HR 1769, the Healthcare Freedom Act of 2023, amends the tax code to rename "health savings accounts" as "health freedom accounts" and expands their use. It allows individuals to use these accounts for direct primary care, health care sharing ministries, and medical cost sharing organizations, increases annual contribution limits to $12,000 (or $24,000 for joint returns), and permits rollovers between accounts within 60 days. Employers may contribute to these accounts for employees hired after a 5-year transition period, with those contributions excluded from taxable income. The bill directly affects individuals using these accounts, employers offering them, and the IRS in tax administration, without changing health insurance coverage requirements.
HR 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.
HR 1399, the "Protect Children's Innocence Act," prohibits medical gender-affirming care for minors under 18 by making it a class C felony for providers to perform such care. The bill defines gender-affirming care broadly to include surgical procedures, hormone treatments, and certain cosmetic procedures, with exceptions for medical conditions like reproductive cancers or intersex conditions. It prohibits federal funding for gender-affirming care through programs like Medicaid, Medicare, and the Affordable Care Act, and bans such care in federal health facilities. The bill also prevents institutions of higher education from teaching gender-affirming care and adds immigration consequences for individuals who provide such care to minors.
This bill repeals specific provisions from the Affordable Care Act and its 2010 amendment that restricted certain physician referrals to hospitals under Medicare. It directly affects hospitals and physicians who previously faced limitations on referring Medicare patients to facilities they owned or had financial ties with. The key mechanism restores the original rules that allowed such referrals without the prior restrictions, effectively undoing the 2010 changes. This is a procedural change to existing law, not a new policy.
The Secure the Border Act of 2023 is a comprehensive immigration bill that focuses on strengthening border security, reforming asylum processes, and updating employment verification systems. The bill requires the immediate resumption of border wall construction, mandates specific staffing levels for Border Patrol agents, and establishes new technology investment plans for Customs and Border Protection. It also introduces stricter asylum eligibility rules, expands penalties for visa overstays, and creates a new employment eligibility verification system that requires employers to check worker authorization status. Additionally, the bill includes provisions for family detention standards, child repatriation policies, and increased funding for border security operations while prohibiting certain types of funding for organizations that facilitate illegal immigration.
This bill amends the Social Security Act to exclude wages earned and self-employment income derived from unauthorized employment in the United States from being counted toward Social Security credits. It directly affects undocumented immigrants who work without authorization, preventing those earnings from contributing to their future Social Security benefits. The law changes existing Social Security rules by adding specific exclusions for "service performed by an alien while employed... not authorized to be so employed" and similar self-employment activities. These changes apply to all wages and income earned before, during, or after the bill's enactment, with Social Security recompiling existing benefit calculations to reflect the new rules.
This bill permanently expands Medicare telehealth coverage for specific mental health services. It adds 20 new HCPCS codes (like 90875 for therapy and 96125 for counseling) to Medicare's telehealth list, allowing audio-only sessions for certain services starting April 2023. The key change waives the requirement for video technology in telehealth, permitting audio-only visits when clinically appropriate and no in-person visit is needed first. This directly affects Medicare beneficiaries seeking mental health care, particularly in rural or underserved areas with limited video access, and the providers serving them. The policy change makes accessing behavioral health services via telehealth more flexible and accessible under Medicare.
HR 497, the Freedom for Health Care Workers Act, eliminates a federal requirement for healthcare workers in Medicare and Medicaid programs to be vaccinated against COVID-19. The bill directly affects healthcare providers who treat patients under these federally funded programs by preventing the enforcement of the November 2021 HHS rule mandating staff vaccinations. Its key provision prohibits the Department of Health and Human Services from implementing, enforcing, or creating a similar rule regarding vaccination for these workers. This bill changes the policy by removing a specific vaccine mandate for providers in Medicare and Medicaid programs.
HR 407, the "Protect the UNBORN Act," prohibits federal agencies from implementing or enforcing two specific executive orders issued by President Biden in 2022 (Executive Orders 14076 and 14079), which aimed to protect access to reproductive healthcare services. The bill bans the use of federal funds, including those from the 2022 Consolidated Appropriations Act, to carry out, administer, or enforce these executive orders. It directly affects federal agencies and programs that would otherwise comply with the Biden administration's policies on reproductive healthcare access. The bill does not create new healthcare rules but blocks the implementation of existing executive actions.
HR 114, the "Fund and Complete the Border Wall Act," establishes a Secure the Southern Border Fund to finance border barrier construction and maintenance along the U.S.-Mexico border. The bill creates a 5% fee on remittance transfers to foreign countries and increases Form I-94 processing fees, with portions of these fees directed to the fund. It requires the Department of Homeland Security to report annually on illegal border crossings and sets a December 31, 2023, deadline for completing border barriers. The legislation also includes provisions for border patrol agent compensation and allows the Secretary of Homeland Security to waive legal requirements to expedite border wall construction.
HR 119, the Freedom from Mandates Act, removes federal requirements for COVID-19 vaccination or testing in several key areas. It specifically nullifies Executive Orders 14042 (for federal contractors' safety protocols) and 14043 (for federal employee vaccinations), and prohibits the Secretary of Labor from requiring private employers to mandate vaccines or testing for employees. Additionally, it bars the Secretary of Health and Human Services from making vaccination or testing a condition for healthcare providers to participate in Medicare or Medicaid programs. The bill directly affects federal contractors, federal employees, private employers, and healthcare providers participating in federal health programs by eliminating these specific mandates.
This bill creates a 2-year moratorium on new hospital registrations for the 340B drug discount program, which provides discounted prescription drugs to certain hospitals serving low-income patients. It establishes strict eligibility criteria for hospitals to participate in the program, including requirements for outpatient services, Medicare cost report documentation, and adherence to charity care policies. The bill mandates detailed annual reporting of financial information about 340B drug purchases, including revenue, acquisition costs, patient payment sources, and charity care costs, with this data made publicly available. It also requires the use of a specific "340B modifier" (JG) on claims for reimbursement of 340B drugs across Medicare, Medicaid, and other programs. These provisions aim to increase transparency and accountability in how hospitals use the 340B program.
