Healthcare (Medicare)

The American Patients First Act of 2026 establishes a new payment rate of $457 per square centimeter for skin substitute products used in Medicare between 2027 and 2030, provided these products are manufactured entirely within the United States using domestically sourced materials. To ensure compliance, the bill defines these products as those made from U.S. human tissue or synthetic materials and requires that all harvesting, processing, and manufacturing occur exclusively in the country, though the Secretary of Health and Human Services may grant temporary waivers for up to 180 days if domestic supply shortages threaten patient access. The legislation also introduces stricter oversight measures, including prepayment claim reviews, prior authorization requirements for certain providers, and limits on payment if a product was purchased for less than a specific threshold price. Additionally, the act mandates that only providers certified by specific wound care organizations can bill for these products and restricts reimbursement for wastage or repeated applications without clinical improvement. Finally, the bill requires the HHS to submit a report to Congress by 2030 analyzing the cost of producing these products and evidence of their effectiveness.

The Medicare at Home Act would expand Medicare coverage to include up to 20 hours per week of personal care services for seniors and people with disabilities in their own homes. To qualify, individuals must be enrolled in Medicare and certified by a doctor as needing assistance with at least two daily living tasks, such as bathing or dressing, while not already receiving duplicate long-term care from state programs. The bill requires a physician to create a care plan that includes help with activities like meal preparation and medication reminders, and it mandates a wage floor for home care workers. Financing for this new benefit would come through adjustments to monthly Medicare premiums, with specific rules set for how payments are made to agencies and individuals providing the care.

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, the Medicare Access to Radiology Care Act of 2026, allows Medicare to pay for services provided by radiologist assistants under the supervision of a radiologist. It defines radiologist assistants as certified professionals who work strictly under a radiologist's direction and clarifies that they cannot independently interpret imaging results. The legislation authorizes Medicare to reimburse these assistants for services performed in hospitals, ambulatory surgical centers, and other specified settings, with the payment directed to the supervising radiologist. These changes take effect on January 1, 2027, aiming to expand access to diagnostic imaging while maintaining existing safety standards.

This bill establishes federal protections and funding to expand access to in vitro fertilization and intrauterine insemination for individuals, military service members, and veterans. It requires most private health plans, Medicaid programs, and Medicare to cover these fertility treatments without imposing higher cost-sharing than other medical services. Additionally, the legislation mandates that the Department of Defense and the Department of Veterans Affairs provide specific fertility preservation and treatment benefits to uniformed service members and eligible veterans. The bill also includes preemption clauses that override state laws restricting these procedures and prohibits discrimination based on marital status, sex, or sexual orientation in the provision of care.

The Lainie Jones Comprehensive Cancer Survivorship Act of 2026 establishes a new Office of Cancer Survivorship within the National Cancer Institute to coordinate research and education focused on the long-term health needs of the 18 million Americans living with or beyond a cancer diagnosis. The bill mandates that Medicare and Medicaid cover specific services, including the creation of personalized care plans to help patients transition from active treatment to ongoing follow-up care, as well as fertility preservation and storage services for cancer patients. Additionally, the legislation creates a grant program to support cancer survivors in maintaining or returning to the workforce and requires the development of a new payment model to improve the quality and coordination of survivorship care.

The Green New Deal for Health Act establishes a comprehensive federal framework to address the intersection of climate change and public health by creating new offices, expanding funding, and mandating specific actions across the health care sector. It directly affects hospitals, health care providers, medical manufacturers, health professions schools, and communities identified as environmentally or medically underserved. Key provisions include establishing an Office of Climate Change and Health Equity to develop a national strategic action plan, requiring hospitals to provide detailed notifications and mitigation plans before discontinuing services or closing, and offering grants to modernize medical facilities for climate resilience. The bill also mandates that the health care sector disclose climate risks associated with medical supplies, expands Medicare coverage for home resiliency services like heat pumps for vulnerable patients, and allocates billions in funding to train health workers on climate-related health risks. Additionally, the legislation creates a research initiative to study climate impacts on health and establishes requirements for green, zero-emission medical manufacturing and supply chains.

The CHARTS Act authorizes $5 million over two years to provide grants to long-term care and post-acute care providers, such as nursing facilities and home health agencies, for implementing specific health information technology systems. These funds, capped at $500,000 per provider, must be used to develop tools that enable real-time data sharing among doctors, insurers, and government programs while improving care coordination and reducing duplicate services. The Department of Health and Human Services will prioritize grants for facilities serving Medicare and Medicaid beneficiaries and will ensure recipients represent a diverse range of geographic and demographic populations. Additionally, the bill requires the agency to submit reports evaluating how these technologies impact patient outcomes, costs, and care transitions over a six-year period.

The PREVENT ESRD Act establishes a ten-year demonstration program to help prevent kidney disease from progressing to end-stage renal disease, which places a heavy financial burden on Medicare. Starting in 2027, the program invites private health plans, Medicaid programs, and other insurers to voluntarily join an initiative where they must cover specific kidney care services, such as screenings, medications, and nutrition support, with little to no cost to patients. Participating plans can earn shared savings payments from Medicare if they successfully reduce the rate of kidney disease progression compared to a benchmark based on their historical data, provided they maintain high quality of care and do not avoid enrolling high-risk patients. The legislation also requires the Department of Health and Human Services to hold listening sessions and gather public input to refine the program's scope and ensure it meets the needs of patients and providers.

The Medicare Dental Benefit Act of 2026 would expand Medicare coverage to include a range of dental and oral health services, such as cleanings, fillings, root canals, and dentures, starting on January 1, 2028. Under the bill, routine preventive care like exams and cleanings would be covered without cost-sharing, while other services would begin with no payment in the first year and gradually increase to cover 80 percent of costs over seven years. The legislation includes specific limits, such as capping coverage for cleanings and exams at two per year and restricting full or partial dentures to once every five years, though the Secretary of Health and Human Services has the authority to modify these rules or waive limits for low-income individuals. Additionally, the act increases federal funding to help states cover the cost-sharing amounts for Medicare beneficiaries who receive these new dental benefits.