Medicare creates free advance directive registry to let seniors control end-of-life care

What it does

This bill creates a Medicare program requiring the federal government to establish a national registry where Medicare beneficiaries can voluntarily store and share advance directives (living wills, healthcare power-of-attorney documents) electronically. The Secretary of Health and Human Services will accredit private vendors to host these directives, set security and privacy standards, and display state-specific advance directive forms on a CMS website. Beneficiaries can enroll, update, or withdraw their directives at any time, and authorized family members, healthcare proxies, and providers can access them in emergencies.

Why we flagged it

The bill's core mechanism is establishing a voluntary, federally-supported registry for advance directives—a public health infrastructure project aimed at improving end-of-life care transparency and beneficiary control. It is not a subsidy, deregulation, or narrow carve-out; it is a straightforward expansion of Medicare beneficiary rights and information access.

What the text implies

• Vendors accredited under the program may collect aggregate data on beneficiary end-of-life preferences, creating a large dataset on mortality and treatment preferences that could be valuable for healthcare research, insurers, or pharmaceutical companies studying treatment patterns—though the bill does not explicitly authorize such secondary use.
• The requirement that vendors pass 'real-time tests simulating realistic volume' of simultaneous access may create a technical barrier to entry for smaller vendors, potentially concentrating the market among larger health IT firms with robust infrastructure.
• State-by-state form variation means beneficiaries moving between states may need to re-execute directives, and the bill does not address portability or reciprocal recognition of out-of-state directives, potentially creating gaps in coverage during relocation or travel.
• The 'interested individual' access provision in cases of treatment disputes (allowing family members to view directives when challenging medical decisions) may create litigation risk if family members use the directive as evidence in end-of-life disputes, potentially chilling beneficiary candor in directive language.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

The bill expands Medicare beneficiaries' autonomy and transparency in end-of-life care by creating a standardized, secure system to document and communicate healthcare wishes. It removes barriers to advance directive adoption (no cost to beneficiaries, standardized access, mobile-friendly), improves emergency access to critical medical instructions, and protects privacy through HIPAA compliance and beneficiary-controlled access. The only concrete cost is administrative overhead, which is modest

Who stands to gain

• Health IT vendors providing advance directive storage and management services
• Electronic health record (EHR) companies integrating with the registry
• Advance directive accreditation organizations contracted by CMS

Named in the bill

Centers for Medicare & Medicaid Services (CMS), Secretary of Health and Human Services, Medicare Part A and Part B beneficiaries, Advance directive vendors, State attorneys general, Comptroller General of the US, Health Insurance Portability and Accountability Act (HIPAA), State courts

Where it stands

1 cosponsor: 1 Democrats.

• Dec 15, 2025 — Introduced · Congress.gov: “Introduced in House”
• Dec 15, 2025 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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

1 lobbying clients named this bill on 1 disclosure filings across 1 quarter, Mar 2026 to Mar 2026. Those filings disclosed $468,727 in lobbying spend. A filing names 47 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 0% of bills with at least one filing.

Gregory Murphy, the sponsor, reported $1,068,698 in PAC receipts in the 2026 cycle.

• American College of Emergency Physicians — $468,727 on 1 filing

Lobbying Disclosure Act filings through May 5, 2026. A filing shows who paid to lobby on a bill it names, not what changed.