Rep. Raúl M. Grijalva

Maddy summaryHR 4752 (the CHANGE Act of 2023) requires Medicare to include standardized cognitive impairment screening during annual wellness visits and initial preventive physical exams for beneficiaries starting in 2024. It mandates doctors use National Institute on Aging-approved tools to detect memory issues and document results in medical records. This directly affects Medicare patients aged 65+ and their healthcare providers, aiming to enable earlier Alzheimer’s diagnosis and care planning. The bill focuses on making routine screenings a standard part of Medicare-covered checkups, not on funding or new programs. It does not alter existing Medicare benefits but adds a specific screening requirement to two existing service categories.

Maddy summaryThe Social Security 2100 Act would significantly enhance Social Security benefits for millions of Americans by increasing monthly payments for retirees, disabled workers, widows/widowers, and children. Key provisions include raising the minimum benefit for long-term low earners, improving cost-of-living adjustments using a more accurate index, eliminating the 5-month waiting period for disability benefits, and extending child benefits to age 26. The bill also changes how Social Security taxes are calculated by applying them to income above $400,000 and establishes a unified Social Security Trust Fund to manage program finances. Most provisions would apply to benefits payable from 2025 through 2034, affecting all current and future Social Security beneficiaries.

Maddy summaryThe PrEP Access and Coverage Act of 2023 requires private health insurance plans, Medicare, Medicaid, and other public health programs to cover pre-exposure prophylaxis (PrEP) for HIV prevention without cost-sharing, including the medication, related lab tests, and follow-up care. The bill also prohibits life, disability, and long-term care insurance companies from denying coverage or charging higher premiums to people taking PrEP. It establishes public education campaigns to increase awareness of PrEP and PEP (post-exposure prophylaxis) and creates funding for state and community programs to expand access to HIV prevention services, particularly for populations disproportionately affected by HIV including Black, Hispanic/Latinx, and transgender individuals. The legislation specifically addresses current disparities in PrEP access, as data shows only 11% of Black/African American and 21% of Hispanic/Latinx individuals eligible for PrEP received prescriptions in 2022 compared to 82% of White individuals. Coverage requirements for most plans will take effect on January 1, 2025.

Maddy summaryThe Comprehensive Cancer Survivorship Act (HR 4363) establishes new Medicare and Medicaid coverage for cancer care planning and coordination services, requiring personalized survivorship care plans for cancer survivors from diagnosis through the end of life. The bill creates a demonstration program to test different models of survivorship care, including navigation services to help survivors transition from cancer treatment to ongoing care, and mandates Medicaid coverage for cancer fertility services. It also establishes a comprehensive cancer survivorship program with resource centers for survivors and health care providers, and includes provisions to help cancer survivors overcome employment barriers and improve their quality of life through physical activity and mental health support. The legislation specifically addresses disparities in care for racial/ethnic minorities, lower socioeconomic groups, and rural populations who face unique challenges as cancer survivors.

Maddy summaryHR 4282, the Equality for Families with Disabilities Act, requires states to develop customized support plans for parents, caregivers, foster parents, and adoptive parents with disabilities who interact with child welfare systems. It mandates individualized parenting assessments (based on personal strengths and evidence, not stereotypes) and disability-informed training for child welfare agencies and courts. The bill directly affects individuals with disabilities in these caregiving roles, ensuring they receive equal access to services and fair treatment during child welfare proceedings. Key mechanisms include revised state plans, mandatory staff training on disability rights, and new reporting requirements to Congress on implementation outcomes. These changes aim to replace generalized assumptions with concrete, evidence-based support within existing federal child welfare frameworks.

Maddy summaryThe ARC Act of 2023 establishes a national program to address peripheral artery disease (PAD), which disproportionately affects minority populations and leads to avoidable amputations. The bill requires Medicare and Medicaid to cover PAD screening tests (such as ankle-brachial index testing) for at-risk beneficiaries without cost-sharing, including people 65+ or those with diabetes, smoking history, or other risk factors. It authorizes $6 million annually for a CDC-led education program to inform healthcare providers and the public about PAD prevention and treatment. The bill also creates quality measures to encourage alternative treatments to amputation and establishes a pilot program to test amputation prevention services at healthcare facilities. These provisions aim to reduce amputation rates and improve outcomes for millions of Americans with PAD.

Maddy summaryThis bill, the Public Servants Protection and Fairness Act of 2023, amends Social Security to better protect public servants who work in jobs not covered by Social Security (such as certain government positions). It creates a new formula for calculating retirement benefits that combines both covered and noncovered earnings, ensuring public servants receive the higher of two benefit calculations. The bill also provides an additional $150 monthly payment for certain public servants whose benefits were previously reduced by the windfall elimination provision. It improves Social Security account statements to clearly show noncovered earnings and requires a study of how state retirement plans handle these benefits. These changes will apply to benefits starting in 2025.

Maddy summaryThe LIFT the BAR Act removes barriers preventing lawfully present noncitizens from accessing federal benefits like food assistance, Medicaid, and school meals. It repeals specific 1996 welfare law provisions that excluded noncitizens and updates terminology to replace "alien" with "noncitizen" throughout federal law. The bill expands eligibility to include noncitizens in categories such as Deferred Action for Childhood Arrivals (DACA) recipients, individuals with special immigrant juvenile status, and those with pending U-visa applications. This change ensures more noncitizens lawfully present in the U.S. can access essential services without being denied based on immigration status.

Maddy summaryHR 3851, the Access to Breast Cancer Diagnosis Act of 2023, requires most health insurance plans (including group and individual coverage) to cover diagnostic and supplemental breast exams without any out-of-pocket costs like copays or deductibles. This applies to medically necessary exams used to evaluate abnormalities detected during screening (diagnostic) or to screen high-risk individuals without abnormalities (supplemental), following National Comprehensive Cancer Network guidelines. Plans may still require prior authorization for these exams, and state laws providing stronger protections remain in effect. The law takes effect for plan years beginning January 1, 2024.

Maddy summaryThis bill requires Medicare to cover genetic counseling services provided by licensed genetic counselors at 85% of the physician payment rate. It defines "genetic counselor" as a state-licensed professional (or meeting federal criteria in non-licensing states) and mandates a new billing modifier for these services starting January 1, 2024. Medicare beneficiaries seeking genetic counseling would gain expanded access to these services under this coverage. The policy change applies to services furnished on or after the effective date, with implementation via interim rule.