Sen. Cindy Hyde-Smith

Maddy summaryThis bill prohibits federal funding - including Medicaid, ACA subsidies, and other federal health programs - from covering gender transition procedures. It specifically bans taxpayer dollars from being used for medical services like hormone therapy, surgery, or puberty-blocking drugs related to gender transition, except for cases involving disorders of sex development or complications from such procedures (as defined in Section 306). The bill also clarifies that ACA premium credits and cost-sharing reductions cannot apply to health plans covering these procedures, though individuals or states may purchase separate non-federal coverage for them. It directly affects federal health programs and beneficiaries relying on government-funded healthcare.

Maddy summaryThis bill prohibits healthcare professionals from performing or referring minors (under 18) for gender transition procedures, including puberty blockers, cross-sex hormones, or surgeries like genital or non-genital transition surgeries. It imposes criminal penalties (fines, up to 5 years imprisonment) on providers who violate this prohibition, while protecting minors from prosecution for the procedures. The bill explicitly excludes medical treatments for disorders of sex development or emergencies where surgery is needed to prevent death or serious harm. It defines key terms like "gender transition procedure" and "biological sex" to clarify the scope of the ban. The law does not affect adults or medical care for conditions unrelated to gender transition.

Maddy summaryThe EARN IT Act of 2023 establishes a National Commission on Online Child Sexual Exploitation Prevention to develop voluntary best practices for interactive computer services (such as social media platforms and messaging apps) to prevent, reduce, and respond to online child sexual exploitation. The Commission will create recommended practices considering different platform sizes and business models, including content moderation, reporting systems, and age verification measures. The bill updates federal law to replace the term "child pornography" with "child sexual abuse material" across numerous statutes and technical amendments. These best practices would be voluntary for platforms to adopt, not mandatory requirements, and must be supported by at least 14 of the Commission's 19 members. The Commission's recommendations will be updated every 5 years and published by the Department of Justice.

Rural Hospital Closure Relief Act of 2023 This bill allows additional hospitals to qualify as critical access hospitals (CAHs) that receive special payment under Medicare. Currently, in order to qualify as a CAH under Medicare, a hospital must either (1) be located more than 35 miles (or 15 miles in mountainous regions or areas with only secondary roads) from another hospital, or (2) have been certified prior to January 1, 2006, by the state as a necessary provider of services in the area. The bill allows a hospital to also qualify if the hospital is a small, rural hospital that (1) serves a health professional shortage area, or a high number of low-income individuals or Medicare or Medicaid beneficiaries; (2) has experienced financial losses for two consecutive years; and (3) attests to having a strategic plan to address financial solvency. The Government Accountability Office must study the effects of the bill's implementation. The Centers for Medicare & Medicaid Services must subsequently establish a mechanism and issue guidance on how newly designated CAHs may transition to different payment models under Medicare.

Maddy summaryThis bill expands the use of 529 college savings plans to cover tuition and related expenses for specific aviation training programs. It allows students to use funds from these tax-advantaged accounts for qualified aviation maintenance courses (taught at FAA-approved schools under part 147 of federal regulations) and qualified commercial pilot courses (taught at FAA-approved flight schools under parts 61 or 141). The change directly affects students enrolled in these approved aviation programs by making 529 savings a viable funding source. The provision applies to distributions made after the bill's enactment date.

Maddy summaryS 1554, the National American Indian Veterans Charter Act, grants a federal charter to the existing nonprofit organization National American Indian Veterans, Incorporated. This charter formally recognizes the group as a federally chartered entity under Title 36 of the U.S. Code, authorizing it to operate as a nonprofit dedicated to serving American Indian veterans. Key provisions include granting the organization exclusive rights to its name and insignia, requiring it to maintain tax-exempt status, and mandating annual reports to Congress on its activities (though these reports are not public documents). The bill directly affects American Indian veterans by legally solidifying the organization’s role as their representative body for advocacy, outreach, and support services.

Maddy summaryThis bill, the "Back the Blue Act of 2023," strengthens federal protections for law enforcement officers by creating new criminal penalties for killing or assaulting them while on duty. It makes it a federal crime to kill or attempt to kill law enforcement officers, federal judges, or federally funded public safety officers (including firefighters and first responders) during official duties, with penalties ranging from 10 years to life in prison or death if the victim dies. The bill also establishes a new federal offense for fleeing interstate to avoid prosecution for killing law enforcement officers and adds a new aggravating factor for death penalty cases involving officers. Additionally, it expands law enforcement officers' rights to carry firearms in certain circumstances and limits federal habeas corpus relief for murder convictions involving law enforcement officers.

Maddy summaryS 1544, the Facilitating Innovative Nuclear Diagnostics Act of 2023, requires Medicare to make separate payments for certain high-cost diagnostic radiopharmaceuticals starting January 1, 2024. It applies to drugs meeting a $500 per day cost threshold (rising annually with inflation), defined as FDA-approved nuclear imaging drugs launched after 2008. Payments will use existing Medicare pricing mechanisms - either average sales price or wholesale acquisition cost - to ensure separate coverage without bundling. This directly affects Medicare beneficiaries receiving these specific nuclear diagnostics and the hospitals/providers billing Medicare for them. The bill does not change patient costs or coverage eligibility but alters Medicare's payment structure for these drugs.

Maddy summaryThe Campus Free Speech Restoration Act (S 1511) strengthens student free speech protections at colleges and universities receiving federal funding. It defines "expressive activity" broadly to include peaceful assembly, protests, distributing literature, and other First Amendment-protected speech, while prohibiting schools from restricting such activities through overly broad speech codes or "free speech zones." The bill requires institutions to clearly disclose their speech policies online and in student handbooks, establishes a complaint process for students who believe their rights were violated, and allows for loss of federal funding if institutions don't comply with the new standards. It applies to public institutions and private institutions receiving federal funds, with exemptions for religiously controlled schools.

Maddy summaryThis bill expands Medicare coverage to include pharmacist services in designated underserved areas. It directly affects Medicare beneficiaries in health professional shortage areas, medically underserved areas, or medically underserved populations, as well as pharmacists licensed to provide these services. Key provisions require Medicare to cover pharmacist services (like those typically provided by physicians) in these areas and set payment at 80% of the lesser of the actual charge or 85% of the physician fee schedule. The changes take effect January 1, 2024, and require new billing codes for pharmacists.