Rep. Kathy Castor

Maddy summaryHR 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.

Maddy summaryThe Patient Debt Relief Act requires Medicare-participating hospitals to establish clear financial assistance policies by January 2026, including publicly available eligibility criteria and 30-day pre-payment screening for charity care. It prohibits hospitals from placing home liens, garnishing wages, or selling debt to collectors without offering income-based repayment plans (capping payments at 4% of gross monthly income) and eliminates interest for patients earning under 250% of the poverty line. Hospitals failing to comply face civil penalties up to $1 million per violation. The bill also creates a $100 million grant program to fund nonprofits that discharge medical debt for individuals meeting income thresholds (5% of income or under 400% of poverty line), with quarterly reporting requirements. These provisions apply directly to hospitals and low-income patients with medical debt.

Maddy summaryThis 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.

Maddy summaryThe Essential Caregivers Act of 2024 requires nursing homes and similar facilities to allow residents to designate essential caregivers who provide emotional support or assistance with daily activities. During emergencies when regular visitation is restricted, facilities must permit at least one essential caregiver access to residents daily and cannot deny access without following specific procedures. Facilities may deny access for a maximum of 7 days during emergencies (or 14 days with state approval), and must provide a written explanation and appeal process if access is denied. The bill establishes a 48-hour appeal process for residents and caregivers to challenge denials, with facilities required to prove violations during appeals. This law applies to Medicare skilled nursing facilities, Medicaid nursing facilities, intermediate care facilities, and certain inpatient rehabilitation facilities.

Maddy summaryHR 7742, the At HOME Services Act, creates a 2-year Medicare demonstration program allowing hospitals to provide outpatient observation services to beneficiaries in their homes. It grants hospitals temporary exemptions from certain hospital requirements (like 24-hour on-site nursing and physical space standards) and expands telehealth access to home settings. Hospitals must maintain inpatient-level care standards, collect data on care quality and costs, and submit to a study comparing home-based care outcomes to traditional hospital care. The program will analyze factors like health outcomes, costs, patient experience, and demographic data before a final report is published.

Maddy summaryHR 7555, the RETRO GSP Act, requires the U.S. government to refund over $3 billion in tariffs paid by American businesses on imports from beneficiary countries during the GSP program's lapse (Dec 31, 2020-enactment date). It directs U.S. Customs to retroactively treat qualifying import entries as if they occurred on Dec 31, 2020, allowing businesses to get tariff refunds. Companies must submit refund requests to Customs within 180 days of the bill's enactment, with payments due within 90 days of processing. This directly affects U.S. importers of goods from GSP-eligible countries who paid duties during the program's suspension.

Maddy summaryThis bill expands eligibility for certain tax-advantaged health accounts to cover medical expenses for parents. It amends the tax code to allow individuals to use funds from Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and Health Reimbursement Arrangements (HRAs) for qualified medical care of their parents or their spouse's parents - previously limited to immediate family members. The changes apply to expenses incurred after December 31, 2023, directly benefiting adult caregivers (like children supporting elderly parents) who use these accounts for parental healthcare costs. The bill makes no new funding commitments but adjusts existing account rules to reduce out-of-pocket costs for caregivers.

Maddy summaryThe 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.

Maddy summaryHR 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.

Maddy summaryHR 6366 delays certain Medicare payment adjustments for physicians and clinical laboratories. It extends the effective year for the "work geographic index" (which sets physician payment rates by location) from 2024 to 2025. The bill also shifts the timeline for implementing reduced Medicare payments for clinical lab tests, moving the phase-in period from 2024-2026 to 2025-2027 and adjusting the reporting years for private payor rate data. These changes directly affect Medicare payments to physicians and clinical laboratories under the Social Security Act. The bill makes technical adjustments to existing payment rules without altering the overall structure of Medicare reimbursement.