Rep. Dean Phillips

Maddy summaryThe State Public Option Act creates a new Medicaid buy-in program allowing individuals without other health insurance to purchase coverage starting January 1, 2025. This program limits premiums to 8.5% of household income and requires states to cover comprehensive sexual and reproductive health services, including abortion, beginning in 2025. The bill also establishes how Affordable Care Act premium tax credits apply to this coverage and includes provisions for quality measures and payment rates for primary care services under Medicaid.

Maddy summaryThe Telehealth Modernization Act of 2024 extends Medicare's temporary telehealth coverage rules permanently, removing the previous 2024 expiration date. It expands who can provide telehealth services by allowing more healthcare professionals (like certain nurse practitioners) to bill Medicare for these services, and ensures Federally Qualified Health Centers and Rural Health Clinics can continue billing for telehealth under existing payment rules after 2024. The bill also explicitly permits audio-only telehealth calls for Medicare coverage and allows telehealth for hospice face-to-face visits and home dialysis assessments as clinically appropriate, without time limits. These changes directly affect Medicare beneficiaries, healthcare providers, and community health centers offering telehealth services.

Maddy summaryThis bill (HR 7397) would define "essential health system" in federal law to specifically include certain hospitals serving high numbers of low-income patients. It targets non-Federal, non-profit hospitals that meet one of three criteria: having Medicaid disproportionate share status, serving at least 35% low-income Medicare patients, or receiving significant uncompensated care payments under Medicare. The definition applies to hospitals already designated under existing Medicaid and Medicare programs. This is a technical clarification to standardize how these hospitals are identified in federal statutes.

Maddy summaryHR 7292, the Health ACCESS Act, amends the Social Security Act to establish new rules for healthcare information platforms (like online provider directories). It prohibits these platforms from steering patients toward specific providers based on payment, making medical claims, sharing patient contact details without consent, arranging transportation, or sending unsolicited marketing. The bill requires platforms to disclose financial arrangements with providers, base provider information on objective criteria, and set compensation terms in advance that don't exceed fair market value or tie to services paid by federal health programs. This directly affects healthcare information service providers and the providers/suppliers using their platforms.

Maddy summaryThis bill clarifies that Medicare must cover fully implanted active middle ear hearing devices as prosthetics, not as hearing aids. It requires the Centers for Medicare & Medicaid Services (CMS) to update its rules within 60 days of the bill's enactment to remove these devices from Medicare's hearing aid coverage exclusion. This directly affects Medicare beneficiaries who rely on these specific implanted devices for hearing. The change means these devices will now be covered under Medicare's prosthetic benefits, not excluded under hearing aid rules, without altering existing coverage for other hearing aids.

Maddy summaryThe 401Kids Savings Account Act of 2024 establishes automatic savings accounts for every U.S. citizen under age 18, created at birth or naturalization (or when the program starts). These accounts receive annual government deposits of $500 (or $750 for families eligible for the Earned Income Credit) and up to $250 in matching contributions for EIC-eligible families. After age 18, account holders can use funds for education, first-time home purchases, or roll over balances into ABLE accounts or Roth IRAs. The accounts are designed to be disregarded for means-tested benefits like SSI and Medicaid, though balances exceeding $100,000 will count toward eligibility.

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 summaryThis bill adds 1,000 new medical residency positions (500 in 2024 and 500 across 2025-2028) specifically for training in addiction medicine, addiction psychiatry, or pain medicine. It directly affects hospitals that have or will establish approved residency programs in these fields. Hospitals receiving these positions must use them for addiction-related training for five years, with unused positions redistributed if requirements aren't met. The goal is to expand the healthcare workforce addressing the substance use disorder crisis by increasing specialized training opportunities.

Maddy summaryThe Nutrition CARE Act of 2024 expands Medicare Part B coverage to include medical nutrition therapy services for beneficiaries diagnosed with eating disorders. It directly affects Medicare beneficiaries with eating disorders - particularly an estimated 420,500-560,700 Black, Indigenous, and People of Color seniors - by requiring coverage for 13 hours of initial care (including assessment) and 4 hours annually for ongoing management. The bill amends Medicare law to specify that these services must be provided by registered dietitians or nutrition professionals following referrals from physicians or psychologists. Coverage applies to all eating disorders as defined by the DSM-5, addressing a gap where Medicare previously excluded this critical treatment component. This policy change aims to improve access to evidence-based care for a condition linked to high mortality and significant healthcare costs.

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.