Bill · S. 1776· Senate(119-S-1776)
Medicare Beneficiary Co-Pay Fairness Act
- Introduced
- 5/15/2025
- Last activity
- 5/15/2025 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Bill Cassidy
- Cosponsors
- - 0 - 1
- Introduced
- In Committee
What this bill would do
The Medicare Beneficiary Co-Pay Fairness Act aims to change the Social Security Act. It limits the coinsurance amount for certain facility services provided in ambulatory surgical centers. If the coinsurance for a surgical procedure exceeds the inpatient hospital deductible for the year, the Secretary must reduce the coinsurance to match that deductible. The Secretary will then pay the supplier the difference. These changes apply to services provided on or after January 1, 2026.
Yes· 3 of 12
Would people over 65 be better off under this?+8
Directly reduces out-of-pocket costs for Medicare beneficiaries, who are primarily seniors.
Would retired people be better off under this?+8
Most retirees are Medicare beneficiaries and will benefit from lower coinsurance costs.
Would households on low incomes be better off under this?+7
Capping coinsurance at the deductible significantly helps those with limited financial means.
The opposite
Does this reduce what the federal government owes?-2
The bill increases government spending by requiring the Secretary to pay the difference in coinsurance.
Does this reduce what the federal government spends?-2
The bill increases federal expenditures to cover Medicare coinsurance gaps.
Does this make the government pay for what it commits to?-2
Increased government spending on healthcare without a specified funding source.
Who it would affect, and how
Potential Positive Impacts for People
- Reduced Out-of-Pocket Costs: Under Section 2(a)(2), the coinsurance amount for certain services in an ambulatory surgical center is limited to the amount of the inpatient hospital deductible. This prevents beneficiaries from paying coinsurance amounts that exceed that deductible.
Potential Negative Impacts for People
- No negative impacts for people are explicitly mentioned in the provided text.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Retirees+8Good For Seniors+8Good For Low Income Households+7Good For Middle Class Households+5Good For People With Disabilities+3Good For High Income Households+2
- Healthcare
- Improves Healthcare Access+5Increases Medicare Funding+5
- Social Issues And Justice
- Improves Social Security+5Improves Poverty Reduction+3
- Governance And Ideology
- Increases Federal Power+2
- Economy And Finance
- Improves Consumer Protection+5Improves Fiscal Responsibility-2Reduces Government Spending-2Reduces National Debt-2
- 5/15/2025
- Read twice and referred to the Committee on Finance.
- 1 Cosponsor added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Richard BlumenthalDemocrat · Connecticut