Congress locks seniors into cut-rate Medicare plans for three years
H.R. 3467 — To amend title XVIII to reform the Medicare Advantage program. · Filed by David Schweikert (R-AZ) · Introduced May 15, 2025 · Referred to committee
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What it does
This bill fundamentally restructures Medicare Advantage (MA) starting in 2028 by requiring plans to use capitated (fixed per-person) payments only, cutting their benchmark payments to 75% of current levels, restricting how they can document patient health conditions for payment adjustments, eliminating quality-based payment bonuses, and automatically enrolling all Medicare beneficiaries into the lowest-cost MA plan with a 3-year lock-in period. It also carves out a Stark Law exception for MA plans providing durable medical equipment and drugs.
Why we flagged it
The bill's core mechanism is a comprehensive reengineering of MA payment and enrollment rules designed to reduce federal spending through capitation mandates, benchmark cuts, and enrollment locks. While framed as 'reform,' the provisions systematically shift financial risk to plans and reduce beneficiary choice.
- Carve-out for MA plans providing durable medical equipment and Part D drugs is substantively unrelated to capitation/payment reform and appears to shield MA plans from anti-kickback scrutiny.
What the text implies
- Automatic enrollment into lowest-cost plans may systematically steer sicker, less-informed beneficiaries into plans with narrower networks, reducing their actual access to specialists and preferred providers.
- The 3-year mandatory continuous enrollment lock prevents beneficiaries from switching plans even if quality declines or networks shrink, eliminating the market discipline that currently forces MA plans to compete for retention.
- Restricting risk adjustment to face-to-face/telehealth diagnoses only (excluding chart reviews and health risk assessments) may cause plans to under-document chronic conditions, reducing payments for high-need patients and incentivizing plans to avoid sicker enrollees.
- Elimination of quality benchmark increases removes financial incentives for MA plans to invest in care coordination, preventive services, and quality improvements, potentially degrading the care experience for millions of seniors.
- The Stark exception for MA-furnished DME and Part D drugs may enable MA plans to self-deal or steer beneficiaries to affiliated suppliers without traditional anti-kickback constraints.
Who it affects
Beneficiaries face mandatory 3-year enrollment locks in MA plans with reduced provider payments and narrower health-status documentation, likely reducing care access and plan quality. The automatic enrollment into lowest-cost plans prioritizes cost containment over choice. Reduced plan payments and eliminated quality bonuses may compress benefits and provider networks, harming seniors' access to care.
Who stands to gain
- Medicare Advantage insurers (UnitedHealth, Humana, CVS Aetna, Anthem)
- Federal government (reduced Medicare spending)
- MA-affiliated durable medical equipment suppliers
- MA-affiliated pharmacy networks
Named in the bill
Medicare Advantage (MA), Social Security Act Section 1852, 1853, 1859A, 1877, Centers for Medicare & Medicaid Services (CMS/Secretary), Stark Law, Part A, Part B, Part C, Part D Medicare, Fee-for-service Medicare, Capitated payments, Risk adjustment, Benchmark payments, Durable medical equipment (DME), Hospice care
Where it stands
- May 15, 2025 — Introduced · Congress.gov: “Introduced in House”
- May 15, 2025 — Referred to House Committee on Energy and Commerce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a…”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
11 lobbying clients named this bill on 16 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $1,340,000 in lobbying spend. A filing names 6 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 92% of bills with at least one filing.
David Schweikert, the sponsor, reported $596,527 in PAC receipts in the 2026 cycle. $6,000 of that came from 1 PAC tied to these lobbying clients.
- Humana Inc — $440,000 on 1 filing
- Vitas Healthcare Corporation — $230,000 on 1 filing
- Ehealth, Inc. — $210,000 on 2 filings
- The National Alliance for Care at Home — $100,000 on 2 filings
- Vitas Healthcare — $100,000 on 2 filings
Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the full bill text on Jun 10, 2026; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Dec 2025 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 20, 2026 · page rendered 2026-10-20.
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