Sen. Roger Marshall

Maddy summaryThe Safe Step Act requires health insurance plans and employer-sponsored health coverage to create a transparent process for patients or their doctors to request exceptions to medication step therapy protocols. These protocols typically mandate trying a lower-cost drug first before covering a more expensive alternative. Exceptions must be approved if previous treatments failed, delaying coverage would cause severe harm, the required drug is unsafe, or the patient is stable on the requested drug. Health plans must respond to requests within 72 hours (or 24 hours in emergencies) and make the process details available online.

Maddy summaryS 641, the FREEBIRD Act, ends the U.S. Centers for Disease Control and Prevention (CDC) requirement that foreign air travelers show proof of COVID-19 vaccination to enter the United States. The bill immediately terminates this rule upon enactment and prohibits federal funding for its administration or enforcement. It requires the CDC to report, within 90 days, how many travelers were denied entry under the previous vaccination rule between April 2022 and the bill’s enactment. The Act does not affect other travel rules, such as the separate requirement for negative COVID-19 test results for travelers from China.

Maddy summaryThe ATF Transparency Act requires the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) to provide applicants with background check transaction numbers when firearm transfer applications are denied, allow appeals of denials (with attorney fee reimbursement for successful cases), and automatically approve applications if decisions aren’t made within 90 days. It directly affects firearm buyers and manufacturers whose applications face delays or denials under the National Instant Criminal Background Check System (NICS). The bill also mandates reports on unresolved background checks and improvements to NICS processing, including a joint agreement between the ATF and FBI. These changes aim to reduce processing delays and errors in firearm transfer approvals.

Maddy summaryS 626, the Comprehensive Care for Alzheimer’s Act, establishes a new Medicare model to provide coordinated care management for beneficiaries with Alzheimer’s disease or related dementia. It directly affects Medicare Part A/B enrollees (not in Part C or hospice) and their unpaid caregivers by requiring eligible entities like health systems or ACOs to deliver comprehensive services including continuous monitoring, personalized care plans, medication management, and caregiver support. Key provisions include assigning patients to care pathways based on health needs, requiring zero cost-sharing for beneficiaries, and paying providers via capitated payments with quality-based bonuses. The model aims to test whether this approach improves health outcomes, caregiver experience, and reduces Medicare spending without lowering care quality.

Maddy summaryThis bill would remove longstanding U.S. restrictions on exports to Cuba by amending key laws including the Cuban Democracy Act and the Cuban Liberty and Democratic Solidarity (LIBERTAD) Act. It specifically eliminates prohibitions on exporting goods and services to Cuba that were in place under the Foreign Assistance Act, the Cuban Democracy Act, and the Trade Sanctions Reform Act. The bill allows U.S. businesses to export to Cuba without prior government approval, directly affecting American exporters and Cuban importers. However, it preserves the President's authority to impose new export controls under specific circumstances, such as declaring a new national emergency related to Cuba.

Maddy summaryThe Title X Abortion Provider Prohibition Act would bar federal funding under the Title X program (which supports family planning services like contraception and STD testing) from going to any health care provider that performs or funds abortions, except in cases of rape, incest, or when a physician certifies an abortion is necessary to prevent death or serious health harm. It requires clinics receiving Title X funds to certify they do not perform or fund abortions (with these exceptions), while hospitals are exempt from this certification if they do not fund non-hospital abortion providers. The bill also mandates annual reports to Congress detailing funded clinics, the number of abortions performed under exceptions, and any funds transferred to other entities. This policy would directly affect Title X-funded clinics that provide abortion services or fund such services, potentially limiting their access to federal funding.

Maddy summaryThis bill prohibits federally funded schools and athletic programs from allowing individuals assigned male at birth to participate in women's or girls' sports teams. It defines "sex" for this purpose solely based on biological sex assigned at birth, including reproductive anatomy and genetics. The law amends Title IX of the Education Amendments of 1972 to make such participation a violation of federal civil rights law. It directly affects all schools, colleges, and organizations receiving federal funds that operate athletic programs for women or girls.

Maddy summaryThis bill (S 588) requires the U.S. President to impose sanctions on specific Chinese officials and block U.S. funding for joint research with China if China fails to allow a transparent international investigation into the origins of COVID-19 at Wuhan laboratories within 90 days of the bill’s enactment. It targets officials involved in concealing the outbreak or obstructing the investigation, including leaders of China’s Chinese Academy of Sciences (CAS) and agencies like the Ministry of Health. Key provisions include blocking assets of sanctioned individuals, denying visas to them, and banning U.S. federal-funded researchers from collaborating with China on certain virus-related research. The bill aims to compel China to grant unrestricted access to labs, data, and personnel for an independent origin investigation.

Maddy summaryThis bill directs the Federal Trade Commission (FTC) to study and report on practices in the pharmaceutical supply chain, focusing on pharmacy benefit managers (PBMs) and their impact on drug pricing. The FTC must submit an interim report within 180 days and a full report within one year, examining issues like whether PBMs steer patients to pharmacies they own, use proprietary data for competitive advantage, or design formularies to favor higher-cost drugs. The reports will also assess competition in the supply chain, legal barriers to enforcement, and the FTC’s ability to address anticompetitive behavior by drug manufacturers. The goal is to identify transparency gaps and recommend policy changes to improve competition and ensure consumers benefit from cost savings.

Maddy summaryThis resolution establishes a procedural requirement for the U.S. Senate to review international pandemic agreements negotiated under the World Health Organization (WHO). It mandates that any WHO agreement on pandemic prevention, preparedness, or response - where the U.S. would make significant commitments - must be submitted to the Senate as a treaty requiring approval before implementation. The resolution requires the President to submit such agreements to the Senate within 60 days of signing, with the Senate declaring it "not in order" to fund or implement any such agreement without prior Senate ratification. This affects how the executive branch handles WHO pandemic agreements, ensuring Senate consultation and approval aligns with constitutional treaty procedures.