A Democratic bill with 2 Democratic cosponsors · See all 2 cosponsors
Last activity — Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Judiciary, 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
The Medicare-X Choice Act of 2026 establishes a coordinated, low-cost public health plan available to qualified individuals and small groups starting in 2028. The plan will be offered through health insurance exchanges and provides primary care services without cost-sharing. It utilizes Medicare fee-for-service rates for provider reimbursement and includes provisions for national reinsurance to lower premiums. The bill also expands tax credits for health insurance and increases funding for antitrust enforcement in health care markets. Additionally, it removes certain limitations on the negotiation of Medicare prescription drug prices.
Yes· 3 of 39
- Scored +9
Would households on low incomes be better off under this?
Eliminates primary care cost-sharing and provides expanded, uncapped tax credits.
- Scored +8
Would people in rural areas be better off under this?
Increased rural reimbursement rates and expanded telehealth integration.
- Scored +8
Does this strengthen the Affordable Care Act?
Integrates with ACA exchanges and expands the premium tax credit system.
The opposite· 3 of 4
- Scored -4
Does this leave more decisions to the states?
Imposes federal requirements on providers that may override state-level Medicaid or health regulations.
- Scored -3
Does this reduce what the federal government spends?
Increases federal spending through new health plan funding and antitrust enforcement appropriations.
- Scored -2
Does this reduce what the federal government owes?
Appropriates billions of dollars for plan reserves, technology funds, and reinsurance.
Who it would affect, and how
Potential Positive Impacts for People
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Elimination of Primary Care Costs: The health plan will not impose any cost-sharing requirements for primary care services, which may reduce out-of-pocket expenses for patients (Section 2203(c)).
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Increased Financial Assistance: The bill expands tax credits by removing the 400 percent income cap and adjusting the sliding scale for premium percentages, potentially making insurance more affordable for a wider range of income levels (Section 5(a), 5(b)).
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Correction of the Family Glitch: The bill amends the tax code so that family members are not treated as eligible for minimum essential coverage if the employee's required contribution for family coverage exceeds 9.5 percent of household income (Section 5(d)).
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Lower Premiums through Reinsurance: The establishment of a nationwide mechanism to pool costs for the highest-cost patients is intended to reduce premiums for individual health insurance coverage (Section 4(a)).
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Improved Access in Rural Areas: The Secretary has the authority to increase reimbursement rates by up to 50 percent for services provided in rural areas (Section 2207(a)(2)).
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Reduced Drug Costs: By striking subsection (i) of section 1860D-11 of the Social Security Act, the bill removes restrictions on negotiating fair prices for Medicare prescription drugs (Section 6).
Potential Negative Impacts for People
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Provider Participation Pressure: Health care providers may be barred from enrolling in Medicare or participating in State Medicaid plans if they do not also participate in the Medicare Exchange health plan (Section 2208(a), 2208(b)).
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Limited Plan Options: The Secretary is restricted to making only a silver and gold level version of the plan available, and no more than two versions for each of the four coverage levels (Section 2203(b)).
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Potential for Provider Exclusion: Providers who place restrictions on which patients they accept for treatment could be excluded from federal health care programs if they do not exempt this plan's enrollees or apply the restrictions equally to everyone (Section 3).
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 households on low incomes be better off under this? — Eliminates primary care cost-sharing and provides expanded, uncapped tax credits. Would people in rural areas be better off under this? — Increased rural reimbursement rates and expanded telehealth integration. Would people in middle age be better off under this? — Increased access to affordable insurance and elimination of primary care cost-sharing. Would middle-income households be better off under this? — Removes the income cap for tax credits and improves affordability for families. Would people with disabilities be better off under this? — Mandates disability-competent feedback and targets the reduction of health disparities for this group. Would people in their twenties and thirties be better off under this? — Increased access to affordable individual market coverage and expanded tax credits. Would Black Americans be better off under this? — Specifically targets the reduction of racial and ethnic health disparities in plan design and delivery. Would Asian Americans be better off under this? — Specifically targets the reduction of racial and ethnic health disparities in plan design and delivery. Would Hispanic Americans be better off under this? — Specifically targets the reduction of racial and ethnic health disparities in plan design and delivery. Would LGBTQ people be better off under this? — Specifically targets the reduction of sexual identity health disparities. Would Native Americans be better off under this? — Specifically targets the reduction of racial and ethnic health disparities in plan design and delivery. Would children be better off under this? — Expanded tax credits and the correction of the 'family glitch' benefit children's coverage. Would farmers be better off under this? — Increased reimbursement rates for rural providers improve access for farming communities. Would retired people be better off under this? — Reduction in prescription drug costs via Medicare negotiation. Would students be better off under this? — Improved affordability for young adults through expanded tax credits. Would women be better off under this? — Targets the reduction of gender-based health disparities. Would business owners be better off under this? — Provides small businesses with a coordinated, low-cost health plan option. Would men be better off under this? — General improvement in healthcare access and affordability. Would people over 65 be better off under this? — Reduces prescription drug costs via increased negotiation authority for Medicare. Would people in cities be better off under this? — General improvement in affordable insurance access. Would white Americans be better off under this? — General improvement in healthcare access and lower prescription drug costs. Would high-income households be better off under this? — Provides access to a low-cost public option and expanded tax credits for those above 400% income.
- Healthcare
- Does this make health care easier to get in general? — Creates a low-cost public health plan with zero cost-sharing for primary care services. Does this strengthen the Affordable Care Act? — Integrates with ACA exchanges and expands the premium tax credit system. Does this lower the price of prescription medicines? — Removes restrictions on the negotiation of fair prices for Medicare prescription drugs. Does this lower what people pay for private health insurance? — Establishes a nationwide reinsurance mechanism to pool high-cost patient costs and lower premiums.
- Social Issues And Justice
- Does this expand the rights of people with disabilities? — Requires disability-competent feedback mechanisms and targets the reduction of health disparities for people with disabilities. Is this likely to lift people out of poverty? — Integrates health care with income assistance and provides zero-cost primary care for low-income enrollees. Does this narrow racial gaps in how people are treated? — Directs the Secretary to use data and innovative payments to reduce racial and ethnic health disparities. Does this narrow the gap between how men and women are treated? — Requires efforts to reduce gender-based health disparities in the delivery of the public plan. Does this expand the rights of LGBTQ people? — Mandates data collection and delivery reforms specifically to reduce sexual identity health disparities. Does this make housing cost less? — Allows integration of medical care with housing assistance to reduce disparities. Is this likely to reduce homelessness? — Enables the coordination of the health plan with housing services.
- Economy And Finance
- Does this give people more protection from unfair business practices? — Increases funding for antitrust enforcement to combat anticompetitive practices in health care markets. Does this cut taxes for middle-income families? — Expands health insurance tax credits by removing the 400 percent income cap and adjusting the sliding scale. Does this make it easier to run a small business? — Provides a low-cost public health plan option specifically for the small group market. Does this reduce what the federal government spends? — Increases federal spending through new health plan funding and antitrust enforcement appropriations. Does this make the government pay for what it commits to? — Increases federal expenditures without specified offsetting revenue. Does this reduce what the federal government owes? — Appropriates billions of dollars for plan reserves, technology funds, and reinsurance.
- Environment Energy And Infrastructure
- Does this invest in rural communities? — Provides up to 50 percent increase in reimbursement rates for services provided in rural areas.
- Education And Technology
- Does this get reliable internet to more people? — Mandates the integration of telehealth tools to increase access in remote or underserved areas.
- Governance And Ideology
- Does this give the federal government more power? — Expands federal authority into health insurance markets and mandates provider participation in the public plan. Does this leave more decisions to the states? — Imposes federal requirements on providers that may override state-level Medicaid or health regulations.
- 7/15/2026
- Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Judiciary, 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.
- 2 Cosponsors added.
- Introduced in House
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Eleanor NortonDemocrat · District of Columbia
Mike QuigleyDemocrat · Illinois