Rep. Doris O. Matsui

Maddy summaryThis bill modifies Medicare Part B late enrollment penalties to better accommodate people with temporary coverage gaps. It increases the penalty rate from 10% to 15% of the monthly premium but limits the penalty period to twice the months without coverage (instead of 12-month increments). It also excludes months with COBRA, retiree, or VA health coverage from penalty calculations and creates a special enrollment period when such coverage ends. These changes directly affect Medicare Part B enrollees who lost employer or retiree coverage, reducing their potential extra fees for late enrollment.

Maddy summaryThis bill amends Medicare, Medicaid, and private insurance rules to improve coverage for drugs treating rare diseases (defined as conditions affecting 200,000 or fewer people in the U.S.). It requires coverage for rare disease drug uses supported by peer-reviewed medical literature and not listed as contraindicated in FDA labeling or medical reference guides. Private insurers must provide expedited review processes for denials of such drugs. The changes apply 30 days after enactment, affecting insurers and patients seeking coverage for rare disease treatments.

Maddy summaryThe CARE for Moms Act aims to reduce maternal mortality in the United States by improving healthcare access and quality for pregnant and postpartum women, with specific attention to racial disparities. Key provisions include requiring 12-month continuous Medicaid coverage for postpartum individuals (up from 60 days), expanding oral health coverage during pregnancy, and funding State-Based Perinatal Quality Collaboratives through $35 million annual grants. The bill specifically targets the higher maternal mortality rates faced by Black women, who are about 3 times more likely to die from pregnancy-related causes than White women. It also includes provisions for doula services, rural mobile health units, and improved data collection on maternal health outcomes.

Maddy summaryThis bill requires Medicare Part D drug plans (which cover seniors' prescription drugs) to include all cheaper generic drugs and at least two cheaper biosimilars in a "preferred" formulary position starting in 2024. Specifically, plans must list these lower-cost options on a tier with lower patient costs than the original brand-name drug, and cannot impose stricter access rules (like prior authorization) on them compared to the brand-name drug. It directly affects Medicare Part D sponsors and seniors enrolled in these plans by mandating more affordable drug options. The key change is requiring formulary placement and cost-sharing for specific lower-cost generics and biosimilars, without restricting patient access to them relative to brand-name alternatives.

Maddy summaryThe Lowering Drug Costs for American Families Act expands Medicare's drug price negotiation program from 20 to 50 drugs, allowing the government to negotiate lower prices for these medications. It requires private health insurance plans and group health coverage to apply these negotiated prices to their members' cost-sharing for covered drugs, with plans able to opt out while publicly disclosing their decision. The bill also extends these negotiated prices to drugs covered by commercial insurance markets, not just Medicare. This would directly affect Medicare beneficiaries and people with private health insurance who take the negotiated drugs.

Maddy summaryThe 9-8-8 Implementation Act of 2023 establishes a national mental health crisis response system centered around the 9-8-8 suicide prevention hotline. It provides $441 million for call center technology, staffing, and operations, and requires Medicare, Medicaid, and private health plans to cover crisis response services including mobile crisis teams and crisis stabilization facilities. The bill also mandates a national suicide prevention media campaign and creates protocols for 9-1-1 dispatchers to better respond to mental health crises. These provisions aim to improve access to mental health crisis care across the United States.

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 summaryThis bill expands Medicare coverage to include home infusion treatment for people with Alpha-1 Antitrypsin Deficiency Disorder, a genetic condition causing lung and liver damage. It specifically covers "augmentation therapy" (a standard treatment using Alpha-1 Proteinase Inhibitor) when administered in a patient's home by qualified providers. Medicare will pay 80% of the cost for intravenous kits and up to 2 hours of nursing care during these home infusions, starting January 1, 2025. The change directly affects Medicare beneficiaries with this condition who require home-based treatment and their qualified home infusion providers.

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.