Territories Health Equity Act of 2025
Territories Health Equity Act of 2025
Plain Language Summary
# Territories Health Equity Act of 2025 Summary **What the Bill Does** This bill aims to improve healthcare access and affordability for residents of U.S. territories (Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, and Northern Mariana Islands) by making changes to federal health insurance programs. Specifically, it would remove spending caps on Medicaid funding for territories starting in 2026, allow Puerto Rico residents more time to enroll in Medicare without facing penalties, improve how Medicare Advantage insurance plans are funded in territorial areas, and give uninsured residents access to the same health insurance options available to Congress members. **Who It Affects** The bill primarily impacts the roughly 3.2 million people living in U.S.
territories who currently face more limited healthcare funding and options compared to the mainland. It could also have modest effects on federal healthcare budgets and insurance companies offering plans in these territories. **Current Status** The bill was introduced in the House by Delegate Stacey Plaskett (D-Virgin Islands) and is currently in committee. It has not yet been voted on by the full House.
CRS Official Summary
Territories Health Equity Act of 2025This bill alters provisions relating to the treatment of U.S. territories under Medicaid, Medicare, and Medicare Advantage.For example, the billeliminates Medicaid funding limitations for U.S. territories beginning in FY2026,exempts an individual from late-enrollment penalties for Medicare medical services if the individual resided in Puerto Rico as of the date of eligibility and the individual enrolls within five years of such date, andestablishes minimum criteria for certain elements used in Medicare Advantage payment calculations for areas within U.S. territories.The bill also allows residents of U.S. territories who are unable to obtain health insurance through their employer or a health insurance exchange to instead obtain coverage that is at least as broad as the coverage available to Members of Congress and their staff through the District of Columbia exchange.
Latest Action
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.