Rep. Raja Krishnamoorthi

Maddy summaryThis bill establishes minimum nurse-to-patient ratios for registered nurses in hospital units (such as 1:1 in trauma units, 2:1 in critical care units, and 3:1 in emergency rooms), requiring hospitals to develop and maintain staffing plans that meet these standards. It mandates transparency in documenting staffing levels, ensures hospitals verify nurses' competence for specific units, and enforces compliance through Medicare and Medicaid programs with penalties for violations. The bill protects nurses who refuse unsafe assignments due to staffing concerns and includes initiatives to improve nurse retention and address staffing shortages. It directly affects hospitals, nurses, and patients by aiming to improve patient safety and care quality through standardized staffing requirements. The bill applies to all hospitals, with extended implementation timelines for rural facilities.

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

Maddy summaryThis bill modifies Medicare's rules for clinical laboratory testing to reduce administrative burdens. It requires the use of statistically valid sampling (instead of full reporting) for "widely available" tests - defined as tests costing under $1,000 per test with over 100 labs performing them - to determine payment rates starting in 2026. The bill also delays reporting deadlines until 2027, updates how labs are defined for payment purposes, and adds annual payment increase caps (2.5% for common tests in 2024-2025, rising to 5% by 2028). These changes directly affect Medicare-participating labs, particularly independent and hospital-based labs conducting common tests.

Maddy summaryThis bill expands Medicare Part B coverage to include specific pharmacist services, directly affecting Medicare beneficiaries and pharmacists who provide these services. It adds new coverage for pharmacist evaluations and treatments related to certain illnesses (like COVID-19, flu, or strep throat) and public health emergencies, requiring payment at 80% of the lesser of actual charge or 85% of physician payment rates (100% during emergencies). The bill also prohibits balance billing for these services, ensuring beneficiaries pay only the standard Medicare copayment. These changes aim to improve access to pharmacist care during health crises while aligning payment with existing physician service frameworks.

Maddy summaryHR 1692, the Health Care Affordability Act of 2023, adjusts how health insurance subsidies are calculated for people buying coverage through the marketplace. It replaces the previous subsidy formula with a sliding scale based on income, where households earning up to 150% of the poverty line pay 0% of premiums, and those at 400% or more pay 8.5%. The change applies to all income tiers between these points, with percentages increasing incrementally (e.g., 2% for 150-200% income). This directly affects individuals purchasing health insurance through the marketplace who qualify for subsidies under the Affordable Care Act. The bill amends Section 36B of the Internal Revenue Code and takes effect for tax years beginning after December 31, 2022.

Maddy summaryThe LEAP Act creates a new tax credit for employers with registered apprenticeship programs, offering $1,500 per qualifying apprentice employee above a threshold based on the employer's average apprenticeship hires over the previous three years, limited to two years per employee. It excludes most construction industry employers (NAICS 23) unless they hire pre-apprenticeship graduates and sponsor apprenticeships. The bill also requires federal agencies to develop a plan to reduce printing costs by increasing online document availability and to disclose printing costs for government publications. This applies to apprenticeship programs registered with the Department of Labor.

Maddy summaryThe Affordable Insulin Now Act (HR 1488) requires health insurance plans and issuers to cover specific insulin products with cost-sharing capped at $35 per 30-day supply or 25% of the negotiated price, whichever is lower, starting in 2024. It directly affects people with diabetes who rely on insulin by limiting out-of-pocket costs for covered products. The bill mandates coverage of all insulin types (rapid-acting, long-acting, etc.) and dosage forms (vials, pumps, etc.) as selected by the plan. This applies to both group and individual health insurance plans under the Public Health Service Act, Internal Revenue Code, and ERISA, with cost-sharing counting toward annual deductibles.

Maddy summaryHR 1368, the "Deter PRC Support to the Russian War Effort Act," would impose U.S. sanctions on Chinese individuals and companies that provide material support to Russia's military operations in Ukraine. The bill targets entities that export defense-related items, financial resources, or technologies that help Russia conduct military actions or evade existing U.S. sanctions. Sanctions could include blocking U.S. property, denying visas, restricting financial transactions, and prohibiting U.S. government procurement from targeted entities. The bill specifically applies to Chinese persons (including state-owned enterprises) who assist Russia's military efforts, with sanctions set to expire after two years or when the Ukraine conflict ends.

Maddy summaryThe Countering Economic Coercion Act of 2023 authorizes the President to provide economic support to U.S. allies and partners affected by economic coercion from foreign adversaries. Key provisions include reducing tariffs on goods from affected countries, expediting export licenses, and requesting foreign aid, all while requiring coordination with allied nations. The bill mandates presidential consultation with Congress before taking action and establishes a 45-day congressional review period for these measures. This legislation aims to strengthen international partnerships while creating new opportunities for U.S. businesses and workers.

Maddy summaryThe Stop the Wait Act of 2023 eliminates the current 5-month waiting period for Social Security Disability Insurance (SSDI) benefits by phasing it out: applications filed in 2023-2025 would face a 3-month wait, 2026 a 2-month wait, and 2027 a 1-month wait, with full elimination by January 2028. It also changes Medicare rules to allow individuals without minimum essential health coverage to receive Medicare benefits retroactively from the first month of SSDI eligibility, rather than waiting 24 months. This directly affects people under 65 applying for SSDI who lack other health insurance, ensuring they have coverage during the waiting period. The bill amends the Social Security Act to implement these changes, effective January 1, 2028.