Sponsors (17)
The bill protects Medicare beneficiaries' choice by blocking automatic MA enrollments, at the cost of reducing administrative flexibility and potentially affecting MA enrollment rates and provider/insurer financial planning.
Medicare beneficiaries retain control over their plan enrollment: the bill prevents automatic enrollment into Medicare Advantage (MA) plans without a valid individual election, protecting beneficiaries from unintended plan changes.
Medicare beneficiaries and state governments may face slower or more burdensome enrollment processes: restricting automatic MA enrollments could reduce HHS's ability to streamline enrollments, increasing paperwork or delays for beneficiaries and agencies.
Hospitals and health systems could see altered patient mixes and financial impacts: limiting automatic MA enrollment may reduce MA plan enrollment rates, affecting insurers' risk pools and providers' enrollment projections/revenues.
Based on analysis of 2 sections of legislative text.
Restricts use of prior-appropriated HHS funds this fiscal year to treat certain Part A/B beneficiaries as having elected Medicare Advantage when they have not, except as already allowed by statute.
Official title: To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program.
Introduced November 18, 2025 by Mark Pocan · Last progress November 18, 2025
Stops the Department of Health and Human Services from using funds already appropriated this fiscal year to treat a traditional Medicare beneficiary (Part A eligible and enrolled in Part B) as if they had elected a Medicare Advantage (Part C) plan when the beneficiary did not make the specific election described in current law, except where an existing statutory exception already allows it. The restriction applies only to funds made available by prior appropriations acts for obligation or expenditure in the current fiscal year and overrides other laws to the extent necessary.