Medicare-X Choice Act of 2021
1/11/2023, 1:47 PMSummary of Bill HR 1227
The Medicare-X Choice Act of 2021, also known as Bill 117 hr 1227, is a piece of legislation introduced in the US Congress. The main goal of this bill is to create a public option for health insurance that would be available through the Medicare program. This public option, known as Medicare-X, would be offered alongside private insurance plans on the health insurance marketplace.Under the Medicare-X Choice Act, individuals and families would have the option to purchase a Medicare-X plan that would provide comprehensive coverage for essential health benefits. This plan would be administered by the federal government and would be available to individuals of all ages, not just those who are eligible for Medicare due to age or disability.
One of the key features of the Medicare-X plan is that it would be designed to be affordable for all Americans. The bill includes provisions to ensure that premiums are affordable and that cost-sharing is limited for low-income individuals and families. Additionally, the bill includes measures to increase access to care in underserved areas and to improve the quality of care provided under the Medicare-X plan. Overall, the Medicare-X Choice Act of 2021 aims to increase competition in the health insurance marketplace, lower costs for consumers, and expand access to quality healthcare for all Americans. The bill is currently being debated in Congress, and its future remains uncertain.
Congressional Summary of HR 1227
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.
