HR 9774, the Health Care Affordability Act of 2024, would expand premium tax credits under the Affordable Care Act for households earning between 150% and 400% of the federal poverty level. It modifies the sliding scale calculation to reduce the percentage of monthly insurance premiums these households must pay, with the lowest out-of-pocket costs for those near 400% of poverty. This directly affects individuals and families purchasing health insurance through marketplace plans who qualify for these tax credits. The changes apply to tax years beginning after December 31, 2025.
This bill requires Medicare Advantage plans to implement electronic prior authorization systems by 2027 and publish detailed data on their approval and denial rates for medical services by 2026. It directly affects Medicare Advantage plans (private insurers offering Medicare coverage) and their enrollees (seniors 65+), mandating transparency about prior authorization decisions, processing times, and appeal outcomes. Key provisions include requiring plans to report annual statistics on request approvals/denials, average processing times, and use of technology, with this data published publicly by the Centers for Medicare & Medicaid Services. The bill also sets timelines for plan responses to prior authorization requests and mandates reports to Congress on implementation and impacts.
The Telehealth Modernization Act of 2024 extends Medicare's temporary telehealth coverage rules permanently, removing the previous 2024 expiration date. It expands who can provide telehealth services by allowing more healthcare professionals (like certain nurse practitioners) to bill Medicare for these services, and ensures Federally Qualified Health Centers and Rural Health Clinics can continue billing for telehealth under existing payment rules after 2024. The bill also explicitly permits audio-only telehealth calls for Medicare coverage and allows telehealth for hospice face-to-face visits and home dialysis assessments as clinically appropriate, without time limits. These changes directly affect Medicare beneficiaries, healthcare providers, and community health centers offering telehealth services.
This bill requires Medicare to cover falls risk assessments and fall prevention services during annual wellness visits and initial preventive physical exams for seniors aged 65+ who have fallen in the previous year. It directly affects Medicare beneficiaries with recent falls and healthcare providers delivering these services under Medicare. The key mechanism expands existing Medicare benefits to include these specific fall prevention services, effective January 1, 2025. Additionally, it mandates annual reports starting in 2026 tracking falls data for seniors over 65 who received fall-related treatment.
This bill updates the Supplemental Security Income (SSI) program to better support low-income elderly, blind, and disabled individuals. It raises key financial thresholds: the resource limit for single individuals increases from $2,250 to $20,000 (adjusted annually for inflation), and the general income exclusion rises from $240 to $1,797 per month. The bill also removes a penalty that reduced benefits for married couples, excludes retirement accounts and tribal general welfare payments from resource calculations, and eliminates outdated requirements like dedicated accounts for past-due benefits. These changes directly affect SSI recipients by making it easier to qualify and maintain benefits without losing support due to minor income or resource fluctuations.
This bill, the EMPSA Act (Eliminating the Marriage Penalty in SSI Act), changes Social Security Income (SSI) rules for married adults with intellectual or developmental disabilities. It directly affects married individuals aged 18+ who have these disabilities and meet income and resource limits. The key change removes the "marriage penalty" by ensuring their spouse’s income and resources no longer count against their SSI eligibility or benefit amount, allowing them to receive the full individual benefit rate. This update modifies specific sections of the Social Security Act to eliminate the previous disadvantage faced by married couples under these disability conditions.
The Nutrition CARE Act of 2024 expands Medicare Part B coverage to include medical nutrition therapy services for beneficiaries diagnosed with eating disorders. It directly affects Medicare beneficiaries with eating disorders - particularly an estimated 420,500-560,700 Black, Indigenous, and People of Color seniors - by requiring coverage for 13 hours of initial care (including assessment) and 4 hours annually for ongoing management. The bill amends Medicare law to specify that these services must be provided by registered dietitians or nutrition professionals following referrals from physicians or psychologists. Coverage applies to all eating disorders as defined by the DSM-5, addressing a gap where Medicare previously excluded this critical treatment component. This policy change aims to improve access to evidence-based care for a condition linked to high mortality and significant healthcare costs.
HR 6780 establishes a 4-year Medicare demonstration program testing whether hospitals providing medically tailored home-delivered meals to specific patients improves health outcomes and reduces hospital readmissions. The program targets Medicare beneficiaries with diet-sensitive chronic conditions (like diabetes or heart failure) who are at high risk of readmission and meet specific discharge criteria, such as limited daily living activities. Selected hospitals must screen patients, provide at least two tailored meals daily for 12 weeks, and offer medical nutrition therapy, all without patient cost-sharing. The program requires hospitals to submit data for evaluation, with the goal of assessing impacts on hospital admissions, care costs, and patient satisfaction before reporting to Congress in 2027 and 2030.
HR 6790 establishes National Institutes of Health centers to advance research, early detection, and public awareness of rare kidney diseases, with a focus on rural and underserved communities. It mandates a federal study on genetic testing barriers, treatment patterns, and public awareness for rare kidney diseases affecting disproportionately impacted populations, including barriers to insurance coverage and access to specialists. The bill also funds nephrology training programs to increase specialists serving these communities and requires experiments to delay or prevent the need for dialysis and transplants. Total funding of $7 million is authorized for fiscal years 2024-2028 to support these research, education, and early intervention efforts.
This bill adds audiology services to Medicare's covered benefits under Section 1861(s)(2)(KK), effective January 1, 2025. It allows qualified audiologists to provide hearing and balance assessments and diagnostic/treatment services without requiring a physician referral or supervision, directly affecting Medicare beneficiaries seeking these services and audiologists practicing under state law. Payment will be 80% of the lower of actual charge or the Medicare fee schedule. The bill does not expand the types of audiology services covered but changes how they are accessed and paid for under Medicare.
HR 6407, the Medical Nutrition Therapy Act of 2023, expands Medicare coverage to include medical nutrition therapy for more chronic conditions beyond current limits. It directly affects Medicare beneficiaries with conditions like obesity, hypertension, dyslipidemia, eating disorders, and others not previously covered under Part B. The bill amends Medicare rules to allow coverage for prevention, management, or treatment of these conditions by a wider range of providers, including registered dietitians and clinical psychologists. This change would make medically necessary nutrition services available for conditions listed in the bill, such as diabetes, cardiovascular disease, and HIV, as determined by the Secretary.
The Disaster Relief Medicaid Act creates a new Medicaid program for survivors of major disasters, providing continuous health coverage for up to two years after a disaster is declared. It establishes simplified eligibility requirements with no documentation needed, allowing individuals with income up to 133% of the poverty level (or their home state's standard) to qualify, including those who received FEMA assistance or lost employment due to the disaster. The law requires states to provide medical assistance equivalent to what would be provided in the survivor's home state, with 100% federal funding for all costs during the relief period. It also includes special provisions for pregnant individuals, children born during the relief period, and expanded mental health services.
