S2032-119

Introduced

To provide for the establishment of Medicare part E public health plans, and for other purposes.

119th Congress Introduced Jun 11, 2025

Summary

What This Bill Does

The bill amends the Social Security Act by adding Title XXII to establish Medicare Part E public health plans available in the individual, small group, and large group markets, provides the new Title XXII of the Social Security Act establishing Medicare Part E plan structure: gold-level qualified health plans covering essential health benefits, all Medicare services, and reproductive services, and amends the Fair Labor Standards Act to require employers that do not offer affordable, minimum-value employer-sponsored health plans to refer each full-time employee to an Exchange navigator (or equivalent entity). It relies on appropriations, price controls, compliance mandates, and exemptions. The main policy areas are Healthcare and Finance.

Who Benefits and How

Uninsured and underinsured individuals could see lower costs, Individual market enrollees could see lower costs, and Medicare fee-for-service beneficiaries could see lower costs.

Who Bears the Burden and How

Federal taxpayers could face higher costs, Health insurance issuers would take on compliance duties, and Private health insurers could lose revenue opportunities.

Key Provisions

  • Amends the Social Security Act by adding Title XXII to establish Medicare Part E public health plans available in the individual, small group, and large group markets.
  • Provides the new Title XXII of the Social Security Act establishing Medicare Part E plan structure: gold-level qualified health plans covering essential health benefits, all Medicare services, and reproductive services.
  • Amends the Fair Labor Standards Act to require employers that do not offer affordable, minimum-value employer-sponsored health plans to refer each full-time employee to an Exchange navigator (or equivalent entity).
  • Adds Section 1899C to the Social Security Act establishing an annual out-of-pocket maximum for Medicare fee-for-service beneficiaries.
  • Amends Section 36B of the Internal Revenue Code to enhance ACA premium tax credits in three ways: (1) changes the benchmark plan from the second lowest cost silver plan to the second lowest cost gold plan, increasing...

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.

At a Glance

What This Bill Does

The bill amends the Social Security Act by adding Title XXII to establish Medicare Part E public health plans available in the individual, small group, and large group markets, provides the new Title XXII of the Social Security Act establishing Medicare Part E plan structure: gold-level qualified health plans covering essential health benefits, all Medicare services, and reproductive services, and amends the Fair Labor Standards Act to require employers that do not offer affordable, minimum-value employer-sponsored health plans to refer each full-time employee to an Exchange navigator (or equivalent entity).

Key Policy Areas

Healthcare, Finance

Primary Purpose

The bill amends the Social Security Act by adding Title XXII to establish Medicare Part E public health plans available in the individual, small group, and large group markets, provides the new Title XXII of the Social Security Act establishing Medicare Part E plan structure: gold-level qualified health plans covering essential health benefits, all Medicare services, and reproductive services, and amends the Fair Labor Standards Act to require employers that do not offer affordable, minimum-value employer-sponsored health plans to refer each full-time employee to an Exchange navigator (or equivalent entity).

Policy Domains

Healthcare Finance

Medicare Part E Public Health Plans (Sec. 2)

Identified Gains
  • Uninsured and underinsured individuals
  • Individual market enrollees
  • Medicare fee-for-service beneficiaries
  • Low-income enrollees (100-200% FPL)
  • ACA marketplace enrollees
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: is
ACA marketplace enrollees:
Individual market enrollees: ,
Low-income enrollees (100-200% FPL):
Medicare fee-for-service beneficiaries:
Uninsured and underinsured individuals: ,
Identified Costs
  • Federal taxpayers
  • Health insurance issuers
  • Private health insurers
  • Pharmaceutical companies
  • Medicare trust funds / federal government
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: is
Federal taxpayers: , , , , ,
Private health insurers: ,
Health insurance issuers:
Pharmaceutical companies: ,
Medicare trust funds / federal government:

Legislative Progress

Introduced
Introduced Committee Passed
Jun 11, 2025

Mr. Merkley (for himself, Mr. Murphy, Ms. Baldwin, Mr. Blumenthal, …

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

General Public
17 mentions across 9 clauses
+11 positive -6 negative

ACA marketplace enrollees, Employees without adequate employer coverage, Health insurance consumers

Positive-direction: ACA marketplace enrollees, Employees without adequate employer coverage, Health insurance consumers, Individual market enrollees, Low-income enrollees (100-200% FPL), Medicare fee-for-service beneficiaries, Middle- and upper-income households above 400% FPL, Moderate-income enrollees (200-400% FPL), Uninsured and underinsured individuals

Negative-direction: Taxpayers

Financial Services
8 mentions across 6 clauses
+2 positive -6 negative

Grandfathered health plan sponsors, Health insurance issuers, Health insurance issuers in individual market

Health insurance issuers faces effects in multiple directions

Positive-direction: Health insurance issuers in individual market

Negative-direction: Grandfathered health plan sponsors, Medigap insurers, Private health insurers

Government
4 mentions across 4 clauses
+2 positive -2 negative

Centers for Medicare & Medicaid Services, Medicare trust funds / federal government, State governments

Positive-direction: State governments, States

Negative-direction: Centers for Medicare & Medicaid Services, Medicare trust funds / federal government

Pharmaceuticals
2 mentions across 2 clauses
-2 negative

Pharmaceutical companies

Healthcare
1 mention across 1 clause
+1 positive

Healthcare providers

Business
1 mention across 1 clause
-1 negative

Employers without affordable coverage

Nonprofits
1 mention across 1 clause
+1 positive

Exchange navigator organizations

9/13
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare Finance
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
"the_administrator"
→ Administrator for the Centers for Medicare & Medicaid Services
Domains
Healthcare Labor
Actor Mappings
"the_comptroller_general"
→ Comptroller General of the United States
Domains
Healthcare Consumer Protection
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
Domains
Taxation Healthcare
Domains
Healthcare Consumer Protection
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
Domains
Insurance Healthcare
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
Domains
Insurance
Domains
Insurance Consumer Protection
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services

Note: {'term': 'The Secretary', 'resolution': 'Refers to the Secretary of Health and Human Services throughout the bill.'}

Key Definitions

Terms defined in this bill

2 terms
"Medicare part E plans" §2

Public health plans established by the Secretary, available in the individual, small group, and large group markets, providing gold-level coverage of essential health benefits plus all Medicare-covered services and reproductive services.

"Out-of-pocket cost-sharing" §4

Expenses incurred by an individual attributable to deductibles, coinsurance, and copayments under Medicare Part A or B, or for services that would have been covered but for benefit exhaustion. Excludes non-covered items and amounts above assignment-related rates.

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