Healthcare (Insurance)

in committee · United States · House Nov 20, 2025

HR 6242: Healthy MOM Act

The Healthy MOM Act (HR 6242) would require health insurance plans to provide a special enrollment period for pregnant individuals beginning when pregnancy is reported to the insurer. It mandates that group health plans and health insurance issuers cover maternity care, including childbirth and postpartum care, for all dependents regardless of age. The bill would extend Medicaid coverage for pregnant individuals and infants to 12 months postpartum (instead of ending at 60 days postpartum) and make this 12-month coverage permanent. These provisions would directly affect pregnant individuals, women with dependent children who are pregnant, and health insurance plans and Medicaid programs.

Topics ✓ HealthcareSupports HealthcareMandates maternity coverage, extends Medicaid postpartum from 60 to 12 months, expands access for pregnant individuals and infants95% confidence

Sub-Topics Insurance Medicaid Women's Health

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in committee · United States · House May 8, 2025

HR 3277: Ensuring Lasting Smiles Act

HR 3277, the Ensuring Lasting Smiles Act, requires group health plans and health insurance issuers to cover medically necessary outpatient and inpatient treatments for congenital anomalies or birth defects primarily affecting the eyes, ears, teeth, mouth, or jaw. This includes reconstructive procedures, dental/orthodontic support during treatment, and follow-up care, but excludes purely cosmetic surgery not tied to a medical diagnosis. Cost-sharing (like copays) for these services must not be stricter than for other medical benefits. The law takes effect for plan years beginning January 1, 2026, and mandates insurers to provide notice about this coverage to beneficiaries.

Topics ✓ HealthcareSupports HealthcareMandates coverage for medically necessary treatments of congenital anomalies, expanding health insurance benefits for patients with specific conditions.95% confidence

Sub-Topics Insurance

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in committee · United States · House Nov 20, 2025

HR 6210: Senior Savings Protection Act

HR 6210, the Senior Savings Protection Act, extends mandatory annual funding for key senior assistance programs through fiscal year 2030. It allocates $15 million each year for State Health Insurance Assistance Programs, $15 million for Area Agencies on Aging, $5 million for Aging and Disability Resource Centers, and $15 million for outreach coordination efforts. These funds directly support low-income seniors by expanding access to counseling, benefits enrollment help, and program information through state and local agencies. The bill makes no new eligibility rules but ensures sustained financial support for existing services that help seniors navigate healthcare and social programs.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill mandates annual $15M+ funding for senior programs (SHIP, AAA, etc.), directly increasing state budget allocations for essential public services supporting low-income seniors.95% confidence ✓ HealthcareSupports HealthcareFunds SHIP, Area Agencies on Aging, and resource centers to expand senior health insurance access and benefits enrollment assistance.95% confidence

Sub-Topics Insurance Tags Seniors

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in committee · United States · House Sep 4, 2025

HR 5139: EPIPEN Act

The EPIPEN Act (HR 5139) requires most health insurance plans to cover epinephrine delivery systems (like EpiPens, nasal sprays, or sublingual devices approved by the FDA) without applying deductibles and limiting out-of-pocket costs to $60 per package of two devices. It directly affects people with severe allergies who rely on these emergency treatments, ensuring they pay no more than $60 per two-device package. The bill mandates that any cost-sharing payments count toward the plan’s annual out-of-pocket maximum, though plans may charge higher fees for out-of-network providers. The requirements will take effect for plan years beginning January 1, 2026.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage without deductibles and caps out-of-pocket costs at $60 for EpiPens, improving access to emergency allergy treatment.95% confidence

Sub-Topics Insurance

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in committee · United States · Senate Jan 28, 2026

S 3712: BO’s Act

S 3712, the "BO's Act," requires the U.S. Department of Health and Human Services to study home cardiorespiratory monitors used for infants, particularly high-risk babies, to assess their effectiveness in preventing sudden unexpected infant death. The bill mandates a report to Congress within one year of enactment, detailing monitor accuracy, new home sleep care models, insurance coverage criteria, and recommendations on whether these devices should be covered by public or private health plans. This legislation directly affects infants (especially high-risk cases), healthcare providers, and insurance companies by initiating a federal review of current practices. The bill does not create new laws or funding but establishes a data-gathering process to inform future policy decisions about infant monitoring devices.

Topics ✓ HealthcareSupports HealthcareBill mandates HHS study to assess monitor effectiveness and recommend insurance coverage, aiming to expand access to critical infant monitoring devices for high-risk babies.85% confidence

Sub-Topics Children's Health Insurance

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in committee · United States · House Sep 18, 2025

HR 5448: Protecting Free Vaccines Act

This bill requires most health insurance plans, Medicare Part D, Medicaid, and CHIP to cover vaccines recommended by the CDC's Advisory Committee on Immunization Practices (ACIP) without cost-sharing (like copays or deductibles). It applies to vaccines recommended as of October 25, 2024, including updates through 2029, and covers all such vaccines for the period starting when the bill is enacted until December 31, 2029. The requirement excludes vaccines given within minimum recommended intervals. It directly affects patients, insurers, and government health programs by ensuring no out-of-pocket costs for covered vaccines during this timeframe.

Topics ✓ HealthcareSupports HealthcareMandates no cost-sharing for CDC-recommended vaccines, expanding insurance coverage and improving patient access to preventive healthcare services.95% confidence

Sub-Topics Children's Health Insurance Medicaid

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in committee · United States · House Mar 18, 2025

HR 2214: DRUG Act

This bill prohibits pharmacy benefit managers (PBMs) from receiving payments tied to prescription drug prices or rebates starting January 1, 2027. Instead, PBMs may only charge flat, itemized fees for actual services performed (e.g., claim processing), not based on drug costs or discounts. It directly affects PBMs and health insurance plans by requiring compensation to be decoupled from drug pricing, while allowing rebates to be passed through to lower net drug costs. The law aims to reduce conflicts of interest in PBM operations without changing drug pricing itself.

Topics ✓ HealthcareSupports HealthcareDecouples PBM fees from drug prices, requiring flat service fees. Aims to reduce net drug costs and improve patient access to medications by eliminating rebate-based compensation structures.92% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · United States · House Feb 24, 2025

HR 1521: DOC Access Act of 2025

Dentist and Optometric Care Access Act of 2025 or the DOC Access Act of 20 25 This bill prohibits private health insurance plans from setting rates for items and services, except for dental cleanings, provided by a doctor of optometry, of dental surgery, or of dental medicine (or an employer of such a doctor) for which the plan does not pay a substantial amount. Additionally, an agreement between a plan and such a doctor for limited scope dental or vision benefits may last longer than two years only with the prior acceptance of the doctor for each term extension. Plans also may not restrict such a doctor's choice of laboratories or suppliers. Such doctors may elect to waive the application of the payment amount and choice of laboratories provisions of this bill. The bill does not supersede state laws regarding health insurers and dental or vision benefit plans.

Topics ✓ HealthcareSupports HealthcarePrevents insurers from arbitrarily setting low rates for dental/vision services, improving access and coverage stability for these healthcare services.90% confidence

Sub-Topics Insurance

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in committee · United States · Senate Jan 28, 2025

S 279: Tim’s Act

Tim's Act establishes new pay and benefits for federal wildland firefighters employed by the Department of Agriculture or Department of the Interior. It creates special base pay rates that are higher than standard General Schedule rates (ranging from 1.5% to 42% more depending on position grade), plus 450% incident response premium pay for firefighters deployed to qualifying wildfire incidents. The bill also establishes rest and recuperation leave after incidents, a mental health support program, a database tracking health issues related to firefighting, and a casualty assistance program for injured or killed firefighters. Additionally, it addresses retirement benefits and requires pay parity between federal wildland firefighters and structural firefighters.

Topics ✓ HealthcareSupports HealthcareBill explicitly establishes a mental health support program for firefighters, directly advancing mental health services under healthcare topic.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBill increases pay (1.5-42% above standard), adds 450% premium pay, mandates rest leave, and creates mental health support - directly advancing worker benefits and safety protections for firefighters.95% confidence

Sub-Topics Insurance Mental Health

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in committee · United States · House Nov 20, 2025

HR 6232: HOPE Act

The HOPE Act extends enhanced premium tax credits through 2027, providing income-based subsidies for individuals with household incomes up to 935% of poverty level who purchase health insurance through ACA marketplaces. It imposes civil penalties of $10,000-$50,000 (and criminal penalties) for agents or brokers who provide false enrollment information. The bill requires new verification processes for agent-assisted enrollments, including documentation of consent and delayed commission payments, and mandates quarterly checks to remove deceased individuals from health insurance plans. These changes directly affect subsidy recipients and insurance agents/brokers operating in healthcare marketplaces.

Topics ✓ Budget & TaxesSupports Budget & TaxesExtends income-based premium tax credits through 2027, providing tax relief for lower-income individuals purchasing ACA insurance.95% confidence ✓ HealthcareSupports HealthcareExtends ACA premium tax credits to 935% poverty level, expanding health insurance access for low-income individuals through income-based subsidies.95% confidence

Sub-Topics Insurance

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