Adriano Espaillat (D-NY)
Earned Benefits Equality and Family Reunification Act
A Democratic bill with no cosponsors
Last activity — 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.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
This bill establishes a 10-year demonstration program allowing eligible Medicare beneficiaries to use their benefits to cover health care items, services, premiums, and cost-sharing in other countries. The program aims to evaluate impacts on care quality, government costs, family reunification, and U.S. medical infrastructure strain. The Secretary of Health and Human Services will initially select at least 11 countries, including Canada, Germany, India, Israel, Korea, the Philippines, Panama, Mexico, the Dominican Republic, and Ghana. Participation in the program is completely voluntary, and beneficiaries can terminate their participation at any time. Participating beneficiaries keep their right to access Medicare items and services when furnished inside the United States. The Secretary must ensure that total program payments do not exceed what Medicare would pay for equivalent services delivered domestically.
Yes· 3 of 16
- Scored +7
Would people over 65 be better off under this?
Enables eligible Medicare beneficiaries to apply their benefits toward healthcare services and coverage abroad.
- Scored +7
Would retired people be better off under this?
Directly benefits retirees by expanding Medicare portability to international locations.
- Scored +6
Would immigrants be better off under this?
Directly supports family reunification goals, allowing former U.S. residents and immigrants to access Medicare abroad.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Family Reunification: Section 1866H(b)(1)(C) states that the program aims to enable applicable beneficiaries to reunify with family members, which could help people live closer to their loved ones abroad.
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Voluntary Participation and Choice: Section 1866H(d)(1) allows beneficiaries to participate in the program voluntarily and terminate their participation at any time, giving individuals control over their healthcare choices.
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Maintained U.S. Healthcare Access: Section 1866H(d)(3) ensures that participating in the program does not limit a beneficiary's access to items and services covered under Medicare when furnished in the United States, meaning people do not lose their domestic benefits.
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Targeting Low-Income Individuals: Section 1866H(b)(3)(C) requires the Secretary to issue guidance on ways to target low-income Americans as participants in the program, potentially helping lower-income individuals access international healthcare options.
Potential Negative Impacts for People
- Caps on Participation: Section 1866H(d)(4) allows the Secretary to cap the number of applicable beneficiaries accepted into the program, which could exclude interested individuals if the cap is reached.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would retired people be better off under this? — Directly benefits retirees by expanding Medicare portability to international locations. Would people over 65 be better off under this? — Enables eligible Medicare beneficiaries to apply their benefits toward healthcare services and coverage abroad. Would immigrants be better off under this? — Directly supports family reunification goals, allowing former U.S. residents and immigrants to access Medicare abroad. Would households on low incomes be better off under this? — Requires guidance to be issued on targeting low-income Americans as participants in the international program. Would middle-income households be better off under this? — Provides middle-class seniors with additional flexibility and international healthcare options. Would Asian Americans be better off under this? — Includes India, the Philippines, and South Korea as selected countries, benefiting Asian-American beneficiaries. Would Hispanic Americans be better off under this? — Includes Mexico, the Dominican Republic, and Panama as selected countries, benefiting Hispanic beneficiaries. Would Black Americans be better off under this? — Includes countries like Ghana in the program, offering options relevant to specific diaspora communities.
- Healthcare
- Does this make health care easier to get in general? — Expands the geographic scope of Medicare coverage by permitting use of benefits in designated foreign countries. Does this lower the price of prescription medicines? — Allows Medicare beneficiaries to utilize international health systems where costs and coverage may be more affordable.
- Economy And Finance
- Does this make the government pay for what it commits to? — Includes strict cost-neutrality guardrails ensuring international payments do not exceed domestic expenditures. Does this reduce what the federal government spends? — The bill caps total demonstration program payments so they do not exceed domestic Medicare costs for equivalent services.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — Requires annual intermediate and final evaluations of the program's outcomes to be reported to Congress. Does this give the federal government more power? — Grants the Secretary of Health and Human Services broad discretionary authority to design and implement the demonstration.
- National Security And Foreign Policy
- Does this favour talking over confrontation abroad? — Engages foreign health authorities and governments in structured healthcare coordination programs. Does this strengthen ties with allied countries? — Fosters cooperative healthcare frameworks with at least 11 selected international partner nations.
- 5/29/2026
- 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.
- Introduced in House