The Affordable Premiums for Seniors Act of 2026 extends a Medicare Part D premium stabilization program through 2029 and makes it permanent starting in 2030, provided that ending the program would not cause prescription drug premiums to rise. This legislation directly affects seniors enrolled in Medicare prescription drug plans by aiming to keep their costs stable over time. The bill requires the Secretary of Health and Human Services to issue updated operational guidelines for the program within 30 days of enactment.
The Hardworking Seniors Act would allow individuals who are eligible for Medicare Part A hospital insurance based on their age to contribute to Health Savings Accounts (HSAs). Currently, these individuals are generally prohibited from making HSA contributions once they become entitled to any form of Medicare. The bill modifies the Internal Revenue Code to exclude age-based Medicare Part A entitlement from the definition of conditions that disqualify a person from contributing to an HSA. This change would take effect for taxable months beginning after December 31, 2026.
This bill strengthens oversight of Medicare hospice programs and home health agencies to prevent fraud and ensure quality care. It requires more frequent inspections for newly enrolled or recently changed agencies and mandates stricter screening for applicants in high-risk areas, including fingerprinting and proof of insurance. The legislation also adjusts financial penalties for failing to submit quality data and requires accreditation organizations to meet higher training and survey standards. Additionally, the bill improves patient communication by mandating clearer notices when individuals enroll in hospice care and establishes a five-year reporting requirement to track enforcement actions against these providers.
Ensuring Access to Lower-Cost Medicines for Seniors Act This bill requires prescription drug plans under the Medicare prescription drug benefit to include generic drugs and biosimilars on their formularies. Specifically, the bill requires plans that use formularies to include generic drugs and biosimilars on the formularies and without any requirements (e.g., prior authorization requirements) that are more restrictive as compared to those for brand-name drugs and biologics. Plans that use cost-sharing tiers must also have specific tiers for generic drugs and biosimilars, in accordance with certain limitations.
This bill requires Medicare Part D prescription drug plans to include certain lower-cost generic drugs and biosimilar biological products in preferred positions on their formularies starting in 2027. It mandates that these lower-cost alternatives be placed on more favorable tiers with reduced out-of-pocket costs compared to their brand-name counterparts. Additionally, the legislation prohibits plans from imposing stricter access restrictions, such as prior authorization or step therapy, on these lower-cost options than those applied to the original brand-name drugs. The measure directly affects Medicare beneficiaries enrolled in Part D plans and the insurance sponsors who manage those formularies.
HR 1339, the Safeguarding Social Security and Medicare Act, requires the Comptroller General to conduct a study within one year of enactment on how inflation and rising living costs impact Social Security and Medicare benefits. The study will examine these effects and provide Congress with specific recommendations for legislative actions to maintain full benefits for these programs. This study directly addresses the needs of 71.7 million Social Security recipients and 66.6 million Medicare beneficiaries, focusing on financial pressures faced by seniors and disabled individuals. The bill itself does not change current benefits but aims to inform future policy decisions through evidence-based analysis.
HR 1244, the "Reducing Drug Prices for Seniors Act," requires Medicare Part D plans to calculate coinsurance for covered drugs based on the plan's actual acquisition cost (the negotiated net price paid by the plan) rather than the drug's wholesale price, starting in 2026. This change directly affects Medicare Part D beneficiaries who pay coinsurance after meeting their deductible but before reaching the out-of-pocket threshold. The bill mandates that plans use the actual cost reported in the Detailed DIR Report, excluding certain drugs covered under specific exceptions. This policy aims to lower out-of-pocket costs for seniors by aligning coinsurance with the price the plan actually pays for medications.
HR 5571, the "Expanding Seniors’ Access to PFAS Testing Act," requires Medicare to cover 100% of the cost for blood tests detecting PFAS chemicals (perfluoroalkyl and polyfluoroalkyl substances) for seniors starting January 1, 2028. It amends Medicare law to add "PFAS testing" as a no-cost preventive service under Part B, defined as a physician-ordered blood test to measure PFAS levels. This directly affects Medicare beneficiaries aged 65+ and certain disabled individuals who need these tests. The coverage eliminates copays and deductibles for the tests, aligning them with other preventive services, but applies only to tests performed on or after the 2028 effective date.
HR 3007, the Medicare Protection Act of 2025, changes how Medicare premiums are calculated for some seniors. It excludes income from selling a primary residence (as defined by tax law) from the income used to determine Medicare's Income-Related Monthly Adjustment Amount (IRMAA) starting in 2025. This specifically affects seniors who sell their homes and would otherwise see higher Medicare premiums based on that sale's proceeds, but only if they haven't previously excluded a home sale under this rule. The bill directly modifies the existing Medicare calculation formula to remove this specific income source.
This bill allows seniors over 65 who only have Medicare Part A hospital insurance (and no other Medicare coverage) to contribute to Health Savings Accounts (HSAs). Currently, Medicare beneficiaries cannot contribute to HSAs, but this bill removes that restriction for seniors enrolled solely in Part A. The change amends the tax code to exclude these individuals from the existing HSA contribution ban during periods they have only Part A coverage. The provision takes effect for tax years beginning after December 31, 2024.
