Rep. Raúl M. Grijalva

Maddy summaryHR 732, the "Save Medicare Act," renames the Medicare Advantage program to "Alternative Private Health Plan" in all federal references. This change directly affects private health plans sold under Medicare Part C, requiring all future materials to use the new name by plan years starting October 15, 2023. The bill also imposes a $100,000 civil penalty for any entity using "Medicare" in a plan's title after enactment. The transition period allows both terms to be used until the deadline to prevent confusion for beneficiaries and providers. The law focuses solely on terminology, not program benefits or funding.

Maddy summaryThis bill amends Medicare rules to allow nurse practitioners and physician assistants to document medical necessity for diabetic shoes, a requirement currently limited to physicians. It directly affects Medicare beneficiaries with diabetes who need these shoes and expands the pool of providers (nurse practitioners and physician assistants) who can fulfill the documentation requirement. The key change inserts "nurse practitioner, or physician assistant" into Medicare's documentation standards for diabetic shoe coverage. This simplifies access for patients by enabling more healthcare providers to support coverage approval without requiring a physician's signature. The bill does not change coverage eligibility or costs, only the documentation process.

Maddy summaryHR 716, the Fair COLA for Seniors Act of 2023, changes how cost-of-living adjustments (COLAs) are calculated for Social Security and related benefits by using the Consumer Price Index for Elderly Consumers (CPI-E) instead of the standard Consumer Price Index. This affects Social Security beneficiaries, veterans receiving disability compensation or survivor benefits, and federal retirees under the Civil Service and Military Retirement Systems. The bill requires that any COLA increase for Social Security also applies to these other benefits using the CPI-E, which better reflects inflation experienced by seniors. The change takes effect for benefit determinations starting September 2023.

Maddy summaryHR 549, the Metastatic Breast Cancer Access to Care Act, removes waiting periods for disability and Medicare coverage for people diagnosed with metastatic breast cancer. Specifically, it amends Social Security Act sections to allow immediate eligibility for disability insurance benefits (eliminating the standard waiting period) and immediate Medicare coverage (waiving the 24-month waiting period) for these patients. The bill directly affects individuals with metastatic breast cancer who would otherwise face delays in accessing critical benefits. These changes apply to applications filed or benefits beginning after the bill's enactment date. The law makes no other policy changes beyond these specific eligibility adjustments.

Maddy summaryThe EACH Act of 2023 would require federal health programs - including Medicaid, Medicare, the Indian Health Service, and TRICARE - to cover abortion services without restrictions. It repeals a provision in the Affordable Care Act that allowed states to limit abortion coverage in health insurance plans sold through state marketplaces. The bill also prohibits the federal government from restricting abortion coverage in private health insurance plans. This would directly affect millions of people, particularly low-income individuals and people of color, who are disproportionately enrolled in Medicaid and currently face barriers to abortion care due to coverage restrictions.

Maddy summaryThis bill, HR 35 (Close the Medigap Act of 2023), prohibits Medicare supplemental insurance (Medigap) insurers from denying coverage or charging higher premiums based on health status, pre-existing conditions, genetic information, or age. It directly affects Medicare beneficiaries (particularly those with pre-existing conditions) and requires insurers to offer guaranteed issue coverage starting January 1, 2024, with full implementation by 2029. Key mechanisms include banning health-based pricing discrimination, requiring insurers to spend at least 65% of individual policy premiums on healthcare (increasing to align with NAIC recommendations), and improving transparency on the Medicare Plan Finder website. The bill does not change Medicare Part A/B benefits but ensures broader access to supplemental coverage without health-related barriers.

Maddy summaryThe Assuring Medicare’s Promise Act of 2023 directs that taxes collected under the net investment income tax (a tax on investment income for high earners) be added to the Medicare Hospital Insurance Trust Fund, which helps finance Medicare Part A benefits. It modifies the tax code to include certain business income of high-income individuals (with modified adjusted gross income over $400,000 for single filers or $500,000 for joint filers) in the tax base, but includes a phase-in mechanism to limit immediate tax increases. This bill primarily affects high-income taxpayers and aims to strengthen Medicare’s financial stability by increasing trust fund revenue.

Maddy summaryHR 33 would expand Medicare to cover dental, vision, and hearing services for beneficiaries, which are currently not covered under Medicare. The bill provides 100% coverage for preventive dental services in 2024, with basic dental services gradually increasing to 80% coverage by 2027. Vision coverage would include routine eye exams and corrective lenses at 80% coverage, while hearing services would cover hearing exams and hearing aids at 80% coverage. The bill includes specific limitations, such as two dental cleanings per year and one pair of glasses every 24 months, with the Secretary of Health and Human Services having authority to apply additional limitations or modify coverage based on medical recommendations. The changes would take effect on January 1, 2024.

Maddy summaryHR 1361 establishes a federal grant program to fund community gun buyback initiatives. It authorizes $360 million annually (2022-2024) for states, local governments, and licensed gun dealers to conduct buybacks using "smart prepaid cards" loaded with 125% of a firearm's market value. The program prohibits using these cards to purchase guns or ammunition, requires recycling collected firearms within 60 days, and bans resale. It directly affects communities through local programs and licensed dealers participating in the buyback system, with criminal penalties for misusing the cards in firearm transactions.

Maddy summaryHR 8995, the Baby Changing on Board Act, requires Amtrak to install baby changing tables in every accessible restroom on new passenger trains purchased after the law's enactment. The bill defines "baby changing tables" as elevated, freestanding structures supporting children up to 30 pounds and specifies they must be clearly marked with signage. This directly affects parents and caregivers traveling on Amtrak's newly acquired trains, ensuring accessible diaper-changing facilities in designated restrooms. The law applies only to Amtrak-owned trains solicited for purchase after the bill becomes law, not to existing trains.