Medicare patients get a say: new federal advance directive registry
S. 3473 — MAP for Care Act · Filed by Bill Cassidy (R-LA) · 3 cosponsors · Introduced Dec 15, 2025 · Referred to committee
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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 and healthcare power-of-attorney documents) electronically. The program certifies vendors who store these directives, ensures they comply with state law and federal privacy rules, and makes directives accessible to doctors, family members, and healthcare proxies in emergencies—aiming to ensure patients' end-of-life wishes are known and followed.
Why we flagged it
The bill's core function is to establish infrastructure for patients to document and communicate their end-of-life medical preferences. It is fundamentally about patient agency and transparency in healthcare decision-making, not about cost control, reimbursement, or industry regulation.
What the text implies
- Vendors accredited under this program may accumulate detailed health preference data on millions of Medicare beneficiaries, creating a valuable dataset for research, product development, or secondary uses if privacy safeguards weaken over time.
- The bill requires vendors to pass 'rigorous independent testing' and 'real-time load tests' but does not specify who conducts these tests or how results are disclosed, potentially creating a compliance theater where vendors self-certify or use friendly auditors.
The full analysis lists 4 implications of this text.
Who stands to gain
Electronic health records vendors; Healthcare IT companies specializing in advance directive management; Cloud storage and data security firms