To require the Secretary of Health and Human Services to submit to Congress a report on the option to elect to pay cost-sharing under a prescription drug plan or MA-PD plan in monthly capped amounts.
Sponsors
Legislative Progress
IntroducedMrs. Kiggans of Virginia (for herself and Mr. Krishnamoorthi) introduced …
Summary
What This Bill Does
The Increasing Medication Access for Seniors Act of 2025 requires the Department of Health and Human Services to regularly report to Congress on how many Medicare Part D enrollees are using the monthly capped cost-sharing option for prescription drugs. This provision allows seniors to spread their out-of-pocket drug costs across the year rather than paying large amounts upfront.
Who Benefits and How
Medicare Part D enrollees (primarily seniors and people with disabilities) benefit indirectly because the reporting requirements will increase awareness and oversight of the monthly payment option, potentially helping more beneficiaries learn about and use this cost-spreading feature. Patient advocacy groups gain access to data they can use to educate seniors about their options.
Who Bears the Burden and How
The Department of Health and Human Services (specifically CMS) must prepare and submit quarterly reports for the first year, then annual reports through March 2031. This creates an ongoing administrative burden for federal staff to compile enrollment data, track outreach efforts, and monitor implementation of point-of-sale election mechanisms.
Key Provisions
- Mandates quarterly reports to Congress for the first year after enactment, then annual reports through March 31, 2031
- Reports must include the number of enrollees using the monthly capped cost-sharing option, broken down by census region and plan type
- Requires estimates of how many enrollees could benefit but are not using the option
- Requires HHS to report on steps taken to implement point-of-sale enrollment mechanisms
- Mandates disclosure of outreach efforts through Medicare.gov, the Medicare & You handbook, and 1-800-MEDICARE
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
Requires the Secretary of Health and Human Services to submit regular reports to Congress on Medicare Part D enrollees using the monthly capped cost-sharing option, including usage data, outreach efforts, and implementation of point-of-sale election mechanisms.
Policy Domains
Legislative Strategy
"Increase transparency and oversight of the Medicare Part D monthly capped cost-sharing option through mandatory reporting requirements, ensuring Congress can monitor uptake and outreach effectiveness"
Likely Beneficiaries
- Medicare Part D enrollees (seniors and disabled individuals) who may benefit from learning about monthly capped cost-sharing options
- Congress and policymakers who gain oversight data on the program
- Patient and consumer advocacy groups who can use the data for education efforts
Likely Burden Bearers
- HHS/CMS staff who must prepare and submit quarterly and annual reports
- Taxpayers (minimal administrative cost for report preparation)
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
Key Definitions
Terms defined in this bill
An individual enrolled in a prescription drug plan or MA-PD plan under part D of title XVIII of the Social Security Act (42 U.S.C. 1395w-101 et seq.)
Has the meaning given in part D of title XVIII of the Social Security Act (42 U.S.C. 1395w-101 et seq.)
Has the meaning given in part D of title XVIII of the Social Security Act (42 U.S.C. 1395w-101 et seq.)
Has the meaning given in part D of title XVIII of the Social Security Act (42 U.S.C. 1395w-101 et seq.)
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology