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Close the Medigap Act of 2025

USA119th CongressHR-610| House 
| Updated: 1/22/2025
Lloyd Doggett

Lloyd Doggett

Democratic Representative

Texas

Cosponsors (43)
April McClain Delaney (Democratic)Nikema Williams (Democratic)Marcy Kaptur (Democratic)John Garamendi (Democratic)Sylvia R. Garcia (Democratic)Marc A. Veasey (Democratic)Julie Johnson (Democratic)Raúl M. Grijalva (Democratic)Mark Pocan (Democratic)Emanuel Cleaver (Democratic)Sanford D. Bishop (Democratic)Terri A. Sewell (Democratic)Dina Titus (Democratic)Debbie Dingell (Democratic)Steve Cohen (Democratic)Paul Tonko (Democratic)Delia C. Ramirez (Democratic)Rosa L. DeLauro (Democratic)Greg Casar (Democratic)Adriano Espaillat (Democratic)Ro Khanna (Democratic)Jasmine Crockett (Democratic)Henry C. "Hank" Johnson (Democratic)André Carson (Democratic)Stephen F. Lynch (Democratic)Sara Jacobs (Democratic)Jerrold Nadler (Democratic)Adelita S. Grijalva (Democratic)Mark Takano (Democratic)Pramila Jayapal (Democratic)Eleanor Holmes Norton (Democratic)Val T. Hoyle (Democratic)Brad Sherman (Democratic)Bonnie Watson Coleman (Democratic)Sean Casten (Democratic)Janice D. Schakowsky (Democratic)Alexandria Ocasio-Cortez (Democratic)Summer L. Lee (Democratic)Lizzie Fletcher (Democratic)Jesús G. "Chuy" García (Democratic)Kweisi Mfume (Democratic)Ayanna Pressley (Democratic)Judy Chu (Democratic)

Ways and Means Committee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This legislation introduces significant reforms to Medicare supplemental health insurance policies, aiming to enhance consumer protections and access. A core provision establishes a guaranteed issue right for all Medicare beneficiaries, prohibiting Medigap issuers from denying coverage, discriminating in pricing, or excluding benefits based on health status, claims experience, medical condition, or genetic information. This also eliminates pre-existing condition waiting periods, with these changes taking effect on or after January 1, 2026, and potentially phasing in until 2031. The bill further addresses pricing and coverage by requiring the Secretary to request the National Association of Insurance Commissioners (NAIC) to revise Medigap standards. These revised standards must prohibit pricing discrimination based on age or eligibility for Medicare due to disability or ESRD, and ensure premiums apply uniformly across a county. Additionally, it restores access to first-dollar Medigap coverage by repealing the prohibition on plans covering the Medicare Part B deductible. To increase transparency, the legislation mandates that Medigap policies, starting January 1, 2026, meet a medical loss ratio (MLR) that is at least as high as current thresholds and any NAIC recommendations. It also requires Medigap issuers to annually report payments and other transfers of value made to agents, brokers, and third parties, similar to existing transparency rules for drug manufacturers. Finally, the bill directs the Medicare plan finder website to provide more detailed information, including out-of-pocket costs, provider networks, and clear comparisons of Medigap options, alongside consumer testing and public comment opportunities.
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Timeline

Bill from Previous Congress

HR 118-35
Close the Medigap Act of 2023

Bill from Previous Congress

HR 117-4640
Close the Medigap Act of 2021
Jan 22, 2025
Introduced in House
Jan 22, 2025
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
  • Bill from Previous Congress

    HR 118-35
    Close the Medigap Act of 2023


  • Bill from Previous Congress

    HR 117-4640
    Close the Medigap Act of 2021


  • January 22, 2025
    Introduced in House


  • January 22, 2025
    Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.

Health

Government information and archivesHealth care costs and insuranceHealth care coverage and accessInsurance industry and regulationMedicaidMedicare

Close the Medigap Act of 2025

USA119th CongressHR-610| House 
| Updated: 1/22/2025
This legislation introduces significant reforms to Medicare supplemental health insurance policies, aiming to enhance consumer protections and access. A core provision establishes a guaranteed issue right for all Medicare beneficiaries, prohibiting Medigap issuers from denying coverage, discriminating in pricing, or excluding benefits based on health status, claims experience, medical condition, or genetic information. This also eliminates pre-existing condition waiting periods, with these changes taking effect on or after January 1, 2026, and potentially phasing in until 2031. The bill further addresses pricing and coverage by requiring the Secretary to request the National Association of Insurance Commissioners (NAIC) to revise Medigap standards. These revised standards must prohibit pricing discrimination based on age or eligibility for Medicare due to disability or ESRD, and ensure premiums apply uniformly across a county. Additionally, it restores access to first-dollar Medigap coverage by repealing the prohibition on plans covering the Medicare Part B deductible. To increase transparency, the legislation mandates that Medigap policies, starting January 1, 2026, meet a medical loss ratio (MLR) that is at least as high as current thresholds and any NAIC recommendations. It also requires Medigap issuers to annually report payments and other transfers of value made to agents, brokers, and third parties, similar to existing transparency rules for drug manufacturers. Finally, the bill directs the Medicare plan finder website to provide more detailed information, including out-of-pocket costs, provider networks, and clear comparisons of Medigap options, alongside consumer testing and public comment opportunities.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline

Bill from Previous Congress

HR 118-35
Close the Medigap Act of 2023

Bill from Previous Congress

HR 117-4640
Close the Medigap Act of 2021
Jan 22, 2025
Introduced in House
Jan 22, 2025
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
  • Bill from Previous Congress

    HR 118-35
    Close the Medigap Act of 2023


  • Bill from Previous Congress

    HR 117-4640
    Close the Medigap Act of 2021


  • January 22, 2025
    Introduced in House


  • January 22, 2025
    Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
Lloyd Doggett

Lloyd Doggett

Democratic Representative

Texas

Cosponsors (43)
April McClain Delaney (Democratic)Nikema Williams (Democratic)Marcy Kaptur (Democratic)John Garamendi (Democratic)Sylvia R. Garcia (Democratic)Marc A. Veasey (Democratic)Julie Johnson (Democratic)Raúl M. Grijalva (Democratic)Mark Pocan (Democratic)Emanuel Cleaver (Democratic)Sanford D. Bishop (Democratic)Terri A. Sewell (Democratic)Dina Titus (Democratic)Debbie Dingell (Democratic)Steve Cohen (Democratic)Paul Tonko (Democratic)Delia C. Ramirez (Democratic)Rosa L. DeLauro (Democratic)Greg Casar (Democratic)Adriano Espaillat (Democratic)Ro Khanna (Democratic)Jasmine Crockett (Democratic)Henry C. "Hank" Johnson (Democratic)André Carson (Democratic)Stephen F. Lynch (Democratic)Sara Jacobs (Democratic)Jerrold Nadler (Democratic)Adelita S. Grijalva (Democratic)Mark Takano (Democratic)Pramila Jayapal (Democratic)Eleanor Holmes Norton (Democratic)Val T. Hoyle (Democratic)Brad Sherman (Democratic)Bonnie Watson Coleman (Democratic)Sean Casten (Democratic)Janice D. Schakowsky (Democratic)Alexandria Ocasio-Cortez (Democratic)Summer L. Lee (Democratic)Lizzie Fletcher (Democratic)Jesús G. "Chuy" García (Democratic)Kweisi Mfume (Democratic)Ayanna Pressley (Democratic)Judy Chu (Democratic)

Ways and Means Committee, Energy and Commerce Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Government information and archivesHealth care costs and insuranceHealth care coverage and accessInsurance industry and regulationMedicaidMedicare