The Close the Medigap Act of 2025 would make a broad set of changes to Medicare supplemental insurance (Medigap) rules. The bill would require guaranteed issue protections for eligible Medicare beneficiaries, prohibiting insurers from denying coverage, charging higher premiums, or imposing preexisting-condition exclusions, waiting periods, or enrollment limits based on health status, claims history, receipt of care, medical condition, or genetic information. It would also direct the Department of Health and Human Services (HHS) to conduct outreach to beneficiaries and allow the Secretary to phase in implementation over up to five years, with full implementation required by January 1, 2031.
The bill also revises Medigap medical loss ratio requirements, directing the National Association of Insurance Commissioners (NAIC) to review and update standards and allowing HHS to adopt a higher minimum percentage of premiums that must be spent on benefits if the NAIC recommends one. In addition, it would require new standards to limit pricing discrimination, including prohibiting age-based pricing discrimination and certain geographic rating practices, and would apply those revised standards to policies sold or renewed for people first becoming eligible for Medicare on or after January 1, 2026. The bill further repeals a subsection of the Social Security Act to restore access to first-dollar Medigap coverage.
A major component of the bill is consumer information and transparency. It would expand the Medicare Plan Finder website to show provider network information, out-of-pocket cost estimates, state guaranteed-issue rules, and clearer comparisons of Medigap, Medicare Advantage, and Part D options. The Secretary would also be required to seek public comment, conduct consumer testing, and update the website periodically to improve how plan options and premiums are presented.
The bill would also add broker transparency requirements by extending federal reporting rules to Medigap issuers for payments or other transfers of value to agents, brokers, and third parties. Those reports would include recipient identity, address, amount, dates, and form of payment, and would be subject to the same public disclosure framework used for other transparency reporting under the Social Security Act. Overall, the bill would significantly expand federal regulation of Medigap underwriting, pricing, disclosure, and consumer-facing information.
There is no recorded committee debate or vote history in the provided materials, so sentiment cannot be measured from hearings or roll calls. Based on the bill’s sponsors and structure, the measure appears intended to expand beneficiary protections and improve transparency, suggesting generally favorable support among its Democratic cosponsors. The main likely points of contention are the restrictions on insurer pricing and underwriting flexibility, the repeal of first-dollar coverage limits, and the new reporting obligations for insurers and brokers, which could raise concerns about premium effects, administrative burden, and market disruption.
The bill would amend Title XVIII of the Social Security Act, primarily section 1882, to change federal Medigap rules nationwide. It would create stronger guaranteed-issue protections, prohibit health-status and genetic-information underwriting, restrict age and certain geographic pricing discrimination, revise medical loss ratio standards, restore first-dollar Medigap coverage by striking subsection (z), and impose new broker and issuer transparency reporting requirements. It would also require HHS and CMS to expand beneficiary outreach and improve the Medicare Plan Finder website, affecting insurers, brokers, Medicare beneficiaries, and state insurance regulators working with NAIC standards.
No committee transcripts or votes were provided, so there is no direct recorded sentiment from debate or floor action. The bill’s many Democratic cosponsors and consumer-protection framing indicate supportive sentiment from its sponsors and likely allied advocates, especially around access, affordability, and transparency. At the same time, the bill’s regulatory changes suggest likely opposition or concern from Medigap insurers, brokers, and others worried about tighter underwriting rules, reduced pricing flexibility, and added compliance obligations.
The most notable contention points are likely to be the bill’s limits on insurer underwriting and pricing discretion, especially the prohibition on denying or pricing policies based on health status, preexisting conditions, genetic information, age, and certain geographic factors. Insurers may also object to the restoration of first-dollar Medigap coverage and the requirement that NAIC and HHS potentially raise medical loss ratio standards, which could affect premiums and product design. Brokers and insurers may further resist the new transparency reporting requirements and the expanded CMS website disclosures, while consumer advocates are likely to support those provisions as necessary for clearer comparisons and better beneficiary decision-making.