Rep. Yvette D. Clarke

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 summaryHR 8390, the Mental Health and MAMA Act of 2024, eliminates cost-sharing (like copays or deductibles) for mental health and substance use disorder services during pregnancy and for one year after birth. It applies to people enrolled in group health plans, individual insurance, or federal employee health plans, covering services provided by in-network providers. The bill requires insurers to waive these costs starting two years after enactment, explicitly including telehealth services. It specifically targets care for pregnant and postpartum individuals, ensuring coverage from pregnancy diagnosis through the 12 months following birth.

Maddy summaryThe Community Housing Act of 2024 significantly increases federal investment in affordable housing through major funding boosts, including $44.5 billion for the Housing Trust Fund and $1.5 billion for the Capital Magnet Fund over the next decade. It repeals the Faircloth amendment, which had limited public housing construction since 1992, allowing public housing authorities to build new units without the previous cap. The bill establishes a permanent emergency rental assistance program providing $3 billion annually through 2029 to help low-income households with rent payments and creates the Unlocking Possibilities program to fund local efforts to streamline housing regulations and reduce zoning barriers. These provisions directly affect low- and moderate-income households, community land trusts, and rural communities facing housing insecurity and affordability challenges.

Maddy summaryHR 7311, the *Combatting International Drug Trafficking and Human Smuggling Partnership Act of 2024*, amends the Homeland Security Act to expand U.S. Customs and Border Protection (CBP) authority for overseas operations. It allows CBP officers to conduct joint operations with foreign governments to monitor, locate, and deter the trafficking of illegal drugs, human smuggling, terrorist threats, and other security risks entering the U.S. The bill also authorizes CBP to pay claims arising from these operations in foreign countries, using existing funds. This directly affects CBP and foreign governments partnering with the U.S. on border security efforts.

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 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.

Maddy summaryThis bill, HR 6860, protects patients with end-stage kidney disease (ESRD) who require dialysis by preventing health insurance plans from discriminating against them. It amends Medicare rules to prohibit plans from treating dialysis coverage differently than other medical services based on a patient’s ESRD diagnosis, need for dialysis, or any other factor. The bill clarifies that plans can still choose which dialysis providers to include in their networks but cannot deny or limit coverage for dialysis services solely because of the patient’s condition. It ensures Medicare remains the secondary payer for these services as intended, without forcing plans to cover specific providers.

Maddy summaryThe Climate Resilience Workforce Act establishes a coordinated federal system to build a workforce for climate resilience, directly affecting workers in climate-related sectors and prioritizing frontline communities (low-income, communities of color, Tribal communities) and populations facing employment barriers (undocumented individuals, formerly incarcerated people). Key mechanisms include grant programs for state and local climate resilience planning, job creation grants requiring 40% of jobs to go to frontline communities and populations facing barriers, and minimum labor standards including $15/hour wages (increasing annually), employer-paid health insurance, and protections against discrimination. The bill creates an Office of Climate Resilience, a Climate Resilience Equity Advisory Board, and a Center for the Climate Resilience Workforce to define climate resilience sectors and ensure equitable hiring practices. It also removes employment barriers through immigration status protections, criminal record reforms, and drug testing policy changes for climate resilience workers.

Maddy summaryThe CARE for Moms Act aims to reduce maternal mortality in the United States by improving healthcare access and quality for pregnant and postpartum women, with specific attention to racial disparities. Key provisions include requiring 12-month continuous Medicaid coverage for postpartum individuals (up from 60 days), expanding oral health coverage during pregnancy, and funding State-Based Perinatal Quality Collaboratives through $35 million annual grants. The bill specifically targets the higher maternal mortality rates faced by Black women, who are about 3 times more likely to die from pregnancy-related causes than White women. It also includes provisions for doula services, rural mobile health units, and improved data collection on maternal health outcomes.