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GailL1
Community Champion ⭐⭐⭐
June 30, 2026

Traditional Medicare - MEDICARE COST CAP ACT

  • June 30, 2026
  • 7 replies
  • 496 views

US Senate.gov Finance - Medicare Cost Cap Act Lowering Out-of-Pocket Costs for People with Medicare 

 

These Senators have gotten it written in Bill Format - so it is ready to be introduced. 

In their own words here (at the link) is what the Medicare Cost Cap Act would do.

 

Per these Senators in the linked article:

Background: Currently, Traditional Medicare has no limit on beneficiaries’ out-of-pocket spending, putting them at risk of confronting unlimited health care costs if they face serious illness or hospitalization. Medicare Advantage, employer-sponsored insurance, and insurance bought on the Marketplace all have annual caps on out-of-pocket spending. Americans who choose Traditional Medicare deserve the same protection. According to AARP, “Adding an out-of-pocket spending limit to traditional Medicare, similar to the one that exists for people

enrolled in MA. This change would not only help protect individuals from the risk of incurring high out-of-pocket costs but would also reduce the policy imbalances between traditional Medicare and MA1.”

 

I cannot find any pro or con from the AARP.org membership organization on this legislation. 

 

From the Senate minority leadership

DEMOCRATS.Senate.gov- 06/25/2026 - Leader Schumer, Senators Blunt Rochester & Wyden, Lead Legislation To Cap Medicare Costs for Seniors 

 

    7 replies

    Conversationalist ⭐
    July 4, 2026

    Thanks for posting this.  My first thought is that this would clearly provide protection for people covered under original Medicare. My second thought is that taxpayers would replace insurance companies in covering healthcare costs not covered by original Medicare in excess of $5,000 annually. The rational policy holder would feel less need to pay premiums with maximum out-of-pocket costs of $5,000. So my third thought is that insurance companies will oppose this legislation and I would strongly support such legislation. And AARP might have mixed feelings about biting the hand (UHC) that feeds it. My guess is that the insurance companies (and UHC is the largest) will be throwing unlimited bucks opposing what appears to be an excellent bill. What a wonderful country!

    Conversationalist ⭐
    July 5, 2026

    My additional thought is that this is not all that much different from a high-deductible Medigap Plan F. Higher deductible ($5,000) than a current HD - F (or HD - G)  but with the premium paid by taxpayers. But the legislation would create another full-employment act for lobbyists.

    Conversationalist ⭐
    July 5, 2026

    But because would be no medical underwriting, anyone with Parts A and B of Medicare  would be eligible to enter the proposed plan, making it so expensive to taxpayers that it would be unsustainable.

    GailL1
    GailL1Author
    Community Champion ⭐⭐⭐
    July 22, 2026

    ADDING TO MY OWN THREAD on the “Medicare Cost Cap Act of 2026” proposal

     

    AARP supports the Medicare Cost Cap Act - here’s their writeup on their advocacy position on it 

     

    AARP.org 07/17/2026 - AARP Backs Bill to Limit Original Medicare Cost 

     

    Seems odd, I know - since as I see it, this would signal an end to most Medicare Advantage plans - and make Medigap plans pretty much one-size-fits-all since all they have to cover is $ 5000.  

    I still don’t believe the figures - especially the cap - $ 5000 ????  I guess there is a reason that cost analysis don’t go hand in hand with bill introductions,

     

     

     

    IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna