On April 2, Sen. Michael Bennet (D-Colo.) and Tim Kaine (D-Va.) introduced the Medicare-X Choice Act of 2019 (S. 981), which would allow individuals that do not currently qualify for Medicare to buy in to the public insurance option through the individual exchange marketplaces. More specifically, the legislation would first target individuals on the exchanges in areas where there is either a shortage of insurers or a lack of competition that drives increased health care costs starting in 2021. In 2024, the system would expand to all areas, and in 2025 the plan would be added as an option in the Small Business Health Options Program (SHOP) Marketplace. Essential health benefits established under the Affordable Care Act (ACA) would be covered by the plan, which would utilize Medicare’s network of providers.

The legislation represents one of several options currently introduced in the House of Representatives, the Senate, or both that would expand public insurance options for individuals nationwide to lower costs through increased insurance coverage. Some of these options include the Medicare for All Act of 2019 (S. 1129) introduced by Sen. Bernie Sanders (I-Vt.), which would collapse Medicare, Medicaid, and private insurance into a universal health care system, the Medicare at 50 Act (S. 470), introduced by Sen. Debbie Stabenow (D-Mich.), which would allow non-Medicaid individuals ages 50 to 64 to buy in to Medicare, and the State Public Option Act (S. 489/H.R. 1277), introduced by Sen. Brian Schatz (D-Hawaii) and Rep. Ben Ray Luján (D-N.M.), which would allow individuals to buy in to Medicaid through the ACA marketplaces. S. 981 currently does not have a Republican cosponsor and its future is uncertain in the Senate.

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