Rep. Debbie Lesko

Maddy summaryHR 3432, the Telemental Health Care Access Act of 2023, expands Medicare coverage for mental and behavioral health services delivered via telehealth. It removes geographic restrictions that previously limited telehealth coverage to rural areas and explicitly adds "behavioral health services" to the list of covered telehealth services under Medicare Part B. The bill requires the Secretary of Health and Human Services to submit a report within one year on utilization of these services, including recommendations on fraud prevention and funding needs for oversight. This change directly affects Medicare beneficiaries seeking remote mental/behavioral health care and the providers who deliver it.

Maddy summaryThis bill prohibits federal funding for gender transition procedures - including hormone therapy, puberty blockers, and surgeries like genital reassignment - across all federal programs and health plans. It exempts procedures for medical conditions (such as disorders of sex development) and treatment of complications arising from such procedures. The bill also blocks Affordable Care Act premium tax credits and cost-sharing reductions for health plans covering these services, though individuals may purchase separate non-federal-funded coverage. State and private insurers can still offer such coverage using their own funds, but federal subsidies cannot be applied to it.

Maddy summaryThis bill repeals the tax on Social Security benefits for seniors, making those benefits fully tax-free. It directly affects seniors who receive Social Security benefits and are currently subject to income tax on a portion of those payments. The key provision removes Section 86 of the tax code that previously included benefits in gross income, while a separate funding mechanism appropriates money to Social Security trust funds to replace the lost revenue. The bill ensures Social Security trust funds remain fully funded without requiring new tax increases.

Maddy summaryHR 3033, the Solidify Iran Sanctions Act of 2023, repeals the expiration date (sunset) from the 1996 Iran Sanctions Act. This permanently maintains existing U.S. sanctions targeting Iran's weapons programs, ballistic missile development, and support for terrorism. The bill directly affects Iran's government and entities involved in these activities by ensuring sanctions remain in effect without needing periodic renewal. It does not impose new sanctions but preserves current policy by removing the automatic expiration provision.

Maddy summaryHR 2640, the Border Security and Enforcement Act of 2023, makes significant changes to U.S. immigration policy. The bill revises asylum eligibility by requiring applicants to demonstrate they couldn't seek protection in countries they transited through, and establishes new rules for credible fear interviews. It creates a new employment eligibility verification system requiring employers to verify work authorization through a government system, with phased implementation based on business size. The bill also changes policies regarding unaccompanied children, requiring faster return to home countries unless they're victims of trafficking or have a credible fear of return. Additionally, it expands penalties for visa overstays and modifies parole policies for certain applicants.

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

Maddy summaryThis bill would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.

Maddy summaryThis bill modifies Medicare's rules for clinical laboratory testing to reduce administrative burdens. It requires the use of statistically valid sampling (instead of full reporting) for "widely available" tests - defined as tests costing under $1,000 per test with over 100 labs performing them - to determine payment rates starting in 2026. The bill also delays reporting deadlines until 2027, updates how labs are defined for payment purposes, and adds annual payment increase caps (2.5% for common tests in 2024-2025, rising to 5% by 2028). These changes directly affect Medicare-participating labs, particularly independent and hospital-based labs conducting common tests.

Maddy summaryThis bill expands Medicare Part B coverage to include specific pharmacist services, directly affecting Medicare beneficiaries and pharmacists who provide these services. It adds new coverage for pharmacist evaluations and treatments related to certain illnesses (like COVID-19, flu, or strep throat) and public health emergencies, requiring payment at 80% of the lesser of actual charge or 85% of physician payment rates (100% during emergencies). The bill also prohibits balance billing for these services, ensuring beneficiaries pay only the standard Medicare copayment. These changes aim to improve access to pharmacist care during health crises while aligning payment with existing physician service frameworks.

Maddy summaryHR 1399, the "Protect Children's Innocence Act," prohibits medical gender-affirming care for minors under 18 by making it a class C felony for providers to perform such care. The bill defines gender-affirming care broadly to include surgical procedures, hormone treatments, and certain cosmetic procedures, with exceptions for medical conditions like reproductive cancers or intersex conditions. It prohibits federal funding for gender-affirming care through programs like Medicaid, Medicare, and the Affordable Care Act, and bans such care in federal health facilities. The bill also prevents institutions of higher education from teaching gender-affirming care and adds immigration consequences for individuals who provide such care to minors.