The Choose Medicare Act would establish a new public health insurance option called Medicare Part E, available to any U.S. resident not already covered by Medicare, Medicaid, or other government programs. The plans would offer comprehensive coverage including all essential health benefits, services covered under traditional Medicare, gold-level cost-sharing, and reproductive services including abortion. The bill provides $2 billion in startup funding for fiscal year 2025, plus additional appropriations for initial claims reserves, and does not specify an enrollment start date beyond requiring establishment "one year after enactment."
The legislation also makes several changes to the Affordable Care Act marketplace. It requires employers without adequate health insurance plans to refer employees to insurance navigators who can help them shop for coverage. It shifts the premium tax credit benchmark from silver-level to gold-level plans, effectively providing more generous subsidies for lower-income individuals. For those with very low incomes, it increases cost-sharing assistance, with the government covering up to 94 percent of costs for people at 100-133 percent of the poverty level. The bill also allocates $30 billion over three years for state reinsurance and affordability programs and allows states to impose stronger rate reviews on insurance companies to prevent excessive premium increases.
For Medicare beneficiaries specifically, the bill caps annual out-of-pocket costs at $6,700 starting in 2026, with annual adjustments for inflation.
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