Bill Overview
Title: Medicare Enrollment Protection Act of 2022
Description: This bill provides for a special enrollment period for Medicare medical benefits for individuals who are enrolled in COBRA continuation coverage at the time they qualify for Medicare. The special enrollment period applies during each month of COBRA coverage and the three-month period after coverage ends; individuals may enroll during the special enrollment period once during their lifetime.
Sponsors: Rep. Schrader, Kurt [D-OR-5]
Target Audience
Population: Individuals enrolled in COBRA eligible for Medicare
Estimated Size: 200000
- The bill applies to individuals who are eligible for Medicare benefits, which mainly includes U.S. citizens or legal residents age 65 and older, and younger individuals with disabilities.
- The bill specifically targets individuals who are currently enrolled in COBRA continuation coverage when they qualify for Medicare.
- COBRA (Consolidated Omnibus Budget Reconciliation Act) allows employees and their families to continue health insurance coverage under their group health plan for a limited time after certain events, such as job loss.
- According to the U.S. Department of Labor, millions of Americans are eligible for COBRA annually, but not all those eligible individuals will also reach the age of 65 or meet the requirements for Medicare during their COBRA coverage period.
- The allowance for a special enrollment period provides flexibility for the potentially significant number of people who transition from employer-based health insurance to Medicare.
Reasoning
- The Medicare Enrollment Protection Act of 2022 is aimed at individuals who are transitioning from COBRA continuation coverage to Medicare. The idea is to make this transition smoother by providing a special enrollment period.
- The target population includes a specialized group of U.S. citizens or legal residents who are 65 or older and are currently on COBRA. The count of this group is likely much smaller than the total number of individuals on Medicare.
- The estimated financial impact must align with budget constraints, focusing on high-impact cases within the identified group.
Simulated Interviews
Retired accountant (Florida)
Age: 66 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 5/20
Statement of Opinion:
- This policy would provide me peace of mind knowing I have more time to navigate my Medicare enrollment.
- COBRA is expensive, and this policy will help me transition more smoothly to more affordable healthcare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Unemployed engineer (California)
Age: 63 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- I appreciate the flexibility this policy offers, though I won't be directly affected until I turn 65.
- It seems like a smart move to help those on the edge of Medicare qualification.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired teacher (Texas)
Age: 70 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- I wish this policy had been in place when I was making my transition from COBRA to Medicare.
- Managing deadlines and paperwork was stressful, and extra time would have been beneficial.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 4 |
| Year 5 | 4 | 4 |
| Year 10 | 4 | 4 |
| Year 20 | 4 | 4 |
Part-time librarian (New York)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.5 years
Commonness: 6/20
Statement of Opinion:
- This policy gives me a much-needed cushion period to transition from COBRA to Medicare.
- It reduces my anxiety about aligning costs and coverage.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Freelance graphic designer (Illinois)
Age: 64 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 7/20
Statement of Opinion:
- The safety net provided by this policy for transitioning to Medicare is reassuring.
- I plan carefully for next steps, and this policy provides stability.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Healthcare consultant (Ohio)
Age: 62 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- Though I'm not currently on COBRA, understanding such safety measures exist eases planning for my eventual transition to Medicare.
- This policy seems like a preventative measure to address potential pitfalls when switching from COBRA.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Social worker (Washington)
Age: 67 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- My employer assisted with enrollment, so I didn't face too much difficulty.
- However, I recognize the value of such a policy for many colleagues who have similar transitions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired mechanic (Colorado)
Age: 65 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 3/20
Statement of Opinion:
- Navigating between COBRA and Medicare is daunting, and this policy seems like it recognizes that struggle.
- The additional time is a significant stress reducer.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Retired military (Pennsylvania)
Age: 69 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 6/20
Statement of Opinion:
- My military benefits already provided a smooth transition to Medicare, so I don’t feel this policy would impact me.
- However, I believe it could be helpful for those without such benefits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Retired nurse (New Jersey)
Age: 72 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- Healthcare has been manageable for me since the transition, due in part to minimal coverage interruption.
- This policy seems beneficial for those in other kinds of employment transitions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Cost Estimates
Year 1: $250000000 (Low: $200000000, High: $300000000)
Year 2: $260000000 (Low: $210000000, High: $310000000)
Year 3: $270000000 (Low: $220000000, High: $320000000)
Year 5: $290000000 (Low: $240000000, High: $340000000)
Year 10: $320000000 (Low: $260000000, High: $380000000)
Year 100: $400000000 (Low: $300000000, High: $500000000)
Key Considerations
- This bill involves coordination with CMS for administrating the special enrollment periods effectively.
- Estimations assume that 100,000 to 200,000 individuals may qualify for this special enrollment annually.
- The impact model needs to evaluate differences in health costs covered under Medicare versus COBRA.