S 3221 — Expanding Health Care Options for First Responders Act
Last action — Read twice and referred to the Committee on Finance.
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✓Introduced
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2In Committee
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3Passed Senate
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4Passed House
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5To Executive
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6Enacted
This bill is in committee in the Senate. Introduced November 19, 2025. It must pass committee before a floor vote.
Next likely step: a committee vote, then a floor vote in the Senate.
Odds of enactment
Low chanceBased on the sponsor, cosponsors, and committee posture, this bill has a low chance of becoming law.
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A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.
Prognosis
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In Committee
Current position in the legislative process.
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1 sponsor
1 primary, 0 co-sponsors signed on.
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Single-party support
Sponsorship is currently within one party (1 D).
Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.
Summary
Expanding Health Care Options for First Responders Act This bill establishes a Medicare buy-in option for certain qualifying first responders. Specifically, the bill allows first responders aged 50 to 64 to enroll in Medicare if they are retired or otherwise separated from service due to a disability. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations for outreach and enrollment activities relating to the buy-in option.
Bill Text
- Introduced Introduced in Senate Current html November 19, 2025
Compared against current U.S. Code AI-generated reading aid — verify against the official bill.
The bill establishes a Medicare buy-in option for first responders aged 50 to 64 who are separated from service due to retirement or disability.
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42 U.S.C. 1395c
medicare buy-in option for first responders 50 to 64 years of age who are separated from service due to retirement or disability
Adds a new section to allow certain first responders to buy into Medicare.
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42 U.S.C. 1395c
Sec. 1899D. (a) Option.--Every individual who meets the requirements described in paragraph (3) shall be eligible to enroll under this section.
Establishes eligibility criteria for enrollment in the new Medicare buy-in option.
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42 U.S.C. 1395c
An individual enrolled under this section is entitled to the same benefits ... including the ability to enroll in a Medicare Advantage plan that provides qualified prescription drug coverage (an MA-PD plan).
Ensures that individuals enrolled in the buy-in option have similar benefits as current Medicare beneficiaries.
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42 U.S.C. 1395c
The individual is a qualified first responder (as defined in paragraph (4)(B)).
Defines qualification for first responders enrolling in the buy-in option.
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42 U.S.C. 1395c
Coverage provided under this section shall be treated as coverage under a qualified health plan in the silver level of coverage in the individual market offered through an Exchange.
Aligns the new coverage with existing health insurance standards under the Affordable Care Act.
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42 U.S.C. 18071
For purposes of applying section 1402 ... coverage provided under this section shall be treated as coverage under a qualified health plan.
Enables cost-sharing subsidies for first responders who enroll in the new Medicare buy-in option.
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42 U.S.C. 1395c
An individual enrolled under this section shall not be treated as enrolled under any part of this title for purposes of obtaining medical assistance for Medicare cost-sharing or otherwise under title XIX.
Clarifies that individuals in the buy-in option cannot receive Medicaid cost-sharing assistance.
Action History
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Introduced in Senate
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Read twice and referred to the Committee on Finance.
Sponsors
- Ruben Gallego · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 546 not signed on
Sponsors (1)
- Gallego, Ruben Democratic
Co-sponsors (0)
None.
Not signed on (546)
546 members have not signed on to this bill.
Show all 546 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does S 3221 do?
- Expanding Health Care Options for First Responders Act This bill establishes a Medicare buy-in option for certain qualifying first responders. Specifically, the bill allows first responders aged 50 to 64 to enroll in Medicare if they are retired or otherwise separated from service due to a disability. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations for outreach and enrollment activities relating to the buy-in option.
- Who sponsors S 3221?
- S 3221 is sponsored by Gallego, Ruben (Democratic).
- What is the current status of S 3221?
- This bill is in committee in the Senate. Introduced November 19, 2025. It must pass committee before a floor vote.
- Where can I track S 3221?
- Track S 3221 free on One Click Politics — get push/email alerts when it moves.
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