Healthcare (Insurance)

in committee · United States · House Mar 6, 2025

HR 1901: CHIPP Act

HR 1901, the CHIPP Act, makes Children's Health Insurance Program (CHIP) funding permanent for all future fiscal years, removing previous expiration dates that required annual congressional renewal. This directly affects low-income children and families who rely on CHIP coverage and the states that administer these programs. The key mechanism is amending federal law to require "such sums as are necessary" for CHIP funding starting in fiscal year 2029 and beyond. Other provisions adjust funding for related programs like pediatric quality measures and outreach, but the primary change is CHIP’s permanent funding structure.

Topics ✓ Budget & TaxesSupports Budget & TaxesMakes CHIP funding permanent, ensuring consistent budget allocation for essential children's health coverage without annual renewal.95% confidence ✓ HealthcareSupports HealthcarePermanently funds CHIP, ensuring continuous coverage for low-income children without annual renewal hurdles, directly strengthening public health program access.95% confidence

Sub-Topics Children's Health Insurance Medicaid Tags Children

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in committee · United States · House May 29, 2025

HR 3665: Medicare Economic Security Solutions Act

HR 3665, the Medicare Economic Security Solutions Act, modifies Medicare Part B late enrollment penalties. It increases the penalty rate from 10% to 15% of the monthly premium but limits the penalty period to twice the original 12-month intervals. The bill also excludes months with COBRA, retiree, or VA coverage from counting toward the penalty and creates a special enrollment period for people whose COBRA or retiree coverage ends. These changes directly affect Medicare Part B enrollees who had gaps in coverage due to employment transitions or other qualifying circumstances.

Topics ✓ HealthcareSupports HealthcareBill reduces Medicare Part B late enrollment penalties for coverage gaps, protects access via special enrollment periods, and excludes COBRA/retiree coverage months from penalties.90% confidence ✓ VeteransSupports VeteransBill excludes VA coverage months from Medicare penalties, protecting veterans from unnecessary costs. VA coverage is specific to veterans.95% confidence

Sub-Topics Insurance Medicare

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in committee · United States · House Feb 4, 2025

HR 957: Parity Enforcement Act of 2025

HR 957, the Parity Enforcement Act of 2025, strengthens enforcement of mental health and substance use disorder coverage parity requirements under federal law. It expands accountability for violations to include not only health plan sponsors but also service providers and administrators of group health plans. The bill adds civil monetary penalties for failing to meet parity rules, specifically targeting requirements related to mental health, substance use disorder coverage, and genetic information protections. These changes apply to health plans for years beginning one year after the bill's enactment. The law directly affects employers, insurers, and health plan administrators offering group health coverage.

Topics ✓ HealthcareSupports HealthcareStrengthens mental health/substance use disorder coverage parity enforcement, expands accountability to providers, adds civil penalties for violations - directly advances mental health services under healthcare policy.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBill strengthens mental health and substance use disorder coverage parity, expanding worker benefits and protecting employee health rights.85% confidence

Sub-Topics Insurance Mental Health Substance Abuse

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in committee · United States · House Nov 19, 2025

HR 6147: Expanding Health Care Options for First Responders Act

This bill creates a new Medicare buy-in option for eligible retired or disabled first responders aged 50-64. It directly affects qualified law enforcement officers, certain emergency medical personnel, and federal firefighters who have separated from service due to retirement or disability. Key provisions include establishing a premium calculated based on Medicare's average costs, coordinating enrollment periods with the Affordable Care Act marketplace, and ensuring coverage counts as "minimum essential coverage" for tax purposes. The bill also prohibits Medicaid beneficiaries from using this option and requires outreach efforts (2027-2029) to help eligible individuals enroll.

Topics ✓ HealthcareSupports HealthcareCreates new Medicare buy-in option expanding health coverage for eligible first responders, directly increasing access through ACA coordination and premium structure.95% confidence

Sub-Topics Insurance Medicaid Medicare

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in committee · United States · House Feb 27, 2025

HR 1699: TOTAL Care Act

HR 1699, the TOTAL Care Act, removes referral requirements for obstetrical and gynecological (OB/GYN) care under the TRICARE Prime health plan. It allows female TRICARE Prime beneficiaries to directly choose an OB/GYN provider as their primary care manager, eliminating the need for a prior referral from another provider. The bill establishes a 5-year pilot program to test this change, requiring the Secretary of Defense to report on enrollment shifts, cost impacts, and other outcomes after four years. This directly affects female military family members enrolled in TRICARE Prime who opt into the pilot.

Topics ✓ HealthcareSupports HealthcareRemoves referral barriers for OB/GYN care under TRICARE, improving patient access to specialized services without prior authorization.95% confidence

Sub-Topics Insurance Primary Care Women's Health

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in committee · United States · House Mar 27, 2025

HR 2450: Prescription Drug Transparency and Affordability Act

The Prescription Drug Transparency and Affordability Act (HR 2450) requires pharmacy benefit managers (PBMs) to provide detailed, regular reports to group health plans and health insurance issuers about prescription drug pricing and spending. These reports, to be submitted every six months (or quarterly if requested), must include specific information about drug costs, rebates, out-of-pocket spending by participants, and other financial details in plain language and machine-readable format. The law specifically applies to "specified large employers" (employers with 100+ employees) and "specified large plans" (plans with 100+ participants), aiming to increase transparency about drug pricing and help health plans make more informed coverage decisions. The bill includes enforcement provisions, with potential civil penalties for non-compliance, and requires reports to be provided in accessible formats while maintaining privacy protections.

Topics ✓ HealthcareSupports HealthcareRequires PBMs to disclose drug pricing transparency, aiming to improve affordability and reduce out-of-pocket costs for patients, directly supporting healthcare access and cost control.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · United States · House Jul 25, 2025

HR 4768: Health Care Fairness for Military Families Act of 2025

This bill updates the TRICARE Young Adult Program to make healthcare coverage more accessible for military dependents. It directly affects young adults (ages 21-26) who are children of active-duty service members, by eliminating a separate premium they previously paid for coverage. Key changes include removing an extra cost for young adults and adjusting eligibility rules to simplify enrollment. These amendments aim to reduce out-of-pocket expenses and streamline access to health insurance under the program.

Topics ✓ HealthcareSupports HealthcareEliminates separate premiums for military dependents (21-26), reducing out-of-pocket costs and streamlining TRICARE access, directly expanding healthcare affordability and access.95% confidence

Sub-Topics Insurance

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in committee · United States · House Apr 17, 2025

HR 2943: Gabriel Rosenberg Dyspraxia/DCD Coverage Act

HR 2943, the Gabriel Rosenberg Dyspraxia/DCD Coverage Act, requires the U.S. Comptroller General to study insurance coverage for dyspraxia/developmental coordination disorder (DCD), a condition affecting movement and coordination. The study, to be completed within one year of enactment, will examine coverage under Medicare, Medicaid, group health plans, and other federal health programs across all states. It will specifically investigate current coverage availability, age limits, barriers like provider shortages, compliance with existing insurance rules, and whether adults lose coverage after diagnosis. The resulting report will provide recommendations for improving coverage, but the bill itself does not change insurance requirements or create new benefits. This is a procedural study bill focused on gathering data about current coverage gaps for people with DCD.

Topics ✓ HealthcareSupports HealthcareBill mandates study of insurance coverage barriers for dyspraxia/DCD under Medicare/Medicaid, aiming to identify gaps in healthcare access and coverage availability, aligning with support indicators.85% confidence

Sub-Topics Insurance Medicaid Medicare

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in committee · United States · House Sep 10, 2025

HR 5278: Affordable Inhalers and Nebulizers Act of 2025

HR 5278, the Affordable Inhalers and Nebulizers Act of 2025, limits out-of-pocket costs for patients using prescription inhalers and nebulizers to treat asthma and chronic obstructive pulmonary disease (COPD). The bill requires private health insurance plans, Medicare Part B and Part D, and new payment programs to cover these products with no deductible and a maximum cost of $15 per 30-day supply. It directly affects patients with asthma or COPD who rely on covered inhalers, nebulizers, and related equipment like spacers. The law applies to all specified inhaler products (including medications and administration equipment) and takes effect for plan years beginning January 1, 2026.

Topics ✓ HealthcareSupports HealthcareMandates no deductible and $15 max cost for inhalers/nebulizers, expanding coverage and reducing patient costs for asthma/COPD treatments.90% confidence

Sub-Topics Insurance Medicare Prescription Drugs

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in committee · United States · House May 5, 2025

HR 3202: MIDWIVES for Service Members Act of 2025

HR 3202, the MIDWIVES for Service Members Act of 2025, creates a 5-year pilot program to provide certified midwife services to military service members and their families through the TRICARE health plan. The program requires the Secretary of Defense to begin implementation within one year of enactment, with detailed annual reports on costs, patient outcomes, satisfaction, and access metrics. It mandates that midwives meet international standards and state licensing requirements, focusing on maternal and infant health outcomes like preterm births and C-section rates. The pilot’s success would determine if midwife services become a permanent TRICARE benefit.

Topics ✓ HealthcareSupports HealthcareExpands TRICARE coverage to include certified midwife services for military families, improving access to maternal healthcare under a pilot program with mandated implementation and outcome reporting.95% confidence

Sub-Topics Children's Health Insurance Women's Health

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