United StatesTerritory residents would use mainland poverty limits for Medicare drug aid
Medicare would apply the mainland poverty line to territory residents when checking income for prescription drug aid, starting January 1, 2027.
What it does
People living outside the 50 states and Washington, D.C., would use the mainland poverty line for Medicare prescription drug aid starting January 1, 2027.
Starting with the last three quarters of federal fiscal year 2027, a Medicaid funding formula would base each covered area's share on its Medicare population.
Argument forUsing one mainland poverty line could give territory residents a consistent income standard when Medicare considers them for prescription drug aid.
Argument againstBasing funding shares on Medicare population could overlook differences in prescription costs and financial need among covered areas.
More detail
Medicare would use the mainland poverty line when applying income rules for prescription drug aid. The rule would cover people living outside the 50 states and Washington, D.C. The standard would be the poverty line for the 48 contiguous states and Washington, D.C. The poverty-line rule would take effect on January 1, 2027.
Medicaid rules would link added funding amounts to each covered area's Medicare population. All areas covered by the same Medicaid funding rule would count toward the combined Medicare population. The count would include people entitled to Medicare Part A benefits or enrolled in Part B. These amendments would take effect upon enactment. The formula would apply to the last three quarters of federal fiscal year 2027 and later fiscal years.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Oct 22Introduced in HouseLatest
- Oct 22Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.Introduced
HealthcareTaxes & Budget