HR 182, the Default Prevention Act, establishes a priority system for paying U.S. government obligations when the national debt limit is reached. It requires the Treasury to first pay Tier I obligations (including Social Security, Medicare, and interest on public debt), then Tier II (defense and veterans benefits), followed by Tier III, Tier IV (federal employee pay and travel expenses), and finally Tier V (Congressional salaries), only if higher-tier payments can still be fully covered. The bill mandates weekly reports to Congress detailing payments made and unpaid across each tier. This directly affects beneficiaries of Social Security/Medicare, veterans, defense programs, federal employees, and Congress by defining which payments must be prioritized during a debt limit crisis.
Alternatives to Prevent Addiction In the Nation Act or the Alternatives to PAIN Act This bill reduces cost-sharing and prohibits the imposition of certain utilization requirements under the Medicare prescription drug benefit for certain non-opioid pain management drugs. Specifically, the bill requires such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier (if any). The bill also prohibits the imposition of prior authorization requirements (i.e., requiring prior approval from a plan) or step therapy requirements (i.e., requiring the use of alternative drugs before a drug is covered under a plan) with respect to such drugs.
The FairTax Act of 2025 would repeal federal income tax, payroll taxes (Social Security and Medicare), and estate and gift taxes, replacing them with a national sales tax. It would impose a 23% tax on the final consumption of goods and services in 2027, with rates adjusting based on federal tax rates. The bill includes a monthly rebate for qualifying families based on the poverty level to offset the tax burden on lower-income households. It would establish a cooperative tax administration system between federal and state governments, with states collecting the tax under certain conditions. The tax would sunset if the 16th Amendment (which allows for income taxes) is not repealed within 7 years of enactment.
The Close the Medigap Act of 2025 would prohibit Medigap insurance issuers from denying coverage or charging higher premiums based on health status, pre-existing conditions, genetic information, or other factors. It requires insurers to spend a minimum percentage of premiums on health care claims and improves the Medicare Plan Finder website to provide clearer information about coverage options, out-of-pocket costs, and guaranteed issue requirements. The bill applies to Medigap policies effective January 1, 2026, with full implementation by 2031, and requires Medigap brokers to disclose payments they receive from insurers. These changes would directly affect Medicare beneficiaries, particularly those with pre-existing conditions who have historically faced barriers to obtaining affordable supplemental coverage.
HR 1492 amends the Social Security Act to extend the negotiation period for standard drug manufacturers under the federal drug pricing program. Specifically, it changes the timeframe from 7 years to 11 years for small-molecule drugs (like traditional pills) to negotiate prices with the government, aligning it with the existing 12-year period for complex biologic drugs (like insulin or monoclonal antibodies). This adjustment directly affects pharmaceutical companies that produce small-molecule drugs, giving them a longer window to negotiate pricing terms. The bill makes this change effective as if it had been part of the 2022 law that established the program.
Medicare Enrollment Protection Act of 2025 This bill provides for a special enrollment period for Medicare medical benefits for individuals who are enrolled in COBRA continuation coverage at the time they qualify for Medicare. The special enrollment period applies during each month of COBRA coverage and the three-month period after coverage ends; individuals may enroll during the special enrollment period once during their lifetime.
This bill removes marriage restrictions that previously caused Disabled Adult Children (DACs) to lose Social Security disability benefits upon marriage. It amends Social Security rules to treat married DACs the same as unmarried ones for eligibility, ensuring they retain benefits for child's insurance based on a disability. Key provisions prevent states from counting a spouse's income/resources against a married DAC and guarantee Medicaid eligibility remains unchanged if the DAC would qualify as unmarried. The bill directly affects DACs receiving Social Security Disability Insurance (SSDI) through a parent's account who are married, ensuring they maintain access to Medicare, Medicaid, and SSDI benefits without geographic or marital status barriers.
This bill adds Medicare coverage for home-based treatment of Alpha-1 Antitrypsin Deficiency Disorder (a rare genetic condition causing lung and liver damage). It specifically covers "augmentation therapy" (replacement protein therapy) delivered at home by qualified suppliers to Medicare Part A and B enrollees with this diagnosis who aren't in Medicare Advantage plans. The bill establishes payment for intravenous kits and up to 2 hours of nursing services per session, set at 80% of the lesser of actual cost or a defined rate. It amends Medicare rules to include this treatment under coverage, effective January 2027.
Lower Costs for Everyday Americans Act This bill reauthorizes and establishes programs and requirements regarding health, commerce, and the environment. The bill reauthorizes and expands programs for health care, including by allowing individuals age 65 and over with a medically improved disability to qualify for Medicaid; extending payment increases for certain providers under Medicare, including physicians and rural hospitals; extending Medicare coverage of certain telehealth services; requiring pharmacy benefit managers to remit 100% of rebates for prescription drugs to group health plans; reauthorizing programs supporting health care in underserved communities, including the National Health Service Corps; expanding and reauthorizing programs for public health emergency preparedness and response, including pandemic preparedness; expanding and reauthorizing programs for prevention and treatment of certain conditions, including substance use disorders, traumatic brain injuries, and sickle cell disease; and expanding the Food and Drug Administration’s authority regarding research on rare pediatric diseases. The bill also establishes requirements relating to commerce, including by prohibiting nonconsensual online publication of intimate visual depictions of individuals, requiring manufacturers of internet-connected devices to disclose whether the device has a camera or microphone prior to purchase, banning products containing 10% or more of sodium nitrite by weight, and requiring additional disclosures relating to the prices of concert tickets and hotel rooms. Additionally, the bill establishes and reauthorizes programs relating to the environment, including grants for community recycling systems, drinking water infrastructure, and reducing diesel emissions. It also allows gasoline that is blended with 10% to 15% ethanol to be sold year-round.
Sustainable Cardiopulmonary Rehabilitation Services in the Home Act This bill permanently allows services relating to cardiac rehabilitation programs, intensive cardiac rehabilitation programs, and pulmonary rehabilitation programs to be furnished via telehealth at a beneficiary's home under Medicare.
