Rep. Nancy Mace

Safe Step Act This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer.  A request for such an exception to the protocol must be granted if (1) an otherwise required treatment has been ineffective, (2) such treatment is expected to be ineffective and delaying effective treatment would lead to irreversible consequences, (3) such treatment will cause or is likely to cause an adverse reaction to the individual, (4) such treatment is expected to prevent the individual from performing daily activities or occupational responsibilities, (5) the individual is stable based on the prescription drugs already selected, or (6) there are other circumstances as determined by the Employee Benefits Security Administration. The bill requires a group health plan to implement and make readily available a clear process for an individual to request an exception to the protocol, including required information and criteria for granting an exception. The bill further specifies timelines under which plans must respond to such requests.

Luke and Alex School Safety Act of 2021 This bill requires the Department of Homeland Security (DHS) to establish a Federal Clearinghouse on School Safety Best Practices for use by state and local educational and law-enforcement agencies, institutions of higher education, health professionals, and the public. The bill requires DHS to collect clearinghouse data analytics, user feedback on the implementation of best practices and recommendations identified by the clearinghouse, and any evaluations conducted on these best practices and recommendations. In addition, DHS must coordinate with the Departments of Education, Health and Human Services, and Justice to assess and identify best practices and recommendations and establish an advisory board to provide feedback and propose additional recommendations. Further, the bill specifies the criteria for best practices and recommendations of the clearinghouse, including evidence that the best practice or recommendation has had a significant effect on improving the health, safety, and welfare of individuals in school settings. Finally, the bill provides for grant program review.

Heartbeat Protection Act of 2021 This bill makes it a crime for a physician to knowingly perform an abortion (1) without determining whether the fetus has a detectable heartbeat, (2) without informing the mother of the results, or (3) after determining that a fetus has a detectable heartbeat. It provides an exception for an abortion that is necessary to save the life of a mother whose life is endangered by a physical (but not psychological or emotional) disorder, illness, or condition. A physician who performs a prohibited abortion is subject to criminal penalties—a fine, up to five years in prison, or both. A woman who undergoes a prohibited abortion may not be prosecuted for violating or conspiring to violate the provisions of this bill.

Born-Alive Abortion Survivors Protection Act This bill establishes requirements for the degree of care a health care practitioner must provide in the case of a child born alive following an abortion or attempted abortion. Specifically, a health care practitioner who is present must (1) exercise the same degree of care as would reasonably be provided to any other child born alive at the same gestational age, and (2) ensure the child is immediately admitted to a hospital. Additionally, a health care practitioner or other employee who has knowledge of a failure to comply with the degree-of-care requirements must immediately report such failure to law enforcement. A health care practitioner who fails to provide the required degree of care, or a health care practitioner or other employee who fails to report such failure, is subject to criminal penalties—a fine, up to five years in prison, or both. An individual who intentionally kills or attempts to kill a child born alive is subject to prosecution for murder. The bill bars the criminal prosecution of a mother of a child born alive under this bill and allows her to bring a civil action against a health care practitioner or other employee for violations.

Shellfish Aquaculture Improvement Act of 2021 This bill limits the ability of an aquaculture worker to bring a civil action against an employer for employment-related injuries. Specifically, the bill limits recovery for injuries sustained by an aquaculture worker if (1) state workers' compensation is available to such individual; and (2) at the time of injury, the individual was engaged in aquaculture in a place where the individual had lawful access. An aquaculture worker is an individual employed by commercial enterprises involved in the controlled cultivation and harvest of aquatic plants and animals, including the cleaning, processing, or canning of fish and fish products, the cultivation and harvesting of shellfish, and the controlled growing and harvesting of other aquatic species.

Huntington's Disease Disability Insurance Access Act of 2021 This bill expedites payment of Social Security Disability Insurance (SSDI) benefits and eligibility for Medicare coverage for those with Huntington's disease. This is an inherited disorder that causes brain cells to die, including in areas of the brain that help to control voluntary movement. Specifically, the bill eliminates the 5-month waiting period for SSDI benefits and the subsequent 24-month waiting period for Medicare coverage for individuals with Huntington's disease. Under current law, individuals generally must wait five months after the onset of disability to begin receiving SSDI benefits and an additional 24 months to become eligible for Medicare.

Let States Cut Taxes Act This bill removes a prohibition on states and territories using COVID-19 (i.e., coronavirus disease 2019) relief funding under the American Rescue Plan Act of 2021 to offset a reduction in revenue resulting from a reduction in taxes or a delay in the imposition of a tax or tax increase.

Cost Openness and Spending Transparency Act of 2021 or the COST Act This bill requires recipients of federal funds to disclose financing information relating to programs, projects, or activities carried out using such funds. Specifically, such a recipient (including a state or local government or a recipient of a federal research grant) must clearly state in any press release, request for proposal, bid solicitation, or other document describing the activity the amount and percentage of federal funding and the amount and percentage of nongovernmental funding. If the Office of Management and Budget determines that a recipient is failing to comply, it may direct each agency providing federal funds to withhold up to 25% of the funds until the recipient complies.

Pharmacy Benefit Manager Accountability Study Act of 2021 This bill requires the Government Accountability Office to report on the role of pharmacy benefit managers in the pharmaceutical supply chain and recommend legislative actions to lower the cost of prescription drugs. The report must address the use of rebates and fees, the average prior authorization approval time, and the use of step therapy within the 10 largest pharmacy benefit managers.

Highway Formula Fairness Act This bill modifies the formula that the Department of Transportation uses to apportion federal highway funds among the states for the national highway performance program, the surface transportation block grant program, the highway safety improvement program, the congestion mitigation and air quality improvement program, the national highway freight program, and metropolitan transportation planning.