Medicare

  As a licensed health insurance agent and candidate for U.S. Senate from Oregon, I began my work helping retirees select Medicare Advantage (MA) plans, Medigap supplements, and Part D coverage after receiving my health insurance license on October 6, 2025.

Even in the short time since then, I’ve been blessed with a clear ability to see vulnerabilities within various plans and—more importantly—the deeper challenges built into how the Medicare system operates today. I’ve sat with Oregon retirees, contacted their medical providers to verify which Medicare Advantage insurers the medical providers are contracted with, reviewed their options, and walked them through enrollment decisions. Then, a few weeks later, received notice that my clients need to find a new plan or change care providers because their medical provider decided to discontinue accepting one of the insurers. This is wrong. 

I have also witnessed firsthand how excessive CMS regulations limit real choice, especially in rural and semi-rural counties like Linn, Benton, and Lincoln. 

One of the most common frustrations I hear is the severely limited number of Medicare Advantage plans available. In Linn County, for instance, retirees are often restricted to just three insurers. When Samaritan Health terminated its Medicare Advantage plans at the end of 2025, impacting nearly 14,000 enrollees, Devoted Health captured a large portion, mostly through HMO plans. That created immediate problems: 

• Many people lost access to their trusted doctors at Corvallis Clinic, which discontinued accepting Wellcare effective January 31, 2026 and did not contract with Devoted
• UnitedHealthcare remains out-of-network with Samaritan hospitals, meaning higher co-pays for hospital stays and tests which may not be available elsewhere.
• The Center for Medicare and Medicaid Services (CMS) blocked Aetna from offering new MA plans in Benton, Linn, and Lincoln counties due to projected losses tied to Devoted’s dominance—further shrinking options.

Too many retirees are forced to either switch doctors, accept higher costs, or pay $300+ per month per person for Medigap supplements just to maintain continuity of care. That’s not choice; that’s government-imposed restriction.

I have seen the burden of late enrollment penalties with my own mother-in-law. If someone misses their initial enrollment window, perhaps due to confusion, a plan change, or simply not understanding the complex rules, they face permanent premium increases: 10% per year delayed for Part B and about 1% per month uncovered for Part D. These penalties last a lifetime, even when the person later enrolls in a solid Medicare Advantage plan. In my view, that’s punitive and unnecessary. 

Another gap stands out: Medicare Advantage and Original Medicare still do not adequately cover evidence-based holistic and naturopathic treatments. Many Oregon seniors value licensed naturopathic physicians, natural therapies, and supplements that complement conventional medicine, yet CMS rules often exclude or severely limit these options, forcing people to pay out-of-pocket for care they believe in. 

Finally, the lack of transparency in how Medicare dollars are spent is troubling. CMS collects the Part B premium ($202.90 standard in 2026, deducted automatically from Social Security), sends that money along with other taxpayer funds to the insurance companies, and pays them a fixed amount for each person enrolled in their Medicare Advantage plan. But where exactly does all that money go—administrative costs, profits, payments to doctors and hospitals? There’s not enough clear, public reporting or independent oversight of the largest insurers to give seniors and taxpayers full confidence that every dollar is being used wisely. 

Because of what I have witnessed firsthand; limited options forcing tough trade-offs, sudden provider changes, lifelong penalties, gaps in holistic coverage, and a lack of transparency, I will introduce a bill after being elected as your U.S. Senator, tentatively titled the Medicare Advantage Market Freedom and Accountability Act of 2027 - to restore real patient choice and cut red tape. 

My bill would: 

• Remove CMS restrictions on the number of MA plans per county and eliminate barriers to entry and marketing based on projected losses or market concentration.
• Make plans portable across counties so retirees can keep seeing their doctors even if they live in Linn County and receive care in Marion County.
• Require coverage of evidence-based holistic and naturopathic treatments in both Medicare Advantage and Original Medicare Parts B and D.
• Completely eliminate late enrollment penalties for Parts B and D—no more lifelong financial punishments.
• Require annual public reports on fund flows and independent audits for insurers receiving more than $250 million annually, with a 10% cap on administrative expenses.

In just a few months since earning my license, I’ve seen how these systemic issues affect real Oregon families. I’ve helped people avoid costly mistakes, but I know the system itself needs fixing, not more bureaucracy, but more freedom, transparency, and accountability. 

Oregon seniors deserve better. They deserve more plan choices, fewer forced trade-offs, greater access to the care they value, and the peace of mind that their Medicare dollars are being used wisely. 

If you are a senior, caregiver, or family member dealing with these Medicare challenges, I want to hear your story. Contact me directly through my campaign website, email me at jorae@joraeperkins.com or reply to me on X (@JoRaePerkins), on Facebook.com/JoRaePerkins. Share your experiences. Whether it’s limited plan options, unexpected provider changes, high Medigap costs, or frustration with penalties. Your voice will help shape this fight in the U.S. Senate. 

Together, we can cut the red tape and restore real choice in Medicare for every Oregon retiree. 

Here is an example of what the bill may actually look like when introduced in the U.S. Senate:

120th Congress
1st Session  

S. [To Be Assigned]
Medicare Advantage Market Freedom and Accountability Act of 2027  restoring patient choice and cutting red tape 

IN THE SENATE OF THE UNITED STATES 

February 12, 2027  

Ms. Perkins of Oregon introduced the following bill; which was read twice and referred to the Committee on Finance  

A BILL 

To promote consumer choice and competition in Medicare Advantage by reducing excessive regulatory barriers imposed by the Centers for Medicare & Medicaid Services, ensure portability of plans across counties, mandate coverage of evidence-based holistic and naturopathic treatments in Medicare Advantage and Original Medicare, eliminate late enrollment penalties, enhance fiscal transparency and accountability, and for other purposes.  

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,  

SECTION 1. SHORT TITLE. 

This Act may be cited as the “Medicare Advantage Market Freedom and Accountability Act of 2027”.  

SECTION 2. FINDINGS AND PURPOSE. 

(a) Findings. Congress finds the following:

(1) Medicare beneficiaries, particularly seniors and retirees in rural and semi-rural areas of the United States, including counties in Oregon such as Linn, Benton, and Lincoln, face limited choices in Medicare Advantage plans due to excessive regulatory oversight by the Centers for Medicare & Medicaid Services (CMS).  

(2) In many counties, beneficiaries are restricted to only a handful of plans (in some cases as few as three), with network mismatches that force them to choose between keeping their trusted doctors and hospitals or accepting higher out-of-pocket costs.  

(3) CMS restrictions on plan entry, marketing, and expansion—often based on projected financial losses or market concentration—stifle competition, reduce innovation, and leave many retirees with no viable options beyond costly Medigap supplements (often exceeding $300 per month per person).  

(4) Arbitrary county-based enrollment and provider-access rules prevent beneficiaries from seeking care from physicians or facilities in adjacent counties, even when those providers are the most appropriate or familiar choice for ongoing treatment.  

(5) Late enrollment penalties for Parts B and D impose lifelong financial burdens on beneficiaries who miss enrollment windows due to confusion, plan terminations, or changes in coverage, even when they maintain continuous coverage through Medicare Advantage plans.  

(6) Current Medicare Advantage and Original Medicare programs do not adequately cover evidence-based holistic and naturopathic treatments, limiting patient-centered care options that many Americans value and that can complement conventional medicine.  

(7) Lack of transparency in how Medicare Advantage payments are allocated and spent—combined with insufficient independent oversight of large insurers—raises concerns about administrative overhead, improper payments, and whether taxpayer and beneficiary dollars are being used efficiently to deliver high-quality care. 

(8) Reducing unnecessary CMS red tape, promoting true market competition, ensuring portability, mandating coverage for holistic and naturopathic care, eliminating punitive penalties, and requiring strong fiscal accountability will restore patient choice, lower costs, improve access, and strengthen the Medicare program for future generations.  

(b) Purpose. The purpose of this Act is to:  

(1) restore patient choice by removing excessive regulatory barriers and allowing free-market competition in Medicare Advantage;  

(2) cut red tape that limits plan availability, marketing, and innovation;  

(3) ensure beneficiaries can access care from trusted providers across county lines without penalty;  

4) expand coverage to include evidence-based holistic and naturopathic treatments;  

(5) eliminate lifelong late enrollment penalties that disproportionately harm vulnerable retirees; and  

(6) enhance fiscal transparency and accountability so that Medicare dollars are used effectively to deliver high-quality care.  

SECTION 3. PROMOTING FREE MARKET COMPETITION IN MEDICARE ADVANTAGE PLANS. 

Section 1857 of the Social Security Act (42 U.S.C. 1395w–27) is amended by adding at the end the following new subsection:  

“(k) Free Market Entry and No Limits on Plans.

The Secretary shall not impose any restrictions, limits, or prohibitions on the number of Medicare Advantage plans available in any county, service area, or State, including based on projected financial losses, market concentration, bid viability, or other factors unrelated to fraud or direct beneficiary harm. The Secretary shall approve new or expanding plans within 45 days if basic network adequacy is demonstrated. This subsection ensures unrestricted competition and options in all areas, including rural counties with limited current choices.”  

SECTION 4. PORTABILITY AND NETWORK FLEXIBILITY. 

Section 1851(b) of the Social Security Act (42 U.S.C. 1395w–21(b)) is amended by adding at the end the following new paragraph:  

“(3) Portability Across Counties.—

A Medicare Advantage plan shall not restrict enrollment, benefits, provider access, or reimbursements based on a beneficiary’s county of residence. Beneficiaries may access providers (including doctors, specialists, and hospitals) in adjacent or nearby counties without out-of-network penalties or higher cost-sharing, provided the plan maintains actuarial soundness. Plans shall leverage existing telehealth standards and flexibilities for underserved areas to enhance access.”  

SECTION 5. MANDATING COVERAGE FOR HOLISTIC AND NATUROPATHIC CARE.  

1. Medicare Advantage. Section 1852(a) of the Social Security Act (42 U.S.C. 1395w–22(a)) is amended by adding at the end the following new paragraph: 

“(4) Required Coverage for Holistic and Naturopathic Treatments.

All Medicare Advantage plans shall cover evidence-based holistic and naturopathic care, including consultations, treatments, therapies, and supplements provided by licensed naturopathic physicians or qualified practitioners. Coverage shall be at least equivalent to conventional medical services, with no arbitrary exclusions, higher cost-sharing, or prior authorization barriers beyond standard program rules.”  

1. Original Medicare.—Section 1832 of the Social Security Act (42 U.S.C. 1395k) is amended by adding at the end similar language applicable to Parts B and D.  

SECTION 6. FISCAL TRANSPARENCY AND ACCOUNTABILITY. 

Section 1858 of the Social Security Act (42 U.S.C. 1395w–28) is amended by adding at the end the following new subsection:  

(g) Public Reporting and Audits.
(1) The Secretary shall annually publish detailed reports on Medicare Advantage fund flows, including per-enrollee capitated payments (broken down by administrative costs, provider reimbursements, profits, recoveries, and other categories) sourced from Part B premiums and general revenues.

(2) Medicare Advantage organizations receiving more than $250,000,000 annually in payments shall undergo independent audits every year to verify payment integrity, coding accuracy, and compliance. Audits shall prioritize risk adjustment validation and administrative expense verification.

(3) Administrative expenses shall be capped at 10 percent of total payments, with excesses rebated to the Supplementary Medical Insurance Trust Fund.”  

SECTION 7. ELIMINATING LATE ENROLLMENT PENALTIES.  

(a) Part B.—Section 1839(b) of the Social Security Act (42 U.S.C. 1395r(b)) is amended by striking the late enrollment penalty provisions in their entirety.  

(b) Part D.—Section 1860D–13(b) of the Social Security Act (42 U.S.C. 1395w–113(b)) is amended by striking the late enrollment penalty provisions in their entirety, including for beneficiaries enrolled in Medicare Advantage Prescription Drug plans.  

SECTION 8. EFFECTIVE DATE.  The amendments made by this Act shall apply to contract years beginning on or after January 1, 2028.