To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program.
Summary
H.R. 6113 aims to amend Title XVIII of the Social Security Act, specifically targeting Medicare Advantage (MA) organizations. The bill seeks to limit the number of contracts the Secretary of Health and Human Services can enter into with MA organizations that offer multiple MA plans. The proposed legislation intends to ensure that MA plans offered by the same organization are significantly different in terms of premiums, benefits, or cost-sharing.
Expected Effects
If enacted, H.R. 6113 would restrict MA organizations from offering numerous similar plans. This could lead to fewer plan choices for beneficiaries but potentially more distinct options. The bill could also impact the negotiation power of MA organizations with healthcare providers.
Potential Benefits
- May lead to clearer choices for Medicare beneficiaries by reducing plan overlap.
- Could encourage MA organizations to offer more innovative and differentiated plans.
- Might improve the ability of beneficiaries to compare and select the most suitable plan.
- Could potentially drive MA organizations to focus on quality and value rather than quantity of plans.
- Could streamline administrative processes for both MA organizations and the Centers for Medicare & Medicaid Services (CMS).
Potential Disadvantages
- May reduce the overall number of plan options available to beneficiaries in some areas.
- Could limit the ability of MA organizations to tailor plans to specific niche needs.
- Might increase administrative burden for MA organizations to demonstrate significant plan differences.
- Could potentially lead to higher premiums or reduced benefits if organizations consolidate offerings.
- May face resistance from MA organizations due to reduced flexibility in plan design.
Most Disadvantaged Areas:
Constitutional Alignment
The bill falls under the purview of Congress's power to legislate on matters related to healthcare and social welfare programs, as outlined in Article I, Section 8 of the Constitution, which grants Congress the power to provide for the general welfare. The bill does not appear to infringe upon any specific constitutional rights or freedoms. It is within the legislative authority to regulate contracts related to federal programs like Medicare.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).