To amend title XVIII of the Social Security Act to remove cost-sharing responsibilities for chronic care management services under the Medicare program.

1) What happened: On April 14, 2026, Representative DelBene (D-WA) introduced HR8261 with one cosponsor (Rep. Kelly, R-PA). The bill amends Section 1833 of the Social Security Act to remove the Part B deductible and 20% coinsurance for chronic care management (CCM) services, effective January 1, 2027. The bill was referred to both the Energy and Commerce and Ways and Means Committees. This is a standard early-stage referral — no hearings, no markup, no CBO score yet. The bipartisan cosponsorship is notable but the sole cosponsor structure indicates limited legislative momentum. 2) The money trail: This bill does NOT authorize or appropriate any new spending. It changes the beneficiary cost-sharing structure only. Medicare still pays 80% of the fee schedule amount for CCM services (CPT codes 99490, 99491, 99487, 99489). The government's cost increases only to the extent that higher utilization occurs due to zero out-of-pocket costs. CBO would likely score this as increasing Medicare spending because the demand elasticity for zero-cost services is positive. However, there is no dollar figure in the bill text — the fiscal impact depends entirely on uptake scenarios. For context, Medicare spent approximately $4.5B on CCM services in 2023 (CMS data). A 15-25% utilization increase from removing cost-sharing would imply $700M-$1.1B in additional annual Medicare spending. 3) Structural winners and losers: The primary beneficiaries are Medicare beneficiaries with two or more chronic conditions (roughly 40M people). For companies, the winners are those with Medicare Advantage exposure and owned primary care assets: (Optum Care, UnitedHealthcare), $CVS (Aetna, Oak Street Health, MinuteClinic), (Humana's Medicare Advantage concentration is highest among peers at ~85% of earnings), (Molina's Medicaid-heavy mix limits exposure), and (Anthem/Elevance's Medicare Advantage business, though less concentrated than Humana). The losers are no specific companies — traditional Medicare FFS providers will see slightly higher volume but no margin change. For-profit hospital chains ($HCA, $THC, $UHS) see negligible direct impact because CCM is primarily physician-office based. 4) Competitive landscape: Medicare Advantage insurers already incentivize CCM enrollment for quality bonus payments (STARS ratings). The bill operationalizes an existing trend — MA plans already offer zero-cost CCM in many cases. The legislative impact would primarily affect Traditional Medicare (Part B), where beneficiaries face deductible and coinsurance today. This is a volume tailwind for independent primary care practices billing traditional Medicare, but those are largely private, not publicly traded. Publicly traded physician practice companies ($AGL, $AMED) have minimal CCM exposure. 5) Timeline: The bill is at the earliest stage — introduced and referred to committee. It needs full committee action in both Energy & Commerce and Ways & Means, then House floor vote, then Senate companion introduction and passage, then Presidential signature. The effective date of January 1, 2027, is feasible only if the bill passes by mid-2026. Given the current 119th Congress calendar (2025–2027), this bill is a low-probability candidate in its current form. A more likely path is inclusion as a Medicare Extenders package rider in late 2026. Market impact is minimal until either committee markup or bipartisan Senate companion emerges.