A bunch of 13 Democratic Home Representatives introduced a bundle of eight payments final week that may crack down on Medicare Benefit and strengthen conventional Medicare.
The bundle was launched by Mark Pocan (D-Wisconsin) and cosponsored by Andre Carson (D-Indiana), Steve Cohen (D-Tennessee), Rosa DeLauro (D-Connecticut), Lloyd Doggett (D-Texas), Pramila Jayapal (D-Washington), Ro Khanna (D-California), Eleanor Holmes Norton (D-D.C.), Alexandria Ocasio-Cortez (D-New York), Jan Schakowsky (D-Illinois), Mark Takano (D-California), Shri Thanedar (D-Michigan) and Rashida Tlaib (D-Michigan).
The payments fall underneath three classes:
1. Delays and denials of care
- Denials Don’t Pay Act: Disincentivizes MA plans from delaying and denying care by means of prior authorization necessities
- Proper to Attraction Affected person Insurance coverage Denials Act: Helps sufferers obtain wanted care by routinely interesting denials
- Disclose Your Denials Act: Requires MA plans to reveal their delay and denial charges when promoting
2. Overcharging taxpayers
- Medicare Benefit Fraud Accountability Act: Bans corporations from taking part in MA in the event that they’ve been convicted of defrauding the federal government
- Hold Medicare Prices Down Act: Requires MA plans to cost the federal government per beneficiary as a lot as or lower than conventional Medicare
- Seniors’ Alternative and Readability Act: Limits the variety of plans that MA corporations can present to only three a 12 months
3. Strengthening conventional Medicare
- Defending Medicare Alternative Act: Prevents Medicare Benefit from being set because the default possibility for seniors, which was proposed in Venture 2025
- Discover My Physician Act: Requires CMS to create a nationwide web site that permits folks to seek for docs by plan
“Solely Medicare is Medicare. It is likely one of the hottest and essential companies our authorities gives,” Pocan stated in an announcement. “However for too lengthy, non-public healthcare corporations benefiting from Medicare’s model and recognition have tricked and wronged seniors. This bundle of commonsense, pro-patient reforms will deliver better accountability, transparency, and affordability to Medicare Benefit, whereas strengthening conventional Medicare and defending affected person alternative. This bundle represents a powerful step ahead to guard seniors, save taxpayer {dollars}, and restore integrity to the Medicare program.”
The payments are endorsed by a number of organizations, together with the Heart for Well being and Democracy, Simply Care USA, Labor Marketing campaign for Single Payer, Physicians for a Nationwide Well being Program, Public Citizen and Social Safety Works.
Based on JustCare, a crackdown on Medicare Benefit is overdue.
“Medicare Benefit insurers revenue from withholding medically crucial care, and might withhold care with close to impunity. So, folks enrolling in company MA plans are pressured to gamble with their well being and with their lives. They’ll’t keep away from the dangerous actors. It’s time Congress protected older Individuals and other people with disabilities from dangerous actor Medicare Benefit insurers, as Congressman Pocan’s MA Invoice bundle would do,” stated Diane Archer, president and founding father of JustCare.
Photograph: designer491, Getty Photographs
