Choose Medicare Act
Sponsored By: Senator Jeff Merkley
Introduced
Summary
Creates Medicare Part E public health plans run by HHS to offer a government-backed insurance option across individual, small group, and large group markets. These plans would combine ACA essential health benefits, Medicare-covered services, gold-level coverage, and reproductive services including abortion.
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
6 provisions identified: 4 benefits, 0 costs, 2 mixed.
Lower premiums and out-of-pocket costs
If enacted, issuers would have to cut cost-sharing so plans pay more of costs for low- and middle-income enrollees. The bill sets plan-share targets by income bands (for example, 94% at 100–133% FPL; 80% at 300–400% FPL) for plan years after 2025. The bill would also fund a State reinsurance or affordability program with $30 billion for FY2026–FY2028 to lower premiums or out-of-pocket costs for individual-market enrollees for three plan years starting January 1, 2026.
New annual Medicare out-of-pocket cap
If enacted, Medicare Part A and B would have an annual out-of-pocket limit. The limit would be $6,700 for 2027. After 2027, the limit would change each year by the medical-care CPI-U for the prior 12 months ending in June, rounded to the nearest $5. The Secretary would announce each year's limit starting in 2026.
New Medicare Part E plans
If enacted, the Secretary would create Medicare Part E public plans you could buy on Exchanges. Part E plans would cover essential health benefits, Medicare items, gold-level coverage, and abortions. The Secretary would treat the government as an issuer and allow portability after loss of employer coverage. The bill would fund startup costs with $2 billion for FY2026 and add reserve funding as needed. Provider payments for Part E would be negotiated so totals are not below Medicare and not above average Exchange rates.
Changes to premium tax credit
If enacted, the law would change the premium tax credit for tax years after 2025. It would remove the explicit 400% of poverty cap and use a sliding scale for subsidy percentages. The benchmark plan for subsidies would change from the second-lowest-cost silver plan to the second-lowest-cost gold plan.
Federal review of health rates
If enacted, the Secretary would set premiums for Medicare Part E plans by market and rating area. The bill would also create federal authority to review and correct health 'rates' that are potentially excessive, unjustified, or unfairly discriminatory. Corrective powers include denying or changing rates, requiring rebates, fines, and making plans ineligible. These rules must be implemented by January 1, 2026.
Employer referrals to exchange navigators
If enacted, employers that do not offer an affordable, minimum-value plan would have to refer each full-time employee to an Exchange navigator at hire or on the effective date. This referral rule would start in each State two years after enactment. The bill would also authorize funds to expand navigator capacity. The Government Accountability Office would study the rule's effect and report by January 1, 2030.
Sponsors & CoSponsors
Sponsor
Jeff Merkley
OR • D
Cosponsors
Christopher Murphy
CT • D
Sponsored 6/11/2025
Tammy Baldwin
WI • D
Sponsored 6/11/2025
Richard Blumenthal
CT • D
Sponsored 6/11/2025
Cory Booker
NJ • D
Sponsored 6/11/2025
Tammy Duckworth
IL • D
Sponsored 6/11/2025
John Reed
RI • D
Sponsored 6/11/2025
Brian Schatz
HI • D
Sponsored 6/11/2025
Kirsten Gillibrand
NY • D
Sponsored 6/11/2025
Tina Smith
MN • D
Sponsored 6/11/2025
Richard Durbin
IL • D
Sponsored 6/12/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.govTake It Personal
Get Your Personalized Policy View
Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in