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Creates a permanent Medicare Part B special enrollment for COBRA enrollees (COBRA starting 1/1/2026), adjusts Part B start and premium-credit rules, and bars COBRA termination solely for Part B eligibility prior to enrollment.
Official title: To amend part B of title XVIII of the Social Security Act to provide for a special enrollment period under Medicare for individuals enrolled in COBRA continuation coverage, and for other purposes.
Introduced April 8, 2025 by Lloyd K. Smucker · Last progress April 8, 2025
The bill improves and clarifies Medicare Part B enrollment and premium treatment for COBRA enrollees—reducing coverage gaps and protecting premium credits—while creating a one-time-use limit on the special enrollment opportunity and imposing administrative and potential cost burdens on employers and plan administrators.
Medicare-eligible people enrolled in COBRA can enroll in Medicare Part B during any month of COBRA coverage and for 3 months after, with Part B coverage starting the first day of the month after enrollment, reducing coverage gaps and improving timely access to care.
Enrollees can exclude months they demonstrate COBRA enrollment from Part B premium-reduction calculations, which helps preserve premium credits and can lower out-of-pocket Part B premiums—especially benefiting low-income beneficiaries.
COBRA enrollees retain continuation benefits even if they are eligible for but not yet enrolled in Part B, preventing plans from cutting or terminating coverage solely due to Medicare eligibility.
Limiting the COBRA-based special enrollment period to one lifetime use could leave future Medicare-eligible COBRA enrollees without the same enrollment flexibility if their circumstances change.
Plans and employers will face added administrative tracking and liabilities (tracking COBRA months, adjusting premium calculations, and preserving COBRA benefits until Part B enrollment), increasing administrative costs that may be passed on as higher premiums, reduced benefits, or added burdens for small employers and employees.
Requiring revised COBRA notices by Jan 1, 2026 creates a near-term compliance deadline that imposes short-term administrative burden on plan administrators and Labor/HHS.
Based on analysis of 2 sections of legislative text.
Creates a permanent Medicare Part B special enrollment period for people enrolled in COBRA continuation coverage starting January 1, 2026, allowing enrollment while on COBRA or within three months after COBRA ends (one lifetime use). It also changes Part B effective-date rules and premium credit calculations for these enrollees, bars COBRA plans from ending or reducing benefits solely because someone is eligible for but not yet enrolled in Part B, and requires updated COBRA notices explaining Medicare secondary payer rules by January 1, 2026.