Healthcare (Insurance)

in committee · United States · Senate Mar 27, 2025

S 1164: Increasing Access to Dental Insurance Act

S 1164, the "Increasing Access to Dental Insurance Act," removes a barrier preventing people from purchasing standalone dental insurance through health insurance marketplaces. The bill amends the Affordable Care Act to prohibit the Secretary from blocking enrollment in dental plans offered via exchanges simply because a person isn't also enrolled in a separate health insurance plan. This change directly affects individuals seeking dental coverage who may not have comprehensive health insurance. The key mechanism is eliminating a prior restriction that required dental plan enrollment to be tied to a health insurance plan.

Topics ✓ HealthcareSupports HealthcareBill removes barrier to standalone dental insurance via health exchanges, expanding access to dental coverage under ACA, directly increasing health insurance options and patient access.95% confidence

Sub-Topics Insurance

Track

in committee · United States · Senate Jul 17, 2025

S 2356: ADAPT Act

The ADAPT Act (S 2356) expands Medicare coverage to include services provided by advanced psychology trainees - such as doctoral interns and postdoctoral residents in APA-accredited programs - under the general supervision of a licensed clinical psychologist (without requiring the supervisor's physical presence during services). It mandates the creation of a new billing code (GC modifier) for these services and directs the Department of Health and Human Services to issue guidance to states on covering these services under Medicaid and CHIP. This bill directly affects trainees, Medicare beneficiaries, and state Medicaid programs by streamlining access to mental health care through standardized billing and coverage mechanisms.

Topics ✓ HealthcareSupports HealthcareExpands Medicare coverage for mental health services by advanced psychology trainees, improving access to care under supervision and creating new billing protocols.95% confidence

Sub-Topics Children's Health Insurance Mental Health

Track

in committee · United States · Senate Mar 19, 2026

S 1677: Ensuring Lasting Smiles Act

This bill (S 1677, Ensuring Lasting Smiles Act) requires health insurance plans to cover medically necessary treatments for congenital anomalies or birth defects affecting the eyes, ears, teeth, mouth, or jaw. It mandates coverage for reconstructive services, dental/orthodontic care, and related treatments during the course of medical treatment, while excluding purely cosmetic procedures not medically necessary. Plans may apply cost-sharing requirements similar to those for other medical services but must provide notice about these coverage requirements to participants by January 1, 2026. The bill also directs a study on provider network adequacy and cost impacts related to these coverage requirements, to be completed by December 2027.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for medically necessary treatments of congenital anomalies, expanding access to essential health services without restricting benefits.95% confidence

Sub-Topics Insurance

Track

in committee · United States · House Nov 7, 2025

HR 5972: Right to Enroll Act of 2025

This bill extends the annual open enrollment period for health insurance marketplaces (Exchanges) to cover the 2026 plan year. It requires the Health and Human Services Secretary to adjust the enrollment window to begin November 1, 2025, and end May 1, 2026 - significantly lengthening the typical enrollment period. This change directly affects individuals and families purchasing health insurance through federal or state-based marketplaces who rely on the annual enrollment period to select or change coverage. The key provision modifies the existing enrollment timeline under the Affordable Care Act, providing a longer window for enrollment decisions.

Topics ✓ HealthcareSupports HealthcareExtends health insurance marketplace enrollment period, increasing access to coverage for individuals and families during the 2026 plan year.95% confidence

Sub-Topics Insurance

Track

in committee · United States · Senate Jan 28, 2025

S 276: Personalized Care Act of 2025

The Personalized Care Act of 2025 expands Health Savings Account (HSA) eligibility to include more types of health coverage, such as health care sharing ministries and certain government programs (like Medicaid, Medicare, and TRICARE). It significantly increases annual HSA contribution limits - from $2,250/$4,500 to $10,800/$29,500 for individuals/families - and allows HSA funds to pay for health plan premiums and medical care service arrangements (like fixed-fee physician contracts). The bill also explicitly treats health care sharing ministry fees as qualified medical expenses, removing barriers for members of these alternative coverage groups. These changes apply to taxable years beginning after December 31, 2025.

Topics ✓ Budget & TaxesSupports Budget & TaxesExpands tax-advantaged HSA eligibility and increases contribution limits, providing tax relief for healthcare costs under federal tax treatment.95% confidence ✓ HealthcareSupports HealthcareExpands HSA eligibility to Medicaid/Medicare, increases contribution limits, and allows HSA funds for premiums - enhancing patient access to healthcare savings.95% confidence ✓ VeteransSupports VeteransBill expands HSA eligibility to include TRICARE and increases contribution limits, directly benefiting veterans' healthcare financial options75% confidence

Sub-Topics Insurance Medicaid Medicare

Track

in committee · United States · House Nov 21, 2025

HR 6255: Affordable Insulin Now Act

HR 6255, the Affordable Insulin Now Act, requires health insurance plans (including employer-sponsored and individual plans) to cover specific insulin products starting in 2026. It caps out-of-pocket costs for these insulin products at $35 per 30-day supply or 25% of the negotiated price, whichever is lower, with no deductibles applied. The bill defines "selected insulin products" to include at least one of each dosage form (like vials or pumps) and type (such as rapid-acting or long-acting) available from the plan. This directly affects people with diabetes who rely on insulin, ensuring more predictable and affordable access to essential medications under their health coverage.

Topics ✓ HealthcareSupports HealthcareCaps insulin costs at $35/month, mandates coverage without deductibles, improving patient access to essential medication.95% confidence

Sub-Topics Insurance Prescription Drugs

Track

in committee · United States · Senate Jun 12, 2025

S 2057: Easy Enrollment in Health Care Act

The Easy Enrollment in Health Care Act (S 2057) creates a system that allows taxpayers to use their federal tax returns to determine eligibility for health insurance programs and automatically enroll household members in coverage with no out-of-pocket costs (zero net premium) if eligible. The bill establishes a process where taxpayers can consent to sharing tax return information (with privacy protections) with health insurance exchanges to determine eligibility for Medicaid, CHIP, or subsidized marketplace plans, eliminating the need for separate applications. It creates a "single, streamlined application" that minimizes the information needed from taxpayers by leveraging existing tax data for eligibility determinations, with procedures for error correction and privacy safeguards. The program is designed to simplify enrollment in health insurance programs by using tax return information, with implementation required by January 1, 2028.

Topics ✓ HealthcareSupports HealthcareAutomates enrollment in Medicaid/CHIP with zero cost, expanding access to health coverage without restricting programs.95% confidence

Sub-Topics Children's Health Insurance Medicaid

Track

in committee · United States · Senate Jun 11, 2025

S 2024: ENROLL Act of 2025

The ENROLL Act of 2025 amends the Affordable Care Act to strengthen the navigator program that helps people enroll in health insurance. It requires state and federal exchanges to award grants to navigators based on their capacity to provide services, not whether they cover non-qualified health plans, and mandates annual grants to community-focused nonprofits. Navigators must now provide information about Medicaid and CHIP programs in plain language and maintain physical presence in their states for in-person assistance. The bill allocates $100 million annually from health insurer user fees to fund federal exchange navigators starting in fiscal year 2026. These changes directly affect navigators, state/federal health insurance exchanges, and consumers seeking coverage.

Topics ✓ HealthcareSupports HealthcareStrengthens navigator program for insurance enrollment, mandates Medicaid/CHIP info in plain language, and funds community nonprofits to improve healthcare access under ACA.95% confidence

Sub-Topics Children's Health Insurance Medicaid

Track

in committee · United States · House Nov 20, 2025

HR 6166: Lowering Drug Costs for American Families Act

This bill expands Medicare's drug price negotiation program to cover 50 drugs (up from 20) and requires health insurers to apply negotiated prices to cost-sharing for beneficiaries. It establishes annual out-of-pocket cost-sharing limits for prescription drugs under group health plans and insurance coverage, with specific limits of $2,000 for self-only coverage in 2027 that will increase annually. The bill also sets specific cost-sharing limits for insulin products, requiring coverage with no deductible and cost-sharing of no more than $35 per 30-day supply or 25% of the negotiated price. These provisions affect Medicare beneficiaries, people with group health plans, and health insurers across the country. The bill applies to plan years beginning on or after January 1, 2027.

Topics ✓ HealthcareSupports HealthcareExpands Medicare drug negotiations, sets out-of-pocket limits, and caps insulin costs - directly lowering patient expenses and improving access to prescription drugs.95% confidence

Sub-Topics Insurance Medicare Prescription Drugs

Track

in committee · United States · House Apr 1, 2025

HR 2529: Convenient Contraception Act

This bill requires health insurance plans (including employer-sponsored and individual plans) to cover up to a full year's supply of contraceptives in a single fill, without copays or deductibles. It applies to all contraceptives already covered under existing law, making it easier for insured individuals to access longer-term supplies. The policy change takes effect for plan years beginning January 1, 2026, and mandates government outreach to inform providers and enrollees about the new coverage option.

Topics ✓ HealthcareSupports HealthcareExpands insurance coverage for contraceptives without cost-sharing, improving patient access to essential healthcare services.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentMandates employer health plans to cover contraceptives without cost-sharing, expanding healthcare benefits for workers as part of employment-based health coverage.85% confidence

Sub-Topics Insurance Women's Health

Track