H.R. 6109

Medicare Affordability and Enrollment Act of 2016

This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to:

• establish an annual limit on out-of-pocket expenditures for Medicare fee-for-service beneficiaries;
• expand income-eligibility for cost-sharing and, with respect to beneficiaries consequently eligible for cost-sharing, establish a federal medical assistance percentage of 100% under Medicaid;
• limit the amount of coinsurance or copayment required of low-income beneficiaries;
• eliminate the two-year waiting period for Medicare coverage with respect to individuals with disabilities;
• allow beneficiaries residing in U.S. territories to be eligible for certain premium and cost-sharing subsidies available to other beneficiaries under the Medicare prescription drug benefit; and
• modify other provisions related to special rules for beneficiaries in Puerto Rico, income and resource determinations, and enrollment procedures.

The bill also amends the Medicare Improvements for Patients and Providers Act of 2008 to extend funding for specified beneficiary outreach and education activities.