The IDEAL Act establishes a pilot program from 2025 through 2028 to help certain health plans serving low-income and elderly individuals better address the social and economic factors that affect health outcomes for people eligible for both Medicare and Medicaid. Participating safety net health plans will receive add-on payments equal to 5 percent of their existing Medicare rebates to provide benefits such as transportation, housing assistance, food support, pest control, air quality improvements, and social programs designed to combat isolation. The bill specifically targets nonprofit and public health plans that serve vulnerable populations and allows them to customize these services based on their enrollees' needs. The Health and Human Services Secretary must evaluate the program's impact on patient outcomes, costs, and satisfaction and report findings to Congress by December 31, 2031. Additionally, the law directs the federal government to establish new procedures allowing states to request administrative flexibility in enrollment and marketing requirements for dual-eligible plans within 60 days of enactment.
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