Medicare-X Proposal Would Allow all Americans to Purchase a Public Health Insurance Plan Through the Popular Medicare Program

WASHINGTON - Today, U.S. Representatives John B. Larson (CT-01), Antonio Delgado (NY-19), and Brian Higgins (NY-26) reintroduced the Medicare-X Choice Act, legislation to create a public option health plan available for purchase on the individual and small business exchanges. Senators Michael Bennet (CO) and Tim Kaine (VA) introduced the bill in the Senate. The bill would combine Medicare physician networks and reimbursement rates with Affordable Care Act (ACA) coverage standards to create a new, public health insurance option available to all Americans. The new Medicare exchange (Medicare-X) would increase competition in the health care market, driving down costs for all Americans amid the COVID-19 pandemic.

"By building on the successful framework of the Medicare system, Medicare X creates a public option for Americans," said Rep. John Larson. "This is a solution that is bold and achievable and will ensure that every American has access to high-quality, affordable health care."

"COVID-19 has made clear that we need universal health care," said Rep. Antonio Delgado. "Under the Medicare-X Choice Act, Americans could access more coverage at lower costs, while folks who are happy with their employer-provided insurance could keep it. 10% of United States counties still have only a single insurer offering health insurance as of 2021. Adding a public option will create competition within the marketplace and drive down premiums and deductibles. For too long, our health care system has failed to provide working families and small business owners with high-quality and affordable health care. I'm proud to lead this fight for universal health care."

"For nearly 56 years Medicare has proven to be an effective and efficient public option for Americans 65 and older," said Rep. Brian Higgins. "The Medicare-X Choice Act builds on the success of the Medicare program by making it available to more people while adding competition to the market toward the goal of lowering the cost-curve for consumers across the healthcare system."

The Medicare-X Choice Act:

* Provides more options for Americans of all ages, including children.

* Covers Essential Health Benefits like maternity, newborn care, and pediatric services.

* Allows for prescription drug negotiation through Medicare Part D.

* Expands access to premium tax credits to those beyond the 400% of the federal poverty line, the current threshold for premium assistance under the ACA.

* Supports rural hospitals and providers and increases access to health care for Americans living in rural communities by allowing for payment adjustments of up to 150% of Medicare fee-for-service rates.

* Corrects a glitch in the ACA, affecting 2 to 6 million, that prevents family members of people who are insured through the health care exchange from receiving a tax credit.

* Directs the Centers for Medicare and Medicaid Services (CMS) to study the impact of covering services such as long-term care services, home and community based services, and vision, hearing and dental.

* Expands on existing ACA standards by requiring coverage of primary care services without cost-sharing for patients.

Beginning in 2022, the Medicare-X plan will be available in rural areas of the country where there are only one or no health insurance providers on the exchange. The plan will also be available in counties where there is a shortage of health plan options, which have driven up costs and rendered prices simply unaffordable for Americans below the age of 65. By 2025, the Medicare Exchange plan would be available on the individual market and an option on the Small Business Health Options Program (SHOP) exchange.

Read this original document at: https://larson.house.gov/media-center/press-releases/reps-larson-delgado-and-higgins-reintroduce-bicameral-public-option-bill