Medicare-X Choice Act of 2021

1/11/2023, 1:46 PM

Medicare-X Choice Act of 2021

This bill establishes and funds the Medicare Exchange health plan, which allows individuals who are not otherwise eligible for Medicare to enroll in a government-administered health insurance plan. The Centers for Medicare & Medicaid Services (CMS) must offer such plan in certain individual health insurance exchanges beginning plan year 2022 and offer it in all individual health insurance exchanges beginning plan year 2025. CMS must offer the plan in the small group market in all geographic areas for plan year 2025.

The plan must cover primary care services without cost sharing and meet the same requirements, including essential health benefits, as existing health insurance exchange plans.

Unless they opt out, health care providers enrolled under Medicare or under a state Medicaid plan must participate in the plan and are reimbursed at Medicare rates.

The bill establishes a grants program for community organizations, educational institutions, and health agencies to create service partnerships and establish interactive data systems for health care providers.

Additionally, the bill expands the premium tax credit available for plans purchased through an exchange and eliminates the restriction on the Department of Health and Human Services negotiating prescription drug prices for Medicare. 

Congress
117

Number
S - 386

Introduced on
2021-02-23

# Amendments
0

Sponsors
+5

Cosponsors
+5

Variations and Revisions

2/23/2021

Status of Legislation

Bill Introduced
Introduced to House
House to Vote
Introduced to Senate
Senate to Vote

Purpose and Summary

Medicare-X Choice Act of 2021

This bill establishes and funds the Medicare Exchange health plan, which allows individuals who are not otherwise eligible for Medicare to enroll in a government-administered health insurance plan. The Centers for Medicare & Medicaid Services (CMS) must offer such plan in certain individual health insurance exchanges beginning plan year 2022 and offer it in all individual health insurance exchanges beginning plan year 2025. CMS must offer the plan in the small group market in all geographic areas for plan year 2025.

The plan must cover primary care services without cost sharing and meet the same requirements, including essential health benefits, as existing health insurance exchange plans.

Unless they opt out, health care providers enrolled under Medicare or under a state Medicaid plan must participate in the plan and are reimbursed at Medicare rates.

The bill establishes a grants program for community organizations, educational institutions, and health agencies to create service partnerships and establish interactive data systems for health care providers.

Additionally, the bill expands the premium tax credit available for plans purchased through an exchange and eliminates the restriction on the Department of Health and Human Services negotiating prescription drug prices for Medicare. 

Alternative Names
Official Title as IntroducedA bill to establish a public health plan.

Policy Areas
Health

Potential Impact
Appropriations
Community life and organization
Competition and antitrust
Congressional oversight
Disability and health-based discrimination
Disability and paralysis
Employee benefits and pensions
Government studies and investigations
Government trust funds
Health care costs and insurance
Health care coverage and access
Health care quality
Health information and medical records
Health personnel
Health programs administration and funding
Health technology, devices, supplies
Higher education
Home and outpatient care
Income tax credits
Inflation and prices
Insurance industry and regulation
Long-term, rehabilitative, and terminal care
Medicaid
Medicare
Minority health
Poverty and welfare assistance
Prescription drugs
Public contracts and procurement
Rural conditions and development
Sex, gender, sexual orientation discrimination

Comments

Recent Activity

Latest Summary3/26/2021

Medicare-X Choice Act of 2021

This bill establishes and funds the Medicare Exchange health plan, which allows individuals who are not otherwise eligible for Medicare to enroll in a government-administered health ins...


Latest Action2/23/2021
Read twice and referred to the Committee on Finance.