Medicare Expansion and Lowering Costs Now Act
- Bill Number
- H.R. 7909
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-03-12: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-05-04T15:32:53Z
AI-Generated Summary
Purpose The legislation aims to expand access to Medicare coverage for individuals aged 50 to 64 through a voluntary buy-in option, stabilize the individual health insurance market, lower prescription drug costs in Medicare Part D, and enhance premium tax credits for lower-income households. It also seeks to address gaps in Medicare coverage and support market reforms without increasing federal expenditures.
Key Provisions
- Medicare Buy-In Option: Creates a new Section 1899D allowing individuals aged 50-64 (who would qualify for Medicare at 65) to enroll in Medicare Parts A, B, and D. Enrollment begins January 1 of the first year at least one year after enactment, with periods aligned to Affordable Care Act (ACA) Exchanges. Premiums are set at the national average per capita cost for benefits and administration, adjustable for geography and to prevent adverse selection.
- Financial Assistance: Provides premium tax credits and cost-sharing reductions similar to those under the ACA for eligible enrollees, funded by transfers to a new Medicare Buy-In Trust Fund.
- Medicare Direct Supplemental Insurance Option: Establishes a voluntary supplemental program (Section 1882A) to cover deductibles, copayments, and cost-sharing under Parts A and B, with a $100 annual deductible and community-rated premiums.
- Drug Price Negotiation: Repeals the noninterference provision in Part D, authorizing the Secretary of Health and Human Services to negotiate prices (including discounts) for covered drugs.
- Market Stabilization: Creates an Individual Market Reinsurance Fund to reimburse insurers for high-cost enrollees in qualified health plans (80% of costs above thresholds, with indexing). Reauthorizes ACA risk corridors through 2031.
- Other Measures: Integrates buy-in enrollees into Center for Medicare and Medicaid Innovation demonstrations; repeals certain reconciliation health provisions from Public Law 119-21; removes the 400% federal poverty level cap on ACA premium tax credits and adjusts applicable percentages on a sliding scale.
Significant Changes to Existing Law
- Amends Title XVIII of the Social Security Act to add Medicare buy-in eligibility and a supplemental insurance program.
- Modifies Section 1860D-11 to permit federal negotiation of Part D drug prices.
- Establishes new trust funds and reinsurance mechanisms outside standard appropriations.
- Amends Internal Revenue Code Section 36B to expand premium tax credit eligibility beyond 400% of the federal poverty level and revises applicable percentage tables.
- Updates Medigap standards to require acceptance of buy-in enrollees during transition periods.
Potential Impacts
- Government Agencies: Increases administrative responsibilities for the Centers for Medicare & Medicaid Services, including premium setting, enrollment coordination with Exchanges, drug negotiations, and oversight via a new Medicare Buy-In Oversight Board. Requires new reporting and feasibility studies.
- Citizens: Provides an additional coverage option for middle-aged adults, potentially lowering out-of-pocket costs through buy-in and supplemental coverage. Expands premium assistance and reinsurance to stabilize individual market premiums.
- International Relations: No direct effects identified.
Main Stakeholders Affected
- Individuals aged 50-64 seeking health coverage.
- Medicare beneficiaries and Part D enrollees.
- Health insurance issuers and qualified health plans in the individual market.
- Pharmaceutical manufacturers.
- State insurance regulators and Exchanges.
- Nonprofit organizations and states receiving outreach grants.
Notable Legal, Constitutional, or Political Implications
- Treats buy-in coverage as minimum essential coverage under the ACA and deems it equivalent to a silver-level qualified health plan for tax credit purposes.
- Prohibits states from shifting Medicaid beneficiaries aged 50-64 into Medicare buy-in.
- Requires public consultation and reporting, with potential for ongoing adjustments via the Oversight Board.
- The repeal of prior reconciliation provisions and drug negotiation authority may raise questions about congressional budget procedures and executive authority in health policy.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Krishnamoorthi, Raja [D-IL-8]
Recent Actions
- 2026-03-12: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-12: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-12: Introduced in House
- 2026-03-12: Introduced in House
Bill Versions
- Medicare Expansion and Lowering Costs Now Act — issued 2026-03-12 — PDF (35 pages)