Healthcare (Medicaid)

Medicaid Personal Needs Allowance Modernization Act or the Medicaid PNA Modernization Act This bill increases the minimum monthly personal needs allowance under Medicaid for an institutionalized individual and couple from $30 to $60 and from $60 to $120, respectively. (The personal needs allowance is deducted from an individual's total income when determining the individual's contribution to the cost of institutionalized care under Medicaid.)

This bill would allow children in foster care who are placed in qualified residential treatment programs to receive Medicaid coverage for their medical services. It directly affects state child welfare systems and healthcare providers by removing a federal exclusion that currently prevents Medicaid from covering institutional care for these children. The law amends the Social Security Act to exempt these children from the Medicaid Institutional Medicaid Days (IMD) exclusion, which typically denies coverage for services provided in institutions. The change would take effect for services provided on or after October 1, 2026, ensuring continuity of healthcare coverage for this vulnerable population.

The Safe Staffing Saves Lives Act establishes minimum nursing staffing levels in skilled nursing facilities and nursing facilities that receive Medicare and Medicaid funding. Beginning January 1, 2029, facilities must provide a total of 4.1 hours of nursing care per resident per day, including specific hours for registered nurses, licensed practical nurses, and nurse aides, with a registered nurse available onsite 24 hours a day. Facilities that fail to meet these requirements face increased inspection frequency, potential denial of payments for new residents, and must display notices about noncompliance at their entrances. The bill also requires facilities to provide written notice of staffing noncompliance to residents and their families, and mandates periodic reports to Congress on the impact of these staffing requirements.

This bill, the PrEP Access and Coverage Act of 2026, requires most health insurance plans to cover HIV prevention medication without charging patients any out-of-pocket costs. It directly affects people with private insurance, government health programs like Medicare and Medicaid, military health care, and the Indian Health Service. The law mandates that insurance companies cannot require pre-approval for these medications, cannot charge deductibles or copayments for them, and cannot deny or charge higher premiums for life, disability, or long-term care insurance based on someone taking HIV prevention medication. The bill also creates a new public education campaign to increase awareness about HIV prevention options and provides federal funding to states and community organizations to expand access to these services.

Essential Caregivers Act of 2025   This bill prohibits certain health care facilities from limiting the access of essential caregivers to residents of those facilities, including during designated emergency periods.   Specifically, the bill generally prohibits Medicare skilled nursing facilities, Medicaid nursing facilities, Medicaid intermediate care facilities, and associated inpatient rehabilitation facilities from restricting the access of essential caregivers to residents of the facilities, including during emergency periods in which visitation rights are otherwise restricted. During emergency periods, facilities may restrict access for an initial period of up to seven days and for one additional maximum seven-day period (if the additional period is approved by the state health department). Facilities may restrict access for a total of 7 days (or 14 days with the approval of the state health department) during an emergency period. Essential caregivers must agree to comply with any safety protocols set by the facility, which may be no more stringent for caregivers compared to those for staff. Caregivers who fail to comply with these requirements may be denied access, subject to an appeals process.

The Make Billionaires Pay Their Fair Share Act (S. 3956) imposes a new 5% annual wealth tax on individuals and trusts whose net assets exceed $1 billion, with the threshold adjusted for inflation. The bill also expands Medicare coverage to include dental, hearing, and vision services, establishes a $60,000 minimum annual salary for public school teachers, and creates a birth-through-five child care entitlement program for families with income up to 250% of state median income. Additional provisions include permanent extensions of Medicaid protections for home and community-based services, increased funding for housing trust funds, and expanded child care and early learning support for working families.

The PATCH Act modifies how Medicare calculates payment rates for physicians providing services in Hawaii starting January 1, 2026. It requires the Centers for Medicare & Medicaid Services to set the work geographic index at a minimum of 1.5 for Hawaii, even if the calculated rate would be lower. This change directly affects physicians who bill Medicare for services in Hawaii by ensuring their reimbursement rates meet a specific threshold. The bill does not apply to other payment systems or states.

HR 3482, the Veterans Community Care Scheduling Improvement Act, requires the VA to replace its current process for scheduling community care appointments with a new IT system. The bill mandates that VA schedulers use this system to book appointments for veterans at non-VA providers participating in the Veterans Community Care Program, allowing them to view, search, and schedule appointments by care type, location, and date. Non-VA providers must be encouraged to join the program through VA outreach, including a public website with participation details. The new system must be implemented within 90 days for regulations and one year for full operation, with reporting requirements to Congress. This change directly affects veterans seeking community care and non-VA providers participating in the program.

This bill expands a pilot program allowing the Department of Veterans Affairs (VA) to accept donated facilities and related improvements. It specifically adds "minor construction or nonrecurring maintenance projects" to the types of donations the VA can accept, broadening the scope beyond just property. The program, originally set to expire in 2026, is extended through December 2031. This change directly affects the VA and potential donors (like community organizations) seeking to support veterans' facilities through donations of property or small-scale projects.

The Equal Health Care for All Act requires health care providers to collect and report disaggregated health data by race, national origin, sex, disability, and age to identify health disparities. It establishes an Office for Civil Rights and Health Equity within HHS to enforce anti-discrimination measures and creates a Federal Health Equity Commission to monitor implementation. The bill prohibits health care providers from delivering inequitable care based on protected characteristics and provides grants to hospitals to improve equitable care through bias training, translation services, and workforce diversity initiatives. Hospitals would need to incorporate equitable health care measures into value-based purchasing programs starting in 2026. This legislation aims to address systemic health care inequities affecting marginalized communities through data collection, enforcement mechanisms, and targeted support for health care providers.