Rep. Sara Jacobs

Maddy summaryThis bill establishes minimum nurse-to-patient ratios for registered nurses in hospital units (such as 1:1 in trauma units, 2:1 in critical care units, and 3:1 in emergency rooms), requiring hospitals to develop and maintain staffing plans that meet these standards. It mandates transparency in documenting staffing levels, ensures hospitals verify nurses' competence for specific units, and enforces compliance through Medicare and Medicaid programs with penalties for violations. The bill protects nurses who refuse unsafe assignments due to staffing concerns and includes initiatives to improve nurse retention and address staffing shortages. It directly affects hospitals, nurses, and patients by aiming to improve patient safety and care quality through standardized staffing requirements. The bill applies to all hospitals, with extended implementation timelines for rural facilities.

Maddy summaryThis bill would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.

Maddy summaryThe LEAP Act creates a new tax credit for employers with registered apprenticeship programs, offering $1,500 per qualifying apprentice employee above a threshold based on the employer's average apprenticeship hires over the previous three years, limited to two years per employee. It excludes most construction industry employers (NAICS 23) unless they hire pre-apprenticeship graduates and sponsor apprenticeships. The bill also requires federal agencies to develop a plan to reduce printing costs by increasing online document availability and to disclose printing costs for government publications. This applies to apprenticeship programs registered with the Department of Labor.

Maddy summaryThe Affordable Insulin Now Act (HR 1488) requires health insurance plans and issuers to cover specific insulin products with cost-sharing capped at $35 per 30-day supply or 25% of the negotiated price, whichever is lower, starting in 2024. It directly affects people with diabetes who rely on insulin by limiting out-of-pocket costs for covered products. The bill mandates coverage of all insulin types (rapid-acting, long-acting, etc.) and dosage forms (vials, pumps, etc.) as selected by the plan. This applies to both group and individual health insurance plans under the Public Health Service Act, Internal Revenue Code, and ERISA, with cost-sharing counting toward annual deductibles.

Maddy summary# Summary of Proposed Election Reform Legislation This document outlines a comprehensive federal election reform bill with multiple titles addressing various aspects of voting rights, election administration, and election integrity. ## Key Provisions: ### 1. Democracy Restoration (Title I) - Restores voting rights to citizens with felony convictions who are not serving a felony sentence in a correctional institution - Requires states to notify individuals of restored voting rights upon release from prison, completion of probation, or sentencing - Prohibits states from conditioning voting rights on payment of fines or fees - Requires states to provide notification of voting rights to citizens with criminal convictions ### 2. Voter Identification Requirements (Title II) - Establishes a broad definition of acceptable identification documents (including utility bills, bank statements, student IDs, etc.) - Requires states to provide free identification to voters who lack one - Authorizes $5 million annually for 5 years to cover costs of providing identification - Sets procedures for provisional voting when identification is not presented ### 3. Voter List Maintenance (Title III) - Prohibits "voter caging" (using undeliverable mail to challenge voter registration) - Bans use of unverified match lists to remove voters from registration lists - Sets strict conditions for removing voters from registration lists - Requires states to provide notice to voters removed from registration lists ### 4. Election Integrity Measures (Title V) - Prohibits hindering or interfering with voter registration (Section 2001) - Restricts removal of local election administrators (Section 3001) - Prohibits harassment of election workers (Section 3101) - Bans deceptive practices in elections (Section 3201), including false statements about voting locations, eligibility, or endorsements ### 5. Additional Provisions - Requires states to provide notice of voting rights restoration to citizens - Establishes private rights of action for violations of the law - Sets criminal penalties for violations (up to $100,000 fines and 5 years imprisonment) - Includes provisions for federal funding to be contingent on compliance with voting rights restoration This legislation represents a significant overhaul of voting rights and election administration procedures across the United States, with a focus on expanding voting access, protecting voter rights, and ensuring fair election administration.

Maddy summaryHR 549, the Metastatic Breast Cancer Access to Care Act, removes waiting periods for disability and Medicare coverage for people diagnosed with metastatic breast cancer. Specifically, it amends Social Security Act sections to allow immediate eligibility for disability insurance benefits (eliminating the standard waiting period) and immediate Medicare coverage (waiving the 24-month waiting period) for these patients. The bill directly affects individuals with metastatic breast cancer who would otherwise face delays in accessing critical benefits. These changes apply to applications filed or benefits beginning after the bill's enactment date. The law makes no other policy changes beyond these specific eligibility adjustments.

Maddy summaryThe EACH Act of 2023 would require federal health programs - including Medicaid, Medicare, the Indian Health Service, and TRICARE - to cover abortion services without restrictions. It repeals a provision in the Affordable Care Act that allowed states to limit abortion coverage in health insurance plans sold through state marketplaces. The bill also prohibits the federal government from restricting abortion coverage in private health insurance plans. This would directly affect millions of people, particularly low-income individuals and people of color, who are disproportionately enrolled in Medicaid and currently face barriers to abortion care due to coverage restrictions.

Maddy summaryHR 415, the "End the Threat of Default Act," repeals the statutory debt ceiling (section 3101 of Title 31, U.S. Code), which currently limits how much the federal government can borrow. This would eliminate the need for Congress to approve increases to the borrowing cap, removing the risk of a government default on its debts. The bill directly affects the Treasury Department’s ability to manage federal borrowing, as it would no longer require congressional action to authorize new debt issuance. The technical amendments update references to the debt ceiling in other laws to reflect this change.

Maddy summaryThis bill, HR 35 (Close the Medigap Act of 2023), prohibits Medicare supplemental insurance (Medigap) insurers from denying coverage or charging higher premiums based on health status, pre-existing conditions, genetic information, or age. It directly affects Medicare beneficiaries (particularly those with pre-existing conditions) and requires insurers to offer guaranteed issue coverage starting January 1, 2024, with full implementation by 2029. Key mechanisms include banning health-based pricing discrimination, requiring insurers to spend at least 65% of individual policy premiums on healthcare (increasing to align with NAIC recommendations), and improving transparency on the Medicare Plan Finder website. The bill does not change Medicare Part A/B benefits but ensures broader access to supplemental coverage without health-related barriers.

Maddy summaryHR 7438 directs the U.S. Treasury to mint commemorative coins for the 2026 FIFA World Cup, including 100,000 $5 gold coins, 500,000 $1 silver coins, and 750,000 half-dollar coins. The coins will be sold to the public at face value plus surcharges ($35, $10, and $5 per coin, respectively), with all surcharge revenue paid to FWC2026 US, Inc. for U.S. soccer programs. These funds must support soccer initiatives, particularly in underserved communities and youth development, as specified in the bill. The coins are legal tender but will only be issued during 2026, with no net cost to the U.S. government.