WASHINGTON (AP) — The House voted overwhelmingly Thursday to eliminate monthly premium increases for millions of Medicare patients next year.

It voted 406 to 18 to send the bill to the Senate, which is expected to act soon. Lawmakers said older Americans shouldn’t have to pay higher Medicare Part B premiums because they are not expected to get a cost of living increase from Social Security.

The vast majority of Medicare recipients already are exempt from Part B premium increases because of a hold-harmless provision that kicks in when there is no increase in Social Security.

Still, several million would face monthly premium increases of $8 to $23, without congressional action. The standard monthly premium is $96.40 this year.

About 42 million seniors and people with disabilities are enrolled in Medicare Part B, which provides coverage for doctor’s visits. By law, about three-fourths are exempt from premium increases when there is no increase in Social Security payments.

Most of the 11 million or so patients who are not exempt from premium increases are low-income people who also qualify for Medicaid. Medicaid, the state-federal health insurance program for the poor, pays their Medicare premiums, meaning states would bear some of the costs.

Among the rest who are not exempt, a little more than 2 million are high-income seniors‚ singles making more than $85,000 a year and couples making more than $170,000. Also, about 1.3 million new enrollees would not be exempt.