Rep. Nanette Diaz Barragán

Maddy summaryThe Patient Access Act of 2024 allows drug manufacturers to cover certain travel, lodging, and meal expenses for patients prescribed specialty drugs who live more than 1 hour driving distance (or 50 miles) from a treatment facility and have income below the median for their area. It permits manufacturers to pay for transportation, lodging near the facility, and meals during treatment periods, but only if patients aren’t already receiving these services for free from the facility and manufacturers don’t advertise the program before a prescription is issued. The bill also requires manufacturers to certify they won’t shift costs to Medicare or Medicaid and mandates a GAO study to track impacts on access, costs, and disparities for these patients. This applies specifically to patients needing transformative therapies like rare disease treatments, with the program starting January 1, 2025.

Maddy summaryThe Patient Debt Relief Act requires Medicare-participating hospitals to establish clear financial assistance policies by January 2026, including publicly available eligibility criteria and 30-day pre-payment screening for charity care. It prohibits hospitals from placing home liens, garnishing wages, or selling debt to collectors without offering income-based repayment plans (capping payments at 4% of gross monthly income) and eliminates interest for patients earning under 250% of the poverty line. Hospitals failing to comply face civil penalties up to $1 million per violation. The bill also creates a $100 million grant program to fund nonprofits that discharge medical debt for individuals meeting income thresholds (5% of income or under 400% of poverty line), with quarterly reporting requirements. These provisions apply directly to hospitals and low-income patients with medical debt.

Maddy summaryHR 9061 increases federal funding to support child welfare caseworkers by raising the annual appropriation under the Social Security Act from $345 million to $385 million. It specifically boosts the reserved amount for caseworker recruitment, retention, and training from $20 million to $60 million annually, and adds a requirement to include worker safety and well-being in these efforts. The bill directly affects state child welfare agencies and their caseworkers by providing more resources to address staffing challenges. The changes take effect in the first fiscal year after enactment.

Maddy summaryHR 8796, the "Stop Comstock Act," removes outdated restrictions from federal law that previously banned the distribution of materials related to contraception and abortion as "obscene" or "indecent." The bill amends Title 18 and the Tariff Act by deleting references to "indecent," "immoral," "unlawful abortion," and "procuring abortion" from provisions governing obscene materials. It clarifies that the law only prohibits "obscene materials" in commerce, eliminating broad restrictions on reproductive health information. This directly affects internet platforms, healthcare providers, and individuals sharing reproductive health resources by removing legal barriers to their distribution.

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic prior authorization systems by 2027 and publish detailed data on their approval and denial rates for medical services by 2026. It directly affects Medicare Advantage plans (private insurers offering Medicare coverage) and their enrollees (seniors 65+), mandating transparency about prior authorization decisions, processing times, and appeal outcomes. Key provisions include requiring plans to report annual statistics on request approvals/denials, average processing times, and use of technology, with this data published publicly by the Centers for Medicare & Medicaid Services. The bill also sets timelines for plan responses to prior authorization requests and mandates reports to Congress on implementation and impacts.

Maddy summaryThe End Polluter Welfare Act of 2024 eliminates numerous subsidies and tax benefits for fossil fuel companies by repealing provisions that provide royalty relief, reducing royalty rates, and ending tax incentives for oil, natural gas, and coal production. The bill prohibits federal funding for fossil fuel projects by restricting international financial institutions, the Export-Import Bank, and the Department of Transportation from supporting fossil fuel infrastructure. It also repeals recent legislation that provided fossil fuel subsidies, including parts of the Fiscal Responsibility Act and Inflation Reduction Act. This comprehensive approach directly affects oil, gas, and coal producers by removing financial benefits that have historically supported the fossil fuel industry, while directing studies to identify and eliminate additional fossil fuel subsidies.

Maddy summaryThe Essential Caregivers Act of 2024 requires nursing homes and similar facilities to allow residents to designate essential caregivers who provide emotional support or assistance with daily activities. During emergencies when regular visitation is restricted, facilities must permit at least one essential caregiver access to residents daily and cannot deny access without following specific procedures. Facilities may deny access for a maximum of 7 days during emergencies (or 14 days with state approval), and must provide a written explanation and appeal process if access is denied. The bill establishes a 48-hour appeal process for residents and caregivers to challenge denials, with facilities required to prove violations during appeals. This law applies to Medicare skilled nursing facilities, Medicaid nursing facilities, intermediate care facilities, and certain inpatient rehabilitation facilities.

Maddy summaryHR 7142 (Alternatives to PAIN Act) requires Medicare Part D plans to cover non-opioid pain management drugs with no deductible and at the lowest copay level starting in 2025. It defines "qualifying non-opioid drugs" as FDA-approved medications that don’t act on opioid receptors (like certain NSAIDs or nerve pain treatments), excluding opioids and schedule I-III drugs. The bill prohibits Medicare plans from forcing patients to try opioids first (step therapy) or requiring prior approval for these non-opioid options. It directly affects Medicare beneficiaries needing pain management, especially those seeking alternatives to opioids for post-surgical or acute pain. The policy change aims to improve access to non-addictive pain treatments while preserving doctors' authority to prescribe medically appropriate care.

Maddy summaryThe Nutrition CARE Act of 2024 expands Medicare Part B coverage to include medical nutrition therapy services for beneficiaries diagnosed with eating disorders. It directly affects Medicare beneficiaries with eating disorders - particularly an estimated 420,500-560,700 Black, Indigenous, and People of Color seniors - by requiring coverage for 13 hours of initial care (including assessment) and 4 hours annually for ongoing management. The bill amends Medicare law to specify that these services must be provided by registered dietitians or nutrition professionals following referrals from physicians or psychologists. Coverage applies to all eating disorders as defined by the DSM-5, addressing a gap where Medicare previously excluded this critical treatment component. This policy change aims to improve access to evidence-based care for a condition linked to high mortality and significant healthcare costs.

Maddy summaryHR 6780 establishes a 4-year Medicare demonstration program testing whether hospitals providing medically tailored home-delivered meals to specific patients improves health outcomes and reduces hospital readmissions. The program targets Medicare beneficiaries with diet-sensitive chronic conditions (like diabetes or heart failure) who are at high risk of readmission and meet specific discharge criteria, such as limited daily living activities. Selected hospitals must screen patients, provide at least two tailored meals daily for 12 weeks, and offer medical nutrition therapy, all without patient cost-sharing. The program requires hospitals to submit data for evaluation, with the goal of assessing impacts on hospital admissions, care costs, and patient satisfaction before reporting to Congress in 2027 and 2030.