Arizona Senate Bill SB1191

Arizona 2026 Regular Session

• Introduced: 1/20/26

Caption

medicare supplement insurance; ALS; ESRD.

Summary

SB 1191 amends Arizona’s Medicare supplement insurance statute to require insurers that sell Medicare supplement policies to people age 65 and older to also offer the same policies to Medicare beneficiaries under age 65 who qualify because of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). The bill extends the same benefits and coverages to these under-65 enrollees that are available to age-65 Medicare enrollees, and it preserves the existing rule that Medicare supplement policies cannot exclude covered services provided by properly licensed health care providers when those services are reimbursable by Medicare. The bill also creates and clarifies enrollment windows for these under-65 ESRD and ALS beneficiaries, including a special application period beginning December 2, 2025 and ending June 1, 2027 for those already enrolled in Medicare Part B on the effective date of the amendment. It further bars insurers from charging under-65 ESRD or ALS enrollees a premium higher than the insurer’s filed rate for the same plan charged to age-65 enrollees. The measure applies to a range of insurance entities operating in Arizona, including disability insurers, hospital and medical service corporations, fraternal benefit societies, and health care service organizations.

Impact

SB 1191 would expand access to Medicare supplement coverage for a specific group of under-65 Medicare beneficiaries in Arizona and would prohibit age-based premium surcharges for those beneficiaries when they qualify through ESRD or ALS. It would amend A.R.S. § 20-1133, which governs Medicare supplement insurance standards, enrollment timing, and applicability to various insurance carriers, and would require the Arizona Department of Insurance and Financial Institutions to align rules with the new requirements. The bill would primarily affect insurers offering Medigap policies, while benefiting Medicare enrollees under 65 who have ESRD or ALS by giving them comparable coverage options and pricing to older Medicare beneficiaries.

Sentiment

The available record shows no committee transcripts, votes, or recorded opposition, so there is no documented floor or committee sentiment to measure. Based on the bill’s text, the measure appears consumer-protective and aimed at parity for vulnerable Medicare beneficiaries under 65, suggesting a generally favorable policy posture toward expanding coverage access. Because the bill had not advanced in the available status information, there is no evidence of formal legislative support or resistance in the provided materials.

Contention

The main policy issue is whether insurers should be required to offer Medigap coverage to under-65 beneficiaries with ESRD or ALS on the same terms as age-65 Medicare enrollees, including identical benefits and rate treatment. Insurers may view the mandate as increasing administrative complexity or affecting pricing and underwriting assumptions, while supporters would likely emphasize fairness and access for people whose Medicare eligibility is based on severe disability or disease. Another possible point of contention is the special enrollment window and retroactive application provisions, which could create compliance and implementation burdens for carriers and regulators.