Rep. Joe Neguse

Maddy summaryThis bill, the EMPSA Act (Eliminating the Marriage Penalty in SSI Act), changes Social Security Income (SSI) rules for married adults with intellectual or developmental disabilities. It directly affects married individuals aged 18+ who have these disabilities and meet income and resource limits. The key change removes the "marriage penalty" by ensuring their spouse’s income and resources no longer count against their SSI eligibility or benefit amount, allowing them to receive the full individual benefit rate. This update modifies specific sections of the Social Security Act to eliminate the previous disadvantage faced by married couples under these disability conditions.

Maddy summaryThe Medical Nutrition Equity Act of 2023 requires Medicare, Medicaid, CHIP, TRICARE, FEHBP, and private health insurance plans to cover medically necessary food for patients with specific digestive and inherited metabolic disorders. The bill defines "medically necessary food" as specialized formulas, vitamins, or amino acids prescribed by a physician for conditions including inherited metabolic disorders, malabsorption syndromes, food allergies, and inflammatory bowel diseases. It mandates coverage for both the food and necessary equipment/supplies to administer it, specifically prohibiting insurers from requiring feeding tubes when oral administration is possible. The bill also establishes that Medicare coverage will be 80% of the cost for these items. This legislation aims to ensure patients with these conditions can access the specialized nutrition therapies they need to prevent serious health complications like malnutrition, hospitalization, or developmental issues.

Maddy summaryThis bill, HR 6860, protects patients with end-stage kidney disease (ESRD) who require dialysis by preventing health insurance plans from discriminating against them. It amends Medicare rules to prohibit plans from treating dialysis coverage differently than other medical services based on a patient’s ESRD diagnosis, need for dialysis, or any other factor. The bill clarifies that plans can still choose which dialysis providers to include in their networks but cannot deny or limit coverage for dialysis services solely because of the patient’s condition. It ensures Medicare remains the secondary payer for these services as intended, without forcing plans to cover specific providers.

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 adds audiology services to Medicare's covered benefits under Section 1861(s)(2)(KK), effective January 1, 2025. It allows qualified audiologists to provide hearing and balance assessments and diagnostic/treatment services without requiring a physician referral or supervision, directly affecting Medicare beneficiaries seeking these services and audiologists practicing under state law. Payment will be 80% of the lower of actual charge or the Medicare fee schedule. The bill does not expand the types of audiology services covered but changes how they are accessed and paid for under Medicare.

Maddy summaryThe ARCH Act extends funding for two critical rural hospital payment programs through 2029 (instead of 2024). It directly affects rural hospitals classified as Medicare-dependent hospitals (MDHs) or low-volume hospitals (LVHs), ensuring continued financial support. Key provisions include extending payment methodologies, allowing hospitals to decline reclassification, and requiring a GAO report analyzing rural hospital classification overlaps and recommending improvements. The GAO must report within 180 days on classification criteria, overlaps, and potential changes to improve rural hospital sustainability and patient access.

Maddy summaryThe ARCC Act provides $100 million in federal funding to help apprentices and pre-apprentices in job training programs cover childcare costs. It authorizes competitive grants to 10 states, which must distribute monthly stipends of at least $500 per dependent child directly to eligible childcare providers on behalf of participants in these programs. The bill prioritizes individuals from historically underrepresented groups (based on race, ethnicity, or gender) and ensures stipends are tax-free while not affecting eligibility for other federal benefits. States must report on participation, program completion rates, and demographic data, with the Secretary later summarizing program impacts for Congress.

Maddy summaryThis bill creates a framework for states to develop their own universal health care systems by applying for waivers from certain federal health care requirements. States must demonstrate they can provide comprehensive coverage meeting or exceeding current federal standards (like Medicaid, Medicare, and CHIP) for at least 95% of residents within 5 years, with the federal government redirecting funds that would have gone to federal programs to support state systems. States must include specific protections like reproductive health care coverage and submit regular reports on coverage rates, affordability, and quality. The bill includes special provisions to protect Indian health care services and ensure they remain accessible under state plans. States that fail to meet coverage goals may face consequences, including potential termination of their waiver.

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 summaryThis bill creates a Medicare buy-in option for retired or disabled first responders aged 50-64 who have lost employer health coverage. It allows them to enroll in Medicare Part A, B, and D (including prescription drug coverage) before age 65, with premiums calculated based on Medicare's average per-person costs. The coverage counts as "minimum essential coverage" under the Affordable Care Act, qualifying individuals for ACA premium tax credits and cost-sharing subsidies. It also establishes an oversight board and outreach grants to assist enrollment, while ensuring the program doesn't reduce benefits for existing Medicare beneficiaries or harm Medicare trust funds.