The Preserving Access to Home Health Act of 2023 repeals a 2018 payment adjustment for Medicare home health agencies, restoring prior payment rates for 2024 and subsequent years. It requires the Medicare Payment Advisory Commission (MedPAC) to analyze how home health agencies' financial performance affects access to care, including reviewing spending and utilization data across Medicare, Medicaid, and other payers. Starting in 2025, the bill mandates home health agencies to report detailed data on visit volumes and payments by payer source (Medicare, Medicaid, private insurers) through updated cost reports. This data will help MedPAC assess payment policy impacts on access to home health services for Medicare beneficiaries.
HR 5008, the HEAL for Immigrant Families Act of 2023, would remove immigration status as a barrier to health insurance coverage for immigrants in the United States. The bill would make all lawfully present immigrants, including those with Deferred Action for Childhood Arrivals (DACA) status, eligible for Medicaid, CHIP, and Affordable Care Act health insurance subsidies. It would eliminate state-level restrictions on Medicaid eligibility for immigrants and allow individuals with federally authorized presence to access premium tax credits and cost-sharing reductions. This legislation aims to address health coverage disparities that disproportionately affect immigrant communities, particularly Black, Indigenous, Latinx, and other communities of color.
The Lowering Drug Costs for American Families Act expands Medicare's drug price negotiation program from 20 to 50 drugs, allowing the government to negotiate lower prices for these medications. It requires private health insurance plans and group health coverage to apply these negotiated prices to their members' cost-sharing for covered drugs, with plans able to opt out while publicly disclosing their decision. The bill also extends these negotiated prices to drugs covered by commercial insurance markets, not just Medicare. This would directly affect Medicare beneficiaries and people with private health insurance who take the negotiated drugs.
The 9-8-8 Implementation Act of 2023 establishes a national mental health crisis response system centered around the 9-8-8 suicide prevention hotline. It provides $441 million for call center technology, staffing, and operations, and requires Medicare, Medicaid, and private health plans to cover crisis response services including mobile crisis teams and crisis stabilization facilities. The bill also mandates a national suicide prevention media campaign and creates protocols for 9-1-1 dispatchers to better respond to mental health crises. These provisions aim to improve access to mental health crisis care across the United States.
The Physical Therapist Workforce and Patient Access Act of 2023 expands the National Health Service Corps to include physical therapists in its loan repayment program and creates designated "physical therapy health professional target areas" for their assignment in underserved communities. It also amends Medicare to cover physical therapy services provided by physical therapists at Rural Health Clinics and Federally Qualified Health Centers, effective January 1, 2025. This directly affects physical therapists by offering new career pathways in underserved areas and patients in those communities by increasing access to physical therapy services for conditions like pain management and rehabilitation. The bill does not alter existing eligibility requirements for physical therapists but formally integrates their services into key federal healthcare programs.
The Access to Infertility Treatment and Care Act would require most health insurance plans to cover infertility treatment (including assisted reproductive technology like IVF) and fertility preservation services for people undergoing medical treatments that might cause infertility, such as cancer therapies. It prohibits cost-sharing (like deductibles and copays) for these services that exceeds what's charged for similar medical services and applies to private insurance, federal employee health plans, TRICARE, veterans' benefits, and Medicaid programs. The bill also requires insurers to provide clear notice to plan members about these coverage requirements. This legislation aims to ensure infertility treatment is covered similarly to other medical conditions, as recognized by medical organizations.
HR 4752 (the CHANGE Act of 2023) requires Medicare to include standardized cognitive impairment screening during annual wellness visits and initial preventive physical exams for beneficiaries starting in 2024. It mandates doctors use National Institute on Aging-approved tools to detect memory issues and document results in medical records. This directly affects Medicare patients aged 65+ and their healthcare providers, aiming to enable earlier Alzheimer’s diagnosis and care planning. The bill focuses on making routine screenings a standard part of Medicare-covered checkups, not on funding or new programs. It does not alter existing Medicare benefits but adds a specific screening requirement to two existing service categories.
The Social Security 2100 Act would significantly enhance Social Security benefits for millions of Americans by increasing monthly payments for retirees, disabled workers, widows/widowers, and children. Key provisions include raising the minimum benefit for long-term low earners, improving cost-of-living adjustments using a more accurate index, eliminating the 5-month waiting period for disability benefits, and extending child benefits to age 26. The bill also changes how Social Security taxes are calculated by applying them to income above $400,000 and establishes a unified Social Security Trust Fund to manage program finances. Most provisions would apply to benefits payable from 2025 through 2034, affecting all current and future Social Security beneficiaries.
This 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.
The PrEP Access and Coverage Act of 2023 requires private health insurance plans, Medicare, Medicaid, and other public health programs to cover pre-exposure prophylaxis (PrEP) for HIV prevention without cost-sharing, including the medication, related lab tests, and follow-up care. The bill also prohibits life, disability, and long-term care insurance companies from denying coverage or charging higher premiums to people taking PrEP. It establishes public education campaigns to increase awareness of PrEP and PEP (post-exposure prophylaxis) and creates funding for state and community programs to expand access to HIV prevention services, particularly for populations disproportionately affected by HIV including Black, Hispanic/Latinx, and transgender individuals. The legislation specifically addresses current disparities in PrEP access, as data shows only 11% of Black/African American and 21% of Hispanic/Latinx individuals eligible for PrEP received prescriptions in 2022 compared to 82% of White individuals. Coverage requirements for most plans will take effect on January 1, 2025.
This bill, the Public Servants Protection and Fairness Act of 2023, amends Social Security to better protect public servants who work in jobs not covered by Social Security (such as certain government positions). It creates a new formula for calculating retirement benefits that combines both covered and noncovered earnings, ensuring public servants receive the higher of two benefit calculations. The bill also provides an additional $150 monthly payment for certain public servants whose benefits were previously reduced by the windfall elimination provision. It improves Social Security account statements to clearly show noncovered earnings and requires a study of how state retirement plans handle these benefits. These changes will apply to benefits starting in 2025.
HR 4195, the Empowering Parents’ Healthcare Choices Act of 2021, allows parents to choose which health insurance plan covers their child when both parents have separate, qualifying coverage (e.g., individual policies or employer-sponsored group plans). Specifically, parents must submit a joint notification within 60 days of the child’s birth to designate one plan as primary coverage. This choice remains in effect until parents revoke it or one parent loses coverage under their plan. The bill applies to children born on or after January 1, 2022, and affects families with dual coverage, insurance issuers, and group health plans.
