To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans.
About This Bill
Committee
Latest Action · November 18, 2025
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
H.R. 6112 would modify Medicare Advantage plans by requiring the federal government to block enrollment in any plan where the average monthly payment the government makes to the plan exceeds what it costs to provide coverage under traditional Medicare (Parts A and B). The rule would apply starting one year after the bill's enactment and would take effect for subsequent plan years, meaning if a plan's costs exceed traditional Medicare's costs in one year, new and returning enrollees couldn't join that plan the following year. The bill exempts specialized Medicare Advantage plans designed for people with specific medical conditions or special needs. This measure is intended to ensure that Medicare Advantage plans don't cost the government more than traditional Medicare while still allowing beneficiaries with complex health needs access to specialized plans. The legislation targets insurers and millions of Medicare beneficiaries currently enrolled in or considering Medicare Advantage plans.
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