The Veterans Medicare Premium Transparency Act requires Medicare to clearly explain how a veteran's enrollment in the Department of Veterans Affairs patient enrollment system affects their monthly insurance premiums. Under this bill, annual notices sent to Medicare beneficiaries will explicitly state that time spent in the VA system counts toward premium calculations and qualifies as valid prescription drug coverage. Additionally, the Secretary of Health and Human Services must post this explanation on the Medicare website and submit a report to Congress within 180 days detailing the updates and estimating how many veterans were previously paying higher premiums due to this lack of clarity.
The No Surprise Bills for New Moms Act updates federal health laws to ensure newborns receive immediate coverage for medical services within 30 days of birth. This legislation directly affects parents enrolled in group health plans, individual insurance policies, or employer-sponsored plans by mandating that these providers cover their newborns without requiring prior enrollment. The bill also requires insurers to offer a special enrollment period lasting at least 60 days after the initial coverage window and to notify parents immediately if a newborn is not enrolled when medical claims are submitted. By amending the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code, the law standardizes these protections across different types of health insurance coverage.
The Right to IVF Act of 2026 establishes federal protections to ensure individuals can access assisted reproductive technology and intrauterine insemination without state-imposed restrictions, while also mandating that health insurance plans, Medicare, Medicaid, and the Federal Employees Health Benefits program cover these services. The bill defines these procedures broadly to include treatments like egg and embryo freezing and requires coverage regardless of whether a patient has been diagnosed with infertility. It further directs the Department of Defense and the Department of Veterans Affairs to provide fertility preservation and reproductive assistance to uniformed service members and veterans, including funding for egg or sperm retrieval and storage. Additionally, the legislation grants federal courts the authority to challenge and block any state laws that limit access to these reproductive treatments or discriminate against providers and patients based on protected characteristics.
This bill, titled the Ensuring Kids Have Access to Medically Necessary Dental Care Act, modifies the Children's Health Insurance Program to expand dental coverage for low-income children and pregnant women. It mandates that states remove any lifetime or annual dollar limits on dental benefits for eligible participants and requires states to offer dental-only supplemental coverage instead of allowing them to opt out. The changes take effect six months after the law is enacted, ensuring that these specific groups receive consistent access to necessary dental services without financial caps.
This bill, titled the Ensuring Kids Have Access to Medically Necessary Dental Care Act, modifies the Children's Health Insurance Program to improve dental coverage for low-income children and pregnant women. It prohibits states from setting lifetime or annual dollar limits on dental benefits for eligible children and pregnant women receiving assistance. Additionally, the law requires states to provide dental-only supplemental coverage to certain children without offering them less favorable terms than those available to children receiving full dental benefits. These changes take effect six months after the bill is enacted.
The Alzheimer's Early Detection Act of 2026 requires private health insurance plans and Medicaid programs to cover specific tests that detect biological markers for Alzheimer's disease. These tests, which can be performed on blood or tissue samples, are intended to help with early detection, diagnosis, and treatment management of the condition. The law mandates that insurers treat these tests like other standard medical benefits, meaning patients cannot face higher costs, separate waiting periods, or step therapy hurdles specifically for this care. Additionally, the bill requires insurance companies to approve requests for these tests within 72 hours and directs the National Institutes of Health to study the value of such testing over three years.
The MediKids Act expands Medicaid eligibility to cover children and young adults up to age 26, regardless of their immigration status, and establishes a system for automatic enrollment of newborns that allows parents to opt out if other qualifying health coverage is available. The bill ensures that states provide full federal funding for these expanded groups and extends specific pediatric health services, such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), to individuals up to age 26. Additionally, the legislation modifies tax rules to prevent this new Medicaid coverage from counting as minimum essential coverage for the purpose of individual health insurance tax penalties.
The Cancer Drug Parity Act of 2026 requires group health plans and insurance coverage to treat the cost-sharing for oral cancer medications no less favorably than that for intravenously administered cancer drugs. This rule applies to FDA-approved oral cancer treatments that a treating physician deems medically necessary and clinically appropriate, ensuring that deductibles, copayments, and coinsurance rates are not higher for oral options. The legislation also prohibits plans from making changes that would increase out-of-pocket costs or impose stricter limitations on oral cancer drugs compared to injected ones, while still allowing for standard utilization controls like prior authorization. Additionally, the bill mandates a Government Accountability Office study within two years to assess the impact of these changes on patient costs and access.
The TRUTH in Coverage Act of 2026 requires group health plans and health insurance issuers that cover gender-affirming procedures to also cover medical services aimed at treating the physical and psychological harms caused by those procedures. This mandate applies regardless of whether the original procedure was covered under the plan and ensures that follow-up care has the same cost-sharing rules and limitations as other standard medical benefits. The bill defines "sex-rejecting procedures" broadly to include hormone therapy, surgeries, and puberty blockers, while explicitly excluding treatments for intersex conditions, precocious puberty, and emergency care. Coverage for these restorative services would become effective for plan years starting on or after January 1, 2027.
The TRUTH in Coverage Act of 2026 requires group health plans and health insurance issuers that cover gender-affirming procedures to also cover medical services intended to treat physical and psychological complications resulting from those procedures. This mandate applies regardless of whether the original gender-affirming treatment was covered by the plan and ensures that any required follow-up care faces the same cost-sharing rules and limitations as standard medical benefits. The bill defines "sex-rejecting procedures" broadly to include hormone therapy, surgeries, and puberty blockers, while explicitly excluding treatments for intersex conditions, life-threatening emergencies, and standard puberty suppression for early puberty. These provisions would take effect for plan years beginning on or after January 1, 2027, affecting individuals with access to employer-sponsored or individual health insurance.
