Social Security and Medicare

No Social Security for Illegal Aliens Act of 2025

This bill excludes wages and self-employment income earned by non-U.S. nationals (aliens under federal law) who are not authorized to work in the United States from consideration for purposes of Social Security eligibility and benefits.

This exclusion applies with respect to all such wages and self-employment income earned both before and after the bill’s enactment. However, any change to the amount of an individual’s Social Security benefits as a result of these provisions may only apply to benefits for months after the bill’s enactment.

Chiropractic Medicare Coverage Modernization Act of 2025

This bill expands Medicare coverage of chiropractic services to include all services provided by chiropractors, rather than only subluxation corrections through manual manipulation of the spine.

FairTax Act of 2025

This bill replaces federal income, payroll, estate, and gift taxes with a federal sales tax beginning in 2027 and eliminates the Internal Revenue Service.

The bill establishes a 23% tax-inclusive (30% tax-exclusive) federal sales tax rate on taxable property and services to be administered primarily by each state. The federal sales tax rate is adjusted annually beginning in 2028 so that it is the sum of the

• general revenue rate (14.91%);

• old-age, survivors and disability insurance rate; and

• hospital insurance rate.

The bill includes exemptions for property or services purchased for business, investment, and certain state government functions.

Registered, qualified families may receive a monthly sales tax rebate in the amount of the monthly federal poverty level (or twice such amount for married individuals) multiplied by the federal sales tax rate. Each family member must have a Social Security number and be a lawful resident of the United States.

Federal sales tax revenues are allocated to general revenue, the Social Security trust funds, and the Medicare trust funds. (Special allocation rules apply for 2027.)

The bill eliminates appropriations for the Internal Revenue Service after FY2029 and establishes an Excise Tax Bureau and a Sales Tax Bureau within the Department of the Treasury.

Finally, the bill terminates the federal sales tax if the Sixteenth Amendment to the Constitution (authorizing a federal income tax) is not repealed within seven years from the date the bill is enacted.

Claiming Age Clarity Act

This bill changes certain terms that are used by the Social Security Administration (SSA) to describe the ages at which a worker may claim Social Security retirement benefits.

First, the SSA must use minimum monthly benefit age instead of early eligibility age. This refers to the earliest age (62 under current law) at which a worker may claim benefits. (Currently, the benefit amount of a worker who claims benefits early is reduced to account for the longer period during which the worker is expected to receive benefits.)

Second, the SSA must use standard monthly benefit age instead of full retirement age and normal retirement age. These terms refer to the age at which a worker may claim benefits without a reduction in the benefit amount. (Currently, this age ranges from 65 to 67, depending on the worker's year of birth.)

Finally, the SSA must use the term maximum monthly benefit age for any reference to age 70 as the maximum age at which a worker may receive delayed retirement credits. The SSA may not use the term delayed retirement credit. These terms refer to the mechanism that increases the benefit amount of a worker who delays claiming benefits after reaching the full retirement age. (Currently, a worker receives a credit for each month between the full retirement age and age 70 that the worker delays claiming benefits. Each credit increases the benefit amount that the worker will receive after claiming benefits by a specified percentage.)

Marriage Equality for Disabled Adults Act

This bill eliminates certain marriage-related criteria for individuals entitled to Social Security child’s benefits and Supplemental Security Income (SSI).

Specifically, the bill removes the requirement that individuals receiving Social Security child’s benefits be unmarried. Those eligible for Social Security child’s benefits generally include the minor children of eligible or deceased workers and disabled adult children (the disabled adult children of such workers for whom the onset of disability occurred before age 22). Under current law, child beneficiaries generally lose their benefits upon marriage to an individual who is not also eligible for Social Security benefits.

With respect to SSI, the bill removes the requirement that couples who present themselves as married in their community be considered married for purposes of SSI eligibility. The bill also exempts SSI recipients who are disabled adult children, or who marry disabled adult children, from the general requirement that the income or resources of an SSI recipient’s spouse be considered in an eligibility determination.

Further, married disabled adult children and their spouses who would otherwise be eligible for Medicaid in a state if they were unmarried must remain eligible for Medicaid regardless of their marriage.

Finn Sawyer Access to Cancer Testing Act

This bill provides for coverage of certain cancer diagnostic and laboratory tests under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Specifically, the bill provides for coverage of microarray analysis, DNA and RNA sequencing, whole-exome sequencing, and other next-generation sequencing for individuals diagnosed with cancer.

Additionally, the Department of Health and Human Services must establish an education and awareness program for physicians and the public about genomic testing and the role of genetic counselors.

Rural Physician Workforce Production Act of 2025

This bill allows certain hospitals to receive additional payment under Medicare for full-time equivalent residents who receive training in rural areas.

Specifically, hospitals, critical access hospitals, sole community hospitals, and rural emergency hospitals may elect to receive payment for time spent by a resident in a rural training location if the resident trains for at least eight weeks in the location and the hospital pays the salary and benefits of the resident during this time. Additionally, hospitals may receive payment for all time spent by residents in a residency program in which 50% of all training is in rural locations, regardless of where the training occurs or specialty.

Payments are based on the difference between the total amount of eligible payments (as determined by the Centers for Medicare & Medicaid Services) and the amount of graduate medical education payments received (if applicable).

Kids' Access to Primary Care Act of 2025

This bill modifies payments for Medicaid primary care services. Specifically, the bill applies a Medicare payment rate floor to Medicaid primary care services that are provided after the date of enactment of the bill and extends the payment rate to additional types of practitioners (e.g., obstetricians).

The Centers for Medicare & Medicaid Services must conduct a study on the number of children enrolled in Medicaid, the number of providers receiving payment for primary care services, and associated payment rates before and after the bill's implementation.

Protecting and Preserving Social Security Act

This bill eliminates the cap on income subject to Social Security taxes and revises methods for calculating various aspects of Social Security benefits.

Under current law, Social Security has a taxable maximum, which refers to the maximum amount of a worker's earnings that are subject to Social Security payroll taxes (set at $176,100 in 2025). The taxable maximum also serves as the maximum amount of earnings used to calculate a worker's Social Security benefits.

This bill phases out the taxable maximum so as to apply payroll taxes to all earnings after 2031, and revises the method used to calculate a worker’s Social Security benefits to account for earnings in excess of the taxable maximum.

The bill also revises the method of calculating cost-of-living adjustments to Social Security benefits to reflect the spending habits of individuals over the age of 62. An increase in Social Security benefits resulting from this change may not be treated as income for purposes of determining eligibility for, or the amount of assistance provided under, the Medicaid or Supplemental Security Income programs.

Medicare Audiology Access Improvement Act of 2025

This bill provides for Medicare coverage of certain audiology services. Specifically, the bill expands coverage to include diagnostic and treatment services that are furnished by audiologists and that would otherwise be covered if provided by a physician, including incidental services, regardless of whether such services are provided pursuant to a referral from, or under the supervision of, a physician or other health care practitioner.

Prevent Interruptions in Physical Therapy Act of 2025

This bill allows a physical therapist to receive payment under Medicare for services provided to the physical therapist's patients by another physical therapist through a qualifying temporary arrangement, regardless of the geographic area or population served. Currently, physical therapists may only receive payment with respect to such arrangements for services provided in medically underserved, rural, or health professional shortage areas.

Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act or the PREVENT DIABETES Act

This bill allows health care entities to provide virtual services under the Medicare Diabetes Prevention Program for an additional three years.

The Medicare Diabetes Prevention Program offers Medicare beneficiaries who are at risk of developing Type 2 diabetes specialized training and education regarding diet, exercise, and other behavioral changes. The Centers for Medicare & Medicaid Services issued temporary authorization for entities participating in the program to provide these services virtually until December 31, 2027.

The bill extends the authorization for virtual services until December 31, 2030.

This bill permanently allows audiologists, physical therapists, occupational therapists, and speech-language pathologists to furnish telehealth services under Medicare.

Improving Social Security's Service to Victims of Identity Theft Act

This bill requires the Social Security Administration to provide a single point of contact for any individual whose Social Security account number has been misused or whose Social Security card has been lost in transit. The single point of contact must consist of a team or subset of specially trained employees, and must track the individual's case to completion and coordinate with other specialized units to resolve issues as quickly as possible.

Social Security Expansion Act

This bill increases Social Security benefits, expands Social Security payroll taxes, and makes other changes to the Social Security program.

Specifically, the bill changes the way Social Security benefits are calculated by increasing the primary insurance amount applicable to average monthly earnings that fall below a specified amount, and increasing bend points for individuals who become eligible for Social Security after 2025. (Bend points are dollar amounts at which earnings are segmented for the purpose of calculating an individual’s primary insurance amount. The share of an individual’s earnings that are replaced by Social Security decreases at each escalating bend point.)

The bill also revises the method of calculating cost-of-living adjustments to account for the spending of individuals over the age of 62 and establishes a new minimum benefit for certain low earners. Further, the bill permits full-time students who are the children of deceased or disabled workers to collect Social Security or railroad retirement child’s benefits until they reach age 22.

With respect to taxes, the bill extends payroll taxes on wages, salaries, and self-employment earnings to income above $250,000. (In 2025, the maximum amount subject to Social Security payroll tax is $176,100.) The bill also increases the net investment income tax and subjects active trade or business income to this tax.

Finally, the bill combines the existing Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund into a single Social Security Trust Fund.

This joint resolution prohibits the Centers for Medicare & Medicaid Services (CMS) from testing a new Medicare payment model in certain states that involves a prior authorization process and the use of enhanced technology by third-party contractors to determine whether certain claims should be paid.

Specifically, the joint resolution nullifies a notice issued by the CMS on July 1, 2025, titled Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model. (On May 12, 2026, the Government Accountability Office issued a letter of opinion stating that this notice constituted an agency rule and is therefore subject to the Congressional Review Act.)

The CMS selected six states to participate in this model over a six-year period: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Under the model, contracted companies must process prior authorization requests (i.e., requests for coverage determinations before a service is furnished) for certain services using enhanced technology (e.g., artificial intelligence). Contracted companies are paid based on the share of resulting savings. The CMS aims to test the model's ability to produce accurate results while streamlining the prior authorization process for Medicare claims. The model is based in part on similar processes used for Medicare Advantage claims.

CMS began implementing the model on January 1, 2026. This joint resolution prohibits the CMS from continuing to do so.

Lung Cancer Screening and Prevention Act of 2025

This bill authorizes Medicare coverage of additional types of lung cancer screening tests that are approved by the Food and Drug Administration, regardless of whether they are recommended by the United States Preventive Services Task Force. The Centers for Medicare & Medicaid Services must set coverage and payment limits for such tests. (Currently, Medicare covers screening tests for the early detection of lung cancer if they are recommended by the task force.)

Medicare Enrollment Protection Act of 2025

This bill provides for a special enrollment period for Medicare medical benefits for individuals who are enrolled in COBRA continuation coverage at the time they qualify for Medicare. The special enrollment period applies during each month of COBRA coverage and the three-month period after coverage ends; individuals may enroll during the special enrollment period once during their lifetime.