Healthcare (Insurance)

This bill prohibits federal health programs (Medicare, Medicaid) and private health insurance from covering organ transplants originating in China or not procured through the U.S. Organ Procurement Network, effective January 1, 2026. It defines a "prohibited organ transplant" as one performed in China or using organs not sourced via the U.S. network, including follow-up care like lab tests or drugs. Exceptions only apply to life-saving services provided *after* such a transplant. The law also imposes criminal penalties (up to 2 years in prison) and civil penalties (three times the cost) for violations.

This bill would allow health insurance companies to sell individual health insurance policies across state lines by designating a single "primary state" whose regulations govern the policies, while being exempt from most regulations of other states ("secondary states"). It prohibits insurers from changing premiums based on health status or medical history, requires clear disclosure to consumers about which state's laws apply, and mandates independent review processes for denied claims. Secondary states would still be able to require insurers to pay taxes, register with the state insurance commissioner, and participate in guaranty associations. This would primarily affect health insurance issuers and consumers who purchase policies across state lines, potentially expanding policy options while reducing some state-specific consumer protections.

This bill amends Medicare rules to prevent private health insurance plans from discriminating against patients with end-stage renal disease (ESRD) who need dialysis. It specifically prohibits plans from: (1) treating dialysis differently than other medical services in coverage or benefits, and (2) shifting the primary responsibility for covering dialysis costs to Medicare. The law clarifies that plans cannot limit dialysis coverage or network access based on ESRD diagnosis, while still allowing plans to choose which dialysis providers they include in their networks. It directly affects ESRD patients and private health insurance plans, ensuring dialysis is covered comparably to other essential medical services under the plan.

This bill repeals a federal rule that allowed short-term health insurance plans to be sold with fewer consumer protections. It specifically targets a rule published by the IRS, EBSA, and CMS on April 3, 2024, which governed short-term, limited-duration insurance and certain noncoordinated health benefits. By nullifying this rule, the bill would allow insurers to offer these short-term plans without the restrictions previously imposed. This directly affects insurers selling short-term coverage and consumers purchasing such plans, as it removes requirements related to coverage duration, pre-existing condition limitations, and essential health benefits.

This bill requires health insurance plans to cover mental health and substance use disorder services without copays, deductibles, or other out-of-pocket costs for pregnant and postpartum individuals. It applies to in-network providers and includes telehealth services, covering care from pregnancy diagnosis through the first year after birth. The law takes effect for plan years beginning two years after enactment. It directly affects individuals enrolled in employer-sponsored or individual health insurance plans who need mental health support during pregnancy and the postpartum period.

This bill, the Conscience Protection Act of 2025, strengthens protections for healthcare providers and organizations that refuse to participate in certain medical procedures (including abortion, assisted suicide, and sterilization) based on religious, moral, or ethical beliefs. It creates a private right of action allowing affected entities to seek legal remedies when their conscience rights are violated, addressing a gap in current law where victims could not defend their rights in court. The bill amends the Public Health Service Act to prohibit discrimination against such healthcare entities and establishes clearer enforcement mechanisms through the Department of Health and Human Services, including administrative investigations and civil actions. It directly affects healthcare providers, hospitals, insurers, and other health-related organizations operating under federal funding. The bill aims to address inconsistent enforcement of existing conscience protections like the Weldon Amendment, which has been challenged in cases such as California's abortion coverage mandate.

The Capping Costs for Consumers Act of 2026 modifies cost-sharing reductions under the Affordable Care Act for health insurance marketplace plans. It directly affects low-to-moderate income individuals (household income between 150%-400% of the federal poverty level) purchasing coverage through the marketplace. Key provisions shift the cost-sharing tiers: for 2028 and later plan years, gold-level coverage replaces silver-level for determining cost-sharing reductions, increasing the percentage of covered costs (e.g., 85% for incomes above 300% of poverty instead of 73-70% under current rules). The bill also adjusts premium assistance credits to use gold plan costs instead of silver plan costs for tax years beginning after 2027.

S 1834, the Supporting Healthy Moms and Babies Act, requires health insurance plans to cover comprehensive maternity and postpartum care without copays or deductibles. It directly affects pregnant people, new parents (including non-birthing parents), and their health insurance providers by mandating coverage for prenatal care, childbirth, neonatal care, and postpartum services - including behavioral health for conditions like diabetes or hypertension. Key provisions include adding maternity care as an essential health benefit under the Affordable Care Act and prohibiting cost-sharing for these services starting in 2024. The bill applies to all group health plans, individual insurance, and employer-sponsored coverage governed by ERISA and tax law.

This bill would deny federal tax deductions for gender transition procedures and prohibit Medicaid, Medicare, and Children's Health Insurance Program (CHIP) funding for such procedures. It defines gender transition procedures broadly to include hormonal treatments, surgeries, and cosmetic procedures intended to align physical appearance with gender identity, with limited exceptions for medically necessary treatments related to disorders of sex development or life-threatening conditions. The legislation would also require health insurance plans to exclude gender transition procedures from essential health benefits under the Affordable Care Act. This would directly affect individuals seeking gender transition care who rely on federal health programs or tax deductions for medical expenses.

Healthcare Freedom and Choice Act This bill nullifies a rule regarding short-term, limited-duration health insurance plans. The rule was promulgated by the Internal Revenue Service, Employee Benefits Security Administration, and Department of Health and Human Services; is titled  Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage ; and was published April 3, 2024. Short-term, limited-duration health insurance plans are plans that may only offer coverage for a limited amount of time and are exempt from the market requirements of the Patient Protection and Affordable Care Act (e.g., coverage of individuals with preexisting conditions). The rule limits the length of the initial contract period for such a plan to no more than three months and, taking into account any renewals or extensions, the maximum coverage period to no more than four months. The rule also includes within the maximum renewal period limitation a new plan sold by the same issuer, or any issuer that is a member of the same controlled group, to the same policyholder within a 12-month period. Regulations in effect prior to the rule this bill nullifies permitted short-term, limited-duration health insurance plans with an initial contract period of fewer than 12 months and a maximum coverage period of up to 36 months, including renewals and extensions.