Rep. Julia Letlow

Maddy summaryThis bill, the EMPSA Act (Eliminating the Marriage Penalty in SSI Act), changes Social Security Income (SSI) rules for married adults with intellectual or developmental disabilities. It directly affects married individuals aged 18+ who have these disabilities and meet income and resource limits. The key change removes the "marriage penalty" by ensuring their spouse’s income and resources no longer count against their SSI eligibility or benefit amount, allowing them to receive the full individual benefit rate. This update modifies specific sections of the Social Security Act to eliminate the previous disadvantage faced by married couples under these disability conditions.

Maddy summaryHR 6344, the Simon Crosier Act, requires Medicare and Medicaid providers to establish written policies for do-not-resuscitate (DNR) orders involving unemancipated minors (under 18 without legal independence). It mandates that providers must inform at least one parent or legal guardian in person or by phone (with 72 hours of effort) before considering a DNR, allow parents/guardians to refuse consent, and prohibit overriding parental objections to life-sustaining treatment. The bill also requires providers to continue life-sustaining care for 15 days if a parent requests a transfer and explicitly prohibits using disability as the sole basis for DNR decisions. These requirements apply to all Medicare/Medicaid-covered facilities and directly affect minors, their parents, and healthcare providers.

Maddy summaryHR 6283, the DRUG Act, regulates pharmacy benefit managers (PBMs) to prevent practices that may increase prescription drug costs for consumers. The bill prohibits PBMs from earning revenue based on drug prices or discounts, requiring them to charge flat dollar service fees instead of fees tied to drug costs. It bans PBMs from steering patients to pharmacies they own or control, mandates equal reimbursement for affiliated and non-affiliated pharmacies, and prohibits charging different fees for the same drug. These provisions apply to group health plans, health insurance issuers, and PBMs, with enforcement beginning for plan years starting January 1, 2026. Violations would result in $10,000 daily penalties and require disgorgement of improperly received payments.

Maddy summaryThis bill establishes an Agricultural Trade Enforcement Task Force to address foreign trade barriers harming U.S. agricultural exports, specifically targeting India's WTO-violating price support programs for rice, wheat, and other commodities. The Task Force, led by the U.S. Trade Representative and Agriculture Department, must identify systemic trade barriers, develop enforcement strategies, and file a WTO dispute against India within 60 days of consultations if needed. It requires quarterly reports to Congress on progress, including a specific plan to challenge India's subsidies that exceed WTO limits (e.g., rice supports at 93.9% of production value). The bill directly affects U.S. farmers, ranchers, and exporters who face market access barriers due to these foreign subsidies.

Maddy summaryThe CONNECT for Health Act of 2023 aims to expand access to telehealth services under Medicare by removing barriers that previously limited who could provide these services and where they could be delivered. The bill eliminates geographic restrictions on telehealth coverage, allows telehealth services to be provided from the patient's home and other clinically appropriate locations, and expands the types of healthcare providers who can offer telehealth services. It also improves the process for adding new telehealth services to Medicare coverage and includes provisions to ensure quality measurement includes telehealth services. This legislation directly affects Medicare beneficiaries seeking remote care and healthcare providers delivering telehealth services, with key provisions taking effect between 2024 and 2025.

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.

Maddy summaryHR 1610 would modernize Medicare coverage for chiropractic care by removing the current restriction that limited beneficiaries to one chiropractic service per visit. It expands coverage to include all services provided by licensed chiropractors within their state-authorized scope, aligning Medicare with VA, military, and private insurance practices. The bill requires chiropractors to complete a Secretary-approved educational webinar to cover non-spinal services, while still allowing payment for spinal manipulation treatments without this requirement. This directly affects Medicare beneficiaries seeking chiropractic care and chiropractors seeking Medicare reimbursement for their services.

Maddy summaryThe Rural Physician Workforce Production Act of 2023 creates a new payment system to support medical residency training in rural areas. It allows hospitals, critical access hospitals, and rural emergency hospitals to receive additional payments for residents who train at least 8 weeks in rural locations, with payments based on national medical training costs adjusted annually. The bill requires hospitals to pay residents' salaries during rural training and defines "rural training location" using census data (rural areas, rural-urban commuting area codes, or locations near sole community hospitals). This program is designed to increase rural physician training without affecting existing residency program limits or Medicare funding for medical education. Payments are budget-neutral, meaning they won't increase overall Medicare spending on medical education.

Maddy summaryHR 751, the FAIR Act, requires hospitals running medical residency programs to report annual data on applicants and acceptances from both osteopathic (DO) and allopathic (MD) medical schools starting in 2024. Specifically, hospitals must submit the number of applicants and accepted candidates from each medical school type, confirm they accept both DO and MD applicants, and state that COMLEX and USMLE exam scores are equally accepted. The Health Secretary must then publish this data online for public transparency. The bill directly affects hospitals operating residency programs and aims to make their admissions processes more visible, without mandating specific acceptance rates or changing admission criteria.

Maddy summaryThis bill bans federal funding for abortions in most cases, prohibiting the use of taxpayer money for abortion services or health insurance plans covering abortion. Exceptions allow funding for abortions resulting from rape, incest, or when a pregnancy endangers a woman's life. It requires health insurance plans sold through the Affordable Care Act (ACA) marketplaces to clearly disclose any separate costs for abortion coverage and prohibits ACA subsidies from being used for plans that cover abortion (except in the specified exceptions). The law directly affects federal programs like Medicaid, ACA marketplace plans, and insurers offering health coverage to individuals using federal subsidies.