Healthcare (Public Safety)

S 3145, the CARE Act of 2025, creates a new Medicare payment model for ground ambulance services provided during emergencies without patient transport. It directly affects Medicare beneficiaries who receive emergency medical dispatch services (like on-site care) and ambulance providers who serve them. The bill requires Medicare to pay for these non-transport services at rates aligned with traditional transport payments, while allowing telehealth services provided alongside them to count as originating sites. The model will operate for five years, with a mandatory report after four years evaluating its impact on beneficiary access, outcomes, and regional variations in emergency services.

Senate Bill 3221, the Expanding Health Care Options for First Responders Act, creates a Medicare buy-in program for retired or disabled first responders aged 50 to 64. Eligible individuals - including law enforcement officers, certain public safety employees, and federal firefighters - can enroll in Medicare Parts A, B, and D at a premium calculated based on average Medicare costs for this group. The coverage counts as "minimum essential coverage" under the Affordable Care Act, making enrollees eligible for premium tax credits and cost-sharing subsidies. The bill also establishes an oversight board and provides federal grants (2027-2029) to support outreach and enrollment for this specific population.