Healthcare (Medicaid)

The Medicare Dental, Hearing, and Vision Expansion Act of 2025 would expand Medicare Part B coverage to include dental, hearing, and vision services starting in 2027. This would cover preventive dental services at 100% and other dental services at 80%, hearing aid examinations and hearing aids at 80%, and routine eye exams at 80% with frequency limits (such as two dental cleanings per year). The bill includes $900 million for dental, $370 million for hearing, and $500 million for vision implementation funding, affecting approximately 65 million Medicare beneficiaries who currently pay out-of-pocket for these services.

The Expanding Access to Palliative Care Act (S 1935) creates a new 5-year Medicare model to provide community-based palliative care for beneficiaries with serious illnesses like cancer, heart disease, dementia, or kidney disease. It directly affects Medicare beneficiaries who need symptom management and care coordination, including those who previously used hospice care (who cannot be excluded). The bill requires 24/7 access via telehealth or in-person care, a team-based approach with certified palliative specialists, and aims to reduce unnecessary emergency visits and hospitalizations. Key provisions include eliminating hospice history barriers, requiring care coordination across settings (including homes and hospitals), and measuring outcomes like emergency department use and patient experience.

This bill requires most health insurance plans to cover HIV prevention services - including PrEP and PEP drugs, related lab tests, counseling, and monitoring - without cost-sharing (like copays or deductibles) or prior approval. It applies to private insurance, Medicare, Medicaid/CHIP, and federal employee health plans, directly affecting people who use HIV prevention medications. Key provisions mandate 100% coverage for FDA-approved HIV prevention drugs, eliminate cost-sharing for these services, and prohibit insurers from requiring preauthorization for them. The bill defines covered services to include all necessary components of HIV prevention care as outlined in current public health guidelines.

This bill requires skilled nursing facilities participating in Medicare and Medicaid to permit immediate visitation by any individual designated by a resident, with no restrictions beyond the resident's right to revoke consent at any time. It directly affects nursing home residents (who gain greater control over visitor access) and the facilities themselves (which must comply with this new rule). The key provision adds a specific requirement to both Medicare and Medicaid regulations, mandating that facilities allow access to at least one designated visitor without any additional limitations. The law does not impose new costs or alter facility operations beyond this visitation standard.

Further Additional Continuing Appropriations and Other Extensions Act, 2025 This bill provides continuing FY2025 appropriations for federal agencies through April 11, 2025. It also extends various expiring programs and authorities, including several public health programs. Specifically, the bill provides continuing FY2025 appropriations to federal agencies through the earlier of April 11, 2025, or the enactment of the applicable appropriations act. It is known as a continuing resolution (CR) and prevents a government shutdown that would otherwise occur if the FY2025 appropriations bills have not been enacted when the existing CR expires on March 14, 2025. The CR funds most programs and activities at the FY2024 levels with some exceptions that provide funding flexibility and additional appropriations for various programs. For example, the CR provides additional emergency funding for the Federal Emergency Management Agency's Disaster Relief Fund, permits the Navy to apportion funds at the rate necessary to fund the Columbia-class submarine program and cost increases for certain shipbuilding programs, and provides additional funding for the Office of Navajo and Hopi Relocation. In addition, the bill extends several expiring programs and authorities, including several public health, Medicare, and Medicaid authorities and programs; authorities related to the Commodity Futures Trading Commission whistleblower program; authorities for the Department of Homeland Security and the Department of Justice to take actions to mitigate a credible threat from an unmanned aircraft system; the special assessment on nonindigent persons or entities convicted of certain offenses involving sexual abuse or human trafficking; and the National Cybersecurity Protection System.

HR 6863, the CAT Act of 2025, requires the Centers for Medicare & Medicaid Services (CMS) to provide Medicare and Medicaid providers with greater transparency and due process when payments are suspended due to fraud allegations. The bill limits payment suspensions to 180 days unless "good cause" is shown, mandates CMS to explain the specific fraud allegations and evidence to providers within 30 days, and requires regular updates during suspensions. It also establishes a new appeals process for providers to challenge suspensions within 180 days of the law's enactment and requires annual reports to Congress on suspension statistics. This directly affects healthcare providers whose payments are suspended, aiming to prevent unnecessary financial harm to those acting in good faith.

Rebuild America’s Health Care Schools Act of 2025 This bill allows hospitals to receive reimbursement under Medicare for certain costs associated with training nursing and allied health students in settings other than the hospital itself.  Currently, hospitals may receive reimbursement under Medicare for the reasonable costs associated with training nursing and allied health students if certain conditions are met; the criteria vary depending on whether the students are enrolled in an educational program that is operated by the hospital or another entity. If the students are part of a program that is operated by another entity, the training must occur at the hospital itself or in areas immediately surrounding the hospital in order to qualify for reimbursement (among other requirements). The bill allows hospitals to receive reimbursement for these costs if the training is conducted at an entity that is related to the hospital (i.e., common ownership or control). The bill requires the Centers for Medicare & Medicaid Services (CMS) to update regulations to reflect these changes. Additionally, the CMS may not recoup or reduce payments to hospitals with respect to costs that are allowed under the bill and must refund any such recoupments or reductions that occurred during the six-year period prior to the bill's enactment.

This bill extends renewal periods for state Medicaid waivers providing home and community-based services from five to ten years. It directly affects states administering these waivers, allowing them longer planning horizons without frequent reauthorization. Key provisions amend specific sections of the Social Security Act to replace "five-year periods" with "10-year periods" for waiver extensions and renewals starting after the bill's enactment. The change aims to provide greater stability for states managing Medicaid programs serving people with disabilities and elderly individuals in community settings.

HR 810, the Personalized Care Act of 2025, expands Health Savings Account (HSA) eligibility and benefits. It broadens who qualifies for HSAs to include individuals covered by more health plans (like Medicaid, Medicare, TRICARE) and health care sharing ministries (section 2). The bill also increases annual HSA contribution limits (to $10,800 for individuals and $29,500 for families) and reduces penalties for non-qualified distributions (section 3, section 7). Additionally, it allows periodic fees paid to physicians for defined medical services and health care sharing ministry fees to be treated as deductible medical expenses (sections 5, 8-9). These changes apply to taxable years beginning after December 31, 2024.

The Easy Enrollment in Health Care Act (HR 3947) would streamline enrollment in health insurance programs by allowing taxpayers to use their federal tax return information to determine eligibility for coverage. Individuals filing tax returns would be able to consent to share relevant tax data (like income and family size) with health insurance exchanges, enabling automatic enrollment in zero-net-premium plans without additional paperwork. The bill establishes a "single, streamlined application" process that minimizes redundant information requests while maintaining privacy protections. It also modernizes eligibility criteria for Medicaid and CHIP programs by allowing states to use tax return data for income determinations, making it easier for eligible individuals to access coverage. This would directly affect millions of Americans who qualify for health insurance assistance through federal or state programs.