Rep. Kim Schrier

Maddy summaryThe Patients First Act of 2026 modifies how Medicare reimburses physicians and primary care providers to improve access and stabilize payments. It establishes a new hybrid payment model for primary care services from 2027 to 2031, which pays a monthly fee per patient to eligible independent practices while covering specific services like care management and telehealth without cost-sharing for patients. The bill also updates the formula for calculating reimbursement rates to account for high inflation years and requires more frequent updates to the costs used in calculating payments. Additionally, the legislation reforms the performance-based payment system by adding care efficiency measures, creating a task force to recommend new quality metrics, and adjusting penalties for providers who fail to report on certain data.

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic pre-approval systems for medical services by 2028 and meet transparency reporting standards starting in 2027. Plans must publicly report data on approval/denial rates, appeal outcomes, response times, and technology use for pre-approval requests, including details on how denials relate to clinical criteria. It establishes a 24-hour response timeframe for certain requests and mandates annual reviews of pre-approval requirements based on data and input from seniors and providers. The law directly affects Medicare Advantage plans, seniors enrolled in these plans, and healthcare providers who submit pre-approval requests. These changes aim to make the pre-approval process faster, more transparent, and more accountable for seniors seeking covered medical services.

Maddy summaryThe Expedited Access to Biosimilars Act modifies federal regulations to streamline the approval process for biosimilar drugs, which are lower-cost versions of existing biologic medicines. The bill requires manufacturers to conduct specific studies on how the drug behaves in the body and how the immune system reacts to it, while limiting the need for additional large-scale clinical trials unless the FDA explicitly determines they are necessary. To ensure transparency, the law mandates that the FDA must provide written notice to drug sponsors within 60 days regarding whether extra studies are required. These changes aim to reduce the time and cost involved in bringing biosimilars to market, potentially increasing patient access to affordable treatment options.

Maddy summaryThe American Enrichment Deployment Act modifies federal rules to allow the construction of uranium enrichment facilities to begin before a full operating license is granted. This change applies to companies building these facilities, permitting them to start construction under the same conditions used for other nuclear fuel cycle projects. The Nuclear Regulatory Commission must update its regulations within 180 days to implement these new procedures while retaining its authority to oversee safety and enforce compliance.

Maddy summaryHR 5549, the Efficient Nuclear Licensing Hearings Act, streamlines the licensing process for nuclear facilities by reducing mandatory hearings. It allows the Nuclear Regulatory Commission (NRC) to issue construction permits, operating licenses, or amendments without a hearing if it provides 30 days' notice and Federal Register publication, skipping the hearing requirement only when an amendment involves "no significant hazards." This change applies to all pending NRC applications after enactment, shifting from current rules requiring hearings unless waived. The bill directly affects nuclear facility developers, the NRC, and communities potentially impacted by licensing decisions through its revised notice and hearing procedures.

Maddy summaryThe Prior Authorization Accountability Act requires health insurance plans and issuers to publicly report detailed data on their prior authorization processes starting in 2027. This includes submitting information on approval and denial rates, appeal outcomes, processing times, and the specific use of artificial intelligence or other automated technologies in making coverage decisions. The bill mandates that these reports be available on public websites for both individual and group coverage, allowing consumers to compare how different plans handle requests for medical services. Additionally, the legislation updates the Affordable Care Act to ensure that health plans sold through insurance exchanges display this new transparency data to help shoppers make informed choices.

Maddy summaryThe Let Doctors Provide Reproductive Health Care Act prohibits states and officials from restricting or penalizing health care providers and their staff for offering reproductive health services that are legal within the state where they are performed. It establishes a federal right for providers to assist patients regardless of where those patients live and allows attorneys general to sue states that enforce such restrictions, including stripping states of legal immunity in these cases. To support this framework, the bill appropriates $40 million each for legal defense grants to help providers navigate lawsuits and $40 million for security grants to improve physical and cyber safety at medical facilities. Additionally, the legislation requires insurance companies to offer professional liability coverage to providers without discrimination based on the reproductive services they provide.

Maddy summaryThe SAFE Training for OB-GYNs Act creates a new federal grant program to help medical residents who must leave their home states to receive training in reproductive health care due to local abortion restrictions. Funded with up to $10 million annually from 2027 to 2031, these grants support residency programs that offer specialized training in sexual and reproductive health, including abortion care. The funding can be used to expand existing programs or establish new ones specifically for out-of-state residents and to cover their travel expenses. This legislation directly affects health care professionals seeking specialized training and the medical residency programs that provide it.

Maddy summaryThe Reproductive Health Care Training Act of 2026 authorizes $25 million over five years to fund a program that provides grants to health schools and clinics for expanding abortion care training. These funds are specifically designated for institutions located in states where comprehensive abortion training is legal, with a priority on serving minority-serving schools and those training students from medically underserved areas. The program supports activities such as developing clinical curricula, utilizing telehealth, recruiting diverse healthcare workers, and offering scholarships to students pursuing this specialized training. Recipients must submit annual reports on program performance while ensuring federal funds supplement, rather than replace, existing state and private resources.

Maddy summaryThis bill redesignates the existing National Parks and Public Land Legacy Restoration Fund as the America's Legacy Restoration Fund to address deferred maintenance on federal lands. It directs revenue from recreation fees and a portion of energy development income into the fund, which must be used primarily for repairing critical infrastructure like roads, trails, and buildings managed by agencies such as the National Park Service and the Forest Service. The legislation establishes strict rules requiring that most funds go toward non-transportation projects, mandates transparency through public dashboards tracking project status, and sets aside a small percentage for matching private donations. Additionally, the bill increases entrance fees for foreign visitors to ensure they contribute to the fund, while prohibiting the use of these specific funds for land acquisition or employee bonuses.