HR 7566 establishes a federal pilot program to provide competitive grants for job guarantee programs in high-unemployment areas. Eligible entities (like states, tribes, or rural communities with unemployment at least 150% of the national rate) must offer jobs to all adults (18+) residing in their area, with wages meeting or exceeding prevailing rates, health insurance comparable to federal benefits, and paid family/sick leave. The program requires supportive services (childcare, training), prohibits displacing existing workers, and mandates annual audits. It runs for up to 3 years in 15 pilot sites, with evaluations tracking impacts on employment, poverty, and environmental outcomes.
This bill (HR 2199) prevents private health insurance plans from discriminating against patients with end-stage kidney disease (ESRD) who require dialysis. It amends the Social Security Act to prohibit plans from treating dialysis coverage differently than other medical services or applying network restrictions that disproportionately harm ESRD patients. The law clarifies that plans cannot deny or limit benefits for dialysis based on a patient’s diagnosis, while preserving a plan’s right to choose which dialysis providers are in their network. It directly affects ESRD patients and their private health insurance coverage, ensuring dialysis is treated equally with other covered medical services. The bill does not require plans to include specific dialysis providers but stops them from unfairly restricting access to necessary care.
HR 6682, the Endometriosis CARE Act, requires federal agencies to advance research, improve treatment access, and increase awareness for people with endometriosis - a chronic condition causing pelvic pain and fertility challenges affecting an estimated 10% of reproductive-age individuals. The bill mandates $50 million annually for NIH research on endometriosis treatments and cures, directs HHS to analyze barriers like insurance coverage and provider shortages in accessing care, and funds public education campaigns targeting underserved racial, ethnic, and minority groups. It also requires HHS to develop provider training materials on diagnosis and care, and to commission a National Academies study on disparities in endometriosis treatment across race, geography, and insurance status. The legislation focuses on data collection, education, and research rather than altering existing insurance coverage or treatment protocols.
HR 2810, the Family Cord Blood Banking Act, allows individuals to deduct payments for private umbilical cord blood or tissue banking as medical expenses on their federal taxes. It directly affects people who pay for these private banking services through accredited providers meeting specific federal safety standards. The bill amends the tax code to add private cord banking services as a qualifying medical expense, effective for tax years starting after December 31, 2024. This change simplifies tax treatment for those using private cord banking without altering insurance coverage or public banking access.
Territories Health Equity Act of 2025 This bill alters provisions relating to the treatment of U.S. territories under Medicaid, Medicare, and Medicare Advantage. For example, the bill eliminates Medicaid funding limitations for U.S. territories beginning in FY2026, exempts an individual from late-enrollment penalties for Medicare medical services if the individual resided in Puerto Rico as of the date of eligibility and the individual enrolls within five years of such date, and establishes minimum criteria for certain elements used in Medicare Advantage payment calculations for areas within U.S. territories. The bill also allows residents of U.S. territories who are unable to obtain health insurance through their employer or a health insurance exchange to instead obtain coverage that is at least as broad as the coverage available to Members of Congress and their staff through the District of Columbia exchange.
HR 4710, the No Surprises Act Enforcement Act, increases penalties for health insurance plans and issuers that violate balance billing protections, which prevent surprise medical bills. The bill raises fines from $100 to $10,000 per violation for specific balance billing rule violations and adds a new penalty of three times the difference between initial payment and out-of-network rates for late payments after Independent Dispute Resolution decisions. It requires health plans and nonparticipating providers to make timely payments within 30 days of a payment determination, with interest accruing on late payments. The bill also establishes new transparency reporting requirements for the Secretary to submit regular reports to Congress about audits, enforcement actions, and penalties. These provisions directly affect health insurance issuers, group health plans, and nonparticipating healthcare providers.
This bill extends and modifies the premium tax credit (subsidy) for health insurance purchased through the marketplace, applying to coverage for 2026 and 2027. It raises the income threshold for full subsidy eligibility from 400% to 600% of the federal poverty level, meaning more low-to-moderate-income households (up to 600% of poverty) will pay lower monthly insurance costs. The bill also adds new penalties for agents or brokers who provide false information during enrollment, including civil fines up to $50,000 per person and criminal charges for intentional fraud. These changes directly affect individuals buying health insurance through marketplaces and the agents/brokers who assist them.
This bill extends the Affordable Care Act's premium tax credit through 2028 (instead of 2026) and raises the household income eligibility cap from 400% to 700% of the federal poverty level. It allows individuals to receive advance credit payments directly into their Health Savings Accounts (HSAs) or to their insurance issuer, depending on their plan type and election. The bill also establishes a minimum monthly premium responsibility amount for coverage and requires federal agencies to verify immigration status for tax credit eligibility. These changes primarily affect low-to-moderate income individuals purchasing health insurance through the ACA marketplace.
HR 7227, the Mental Health and MAMA Act of 2026, eliminates cost-sharing (like copays or deductibles) for mental health and substance use treatment services during pregnancy and for one year after childbirth. It directly affects pregnant and postpartum individuals covered by group health plans or individual insurance policies, requiring these plans to cover such services with no out-of-pocket costs from pregnancy diagnosis through the 12-month period following birth. The law applies to in-network providers and includes telehealth services, with implementation delayed until two years after enactment. It amends key laws including the Public Health Service Act, ERISA, and the Internal Revenue Code to standardize this coverage requirement across health insurance systems. This policy change aims to improve access to care during a critical health period without altering existing coverage definitions.
The Choose Medicare Act would establish a new Medicare Part E public health plan available across individual, small group, and large group insurance markets. This plan would provide comprehensive coverage including all essential health benefits, gold-level coverage, and reproductive services, with premiums negotiated to be at least as favorable as current Medicare rates. The bill would create a $6,700 annual out-of-pocket spending limit for Medicare beneficiaries starting in 2027, require employers to refer employees without adequate coverage to navigators, and change premium assistance credits to use gold-level plans as the benchmark. It would also establish a $2 billion startup fund for the program and expand reduced cost-sharing for lower-income individuals.
