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Requires that most people who enroll in Medicare Part B and are entitled to Part A must be offered Medigap (Medicare supplemental) policies on a guaranteed-issue basis without pricing or benefit limits based on health status, preexisting conditions, or genetic information. It also raises insurer transparency, asks the NAIC to update Medigap standards (including limits on age- and area-based pricing), adjusts medical loss ratio floor-setting to incorporate NAIC recommendations, strengthens broker/agent payment reporting, and directs CMS to improve the Medicare Plan Finder site for clearer, comparable information. Key changes take effect for Medigap policies effective on or after January 1, 2026 (with phased implementation allowed through January 1, 2031); some reporting and website actions start within 12 months or upon enactment as specified.
The bill expands guaranteed access, richer supplemental options, and consumer transparency for Medigap—improving affordability predictability and choice for many Medicare enrollees—while increasing the risk of higher premiums, greater federal spending, administrative burdens, and uneven benefits across cohorts and local markets.
Medicare beneficiaries (people with Part A enrolled in Part B) will be guaranteed access to Medigap policies without medical underwriting, preventing denials or exclusions for preexisting conditions and reducing barriers to obtaining supplemental coverage.
People with Medicare will be able to buy/restored first-dollar Medigap coverage (broader benefits that pay initial cost-sharing), lowering out-of-pocket spending and making medical costs more predictable for beneficiaries who want comprehensive supplemental insurance.
Medicare beneficiaries will get clearer, comparable plan and Medigap information (Plan Finder enhancements and guaranteed-issue notices online) to better compare networks, premiums, inflation trends, and issuer financial stability when choosing Part A/B/MA/Part D and supplemental plans.
Many Medicare beneficiaries could face higher Medigap premiums as insurers spread the costs of broader guaranteed issue and first-dollar coverage across enrollees or pass on new compliance costs.
Restoring more generous Medigap benefits and easier access could increase Medicare program use and overall federal spending (or shift costs to taxpayers) if utilization rises as out-of-pocket barriers fall.
Restrictions on age- and area-based pricing and other pricing limits could reduce insurer participation in some local markets, narrowing plan choices for beneficiaries—particularly in rural or thin markets.
Introduced January 22, 2025 by Lloyd Alton Doggett · Last progress January 22, 2025