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Committee hears support for bill letting certain under‑65 Medicare beneficiaries buy Medigap coverage
Summary
House Bill 24 would let Medicare‑eligible Ohioans under 65 who have ALS or end‑stage renal disease buy Medicare Supplement (Medigap) coverage and create a one‑time enrollment window for currently eligible people. Advocates said the change would help a small, high‑need population and have negligible actuarial impact on the wider Medigap market.
The Ohio House Insurance Committee held a second hearing on House Bill 24, which would permit Medicare‑eligible Ohioans under age 65 who qualify for Medicare because of ALS or end‑stage renal disease (ESRD) to purchase Medicare Supplement (Medigap) coverage and would create a one‑time six‑month enrollment window for currently eligible beneficiaries.
Why it matters: Supporters said the bill would give a small but vulnerable group access to secondary coverage that reduces out‑of‑pocket costs and improves access to transplant and specialty care. Proponents pointed to an independent actuarial study projecting a de minimis impact on the broader Medigap market.
Alex Meixner, with the ALS Association, told the committee the bill would address a longstanding gap for younger people diagnosed with ALS who are eligible for Medicare but cannot buy Medigap because they are under 65. Meixner read a written statement from Angelina Fanus of Strongsville, who described delays and denials while on Medicare Advantage and wrote that she “learned that I couldn't enroll in traditional Medicare because I was under 65 and ineligible for a Medigap plan.” Meixner said the legislation mirrors measures in 17 other states and would allow younger Medicare beneficiaries to use their own funds to purchase Medigap.
Elizabeth Lively, Eastern Region Advocacy Director for Dialysis Patient Citizens, supported the bill for people with ESRD and said about 1,700 Ohio residents under 65 would be affected. Lively told the committee that dialysis patients can face up to $16,000 a year in out‑of‑pocket costs and that secondary coverage helps patients get onto active transplant wait lists. She said Medigap enables access to out‑of‑state transplant centers that many Medicare Advantage plans block as out of network.
On costs, proponents cited a third‑party actuarial analysis by Health Management Associates (HMA) that estimated the bill would raise average Medigap premiums across the larger market by about 0.2 percent — roughly 40¢ per month — and that adding eligible under‑65 beneficiaries could avert Medicaid spend‑down for some patients. HMA projected up to about $3,200,000 in five‑year Medicaid savings if fewer people exhaust assets and enroll in Medicaid because of uncovered Medicare cost‑sharing.
Committee members asked whether the bill would create new underwriting windows. Meixner and Lively said the measure preserves a limited enrollment period mirroring the existing Medigap eligibility window and would allow switching between carriers for the same lettered Medigap plan without new medical underwriting in that limited context.
No committee vote was taken at the hearing; the bill record includes multiple written statements from patient groups and national health organizations in support.
Ending: Proponents said the measure would be transformational to a small group of patients, while members asked for further details about premium impacts and how the limited enrollment window would be administered.
