H.R. 8840
Fair Care Act of 2026
Sponsor: Bruce Westerman · 0 cosponsors
Official summary
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Text of the bill
I Modernization of health savings accounts
A Modernization of health savings accounts and contributions
B Assistance to health savings accounts
II Improving Private Health Insurance
A Maintaining Protections for Patients with Preexisting Conditions
B Expanding Coverage Options
C Improving Commercial Health Insurance
III Competition, Transparency and Accountability
A Provider and Insurer Competition
B Price Transparency
C Prescription Drug Competition and Innovation
D Prescription Drug and Pharmacy Benefit Manager Transparency
E Medicare and Medicaid Prescription Drug Reforms
F Medical Malpractice Reform
IV Medicare and Medicaid Reforms
A Medicaid Reforms
B Medicare Reforms
C Medicare Choice and Competition
(a) In general. Part E of title XVIII of the Social Security Act, as added by section 101 and amended by section 103, is further amended by adding at the end the following:
3 Competitive bidding and premiums
1860E–31. Application of competitive bidding in enrollment
(a) In general. Notwithstanding any other provision of this title, the Secretary shall, beginning with plan year 2026, establish a method whereby individuals enrolling under this title so enroll through an online process designed to highlight enrollment options for such individuals and allow such individuals to compare costs of enrollment in such options.
(b) Enrollment options. For purposes of subsection (a), the Secretary shall make the following options available to individuals for enrollment under this title:
(1) Traditional fee-for-service coverage.
(2) Provider-led risk-bearing plans (also known as ACOs).
(3) Medicare Advantage plans.
(c) Medicare advantage plan actuarial value requirement. Each Medicare Advantage plan offered through the process described in subsection (a) shall have an actuarial value equal to traditional fee-for-service coverage under parts A and B.
(d) MA direct deposit of certain rebates. In the case of an Medicare Advantage plan with a bid for a year that involves a premium differential between such bid and the benchmark for such year and plan, such plan shall provide for a direct deposit of such differential if the applicable enrollee in such plan does not elect any supplemental coverage under such plan.
(e) Enrollment in prescription drug coverage. As part of the method described in subsection (a), the Secretary shall establish a process to allow an individual to enroll in prescription drug coverage. In the case of an individual who enrolls in a Medicare Advantage plan, such coverage shall be provided under such plan. In a case of an individual who enrolls in an ACO, such coverage shall be provided under such network. In the case of an individual who enrolls under traditional fee-for-service coverage, such drug coverage shall be provided through a prescription drug plan.
(f) Supplemental benefits
(1) MA plans. An MA plan is allowed to offer two different packages of supplemental benefits (these packages are available only to individuals who select such plans).
(2) ACOs. ACOs may limit supplemental options for their enrollees to Medigap plans with contractual ties.
(3) Fee-for-service. Fee-for-service individuals may select supplemental coverage from Medigap policies.
1860E–32. Competition
(a) Bid areas. Market areas used for bid submissions for Medicare Advantage plans, ACOs, and for calculation per person fee-for-services costs shall be metropolitan statistical regions plus associated regions.
(b) Premiums. Medicare payment benchmark by market area shall be calculated based on weighted average (by enrollment in previous year) of the premium bids from MA plans, ACOs, and the per person costs of fee-for-service, less the statutory part B premium.
(c) Beneficiary responsibility. Beneficiaries shall pay the difference between Medicare payment and required premium of the plan they choose, and get 100 percent of the savings by choosing a plan with a premium below the benchmark.
(d) Transition. For beneficiaries who are in fee-for-service at the time of the enactment of this section, there shall be a limit on the amount of a premium increase allowable by year of no more than $20 per month compared to what such premium would have otherwise been if this subpart had not been enacted for each year through the fifth year.
(e) Multiyear contracts. A Medicare Advantage plan may offer to beneficiaries multiyear contracts with guaranteed premiums over such years, bearing the risk of any change in payments from the Secretary in subsequent years. A beneficiary enrolling under such a contract shall be exempt from the method described in subsection (a).
(b) Conforming amendments
(1) Section 1853(a)(1)(A) of the Social Security Act is amended by striking and section 1859(e)(4) and inserting , section 1859(e)(4), and subpart 3 of part E.
(2) Section 1853(j) of such Act is amended by inserting and subpart 3 of part E after subsection (o).
(3) Section 1854 of such Act is amended—
(A) in subsection (a), after the heading, by inserting Subject to subpart 3 of part E:;
(B) in subsection (b), after the heading, by inserting Subject to subpart 3 of part E:;
(C) in subsection (d), after the heading, by inserting Subject to subpart 3 of part E:; and
(D) in subsection (e), after the heading, by inserting Subject to subpart 3 of part E:.
D Telehealth Improvements and Expansion