What the Lame Duck Session Means for Medicare

duck and medicare card over blue background; what lame duck sessions means for medicare

Now that the midterms are over, the lame duck session has begun. The lame duck session is the time period between an election and when newly-elected members are inducted into Congress. During this time, outgoing members still have voting power.

This can be a crucial time for social programs like Medicare, Medicaid, and Social Security that are vulnerable to big hits when lawmakers don’t have another election ahead of them to lose.

What can we anticipate from the lame duck session?

During the lame duck session, Congress will be asked to pass, prioritize, or strengthen three key healthcare Acts:

  1. The Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act
  2. The Bipartisan Budget Act (BBA) of 2018’s Part D donut hole reform
  3. The Medicaid Money Follows the Person (MFP) program


Too many Medicare beneficiaries are hit with lifetime late enrollment penalties due to confusion about when to enroll in Medicare coverage. This can lead to higher premiums, increased out-of-pocket costs, gaps in coverage, and less access to healthcare.

The BENES Act aims to prevent enrollment mistakes by empowering beneficiaries to make timely, well-informed enrollment decisions. This can be accomplished by streamlining the outdated Medicare Part B enrollment process.

The BBA of 2018 Part D donut hole reform

The affordability of drugs is an ongoing issue in American healthcare. Prices for drugs like insulin continue to climb higher and higher, and patients are left struggling to pick up the tab. The BBA of 2018 aimed to ease this burden by closing the Part D donut hole for brand name drugs a year earlier than expected.

The Part D donut hole is a coverage period in which your drug plan will not pay for any part of your prescription drug costs. The closing of the donut hole is accomplished by increasing government-funded discounts for brand name drugs, which allows patients to move through the coverage period faster. This effectively lowers out-of-pocket healthcare costs and ensures better healthcare outcomes.

The EMPOWER Care Act

The EMPOWER Care Act was launched in 2007 with the purpose of extending and improving the lapsed Medicaid Money Follows the Person (MFP) program. Since the program launched, it helped over 88,000 older adults and people with disabilities transition from a skilled nursing facility back into their community.

Beneficiaries of the program experienced improved quality of life as well as a 23 percent reduction in Medicare and Medicaid expenses. Lower healthcare expenses generate even more savings for the programs themselves.

What you can do during the lame duck session

During the lame duck session, you can contact your Congressmember and request they do three things: pass the BENES Act, protect the BBA’s donut hole reform, and extend the MFP. Find the contact information for your Congressmembers by searching here.

Visit us on Facebook for the latest news in healthcare legislation.

Up Next...

blog image

Medicare World Blog

CA Residents: Privacy Notice for California Residents |