Rep. Paul A. Gosar

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 summaryThis bill creates a new tax deduction for healthcare providers who offer free medical care to eligible patients. It allows direct primary care physicians (those charging a subscription fee) to deduct the published fees for free care provided, plus half the subscription fee per visit. Other providers can deduct the Medicare-reimbursed value of free care given to patients enrolled in Medicaid or children's health programs. The deduction is limited to the provider's total income from medical services that year. It directly affects healthcare providers who offer free care to Medicaid/Medicare-eligible patients without expecting payment.

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 summaryHR 1783, the Senior Independence Act of 2023, increases the annual earnings limit for Social Security early retirees. It raises the monthly exempt amount from $1,970 (under current law) to $2,500 for 2024, allowing people collecting benefits before full retirement age to earn more without having their monthly payments reduced. This change applies to taxable years ending after 2023, with future adjustments for wage inflation. The bill directly affects early retirees who continue working, enabling them to keep more of their earnings while retaining Social Security benefits.

Maddy summaryThe HELLPP Act (HR 1634) amends Medicaid to recognize doctors of podiatric medicine (podiatrists) as physicians, enabling them to be reimbursed for services under Medicaid starting January 1, 2024. It also clarifies Medicare’s documentation requirements for therapeutic shoes for people with diabetes, mandating specific written certifications from a managing physician and a podiatrist to confirm medical necessity. These changes directly affect patients with foot conditions, especially those with diabetes, by improving access to podiatrist-provided care and coverage for therapeutic shoes. The bill includes a separate provision strengthening Medicaid program integrity through continuous levies on provider payments, but this does not alter patient coverage. All key provisions take effect on January 1, 2024.

Maddy summaryHR 1610 would modernize Medicare coverage for chiropractic care by removing the current restriction that limited beneficiaries to one chiropractic service per visit. It expands coverage to include all services provided by licensed chiropractors within their state-authorized scope, aligning Medicare with VA, military, and private insurance practices. The bill requires chiropractors to complete a Secretary-approved educational webinar to cover non-spinal services, while still allowing payment for spinal manipulation treatments without this requirement. This directly affects Medicare beneficiaries seeking chiropractic care and chiropractors seeking Medicare reimbursement for their services.

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.

Maddy summaryThis bill makes permanent Medicare coverage for cardiac and pulmonary rehabilitation services delivered via telehealth in patients' homes, which were temporarily allowed during the pandemic. It removes geographic restrictions that previously required in-person visits or limited services to specific locations like clinics. The change directly affects Medicare beneficiaries needing heart or lung rehabilitation and healthcare providers offering these programs. It ensures home-based telehealth visits for cardiac, intensive cardiac, and pulmonary rehabilitation receive the same coverage as in-clinic services under Medicare.

Maddy summaryThis bill amends the Social Security Act to exclude wages earned and self-employment income derived from unauthorized employment in the United States from being counted toward Social Security credits. It directly affects undocumented immigrants who work without authorization, preventing those earnings from contributing to their future Social Security benefits. The law changes existing Social Security rules by adding specific exclusions for "service performed by an alien while employed... not authorized to be so employed" and similar self-employment activities. These changes apply to all wages and income earned before, during, or after the bill's enactment, with Social Security recompiling existing benefit calculations to reflect the new rules.

Maddy summaryHR 497, the Freedom for Health Care Workers Act, eliminates a federal requirement for healthcare workers in Medicare and Medicaid programs to be vaccinated against COVID-19. The bill directly affects healthcare providers who treat patients under these federally funded programs by preventing the enforcement of the November 2021 HHS rule mandating staff vaccinations. Its key provision prohibits the Department of Health and Human Services from implementing, enforcing, or creating a similar rule regarding vaccination for these workers. This bill changes the policy by removing a specific vaccine mandate for providers in Medicare and Medicaid programs.