A Democratic bill with 16 Democratic cosponsors · See all 16 cosponsors
Last activity — Read twice and referred to the Committee on Finance.
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 Cost Cap Act of 2026 aims to protect Medicare beneficiaries from high out-of-pocket costs. It establishes an annual out-of-pocket limit for Medicare fee-for-service benefits, starting at $5,000 for the year 2028. The bill also includes provisions to enhance programs that protect low-income Medicare beneficiaries. These enhancements include aligning eligibility criteria and eliminating certain resource standards.
Yes· 3 of 6
- Scored +8
Would people over 65 be better off under this?
The bill significantly reduces the financial burden of healthcare costs for Medicare beneficiaries through annual out-of-pocket limits.
- Scored +7
Would households on low incomes be better off under this?
The bill increases support for low-income households by expanding eligibility for the Low Income Subsidy and Medicare Savings Programs.
- Scored +5
Does this put more money into Medicare, the health coverage for people over 65?
The bill increases Medicare spending by capping annual out-of-pocket costs for beneficiaries and expanding subsidy eligibility.
The opposite
- Scored -3
Does this reduce what the federal government spends?
The bill increases government spending by establishing out-of-pocket limits and expanding eligibility for Medicare and Medicaid programs.
Who it would affect, and how
Potential Positive Impacts for People
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Out-of-Pocket Cost Protection: Beneficiaries enrolled in Medicare Part A or Part B will not be responsible for additional out-of-pocket cost-sharing once they reach the annual out-of-pocket limit (Section 2(a)).
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Predictable Annual Limits: The annual out-of-pocket limit will be set at $5,000 for 2028 and adjusted annually based on average per capita aggregate expenditures (Section 2(a)).
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Improved Program Alignment: The bill aligns eligibility criteria for the Low Income Subsidy (LIS) and the Medicare Savings Program (MSP) to 200 percent of the poverty line starting in 2028 (Section 3(a) and 3(b)).
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Simplified Enrollment: The bill eliminates resource standards for eligibility and enrollment determinations for LIS and MSP prior to January 1, 2028 (Section 3(a)).
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Automated Benefits Processing: States are required to treat certain transmitted data as applications for the Medicare Savings Program, allowing for prompt treatment of eligible individuals (Section 3(c)).
Potential Negative Impacts for People
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Exclusions from Cost-Sharing Protection: Expenses for items and services that are not covered under Part A or B are not considered part of the out-of-pocket cost-sharing calculation (Section 2(a)).
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Provider Charge Limitations: If an item or service is not furnished on an assignment-related basis, additional expenses incurred above the amount for an assignment-related service are not included in the out-of-pocket cost-sharing determination (Section 2(a)).
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 people over 65 be better off under this? — The bill significantly reduces the financial burden of healthcare costs for Medicare beneficiaries through annual out-of-pocket limits. Would households on low incomes be better off under this? — The bill increases support for low-income households by expanding eligibility for the Low Income Subsidy and Medicare Savings Programs. Would middle-income households be better off under this? — The bill provides a cap on annual out-of-pocket medical expenses for Medicare beneficiaries.
- Healthcare
- Does this put more money into Medicaid, the health coverage for people on low incomes? — The bill expands Medicaid coverage by increasing the income eligibility threshold for the Medicare Savings Program. Does this put more money into Medicare, the health coverage for people over 65? — The bill increases Medicare spending by capping annual out-of-pocket costs for beneficiaries and expanding subsidy eligibility.
- Economy And Finance
- Does this reduce what the federal government spends? — The bill increases government spending by establishing out-of-pocket limits and expanding eligibility for Medicare and Medicaid programs.
- Social Issues And Justice
- Is this likely to lift people out of poverty? — The bill provides financial relief to low-income individuals by expanding eligibility for Medicare and Medicaid assistance programs.
- 7/22/2026
- 2 Cosponsors added.
- 6/24/2026
- Read twice and referred to the Committee on Finance.
- 14 Cosponsors added.
- Introduced in Senate
Richard BlumenthalDemocrat · Connecticut
Cory BookerDemocrat · New Jersey
Tammy DuckworthDemocrat · Illinois
Kirsten GillibrandDemocrat · New York
Ben LujánDemocrat · New Mexico
Edward MarkeyDemocrat · Massachusetts
Patty MurrayDemocrat · Washington
Jeff MerkleyDemocrat · Oregon
Alex PadillaDemocrat · California
John ReedDemocrat · Rhode Island
Charles SchumerDemocrat · New York
Adam SchiffDemocrat · California
Chris Van HollenDemocrat · Maryland
Ron WydenDemocrat · Oregon
Peter WelchDemocrat · Vermont
Elizabeth WarrenDemocrat · Massachusetts