Medicare deregulation bill lets doctors charge unlimited fees to seniors
S. 4583 — Legalizing Premium Health Care Act of 2026 · Filed by Rand Paul (R-KY) · 1 cosponsor · Introduced May 20, 2026 · Referred to committee
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What it does
This bill allows Medicare beneficiaries to sign private contracts with doctors and other health professionals to receive covered services outside the standard Medicare payment system. Under these contracts, patients can agree to pay whatever amount the provider charges (potentially far above Medicare rates), and the provider is freed from Medicare's payment limits and billing rules. The bill also prevents states from capping what providers can charge for these privately contracted services.
Why we flagged it
The bill's core function is to exempt private Medicare contracts from federal price controls and state rate limits, allowing unlimited billing. The title 'Legalizing Premium Health Care' obscures that it is fundamentally a deregulation of Medicare pricing and a dismantling of beneficiary protections.
What the text implies
- Creates a two-tier Medicare system: wealthy beneficiaries can negotiate private contracts at potentially lower rates, while others remain in standard Medicare facing higher costs as providers migrate to private contracts.
- Preemption of state rate-limiting laws removes a critical consumer protection layer, preventing states from protecting their residents against price gouging by providers.
The full analysis lists 5 implications of this text.
Who stands to gain
pharmaceutical companies; health insurers; large hospital systems and health networks