Rep. Adrian Smith

Maddy summaryThis bill, the Protecting Ballot Measures From Foreign Influence Act of 2025, bans foreign nationals from contributing money to state and local ballot initiatives and referendums. It amends the Federal Election Campaign Act to explicitly include these state and local voting measures under the existing prohibition on foreign contributions for federal elections. The key provision requires that contributions to ballot measures - like state-level policy votes - must not come from foreign individuals or entities. The law would apply to all contributions made after its enactment date.

Maddy summaryThis bill allows groups of small businesses or self-employed individuals to form a single health plan that treats all members as one employer for coverage purposes. It directly affects small business associations and self-employed people who can join such groups to access pooled health coverage, provided they meet specific requirements (e.g., 51+ total employees, 2+ years in existence, no health-based discrimination). Key mechanisms include permitting modified community rating for premiums (based on pooled claims) while prohibiting health status-related discrimination in enrollment, premiums, or pre-existing condition coverage. The plan remains subject to federal ERISA rules, and self-employed members must meet defined criteria to participate as both employers and employees.

Miracle on Ice Congressional Gold Medal Act This act provides for the award of Congressional Gold Medals to the members of the 1980 U.S. Olympic men's ice hockey team in recognition of the team's achievement at the 1980 Winter Olympic Games.

Maddy summaryHR 6466, the Forced Abortion Prevention and Accountability Act, prohibits non-consensual administration of abortion drugs (like mifepristone or misoprostol) to pregnant women without their informed consent. It criminalizes this act with penalties up to 25 years in prison and allows victims to sue for triple damages, psychological/physical injury compensation, and attorney fees. The bill directly affects pregnant women who might face coerced procedures and medical providers or others who administer such drugs without consent. Key provisions include criminal penalties for the act itself, enhanced penalties for serious injury or death, and a civil remedy framework for victims seeking compensation.

Maddy summaryThis bill creates two federal grant programs to support medical residency training in rural areas. The first program provides grants to eligible organizations (like rural hospitals, health centers, and medical schools) to establish or expand residency programs where doctors train in rural settings for over half their residency time, focusing on primary care, high-need specialties, or maternal health. The second program funds technical assistance grants to help these organizations apply for and run the training programs. The bill authorizes $12.7 million annually from 2026 to 2030, with grants for the training programs lasting up to 3 years and technical assistance grants up to 4 years.

Maddy summaryThis bill requires IRS employees to obtain written approval from a supervisor before sending any penalty notice to a taxpayer. It modifies the Internal Revenue Code to mandate that an IRS official’s immediate supervisor (the person they report to) must personally approve penalty assessments in writing before any penalty communication is sent. The rule applies to all penalties issued after December 31, 2025. This directly affects taxpayers who face IRS penalty notices, adding a review step before penalties are formally proposed or imposed.

Maddy summaryHR 4313, the Hospital Inpatient Services Modernization Act, extends Medicare's waiver allowing acute hospital care at home until 2030 (previously expiring in 2025). It requires the Secretary of Health and Human Services to conduct a detailed study by September 2028 comparing home-based hospital care to traditional inpatient care. The study must analyze quality metrics (like readmission rates and patient outcomes), costs, staffing patterns, and patient demographics - including racial, ethnic, and socioeconomic data - across participating and non-participating hospitals. This bill directly affects Medicare beneficiaries receiving home-based care and hospitals operating under the waiver program.

Give Kids a Chance Act of 2025 This bill expands the Food and Drug Administration’s (FDA’s) authority with respect to research on rare pediatric diseases, including by permitting the FDA to take enforcement action against drug sponsors that fail to satisfy pediatric study requirements and by reauthorizing programs that support pediatric research.  Specifically, the bill modifies requirements relating to molecularly targeted pediatric cancer investigations to permit research on new drugs in combination with active ingredients that have already been approved, provided certain conditions are met; permits the FDA to take enforcement action against drug sponsors that fail to comply with pediatric study requirements, if such sponsors demonstrated a lack of due diligence in satisfying the requirement; renews the FDA’s authority to award priority review vouchers to sponsors of new products intended to treat rare pediatric diseases through September 30, 2029; and reauthorizes through FY2027 certain funding for the National Institutes of Health to support priority pediatric research.  The bill also provides statutory authority for the FDA’s interpretation of the orphan drug exclusivity period. The bill specifies, consistent with FDA regulations, that the seven-year market exclusivity period for drugs for rare diseases or conditions (i.e., orphan drugs) prohibits the approval of the same drug for the same approved use or indication with respect to the disease or condition. (In Catalyst Pharmaceuticals, Inc. v. Becerra , a court rejected the FDA’s interpretation and held that orphan drug exclusivity extends to all uses or indications for the disease or condition.)

Maddy summaryThis bill expands Medicare coverage to include genetic counseling services provided by licensed or certified genetic counselors, effective January 1, 2027. It defines "covered genetic counseling services" as those furnished by qualified counselors under state law or certification, with payments set at 80% of the lesser of the actual charge or 85% of the physician fee schedule. Medicare beneficiaries seeking genetic counseling will gain access to these services through covered providers, while preventing balance billing for these specific services. The bill does not restrict physicians from billing for similar services under existing Medicare rules.

Maddy summaryThis bill prohibits Medicare-approved medical residency programs from requiring residents to undergo abortion training without their voluntary consent. It specifically bans programs from making such training mandatory (requiring residents to "opt-in" rather than "opt-out") or from discriminating against residents who refuse this training or do not perform abortions. The law directly affects medical residents in Medicare-funded postgraduate training programs across the U.S., ensuring they cannot be forced into abortion-related clinical experiences or penalized for declining them.