Rep. Julia Brownley

Maddy summaryThis bill changes how Medicare counts hospital stays for coverage of skilled nursing care. It treats time spent in outpatient observation (not admitted as an inpatient) as part of the required 3-day inpatient hospital stay. This means beneficiaries who received outpatient observation services will have that time counted toward the 3-day requirement, potentially making them eligible for skilled nursing facility coverage they might otherwise have lost. The change applies to services beginning January 1, 2024, with limited retroactive appeal options for services completed before the law's enactment. It directly affects Medicare beneficiaries needing skilled nursing care after hospital treatment.

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 summaryThis bill prohibits Medicare from paying for certain custom-fitted or custom-fabricated orthotic and prosthetic devices delivered via "drop shipment" (direct shipping without in-person training from a qualified provider). It directly affects Medicare beneficiaries who need these devices, ensuring they receive necessary in-person fitting and training. The bill also expands which healthcare professionals (including physical therapists, occupational therapists, orthotists, and prosthetists) can prescribe these devices and updates definitions to clarify terms like "orthoses" and "prostheses." Final regulations implementing these changes must be issued within one year of the bill's enactment.

Maddy summaryThe ARC Act of 2023 establishes a national program to address peripheral artery disease (PAD), which disproportionately affects minority populations and leads to avoidable amputations. The bill requires Medicare and Medicaid to cover PAD screening tests (such as ankle-brachial index testing) for at-risk beneficiaries without cost-sharing, including people 65+ or those with diabetes, smoking history, or other risk factors. It authorizes $6 million annually for a CDC-led education program to inform healthcare providers and the public about PAD prevention and treatment. The bill also creates quality measures to encourage alternative treatments to amputation and establishes a pilot program to test amputation prevention services at healthcare facilities. These provisions aim to reduce amputation rates and improve outcomes for millions of Americans with PAD.

Maddy summaryThis bill, the Public Servants Protection and Fairness Act of 2023, amends Social Security to better protect public servants who work in jobs not covered by Social Security (such as certain government positions). It creates a new formula for calculating retirement benefits that combines both covered and noncovered earnings, ensuring public servants receive the higher of two benefit calculations. The bill also provides an additional $150 monthly payment for certain public servants whose benefits were previously reduced by the windfall elimination provision. It improves Social Security account statements to clearly show noncovered earnings and requires a study of how state retirement plans handle these benefits. These changes will apply to benefits starting in 2025.

Maddy summaryHR 4195, the Empowering Parents’ Healthcare Choices Act of 2021, allows parents to choose which health insurance plan covers their child when both parents have separate, qualifying coverage (e.g., individual policies or employer-sponsored group plans). Specifically, parents must submit a joint notification within 60 days of the child’s birth to designate one plan as primary coverage. This choice remains in effect until parents revoke it or one parent loses coverage under their plan. The bill applies to children born on or after January 1, 2022, and affects families with dual coverage, insurance issuers, and group health plans.

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 summaryThe Menstrual Equity For All Act of 2023 requires free menstrual products to be available at no cost in public schools, colleges, correctional facilities, and federal buildings. It makes menstrual products covered by Medicaid, prohibits taxes on these products, and provides funding through social services programs to help low-income individuals access menstrual products. The bill directly affects students (K-12 and college), incarcerated people, homeless individuals, employees (in businesses with 100+ workers), Medicaid beneficiaries, and people receiving Temporary Assistance for Needy Families (TANF). Key provisions include amending school funding to require free products, creating college grant programs for menstrual product distribution, and adding menstrual products to Medicaid coverage and social services programs.