Healthcare (Medicaid)

in committee · United States · House Apr 1, 2025

HR 2533: EASE Act of 2025

HR 2533, the EASE Act of 2025, requires Medicare and Medicaid to test a new telehealth model designed to improve specialty care access for rural and underserved Medicare/Medicaid beneficiaries. The bill mandates the Centers for Medicare & Medicaid Services (CMS) to partner with nonprofit provider networks - comprising at least 50 community health centers or rural clinics (half in rural areas) - to deliver specialty care via telehealth and coordinate with primary care providers. Eligible individuals must be enrolled in Medicare Part B, Medicaid, or CHIP and reside in designated rural or underserved areas. The model requires networks to collect and evaluate data on service delivery, with funding subject to existing program rules. This creates a structured pilot program focused on expanding remote specialty care access in underserved regions.

Topics ✓ HealthcareSupports HealthcareMandates telehealth expansion for rural/underserved Medicare/Medicaid beneficiaries, improving specialty care access per bill summary.95% confidence ✓ TechnologySupports TechnologyBill mandates telehealth implementation for rural healthcare access, promoting technology-driven care delivery and digital equity in underserved communities.85% confidence

Sub-Topics Medicaid Primary Care Telehealth Broadband Access Tags Rural Communities

Track

in committee · United States · Senate Jun 12, 2025

S 2084: Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2025

This bill would add dental, vision, and hearing services to Medicare coverage for beneficiaries. It defines specific services including routine dental cleanings, eye exams, and hearing assessments, with coverage gradually increasing from 0% to 80% over eight years. The bill also establishes frequency limits, such as two dental cleanings per year and one eye exam annually. Medicaid would see increased federal funding (90% FMAP) for these services starting six months after enactment. This legislation directly affects Medicare beneficiaries, particularly seniors and people with disabilities, by expanding access to previously uncovered preventive health services.

Topics ✓ HealthcareSupports HealthcareExpands Medicare coverage to include dental/vision/hearing services with gradual 80% coverage, increases Medicaid federal funding (90% FMAP).95% confidence

Sub-Topics Medicaid Medicare Tags Seniors

Track

in committee · United States · Senate May 22, 2025

S 1920: Continuous Skilled Nursing Quality Improvement Act of 2025

This bill redefines "private duty nursing services" under Medicaid as "continuous skilled nursing services" requiring licensed nurses (RNs or LPNs) for complex-care patients needing multiple hours of daily nursing. It directly affects Medicaid beneficiaries, particularly "full-benefit dual eligible individuals" (those qualifying for both Medicare and full Medicaid benefits), who rely on these services. Key mechanisms include mandating licensed providers, establishing a working group to develop national quality standards within 180 days, and updating Medicaid program guidelines to include these services by 18 months. The bill also requires states to incorporate these standards into their Medicaid programs and quality measure sets.

Topics ✓ HealthcareSupports HealthcareMandates licensed RNs/LPNs for Medicaid continuous skilled nursing, improving quality/access for dual-eligible beneficiaries under Medicaid, directly strengthening service standards.95% confidence

Sub-Topics Healthcare Workforce Long-Term Care Medicaid

Track

in committee · United States · Senate Feb 11, 2026

S 3834: Expanded Telehealth Access Act

This bill expands Medicare coverage for telehealth services by adding new healthcare professionals to the list of providers eligible for payment. It directly affects Medicare beneficiaries who use remote care and allows qualified audiologists, occupational therapists (including assistants), physical therapists (including assistants), and speech-language pathologists to bill Medicare for telehealth services. Key changes update Medicare rules to include these professionals under the definition of "practitioner" and specify that facilities can also provide telehealth services under Medicare. This policy change removes previous restrictions, making it easier for patients in rural or underserved areas to access these specialized telehealth services.

Topics ✓ HealthcareSupports HealthcareExpands Medicare telehealth coverage to include audiologists, therapists, and speech-language pathologists, improving patient access to care and strengthening provider eligibility under Medicare.95% confidence ✓ TechnologySupports TechnologyBill expands telehealth access by including more healthcare professionals, promoting digital health equity and technology adoption in healthcare delivery.75% confidence

Sub-Topics Medicaid Medicare Telehealth

Track

in committee · United States · House Dec 15, 2025

HR 6727: Repealing the IMD Exclusion Act

This bill removes an age restriction that previously prevented Medicaid from covering mental health care in specialized institutions for people under 65. It amends the Social Security Act to eliminate the "65 years or older" requirement, allowing all age groups to qualify for Medicaid coverage of services at these facilities. The bill also establishes new evidence-based standards for these institutions, requiring them to meet nationally recognized criteria for mental health and substance use disorder care. This change directly affects younger adults with mental health conditions who rely on Medicaid for institutional treatment.

Topics ✓ HealthcareSupports HealthcareRemoves age restriction on Medicaid mental health coverage, expanding access for all ages and establishing quality standards for facilities.95% confidence

Sub-Topics Medicaid Mental Health Substance Abuse

Track

in committee · United States · House Jun 12, 2025

HR 3995: State Public Option Act

This bill creates a new Medicaid buy-in program allowing certain individuals to purchase Medicaid coverage starting January 1, 2026. It directly affects state residents who are not enrolled in other health insurance plans and meet income requirements, with premiums limited to 8.5% of household income. Key provisions include allowing individuals to use premium tax credits, providing states with enhanced federal funding (90% match) for administrative costs, and requiring states to update quality measures by 2030. The program would be structured similarly to private Marketplace insurance, with cost-sharing aligned with the Affordable Care Act. States would also be required to cover comprehensive sexual and reproductive health services as part of this Medicaid buy-in program.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill provides 90% federal funding for state Medicaid administrative costs, reducing state budget burden for essential health program. Directly lowers state spending requirements.90% confidence ✓ HealthcareSupports HealthcareCreates Medicaid buy-in program expanding coverage options for income-eligible individuals with capped premiums and federal funding (90% match).95% confidence

Sub-Topics Insurance Medicaid Women's Health

Track

in committee · United States · Senate Dec 9, 2025

S 3402: Ensuring Excellence in Mental Health Act

This bill establishes a new payment system for certified community behavioral health clinics (CCBHCs) under Medicaid, creating a prospective payment system that will pay based on actual clinic costs starting in 2026. It expands Medicare coverage for CCBHC services beginning in 2027 and creates a new grant program to help community behavioral health clinics meet CCBHC certification standards, including funding $552.5 million annually from 2026-2030. The bill also provides liability protection for clinicians in CCBHCs under the Federal Tort Claims Act and requires states to coordinate Medicaid-certified community behavioral health services with existing community behavioral health clinics. These changes aim to improve access to comprehensive mental health services, particularly for veterans, rural residents, and other underserved populations.

Topics ✓ HealthcareSupports HealthcareExpands Medicare coverage for CCBHC services, allocates $552.5M annually for mental health clinics, and creates new funding/grant programs to strengthen mental health care access.90% confidence

Sub-Topics Medicaid Medicare Mental Health

Track

in committee · United States · House Jul 2, 2025

HR 3391: End Price Gouging for Medications Act

The End Price Gouging for Medications Act establishes annual reference prices for prescription drugs based on the lowest retail prices in 12 international reference countries (like Canada and the UK) or specific criteria if international data is unavailable. It requires drug manufacturers to sell medications at or below these reference prices for all patients covered by federal health programs - including Medicare, Medicaid, TRICARE, and VA care - as well as for all other patients, including those with private insurance. Manufacturers violating this rule face civil penalties of five times the revenue difference, with collected funds directed to the National Institutes of Health for drug research. This bill directly affects drug manufacturers and millions of Americans enrolled in the specified federal health programs.

Topics ✓ HealthcareSupports HealthcareEstablishes reference prices to cap drug costs for Medicare/Medicaid, improving patient access to affordable medications by preventing price gouging.95% confidence ✓ VeteransSupports VeteransBill explicitly requires drug manufacturers to sell at reference prices for VA care, directly lowering medication costs for veterans receiving VA healthcare.95% confidence

Sub-Topics Medicaid Medicare Prescription Drugs

Track

in committee · United States · Senate Apr 29, 2025

S 1506: Medicare for All Act

The Medicare for All Act would establish a government-run health insurance program providing comprehensive coverage to all U.S. residents, replacing current private insurance, Medicare, and Medicaid. The program would cover all medically necessary services including hospital care, prescription drugs, dental, vision, mental health, and reproductive care without patient cost-sharing (except for limited prescription drug cost-sharing under specific conditions). It would prohibit private insurers from selling duplicate coverage and require employers to stop providing duplicate benefits, while allowing supplemental coverage for additional services not included in the core benefits package. The bill includes a transition period with immediate coverage for children and a gradual phase-in for full implementation, with benefits first available for most individuals in 2027. The program would be funded through a new Medicare for All Trust Fund, consolidating current health care program revenues.

Topics ✓ HealthcareSupports HealthcareBill establishes universal government health insurance covering all medically necessary services including mental health and reproductive care with no patient cost-sharing, directly expanding coverage and access beyond current systems.95% confidence ✓ VeteransSupports VeteransMedicare for All Act provides comprehensive healthcare coverage to all U.S. residents including veterans, improving access to medical services and eliminating cost-sharing barriers for veteran healthcare.85% confidence

Sub-Topics Insurance Medicaid Medicare

Track

in committee · United States · House Jul 10, 2025

HR 4331: Access to Claims Data Act

This bill requires the Health and Human Services Secretary to create a process by January 1, 2026, allowing specific healthcare research groups (qualified clinical data registries and clinician-led registries) to access Medicare claims data, and potentially Medicaid/CHIP data if approved. These groups can link claims data with clinical outcomes to assess provider quality, improve patient safety, and conduct research. The data will be provided at cost (covering only the fee to make it available), with fees deposited into the CMS account. It directly affects healthcare researchers and providers by enabling data-driven quality improvement efforts.

Topics ✓ HealthcareSupports HealthcareEnables research using Medicare data to improve provider quality and patient safety, directly advancing healthcare quality assessment and safety initiatives.90% confidence

Sub-Topics Children's Health Medicaid Medicare

Track