Adam B. Schiff

Supporting provisions

“Protecting Health Care and Lowering Costs Act This bill makes permanent temporary provisions that generally expand eligibility for and increase the amount of the premium tax credit.”

“This bill also repeals multiple Medicaid, Medicare, and health-related tax provisions enacted by the One Big Beautiful Bill Act (OBBBA).”

“Currently, eligible taxpayers may claim the premium tax credit, which applies toward the cost of obtaining health insurance through health insurance exchanges.”

“For 2021-2025, the maximum income limit is eliminated, which generally expands eligibility for the premium tax credit.”

“For 2021-2025, the applicable percentages are lowered and the adjustment of the applicable percentages for inflation is eliminated, which generally increases the amount of the premium tax credit.”

“The bill permanently eliminates the 400% maximum income limit, lowers the applicable percentages, and eliminates the inflation adjustment for the applicable percentages.”

Supporting provisions

“Equitable Community Access to Pharmacist Services Act This bill provides for permanent coverage under Medicare of certain pharmacist services.”

“Specifically, the bill provides for permanent coverage of testing and treatment services provided by pharmacists relating to (1) COVID-19, influenza, respiratory syncytial virus (RSV), and streptococcal pharyngitis (strep throat); and (2) other public health needs in relation to a declared public health emergency.”

Supporting provisions

“Equal Health Care for All Act This bill prohibits the inequitable provision of health care (i.e., failure to meet a high-quality care standard that is discriminatory in intent or effect) based on race, religion, or other characteristics.”

“It also revises reporting requirements, adds equity-related measures to certain Medicare programs, and makes other changes to reduce health disparities.”

“To enforce the prohibition, the Department of Health and Human Services (HHS) must establish an administrative process to resolve complaints about inequitable health care.”

“HHS must investigate these complaints and mediate agreements to resolve issues. In the event of noncompliance with a mediated agreement, an aggrieved individual may bring a civil action.”

“HHS may exclude from federal health care programs providers HHS determines engaged in the inequitable provision of health care.”

“The Department of Justice may bring civil actions against health care providers to enforce the prohibition, including for punitive damages.”

Opposing provisions

“Additionally, the Centers for Medicare & Medicaid Services must include measures related to equitable health care in the Medicare value-based purchasing program for hospitals.”

“This program provides incentive payments based on quality of care. The bill also establishes (1) the Federal Health Equity Commission to monitor implementation of the bill, and (2) grants for hospitals to promote equitable health care.”

Supporting provisions

“Disaster Relief Medicaid Act This bill establishes a series of programs and requirements relating to Medicaid coverage of individuals affected by a federally declared major disaster, national emergency, or public health emergency.”

“In particular, the bill provides for specific coverage under Medicaid for individuals who meet specified income eligibility standards and were either residents of the impacted area or were employed in the impacted area (and subsequently lost employment).”

“Coverage is effective for two years after the date of the disaster or emergency declaration.”

“State Medicaid programs must provide coverage that is at least as comprehensive as the state's Medicaid coverage and the Medicaid coverage of the individual's home state, as applicable.”

“The bill applies a 100% Federal Medical Assistance Percentage (i.e., federal matching rate) to such coverage and related administrative expenses.”

Supporting provisions

“Improving Seniors' Timely Access to Care Act of 2025 This bill establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans.”

“Specifically, MA plans must (1) establish an electronic prior authorization program that meets specified standards; (2) annually submit to the CMS for publication specified prior authorization information, including the percentage of requests approved and the average response time; and (3) meet other standards, as set by the Centers for Medicare & Medicaid Services (CMS), relating to the quality and timeliness of prior authorization determinations.”

“The CMS and the Office of the National Coordinator for Health Information Technology must publish on the CMS' website a report that analyzes the information received from MA plans, the feasibility of implementing real-time decision making with respect to prior authorization requests, and the impact of decisions that are made using artificial intelligence on patient access.”