Krishnamoorthi Introduces Bill to Allow Medicare Buy-In for Americans Ages 50–64, Reduce Drug Prices Through Negotiation, and Strengthen ACA Tax Credits

WASHINGTON - Congressman Raja Krishnamoorthi (D-IL) today introduced the Medicare Expansion and Lowering Costs Now Act, legislation designed to lower health care costs for Illinois families by allowing Americans ages 50 to 64 to buy into Medicare, reducing prescription drug prices through direct negotiation, and strengthening Affordable Care Act (ACA) premium tax credits. In Illinois, more than two million residents are between the ages of 50 and 64 - a group that often faces significantly higher premiums in the individual market due to age-based pricing. Many also shoulder substantial out-of-pocket prescription drug costs before becoming eligible for Medicare. Nationally, analysts estimatethat millions of Americans could enroll in a voluntary Medicare Buy-In program.

"Across Illinois, I hear from families who are getting squeezed by rising premiums and high prescription drug costs," said Congressman Krishnamoorthi. "My legislation lowers health care costs in three clear ways: it allows Americans ages 50 to 64 to buy into Medicare, strengthens ACA tax credits to make coverage more affordable for working families, and expands Medicare's authority to negotiate lower prescription drug prices. By strengthening Medicare's negotiating power, we can reduce drug costs for seniors and put downward pressure on prices across the system. Illinois families deserve more choices and lower costs."

Under the legislation, eligible individuals ages 50-64 could voluntarily enroll in Medicare Parts A, B, and D, including Medicare Advantage plans, through a premium-financed Buy-In option structured to avoid increasing overall Medicare expenditures. Enrollees would receive financial assistance comparable to ACA premium tax credits and cost-sharing reductions to help ensure affordability. Allowing Americans in this age group to participate in Medicare would also help diversify and strengthen the program's overall risk pool, as individuals ages 50-64 are generally younger and healthier than the current Medicare population. Research indicates that a Medicare Buy-In option can contribute to greater premium stability across both Medicare and ACA marketplace coverage.

The legislation repeals the Medicare Part D non-interference clause and directs the Secretary of Health and Human Services to negotiate directly with pharmaceutical manufacturers to secure lower drug prices for beneficiaries. Expanding Medicare's negotiating authority builds on recent reforms projected to generate billions in savings and reduce out-of-pocket drug costs for seniors.

To further reduce costs and strengthen coverage, the bill removes the 400 percent federal poverty level cap on ACA premium tax credits, enhances sliding-scale affordability protections, establishes a federal reinsurance fund to lower premiums for high-cost enrollees, reauthorizes risk corridor protections, and creates a federally administered Medicare supplemental insurance option to help beneficiaries cover deductibles, copayments, and other out-of-pocket costs.

Summary of the Medicare Expansion and Lowering Costs Now Act

• Voluntary Medicare Buy-In for Ages 50-64: Allows eligible Americans to enroll in Medicare Parts A, B, and D, including Medicare Advantage plans.

• Reduces Prescription Drug Prices Through Negotiation: Repeals the Part D non-interference clause and expands Medicare's authority to negotiate directly with manufacturers to secure lower drug prices.

• Strengthens ACA Premium Tax Credits: Removes the 400% federal poverty level cap and enhances affordability protections to lower premiums.

• Reduces Out-of-Pocket Costs: Establishes a federal Medicare supplemental insurance option to help cover deductibles and copays.

• Stabilizes Insurance Markets: Creates a federal reinsurance fund and reauthorizes risk corridor protections to reduce premiums and strengthen marketplace stability.

The full text of the bill is available here.