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HR 930119th CongressIn Committee

Stop the Wait Act of 2025

Introduced: Feb 4, 2025
Standard Summary
Comprehensive overview in 1-2 paragraphs

The Stop the Wait Act of 2025 would remove or shorten the waiting period for Social Security Disability Insurance (SSDI) benefits and make related changes to Medicare eligibility for people waiting to begin SSDI. Specifically, the bill phases down the SSDI waiting period from five months toward zero between 2025 and 2029, with the waiting period fully eliminated on January 1, 2030 (and applying to applications filed on or after January 1, 2029). In addition, the bill creates special Medicare rules for certain individuals who would be without minimum essential coverage while waiting for SSDI, allowing retroactive Medicare eligibility to begin earlier and providing special enrollment options. The bill also includes conforming amendments to related programs (e.g., the Railroad Retirement Act) and adjusts definitions to support the revised timing of eligibility. In short: the bill aims to speed up access to SSDI benefits and Medicare for people with disabilities by removing the initial waiting period and smoothing enrollment and coverage rules during the transition.

Key Points

  • 1Elimination and phase-down of SSDI waiting period: The law would remove the disability waiting period, but during 2025–2029 it would be phased down from five months to one month, with full elimination effective January 1, 2030 (applies to applications filed on or after January 1, 2029).
  • 2Aminor adjustments to insured status and timing: The bill restructures definitions related to insured status for disability benefits to reflect the removal of the waiting period and aligns related provisions accordingly.
  • 3Medicare eligibility during SSDI waiting period: The bill adds a new special rule under the Social Security Act to allow certain individuals who would otherwise be without MEC coverage to receive Medicare with modified timing and benefits, effectively expediting health coverage as disability benefits become available.
  • 4Retroactive and expanded Medicare rules for eligible individuals: The new rules provide retroactive entitlement to Medicare benefits and adjust how long prior coverage is considered, particularly for individuals under age 65 who are qualifying for SSDI-related benefits without MEC.
  • 5Special enrollment and coverage rules: The bill creates new special enrollment provisions under Medicare for eligible individuals affected by the revised SSDI timing, ensuring enrollment can occur with the adjusted timeline for disability entitlement.

Impact Areas

Primary group/area affected: Individuals under 65 who become eligible for SSDI (and who would otherwise be subject to the standard waiting period), and their access to Medicare during the transition. This includes people who lack minimum essential coverage during the SSDI wait and those who would benefit from expedited health coverage.Secondary group/area affected: The Medicare program and health coverage markets for individuals transitioning from SSDI eligibility, including how enrollment periods operate and how coverage is retroactively applied. Related adjustments to the Railroad Retirement Act are included, affecting benefits coordination for rail workers.Additional impacts: Potential changes to federal budget outlays due to earlier SSDI and Medicare eligibility, administrative changes for SSA, CMS, and related agencies to implement the phase-down and new enrollment rules, and possible interactions with existing health coverage provisions (e.g., ACA minimum coverage requirements) given the references to minimum essential coverage and related thresholds.
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