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House Committees Mark Up Medicare Bills That Aim for Improvements, but Have Unintended Consequences 

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This week, the House Ways and Means and Energy and Commerce Committees met to review bills that aim to reduce coverage restrictions and costs for select services for certain Medicare beneficiaries. These important goals are, however, undermined by some components of the bills.  

Increased Free Screening, but Only for Some 

One of the pieces of proposed legislation considered, H.R. 842, would provide coverage without cost-sharing for emerging blood-based cancer screening services. But only people under 68 in 2028 would be eligible for that coverage. This limitation is not based on clinical factors—indeed, the age limit increases over time.  Medicare Rights strongly opposes such arbitrary limitations on access to reasonable and necessary services and urges Congress to instead work to ensure that everyone with Medicare can get the appropriate, high-quality services they need.  

Breakthrough Device Access, Without Brakes 

Another bill considered, H.R. 5343, would require Medicare to automatically cover all Food and Drug Administration (FDA)–designated medical breakthrough devices during a four-year transitional period, bypassing Medicare’s obligation to determine what services are “reasonable and necessary” under what circumstances, for Medicare beneficiaries. This evaluation is essential for protecting patient safety, consumer integrity, and programmatic integrity.  

Importantly, the Centers for Medicare & Medicaid Services (CMS) has, as of 2024, established a specific, accelerated pathway for the evaluation and coverage of breakthrough devices that retains Medicare’s important role in ensuring that covered devices meet the statutory “reasonable and necessary” standard.

Efforts to reduce these problems must not create artificial divisions between Medicare beneficiaries.

We applaud Congress’s attention to the issues Medicare beneficiaries face, including coverage restrictions and affordability challenges that prevent people from accessing the services and medications they need to build and maintain health. But efforts to reduce these problems must not create artificial divisions between Medicare beneficiaries or undermine key patient safety and fraud-prevention functions.   

Policy Issues: Coverage and Benefits

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4 Comments on “House Committees Mark Up Medicare Bills That Aim for Improvements, but Have Unintended Consequences 

Michael King
September 18, 2025 at 4:05 pm

they need to work on more important things,,,,,,,,,,,,,like the COBRA BILL HR 2744 and HR 4206 ( telehealth) or Senate Bill 2625 ( broker bill vs call centers)

Reply
Geff Ratcheson
September 18, 2025 at 8:17 pm

I don’t trust republicans.

Reply
Geff Ratcheson
September 18, 2025 at 8:17 pm

I don’t trust republicans.

Reply
TAMIE L. CYRUS
September 28, 2025 at 6:26 am

IF AND WHEN THIS HAPPENS, I’M LOSING ALL THE WAY AROUND!! I BARELY GET BY AS IT IS !! I SAW THE CHANGES TO MY HUMANA MEDICARE ADVANTAGE AND IT IS AN OUT RAGE DISAPPOINT!! I’VE BEEN WITH THEM FOR 20 YEARS AND THE PRICES OF EVERYTHING ARE BEYOND MY REACH !! FRUSTRATED AND UPSET !! THAT I HAVE TO FIND A NEW PLAN ALL OVER AGAIN THAT COVERS ALL MY SPECIALIST AND MEDICATIONS!!!

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