Expanding Health Care Options for First Responders Act
Sponsored By: Representative Landsman
Introduced
Summary
Creates a Medicare buy-in for certain retired or disabled first responders aged 50–64. This bill would let eligible individuals enroll in Medicare Parts A and B and Part D and choose Medicare Advantage plans with prescription drug coverage while coordinating enrollments with the Affordable Care Act.
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- Qualified first responders who separated from service due to retirement or disability could buy into Medicare at ages 50–64 and receive the same Parts A, B and D benefits and protections. They would also get guaranteed-issue Medigap policies at first enrollment and on reenrollment.
- Premiums would be set by the Secretary as a monthly share of the annual per-person cost for Parts A, B and D and deposited into the Medicare Hospital Insurance and Supplementary Medical Insurance trust funds. People who pick higher-cost Medicare Advantage or drug plans would pay extra monthly premiums.
- Coverage under this option would count as minimum essential coverage for ACA rules and be treated like a silver-level plan for premium tax credits. The bill would fund Treasury grants from 2027 through 2029 to help states and nonprofits with outreach, enrollment, and information on premium assistance.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 2 benefits, 1 costs, 1 mixed.
Medicare buy-in for first responders 50 to 64
If enacted, this bill would let qualified first responders ages 50 to 64 buy into Medicare. You would need to live in the U.S., be a citizen, national, or lawful permanent resident, and not already entitled to or eligible to enroll in Medicare Part A or Part B. Eligible jobs would include qualified law enforcement officers, certain public safety employees, and federal firefighters who retired or became disabled. Enrollment windows would line up with ACA Marketplace and Medicare C and D periods, with special enrollment periods allowed. Coverage would start on January 1 of the first year that begins at least one year after enactment. Buy-in enrollees would also get Medigap guaranteed‑issue rights at age 50 and again each time they reenroll; at age 65, the regular Medigap rules for new seniors would apply.
Costs and subsidies for buy-in coverage
If enacted, the Secretary would set a yearly average cost for this coverage, and your monthly premium would be one‑twelfth of that amount. If you choose a higher‑cost Medicare Advantage or drug plan, you would pay the extra monthly charge. Buy‑in coverage would count as minimum essential coverage and be treated like a silver Marketplace plan for premium tax credits and cost‑sharing reductions. The Secretary would determine the second‑lowest‑cost silver plan used to set your subsidy amount.
Outreach grants and rollout safeguards
If enacted, the government would award grants from January 1, 2027 through December 31, 2029 to help with outreach, enrollment, and transitions. States, nonprofit community groups, and nonprofit first responder groups could receive funding; insurers would be excluded. Priority would go to areas at risk of having no Marketplace plans. Funding would be "such sums as are necessary" from the Treasury starting in 2026 to run this program. The Secretary would also have to consult key groups and protect current Medicare benefits and the Medicare trust funds when writing the rules.
Medicaid limits for buy-in enrollees
If enacted, people in the buy‑in would not get Medicaid help with Medicare cost sharing. States could not buy Medicaid beneficiaries ages 50 to 64 into the buy‑in. People otherwise eligible for Medicaid generally could not enroll in the buy‑in, except for those with certain Medicaid coverage that is not minimum essential coverage.
Sponsors & CoSponsors
Sponsor
Landsman
OH • D
Cosponsors
Frankel, Lois
FL • D
Sponsored 11/21/2025
Ryan
NY • D
Sponsored 11/21/2025
Casten
IL • D
Sponsored 12/3/2025
Gottheimer
NJ • D
Sponsored 4/2/2026
Roll Call Votes
No roll call votes available for this bill.
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