The Proposed Medicare Bill That Could Trap Retirees

The phrase "auto-enrollment" should strike fear into anyone's heart when it comes to matters of health insurance. The dread of being forced into unwanted options should be especially potent for retirees who rely on Medicare. Having to accept an unsuitable benefit option in one's later years can be the expensive difference between appropriate care and a struggle to maintain quality of life. But a new bill, H.R.3467, is in the House of Representatives — and it aims to seriously reform the Medicare Advantage program by introducing mandatory auto-enrollment.

The bill, titled "To amend title XVIII to reform the Medicare Advantage program," was sponsored by Representative David Schweikert, a Republican from Arizona's first congressional district. Per the proposed bill, as of January 1, 2028, anyone who qualifies for Medicare Part A and is enrolled in Part B will instead be automatically enrolled in whatever Medicare Advantage plan is available for the lowest premium price in their zip code. This could force seniors (especially those newly qualifying for Medicare) into only one limited plan for three years, with no changes to the plan possible in that timeframe, except in extremely limited circumstances.

Older adults selecting healthcare benefits already face a stressful maze of options and disappointments. As it is, Medicare won't cover certain medical costs for seniors and offers limited coverage for inpatient hospital care costs. This new bill proposes even more limits for most Medicare beneficiaries as well as a drastic change for end-of-life care that senators on both sides of the aisle have spoken out against.

If bill H.R.3467 becomes law, there will be a period for beneficiaries to opt out of automatic enrollment in the lowest-premium plan of Medicare Advantage. However, opting out of one healthcare plan for another is about as clear as mud. There is also a very narrow set of standards for hardship that may allow beneficiaries to change the plan after auto-enrollment. But most beneficiaries, especially those new to Medicare entirely, would find themselves locked into a healthcare plan with thin benefits. These beneficiaries may also be forced to look for new providers, since covered networks can shift drastically between plans.

The three-year lock-in is not designed for cruelty's sake. The intention is to keep people insured for at least three years. However, with changes coming to Medicare Advantage plans in 2026, after Medicare cuts already took place in 2025, this proposal can feel like another pending slash to benefits. Those likely to feel the most strain under the potentially changing plans could be people who care for a senior new to Medicare in 2028, as well as seniors confused by the complicated system. For seniors without a family member to help them, and for those with cognitive difficulties, the new rules could be life changing. H.R.3467 proposes to remove freedom to choose end-of-life plans and requires Medicare Advantage to pay for hospice care. This could remove choice from beneficiaries and lead to lower reimbursement rates for hospice care providers.