Social Security and Medicare

Ensuring Outpatient Quality for Rural States Act

This bill allows Medicare payments for covered hospital outpatient services in Alaska or Hawaii to include certain cost-of-living adjustments.

Critical Access Hospital Relief Act of 2025

This bill repeals the 96-hour physician-certification requirement for inpatient critical access hospital services under Medicare. Under current law, as a condition for Medicare payment for such services, a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital.

Medicare Advantage Integrity Act of 2025

This bill temporarily establishes geographic adjustments for certain Medicare Advantage payment formulations, and specifies that a certain percentage of corresponding payment increases must be directed toward payments for basic benefits.

No Tax on Social Security

This bill excludes Social Security and Tier I railroad retirement benefits from gross income for purposes of federal income taxes. The bill also provides funds to cover reductions in transfers to the Social Security, Medicare, and Railroad Retirement trust funds resulting from the enactment of this bill.

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 Dental Benefit Act of 2026

This bill provides for Medicare coverage of dental and oral health services, including routine diagnostic and preventive services, basic and major dental services, and emergency care; dental prostheses are also covered. Currently, such services are excluded from Medicare coverage.

Ensuring Outpatient Quality for Rural States Act

This bill allows Medicare payments for covered hospital outpatient services in Alaska or Hawaii to include certain cost-of-living adjustments.

Save our Lone Emergency Services Act or the SOLES Act

This bill requires Medicare payments to sole community hospitals in Alaska or Hawaii to cover at least 94% of the reasonable costs of covered outpatient services.

Protecting Rural Seniors’ Access to Care Act

This bill prohibits administration, implementation, or enforcement of the rule titled Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting, which was issued by the Centers for Medicare & Medicaid Services on May 10, 2024.

Specifically, the bill prohibits administration, implementation, or enforcement of provisions that, among other changes, (1) establish minimum staffing standards for nurses in Medicare and Medicaid long-term care facilities, including requiring a nurse to be onsite 24/7 and requiring a minimum of 3.48 total nurse staffing hours per resident per day; and (2) require state Medicaid programs to report on payments to direct care workers and support staff of nursing facilities and intermediate care facilities for individuals with intellectual disabilities.

Also, the bill requires the Department of Health and Human Services to establish an Advisory Panel on the Nursing Home Workforce. The panel must report annually to Congress, including on workforce shortages and barriers to accessing nursing homes in rural and underserved areas.

Supporting Access to Rural Community Hospitals Act of 2025

This bill temporarily allows additional hospitals to qualify as critical access hospitals (CAHs) that receive special payment under Medicare.

Currently, in order to qualify as a CAH under Medicare, a hospital must either (1) be located more than 35 miles (or 15 miles in mountainous regions or areas with only secondary roads) from another hospital, or (2) have been certified prior to January 1, 2006, by the state as a necessary provider of services in the area. Hospitals also must meet certain size and service requirements, including having no more than 25 acute care inpatient beds.

The bill allows, for one year, hospitals that are participating in the Rural Community Hospital Demonstration Program to also qualify as CAHs. (The program tests the feasibility of cost-based reimbursement for small rural hospitals that are too large to qualify as CAHs.)

Safeguarding Social Security and Medicare Act

This bill requires the Government Accountability Office to study and provide recommendations to Congress with respect to the effect of inflation and cost-of-living increases on Medicare and Social Security.

Default Prevention Act

This bill exempts certain obligations of the federal government from the statutory debt limit and establishes requirements for paying and prioritizing obligations after the debt limit is reached.

If the debt limit is reached, the bill requires the Department of the Treasury to continue issuing debt and making payments necessary to (1) pay the principal and interest on debt held by the public, the Social Security trust funds, and the Medicare trust funds; and (2) pay Medicare benefits. The bill also exempts these obligations from the debt limit until the debt limit has been modified or suspended.

The bill also establishes requirements for prioritizing the remaining obligations after the debt limit has been reached. Specifically, Treasury may not

• pay any remaining obligations unless it can still pay obligations of the Department of Defense and any obligations necessary to provide benefits under laws administered by the Department of Veterans Affairs;

• pay obligations related to the compensation of federal employees for official time; government travel for executive branch officers or employees; and the compensation of the President, the Vice President, and other members of the executive branch (other than individuals in the competitive service) unless all other obligations except for compensation of Members of Congress can still be paid; and

• compensate Members of Congress unless all other obligations can still be paid.

Finally, the bill requires Treasury to provide weekly reports to Congress regarding new debt issued and obligations that have been paid or not paid under the bill.