Sen. Cindy Hyde-Smith

Maddy summaryS 526, the Pharmacy Benefit Manager Transparency Act of 2025, requires pharmacy benefit managers (PBMs) - the middlemen managing drug coverage for health plans - to disclose financial details and stop unfair practices. It prohibits PBMs from keeping price differences between what they charge health plans and pay pharmacies, arbitrarily clawing back payments, or inflating fees to offset government-mandated changes. PBMs must annually report to the FTC and HHS on rebate sharing, fee structures, formulary changes, and reimbursement differences, including whether drug tier shifts were influenced by manufacturers. This directly affects PBMs, pharmacies, health plans, and patients by increasing transparency in drug pricing and reimbursement.

Maddy summaryThis bill allows states to waive the 35-mile rule for certain rural hospitals seeking Critical Access Hospital (CAH) designation under Medicare. It targets hospitals that are sole community hospitals, Medicare-dependent small rural hospitals, low-volume hospitals, or subsection (d) hospitals located in high-poverty or health professional shortage areas, with two consecutive years of negative margins. To qualify, hospitals must commit to adding high-demand services like obstetrics or behavioral health and submit annual reports on these services. The bill caps total CAH designations at 120 nationwide (5 per state) and requires transition to new payment models after 9 years. It also mandates studies by GAO and MedPAC to evaluate impacts on access and costs.

Maddy summaryThis joint resolution proposes a constitutional amendment to permanently set the number of justices on the Supreme Court at nine. It would require the Supreme Court to always consist of exactly nine justices, directly affecting the Court's composition. The amendment would become part of the Constitution only if ratified by three-fourths of state legislatures within seven years. This is a procedural change to the Constitution's structure, not a policy affecting other areas.

Maddy summarySRES 64 is a Senate resolution honoring the 67 victims of a mid-air collision between American Airlines Flight 5342 and a U.S. Army aircraft near Washington, D.C., on January 29, 2025. It directly affects the families, friends, and communities of the victims, who were from multiple U.S. states and several countries. The resolution formally commemorates the lives lost, offers condolences to grieving families, and expresses gratitude to the 42 emergency response agencies that assisted in rescue and recovery efforts. As a commemorative resolution, it has no policy or legal effect beyond expressing collective mourning and recognition.

This resolution supports the designation of Career and Technical Education Month to celebrate career and technical education across the United States.

Supporting Made in America Energy Act This bill requires oil and natural gas lease sales that include certain public land and waters, prohibits lease sales in other areas, and establishes related requirements. Beginning in FY2025, the Department of the Interior must conduct a minimum of four onshore lease sales annually in each state that has federal land available for oil and natural gas leasing. If a lease sale is canceled, delayed, or deferred, Interior must conduct a replacement sale during the same year.  Beginning in FY2026, Interior must conduct a minimum of two offshore, region-wide lease sales annually in the Gulf of Mexico Region of the Outer Continental Shelf (OCS) by specified dates. The sales must include the Central Gulf of Mexico Planning Area and the Western Gulf of Mexico Planning Area. Interior must also conduct a minimum of six offshore lease sales of at least 1 million acres each over a 10-year period in the Cook Inlet Planning Area. The bill sets a 12.5% royalty rate for such leases. Interior must plan and approve the subsequent OCS oil and gas leasing programs by specified deadlines. The bill extends through 2035 a moratorium on oil and gas leasing in certain eastern and central portions of the Gulf of Mexico and expands the moratorium to include the South Atlantic Planning Area and the Straits of Florida Planning Area. The bill also requires the President to obtain congressional approval before impeding or circumventing certain federal energy mineral leasing processes.

Maddy summaryThis bill amends the CARES Act by removing subsection (c) of Section 4024. It does not create new policies or directly affect any specific group; it only modifies an existing provision in federal law. The change is purely procedural, eliminating a specific subsection without altering the law's overall structure or requirements. No new rules or impacts on housing are introduced. (1 sentence, as it is a procedural amendment).

Maddy summaryThis bill permanently extends the New Markets Tax Credit (NMTC) program, which incentivizes private investment in low-income communities. It modifies the tax code to keep the credit available beyond 2025 (replacing "2020 through 2025" with "2020 and each calendar year thereafter") and adds automatic annual inflation adjustments to the credit amount starting in 2026. The bill also provides tax relief by allowing NMTC credits to offset the alternative minimum tax, specifically for investments made after December 2024. This directly affects community development financial institutions (CDFIs) and investors who fund projects in designated low-income areas.

Maddy summaryS 475, the Alternatives to PAIN Act, changes Medicare Part D coverage to make non-opioid pain management drugs more accessible and affordable for beneficiaries. It requires Medicare plans to cover qualifying non-opioid pain drugs without deductibles and place them on the lowest cost-sharing tier (meaning patients pay the least out-of-pocket) starting in 2026. The bill also prohibits plans from requiring step therapy (forcing patients to try opioids first) or prior authorization for these specific drugs. Qualifying drugs must treat acute pain (like post-surgery), not work on opioid receptors, have no equivalent alternatives, and meet cost thresholds. This directly affects Medicare Part D beneficiaries needing pain management and the plans that cover them.

Maddy summaryThe Rural Health Focus Act (S 403) creates a new Office of Rural Health within the CDC, headed by a director appointed by the CDC Director. This office will directly serve rural communities by coordinating CDC research on rural health challenges, developing policies to improve care (including telehealth), and awarding grants to support rural health initiatives. Key mechanisms include acting as the CDC’s main contact for rural health issues, identifying healthcare disparities in rural areas, and collaborating with other federal health offices to avoid duplication. The bill aims to address specific health access and outcomes gaps faced by people living in rural populations through targeted federal coordination and support.