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HR 6112119th CongressIn Committee
To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans.
Introduced: Nov 18, 2025
Sponsor: Rep. Pocan, Mark [D-WI-2] (D-Wisconsin)
Standard Summary
Comprehensive overview in 1-2 paragraphs
A bill amending Title XVIII of the Social Security Act to require Medicare Advantage plans to keep average monthly cost to provide coverage below the average monthly cost of original Medicare, otherwise enrollment is prohibited for the following plan year.
Key Points
- 1Comparison of average monthly cost to original Medicare
- 2Enforcement: prohibition of enrollment if cost exceeds threshold
- 3Exception for specialized plans for special‑needs individuals
- 4Objective to prevent cost‑inflation in MA plans
- 5Impact on plan design and beneficiary choice
Impact Areas
Medicare Advantage plansEnrollees and beneficiariesHealthcare providersMedicare program administration
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