Bill > HR6494

This bill aims to improve healthcare coverage and funding for U.S. territories (Puerto Rico, Virgin Islands, Guam, Northern Mariana Islands, and American Samoa) by making significant changes to Medicare and Medicaid programs. Starting in fiscal year 2026, the bill eliminates funding caps and limitations for territories' Medicaid programs, allows territories to receive disproportionate share hospital (DSH) allotments, and adjusts Medicare payment calculations to provide more equitable funding. For Medicare, the bill includes provisions such as eliminating late enrollment penalties for Puerto Rico residents, adjusting benchmark payments for Medicare Advantage plans, and providing automatic premium and cost-sharing subsidies for low-income territorial residents. Additionally, the bill requires the Department of Health and Human Services to publish transparency information about Medicaid and CHIP in territories and submit a report on the territories' exclusion from health insurance exchanges. The legislation seeks to address longstanding disparities in healthcare funding and access for U.S. territories, ensuring they receive more comparable support to states.