Rep. Mark DeSaulnier

Maddy summaryThe Lowering Drug Costs for American Families Act expands Medicare's drug price negotiation program from 20 to 50 drugs, allowing the government to negotiate lower prices for these medications. It requires private health insurance plans and group health coverage to apply these negotiated prices to their members' cost-sharing for covered drugs, with plans able to opt out while publicly disclosing their decision. The bill also extends these negotiated prices to drugs covered by commercial insurance markets, not just Medicare. This would directly affect Medicare beneficiaries and people with private health insurance who take the negotiated drugs.

Maddy summaryThe Access to Infertility Treatment and Care Act would require most health insurance plans to cover infertility treatment (including assisted reproductive technology like IVF) and fertility preservation services for people undergoing medical treatments that might cause infertility, such as cancer therapies. It prohibits cost-sharing (like deductibles and copays) for these services that exceeds what's charged for similar medical services and applies to private insurance, federal employee health plans, TRICARE, veterans' benefits, and Medicaid programs. The bill also requires insurers to provide clear notice to plan members about these coverage requirements. This legislation aims to ensure infertility treatment is covered similarly to other medical conditions, as recognized by medical organizations.

Maddy summaryThe Social Security 2100 Act would significantly enhance Social Security benefits for millions of Americans by increasing monthly payments for retirees, disabled workers, widows/widowers, and children. Key provisions include raising the minimum benefit for long-term low earners, improving cost-of-living adjustments using a more accurate index, eliminating the 5-month waiting period for disability benefits, and extending child benefits to age 26. The bill also changes how Social Security taxes are calculated by applying them to income above $400,000 and establishes a unified Social Security Trust Fund to manage program finances. Most provisions would apply to benefits payable from 2025 through 2034, affecting all current and future Social Security beneficiaries.

Maddy summaryThe PrEP Access and Coverage Act of 2023 requires private health insurance plans, Medicare, Medicaid, and other public health programs to cover pre-exposure prophylaxis (PrEP) for HIV prevention without cost-sharing, including the medication, related lab tests, and follow-up care. The bill also prohibits life, disability, and long-term care insurance companies from denying coverage or charging higher premiums to people taking PrEP. It establishes public education campaigns to increase awareness of PrEP and PEP (post-exposure prophylaxis) and creates funding for state and community programs to expand access to HIV prevention services, particularly for populations disproportionately affected by HIV including Black, Hispanic/Latinx, and transgender individuals. The legislation specifically addresses current disparities in PrEP access, as data shows only 11% of Black/African American and 21% of Hispanic/Latinx individuals eligible for PrEP received prescriptions in 2022 compared to 82% of White individuals. Coverage requirements for most plans will take effect on January 1, 2025.

Maddy summaryThe Comprehensive Cancer Survivorship Act (HR 4363) establishes new Medicare and Medicaid coverage for cancer care planning and coordination services, requiring personalized survivorship care plans for cancer survivors from diagnosis through the end of life. The bill creates a demonstration program to test different models of survivorship care, including navigation services to help survivors transition from cancer treatment to ongoing care, and mandates Medicaid coverage for cancer fertility services. It also establishes a comprehensive cancer survivorship program with resource centers for survivors and health care providers, and includes provisions to help cancer survivors overcome employment barriers and improve their quality of life through physical activity and mental health support. The legislation specifically addresses disparities in care for racial/ethnic minorities, lower socioeconomic groups, and rural populations who face unique challenges as cancer survivors.

Maddy summaryThe CONNECT for Health Act of 2023 aims to expand access to telehealth services under Medicare by removing barriers that previously limited who could provide these services and where they could be delivered. The bill eliminates geographic restrictions on telehealth coverage, allows telehealth services to be provided from the patient's home and other clinically appropriate locations, and expands the types of healthcare providers who can offer telehealth services. It also improves the process for adding new telehealth services to Medicare coverage and includes provisions to ensure quality measurement includes telehealth services. This legislation directly affects Medicare beneficiaries seeking remote care and healthcare providers delivering telehealth services, with key provisions taking effect between 2024 and 2025.

Maddy summaryThe LIFT the BAR Act removes barriers preventing lawfully present noncitizens from accessing federal benefits like food assistance, Medicaid, and school meals. It repeals specific 1996 welfare law provisions that excluded noncitizens and updates terminology to replace "alien" with "noncitizen" throughout federal law. The bill expands eligibility to include noncitizens in categories such as Deferred Action for Childhood Arrivals (DACA) recipients, individuals with special immigrant juvenile status, and those with pending U-visa applications. This change ensures more noncitizens lawfully present in the U.S. can access essential services without being denied based on immigration status.

Maddy summaryThis bill amends Medicare rules to improve access to home infusion therapy, which delivers IV medications at home for conditions like chronic diseases. It adds pharmacy services (including drug preparation and compounding) to covered Medicare benefits and creates a payment rule: if a supplier isn't physically present during therapy, Medicare pays 50% of the full rate instead of denying payment. It also allows nurse practitioners and physician assistants to establish and review home infusion care plans, previously limited to physicians. These changes, effective January 2024, directly affect Medicare beneficiaries requiring home infusion therapy and providers delivering these services.

Maddy summaryHR 4034 would add cranial prostheses (such as medical wigs) to Medicare's list of covered durable medical equipment. It requires a dermatologist, oncologist, or attending physician to certify in writing that the prosthesis is medically necessary as part of rehabilitative treatment. This change directly affects Medicare beneficiaries experiencing hair loss due to medical conditions like cancer treatment who need these prostheses for health reasons. The bill does not cover cosmetic wigs but specifically targets medically necessary cranial prostheses under existing Medicare coverage rules.

Maddy summaryHR 3851, the Access to Breast Cancer Diagnosis Act of 2023, requires most health insurance plans (including group and individual coverage) to cover diagnostic and supplemental breast exams without any out-of-pocket costs like copays or deductibles. This applies to medically necessary exams used to evaluate abnormalities detected during screening (diagnostic) or to screen high-risk individuals without abnormalities (supplemental), following National Comprehensive Cancer Network guidelines. Plans may still require prior authorization for these exams, and state laws providing stronger protections remain in effect. The law takes effect for plan years beginning January 1, 2024.