rep. Steve StockmanR-TX-9

Data notes

The House’s recorded vote on the final version of the law (roll call 454 in Voteview), matched to the vote the record cites and checked against its totals. Positions are each member’s DW-NOMINATE score for that Congress, as on the Ideology page; left to right is more liberal to more conservative. Paired and announced yea votes count as yea. Lists follow the compass, most liberal first. A name links to a profile only for members of the current Congress. A law passed by voice vote or unanimous consent has no member list, and neither does a vote Voteview has not yet recorded.

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Committees

The committees the bill was sent to, and what each did with it.

Energy and Commerce Committee · House · markup by, referred to, reported bySubcommittee: Health and Environment Subcommittee
Ways and Means Committee · House · markup by, referred to, reported bySubcommittee: Health Subcommittee

Data notes

A committee links to its page only where it exists in the current Congress; older and renamed committees are named without a link.

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Timeline

From introduction to signing, newest first: the committees, the floor and the president. 47 actions.

Jul 7, 1995Became lawBecame law · Became Public Law No: 104-18.
Became lawBecame law · Signed by President.
Jun 30, 1995PresidentPresident · Presented to President.
Resolving differencesResolving differences · On agreeing to the conference report Agreed to by the Yeas and Nays: 350 - 68 (Roll no. 467).House roll call 467
Resolving differencesResolving differences · Motion to reconsider laid on the table Agreed to without objection.
Resolving differencesResolving differences · Conference report agreed to in House: On agreeing to the conference report Agreed to by the Yeas and Nays: 350 - 68 (Roll no. 467).House roll call 467
Resolving differencesResolving differences · Mr. Bliley brought up conference report H. Rept. 104-157 for consideration under the provisions of H. Res. 180.
FloorFloor · DEBATE - The House proceeded with one hour of debate on the conference report.
FloorFloor · Rule H. Res. 180 passed House.
Jun 29, 1995FloorFloor · Rules Committee Resolution H. Res. 180 Reported to House. Rule provides for consideration of the conference report to H.R. 483 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions. Providing for the consideration of the in t…
Jun 26, 1995Resolving differencesResolving differences · Senate agreed to conference report by Voice Vote.
Resolving differencesResolving differences · Conference report agreed to in Senate: Senate agreed to conference report by Voice Vote.
Jun 22, 1995Resolving differencesResolving differences · Conference papers: Senate report and managers' statement and official papers held at the desk in Senate.
Resolving differencesResolving differences · Conference report H. Rept. 104-157 filed.
Resolving differencesResolving differences · Conference report filed: Conference report H. Rept. 104-157 filed.
Resolving differencesResolving differences · Conferees agreed to file conference report.
Resolving differencesResolving differences · Conference committee actions: Conferees agreed to file conference report.
Jun 5, 1995Resolving differencesResolving differences · Senate insists on its amendment agrees to request for a conference, appoints conferees Packwood; Dole; Moynihan.
May 25, 1995Resolving differencesResolving differences · The Speaker appointed conferees: Bliley, Bilirakis, Hastert, Archer, Thomas, Johnson (CT), Dingell, Waxman, Gibbons, and Stark.
Resolving differencesResolving differences · Motion to reconsider laid on the table Agreed to without objection.
Resolving differencesResolving differences · On motion that the House instruct conferees Failed by the Yeas and Nays: 197 - 224 (Roll no. 355).House roll call 355
Resolving differencesResolving differences · The previous question was ordered without objection.
Resolving differencesResolving differences · Mr. Doggett moved that the House instruct conferees.
Resolving differencesResolving differences · On motion that the House disagree to the Senate amendment, and request a conference Agreed to without objection.
Resolving differencesResolving differences · Mr. Bliley asked unanimous consent that the House disagree to the Senate amendment, and request a conference.
FloorFloor · Message on House action received in Senate and at the desk: House requests a conference.
FloorFloor · DEBATE - The House proceeded with one hour of debate on the motion to instruct conferees on the part of the House to resolve the differences between the House's 8 1/2-year program and the Senate's 5-year program of medicare select policies, in light of the changes in Medicare co…
May 17, 1995FloorFloor · Passed Senate with an amendment by Voice Vote.
FloorFloor · Amendment SP 1108 agreed to in Senate by Voice Vote.
FloorFloor · Measure laid before Senate by unanimous consent.

Data notes

Shows the introduction, each committee and subcommittee step the source dates (referral, hearings, markup, report, discharge), and the floor, conference, presidential and became-law steps. Calendar placements, messages between the chambers, amendments and committee report numbers are not shown for laws before the 108th Congress. Two entries the source lists twice are shown once.

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Official record

The bill’s full text and every action, including introduction and committee steps, are on Congress.gov. Data through Oct 7, 2026.