Title: Healthcare Enrollment Reform Modernization and Navigation Act
Policy area: Health

Summary:
Healthcare Enrollment Reform Modernization and Navigation Act
This bill establishes and otherwise modifies requirements relating to coordinated coverage between employer health insurance and Medicare.
Specifically, the bill prohibits employer-sponsored health plans for certain smaller employers from reducing benefits for employees who are eligible for Medicare but have not yet enrolled.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 5088 Introduced in Senate (IS)]

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117th CONGRESS
  2d Session
                                S. 5088

    To amend title XVIII of the Social Security Act to improve the 
      enrollment of retiring individuals in the Medicare program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 15, 2022

Mr. Casey (for himself and Mr. Portman) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to improve the 
      enrollment of retiring individuals in the Medicare program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Healthcare Enrollment Reform 
Modernization and Navigation Act''.

SEC. 2. COORDINATION OF MEDICARE BENEFITS WITH OTHER HEALTH CARE 
              INSURANCE.

    (a) In General.--Section 1862(b)(1)(A) of the Social Security Act 
(42 U.S.C. 1395y(b)(1)(A)) is amended by adding at the end the 
following new clause:
                            ``(vi) Coordination of benefits with other 
                        health care insurance.--Notwithstanding any 
                        other provision of law, in the event that an 
                        individual is enrolled in an employer group 
                        health plan (including a multiemployer or 
                        multiple employer group health plan) by virtue 
                        of current employment status with an employer 
                        that does not have 20 or more individuals in 
                        current employment status for each working day 
                        in each of 20 or more calendar weeks in the 
                        current calendar year and the preceding 
                        calendar year and the individual is eligible 
                        but not enrolled in coverage under part B, such 
                        employer group health plan shall not reduce 
                        benefits under the plan with respect to the 
                        individual on the basis that the individual 
                        could have been enrolled in coverage under part 
                        B. Nothing in the preceding sentence shall 
                        require such employer group health plan to 
                        provide coverage to an individual who elects to 
                        enroll in coverage under part B or to prohibit 
                        such plan from terminating such coverage or 
                        reducing benefits if such individual makes such 
                        election.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to items and services furnished on or after the date of the 
enactment of this Act.
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