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Advancing Enrollment and Reducing Drug Costs Act
To amend title XVIII of the Social Security Act to provide for the automatic qualification of certain Medicaid beneficiaries for premium and cost-sharing subsidies under part D of the Medicare program, and for other purposes.
Summary
This bill amends Medicare law to automatically qualify certain Medicaid beneficiaries for premium and cost-sharing subsidies under Medicare Part D (prescription drug coverage) when they turn 65, rather than requiring a separate application. The automatic qualification applies to individuals who are enrolled in Medicaid before age 65 and have income below 200 percent of the federal poverty line. These individuals would be treated as "subsidy eligible" for a limited period determined by the Secretary of Health and Human Services. The provision applies to Medicare plan years beginning on or after January 1, 2027.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Rep. Pappas, Chris [D-NH-1] (D-NH)
1 cosponsor
- Rep. Tonko, Paul [D-NY-20] (D-NY)
Actions (2)
- Mar 25, 2025 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. · house
- Mar 25, 2025 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Text versions (1)
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Full text
IN THE HOUSE OF REPRESENTATIVES
March 25, 2025
Mr. Pappas (for himself and Mr. Tonko) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to provide for the automatic qualification of certain Medicaid beneficiaries for premium and cost-sharing subsidies under part D of the Medicare program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Advancing Enrollment and Reducing Drug Costs Act”.
SEC. 2. AUTOMATIC QUALIFICATION OF CERTAIN MEDICAID BENEFICIARIES FOR PREMIUM AND COST-SHARING SUBSIDIES UNDER PART D OF THE MEDICARE PROGRAM.
(a) In General.—Clause (v) of section 1860D-14(a)(3)(B) of the Social Security Act (42 U.S.C. 1395w-114(a)(3)(B)) is amended—
(1) in subclause (I), by striking “and” at the end;
(2) in subclause (II), by striking the period and inserting “; and”; and
(3) by inserting after subclause (II) the following new subclause:
“(III) shall, notwithstanding the preceding clauses of this subparagraph, provide that any part D eligible individual not described in subclause
(I) or (II) who is enrolled, as of the day before the date on which such individual attains the age of 65, for medical assistance under a State plan under title XIX (or a waiver of such plan) pursuant to clause (i)(VIII) or
(ii)(XX) of section 1902(a)(10)(A), and who has income below 200 percent of the poverty line applicable to a family of the size involved, shall be treated as a subsidy eligible individual described in paragraph (1) for a limited period of time, as specified by the Secretary.”.
(b) Effective Date.—The amendments made by subsection (a) shall apply with respect to plan years beginning on or after January 1, 2027. <all>
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