Bennet, Kaine Announce Introduction of Medicare-X Choice Act to Achieve Universal Health Care Updated Proposal WouldFebrary17,Help2021 Millions of Americans Access Affordable Coverage and Reduce Health Care Costs Amid COVID- 19 Pandemic Denver – Today, U.S. Senators Michael Bennet (D-Colo.) and Tim Kaine (D-Va.) announced the reintroduction of their legislation, the Medicare-X Choice Act, which would create a public option by expanding on the Affordable Care Act (ACA) and Medicare. The Medicare Exchange (Medicare-X) plan would offer families, individuals, and small businesses low-cost health insurance, decrease the number of uninsured Americans, control the cost of health care, and increase competition in the health insurance market. The Coronavirus Disease 2019 (COVID-19) pandemic has underscored the need to expand access to high-quality and affordable coverage. Bennet and Kaine’s bill would help achieve universal health care by making coverage more affordable and accessible. The bill also updates previously introduced versions.  “The Affordable Care Act dramatically improved coverage and affordability for health care in America,” said Bennet. “As we continue to face a devastating pandemic where millions of Americans are uninsured or underinsured, we are committed to working with the Biden Administration to strengthen the ACA. Medicare-X is the best way to cover everyone, reduce health costs, and improve the quality of health insurance for all Americans, including those who’ve historically suffered the most from poor access to quality coverage and care. We have a responsibility to create the best health care system possible and achieve universal coverage in our country. We can do that through Medicare-X.” “With massive job losses, exacerbated health disparities, and increasing health care costs, the COVID-19 pandemic has further reinforced the urgent need for us to expand access to quality, affordable care,” said Kaine. “At a time when health care is a top concern for so many people, we must pass this legislation to offer more Americans, particularly in rural communities, more quality, affordable health care choices and help people get the care they need.”  The ACA expanded health insurance coverage to an additional 20 million Americans, established critical protections for patients with pre-existing conditions, and standardized essential health benefits for all qualified health plans. However, many Americans still face high health care costs and limited options for affordable health insurance. Currently, 10% of counties still have only a single insurer offering health insurance in 2021.  The bill would work within the Medicare framework to establish a Medicare Exchange public option plan in every county in America for individuals and small businesses, providing an additional, affordable option in all communities. It would also build on the ACA and expand premium and cost - sharing support to make all exchange options even more affordable for the uninsured.  Under Medicare-X, the public option would initially be available on the individual exchange in areas where there is a shortage of insurers or higher health care costs due to less competition—including rural communities in Colorado and Virginia. By 2025, the Medicare Exchange plan would expand to every ZIP code in the country and be added as another option on the Small Business Health Options Program Marketplace.  Medicare-X would expand Medicare’s network of doctors and providers and guarantee the essential health benefits established in the ACA, such as maternity care and mental health services. Medicare Exchange plans would expand benefits and provide all primary care services without cost-sharing requirements for plan holders. Additionally, it would ensure access to affordable prescription drugs by empowering the Secretary of Health and Human Services to negotiate drug prices for Medicare Exchange plans and the Medicare Part D program. The legislation includes several updates to make coverage affordable for more Americans: To better support rural hospitals and providers and increase access to health care for Americans living in rural communities, the proposal would allow for payment adjustments of up to 150% of Medicare fee-for-service rates. Previously, the bill allowed for payment adjustments in rural areas up to 125%.On top of the essential health benefits required for qualified health plans under the ACA, Medicare Exchange plans would expand on those benefits and provide primary care services with no cost-sharing for plan holders.The bill provides a larger tax premium subsidy for Americans living below 400% of the Federal Poverty Level (FPL). This would help low-income Americans access coverage by making premiums more affordable, including no premiums for those living at and below 150% of the FPL.Families earning more than 400% of the FPL would be eligible for the ACA tax credit, helping more middle-income Americans afford quality health insurance. This proposal expands eligibility for the ACA’s premium tax credit to families above 400% of the FPL and makes the tax credits even more generous than in the previous iteration of the bill.This proposal now fixes a glitch in the ACA that prevents family members of people who are insured through the health care exchange from receiving a tax credit. This could expand coverage to 2 to 6 million more Americans.This legislation would direct the Centers for Medicare and Medicaid Services to study the impact of covering services such as long-term services and support; home- and community-based services; assistive and enabling technologies; and vision, hearing, and dental services. The study would examine the effects on benefits and the costs to beneficiaries. It would also review the implications in the health market and provide recommendations to Congress on potential inclusion of these benefits under Medicare plans.This plan would help drive down costs across the entire health care industry by providing additional resources to the Department of Justice and the Federal Trade Commission to take appropriate antitrust enforcement actions and address the root causes of consolidation in the health care market.         The Medicare-X Choice Act of 2021 U.S. Senators Michael Bennet (D-Colo.) and Tim Kaine (D-Va.) The Affordable Care Act (ACA) expanded health insurance coverage to an additional 20 million Americans, established critical protections for patients with pre-existing conditions, and standardized essential health benefits for all qualified health plans. Many Americans still face high health care costs and limited options for affordable health insurance. The Medicare-X Choice Act builds on the Medicare framework by establishing the Medicare Exchange (Medicare-X) Health Plan, a public option for uninsured individuals, families, and small businesses. Establishment and Plan Availability. Initially, the Secretary of Health and Human Services (HHS) will make the Medicare-X plan available in areas with one or no options on the Federal- or State-based individual exchanges. Over four years, the plan would expand, starting in areas with high-cost plans and those with fewer plans offered, including health professional shortage areas and rural areas, to all rating areas and the Small Business Health Options Program Marketplace. The secretary can utilize contracts that currently help administer Medicare or contract with new entities to process claims or administer additional components of the plan. Benefits and Plan Requirements. The plan would cover essential health benefits like other qualified health plans (QHP), including maternity and newborn care, pediatric services, and mental and behavioral health care. The plans would cover primary care services without cost-sharing, a more robust benefit on top of QHP requirements. The bill directs the HHS Secretary to create options in the silver and gold tiers with flexibility to add bronze and platinum options. The secretary will gather data from State Insurance Commissioners and other entities—including on racial and ethnic health disparities—in order to set adequate premiums and help improve the quality of health plans. Improving Premium Tax Credits and Affordability. The bill would extend eligibility for the premium tax credit to those at and above 400% of the Federal Poverty Level (FPL), limiting how much these individuals pay to 8.5% of their income. For Americans below 400% of the FPL, the legislation would reduce the percentage of income an individual is expected to contribute toward a plan. Fixing the Family Glitch. Currently, eligibility for tax credits is determined not only by income, but also considers whether a person or anyone in their family has access to “affordable” employer-sponsored insurance, among other factors. If any member of a family does have such access, the whole family is barred from receiving tax credits to purchase an ACA plan. This is known as the “family glitch.” What constitutes “affordable” employer-sponsored coverage for an employee and their family is based on the cost of individual-only coverage rather than the cost of family or spousal coverage, which can be more expensive. The bill fixes that glitch by recognizing that the cost of a family plan should be used when determining “affordability” for an employee with a family, rather than the cost of individual only coverage. As a result, 2 to 6 million more Americans may be eligible for tax credits. Reinsurance. The bill authorizes three years of funding for a national reinsurance program at $10 billion per year to help cover the cost of high-cost patients, keeping premiums lower for all Medicare-X and other marketplace plan holders. Provider Network and Reimbursement Rates. Providers who participate in Medicare and/or Medicaid must also accept Medicare-X plan patients and must serve plan holders on similar terms and conditions as any other Federal or State health plan holder. Providers may opt out only in exceptional circumstances. The HHS Secretary may enroll additional providers, such as pediatricians and OB/GYNs. The plan will reimburse providers at 100% of Medicare fee-for-service (FFS) rates, with flexibility for the secretary to reimburse up to 150% of Medicare rates for hospitals and physicians located in rural areas. Prescription Drug Negotiation. The bill gives the HHS Secretary authority to negotiate drug prices under the Medicare-X plan and Medicare Part D. The secretary may utilize value-based payment arrangements for prescription drugs. Delivery System Reform for an Enhanced Health Plan. The HHS Secretary may use outcomes-based alternative payment models that are aimed at improving care, improving quality, reducing cost, and addressing racial, ethnic, socioeconomic, geographic, gender, sexual identity, and other health disparities. Providers may use innovative technology, such as telehealth and remote patient monitoring, and integrate social services like food, housing, and transportation assistance. The bill additionally authorizes the secretary to establish a grant program that would allow for broader experimentation with accountable communities for health, in order to integrate social needs into the delivery of health care services. Covering Additional Services. The bill directs the Centers for Medicare and Medicaid Services to study the impact of and provide recommendations to Congress on covering services such as long-term services and support; home- and community-based services; assistive and enabling technologies; and vision, hearing, and dental services. The study would examine impacts on premiums, cost-sharing, and implications on the risk pool and individual and small group markets if such benefits were covered by the plan. Addressing Health Care Market Consolidation. The bill authorizes $50 million for the Department of Justice Antitrust Division and $100 million for the Federal Trade Commission for each of the following five years to investigate health care markets and anticompetitive practices and take appropriate enforcement action. It also requires the agencies to report to Congress on their progress. Protecting Traditional Medicare. The Medicare-X Choice Act would have no effect on benefits offered through Medicare FFS, Medicare Advantage, or the Medicare trust fund.

Bennet, Kaine Announce Bill Expanding Premium Tax Credit

Bennet, Kaine Announce Bill Expanding Premium Tax Credit

U.S. Senate

The Medicare-X Choice Act of 2021 would create a public health plan, including an expansion of the premium tax credit, to “cover everyone, reduce health costs, and improve the quality of health insurance for all Americans,” Senate Finance Committee member Michael F. Bennet, D-Colo. and Sen. Tim Kaine, D-Va., said in a February 17 release.

The Medicare-X Choice Act of 2021 would create a public health plan, including an expansion of the premium tax credit, to “cover everyone, reduce health costs, and improve the quality of health insurance for all Americans,” Senate Finance Committee member Michael F. Bennet, D-Colo. and Sen. Tim Kaine, D-Va., said in a February 17 release.

The <a href="/lr/resolve//2zdsq">Medicare-X Choice Act of 2021</a> would create a public health plan, including an expansion of the premium tax credit, to “cover everyone, reduce health costs, and improve the quality of health insurance for all Americans,” Senate Finance Committee member Michael F. Bennet, D-Colo. and Sen. Tim Kaine, D-Va., said in a February 17 release.