Regulation as published in the Federal Register on December 4, 1998, and as subsequently updated by the National Association of Insurance Commissioners to reflect previous changes in law and the reference to date of enactment of this subsection deemed a reference to the date of enactment of this subsection (aa). . 4. Medicare direct supplemental insurance option (a) In general Title XVIII of the Social Security Act is amended by inserting after section 1882 ( 42 U.S.C. 1395ss ) the following new section: 1882A. MEDICARE DIRECT SUPPLEMENTAL INSURANCE OPTION (a) In general The Secretary shall provide for the offering under this section of a voluntary program to supplement the benefits provided to individuals under parts A and B of this title. (b) Eligibility