Rep. Jill N. Tokuda

Alternatives to Prevent Addiction In the Nation Act or the Alternatives to PAIN Act This bill reduces cost-sharing and prohibits the imposition of certain utilization requirements under the Medicare prescription drug benefit for certain non-opioid pain management drugs. Specifically, the bill requires such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier (if any). The bill also prohibits the imposition of prior authorization requirements (i.e., requiring prior approval from a plan) or step therapy requirements (i.e., requiring the use of alternative drugs before a drug is covered under a plan) with respect to such drugs.

Maddy summaryHR 1267, the Water Systems PFAS Liability Protection Act, exempts certain water and wastewater treatment facilities from liability under the federal environmental cleanup law (CERCLA) for releases of specific PFAS chemicals. It directly affects public water systems, wastewater treatment plants, municipalities with stormwater permits, and their contractors who handle PFAS while following all applicable laws. The exemption applies only if facilities manage PFAS in compliance with existing federal or state water quality rules, such as through proper biosolids disposal or treated water discharge under permits. However, the bill does not protect facilities that act with gross negligence or willful misconduct in handling PFAS. This law changes liability rules for water systems but does not alter PFAS regulation standards.

Maddy summaryHR 1259, the Global Demining Protection Act, requires the U.S. Secretary of State to immediately resume all Department of State programs focused on clearing landmines, unexploded ordnance, and destroying small arms. It mandates issuing a waiver under existing authority to restart these activities without delay after the bill becomes law. This bill directly affects U.S. foreign aid programs administered by the State Department that support global demining efforts, ensuring their immediate continuation. The key mechanism is the mandatory waiver to override any current restrictions on these specific demining activities.

Maddy summaryThe Fair Play for Women Act would require schools and athletic associations receiving federal funding to collect and publicly disclose detailed data on gender equity in sports, including participation rates, funding, facilities, and coaching. It mandates annual training for staff and athletes about Title IX rights and establishes civil penalties for schools that fail to comply with gender equity requirements. The bill directly affects all public elementary, secondary, and higher education institutions, as well as state athletic associations. Key provisions include requiring detailed reporting on gender disparities in sports participation and funding, and creating enforcement mechanisms to hold schools accountable for noncompliance.

Maddy summaryThis bill restricts access to Treasury payment systems (including the Bureau of the Fiscal Service) to only Treasury employees with a "fully successful" performance rating and at least one year of civil service, or contractors/outsiders with security clearances, required privacy/cybersecurity training, ethics agreements, and no conflicts of interest. It treats non-government users accessing these systems as government employees for ethics rules and defines specific actions (like stopping payments) as "personal and substantial participation" in government matters. The Treasury Inspector General must investigate any unauthorized access within 30 days and report to Congress, detailing the breach, security risks, and any halted payments. The bill directly affects Treasury staff, contractors, and any external entities accessing federal payment systems.

Maddy summaryThis proposed bill (HR 220) would expand VA healthcare benefits to cover infertility treatments like in vitro fertilization (IVF) and fertility preservation services for veterans with infertility or at risk of infertility (e.g., due to medical treatments), and their partners. It limits VA coverage to three successful IVF cycles or ten attempts, requires consent from veterans, partners, and donors, and allows use of donated eggs or embryos. Partners would receive travel reimbursement as if they were veterans, and temporary rules during implementation will immediately allow partners to access care without marriage requirements. The bill clarifies VA isn’t required to cover maternity care beyond existing rules and defers full implementation until VA issues final regulations within one year of enactment.

Maddy summaryThis bill requires the Comptroller General to study and report on menopause care provided by the Department of Veterans Affairs (VA) to women veterans experiencing perimenopause, menopause, or genitourinary syndrome of menopause. The study will examine current VA protocols for diagnosis, treatment, provider training, veteran access to care, outreach efforts, and quality of care, including veteran feedback. The VA Secretary must then develop a strategic plan within six months of the report's release to improve menopause care access and quality for women veterans under VA healthcare programs.

Maddy summaryHR 1153, the Rural Physician Workforce Production Act of 2025, provides additional Medicare payments to hospitals training medical residents in rural areas to address physician shortages. Hospitals can receive payments equal to the difference between rural training costs (based on 2015 GAO data adjusted for inflation) and standard graduate medical education payments, for residents spending at least 8 weeks in rural settings. It specifically supports hospitals with residency programs where over 50% of training occurs in rural locations, regardless of specialty or training site. This bill directly affects eligible hospitals, including critical access and rural emergency hospitals, by incentivizing rural physician training through updated Medicare funding mechanisms.

Maddy summaryThe SAFE Act requires Medicare to cover falls risk assessments and fall prevention services for seniors aged 65+ who have fallen in the previous year. These services, provided by physical or occupational therapists, will be included in Medicare's annual wellness visits and initial preventive physical exams starting January 1, 2026. The bill also mandates annual reports to Congress beginning in 2027 on falls among seniors aged 65+ that required treatment for fall-related injuries. This policy directly affects Medicare beneficiaries with a documented history of falls by adding targeted preventive care to their covered benefits.

Maddy summaryThis bill amends the Omnibus Crime Control and Safe Streets Act to include Transportation Security Administration (TSA) employees as eligible for public safety officers' death benefits. It specifically covers TSA officers who die while performing duties related to protecting transportation systems, ensuring their families receive financial support similar to other public safety officers. The key change adds a new definition (subparagraph H) to the existing law, expanding eligibility to TSA personnel who are actively safeguarding transportation infrastructure. This directly affects TSA employees and their dependents by granting access to these death benefits for on-duty fatalities. The amendment applies to incidents occurring on or after October 31, 2013.