Assuring Medicare’s Promise Act of 2025

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs No Tax Breaks for Outsourcing Act H.R. 995 S. 409 - Makes changes to various tax provisions to discourage offshoring of jobs S.2845, Billionaires Income Tax Act - new taxes for high wealth individuals Death Tax Repeal Act H.R. 1301 S. 587 - This bill repeals the estate and generation-skipping transfer taxes. It also sets forth conforming amendments related to the gift tax Main Street Tax Certainty Act H.R. 703 S. 213 - This bill makes permanent the tax deduction for qualified business income TCJA Permanency Act H.R. 137 - Makes permanent the Tax Cuts and Jobs Act Taxes - Administrations tax policies and budget Fueling Alternative Transportation with a Carbon Aviation Tax S. 173 - Imposes jet fuel taxes on private jets Carried Interest Fairness Act H.R. 1091 S. 445 - Eliminated Carried Interest loophole No Tax Breaks for Union Busting Act H.R. 5456 S. 737 - Makes changes to the tax code to disincentivize writing off expenses related to union busting taxes H.R.609 Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency H.R. 451, S. 96 Fair PREP Act of 2025 - Repealing direct file program Millionaires Surtax Act (not intro'd) - places a surtax on millionaires Fair Trust Withholding Act - amends estate tax and other estate planning tax related issues HR 6438 Robinhood Act - taxes the loans taken out by the ultra wealthy that are backed by capital assets Stop CHEATERs Act - Appropriates mandatory funding to the IRS and increase enforcement on wealthy taxpayers Equal Tax Act HR 5336 - Equalizes tax rates among different types of income Make Billionaires Pay Their Fair Share Act - Creates a wealth tax for billionaires Ultra Millionaires Tax Act - Creates a wealth tax for ultra millionaires and billionaires Wall Street Tax Act S. 2127, HR 4035 - Creates a financial transaction tax for wall street Social Security 2100 Act - Adds solvency to Social Security

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of, White House Office

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Law to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare Hearing Coverage: The Medicare Hearing Aid Coverage Act of 2025 (H.R. 500): Proposals to add hearing benefits to Medicare. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid. The HCBS Access Act (H.R. 8540): Proposals to expand Medicaid home and community-based services (HCBS) by elevating them to a mandatory entitlement. H.R. 8540 would reduce waitlists and guarantee seniors and individuals with disabilities a choice between home care and institutional care. Would also establish new grant programs and a technical assistance center to improve the wages, benefits, and training pathways for the direct care workforce. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposal to establish mandatory, statutory, minimum nurse staffing standards in nursing homes to ensure at least 4.1 hours of total nursing care per resident per day. Medicare, Medicaid Nursing Homes. The Nurses Belong in Nursing Homes Act (S. 3886): Proposal aims to establish federal minimum staffing standards, specifically requiring 3.48 hours per resident per day (HPRD) of total nursing care and 24/7 on-site Registered Nurse (RN) coverage. Medicare, Medicaid Nursing homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposals to establish a minimum of 4.1 hours of direct nursing home care per resident per day, and a Registered Nurse on duty on-site 24/7. Adds penalties for facilities failing to meet required minimums. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 7096): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Medicare and Medicaid Waste, Fraud and Abuse (No bill): Submitted comments with other organizations to a CMS Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), 91 Fed. Reg. 9803 (February 27, 2026) CMS-6098-NC. Medicaid Work Requirements Affecting Eligibility (No bill): Submitted comments with other organizations to request CMS to clarify in regulations that people with disabilities, older adults, and caregivers are exempt from the Medicaid working requirements in P.L. 119-21. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. The Lower Health Care Premiums for All Americans Act (H.R. 6703) Proposals to weakening consumer protections and destabilizing markets by allowing skimpier, less‑regulated plans that can cherry‑pick healthier groups and leave higher‑cost enrollees in the ACA‑regulated small‑group and individual markets with higher premiums. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits. Medicare. The Medicare Cost Cap Act (S. 4886): Proposals to add a $5,000 annual cap on out-of-pocket costs for traditional Medicare (Part A and Part B) beneficiaries. Would require Medicare to pay 100 percent of covered health care costs once the $5,000 cap is reached.

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs H.R.609 - Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs No Tax Breaks for Outsourcing Act H.R. 995 S. 409 - Makes changes to various tax provisions to discourage offshoring of jobs S.2845, Billionaires Income Tax Act - new taxes for high wealth individuals Death Tax Repeal Act H.R. 1301 S. 587 - This bill repeals the estate and generation-skipping transfer taxes. It also sets forth conforming amendments related to the gift tax Main Street Tax Certainty Act H.R. 703 S. 213 - This bill makes permanent the tax deduction for qualified business income TCJA Permanency Act H.R. 137 - Makes permanent the Tax Cuts and Jobs Act Taxes - Administrations tax policies and budget Fueling Alternative Transportation with a Carbon Aviation Tax S. 173 - Imposes jet fuel taxes on private jets Carried Interest Fairness Act H.R. 1091 S. 445 - Eliminated Carried Interest loophole No Tax Breaks for Union Busting Act H.R. 5456 S. 737 - Makes changes to the tax code to disincentivize writing off expenses related to union busting taxes H.R.609 Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency H.R. 451, S. 96 Fair PREP Act of 2025 - Repealing direct file program Millionaires Surtax Act (not intro'd) - places a surtax on millionaires Fair Trust Withholding Act - amends estate tax and other estate planning tax related issues 23518 characters remaining HR 6438 Robinhood Act - taxes the loans taken out by the ultra wealthy that are backed by capital assets Stop CHEATERs Act - Appropriates mandatory funding to the IRS and increase enforcement on wealthy taxpayers Equal Tax Act HR 5336 - Equalizes tax rates among different types of income Make Billionaires Pay Their Fair Share Act - Creates a wealth tax for billionaires Ultra Millionaires Tax Act - Creates a wealth tax for ultra millionaires and billionaires Wall Street Tax Act S. 2127, HR 4035 - Creates a financial transaction tax for wall street Social Security 2100 Act - Adds solvency to Social Security

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Law to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare Hearing Coverage: The Medicare Hearing Aid Coverage Act of 2025 (H.R. 500): Proposals to add hearing benefits to Medicare. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposal to establish mandatory, statutory, minimum nurse staffing standards in nursing homes to ensure at least 4.1 hours of total nursing care per resident per day. Medicare, Medicaid Nursing Homes. The Nurses Belong in Nursing Homes Act (S. 3886): Proposal aims to establish federal minimum staffing standards, specifically requiring 3.48 hours per resident per day (HPRD) of total nursing care and 24/7 on-site Registered Nurse (RN) coverage. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 7096): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Medicare and Medicaid Waste, Fraud and Abuse (No bill): Submitted comments with other organizations to a CMS Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), 91 Fed. Reg. 9803 (February 27, 2026) CMS-6098-NC. Medicaid Work Requirements Affecting Eligibility (No bill): Submitted comments with other organizations to request CMS to clarify in regulations that people with disabilities, older adults, and caregivers are exempt from the Medicaid working requirements in P.L. 119-21. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. The Lower Health Care Premiums for All Americans Act (H.R. 6703) Proposals to weakening consumer protections and destabilizing markets by allowing skimpier, less‑regulated plans that can cherry‑pick healthier groups and leave higher‑cost enrollees in the ACA‑regulated small‑group and individual markets with higher premiums. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits.

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs No Tax Breaks for Outsourcing Act H.R. 995 S. 409 - Makes changes to various tax provisions to discourage offshoring of jobs S.2845, Billionaires Income Tax Act - new taxes for high wealth individuals Death Tax Repeal Act H.R. 1301 S. 587 - This bill repeals the estate and generation-skipping transfer taxes. It also sets forth conforming amendments related to the gift tax Main Street Tax Certainty Act H.R. 703 S. 213 - This bill makes permanent the tax deduction for qualified business income TCJA Permanency Act H.R. 137 - Makes permanent the Tax Cuts and Jobs Act Taxes - Administrations tax policies and budget Fueling Alternative Transportation with a Carbon Aviation Tax S. 173 - Imposes jet fuel taxes on private jets Carried Interest Fairness Act H.R. 1091 S. 445 - Eliminated Carried Interest loophole No Tax Breaks for Union Busting Act H.R. 5456 S. 737 - Makes changes to the tax code to disincentivize writing off expenses related to union busting taxes H.R.609 Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency H.R. 451, S. 96 Fair PREP Act of 2025 - Repealing direct file program Millionaires Surtax Act (not intro'd) - places a surtax on millionaires Fair Trust Withholding Act - amends estate tax and other estate planning tax related issues 23518 characters remaining HR 6438 Robinhood Act - taxes the loans taken out by the ultra wealthy that are backed by capital assets

Client expense: $33,000 · Firm income: Not reported

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs H.R.609 - Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency

Client expense: $33,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (No bill): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. (H.R. 6703). Proposals to allow associated health plans. Places new transparency and reporting requirements on pharmacy benefit managers to disclose drug spending, rebates, and pricing information to group health plans, with penalties for noncompliance. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits.

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (No bill): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Health Insurance. Health Insurance Premium Fairness Act (No bill). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (No bill). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits.

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs No Tax Breaks for Outsourcing Act H.R. 995 S. 409 - Makes changes to various tax provisions to discourage offshoring of jobs S.2845, Billionaires Income Tax Act - new taxes for high wealth individuals Death Tax Repeal Act H.R. 1301 S. 587 - This bill repeals the estate and generation-skipping transfer taxes. It also sets forth conforming amendments related to the gift tax Main Street Tax Certainty Act H.R. 703 S. 213 - This bill makes permanent the tax deduction for qualified business income TCJA Permanency Act H.R. 137 - Makes permanent the Tax Cuts and Jobs Act Taxes - Administrations tax policies and budget Fueling Alternative Transportation with a Carbon Aviation Tax S. 173 - Imposes jet fuel taxes on private jets Carried Interest Fairness Act H.R. 1091 S. 445 - Eliminated Carried Interest loophole No Tax Breaks for Union Busting Act H.R. 5456 S. 737 - Makes changes to the tax code to disincentivize writing off expenses related to union busting taxes H.R.609 Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency H.R. 451, S. 96 Fair PREP Act of 2025 - Repealing direct file program Millionaires Surtax Act (not intro'd) - places a surtax on millionaires Fair Trust Withholding Act - amends estate tax and other estate planning tax related issues

Client expense: $40,000 · Firm income: Not reported

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs H.R.609 - Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1968 Full-Year Continuing Appropriations and Extensions Act, 2025 - Funding for the federal government for FY25 H.R. 609 - Assuring Medicare's Promise Act of 2025 - Changes to ensure Medicare solvency

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs No Tax Breaks for Outsourcing Act H.R. 995 S. 409 - Makes changes to various tax provisions to discourage offshoring of jobs Death Tax Repeal Act H.R. 1301 S. 587 - This bill repeals the estate and generation-skipping transfer taxes. It also sets forth conforming amendments related to the gift tax Main Street Tax Certainty Act H.R. 703 S. 213 - This bill makes permanent the tax deduction for qualified business income TCJA Permanency Act H.R. 137 - Makes permanent the Tax Cuts and Jobs Act Taxes - Administrations tax policies and budget Fueling Alternative Transportation with a Carbon Aviation Tax S. 173 - Imposes jet fuel taxes on private jets Carried Interest Fairness Act H.R. 1091 S. 445 - Eliminated Carried Interest loophole No Tax Breaks for Union Busting Act H.R. 5456 S. 737 - Makes changes to the tax code to disincentivize writing off expenses related to union busting taxes H.R.609 Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency H.R. 451, S. 96 Fair PREP Act of 2025 - Repealing direct file program Millionaires Surtax Act (not intro'd) - places a surtax on millionaires Fair Trust Withholding Act - amends estate tax and other estate planning tax related issues

Client expense: $40,000 · Firm income: Not reported

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.1, One Big Beautiful Bill - Budget reconciliation re taxes, cuts to Medicaid, SNAP, and other programs H.R.609 - Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Caregiving. The Alleviating Barriers to Caregiving Act (No bill): Proposal to require the Secretaries of HHS and SSA to review and streamline enrollment in coverage and benefits for family caregivers in Medicare, Medicaid, CHIP and Social Security. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (No bill): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care).

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation No Tax Breaks for Outsourcing Act H.R. 995 S. 409 - Makes changes to various tax provisions to discourage offshoring of jobs Death Tax Repeal Act H.R. 1301 S. 587 - This bill repeals the estate and generation-skipping transfer taxes. It also sets forth conforming amendments related to the gift tax Main Street Tax Certainty Act H.R. 703 S. 213 - This bill makes permanent the tax deduction for qualified business income TCJA Permanency Act H.R. 137 - Makes permanent the Tax Cuts and Jobs Act Taxes - Administrations tax policies and budget Fueling Alternative Transportation with a Carbon Aviation Tax S. 173 - Imposes jet fuel taxes on private jets Carried Interest Fairness Act H.R. 1091 S. 445 - Eliminated Carried Interest loophole No Tax Breaks for Union Busting Act H.R. 5456 S. 737 - Makes changes to the tax code to disincentivize writing off expenses related to union busting taxes H.R.609 - Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of, White House Office

H. Con. Res. 14, FY25 Budget Resolution - Budget resolution and reconciliation H.R.609 - Assuring Medicares Promise Act of 2025 - Makes changes to ensure Medicare solvency

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (No bill): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. The Seniors Securing Access to Vital and Essential Prescription Drugs Act (No bill): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (No bill): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Prescription Drugs. The PACE Part D Choice Act (No bill): Proposal to increase the affordability of the Program of All-Inclusive Care for the Elderly (PACE) for Medicare beneficiaries by lowering the cost of Part D premiums substantially for Medicare-only enrollees, thus opening up the PACE program to this population. Medicare Low-Income Subsidy (LIS) Program. (No bill): Proposal to increase funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609) and The Medicare and Social Security Fair Share Act (No bill): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Trustees Report (No bill). Review of the findings on economic, legislative and other developments affecting the actuarial soundness of the Medicare Part A (Hospital Insurance) Trust Fund and the Trust Funds for Parts B and D coverage. Medicare Dental Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045 ): Proposal to add dental, vision and hearing benefits to Medicare. Medicare Hearing Coverage. The Help Extend Auditory Relief Act (No bill): Proposal to expand Medicare coverage to include hearing examinations and diagnoses, fittings and hearing aids. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Caregiving. The Alleviating Barriers to Caregiving Act (No bill): Proposal to require the Secretaries of HHS and SSA to review and streamline enrollment in coverage and benefits for family caregivers in Medicare, Medicaid, CHIP and Social Security. Medicare and Medicaid Nursing Homes. The Nursing Home Disclosure Act (No bill): Proposal to direct HHS to establish a national registry of medical directors. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (No bill): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. (No bill): HHS Secretarys final rule promulgating national staffing standards in nursing homes Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (No bill): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare, Medicaid Nursing Homes, Assisted Living and Other Long Term Care Services and Supports (LTSS) Settings. The Long-Term Care Workforce Support Act (No bill): Proposals to increase the number of direct care professionals, including in rural communities; pathways to enter and be supported in the workforce for women, people of color, and people with disabilities; and to improve compensation for direct care professionals to reduce vacancies and turnover. Medicare and Medicaid Nursing Home Ownership. (No bill): A final HHS regulation for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Rule calls for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill): Final regulations establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposals to request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities. Oversight of Health Care Industry Owned by Private Equity Firms. (No bill): Joined with other organizations in submitting comments (April 2024) to HHS, the Federal Trade Commission and the Department of Justice urging sustained, stepped up and rigorous oversight be extended to health care industry transactions that are financed by private equity company companies and other types of private investors. Medicaid Eligibility and Beneficiary Assets. Medicaid Estate Recovery Act (No bill): Proposals to provide financial protection to the families of Medicaid beneficiaries, including ending Medicaid estate claims and Medicaid liens, except in cases when benefits had been incorrectly paid, as determined by a court.