H.R. 6494
Territories Health Equity Act of 2025
Official summary
Written by the Congressional Research Service.
Territories Health Equity Act of 2025
This bill alters provisions relating to the treatment of U.S. territories under Medicaid, Medicare, and Medicare Advantage.
For example, the bill
- eliminates Medicaid funding limitations for U.S. territories beginning in FY2026,
- exempts an individual from late-enrollment penalties for Medicare medical services if the individual resided in Puerto Rico as of the date of eligibility and the individual enrolls within five years of such date, and
- establishes minimum criteria for certain elements used in Medicare Advantage payment calculations for areas within U.S. territories.
The bill also allows residents of U.S. territories who are unable to obtain health insurance through their employer or a health insurance exchange to instead obtain coverage that is at least as broad as the coverage available to Members of Congress and their staff through the District of Columbia exchange.
Text of the bill
I MEDICAID
Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended—
(1) in subsection (b)(2), by inserting for fiscal years before fiscal year 2026 after American Samoa; and
(2) in subsection (ff)(2), by striking 2027 and inserting 2025.
II MEDICARE
A Part A
B Part B
C Medicare Advantage (Part C)
D Part D
III MISCELLANEOUS