The BENES Act Advances in the House

Yesterday, the U.S. House Committee on Energy and Commerce unanimously advanced the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act (H.R. 2477). Next steps for the bill include consideration by the full House.

The BENES Act would update Medicare Part B enrollment rules for the first time in over 50 years, simplifying the process and empowering beneficiary decision-making. The current system is overly complicated and extremely confusing. Far too many people make mistakes when trying to understand and navigate it.

The consequences of such missteps can be significant and may include a lifetime Part B late enrollment penalty. This penalty accrues at 10% for every year someone should have been enrolled in Part B but was not. In 2019, about 764,000 people with Medicare were paying a late enrollment penalty and the average amount represented nearly a 30% increase in their monthly premiums. In addition to this considerable financial burden, older adults and people with disabilities often face disruptions in care, unexpected health expenses, and lack of coverage because of unduly complex Medicare transitions.

The rules are so confusing that even human resources experts and employer benefits departments can struggle with them—leaving beneficiaries to navigate the enrollment process on their own. Clear advice from the federal government to those approaching Medicare eligibility would help, but no such notice is currently required.

As a result of this information vacuum, among the most frequent calls to Medicare Rights’ national helpline are those from or on behalf of people eligible for Medicare who inadvertently and through no fault of their own failed to enroll in Part B on time. These callers and their loved ones are experiencing severe repercussions, including being uninsured and unable to pay for care.

Without immediate action, a growing number of Americans will encounter these pitfalls. As the population ages and people stay in the workforce longer, delaying Social Security, more and more beneficiaries will face critical Part B enrollment decisions.

The BENES Act would help. It would, for the first time, require the federal government to notify individuals approaching Medicare eligibility about basic enrollment rules. It would also update enrollment timelines to eliminate unnecessary breaks in coverage and inform future policymaking on enrollment period alignment. These long overdue changes would greatly improve the health and well-being of people with Medicare.

Stakeholders and experts agree. The BENES Act has the support of every former living Administrator of the Centers for Medicare & Medicaid Services (previously the Health Care Financing Administration)—a group made up of 10 Republicans and Democrats. It enjoys widespread bipartisan consensus among members of Congress as well, in both the House and Senate, and it is championed by over 100 organizations, including consumer advocates, health insurers, unions, and providers.

The Committee’s approval this week is a welcome and important step towards enactment of the BENES Act’s commonsense reforms. Medicare Rights applauds the tireless and bipartisan work of the Committee and that of the bill’s leads, Representatives Ruiz (D-CA) and Bilirakis (R-FL). We also thank Rep. Schneider (D-IL) and Rep. Walorski (R-IN) for heading the bill on the Ways and Means Committee, and the BENES Act’s many supporters for their engagement, partnership, and advocacy.

We continue to urge lawmakers to prioritize the BENES Act for immediate passage.

The archived Energy and Commerce markup is available here.

Read Medicare Rights’ one-pager on the BENES Act.

Take Action! Urge your lawmakers to pass the BENES Act without delay.