House Democratic Health Leaders Introduce Bill to Improve Medicare Benefits and Update Enrollment Process
Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), Ways and Means Committee Ranking Member Sander Levin (D-MI), Energy and Commerce Health Subcommittee Ranking Member Gene Green (D-TX), and Ways and Means Health Subcommittee Ranking Member Jim McDermott (D-WA) today introduced the Medicare Affordability and Enrollment Act, which would improve Medicare coverage for all seniors and those with disabilities and modernize the enrollment system to help facilitate easier enrollment. Senate Finance Committee Ranking Member Ron Wyden (D-OR) introduced companion legislation in the Senate today.
The legislation seeks to make several key improvements to Medicare by establishing a maximum out-of-pocket spending cap for traditional Medicare, expanding access to premium and out-of-pocket payment assistance for low-income beneficiaries, and updating and improving the current Medicare enrollment process.
“As a growing number of Americans begin to enroll in Medicare, we have to make sure the program continues to meet their needs and provides affordable, high-quality health coverage,” said Pallone, Levin, Green and McDermott. “This bill would help simplify Medicare for seniors, make coverage more affordable for more Americans, and enable individuals with disabilities to obtain their coverage without a waiting period. Instead of privatizing Medicare—as suggested by Republicans—and destroying it for current and future generations, Democrats are committed to making sure the program works for all Americans who paid into it.”
With more than 85 percent of Medicare beneficiaries currently needing supplemental insurance to fully meet their healthcare needs, the four House Health leaders said Congress must improve the actual benefit that Medicare provides.
The bill would:
- Set a maximum out-of-pocket cap of $5,500 for medical services under traditional Medicare, which exists today for Medicare Advantage and most commercial insurance plans;
- Significantly expand the number of low-income beneficiaries eligible for financial assistance to cover premiums and out-of-pocket costs;
- Reduce cost-sharing for “near-poor” beneficiaries who are not eligible for any assistance today;
- Eliminate the arbitrary two-year waiting period for people with disabilities to enroll in Medicare;
- Modernize the Medicare enrollment system to facilitate easier enrollment, allow people to begin coverage earlier and reduce arbitrary late-enrollment penalties that today are paid for over a lifetime;
- Extend cost-sharing assistance for Part D enrollees for their prescription drugs in Puerto Rico, which is currently offered to all other eligible Medicare beneficiaries; and,
- Increase and extend permanent funding for low-income Medicare beneficiary outreach and education activities.
The bill has been endorsed by the following organizations: National Coalition on Aging, Medicare Rights Center, The Arc, AFSCME, Justice in Aging, Dialysis Patient Citizens, National Committee to Preserve Social Security and Medicare, Center for Medicare Advocacy, Families USA, and the National Consumer Voice for Quality Long Term Care.
A one-page summary is available here.
A section-by-section summary of the bill can be found here.
Legislative text of the bill can be found here.