Rep. Madeleine Dean

Maddy summaryThis bill expands Medicare coverage to include home infusion treatment for people with Alpha-1 Antitrypsin Deficiency Disorder, a genetic condition causing lung and liver damage. It specifically covers "augmentation therapy" (a standard treatment using Alpha-1 Proteinase Inhibitor) when administered in a patient's home by qualified providers. Medicare will pay 80% of the cost for intravenous kits and up to 2 hours of nursing care during these home infusions, starting January 1, 2025. The change directly affects Medicare beneficiaries with this condition who require home-based treatment and their qualified home infusion providers.

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, 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 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 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.

Maddy summaryThis bill requires Medicare to cover genetic counseling services provided by licensed genetic counselors at 85% of the physician payment rate. It defines "genetic counselor" as a state-licensed professional (or meeting federal criteria in non-licensing states) and mandates a new billing modifier for these services starting January 1, 2024. Medicare beneficiaries seeking genetic counseling would gain expanded access to these services under this coverage. The policy change applies to services furnished on or after the effective date, with implementation via interim rule.

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.

Maddy summaryThe Bear Protection Act of 2023 (HR 3518) prohibits the interstate and international trade of bear viscera (internal organs like gallbladders) and products containing them, such as traditional medicine ingredients. It directly affects businesses, importers, exporters, and anyone involved in trading these items across state lines or internationally. The bill creates criminal penalties (up to 1 year in prison or $25,000 fines) and civil enforcement through the Department of the Interior, while allowing limited exceptions for wildlife law enforcement and Native American cultural practices. It aims to reduce poaching and habitat loss by cutting demand for bear parts, particularly targeting trade linked to declining bear populations in Asia and the U.S.

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 3432, the Telemental Health Care Access Act of 2023, expands Medicare coverage for mental and behavioral health services delivered via telehealth. It removes geographic restrictions that previously limited telehealth coverage to rural areas and explicitly adds "behavioral health services" to the list of covered telehealth services under Medicare Part B. The bill requires the Secretary of Health and Human Services to submit a report within one year on utilization of these services, including recommendations on fraud prevention and funding needs for oversight. This change directly affects Medicare beneficiaries seeking remote mental/behavioral health care and the providers who deliver it.