Medicare Update: Lawmakers Introduce Bill to Expand Health Care Program

Newsweek

8 hours ago

Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.
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Lawmakers on Capitol Hill have reintroduced the Choose Medicare Act, a proposal that would allow individuals and employers to voluntarily enroll in a new, expanded version of Medicare.
Democratic Representatives Jimmy Gomez of California and Don Beyer of Virginia led the unveiling of the new version of the bill in the House on Tuesday, while Democratic Senators Jeff Merkley of Oregon and Chris Murphy of Connecticut introduced companion legislation in the Senate last week.
The proposed legislation would establish "Part E," a self-funded Medicare plan to be offered alongside private insurance in all state and federal marketplaces, giving Americans and businesses a public option for comprehensive health coverage.
Why It Matters
The move to expand Medicare comes as millions of Americans remain uninsured or face financial instability due to high medical costs.
While current Medicare eligibility is primarily for individuals aged 65 and older or those with certain disabilities who are younger, the Choose Medicare Act aims to provide a voluntary public insurance option to anyone, regardless of age or employment status.
What To Know
Medicare "Part E" would be self-sustaining, funded entirely by premiums, and available through all existing state and federal health exchanges.
According to the legislation's sponsors, all employers could choose to offer Medicare Part E as a workplace benefit, in addition to, rather than as a replacement for, existing insurance plans.
Individuals not covered by employer insurance could also opt in directly. Part E would provide all of Medicare's traditional benefits, incorporate the Affordable Care Act's ten essential health benefits, guarantee access to reproductive health services (including abortion), and protect patients with pre-existing conditions from discrimination.
The legislation caps annual out-of-pocket spending for traditional Medicare recipients, expands premium assistance eligibility without income limitations, and allows existing Affordable Care Act subsidies to be applied to Medicare Part E premiums.
Medicare would be required to negotiate drug prices under Part E, a measure intended to lower prescription costs for all enrollees.
Representative Jimmy Gomez speaks at a rally outside the U.S. Capitol on April 10, 2025.
Representative Jimmy Gomez speaks at a rally outside the U.S. Capitol on April 10, 2025.for Fair Share America
The bill is co-sponsored by Democratic Senators Tammy Baldwin (WI), Richard Blumenthal (CT), Cory Booker (NJ), Tammy Duckworth (IL), Jack Reed (RI), Brian Schatz (HI), Tina Smith (MN), Kirsten Gillibrand (NY), and Dick Durbin (IL), as well as Representatives Jared Huffman (CA), LaMonica McIver (NJ), and Eleanor Holmes Norton (DC).
Public support has come from groups including Families USA, MoveOn, the American Federation of Teachers, the Center for Medicare Advocacy, and the Center for Health and Democracy.
However, some have concerns that the legislation overly romanticizes Medicare, which has widespread issues, still, according to Chris Fong, the CEO of Smile Insurance and a Medicare specialist.
"The members of the House and Senate who are proposing the legislation are not considering the inefficiencies of Medicare. They seem to be romanticizing Medicare to be the perfect system, which it is not," Fong told Newsweek.
Medicare, on its own, is an 80/20 insurance plan, where members are responsible for about 20 percent, plus deductibles, with no maximum out-of-pocket protection, Fong said. And Medicare also does not cover prescription drugs, which must be covered under an additional private insurance policy.
"If something like this were to pass, it would be a very dramatic change to the health insurance of all Americans," Fong said. "It has many positives, but I think the path to passing legislation like this has many challenges and it would be unlikely for this to pass."
On the other side of the political aisle, Republicans have pushed for $2 trillion in mandatory spending reductions. For both Medicaid and Medicare, that could translate to major cuts, although Republicans have been vocal about not actively reducing benefits.
"The president has said, for example, that he doesn't want to touch Medicare and Medicaid...He's saying don't cut benefits to beneficiaries," Louisiana Senator Bill Cassidy told CNBC in April.
"Let's look at Medicare. Is there some way that we can...reform Medicare so that benefits stay the same? But that is less expensive, more efficient, I would say that there is, and that's where our opportunity lies," Cassidy said.
What People Are Saying
Representative Jimmy Gomez, in a statement: "I got pneumonia when I was seven years old, and my family almost went bankrupt because we were uninsured. Today too many families are still one medical emergency away from financial crisis. Our bicameral legislation lets every American opt into Medicare — which is affordable, effective, and trusted — and we're going to keep fighting until everyone has access to the care they need."
Representative Don Beyer, in a statement: "Our bill would give all Americans access to Medicare, one of the most popular and successful health care delivery programs in history. Allowing employers and the general public the option to choose Medicare would fill many of the gaps in our health care system, get more people covered, and make the nation healthier. Every American should be able to access affordable, quality health care, and this bill represents the kind of bold action required to make that a reality for all."
Chris Fong, the CEO of Smile Insurance and a Medicare specialist, told Newsweek: "An expansion of Medicare with Part E could increase the concerns over the long-term financial sustainability of the Medicare program. The Medicare Hospital Insurance trust fund is projected to be depleted by 2036. If Part E were to be approved, then there would need to be additional funding to maintain the current Medicare benefits."
Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, told Newsweek: "The proposal made in the bill isn't far removed from similar calls for Medicare for all in the past. It would expand Medicare to being an option for all Americans and would allow it to be offered by online marketplaces and through employers as an option.
"While the bill may have a hard time gaining traction under current leadership, it is important to note some medical facilities have actually been more supportive of these measures than you would think.
"With private insurers becoming harder in some situations to get reimbursement from, some hospitals and clinics would rather work with Medicare as they know the odds are higher of getting paid."
What Happens Next
The Choose Medicare Act faces consideration in both chambers of Congress, with further debate and potential amendments expected in committee before any possible floor votes.
Lawmakers have not announced a date for further action. However, the legislation is unlikely to move forward in the near term, as Republicans control both chambers of Congress.
"I think this is still in its early stages of the legislative process," Fong said. "The bill still needs a lot more work to determine feasibility. Also, there would need to be significant increases in federal tax revenue or reappropriation from other federal allocations. I would say this is an interesting development but there is still a lot of work to be done."