Bill · S. 2793· Senate(119-S-2793)
Ensuring Access to Essential Providers Act of 2025
- Introduced
- 9/11/2025
- Last activity
- 9/11/2025 — 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 Ensuring Access to Essential Providers Act of 2025 seeks to amend the Social Security Act regarding Medicare Advantage plans. The bill would require these plans to meet an "essential community provider standard." This standard involves including a specific number of essential community providers within a plan's service area. It also mandates that these plans offer contracts to such providers and ensure reasonable and timely access for specific groups. Furthermore, the bill establishes specific payment requirements for Federally qualified health centers.
Yes· 3 of 10
Would households on low incomes be better off under this?+6
The bill mandates that Medicare Advantage plans provide reasonable and timely access to essential community providers for low-income individuals.
Does this make health care easier to get in general?+6
The bill requires Medicare Advantage plans to ensure reasonable and timely access to essential community providers for low-income individuals and those in health professional shortage areas.
Would people over 65 be better off under this?+5
The bill improves access to essential community providers for seniors enrolled in Medicare Advantage plans.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Improved access for vulnerable groups: The bill requires Medicare Advantage organizations to ensure that low-income individuals, people in rural areas, and those in health professional shortage areas have reasonable and timely access to a broad range of essential community providers (Section 2, paragraph 7(A)(ii)).
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Support for essential medical facilities: The bill defines "essential community providers" to include several types of facilities that serve low-income and medically underserved populations, such as Federally qualified health centers, Indian Health Service facilities, and mental health or substance use treatment facilities (Section 2, paragraph 7(E)).
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Guaranteed payment standards: The bill requires Medicare Advantage organizations to pay Federally qualified health centers an amount consistent with specific statutory requirements (Section 2, paragraph 7(C)).
Potential Negative Impacts for People
- Lack of specific coverage guarantees: The bill explicitly states that nothing in the new standard should be construed to require a Medicare Advantage plan to provide coverage for any specific medical procedure (Section 2, paragraph 7(D)).
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 Low Income Households+6Good For Native Americans+5Good For Rural Residents+5Good For Seniors+5
- Healthcare
- Improves Healthcare Access+6Improves Mental Health Access+5Improves Opioid Crisis Response+4Increases Medicare Funding+3
- Social Issues And Justice
- Improves Racial Equity+3Improves Poverty Reduction+2
- 9/11/2025
- Read twice and referred to the Committee on Finance.
- 1 Cosponsor added.
- Introduced in Senate
Ben LujánDemocrat · New Mexico