To allow certain State and local government employees to elect to treat employment as medicare qualified government employment for purposes of entitlement to Medicare coverage.

Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act (SSA) to direct the Commissioner of Social Security to: (1) establish procedures under which an eligible state or local government employee who is not otherwise covered under a state's voluntary agreement for coverage of state and local employees may make an irrevocable election to treat employment as Medicare qualified government employment; and so (2) extend to services performed by such employees entitlement to Medicare coverage under SSA title XVIII, including hospital insurance benefits, as well as coverage for end state renal disease (ESRD).

Amends the Internal Revenue Code to apply the Medicare portion of payroll taxes to state and local government employees making such an election.