Rep. Jared Moskowitz

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 summaryThis bill establishes "cottage family homes" as a new foster care placement option under federal law. It defines cottage homes as licensed residences caring for up to 2 children per bedroom (with exceptions), requiring trauma-informed care, prohibiting most restraints, and mandating systems for children to report concerns. The bill directly affects foster children placed in these homes and state child welfare agencies, by making cottage homes eligible for federal foster care maintenance payments without time limits. Key provisions include requiring states to adopt the new definition, allowing states flexibility in how they classify these homes, and ensuring children in cottage homes receive the same care standards as those in traditional foster placements.

Maddy summary# Comprehensive Immigration Reform Bill Summary This document appears to be a draft of a comprehensive immigration reform bill with significant changes to U.S. immigration policy, particularly focusing on employment verification and asylum processing. ## Key Provisions ### Employment Eligibility Verification (E-Verify) System - **Replaces the current E-Verify system** with a new "Employment Eligibility Verification" system under Section 274A - **Phased implementation schedule** for different employer sizes (10,000+ employees, 500-10,000 employees, 20-500 employees, and fewer than 20 employees) - **New penalties** for violations, including: - Civil penalties ranging from $2,500 to $25,000 per violation - Criminal penalties of up to $5,000 per unauthorized alien - **Good faith defense** for employers who comply with verification requirements - **Repeal of Subtitle A of Title IV of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996** ### Asylum Reform - **Establishment of 5 "Humanitarian Campuses"** along the southern border for processing asylum seekers - **Expedited asylum procedures** including: - Mandatory 72-hour rest period after arrival - Initial screening within 15 days - Expedited asylum decisions within 45 days for approved cases - Case management for those referred to immigration judges - **5 Western Hemisphere facilities** for asylum pre-screening and family reunification - **New requirements** for recording credible fear interviews and expedited removal proceedings - **Stricter penalties** for asylum fraud, including permanent ineligibility for asylum benefits ### Additional Provisions - **Criminal background checks** for sponsors of unaccompanied children - **Fraud prevention measures** for Social Security numbers and identity verification - **New verification system** with requirements for biometric checks, medical screenings, and legal orientation - **Provisions for vulnerable populations** including pregnant women, victims of violence, and people with disabilities The bill contains detailed implementation timelines (with many provisions taking effect within 1-5 years), specific numerical requirements for staffing, and extensive procedural requirements for processing immigrants and asylum seekers. This appears to be a comprehensive proposal that would significantly change U.S. immigration enforcement, asylum processing, and employer verification requirements.

Maddy summaryHR 3589, the Affordability is Access Act of 2023, requires health insurance plans to cover FDA-approved over-the-counter birth control without cost-sharing (like copays or deductibles). It directly affects millions of people who use contraception, particularly low-income individuals and those in areas with limited access to reproductive health services ("contraceptive deserts"). The bill clarifies that existing insurance coverage rules under the Affordable Care Act apply to over-the-counter contraceptives, and directs the FDA to expedite reviews for over-the-counter status. Retailers must not block access to these products but may refuse sales if payment isn’t provided.

Maddy summaryThe FAMILY Act (HR 3481) would establish a national paid family and medical leave insurance program administered by the Social Security Administration. Eligible workers would receive wage replacement benefits (up to 85% of average earnings, with a maximum of $4,000 monthly) for up to 60 caregiving days per 12-month benefit period for qualifying reasons like caring for a sick family member, personal serious health conditions, or responding to domestic violence. The program would be funded through 0.2% payroll taxes from employees and employers (with self-employed individuals paying 0.4%), with benefits coordinated with existing state programs. The law includes protections against employer retaliation for taking leave and requires employers to maintain health coverage during leave periods.

Maddy summaryHR 3443, the Foster Youth Mentoring Act of 2023, creates a federal grant program to fund structured mentoring programs for youth in foster care and those who have aged out of foster care (under age 26). The bill authorizes $50 million annually for grants to eligible organizations (like nonprofits, state agencies, or tribes) to establish or expand mentoring that provides consistent, year-long relationships focused on academic support, emotional development, and transition to adulthood. Key requirements include mandatory mentor training on trauma, cultural competence, and child welfare coordination, along with strict background checks and recruitment strategies to reflect the diversity of youth served. The program directly affects approximately 443,000 youth in foster care (per 2017 data) and aims to improve their educational outcomes, reduce school absences, and build supportive connections through evidence-based mentoring.

Maddy summaryHR 3033, the Solidify Iran Sanctions Act of 2023, repeals the expiration date (sunset) from the 1996 Iran Sanctions Act. This permanently maintains existing U.S. sanctions targeting Iran's weapons programs, ballistic missile development, and support for terrorism. The bill directly affects Iran's government and entities involved in these activities by ensuring sanctions remain in effect without needing periodic renewal. It does not impose new sanctions but preserves current policy by removing the automatic expiration provision.

Maddy summaryThe Elder Justice Reauthorization and Modernization Act of 2023 reauthorizes $400 million annually for 2024-2027 to support nursing home worker training and retention through wage subsidies, tuition assistance, child care support, and transportation assistance for eligible workers. It also provides $8 million annually for adult protective services and $125 million annually for medical-legal partnerships that integrate legal services with health care for older adults. Additionally, the bill allocates $62.5 million annually to address social isolation among seniors through community-based interventions. These provisions aim to strengthen the elder care workforce, improve protections for vulnerable seniors, and enhance coordination between health, human services, and legal systems.

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.