Rep. Sharice Davids

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 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 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.

Maddy summaryThis bill prohibits Medicare from paying for certain custom-fitted or custom-fabricated orthotic and prosthetic devices delivered via "drop shipment" (direct shipping without in-person training from a qualified provider). It directly affects Medicare beneficiaries who need these devices, ensuring they receive necessary in-person fitting and training. The bill also expands which healthcare professionals (including physical therapists, occupational therapists, orthotists, and prosthetists) can prescribe these devices and updates definitions to clarify terms like "orthoses" and "prostheses." Final regulations implementing these changes must be issued within one year of the bill's enactment.

Maddy summaryThe ARC Act of 2023 establishes a national program to address peripheral artery disease (PAD), which disproportionately affects minority populations and leads to avoidable amputations. The bill requires Medicare and Medicaid to cover PAD screening tests (such as ankle-brachial index testing) for at-risk beneficiaries without cost-sharing, including people 65+ or those with diabetes, smoking history, or other risk factors. It authorizes $6 million annually for a CDC-led education program to inform healthcare providers and the public about PAD prevention and treatment. The bill also creates quality measures to encourage alternative treatments to amputation and establishes a pilot program to test amputation prevention services at healthcare facilities. These provisions aim to reduce amputation rates and improve outcomes for millions of Americans with PAD.

Maddy summaryHR 4195, the Empowering Parents’ Healthcare Choices Act of 2021, allows parents to choose which health insurance plan covers their child when both parents have separate, qualifying coverage (e.g., individual policies or employer-sponsored group plans). Specifically, parents must submit a joint notification within 60 days of the child’s birth to designate one plan as primary coverage. This choice remains in effect until parents revoke it or one parent loses coverage under their plan. The bill applies to children born on or after January 1, 2022, and affects families with dual coverage, insurance issuers, and group health plans.

Maddy summaryThe Strengthening Tribal Families Act of 2023 requires U.S. states receiving federal child welfare funding to explicitly comply with the Indian Child Welfare Act (ICWA) of 1978. It amends federal law to mandate that state child welfare agencies follow ICWA standards in cases involving Native American children, including timely tribal notice and proper placement decisions. The bill establishes specific metrics for measuring compliance, such as tracking how often courts return cases for insufficient "active efforts" and documenting foster care or adoption placements. States must submit biennial reports to Congress on their progress, and a new federal process will develop standardized compliance assessment tools by 2024. This directly affects state child welfare agencies, tribal organizations, and Native American families involved in custody proceedings.

Maddy summaryThe Strengthening Tribal Families Act of 2023 requires state child welfare agencies to comply with the Indian Child Welfare Act of 1978 (ICWA) in all cases involving Native American children. It amends federal child welfare laws to mandate specific ICWA compliance measures in state plans, such as timely tribal notice in custody cases and proper foster care placements. The bill establishes a system for measuring state compliance, tracking factors like identification of Indian children and court decisions on parental rights. States must submit biennial reports to Congress on their progress in meeting these requirements.

Maddy summaryThe Tribal Family Fairness Act (HR 2762) increases federal funding and streamlines support for tribal child welfare programs. It sets a minimum $10,000 grant per tribe (up from $5,000), raises the tribal set-aside for child welfare funding from 3% to 4.5%, and boosts total mandatory funding from $345 million to $356 million annually. The bill also allows tribes to use funds for "tribal customary adoptions" and simplifies application/reporting for tribes receiving under $50,000, while permitting in-kind contributions to meet matching requirements. These changes directly affect federally recognized tribes operating child welfare programs under the Social Security Act.

Maddy summaryThis bill establishes a new workplace violence prevention standard for healthcare and social service workers. It requires employers in covered facilities - including hospitals, nursing homes, mental health clinics, and social service settings - to develop and implement comprehensive prevention plans with specific requirements. These plans must include risk assessments, hazard prevention measures, employee training on violence prevention, and procedures for reporting and investigating violent incidents. The bill also amends Medicare regulations to require compliance with these standards for hospitals and skilled nursing facilities receiving Medicare funds.