FORCE Act of 2025
- Sponsor
- Rep. Panetta, Jimmy [D-CA-19]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Nov 19, 2025
Bottom line
The bill expands Medicare eligibility to certain first responders aged 57-64, requiring them to pay premiums for coverage, and establishes a new trust fund for these premiums.
What it actually does
This bill amends the Social Security Act to create a new Medicare enrollment option for first responders aged 57-64 who have served for at least 10 years in specific occupations. It allows them to receive Medicare Part A, B, and D benefits by paying premiums and establishes a dedicated Medicare First Responder Trust Fund to manage these finances.
Proponents argue
Supporters argue this bill provides crucial early access to Medicare for first responders, recognizing the physically demanding and often hazardous nature of their work, which can lead to earlier retirement or health issues. It offers a vital bridge to full Medicare eligibility at 65, ensuring they have access to necessary healthcare.
Opponents contend
Opponents might raise concerns about the potential impact on the overall Medicare system's solvency, even with dedicated premiums, and the precedent it sets for expanding eligibility based on occupation. They may also question the administrative complexity of creating a new trust fund and eligibility pathway, and whether premiums will truly cover the actuarial costs.
The bill is relatively short and its core provisions are clear, making it accessible for an informed reader to evaluate within a reasonable timeframe.
Section 1
Short Title
This section establishes the official short titles for the Act as the "First Responders' Care Expansion Act of 2025" and the "FORCE Act of 2025," providing easily recognizable names for the legislation.
Supporters argue
Supporters argue that clear and concise short titles help in public discourse and legislative tracking, making the bill's purpose more accessible.
Critics contend
No specific opposition is typically raised against short titles, as they are standard legislative practice.
Section 2(a), adding new Section 1899C(a) to Title XVIII of the Social Security Act
Eligibility for First Responders
This provision creates a new option for individuals aged 57-64 to enroll in Medicare if they have worked for at least 10 years in specific first responder occupations (identified by Standard Occupations Classification System codes). These individuals must not otherwise be eligible for Medicare Part A or B, but would be if they were 65.
Section 2(a), adding new Section 1899C(a)(3)
Part A, B, and D Benefits and Protections
Individuals enrolled under this new section will receive the same benefits and protections as those entitled to Part A and enrolled in Part B. This includes the ability to enroll in a Part D prescription drug plan or a Medicare Advantage plan (including MA-PD plans) and access to the Medicare Beneficiary Ombudsman.
Section 2(a), adding new Section 1899C(c)
Monthly Premiums for Coverage
Enrollees under this section must pay a monthly premium equal to the Part B premium, plus the Part A premium if they would not otherwise be entitled to premium-free Part A at age 65. Additional premiums for Part C (Medicare Advantage) or Part D (prescription drug plans) would also apply as usual.
Section 2(a), adding new Section 1899C(e)
Establishment of Medicare First Responder Trust Fund
This section establishes a new "Medicare First Responder Trust Fund" within the U.S. Treasury. Premiums collected from individuals enrolled under this section (excluding Part C/D premiums) will be deposited into this new Trust Fund. The Trust Fund will operate similarly to the Federal Supplementary Medical Insurance Trust Fund (Part B).
Section 2(b), amending Section 1882 of the Social Security Act
Development of New Medigap Standards
The Secretary is directed to request the National Association of Insurance Commissioners (NAIC) to review and revise Medigap (Medicare supplemental policy) standards. These revisions must include requirements for Medigap policies to accept every eligible first responder who enrolls under the new Section 1899C during a 30-day enrollment period, and also during a transition period when they move from early enrollment to standard Medicare eligibility.
The bill defines "first responder" by referencing specific Standard Occupations Classification System (SOC) codes from the Bureau of Labor Statistics: 33-1010 (First-Line Supervisors of Law Enforcement Workers), 33-1020 (First-Line Supervisors of Fire Fighting and Prevention Workers), 33-2000 (Firefighting and Prevention Workers), 33-3000 (Law Enforcement Workers, excluding 33-3040 which is Transit and Railroad Police), and 33-9092 (Emergency Management Directors).
Section 1899C(a)(2)(B)
Why it matters:This is standard legislative practice for precision and to leverage existing federal classification systems. It avoids ambiguity but requires specialized knowledge.
Case for: Using specific SOC codes ensures a precise and consistent definition of "first responder" across federal programs, preventing disputes over eligibility and leveraging established statistical frameworks.
Case against: Relying on external codes can make the bill less transparent to the general public and may require periodic updates if the SOC system changes, potentially leading to confusion or unintended exclusions.
Estimated impact: Defines the exact scope of eligible individuals, potentially affecting hundreds of thousands of first responders.
States are prohibited from buying their Medicaid beneficiaries aged 57-64 into this new Medicare program. Individuals already eligible for Medicaid are also prohibited from coverage under this new Medicare section, with an exception for Medicaid beneficiaries whose coverage does not meet the definition of minimum essential coverage under federal regulations.
Section 1899C(g)(2)
Why it matters:This provision prevents states from shifting costs from Medicaid to the new Medicare program, which could otherwise be an incentive for states to enroll their beneficiaries. It's a standard cost-containment measure.
Case for: Prevents cost-shifting from state Medicaid programs to the federal Medicare First Responder Trust Fund, ensuring the new program's financial integrity and preventing unintended burdens on federal taxpayers.
Case against: Some might argue it limits state flexibility in managing their healthcare populations and could prevent some low-income first responders from accessing the new Medicare option if their Medicaid coverage is robust.
Estimated impact: Prevents potentially significant cost transfers from states to the federal government, maintaining the intended scope of the new trust fund.