# 119-hr-6494: Territories Health Equity Act of 2025

119-hr-6494, Territories Health Equity Act of 2025, is a 119th Congress bill sponsored by Del. Plaskett, Stacey E. [D-VI-At Large] (D-VI); status introduced; PRIA reads it as touching household money (as of 2026-10-10).

- Canonical: https://policyrisk.com/legislation/119-hr-6494
- As of: 2026-10-10
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-6494
- Congress: 119
- Title: Territories Health Equity Act of 2025
- Status: introduced
- Introduced: 2025-12-05
- Sponsor: Del. Plaskett, Stacey E. [D-VI-At Large] (D-VI)
- Cosponsors: 4
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-10

## Summary

**Aligns U.S. territories with U.S. tax and federal health program rules** while creating territory-specific Medicare and Medicaid financing and subsidy changes. The bill would change how hospitals are paid, expand low-income Medicare help, and set a mirror tax system for possessions. - Would create new Disproportionate Share Hospital (DSH) funding mechanisms for the five U.S. territories: Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. It revises DSH target and benchmark calculations to adjust payments to territorial hospitals. - Would provide relief from Medicare Part B late enrollment penalties for Puerto Rico and would establish automatic Part B premium and cost-sharing subsidies for eligible low-income residents in the territories. It also requires more reporting, transparency, and applies Affordable Care Act exchange rules to territories that lack functioning exchanges. - Would establish a formal mirror code tax system so residents of U.S. possessions have their income taxes determined as if the possession were the United States. Payments under that system would be treated like premium tax credit refunds and the effective date depends on when the Secretary sets up the required mechanism.

## Cosponsors (4)

- Del. Radewagen, Aumua Amata Coleman [R-AS-At Large] (R-AS), 2025-12-05T00:00:00.000Z
- Rescom. Hernández, Pablo Jose [D-PR-At Large] (D-PR), 2025-12-05T00:00:00.000Z
- Del. Moylan, James C. [R-GU-At Large] (R-GU), 2025-12-05T00:00:00.000Z
- Del. King-Hinds, Kimberlyn [R-MP-At Large] (R-MP), 2025-12-05T00:00:00.000Z

## Provisions PRIA read

- DC Exchange access for possessions: benefit, medium. If enacted, the HHS Secretary would set up, within 3 months, a way for bona fide residents of qualifying U.S. possessions to buy coverage through the DC health exchange. If enacted, those residents who are not eligible for employer coverage could get federal premium tax credits and lower cost-shari…
- Lower Medicare costs for territory enrollees: benefit, medium. If enacted, people in U.S. territories who are eligible for Medicare Part D and who are enrolled in territory Medicaid would be treated as eligible for Part D premium and cost-sharing subsidies starting with plan years on or after January 1, 2026. If enacted, the bill would set a Part D blended ben…
- More federal payments to territory hospitals: benefit, medium. If enacted, starting in fiscal year 2026 the five territories would share a $300,000,000 Medicaid DSH pool for hospitals, with each territory’s share based on its estimated low-income or uninsured population. If enacted, Medicare rules for hospitals in the territories would change for discharges an…
- Puerto Rico Medicaid match timing changes: mixed, low. If enacted, the bill would change the years referenced in certain Puerto Rico Medicaid matching rate rules. If enacted, it would insert the phrase 'for fiscal years before fiscal year 2026' in one rule and replace '2027' with '2025' in another rule. If enacted, these are narrow timing edits to when…

## Related bills

- 119-hr-9877: Health Equity and Accountability Act of 2026
- 119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act
- 119-hr-9237: Take Care of America’s Veterans Act
- 119-hr-5409: Territory Health Revitalization Act
- 119-hr-380: Affordable Shipping for All Act
- 119-hr-6472: Territorial Student Access to Higher Education Act

## Sources
- [119-hr-6494 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/6494)

## Related
- [119-hr-9877: Health Equity and Accountability Act of 2026](https://policyrisk.com/legislation/119-hr-9877)
- [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842)
- [119-hr-9237: Take Care of America’s Veterans Act](https://policyrisk.com/legislation/119-hr-9237)
- [119-hr-5409: Territory Health Revitalization Act](https://policyrisk.com/legislation/119-hr-5409)
- [119-hr-380: Affordable Shipping for All Act](https://policyrisk.com/legislation/119-hr-380)
- [119-hr-6472: Territorial Student Access to Higher Education Act](https://policyrisk.com/legislation/119-hr-6472)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-6494 (as of 2026-10-10).