HR-7909 — Medicare Expansion and Lowering Costs Now Act

YourVoice.Now Summary

Your MoneyCorporate BenefitsTransparency & Accountability

Lets people 50 to 64 pay to join Medicare early — and ends the Medicaid work requirement passed in 2025.

Your Money

Medicare buy-in opens at age 50 — coverage starts a year after enactment

People ages 50 to 64 who would qualify for Medicare at 65 could pay to join early. They would get the same Part A, Part B, and Part D benefits as older enrollees.

Help paying buy-in premiums — same aid as marketplace plans give

Buy-in enrollees would get help with premiums and copays based on their income. The money would equal the marketplace tax credit they would have received instead.

Marketplace subsidies above 400% of poverty — start in tax year 2027

Current law cuts off the premium tax credit above 400% of the poverty line. The bill would remove that cutoff and cap what those households pay at 8.5% of income.

New Medicare plan covering copays — $100 yearly deductible

Medicare would sell its own supplement plan, with benefits starting in January 2028. It would cover Part A and Part B deductibles and copays, with no health questions asked.

Late-joiner penalty on the new plan — 10% per year skipped

If you skip your first chance to enroll, the monthly premium would rise 10% for every year you waited. The increase stops at double the normal premium.

Medicaid coverage without work hours — 2025 work rule repealed

The 2025 reconciliation law ties Medicaid for many adults in the expansion group to 80 hours a month of work or similar activity. The bill would repeal that law's health provisions, so the rule would end.

Prices Medicare pays for drugs — negotiated with drugmakers from 2029

Medicare would have to bargain with drugmakers over Part D prices for 2029 and later. Plans could still get lower prices on their own.

Corporate Benefits

Insurer payments for costly patients — 80% of the biggest claims

A federal fund would repay insurers 80% of one person's claims above a set dollar amount, up to a cap. Plans that take part would pay a fee into the fund.

Government payments for insurer losses — cover 2028 through 2031

The bill would restart an ACA program that shares insurers' marketplace gains and losses with the government. It would run four years and then stop.

Drugmakers' protection from price talks — ends for 2029 and later

Current law bars Medicare from negotiating drug prices with manufacturers. The bill would strike that ban for plan years starting January 1, 2029.

Transparency & Accountability

Reports on drug price talks — due twice a year from 2029

Medicare would have to tell Congress which prices and discounts it won. The first report would be due June 1, 2029.

More about this bill

If you are 50 to 64 and not yet on Medicare, you could pay to join it early. Coverage would start the January at least a year after the bill becomes law. Your premium would be set to cover the average cost of Medicare benefits. Lower-income buyers would get the same help they would get on a marketplace plan. People already on Medicaid could not switch into this new option. If you already have Medicare, two things would change. A new government plan would pay your deductibles and copays after a $100 yearly deductible. Sign-up would open in late 2027, with benefits starting in January 2028. Waiting to join would raise that premium by 10% for each year you skip. Medicare would also bargain with drugmakers over Part D prices for 2029 and later. Today a ban blocks those talks. Marketplace subsidies would no longer cut off above 400% of the poverty line. Starting in tax year 2027, a sliding scale would cap premiums at 8.5% of income. The bill would also repeal the health provisions of the 2025 reconciliation law. Those include a rule that ties Medicaid for some adults to 80 hours a month of work. Insurers would get federal money for their costliest patients. A gain-and-loss sharing program would return for 2028 through 2031.

Congressional Summary

Medicare Expansion and Lowering Costs Now Act This bill establishes a Medicare buy-in option for certain qualifying individuals and makes a series of other changes relating to health care costs. It also repeals the health provisions that were enacted under what is commonly known as the One Big Beautiful Bill Act. Specifically, the bill allows individuals aged 50 to 64 to enroll in Medicare if such individuals would otherwise qualify for Medicare at the age of 65. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations for outreach and enrollment activities relating to the buy-in option. Additionally, the bill repeals the health provisions that were enacted under what is commonly known as the One Big Beautiful Bill Act. Among other provisions, the act required individuals who are eligible for Medicaid as part of the Medicaid expansion population to engage in community service, work, or other activities in order to qualify for Medicaid. (For more information about these and other health provisions in the act, see CRS Report R48633.) The bill also (1) establishes a supplemental option under Medicare to cover cost-sharing for beneficiaries; (2) establishes an individual market reinsurance program relating to coverage of high-cost individuals, as specified; and (3) expands eligibility for the premium tax credit.

Details

Congress: 119th
Chamber: House
Status: summarized
Action: Introduced in House
Action Date: 2026-03-12
Date Added: 2026-05-05
Source: Congress.gov →

Like reading a bill in plain English?

We're building an app that does this for every bill in Congress and lets you tell your reps how you want them to vote. We're a small team getting ready to launch, and we're trying to show investors that real people want this. Be one of them. Help us get it built. Leave your email and we'll tell you the moment the app is ready.