HouseH.R. 10874119th Congress
Medicare Low Income Subsidy Equality Act of 2026
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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10874 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 10874
To amend titles XVIII and XIX of the Social Security Act to make
premium and cost-sharing subsidies available to low-income Medicare
part D beneficiaries who reside in the Commonwealth of Puerto Rico or
another territory of the United States.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 22, 2026
Mr. Hernandez (for himself, Mr. Moylan, and Mr. Soto) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend titles XVIII and XIX of the Social Security Act to make
premium and cost-sharing subsidies available to low-income Medicare
part D beneficiaries who reside in the Commonwealth of Puerto Rico or
another territory of the United States.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Low Income Subsidy Equality
Act of 2026''.
SEC. 2. EQUAL TREATMENT OF RESIDENTS OF THE COMMONWEALTH OF PUERTO RICO
AND OTHER TERRITORIES IN PREMIUM AND COST-SHARING
SUBSIDIES UNDER MEDICARE PRESCRIPTION DRUG PROGRAM.
(a) Medicare Assistance.--Section 1860D-14(a)(3) of the Social
Security Act (42 U.S.C. 1395w-114(a)(3)) is amended--
(1) in subparagraph (A), in the matter preceding clause
(i), by striking ``subject to subparagraph (F),'';
(2) in subparagraph (B)(v), in the matter preceding
subclause (I), by striking ``Subject to subparagraph (F), the
Secretary'' and inserting ``The Secretary'';
(3) in subparagraph (C), by adding at the end the following
new sentence: ``In the case of an individual who is not a
resident of the 50 States or the District of Columbia, the
poverty line (as such term is defined in clause (ii)) that
shall apply to such individual shall be the poverty line for
the 48 contiguous States and the District of Columbia.''; and
(4) by striking subparagraph (F).
(b) Medicaid Assistance.--Section 1935 of the Social Security Act
(42 U.S.C. 1396u-5) is amended--
(1) in subsection (c)(1)(A)--
(A) by inserting ``(and each other State for each
month beginning with January 2027)'' after ``January
2006''; and
(B) in clause (i), by inserting ``or (2)(B) (as the
case may be)'' after ``paragraph (2)(A)'';
(2) in subsection (c)(2)--
(A) in subparagraph (A)--
(i) by amending the heading to read as
follows: ``Computation for 50 states and the
district of columbia''; and
(ii) by striking ``a State described in
paragraph (1)'' and inserting ``one of the 50
States or the District of Columbia'';
(B) in subparagraph (B)--
(i) by striking ``subparagraph (A)'' and
inserting ``subparagraph (A) or (B) (as the
case may be)''; and
(ii) by redesignating such subparagraph as
subparagraph (C); and
(C) by inserting after subparagraph (A) the
following new subparagraph:
``(B) Computation for the commonwealth of puerto
rico and other territories.--The amount computed under
this paragraph for a State not described in
subparagraph (A) and for a month in a year (beginning
with 2027) is equal to--
``(i) \1/12\ of the product of--
``(I) the amount determined under
subsection (e) for the State for 2026;
and
``(II) 100 percent minus the
highest possible Federal medical
assistance percentage that may be
applied to any of the 50 States for
fiscal year 2024 under section
1905(b)(1); and
``(ii) increased for each year (beginning
with 2027 up to and including the year
involved) by the applicable growth factor
specified in paragraph (4) for that year.'';
and
(3) in subsection (e)--
(A) in paragraph (1)--
(i) in subparagraph (A), by striking ``of
such State; and'' and inserting ``of such State
for years before 2027;'';
(ii) in subparagraph (B)--
(I) by inserting ``for periods
before January 1, 2027'' after ``(B)'';
and
(II) by striking the period at the
end and inserting ``; and''; and
(iii) by adding at the end the following
new subparagraph:
``(C) for the last 3 quarters of fiscal year 2027
and for each subsequent fiscal year, the amount
otherwise applied under section 1108(f) for the State
shall be increased by the amount specified in paragraph
(4)(A) for such period or fiscal year.'';
(B) in paragraph (2), by striking ``The Secretary''
and inserting ``For periods before January 2027, the
Secretary'';
(C) in paragraph (3)--
(i) in the heading, by inserting ``before
second quarter of fiscal year 2027'' after
``Increased amount'';
(ii) in subparagraph (A)--
(I) in the matter before clause
(i), by inserting ``or other fiscal
period'' after ``for a year''; and
(II) in clause (i), by inserting
``for such year or period'' after
``subparagraph (B)''; and
(iii) in subparagraph (B)--
(I) in clause (ii), by striking
``or'' at the end;
(II) in clause (iii), by striking
``a subsequent year'' and inserting ``a
subsequent fiscal year (before the
second quarter of fiscal year 2027)'';
(III) in clause (iii), by striking
the period at the end and inserting ``;
and''; and
(IV) by adding at the end the
following:
``(iv) for the first quarter of fiscal year
2027, is equal to 25 percent of the aggregate
amount specified in this subparagraph for the
previous fiscal year increased by the annual
percentage increase specified in section 1860D-
2(b)(6) for the year involved.'';
(D) by striking paragraph (4); and
(E) by inserting after paragraph (3) the following
new paragraph:
``(4) Increased amount beginning with second quarter of
fiscal year 2027.--
``(A) In general.--The amount specified in this
paragraph for a State for the last 3 quarters of fiscal
year 2027 or for a subsequent fiscal year is equal to
the product of--
``(i) the aggregate amount specified in
subparagraph (B) for such period or fiscal
year; and
``(ii) the ratio (as estimated by the
Secretary) of--
``(I) the number of individuals who
are entitled to benefits under part A
or enrolled under part B and who reside
in the State (as determined by the
Secretary based on the most recent
available data before the beginning of
the period or year); to
``(II) the sum of such numbers for
all States that are subject to this
subsection.
``(B) Aggregate amount.--The aggregate amount
specified in this subparagraph for--
``(i) the last 3 quarters of fiscal year
2027, is equal to 3 times the amount specified
in paragraph (3)(B)(iv);
``(ii) fiscal year 2028, is equal to 4
times the amount specified in paragraph
(3)(B)(iv) increased by the same annual
percentage increase as is applied to increases
in the amounts applied for the fiscal year and
State under section 1108(f); or
``(iii) a subsequent fiscal year, is equal
to the aggregate amount specified in this
subparagraph for the previous fiscal year
increased by the same annual percentage
increase as is applied for the fiscal year and
State under section 1108(f).''.
(c) Conforming Amendment.--Section 1108(f) of the Social Security
Act (42 U.S.C. 1308(f)) is amended by striking ``1935(e)(1)(B)'' and
inserting ``1935(e)(1)''.
(d) Effective Dates.--The amendments made by subsection (a) shall
take effect on January 1, 2027, and the amendments made by subsections
(b) and (c) shall take effect on the date of the enactment of this Act.
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