Puerto Rico Medicare Advantage Fairness Act of 2026
Sponsored By: Representative Ruiz, Raul [D-CA-25]
Introduced
Summary
Aligns Puerto Rico's Medicare Advantage geographic adjustment with the U.S. Virgin Islands. This bill would add a sentence to Social Security Act section 1853(c)(1)(D)(i) so that for the years specified in clause (ii) beginning on or after January 1, 2027, the geographic adjustment used to compute the adjusted average per capita cost for Medicare Advantage payment areas in Puerto Rico matches the geographic adjustment applied to a Medicare Advantage payment area in the U.S. Virgin Islands for the same year. The change targets the geographic adjustment component of the MA benchmark calculation for those specified years.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
Change Medicare Advantage payments for Puerto Rico
If enacted, this bill would change how Medicare Advantage plan payments are calculated for Puerto Rico. It would apply to years listed in clause (ii) starting on or after January 1, 2027. Puerto Rico's geographic adjustment would equal the U.S. Virgin Islands' adjustment for each such year. The bill does not add funding or say how premiums or plan access would change.
Sponsors & CoSponsors
Sponsor
Ruiz, Raul [D-CA-25]
CA • D
Cosponsors
Rep. Soto, Darren [D-FL-9]
FL • D
Sponsored 10/5/2026
Rep. Bilirakis, Gus M. [R-FL-12]
FL • R
Sponsored 10/5/2026
Rescom. Hernández, Pablo Jose [D-PR-At Large]
PR • D
Sponsored 10/5/2026
Roll Call Votes
No roll call votes available for this bill.
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