Four years after shouts of “Death Panels” killed off all talk of end-of-life planning provisions in the Affordable Care Act,  Sens. Mark Warner and Johnny Isakson are going forward with a revised version of the legislation that helped spark the 2009 uproar.

Senator Warner's mother, Marjorie

The Care Planning Act of 2013 will be introduced Thursday  by Mr. Warner, a Virginia Democrat,  and Mr. Isakson,  a Georgia Republican, who want to give seriously ill patients and their families the chance to receive thorough information about their prognosis and counseling from health-care providers, paid by the government.

“This is about honoring a patient’s choice, not making it for them,” said Mr. Warner.

The bill creates a new Medicare/Medicaid benefit that, says Mr. Warner,  gives a patient the freedom to learn about, discuss, and choose medical treatment options  before their illness progresses too far.  “It gives patients more control over how they will live,” Mr. Warner said.

“We never had ‘the conversation’ with my mother,” said Mr. Warner in an interview.  When his mother, Marjorie, developed Alzheimer’s,  she and her husband and children had not yet discussed what kind of medical care she wanted as the disease progressed, including whether she would be willing to go into a nursing facility.  Mr. Warner, a former telecom tycoon, said: “I had financial resources other families don’t that I could provide, but I was helpless — we didn’t know what to do.”

His 85-year-old father and his sister kept Marjorie at home where they cared for her, until her death in early 2010 after a decade with Alzheimer’s.

Mr. Warner said he’s still haunted by the situation.

By contrast, Mr. Warner’s co-sponsor, Mr. Isakson, brings a happier memory to the effort.

“Both my parents took time to plan what they wanted with their doctors and me and  my siblings,” he said, adding that his parents made durable powers of attorney in advance.

“This is about planning for care while a person still can.  Because of their preparation and decisions, my parents had terrific quality of life at the end,” and he and his siblings had relief, Mr. Isakson said.

This new bill would allow the patient and family members to meet with a team that can include, per the patient’s wishes,  a doctor, nurse, social worker and a religious leader in a session to get information about the expected course of their disease, the pros and the cons of  relevant treatments,  and explanations of advanced medical directives. 

Currently, Medicare doesn’t cover  time-intensive medical discussions with the patient and family.

The bill also would set up a demonstration program in several sites around the country for some patients who would not currently qualify for home hospice benefits.  They  would have the option of receiving “wrap-around” hospice-type provisions such as home medical visits and treatment, and caregiver relief as part of a trial project.

Ultimately, Mr. Warner and Mr. Isakson both said that they would like sick patients to be able to get government-funded home-hospice support without having to forfeit “curative” treatments for their disease and only get palliative care.  Currently, patients currently must have a prognosis of living six months or less,  and agree to limit their medical treatment to pain relief and symptoms related to their terminal illness in order to qualify for hospice coverage.

The new bill also differs from 2009 proposals  in that it targets only seriously ill patients, and, Mr. Warner stressed,  isn’t about cost-cutting. Senate aides say about six million seriously ill, frail Americans would likely meet the criteria for access to care planning sessions; and the program, in its early rollout period,  would cost the government less than $200 million a year.

The bill also emphasizes the need for input from a patient’s religious counselor—faith leaders have been consulted several times in the past year in preparing the legislation.