Rep. Anthony D’Esposito

Maddy summaryThe American Workforce Act creates a federal program providing paid training opportunities for U.S. citizens with high school diplomas but no bachelor's degrees. Employers in high-wage, high-demand industries receive workforce education subsidies (up to $9,000 per trainee) to cover training costs while trainees receive structured on-the-job work and educational training at a minimum wage. The program requires employers to provide transparent disclosure documents about training details, maintain minimum wage standards, and submit to oversight by a new American Workforce Division within the Department of Commerce. The program includes accountability measures such as whistleblower protections, penalties for noncompliance, and will expire after 10 years or following a comprehensive report to Congress.

Maddy summaryThe Essential Caregivers Act of 2024 requires nursing homes and similar facilities to allow residents to designate essential caregivers who provide emotional support or assistance with daily activities. During emergencies when regular visitation is restricted, facilities must permit at least one essential caregiver access to residents daily and cannot deny access without following specific procedures. Facilities may deny access for a maximum of 7 days during emergencies (or 14 days with state approval), and must provide a written explanation and appeal process if access is denied. The bill establishes a 48-hour appeal process for residents and caregivers to challenge denials, with facilities required to prove violations during appeals. This law applies to Medicare skilled nursing facilities, Medicaid nursing facilities, intermediate care facilities, and certain inpatient rehabilitation facilities.

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 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 summaryHR 5408, the SSI Savings Penalty Elimination Act, increases the resource limits for Supplemental Security Income (SSI) program eligibility. It raises the individual resource limit from $2,250 to $20,000 (and the couple limit from $1,500 to $10,000) for 2023, with future annual increases tied to inflation using the Consumer Price Index. This change directly affects low-income SSI recipients who currently lose benefits if their savings exceed the current thresholds. The key mechanism is raising these savings limits to reduce the "penalty" for saving modest amounts, while maintaining program integrity through automatic inflation adjustments.

Maddy summaryThis bill expands Medicare coverage to include home infusion treatment for people with Alpha-1 Antitrypsin Deficiency Disorder, a genetic condition causing lung and liver damage. It specifically covers "augmentation therapy" (a standard treatment using Alpha-1 Proteinase Inhibitor) when administered in a patient's home by qualified providers. Medicare will pay 80% of the cost for intravenous kits and up to 2 hours of nursing care during these home infusions, starting January 1, 2025. The change directly affects Medicare beneficiaries with this condition who require home-based treatment and their qualified home infusion providers.

Maddy summaryThis bill requires Medicare to cover genetic counseling services provided by licensed genetic counselors at 85% of the physician payment rate. It defines "genetic counselor" as a state-licensed professional (or meeting federal criteria in non-licensing states) and mandates a new billing modifier for these services starting January 1, 2024. Medicare beneficiaries seeking genetic counseling would gain expanded access to these services under this coverage. The policy change applies to services furnished on or after the effective date, with implementation via interim rule.

Maddy summaryThe Border Reinforcement Act of 2023 requires the immediate resumption of border wall construction along the US-Mexico border using previously allocated funds, with annual goals to complete 200 miles of wall until operational control is achieved. It mandates a comprehensive 5-year technology investment plan for border security systems, including surveillance and detection technology, and sets staffing requirements for U.S. Border Patrol, including a target of 22,000 full-time equivalent agents by 2025. The bill also requires U.S. Customs and Border Protection to publish monthly operational statistics on border encounters, drug seizures, and other border security metrics. Additionally, it includes provisions for DNA collection at land borders, eradication of certain vegetation impeding border security, and a report on Mexican cartels as potential foreign terrorist organizations.

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 would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.