Healthcare (Medicaid)

in committee · United States · House Aug 1, 2025

HR 4849: Protecting Health Care and Lowering Costs Act of 2025

This bill adjusts health insurance subsidies by modifying the premium tax credit structure under the Internal Revenue Code. It replaces previous income thresholds with a sliding-scale formula, increasing subsidies for households earning between 150% and 400% of the federal poverty level - reducing their required premium payments as income rises within these tiers. The changes apply to tax years beginning after December 31, 2025, directly affecting middle-income individuals and families purchasing coverage through health insurance marketplaces. It also repeals specific provisions from a prior reconciliation law related to health care.

Topics ✓ Budget & TaxesSupports Budget & TaxesIncreases tax credits for 150-400% FPL households, lowering health insurance costs via sliding-scale subsidies under tax code.95% confidence ✓ HealthcareSupports HealthcareIncreases subsidies for 150-400% FPL households, lowering premiums and expanding coverage access for middle-income families under health insurance tax credits.95% confidence

Sub-Topics Procurement Tax Credits Insurance Medicaid Medicare

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in committee · United States · House Feb 12, 2025

HJRES 58: Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies".

HJRES 58 is a procedural resolution requesting Congress reject a rule issued by the Centers for Medicare & Medicaid Services (CMS) for 2025. The rule would have set payment rates, quality reporting standards, and other policies for home health care services under Medicare, including updates for intravenous immune globulin (IVIG) treatments. This resolution, if passed, would block the CMS rule from taking effect, directly affecting home health care providers and Medicare beneficiaries who rely on these services. It does not create new policy but aims to prevent the implementation of the specific 2025 Medicare home health regulations.

Topics ✗ HealthcareOpposes HealthcareBill blocks CMS rule setting 2025 home health payment rates and quality standards, preventing implementation of healthcare policies that would have affected Medicare beneficiaries and providers.95% confidence

Sub-Topics Long-Term Care Medicaid Medicare

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in committee · United States · Senate Feb 6, 2025

S 474: Fair Funding for Rural Hospitals Act

This bill establishes minimum annual funding levels for Medicaid Disproportionate Share Hospital (DSH) payments to states, directly affecting rural hospitals and state Medicaid programs. For fiscal years 2025 through 2029, it sets a minimum $20 million DSH allotment per state, and for 2030 onward, it requires states to maintain the prior year's minimum amount adjusted for inflation. The provision prevents states from reducing DSH funding below these specified floors, ensuring consistent support for hospitals serving high numbers of low-income patients. It applies to all states receiving Medicaid DSH payments under federal law.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill mandates minimum $20M annual DSH funding for rural hospitals, preventing state cuts and ensuring consistent Medicaid spending on essential healthcare programs.95% confidence ✓ HealthcareSupports HealthcareBill mandates minimum Medicaid DSH funding to prevent cuts, ensuring rural hospital financial stability and continued patient access to care.95% confidence

Sub-Topics Hospitals Medicaid Tags Rural Communities

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in committee · United States · Senate Feb 26, 2025

S 760: Kids’ Access to Primary Care Act of 2025

This bill extends a Medicaid payment floor ensuring primary care services (like check-ups and vaccinations) are paid at no less than 100% of Medicare rates for children. It directly affects Medicaid-eligible children by expanding access to care from a broader range of providers, including pediatricians, family doctors, nurse practitioners, certified nurse-midwives, and rural health clinics. Key provisions require managed care plans to meet these payment standards and mandate a study tracking enrollment changes, provider participation, and payment rates across states. The study will compare Medicaid payment rates to Medicare benchmarks and analyze state-level variations over time.

Topics ✓ HealthcareSupports HealthcareBill ensures Medicaid payments for children's primary care at 100% Medicare rates, expanding provider access and improving coverage for vulnerable populations.95% confidence

Sub-Topics Children's Health Medicaid Primary Care

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in committee · United States · House Feb 10, 2025

HR 1162: Medicaid Primary Care Improvement Act

This bill clarifies that states may use direct primary care arrangements under Medicaid, where patients pay a fixed fee for primary care only (not for other services). It requires the HHS Secretary to issue implementation guidance within one year and submit a report to Congress within two years analyzing state contracting practices and outcomes of these arrangements. The bill directly affects state Medicaid programs and managed care organizations by removing barriers to adopting this payment model. It does not change Medicaid eligibility, funding, or cost-sharing requirements. The focus is on enabling states to explore new primary care delivery methods through clear regulatory guidance.

Topics ✓ HealthcareSupports HealthcareRemoves barriers for states to adopt direct primary care under Medicaid, improving access to primary care services and strengthening Medicaid program flexibility.95% confidence

Sub-Topics Medicaid Medical Licensing Primary Care

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in committee · United States · Senate Jun 24, 2025

S 2149: Health Equity and Access under the Law for Immigrant Families Act of 2025

This bill removes immigration status barriers to health care for lawfully present immigrants and those with Federally authorized presence (like deferred action). It requires states to cover all lawfully present individuals in Medicaid and CHIP, expands ACA exchange eligibility for undocumented people with authorized presence, and allows states to opt into covering undocumented children in CHIP. Key provisions amend the Social Security Act to eliminate citizenship requirements for Medicaid/CHIP and treat Federally authorized presence as equivalent to lawfully present for ACA subsidies. The bill does not automatically cover all undocumented people but creates a state option to extend coverage to undocumented individuals meeting income criteria.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid/CHIP coverage to lawfully present immigrants and undocumented children with authorized presence, removing immigration barriers to healthcare access.95% confidence ✓ ImmigrationSupports ImmigrationRemoves immigration status barriers for healthcare access, requires Medicaid/CHIP coverage for lawfully present immigrants, and expands ACA eligibility for undocumented people with authorized presence.95% confidence

Sub-Topics Children's Health Medicaid DACA & Dreamers Driver Licenses & IDs Sanctuary Policies

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in committee · United States · House May 5, 2025

HRES 382: Providing a point of order in the House of Representatives during the 119th Congress against reconciliation measures that reduce benefits under the Medicaid program or the supplemental nutrition assistance program.

HRES 382 creates a procedural rule in the House of Representatives during the 119th Congress (2025-2026) to block budget reconciliation bills that cut Medicaid or SNAP benefits for specific vulnerable groups. It prohibits consideration of any reconciliation measure reducing benefits for children under 19, seniors 65+, pregnant women, or people with disabilities (as defined by Social Security law). The rule does not apply to provisions targeting fraud, improper payments, or improving eligibility verification. This resolution is a procedural tool, not a law, and would prevent such benefit cuts from advancing through the budget process.

Topics ✓ Budget & TaxesSupports Budget & TaxesPrevents cuts to Medicaid/SNAP funding for vulnerable groups, protecting essential government spending on social programs.95% confidence ✓ HealthcareSupports HealthcareBlocks Medicaid/SNAP benefit cuts for vulnerable groups, protecting healthcare coverage and nutrition assistance programs.95% confidence

Sub-Topics Medicaid

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in committee · United States · Senate Jul 23, 2025

S 2408: Access to Fertility Treatment and Care Act

This bill would require health insurance plans that cover obstetrical services to also cover fertility treatment, including procedures like in vitro fertilization, artificial insemination, embryo preservation, and related medications. It applies to private insurance plans, federal employee health benefits, TRICARE, VA benefits, Medicaid programs, and Medicare. The law mandates coverage regardless of whether a patient has been diagnosed with infertility, prohibits cost-sharing exceeding what's applied to other medical services, and requires plans to provide clear notice about the coverage to participants. The goal is to make fertility treatment more accessible and affordable for people who need it.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for fertility treatments, expanding access to reproductive healthcare services under multiple insurance programs including Medicaid and Medicare.95% confidence ✓ VeteransSupports VeteransBill explicitly mandates VA benefits to cover fertility treatments, expanding veteran healthcare access beyond current coverage.95% confidence

Sub-Topics Insurance Medicaid Women's Health

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in committee · United States · Senate Jul 29, 2025

S 2524: Restoring Essential Healthcare Act

The Restoring Essential Healthcare Act repeals a provision that blocked Medicaid payments to certain healthcare providers. Specifically, it removes a restriction from Public Law 119-21 that prevented Medicaid from paying "prohibited entities" for services provided between the law's enactment and this bill's effective date. Payments for those services will now be made retroactively, as if the restriction had never existed. This directly affects Medicaid programs and the healthcare providers previously excluded from receiving these payments.

Topics ✓ HealthcareSupports HealthcareRepeals Medicaid payment restriction, enabling retroactive payments to providers and strengthening Medicaid program access for patients and healthcare services.95% confidence

Sub-Topics Medicaid

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in committee · United States · House Feb 4, 2025

HR 936: Medicaid Improvement and State Flexibility Act of 2025

This bill allows states to create new Medicaid demonstration projects that give enrollees an electronic benefits card for primary care and medications, with unused funds converted to cash annually. Participants could also enroll in state-determined catastrophic insurance for coverage beyond the card's limits. The projects must not increase federal spending compared to standard Medicaid and prohibit abortion coverage except when necessary to save a mother's life or in cases of rape or incest. It directly affects Medicaid enrollees in states that adopt such projects, granting states more flexibility in program design.

Topics ✓ HealthcareSupports HealthcareBill creates Medicaid flexibility for primary care/medication access via electronic benefits cards, expanding coverage options without increasing federal spending, aligning with healthcare access improvement.90% confidence

Sub-Topics Insurance Medicaid Medicare

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