H.R. 6147 — Expanding Health Care Options for First Responders Act

This section establishes a Medicare buy-in option for qualified first responders aged 50 to 64 who are separated from service due to retirement or disability. Eligible individuals—U.S. residents who are citizens, nationals, or lawful permanent residents and not otherwise entitled to Medicare Parts A or B—receive the same Part A benefits and Part B and D enrollment options (including Medicare Advantage plans with prescription drug coverage) as standard Medicare beneficiaries. Enrollment and coverage periods, coordinated with ACA Exchanges and Medicare Parts C and D, begin January 1 of the first year at least one year after enactment and include special enrollment periods applicable to Exchange plans. Monthly premiums, determined by the Secretary and equal to one-twelfth of estimated average annual per capita costs for Parts A, B, and D benefits and administration, are paid to the Secretary and deposited into the relevant Medicare trust funds; enrollees may owe additional amounts for certain Medicare Advantage or Part D plans. Coverage counts as minimum essential coverage under the ACA individual mandate and as a qualified health plan enrolled through an Exchange for premium tax credit eligibility (other than IRC §36B(c)(2)(B)). Enrollees are ineligible for Medicaid Medicare cost-sharing assistance.