Larson and Colleagues Introduce Bipartisan Medicare Beneficiary Co-Pay Fairness Act

Washington, D.C. - Rep. John B. Larson (CT-01) introduced the bipartisan Medicare Beneficiary Co-Pay Fairness Act of 2025 with Reps. Mike Kelly (PA-16), Rob Menendez (NJ-08), and Troy Balderson (OH-12). Their bill would lower costs by eliminating the co-pay penalty for Medicare beneficiaries who seek care from outpatient Ambulatory Surgical Centers (ASCs). 

“I am proud to introduce this bill with my colleagues on both sides of the aisle to make surgical care more affordable and accessible for our seniors,” said Larson. “Connecticut’s 61 Ambulatory Surgical Centers provide preventive services and essential procedures to thousands of patients annually, including cataract surgeries and orthopedic care. The Medicare Beneficiary Co-Pay Fairness Act will ensure patients no longer have to pay more for a procedure simply because they went to an outpatient provider.”  

"The Medicare Beneficiary Co-Pay Fairness Act takes a major step toward lowering patient costs. This legislation saves taxpayer money by streamlining the payment process. I thank my colleagues for joining me in this effort," said Kelly. 

"Our healthcare system should reward value and efficiency, not penalize patients based on where they receive care," said Menendez. "With the legislation, we’re ensuring fairness, lowering out-of-pocket costs, and reinforcing the principle that Medicare should always work for patients." 

"Extending co-pay caps improves efficiency and provides fairer costs for patients,” said Balderson. “This ensures patients are able to receive necessary and preventative services in lower-cost health care settings.” 

Currently, while patients in both Ambulatory Surgical Centers and Hospital Outpatient Departments (HOPDs) typically face a 20% co-pay, only HOPDs benefit from a co-pay cap, set at $1,676 for 2025. Because of this policy, Medicare beneficiaries who seek care at one of the over 6,300 ASCs nationwide, including 61 in Connecticut, have to pay more out-of-pocket for the same procedures. 

The Medicare Beneficiary Co-Pay Fairness Act will extend the existing co-pay cap to ASCs, ensuring fairer costs for patients and supporting the continued growth and utilization of efficient, lower-cost surgical settings. 

Full text of the bill can be found HERE.