Rep. Nikki Budzinski

Maddy summaryThe Pharmacists Fight Back Act (HR 9096) sets new rules for Pharmacy Benefits Managers (PBMs) working with federal health care programs like Medicare Part D and Medicaid. It requires PBMs to reimburse in-network pharmacies at a rate covering the drug's actual cost plus a small fee (capped at $25), and to reduce patient cost-sharing by at least 80% of rebates received from drug manufacturers. The bill bans PBMs from steering patients to specific pharmacies, charging patients more than pharmacies are paid, or using rebates to lower pharmacy payments after claims are processed. It also mandates public reporting of drug pricing data to improve transparency, ensuring patients and pharmacies receive fairer treatment under federal health programs.

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 summaryThis bill would require the U.S. to reimpose tariffs on steel imports from Mexico that were in effect before May 2019. The tariffs must remain in place for at least one year, and the U.S. Trade Representative and Commerce Secretary must certify that Mexico has fixed its trade practices before lifting them. The President may also add import limits to return steel imports from Mexico to pre-2019 trade levels. The bill directly affects Mexican steel exporters and aims to address claims that Mexico violated a 2019 trade agreement.

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 PEERS Act of 2023 (HR 6748) would add Medicare coverage for "peer support services" starting January 1, 2025. These services, provided by certified specialists who have recovered from mental health or substance use conditions, offer emotional, informational, and community support to Medicare beneficiaries diagnosed with mental disorders or substance use disorders. The bill establishes payment rates (80% of a fee schedule) for community mental health centers and certified community behavioral health clinics offering these services and modifies Medicare exclusions to allow coverage. It directly affects Medicare beneficiaries with these diagnoses, certified peer support specialists, and eligible healthcare providers like Federally Qualified Health Centers.

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 summaryHR 6280, the Smart Border Protection Act, provides $570 million in new funding for U.S. Customs and Border Protection (CBP) operations at ports of entry. It allocates $300 million for hiring personnel (including agents and specialists), $200 million for screening technology to detect threats like fentanyl in cargo, and $70 million for infrastructure improvements such as expanded vehicle lanes and building upgrades. All funds must be spent within one year of enactment and are in addition to existing appropriations. The bill directly supports CBP’s capacity to manage border security operations at designated ports.

Maddy summaryHR 6063, the Empowering Striking Workers Act of 2023, modifies unemployment insurance rules to provide benefits for workers unable to work due to strikes or lockouts. It directs that unemployment compensation begins 14 days after a strike starts, or earlier if permanent replacements are hired, a lockout begins, or the dispute ends. The bill directly affects workers participating in labor disputes by making them eligible for benefits under these specific conditions, rather than requiring them to meet standard job search requirements. This change is implemented through amendments to the Internal Revenue Code and Social Security Act.

Maddy summaryHR 5663, the ALS Better Care Act, creates a new Medicare payment system to improve reimbursement for specialized care services provided to ALS patients. It establishes a $800 per visit payment rate starting in 2025 for qualified ALS care facilities, with annual increases based on market basket adjustments. The bill requires the Comptroller General to report on appropriate payment amounts and ensures this new payment is in addition to, not replacing, existing Medicare payments for ALS-related services. This aims to reduce wait times, support facilities in rural areas through telehealth access, and address funding challenges for ALS clinical trials.

Maddy summaryThe MORE Act (HR 5601) would federally decriminalize cannabis by removing it from the Schedule I list of controlled substances under the Controlled Substances Act. It requires federal courts to expunge non-violent cannabis convictions and associated arrests, with a focus on addressing racial disparities in cannabis enforcement. The bill creates an Opportunity Trust Fund that would allocate 50% of funds to criminal justice programs, 20% to small business assistance for minority cannabis entrepreneurs, and 20% to community reinvestment grants for individuals impacted by the War on Drugs. It also prohibits federal agencies from denying benefits or security clearances based on cannabis use or past cannabis convictions, and establishes a Cannabis Justice Office to administer these programs.