Medicare-X Choice Act of 2026

Key Points

• The bill creates a new government run health plan called Medicare-X, sold alongside private insurance on ACA exchanges starting in 2028 for people who buy their own coverage or work for small businesses.
• The plan must offer silver and gold coverage tiers and cannot charge any cost sharing for primary care visits, making routine checkups free for enrollees.
• Most doctors who treat Medicare or Medicaid patients would be required to also join Medicare-X starting in 2028, and the plan generally pays doctors at Medicare rates, with up to 50% more for rural providers.
• The bill removes the current 400% of poverty line income cap on ACA premium tax credits, letting higher earning middle class families qualify for subsidies for the first time.
• It repeals the cap on how many prescription drugs Medicare can negotiate prices for, expanding the government's drug price negotiation authority.
• The bill funds antitrust enforcement in health care markets, giving the Justice Department and FTC a combined $150 million over five years to study and act against anticompetitive practices.