Lower Health Care Premiums for All Americans Act

H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl "Buddy" - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2082 - WISH Act - Rep. Suozzi, Thomas - Long-term care insurance benefits H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3257 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicaid expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710 - No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 5509 - Safe Step Act - Rep. Allen, Rick - Step therapy requirements H.R. 5582 - Patients Deserve Price Tags Act - Rep. James, John - Hospital and insurer price transparency requirement H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums H.R. 7023 - Affordable CHOICE Act - Rep. Schakowsky, Janice - public option under ACA H.R. 7164 - Capping Costs for Consumers Act - Rep. Schrier, Kim - ACA cost-sharing reductions H.R. 8270 - Every Dollar Counts Act - Rep. Murphy, Greg - Requirements for deductibles and MOOP to include expenditures for DTC prescriptions H.R. 8684 - Transparency in Billing Act - Rep. Foxx, Virginia - Transparency enforcement H.R. 9393 - Lower Costs, More Transparency Act - Rep. Guthrie, Brett - Healthcare price transparency H.R. 9645 - Health Care Price Certainty for All Americans Act - Rep. Smith, Jason - Price transparency requirements H.R. 10024 - Health Insurance Transparency for Patients Act - Rep. Hinson, Ashley - Price transparency requirements S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Sen. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2903 - Safe Step Act - Sen. Murkowski, Lisa - Step therapy requirement S. 3599 - Affordable CHOICE Act - Sen. Whitehouse, Sheldon - public option under ACA S. 4189 - INSULIN Act - Sen. Collins, Susan - Insulin cost-sharing caps S. 4512 - Affordable Insulin Now Act - Sen. Kennedy, John - Insulin cost-sharing caps Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Waste Fraud and Abuse; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; affordability; and health savings accounts.

Client expense: $3,010,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of the Vice President of the United States, SENATE, White House Office

Natural Disasters Communications with the House of Representatives supporting H.R. 1491 Disaster Related Extension of Deadlines Act and H.R. 517 The Filing Relief for Natural Disasters Act. FEMA Act Association Health Plans H.R> 2528 Association Health Plans Act Communications with the House of Representatives supporting H.R. 1105, the Disaster Resiliency and Coverage Act that would provide pre-disaster mitigation grants and tax incentives for households to reduce the risk of real property damage due to natural disasters, including floods, hurricanes, and wildfires. Communications with the Senate supporting S.127 Whole Homes Repairs Act and the nomination of Travis Hill for the Federal Deposit Insurance Corporation. Government Accountability Office (GAO) Discussions regarding the National Flood Insurance Program. Federal Emergency Management Agency (FEMA) within the Department of Homeland Security Communications regarding disaster mitigation and assistance, and flood insurance. Discussions with the Treasury Department/Federal Insurance Office regarding flood insurance and general insurance issues. Communications with the House of Representatives and Senate urging the extension of the National Flood Insurance Program. Communications with the House of Representatives supporting H.R. 7128/S. 439 TRIA Program Reauthorization Act to extend the Terrorism Risk Insurance Program. Communications with the House of Representatives regarding association health plans and H.R. 6703 Lower Heath Care Premiums for All Americans Act. Communications with the National Oceanic and Atmospheric Administration regarding natural disasters. Communications with the U.S. Geological Service regarding flood mapping. Discussions with the Office of Management and Budget regarding NFIP and flood map funding. Discussions with the Department of Health and Human Services regarding Association Health Plans.

Client expense: $27,400,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Oceanic & Atmospheric Administration (NOAA), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, U.S. Geological Survey (USGS), White House Office

HR 6703 Lower Health Care Premiums for All Americans Act; issues relating to the guaranteed issue small group market

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1 One Big Beautiful Bill Act; HR 6703 Lower Health Care Premiums for All Americans Act; issues relating to the guaranteed issue small group market; issues relating to the employer tax exclusion

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Ending Discrimination Against Gay and Bisexual Blood and Tissue Donors Funding for HIV/AIDS Education, Prevention, and Research Funding for and Education Regarding Comprehensive Sexual Health Education Implementation of Section 1557 Nondiscrimination regulations Implementation and Protection of the Patient Protection and Affordable Care Act Labor, HHS, and Education Appropriations PrEP Insurance Coverage Title X Family Planning Funding Access to Gender Affirming Care Employment Benefits Conversion Therapy H.R. 2197: No 340B Savings for Transgender Care Act H.R. 2107: To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs, and for other purposes. S. 312: Jamie Reed Protecting Our Kids from Child Abuse Act H.R. 742: PROTECTS Act of 2025 H.R. 653; S. 209: Protecting Minors from Medical Malpractice Act of 2025 H.R. 498: Do No Harm in Medicaid Act H.R. 2487; S. 3206: Transgender Healthcare Access Act S. 422 Right to Contraception Act H.R. 2387: No Harm Act H.R. 3757: Pride in Mental Health Act of 2025 S. 2035: Protect IVF Act H.R. 3811: The Elder Pride Protection Act of 2025 H.R. 3688: Protecting Children from Experimentation Act of 2025 S. 1774: Protecting Minors in Federal Health Plans Act H.R. 3527; S. 1910: Real Education for Healthy Youth H.R. 5434; S. 2826: 988 LGBTQ+ Youth Access Act of 2025 H.R. 5390; S. 2823: FAMILY Act H.R. 4648; S. 2408: Access to Fertility Treatment and Care Act H.R. 3492: Protect Childrens Innocence Act H.R. 5483; S. 2907: Chloe Cole Act H.R. 4953: Gender-Affirming Child Abuse Prevention Act H.R. 4618: Jamie Reed Protecting Our Kid from Child Abuse Act S.2907 A bill to prohibit health care professionals, hospitals, or clinics from participating in the chemical or surgical mutilation of a child and to provide a private right of action for children and the parents of children whose healthy body parts have been damaged by medical professionals practicing chemical and genital mutilation H.R. 5592 Childhood Genital Mutilation Prevention Act H.R. 600; S. 774: WHO is Accountable Act H.R. 4151: Ruthie and Connie LGBTQI Elder Americans Act of 2025 H.R. 6703: Lower Healthcare Premiums for All Americans Act H.R. 3386: Health Care Freedom for Patients Act of 2025 H.R. 6372; S. 3327: D.C. Shield Law Repeal Act S. 3011: Prohibiting Abortion & Transgender Procedures on Exchanges Act S. 3385: Lower Health Care Costs Act H.R. 7420: Stop Gender Trafficking of Minors Act H.R. 7853; S. 3990: PrEP Access and Coverage Act of 2026 H.R. 7148, the Consolidated Appropriations Act, 2026 H.R. 6876: Protecting Children from Foreign Muttilation Act H.R. 9260: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027 H.R. 8573; S. 4426: STOP Act H.R. 8952; S. 4625: Elder Pride Act of 2026 H.R. 7531; S. 3869 Healthy Families Act H.R. 7385: PrEP Assistance Program Act H.R. 12: Womens Health Protection Act H.Res. 445: Supporting the goals and ideals of the month of May as Sex Ed For All Month: Equity and Access for All. H.R. 6512: Putting Patients First Healthcare Freedom Act H.R. 9941; S. 5108: Right to IVF Act of 2026 H.R. 9946: Equity in STI Testing Act S. 5202: Protecting our Kids from Harmful Research Act

Client expense: $203,894 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 10373 Protecting Wages from Medical Debt Act Centers for Medicare & Medicaid Services proposed rule detailing the process and timeline for terminating Medicare coverage for many noncitizens, CMS-1848-P Pharmaceutical pricing policy H.R.3069/S.1506, Medicare for All Medicaid Program; Community Engagement Requirement for Certain Individuals - RIN 0938-AV98, CMS-2454-IFC S.4804/H.R.9910 Health Over Wealth Act S.5066 Health Equity and Accountability Act H.R.9962/S.5134 Green New Deal for Health S.5037 MediKids Act Monitor the following: S.J.Res.198 and S.J.Res.192 Congressional Review Act resolution, CMSs Wasteful and Inappropriate Service Reduction (WISeR) model S.4086/H.R.8310, Patient Safety and Whistleblower Protections Act H.R.8484/ S.4357Hazard Pay for Healthcare Heroes Act Fund health care over attacks on immigrants and communities H.R.7985, CHATBOT Act H.R.7858 Data Center Community Impact Act H.R.6984, The Data Center Transparency Act S.4085, Taking Back Our Hospitals Act Healthcare funding H-1B fees and the healthcare workforce U.S. Vaccine schedule Private equity and healthcare S.3480, SMARTER Care Act H.R.6361, Ban AI Denials in Medicare Act S.3323, Family Vaccine Protection Act Discharge Petition No: 119-10, related to a three-year extension of the ACA tax credits H.R.6703, the Lower Health Care Premiums for All Americans Act S.1562/H.R.1197, PREEMIE Reauthorization Act S.2621/H.R.1909, Preventing Maternal Deaths Reauthorization Act Repeal healthcare provisions of H.R.1, One Big Beautiful Bill Act H.R.5557, Mental Health Services for Students Act S.2556/H.R.4849, Protecting Health Care and Lowering Costs Act Preserve the United States Preventive Services Task Force H.R.1197/S.1562, PREEMIE Reauthorization Act S.2621, Preventing Maternal Deaths Act Nurse Staffing Standards for Hospital Patent Safety and Quality Care Act Public Law 119-21, To provide for reconciliation pursuant to title II of H. Con. Res. 14, Healthcare related provisions. Medicaid, Medicare, ACA cuts H.R.4253, Expanding Access to Mental Health Services in Schools Act H.R.3907/S.2024, ENROLL Act Stop Medical Profiteering and Theft Act Justice Department anticompetitive regulations related issues H.R.3063, Rural Hospital Stabilization Act H.R.3262, NURSE Act Restructuring of the Department of Health and Human Services H.R.593, Strengthening Pathways to Health Professions Act Healthcare workforce issues Funding for SUNY Downstate hospital Impact of private equity on healthcare Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Rural healthcare and hospital workforce challenges and related issues Supporting investments in school-based mental health professionals Healthcare high school apprenticeships Artificial Intelligence, Healthcare related issues Medicare drug negotiation program PBM reform Reauthorization of healthcare workforce programs Medicaid DSH Payments, Hospital funding formula Student Loan Forgiveness for Frontline Health Workers Affordability of pharmaceuticals, generally Telehealth issues Mental health supports for educators Workplace Violence Prevention for Health Care and Social Service Worker Act Workplace violence related issues Health Worker Shortage/Staffing Crisis Funding for Medicare low-income outreach and enrollment efforts Prevention and Public Health Fund related issues Healthcare cybersecurity related issues Safe staffing levels Department of Health and Human Services, WiSER model H.R.1834, Breaking the Gridlock Act, ACA Tax Credits Healthcare Affordability

Client expense: $420,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

House: H.R.1, An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14. H.R. 425, the Repealing Big Brother Overreach Act H.R.7035, the Credit Card Competition Act of 2026 H.R. 6213, the Heat Workforce Standards Act of 2025 H.R. 4776, the Standardizing Permitting and Expediting Economic Development (SPEED) Act H.R. 4366, the Save Local Business Act H.R. 3898, the Promoting Efficient Review for Modern Infrastructure Today (PERMIT) Act H.R. 3699, the Energy Choice Act H.R. 4424, the Securing Help for Involuntary Employment Loss and Displacement (SHIELD) Act H.R. 5463, the Custom Health Option and Individual Care Expense (CHOICE) Arrangement Act H.R.6703, the Lower Health Care Premiums for All Americans Act H.R. 20, the Richard L. Trumka Protecting the Right to Organize (PRO) Act H.R. 4896, the Warehouse Worker Protection Act H.R. 2743, the Raise the Wage Act H.R. 1319, the Modern Worker Empowerment Act H.R. 1566, the Right to Equitable and Professional Auto Industry Repair (REPAIR) Act H.R. 5349, the Tax Court Improvement Act H.R. 5346, the Fair and Accountable IRS Review Act H.R.5267, the American Franchise Act H.R. 2528, the Association Health Plans Act H.R. 6420, the Affordable Care Economic Stability and Small Business (ACCESS) Act H.R.1163, the Prove It Act of 2025 H.R. 5258, the Lawsuit Abuse Reduction Act of 2025 H.R. 2675, the Protecting Our Courts from Foreign Manipulation Act of 2025 H.R. 4626, the Home Appliance Protection and Affordability Act H.R.7148 - Consolidated Appropriations Act, 2026 H.R.7328 - Protecting Small Businesses from Predatory Website Lawsuits Act H.R. 6250, the Cold Weather Diesel Reliability Act of 2025 H.R. 6453, the Americans with Disabilities Act 30 Days to Comply Act H.R.7847, the Stop Unemployment Fraud Act H.R. 2528, the Association Health Plans Act H.R. 8082, the Competition and Openness in Markets to Promote Efficiency, Transparency, and Enhanced Affordability (COMPETE) Act H.R. 6538, the More Affordable Care Act H.R. 5582, the Patients Deserve Price Tags Act H.R. 5408, the Faster Labor Contracts Act H.R.8800, National Defense Authorization Act for Fiscal Year 2027 H.R.3269, Eliminating Thickets to Increase Competition (ETHIC) Act H.R. 5337, Motor Carrier Safety Selection Standard Act Consumer Financial Protection Bureau Section 1071 rule requires covered financial institutions to collect and report demographic and credit data on small business loan applications. H.R. 8415, Small Business Tax Cut Act H.R. 1897, Endangered Species (ES) Amendments Act of 2025 H.R.5166, Financial Services and General Government Appropriations Act, 2026 H.R. 1687, the Committing Leases for Energy Access Now (CLEAN) Act H.R. 6398, the Reducing and Eliminating Duplicative Environmental Regulations Act H.R. 8414, Know Your Labor Rights Act H.R. 7861, HSAs for All Act H.R. 7895, PBM Kickback Prohibition Act H.R. 9618, Diesel Engine Flexibility Act H.R. 9340, Ratepayer Protection Act H.R.1515, Guidance Out of the Darkness (GOOD) Act H.R. 10015, Great American Healthcare Act H.R. 5883, Safer Supervision Act of 2025 H.R. 1501, the Protecting Domestic Mining Act H.R. 9618, the Diesel Engine Flexibility (DEF) Act H.R. 10263, Halt Abusive Internet Lawsuits Act of 2026 H.R. 2675, the Protecting Our Courts from Foreign Manipulation H.J. Res. 210, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Environmental Protection Agency relating to "California State Nonroad Engine Pollution Control Standards; Ocean-Going Vessels At-Berth; Notice of Decision", which would repeal an Environmental Protection Agency (EPA) rule requiring ocean-going vessels to reduce emissions while docked at California ports that increased shipping costs for energy, consumer products and inputs, and increased electricity demand and costs for small businesses and consumers. H.J. Res 213, Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule issued by the Environmental Protection Agency relating to the "California State Nonroad Engine Pollution Control Standards; Commercial Harbor Craft Regulations; Notice of Decision", which would repeal the Environmental Protection Agencys (EPA) "California State Nonroad Engine Pollution Control Standards; Commercial Harbor Craft Regulations; Notice of Decision" rule which mandated that harbor vessels install more expensive zero-emissions engines. This regulation increased operating and energy costs for small businesses and consumers in California and across the country Issues relating to small business taxation Issues related to the expiring TCJA tax provisions Issues related to ADA website reforms Issues related to the minimum wage increase Issues related to "Affordable Care Act Reform" Issues related to Pharmacy Benefit Managers Issues related to Health Reform Issues related to regulatory reforms Issues related to Waters of United State Senate: S. 100, the Repealing Big Brother Overreach Act S.3623, the Credit Card Competition Act of 2026 S. 4427, Heat Workforce Standards Act of 2026 S. 3117, the Worker Reforming Elections for Speedy and Unimpeded Labor Talks (RESULTS) Act S. 3116, the Fairness in Filing Act S. 5213, the Union Members' Right to Know Act S.3124, the Protection on the Picket Line Act S.3128, the Worker Privacy Act S. 852, the Richard L. Trumka Protecting the Right to Organize (PRO) Act S. 2613, the Warehouse Worker Protection Act S. 844, the Faster Labor Contracts Act S. 2013, the Higher Wages for American Workers Act S. 1332, the Raise the Wage Act S. 1945, the Energy Choice Act S. 1379, the Right to Equitable and Professional Auto Industry Repair (REPAIR) Act S.2875, the Custom Health Option and Individual Care Expense (CHOICE) Act S. 1847, the Association Health Plans Act S. 3418, the Competition and Openness in Markets to Promote Efficiency, Transparency, and Enhanced Affordability (COMPETE) Act S.495, Prove it Act of 2025 S. 3264, the More Affordable Care Act S. 2355, the Patients Deserve Price Tags Act S. 4366, Know Your Labor Rights Act S. 2276, Eliminating Thickets to Increase Competition (ETHIC) Act S. 4419: A bill to amend title 31, United States Code, to require only foreign entities to report beneficial ownership information, and for other purposes. S.J. Res. 208, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Environmental Protection Agency relating to "California State Motor Vehicle Pollution Control Standards; Advanced Clean Car Program; Reconsideration of a Previous Withdrawal of a Waiver of Preemption; Notice of Decision", which would repeal an Environmental Protection Agency (EPA) waiver granted to the California Air Resources Board (CARB), allowing the continuation of the Advanced Clean Cars (ACC) framework. These overreaching standards would have resulted in a costly and unrealistic electric vehicle mandate on small business owners and consumers nationwide. S.J. Res. 209, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Environmental Protection Agency relating to "California State Nonroad Engine Pollution Control Standards; Ocean-Going Vessels At-Berth; Notice of Decision" which would repeal an Environmental Protection Agency (EPA) rule requiring ocean-going vessels to reduce emissions while docked at California ports. Issue relating to small business taxation S.J. Res. 206, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Environmental Protection Agency relating to "California State Motor Vehicle Pollution Control Standards; Notice of Decision Granting a Waiver of Clean Air Act Preemption for California's 2009 and Subsequent Model Year Greenhouse Gas Emission Standards for New Motor Vehicles" which would repeal an Environmental Protection Agency (EPA) rule titled California State Motor Vehicle Pollution Control Standards; Notice of Decision Granting a Waiver of Clean Air Act [CAA] Preemption for California's 2009 and Subsequent Model Year Greenhouse Gas Emission Standards for New Motor Vehicles that increased the cost of vehicles for small businesses and consumers. S.J. Res. 207, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Environmental Protection Agency relating to "California State Motor Vehicle Pollution Control Standards; Notice of Decision Granting a Waiver of Clean Air Act Preemption for California's Advanced Clean Car Program and a Within the Scope Conformation for California's Zero Emission Vehicle Amendments for 2017 and Earlier Model Years" which would repeal the Environmental Protection Agencys (EPA) waiver granting the California Air Resources Board (CARB) the authority to create the Advanced Clean Cars (ACC) framework. This overreaching rule increased costs for small businesses and consumers by creating a de facto electric vehicle mandate. S.J. Res. 205, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Environmental Protection Agency relating to "California State Nonroad Engine Pollution Control Standards; Small Off-Road Engines Regulations; Notice of Decision" which would repeal the Environmental Protection Agencys (EPA) rule titled "California State Nonroad Engine Pollution Control Standards; Small Off-Road Engines [SORE] Regulations. Issue related to the expiring TCJA tax provisions Issue related to ADA website reforms Issue related to the minimum wage increase Issue related to "Affordable Care Act Reform" Issue related to Pharmacy Benefits Managers Issue related to Health reform Issues related to wiretapping and eavesdropping law abuse Department of the Treasury: Beneficial Ownership Information (BOI) Reporting Rule White House: Beneficial Ownership Information (BOI) Reporting Rule Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Issues related to Short-Term, Limited-Duration Insurance Plans Issues related to Health Savings Accounts Issues related to CHOICE Arrangements Healthcare Transparency Rule Vice President of the U.S.: Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Department of Labor: Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Issues related to Short-Term, Limited-Duration Insurance Plans Occupational Safety and Health Administration: Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Small Business Administration: Beneficial Ownership Information (BOI) Reporting Rule Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Issues related to Title III ADA website reforms Department Health and Human Services: Short-Term, Limited Duration Insurance Rule Individual Coverage Health Reimbursement Arrangement Rule Health Savings Account Rule

Client expense: $1,910,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE, Small Business Administration (SBA), Treasury, Dept of, Vice President of the U.S., White House Office

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related asthma, COPD, influenza, lung cancer, pneumonia, pulmonary fibrosis, tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to agency restructuring; Issues related to the Childrens Health Insurance Program; Issues related to Medicaid; Issues related to ERISA; Issues related to COVID-19 Response; Issues related to vaccines; Issues related to infrastructure; Issues related to supplemental oxygen; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to Cancer Moonshot; Issues related to short-term limited duration plans; Issues related to Healthy Future Taskforce; Issues related to regulatory reform; Issues relating to FY26 appropriations; Issues relating to FY27 appropriations; S 1406 the Supplemental Oxygen Access Reform Act; HR 2902 the Supplemental Oxygen Access Reform Act; H.R. 783 Sustainable Cardiopulmonary Rehabilitation Services in the Home Act; S. 248 Sustainable Cardiopulmonary Rehabilitation Services in the Home Act; S 717Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025; S 77 Early Participation in Regulations Act; S 81 Guidance Clarity Act; HR 77 Midnight Rules Relief Act; H.R. 3701 Family Vaccine Protection Act; H.R. 3521 Clinical Trial Modernization Act; HR 4417 Mobile Cancer Screening Act HR 3701 Family Vaccine Protection Act; HR 5304Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026; S 2587 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026; HR 5278/S 2756 Affordable Inhalers and Nebulizers Act of 2025; HR 6703 Lower Health Care Premiums for All Americans Act; S 2466 Senior Savings Protection Act; HR Senior Savings Protection Act; HR 6052 Elijah E. Cummings Family Asthma Act; HR 6319 Benay Taub Lung Cancer Research Act; HR 45448 Protecting Free Vaccines Act; Consolidated Appropriations Act, 2026; Breaking the Gridlock Act; HR 9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027; S. 4440, Clinical Trial Modernization Act; S. 5428, Stop the Wait Act of 2026; H.R. 2319, Women and Lung Cancer Research and Preventive Services Act of 2025; S. 1157 Women and Lung Cancer Research and Preventive Services Act of 2025

Client expense: $70,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Good Government White House Conference on Small Business Act, H.R. 6855: Support action by U.S. House to advance the legislation. DME Scammer Prevention Act of 2026, H.R. 8871: Support the legislation and advancement through House Ways and Means Committee. Preventing Waste, Fraud and Abuse in TANF Act, H.R. 8872: Support the legislation and advancement through House Ways and Means Committee. Protecting Seniors and Stopping Fraudsters Act, H.R. 8883: Support the legislation and advancement through House Ways and Means Committee. Recover COVID Unemployment Fraud in Banks Act, H.R. 8873: Support the legislation and advancement through House Ways and Means Committee. Workforce Issues Valuing Employee Stock Today Act, H.R.8660: Support the legislation. Workforce Apprenticeship Growth and Education Support (WAGES) Act, H.R. 8624 and S. 4463: Support the legislation. Empowering Employer Child and Elder Care Solutions Act, H.R. 2270: Continue to support U.S. House passage of the bill. Working Families Flexibility Act, H.R. 2870: Continue to support full U.S. House passage of the bill. Tipped Employee Protection Act, H.R. 2312: Continue to support U.S. House passage of the bill. Access to Capital: INVEST Act, H.R. 3383: Continue to support U.S. Senate passage of this Housed-passed bill. Comments to Securities and Exchange Commission: Submitted comments in in support of a petition to raise the Regulation Crowdfunding offering limit to $20 million. Tax Policy Small Business Tax Cut Act, H.R. 8415: Support the legislation. Indexing Capital Gains Tax Liability to Inflation: Support legislative or administrative action to make this reform. More Homes on the Market Act, H.R. 1340, S.3332: Support the legislation. American Innovation Act, H.R. 1778, S. 4207: Support the legislation. Business Startup & Growth SAVE Local Businesses Act, H.R. 4366: Support U.S. House passage of the bill. New Opportunities for Business Ownership and Self-Sufficiency Act (NO BOSS Act), H.R. 6431: Supported U.S. House passage of the legislation and U.S. Senate introduction of the legislation. American Innovation Act, H.R. 1778, S. 4207: Support the legislation. AI and Technology Continue to voice restraint on excessive regulatory frameworks or actions that would undermine what is a critical new technology for small businesses. Comments to Federal Trade Commission: Submitted comments on the Proposed Enforcement Policy Statement Regarding Personalized Pricing, expressing concerns about the scope of the proposal the proposed frameworks misunderstanding of how dynamic and data-driven pricing tools are utilized by small businesses, and therefore how it would negatively impact their competitiveness and growth. AI Education: Continue to brief congressional staff on the benefits of AI to small businesses and startups as conveyed through SBE Council research and surveys. American Innovation and Choice Online Act (AICOA). S. 4746: Continue to oppose the legislation. Regulatory Modernization and Reform Guidance Out of Darkness (GOOD) Act (H.R. 1515): Urged Senate to advance House-passed bill. Bipartisan American Affordability and Jobs Act: Support the Senate introduced legislation. Latest Action on CTAs BOI Rule: Expressed support for the U.S. Department of the Treasury and Financial Crimes Enforcement Network (FinCEN) step in finalizing its rule ending the Beneficial Ownership Information (BOI) reporting mandate for U.S. businesses and individuals under the Corporate Transparency Act (CTA), and for taking the important additional step of deleting previously submitted information pertaining to U.S. persons. Comments to Small Business Administration: Submitted comments on the SBAs Proposed Small Business Size Standards, expressing support for modernization but a reconsideration of aspects of the methodology that could unintentionally disadvantage the very firms SBA exists to serve. Comments to Securities and Exchange Commission: Submitted comments in support of the Proposed Rule on Semiannual Reporting. NEPA Modernization: Expressed support for the Federal Communications Commissions vote to modernize its National Environmental Policy Act (NEPA) rules and streamline permitting for communications infrastructure. Packaging and Claims Knowledge Act (PACK Act), H.R. 6832: Support the legislation. Information Quality Assurance Act (H.R. 6329): Urged Senate to advance House-passed bill. ESA Amendments Act, H.R. 1897: Continue to support U.S. House passage of the bill. Prove It Act of 2025, H.R. 1163: Continue to support full U.S. House action and passage of the bill. Reducing and Eliminating Duplicative Environmental Regulations (RED Tape) Act, H.R. 6398: Supported House passage of the legislation and Senate action. Standardizing Permitting and Expediting Economic Development Act (SPEED Act), H.R. 4776: Continue to support Senate action on House-passed bill. Promoting Efficient Review for Modern Infrastructure Today (PERMIT) Act, H.R. 3898: Continue to support Senate action on House-passed bill. Repealing Big Brother Overreach Act, H.R. 425: Continue to support the legislation. Nominations Supported the nomination and confirmation of Keith Sonderling as U.S. Labor Department Secretary. Government Reform and Operations Tax Relief for Fraud Victims Act, H.R. 9500: Supported U.S. House passage of the legislation. AI Tax Integrity Act of 2026, H.R. 9501: Support full U.S. House passage of the legislation. Taxpayer Advocate Participation Act, H.R. 9498: Supported U.S. House passage of the legislation. Taxpayer Assistance and Service Act. S. 3931: Support full U.S. Senate passage of the legislation. Taxpayer Due Process Enhancement Act, H.R. 6506: Support U.S. Senate action on the House-passed bill. Taxpayer Notification and Privacy Act, H.R. 6495: Continue to support U.S. Senate action on the House-passed bill. Healthcare and Affordable Health Coverage HSAs For All Act, H.R. 7681: Continue to support the legislation. Lower Health Care Premiums for All Americans Act, H.R. 6703: Support Senate action of House-passed bill. Comments to the Centers for Medicare & Medicaid Services: Submitted comments on the proposed Medicare Program: Medicare Drug Price Negotiation Program and Medicare Prescription Drug Benefit Program rule, opposing CMSs proposed modification for initial price applicability year (IPAY) 2029 that would change how the agency identifies a qualifying single source drug under the Medicare Drug Price Negotiation Program created by the Inflation Reduction Act (IRA). Request for Information on Common Sense Policy Options to Lower Drug Prices for Patients: Submitted comments to Senate Finance Committees (via Ranking Member Wyden) Request for Information on policy options to lower prescription drug costs. 340B Drug Program: Continue to voice concerns about this program to Congress (in terms of effects on high drug and health premium costs) and the need for reforms. Abolish the Center for Medicare and Medicaid Innovation (CMMI) Act, H.R. 8293: Support the legislation. Intellectual Property Patent Eligibility Restoration Act (PERA), S. 1546: Reiterated support for the Senate introduced bill. Trade and Global Market Access Comments to the Office of the United States Trade Representative: Submitted comments on the 301 Investigation into Germanys persistent underpayment for innovative drugs, expressing encouragement about the investigation into the countrys unfair pharmaceutical pricing and the use of available USTR tools to press Americas trading partners to lift their price controls and contribute fairly to the innovation ecosystem from which they benefit American Global Competitiveness at 250: Legislative Proposals to Secure U.S. Technology Leadership: Submitted written testimony for the record before U.S. House Committee on Energy and Commerce expressing concerns about the European Unions Corporate Sustainability Due Diligence Directive (commonly referred to as CSDDD or CS3D) and the significant implications it poses for American businesses, small businesses and entrepreneurs. USMCA Review: Expressed overall support for the USMCA as it undergoes a review process. Urged the Administration to focus on strengthening and building upon the success of USMCA, make changes where warranted - such in the area of enforcement - so as not to destabilize supply chains and markets have become increasingly important to Americas entrepreneurs and small businesses.

Client expense: $35,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Federal Communications Commission (FCC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, SENATE, Small Business Administration (SBA), U.S. Trade Representative (USTR)

H.R. 7681, the HSAs for All Act. H.R. 5463, the CHOICE Act. H.R. 6703, the Lower Health Care Premiums for All Americans Act. H.R. 6538, the More Affordable Care Act. H.R. 5582, the Patients Deserve Price Tags Act. H.R. 6248, the Healthy Competition for Better Care Act. H.R. 8270, the Every Dollar Counts Act. H.R. 7871, the Medicaid VBPs for Patients (MVP) Act

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Issues related to employer provided benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits. H.R. 548, The HSA Modernization Act of 2025. H.R. 138, The Lowering Costs for Caregivers Act of 2025. H.R. 3799, The Choice Arrangement Act. H.R. 1421, The Improving Child Care for Working Families Act. H.R. 5463 - Choice Arrangement Act of 2025. S. 2875 - CHOICE Act. H.R. 6703 - Lower Healthcare Premiums for All Americans Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954/S. 4641): 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/S. 5321): 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 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. Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act (H.R. 10094): Proposals that would lower prices or shorten exclusivity periods when revenues exceed targets, which exceed a standard of cost per health benefit achieved, and constitute significant barriers to access or fiscal burdens on patients.

Client expense: $190,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to tax advantaged savings vehicles for health expenses One Big Beautiful Bill Act HSA Expansion Provisions - Public Law No. 119-21 Bipartisan Health Insurance Affordability Act - H.R. 6501 Health Care Freedom for Patients Act of 2025 - S. 3386 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSAs for All Act - H.R. 7681 The Chronic Disease Flexible Coverage Act - H.R. 919 Lowering Cost for Caregivers Act of 2025 - H.R. 138 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSA Modernization Act- H.R. 548 Lowering Health Care Costs for Americans Act - S.3389 Hard Working Seniors Act - HR 10072

Client expense: $400,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Issues related to tax advantaged savings vehicles for health expenses One Big Beautiful Bill Act HSA Expansion Provisions - Public Law No. 119-21 Bipartisan Health Insurance Affordability Act - H.R. 6501 Health Care Freedom for Patients Act of 2025 - S. 3386 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSAs for All Act - H.R. 7681 The Chronic Disease Flexible Coverage Act - H.R. 919 Lowering Cost for Caregivers Act of 2025 - H.R. 138 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSA Modernization Act- H.R. 548 Lowering Health Care Costs for Americans Act - S.3389 Hard Working Seniors Act - HR 10072

Client expense: $400,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Affordable Care Act and Extending Enhanced APTCs (H.R. 247; S. 46), Individual Market/ACA exchanges; Fraudulent Enrollments in Qualified Health Plans (S. 976, HR 2079), Behavioral Health, Employer-Provided Health Coverage; Surprise Billing (S. 2420, H.R. 4710); Cybersecurity; Health IT, Health Care Innovation, Transparency & PBMs (S. 891, H.R. 6703), PBM Compensation (H.R. 7895), Prescription Drugs (S. 1954, S. 1096, S.1040), Price Transparency (S. 2355, H.R. 9393, H.R. 9397, H.R. 9645, H.R. 9390), Prior Authorization (H.R. 9396), 340B, Insulin (S. 4189), Corporate Practice of Medicine, Anticompetitive Contracting (H.R. 6248, S. 4027).

Client expense: $670,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Work on extending advanced premium tax credits. This includes related proposals S. 3385, the Lower Health Care Costs Act; S. 3386, the Health Care Freedom for Patients Act; and H.R. 6703, the Lower Health Care Premiums for All Americans Act.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Potential changes in authorizations for nurse education, workforce, and research programs as a result of workforce reductions and reorganization of agencies and programs within the Department of Health and Human Services Policies related to the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, child vaccine recommendations and schedule, the Vaccines For Children Program, and the Vaccine Injury Compensation Fund Cancellation of federal nursing workforce grants Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Use of provider-neutral and inclusive language in federal documents, forms, and surveys Reauthorization of the Child Nutrition Act Implementation of 42 USC 300gg-5(a) regarding provider non-discrimination by health plans Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Mental health services and violence prevention Tobacco and vaping prevention and cessation Implementation of provisions of the One Big, Beautiful Bill Act (PL 119-21) H.R. 1197/S. 1562, PREEMIE Reauthorization Act H.R. 1435/S. 3714, Family-to-Family Reauthorization Act of 2025 H.R. 1735/S. 779, Early Action and Responsiveness Lifts Youth Minds (EARLY Minds) Act H.R. 2472, Improving Newborns' Food and Nutrition Testing Safety (INFANTS) Act of 2025 H.R. 2493, Improving Care in Rural America Reauthorization Act of 2025 H.R. 3333, Magnifying Opportunities to Recruit and Educate (MORE) Nurses Act H.R. 3492, Protect Childrens Innocence Act H.R. 3624/S. 1924, Improving Mental Health Access for Students Act H.R. 3701, Family Vaccine Protection Act H.R. 3884/S. 2011, Telemental Health Care Access Act H.R. 4262/S. 4110, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act H.R. 4340/S. 921, Tyler's Law H.R. 4564, Dillons Law H.R. 4709, Newborn Screening Saves Lives Reauthorization Act of 2025 H.R. 4725, Transparency, Readability, Understandability, Truth, and Helpfulness (TRUTH) in Labeling Act H.R. 5145, Bipartisan Premium Tax Credit Extension Act H.R. 5434/S. 2826, 988 LGBTQ+ Youth Access Act of 2025 H.R. 5469/S. 2858, Stillbirth Health Improvement and Education (SHINE) for Autumn Act H.R. 5582, Patients Deserve Price Tags Act H.R. 6088/S. 3281, Restoring Food Security for Families & Farmers Act of 2025 H.R. 6121/S. 2303, Promoting Physical Activity for Americans Act H.R. 6252, Food Assurance and Security Act H.R. 6396, Kid Providing Resources for Optimal Outcomes against Fatalities (Kid PROOF) Act of 2025 H.R. 6561, PREVENT HPV Cancers Act of 2025 H.R. 6703, Lower Health Care Premiums for All Americans Act H.R. 6844, Tobacco TRACE Act H.R. 6845/S. 3569, S.T.O.P. Illegal Vaping Act H.R. 6945/S. 4242, Supporting Pregnant and Parenting Women and Families Act H.R. 7092/S. 4061, Raising Awareness for Youth Suicide (RAYS) Prevention Act H.R. 7567, Farm, Food, and National Security Act of 2026 H.R. 7757, Kids Internet and Digital Safety (KIDS) Act H.R. 7867, Infant Formula Safety Modernization Act of 2026 H.R. 7875, Providing Opportunities for Individuals in Need of Treatment and Support (POINTS) Act H.R. 7973, Momnibus Act H.R. 8081/S. 4202, Mental Health Access and Provider Support Act H.R. 8089/S. 4186, Perinatal Workforce Act H.R. 8163, Provider Reimbursement Stability Act H.R. 8201, Expanding Community Access to Health Services Act H.R. 8209, School-Based Health Centers Reauthorization Act of 2026 H.R. 8385, Food Labeling Modernization Act of 2026 H.R. 8425, Strengthening the Vaccines for Children Program Act of 2026 H.R. 8429, Baby Food Safety Act of 2026 H.R. 8521/S. 4387, Protect Moms from Domestic Violence Act H.R. 8657, Campus Lifeline Act H.R. 9257/S. 4754, Primary and Behavioral Health Care Access Act H.R. 9393, Lower Costs, More Transparency Act of 2026 S. 222/H.R. 649, Whole Milk for Healthy Kids Act of 2025 S. 266/H.R. 929, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. 272, Protect Infant Formula from Contamination Act S. 278, Kids Off Social Media Act S. 705, Innovations in Pediatric Drugs Act S. 836/H.R. 6291, Children and Teens Online Privacy Protection Act (COPPA 2.0) S. 891, Bipartisan Health Care Act S. 1157/H.R. 2319, Women and Lung Cancer Research and Preventive Services Act of 2025 S. 1885, Stop the Scroll Act S. 1482, National Nursing Workforce Center Act of 2025 S. 1599/H.R. 6394, Midwives for Maximizing Optimal Maternity Services (MOMS) Act of 2025 S. 1748/H.R. 6484, Kids Online Safety Act S. 1874/H.R. 3593, Title VIII Nursing Workforce Reauthorization Act of 2025 S. 2169, Rural Hospital Cybersecurity Enhancement Act S. 2857/H.R. 5448, Protecting Free Vaccines Act S. 2954, Health Care Workforce Expansion Act of 2025 S. 3199, 988 Lifeline Location Improvement Act of 2025 S. 3315, Health Care Cybersecurity and Resiliency Act of 2025 S. 3386, Health Care Freedom for Patients Act of 2025 S. 3402, Ensuring Excellence in Mental Health Act S. 3799, Healthy Start Reauthorization Act of 2026 S. 3853, End the Vaccine Carveout Act S. 4088, Welcome Back to the Health Care Workforce Act S. 4141, Rural Hospital Revitalization Act S. 4189, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act

Client expense: Not reported · Firm income: $24,000

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

P.L. 119-21 (H.R. 1): One Big Beautiful Bill Act; provisions related to Title VII, Subtitle B H.R. 946: Orphan CURES Act; all provisions H.R. 2214: DRUG Act; all provisions H.R. 4317: PBM Reform Act of 2025; all provisions H.R. 6703: Lower Health Care Premiums for All Americans Act; provisions related to Pharmacy Benefit Management (PBM) S. 864: HELP Copays Act; all provisions S. 882: Patients Before Middlemen Act; all provisions S. 891: Bipartisan Health Care Act; provisions related to Titles I, II, VIII, and IX S. 1862: Orphan CURES Act; all provisions S. 3345: PBM Price Transparency and Accountability Act; all provisions Executive Order: Expanding Access to In Vitro Fertilization; all provisions of the order Executive Order: Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients; all provisions of the order General discussions related to Pharmacy Benefit Manager (PBM) policy issues General discussions related to Healthcare supply chain policy issues General discussions related to Drug cost and pricing policy issues General discussions related to caregiving support and awareness policy issues

Client expense: $700,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl Buddy - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3527 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicare expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710 - No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 5509 - Safe Step Act - Rep. Allen, Rick - Step therapy requirements H.R. 5582 - Patients Deserve Price Tags Act - Rep. James, John - Hospital and insurer price transparency requirement H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums H.R. 7023 - Affordable CHOICE Act - Rep. Schakowsky, Janice - public option under ACA H.R. 7164 - Capping Costs for Consumers Act - Rep. Schrier, Kim - ACA cost-sharing reductions H.R. 8270 - Every Dollar Counts Act - Rep. Murphy, Greg - Requirements for deductibles and MOOP to include expenditures for DTC prescriptions H.R. 8684 - Transparency in Billing Act - Rep. Foxx, Virginia - Transparency enforcement H.R. 9393 - Lower Costs, More Transparency Act - Rep. Guthrie, Brett - Healthcare price transparency S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Sen. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2824 - A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium tax credits - Sen. Murkowski, Lisa - Temporary extension of ACA enhanced premium tax credits S. 2903 - Safe Step Act - Sen. Murkowski, Lisa - Step therapy requirement S. 3599 - Affordable CHOICE Act - Sen. Whitehouse, Sheldon - public option under ACA S. 3990 - PrEP Access and Coverage Act - Sen. Smith, Tina - Coverage requirements for HIV services S. 4189 - INSULIN Act - Sen. Collins, Susan - Insulin cost-sharing caps S. 4512 - Affordable Insulin Now Act - Sen. Kennedy, John - Insulin cost-sharing caps Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Waste Fraud and Abuse; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; affordability; and health savings accounts.

Client expense: $3,010,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to employer, small group and individual insurance markets. H.R. 2214, the Delinking Revenue from Unfair Gouging (DRUG) Act H.R. 5433 - The Patients Over Profits Act S. 2836 - The Patients Over Profits Act H.R. 4409 - The Fair Pharmacies for Federal Employees Act of 2025 H.R. 6703, Lower Healthcare Premiums for All Americans Act H.R. 6610, The Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act] S. 3822, Break Up Big Medicine Act S. 4509, The Patients Before Monopolies Act

Client expense: $3,570,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare Part D, Medicare Advantage, Medicaid, mental health, and telehealth. Issues related to pharmacy testing, vaccination, and treatment. Issues related to Accountable Care Organizations. Issues related to Medicare Shared Savings Program. Issues related to Medicaid. S. 882, The Patients Before Middlemen (PBM) Act S. 927, The Protecting Pharmacies in Medicaid Act S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act S. 3345, The PBM Price Transparency and Accountability Act H.R. 4317, The Pharmacy Benefit Manager (PBM) Reform Act H.R. 4093, Apple to Apples Comparison Act H.R. 6575, CommonGround for Affordable Health Care Act H.R. 6703, The Lower Healthcare Premiums for All Americans Act H.R.6609, Pharmacists Fight Back in Medicare and Medicaid Act

Client expense: $3,570,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Issues related to tax advantaged savings vehicles for health expenses One Big Beautiful Bill Act HSA Expansion Provisions - Public Law No. 119-21 Bipartisan Health Insurance Affordability Act - H.R. 6501 Health Care Freedom for Patients Act of 2025 - S. 3386 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSAs for All Act - H.R. 7681 The Chronic Disease Flexible Coverage Act - H.R. 919 Lowering Cost for Caregivers Act of 2025 - H.R. 138 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSA Modernization Act- H.R. 548 Lowering Health Care Costs for Americans Act - S.3389

Client expense: $660,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to tax advantaged savings vehicles for health expenses One Big Beautiful Bill Act HSA Expansion Provisions - Public Law No. 119-21 Bipartisan Health Insurance Affordability Act - H.R. 6501 Health Care Freedom for Patients Act of 2025 - S. 3386 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSAs for All Act - H.R. 7681 The Chronic Disease Flexible Coverage Act - H.R. 919 Lowering Cost for Caregivers Act of 2025 - H.R. 138 Lower Health Care Premiums for All Americans Act - H.R. 6703 HSA Modernization Act- H.R. 548 Lowering Health Care Costs for Americans Act - S.3389

Client expense: $660,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Natural Disasters Communications with the House of Representatives supporting H.R. 1491 Disaster Related Extension of Deadlines Act and H.R. 517 The Filing Relief for Natural Disasters Act. FEMA Act Communications with the House of Representatives supporting H.R. 1105, the Disaster Resiliency and Coverage Act that would provide pre-disaster mitigation grants and tax incentives for households to reduce the risk of real property damage due to natural disasters, including floods, hurricanes, and wildfires. Communications with the Senate supporting S.127 Whole Homes Repairs Act and the nomination of Travis Hill for the Federal Deposit Insurance Corporation. Government Accountability Office (GAO) Discussions regarding the National Flood Insurance Program. Federal Emergency Management Agency (FEMA) Communications regarding disaster mitigation and assistance, and flood insurance. Discussions with the Treasury Department/Federal Insurance Office regarding flood insurance and general insurance issues. Communications with the House of Representatives and Senate urging the extension of the National Flood Insurance Program. Communications with the House of Representatives supporting H.R. 7128 TRIA Program Reauthorization Act to extend the Terrorism Risk Insurance Program. Communications with the House of Representatives regarding association health plans and H.R. 6703 Lower Heath Care Premiums for All Americans Act. Communications with the National Oceanic and Atmospheric Administration regarding natural disasters.

Client expense: $14,580,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Natl Oceanic & Atmospheric Administration (NOAA), SENATE, Treasury, Dept of, White House Office

S.J.Res.198 and S.J.Res.192 Congressional Review Act resolution, CMSs Wasteful and Inappropriate Service Reduction (WISeR) model S.4086/H.R.8310, Patient Safety and Whistleblower Protections Act H.R.8484/ S.4357Hazard Pay for Healthcare Heroes Act Fund health care over attacks on immigrants and communities Monitor the following: H.R.7985, CHATBOT Act H.R.7858 Data Center Community Impact Act H.R.6984, The Data Center Transparency Act S.4085, Taking Back Our Hospitals Act Healthcare funding H-1B fees and the healthcare workforce U.S. Vaccine schedule Private equity and healthcare S.3480, SMARTER Care Act H.R.6361, Ban AI Denials in Medicare Act S.3323, Family Vaccine Protection Act Discharge Petition No: 119-10, related to a three-year extension of the ACA tax credits H.R.6703, the Lower Health Care Premiums for All Americans Act S.1562/H.R.1197, PREEMIE Reauthorization Act S.2621/H.R.1909, Preventing Maternal Deaths Reauthorization Act Repeal healthcare provisions of H.R.1, One Big Beautiful Bill Act H.R.5557, Mental Health Services for Students Act S.2556/H.R.4849, Protecting Health Care and Lowering Costs Act Preserve the United States Preventive Services Task Force H.R.1197/S.1562, PREEMIE Reauthorization Act S.2621, Preventing Maternal Deaths Act Nurse Staffing Standards for Hospital Patent Safety and Quality Care Act Public Law 119-21, To provide for reconciliation pursuant to title II of H. Con. Res. 14, Healthcare related provisions. Medicaid, Medicare, ACA cuts H.R.4253, Expanding Access to Mental Health Services in Schools Act H.R.3907/S.2024, ENROLL Act Stop Medical Profiteering and Theft Act Justice Department anticompetitive regulations related issues H.R.3063, Rural Hospital Stabilization Act H.R.3262, NURSE Act Restructuring of the Department of Health and Human Services H.R.593, Strengthening Pathways to Health Professions Act Healthcare workforce issues Funding for SUNY Downstate hospital Impact of private equity on healthcare Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Rural healthcare and hospital workforce challenges and related issues Supporting investments in school-based mental health professionals Healthcare high school apprenticeships Artificial Intelligence, Healthcare related issues Medicare drug negotiation program PBM reform Reauthorization of healthcare workforce programs Medicaid DSH Payments, Hospital funding formula Student Loan Forgiveness for Frontline Health Workers Affordability of pharmaceuticals, generally Telehealth issues Mental health supports for educators Workplace Violence Prevention for Health Care and Social Service Worker Act Workplace violence related issues Health Worker Shortage/Staffing Crisis Funding for Medicare low-income outreach and enrollment efforts Prevention and Public Health Fund related issues Healthcare cybersecurity related issues Safe staffing levels Department of Health and Human Services, WiSER model H.R.1834, Breaking the Gridlock Act, ACA Tax Credits Healthcare Affordability

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposals addressing pharmacy benefit manager (PBM) practices, including those focused on PBM/pharmacy contracts, pharmacy reimbursement, direct and indirect remuneration (DIR), and transparency Issues relating to pharmacy reimbursement, scope of practice, access to pharmacist-provided care Patients Before Middlemen Act (S. 882) Protecting Pharmacies in Medicaid Act (S. 927) Main Street Pharmacy Access Act (H.R. 3164/S. 2426) PBM Reform Act (H.R. 4317) S.3345 - PBM Price Transparency and Accountability Act H.R.6703 - Lower Health Care Premiums for All Americans Act H.R. 7148 - Consolidated Appropriations Act, 2026 Administration prescription drug pricing platform (Trump Rx)

Client expense: $584,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

GOOD GOVERNMENT: White House Conference on Small Business Act, H.R. 6855: Support action by U.S. House to advance the legislation. DME Scammer Prevention Act of 2026, H.R. 8871: Support the legislation. Preventing Waste, Fraud and Abuse in TANF Act, H.R. 8872: Support the legislation. Protecting Seniors and Stopping Fraudsters Act, H.R. 8883: Support the legislation. Recover COVID Unemployment Fraud in Banks Act, H.R. 8873: Support the legislation. Supporting Rural Communities, H. Res. 1182: Supported House passage of the resolution. WORKFORCE ISSUES: Workforce Apprenticeship Growth and Education Support (WAGES) Act, H.R. 8624 and S. 4463: Support the legislation. Faster Labor Contracts Act, H.R. 5408: Opposed House passage of the legislation. Flexibility for Workers Education Act, H.R. 2262: Continue to support U.S. House passage of the bill. Empowering Employer Child and Elder Care Solutions Act, H.R. 2270: Continue to support U.S. House passage of the bill. Working Families Flexibility Act, H.R. 2870: Continue to support U.S. House passage of the bill. Tipped Employee Protection Act, H.R. 2312: Support U.S. House passage of the bill. DOLs Proposal to Expand Investment Opportunities in 401(k) Plans (Fiduciary Duties in Selecting Designated Investment Alternatives): Expressed support for a proposed rulemaking to provide American workers, small business owners and their employees with access to the same diversified opportunities long available to large pension funds. Submitted Comments to Department of Labor (DOL) on Employee or Independent Contractor Status Under the Fair Labor Standards Act, Family and Medical Leave Act, and Migrant and Seasonal Agricultural Worker Protection Act: Expressed support for the proposed rule changes on independent contractors. President Trumps Executive Order on PROMOTING RETIREMENT-SAVINGS ACCESS FOR AMERICAN WORKERS BY ESTABLISHING TRUMPIRA.GOV: Expressed support for the initiative. ACCESS TO CAPITAL: INVEST Act, H.R. 3383: Support U.S. Senate passage of this Housed-passed bill. Submitted Comments to the Federal Reserve on Regulatory Capital Rule: Category I and II Banking Organizations, Banking Organizations with Significant Trading Activity, and Optional Adoption for Other Banking Organizations [R-1887]: SBE Council welcomed the re-proposal as a substantive improvement over the 2023 version and made slight recommendations. Submitted Comments to the Office of the Comptroller (OCC) on National Bank Non-Interest Charges and Fees, and interim final order, Order Preempting the Illinois Interchange Fee Prohibition Act. SBE Council expressed support for these actions. TAX POLICY: Small Business Tax Cut Act, H.R. 8415: Support the legislation. Indexing Capital Gains Tax Liability to Inflation: Support legislative or administrative action to make this change. H. Res. 1156 which Expresses Support for Tax Policies that Support Working Families: Supported the House resolution. More Homes on the Market Act, H.R. 1340, S.3332: Support the legislation. American Innovation Act, H.R. 1778, S. 4207: Support the legislation. BUSINESS STARTUP AND GROWTH: SAVE Local Businesses Act, H.R. 4366: Support U.S. House passage of the bill. New Opportunities for Business Ownership and Self-Sufficiency Act (NO BOSS Act), H.R. 6431: Supported U.S. House passage of the legislation. American Innovation Act, H.R. 1778, S. 4207: Support the legislation. Submitted Comments to Federal Trade Commission and Department of Justice on Making Improvements to the Premerger Notification and Report Form: Urged the agencies to consider maintaining the current HSR form and system, as potential changes have not been substantiated with failures, problems or flaws. AI AND TECHNOLOGY Continue to voice restraint on excessive regulatory frameworks or actions that would undermine what is a critical new technology for small businesses. SECURE Data Act (Securing and Establishing Consumer Uniform Rights and Enforcement over Data Act), H.R. 8413: Welcomed the introduction of comprehensive data privacy legislation. AI Education: Continue to brief congressional staff on the benefits of AI to small businesses and startups as conveyed through SBE Council research and surveys. American Innovation and Choice Online Act (AICOA). S. 4746: Oppose the legislation. REGULATORY REFORM AND MODERNIZATION Guidance Out of Darkness (GOOD) Act (H.R. 1515): Urged Senate to advance House-passed bill. Information Quality Assurance Act (H.R. 6329): Urged Senate to advance House-passed bill. ESA Amendments Act, H.R. 1897: Supported House passage of the bill. Prove It Act of 2025, H.R. 1163: Support House action and passage of the bill. 21st Century ROAD to Housing Act, H.R. 6644: Supported House amendment to the Senate-passed bill and final bill that went into law. Reducing and Eliminating Duplicative Environmental Regulations (RED Tape) Act, H.R. 6398: Supported House passage of the legislation. Earnings Claims Rulemaking and Business Opportunity Rule: Continue to express concerns about these Biden-Era regulatory efforts that remain on the Federal Trade Commissions regulatory agenda Standardizing Permitting and Expediting Economic Development Act (SPEED Act), H.R. 4776: Supporting Senate action on House-passed bill. Promoting Efficient Review for Modern Infrastructure Today (PERMIT) Act, H.R. 3898: Support Senate action on House-passed bill. Repealing Big Brother Overreach Act, H.R. 425: Support the legislation. GOVERNMENT REFORM AND OPERATIONS: Tax Relief for Fraud Victims Act, H.R. 9500: Support the legislation. AI Tax Integrity Act of 2026, H.R. 9501: Support the legislation. Taxpayer Advocate Participation Act, H.R. 9498: Support the legislation. Taxpayer Assistance and Service Act. S. 3931: Support the legislation. Taxpayer Due Process Enhancement Act, H.R. 6506: Support U.S. Senate action on the House-passed bill. Taxpayer Notification and Privacy Act, H.R. 6495: Support U.S. Senate action on the House-passed bill. HEALTHCARE AND AFFORDABLE HEALTH COVERAGE: HSAs For All Act, H.R. 7681: Support the legislation. Lower Health Care Premiums for All Americans Act, H.R. 6703: Support Senate action of House-passed bill. 340B Drug Program: Continue to voice concerns about this program to Congress (in terms of effects on high drug and health premium costs) and the need for reforms. Medication Affordability and Patent Integrity Act, S. 2658: Expressed concern about the legislation. Biosimilar Red Tape Elimination Act, S. 1954: Expressed concern about the legislation. Ensuring Timely Access to Generics Act, S. 3014: Expressed concern about the legislation. Abolish the Center for Medicare and Medicaid Innovation (CMMI) Act, H.R. 8293: Support the legislation. TRADE AND GLOBAL MARKET ACCESS: Submitted coalition comments to U.S. Department of Commerce on Section 232 Investigation of Imports of Semiconductors and Semiconductor Manufacturing Equipment (91 FR 2443): Urged the Administration to refrain from imposing tariffs on semiconductors and downstream consumer and commercial technology products.

Client expense: $45,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of the Comptroller of the Currency (OCC), SENATE, White House Office

H.R. 1 One Big Beautiful Bill Act; HR 6703 Lower Health Care Premiums for All Americans Act; issues relating to the guaranteed issue small group market; issues relating to the employer tax exclusion

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6703 Lower Health Care Premiums for All Americans Act; issues relating to the guaranteed issue small group market

Client expense: Not reported · Firm income: $10,000

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): 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.

Client expense: $210,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Affordable Care Act and Extending Enhanced APTCs (H.R. 247; S. 46), 2026 Proposed NBPP/Individual Market/ACA exchanges; Fraudulent Enrollments in Qualified Health Plans (S. 976, HR 2079), Behavioral Health, Employer-Provided Health Coverage; Surprise Billing (S. 2420, H.R. 4710); Cybersecurity; Health IT, Health Care Innovation, Transparency & PBMs (S. 891, H.R. 6703), PBM Compensation (H.R. 7895), Prescription Drugs (S. 1954, S. 1096, S. 1096, S.1040) Price Transparency (S. 2355, H.R. 9393, H.R. 9397), Prior Authorization (H.R. 9396), 340B.

Client expense: $700,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

House: H.R.1, An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14. H.R. 425, the Repealing Big Brother Overreach Act H.R.7035, the Credit Card Competition Act of 2026 H.R. 6213, the Heat Workforce Standards Act of 2025 H.R. 4776, the Standardizing Permitting and Expediting Economic Development (SPEED) Act H.R. 4366, the Save Local Business Act H.R. 3898, the Promoting Efficient Review for Modern Infrastructure Today (PERMIT) Act H.R. 3699, the Energy Choice Act H.R. 4424, the Securing Help for Involuntary Employment Loss and Displacement (SHIELD) Act H.R. 5463, the Custom Health Option and Individual Care Expense (CHOICE) Arrangement Act H.R.6703, the Lower Health Care Premiums for All Americans Act H.R. 20, the Richard L. Trumka Protecting the Right to Organize (PRO) Act H.R. 4896, the Warehouse Worker Protection Act H.R. 2743, the Raise the Wage Act H.R. 1319, the Modern Worker Empowerment Act H.R. 1566, the Right to Equitable and Professional Auto Industry Repair (REPAIR) Act H.R. 5349, the Tax Court Improvement Act H.R. 5346, the Fair and Accountable IRS Review Act H.R.5267, the American Franchise Act H.R. 2528, the Association Health Plans Act H.R. 6420, the Affordable Care Economic Stability and Small Business (ACCESS) Act H.R.1163, the Prove It Act of 2025 H.R. 5258, the Lawsuit Abuse Reduction Act of 2025 H.R. 2675, the Protecting Our Courts from Foreign Manipulation Act of 2025 H.R. 4626, the Home Appliance Protection and Affordability Act H.R.7148 - Consolidated Appropriations Act, 2026 H.R.7328 - Protecting Small Businesses from Predatory Website Lawsuits Act H.R. 6250, the Cold Weather Diesel Reliability Act of 2025 H.R. 6453, the Americans with Disabilities Act 30 Days to Comply Act H.R.7847, the Stop Unemployment Fraud Act H.R. 2528, the Association Health Plans Act H.R. 8082, the Competition and Openness in Markets to Promote Efficiency, Transparency, and Enhanced Affordability (COMPETE) Act H.R. 6538, the More Affordable Care Act H.R. 5582, the Patients Deserve Price Tags Act H.R. 5408, the Faster Labor Contracts Act H.R.8800, National Defense Authorization Act for Fiscal Year 2027 H.R.3269, Eliminating Thickets to Increase Competition (ETHIC) Act H.R. 5337, Motor Carrier Safety Selection Standard Act Consumer Financial Protection Bureau Section 1071 rule requires covered financial institutions to collect and report demographic and credit data on small business loan applications. H.R. 8415, Small Business Tax Cut Act H.R. 1897, Endangered Species (ES) Amendments Act of 2025 H.R.5166, Financial Services and General Government Appropriations Act, 2026 H.R. 1687, the Committing Leases for Energy Access Now (CLEAN) Act H.R. 6398, the Reducing and Eliminating Duplicative Environmental Regulations Act H.R. 8414, Know Your Labor Rights Act H.R. 8415, Small Business Tax Cuts Act of 2026 H.R. 7861, HSAs for All Act H.R. 7895, PBM Kickback Prohibition Act Issues relating to small business taxation Issues related to the expiring TCJA tax provisions Issues related to ADA website reforms Issues related to the minimum wage increase Issues related to "Affordable Care Act Reform" Issues related to Pharmacy Benefit Managers Issues related to Health Reform Issues related to regulatory reforms Senate: S. 100, the Repealing Big Brother Overreach Act S.3623, the Credit Card Competition Act of 2026 S. 4427, Heat Workforce Standards Act of 2026 S. 3117, the Worker Reforming Elections for Speedy and Unimpeded Labor Talks (RESULTS) Act S. 3116, the Fairness in Filing Act S. 5213, the Union Members' Right to Know Act S.3124, the Protection on the Picket Line Act S.3128, the Worker Privacy Act S. 852, the Richard L. Trumka Protecting the Right to Organize (PRO) Act S. 2613, the Warehouse Worker Protection Act S. 844, the Faster Labor Contracts Act S. 2013, the Higher Wages for American Workers Act S. 1332, the Raise the Wage Act S. 1945, the Energy Choice Act S. 1379, the Right to Equitable and Professional Auto Industry Repair (REPAIR) Act S.2875, the Custom Health Option and Individual Care Expense (CHOICE) Act S. 1847, the Association Health Plans Act S. 3418, the Competition and Openness in Markets to Promote Efficiency, Transparency, and Enhanced Affordability (COMPETE) Act S.495, Prove it Act of 2025 S. 3264, the More Affordable Care Act S. 2355, the Patients Deserve Price Tags Act S. 4366, Know Your Labor Rights Act S. 2276, Eliminating Thickets to Increase Competition (ETHIC) Act S. 4419: A bill to amend title 31, United States Code, to require only foreign entities to report beneficial ownership information, and for other purposes. Issue relating to small business taxation Issue related to the expiring TCJA tax provisions Issue related to ADA website reforms Issue related to the minimum wage increase Issue related to "Affordable Care Act Reform" Issue related to Pharmacy Benefits Managers Department of the Treasury: Beneficial Ownership Information (BOI) Reporting Rule H.R.1, An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14. White House: Beneficial Ownership Information (BOI) Reporting Rule Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Issues relating to the right to repair Office of Management and Budget: Beneficial Ownership Information (BOI) Reporting Rule H.R.7035/S.3623, the Credit Card Competition Act of 2026 H.R. 1566/S. 1379, the Right to Equitable and Professional Auto Industry Repair (REPAIR) Act Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Issues related to Short-Term Limited Duration Insurance Plans Financial Crimes Enforcement Network: Beneficial Ownership Information (BOI) Reporting Rule Department of Health and Human Services: Issues related to Individual Coverage Health Reimbursement Arrangements (ICHRA) Regulation Reform Department of Labor: Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule Issues related to General Health Care Reform Occupational Safety and Health Administration: Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rule

Client expense: $1,670,000 · Firm income: Not reported

Government targets: Financial Crimes Enforcement Network (FinCEN), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

PBM Reform, transparency H.R. 6703 - Lower Health Care Premiums for All Americans Act - A bill to ensure access to affordable health insurance. S.4189 - INSULIN Act of 2026 - A bill to reduce the price of insulin and provide for patient protections with respect to the cost of insulin. H.R.7895 - PBM Kickback Prohibition Act - A bill to prohibit kickbacks to pharmacy benefit managers.

Client expense: $230,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related asthma, COPD, influenza, lung cancer, pneumonia, pulmonary fibrosis, tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to agency restructuring; Issues related to the Childrens Health Insurance Program; Issues related to Medicaid; Issues related to ERISA; Issues related to COVID-19 Response; Issues related to vaccines; Issues related to infrastructure; Issues related to supplemental oxygen; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to Cancer Moonshot; Issues related to short-term limited duration plans; Issues related to Healthy Future Taskforce; Issues related to regulatory reform; Issues relating to FY25 appropriations; Issues relating to FY26 appropriations; S 1406 the Supplemental Oxygen Access Reform Act; HR 2902 the Supplemental Oxygen Access Reform Act; H.R. 783 Sustainable Cardiopulmonary Rehabilitation Services in the Home Act; S. 248 Sustainable Cardiopulmonary Rehabilitation Services in the Home Act; S 717Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025; S 77 Early Participation in Regulations Act; S 81 Guidance Clarity Act; HR 77 Midnight Rules Relief Act; H.R. 3701 Family Vaccine Protection Act; H.R. 3521 Clinical Trial Modernization Act;;; HR 4417 Mobile Cancer Screening Act HR 3701 Family Vaccine Protection Act; HR 5304Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026; S 2587 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026; HR 5278/S 2756 Affordable Inhalers and Nebulizers Act of 2025; HR 6703 Lower Health Care Premiums for All Americans Act; S 2466 Senior Savings Protection Act; HR Senior Savings Protection Act; HR 6052 Elijah E. Cummings Family Asthma Act; HR 6319 Benay Taub Lung Cancer Research Act; HR 45448 Protecting Free Vaccines Act; Consolidated Appropriations Act, 2026; Breaking the Gridlock Act; HR 9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027

Client expense: $120,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

H.R. 7681, the HSAs for All Act. H.R. 5463, the CHOICE Act. H.R. 6703, the Lower Health Care Premiums for All Americans Act. H.R. 6538, the More Affordable Care Act. H.R. 5582, the Patients Deserve Price Tags Act. H.R. 6248, the Healthy Competition for Better Care Act. H.R. 8270, the Every Dollar Counts Act. H.R. 7871, the Medicaid VBPs for Patients (MVP) Act

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

H.R. 2214, the Delinking Revenue from Unfair Gouging Act; H.R. 1968, the Full-Year Continuing Appropriations and Extensions Act, 2025; H.Con.Res 14/S. Con. Res. 7, Establishing the congressional budget for the United States Government for fiscal year 2025 and setting forth the appropriate budgetary levels for fiscal years 2026 through 2034; H.R. 1, the One Big Beautiful Bill; Comments to FDA on "Re: Agency Information Collection Activities; Proposed Collection; Comment Request; Compounding Animal Drugs From Bulk Drug Substances [Docket No. FDA-2025-N-0082]"; LHHS Report Language Request to Improve the Care and Treatment of Long-Term Care Residents with Neuropsychiatric Symptoms; Comments to OMB on "Re: Request for Information: Deregulation"; Comments to HHS/DOGE on government efficiency, fraud, waste and PBMs; Comments on "Executive Order 14297 of May 12, 2025 - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients"; Comments to CDC on "RE: June 25-26 Advisory Committee on Immunization Practices Meeting"; H.R.5316, the Drug Shortage Compounding and Patient Access Act; H.R.5256, the 340B ACCESS Act; Comments to FDA on "RE: Docket No. FDA-2025-N-2589, Comments on the Risks and Benefits of Menopause Hormone Therapy"; H.Res. 805, Recognizing October 2025 as American Pharmacists Month in honor of the contribution of pharmacists to provide safe, accessible, affordable, and beneficial patient care services and products to all residents and protect the public health of our communities; S.3345, the PBM Price Transparency and Accountability Act; H.R. 6609, Pharmacists Fight Back in Medicare and Medicaid Act; H.R. 6610, Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act]; H.R. 6703, the Lower Health Care Premiums for All Americans Act; H.R.5133, the Patient's Right to Know Their Medication Act; H.R. 4409, the Fair Pharmacies for Federal Employees Act; S.3549/H.R.6837, the Fiduciary Accountability, Integrity and Reform (FAIR) Act; H.R.7148, the Consolidated Appropriations Act of 2026; Rural Health Transformation Program; Creation and Implementation of TrumpRx; Comments to FDA on RFI, "Re: Increasing Access to Nonprescription Drugs; Request for Information"; S.3822, Break up Big Medicine Act; Comments to FDA on RFT, "Re: [Docket No. FDA-2025-N-6743] - Scientific and Clinical Considerations for Testosterone Replacement Therapy (TRT) in Men with Hypogonadism"; Comments to DoL, HHS, and DoT regarding "Re: Transparency in Coverage Proposed Rule [CMS-9882-P]"; Pharmacy Shortage Areas in reference to USC-NCPA joint project Mapping Tool; H.R. 7895, the PBM Kickback Prohibition Act; Comments to FDA on their comment request "Re: Agency Information Collection Activities; Proposed Collection; Comment Request; Medication Guides for Prescription Drug Products [FDA-2025-N-6869]"; H.R.6509/S.3794, the SAFE Drug Act; H.R.5316, the Drug Shortage Compounding Patient Access Act; H.R.8779/S.4509, the Patients Before Monopolies Act; S.3788/H.R.8269, the CLEAR LABELS Act; S.1941, the Cure Hepatitis C Act of 2025;

Client expense: $270,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)

Ending Discrimination Against Gay and Bisexual Blood and Tissue Donors Funding for HIV/AIDS Education, Prevention, and Research Funding for and Education Regarding Comprehensive Sexual Health Education Implementation of Section 1557 Nondiscrimination regulations Implementation and Protection of the Patient Protection and Affordable Care Act Labor, HHS, and Education Appropriations PrEP Insurance Coverage Title X Family Planning Funding Access to Gender Affirming Care Employment Benefits Conversion Therapy H.R. 2197: No 340B Savings for Transgender Care Act H.R. 2107: To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs, and for other purposes. S. 312: Jamie Reed Protecting Our Kids from Child Abuse Act H.R. 742: PROTECTS Act of 2025 H.R. 653; S. 209: Protecting Minors from Medical Malpractice Act of 2025 H.R. 498: Do No Harm in Medicaid Act H.R. 2487; S. 3206: Transgender Healthcare Access Act S. 422 Right to Contraception Act H.R. 2387: No Harm Act H.R. 3757: Pride in Mental Health Act of 2025 S. 2035: Protect IVF Act H.R. 3811: The Elder Pride Protection Act of 2025 H.R. 3688: Protecting Children from Experimentation Act of 2025 S. 1774: Protecting Minors in Federal Health Plans Act H.R. 3527; S. 1910: Real Education for Healthy Youth H.R. 5434; S. 2826: 988 LGBTQ+ Youth Access Act of 2025 H.R. 5390; S. 2823: FAMILY Act H.R. 4648; S. 2408: Access to Fertility Treatment and Care Act H.R. 3492: Protect Childrens Innocence Act H.R. 5483; S. 2907: Chloe Cole Act H.R. 4953: Gender-Affirming Child Abuse Prevention Act H.R. 4618: Jamie Reed Protecting Our Kid from Child Abuse Act S.2907 A bill to prohibit health care professionals, hospitals, or clinics from participating in the chemical or surgical mutilation of a child and to provide a private right of action for children and the parents of children whose healthy body parts have been damaged by medical professionals practicing chemical and genital mutilation H.R. 5592 Childhood Genital Mutilation Prevention Act H.R. 600; S. 774: WHO is Accountable Act H.R. 4151: Ruthie and Connie LGBTQI Elder Americans Act of 2025 H.R. 6703: Lower Healthcare Premiums for All Americans Act H.R. 3386: Health Care Freedom for Patients Act of 2025 H.R. 6372; S. 3327: D.C. Shield Law Repeal Act S. 3011: Prohibiting Abortion & Transgender Procedures on Exchanges Act S. 3385: Lower Health Care Costs Act H.R. 7420: Stop Gender Trafficking of Minors Act H.R. 7853; S. 3990: PrEP Access and Coverage Act of 2026 H.R. 7148, the Consolidated Appropriations Act, 2026 H.R. 6876: Protecting Children from Foreign Muttilation Act H.R. 9260: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027 H.R. 8573; S. 4426: STOP Act H.R. 8952; S. 4625: Elder Pride Act of 2026 H.R. 7531; S. 3869 Healthy Families Act H.R. 7385: PrEP Assistance Program Act H.R. 12: Womens Health Protection Act H.Res. 445: Supporting the goals and ideals of the month of May as Sex Ed For All Month: Equity and Access for All. H.R. 6512: Putting Patients First Healthcare Freedom Act

Client expense: $223,727 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues related to employer provided benefits such as HSAs, FSAs, HRAs, ICHRAs, DCFSAs and commuter benefits. H.R. 548, The HSA Modernization Act of 2025. H.R. 138, The Lowering Costs for Caregivers Act of 2025. H.R. 3799, The Choice Arrangement Act. H.R. 1421, The Improving Child Care for Working Families Act. H.R. 5463 - Choice Arrangement Act of 2025. S. 2875 - CHOICE Act. H.R. 6703 - Lower Healthcare Premiums for All Americans Act.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Budget Reconciliation (no bill number yet) - Oppsose additional healthcare cuts or changes to EITC and CTC that would reduce tax credits H.R.3069 and S.1506 - Medicare for All Act - Provide healthcare coverage for all under a single payer system H.R.3911 and S.2032 - Choose Medicare Act - Provide Medicare option for universal coverage HR 4849/S.2556 - Protecting Healthcare and Lowering Costs Act of 2025 (Rep. Gray/Sen. Schumer) -Support to Repeal healthcare title of HR. 1 and permanently extend ACA enhanced premium tax credits S.2824 - A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium credits (Sen. Murkowski) -Oppose a temporary two year extenstion of the ACA EPTCs S.3385 Lower Health Care Costs Act (Schumer) -Suport clean three year extension to ACA ePTCs Discharge Petition No. 10 H.Res. 780 (Jeffries) -Support three year clean extention of ACA ePTCs S.3386 Health Care Freedom for Patients Act of 2025 (Crapo/Cassidy) -Oppose bill to provide a health savings account contribution to certain enrollees, to reduce health care costs, and for other purposes H.R.6703 - Lower Health Care Premiums for All Americans Act -House Republicans alternative approach to addressing rising health insurance costs without extending ACA ePTCs S.2 Secure America Act -Opposed additional funding for ICE/CBP in Budget Reconciliation 2.0 S.1506 - Medicare for All Act -Provide healthcare coverage for all under a single payer system S.2032 - Choose Medicare Act -S.2032 - Provide Medicare option for universal coverage

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1650/S. 763, Telehealth Expansion Act of 2025 H.R. 2528/S. 1847, Association Health Plans Act H.R. 6703, Lower Health Care Premiums for All Americans Act, including PBM transparency provisions Various issues relating to the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, health savings account (HSAs), health reimbursement account (HRAs), association health plans (AHPs), cost sharing reduction payments (CSRs), individual health reimbursement arrangements (ICHRAs), employer mandates; implementation of the One Big Beautiful Bill Act, (P.L. 119-21); health reimbursement arrangements and other account-based group health plans; mental health parity; Federal Trade Commissions multilateral pharmaceutical merger taskforce; telehealth, including coverage of telehealth under High-Deductible Health Plans (HDHPs) and expanding telehealth options for employees; impact of Pharmacy Benefit Managers Practices; FTC-2022-0015; petition to HHS to grant march-in rights for the patents on the drug Xtandi; legislative proposals to tax employer-provided health care coverage; artificial price caps on providing insulin; Executive Order 14297, Delivering Most‑Favored‑Nation Prescription Drug Pricing to American Patients; ERISA preemption protections including information on constructive changes/modifications to ERISA; TRUMP AMERICA AI Act and AI proposals impacting health care; efforts to reform the World Health Organizations (WHO) engagement with private sector; continued U.S. membership to the WHO; support for necessary market conditions to incentivize health sector investment, grow markets, sustain business operations, and improve access to health commodities globally; promote greater harmonization of standards and investment in digital health; health-related policy issues in the G20/G7 forums and other multilateral forums; support for continued and reformed U.S. foreign assistance, including in global health

Client expense: $19,750,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

Work on extending advanced premium tax credits. This includes related proposals S. 3385, the Lower Health Care Costs Act; S. 3386, the Health Care Freedom for Patients Act; and H.R. 6703, the Lower Health Care Premiums for All Americans Act.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Supported S. 832, the Ensuring Pathways to Innovative Cures Act of 2025 or the EPIC Act of 2025," bipartisan, bicameral legislation that fixes the Inflation Reduction Act's small molecule pill penalty to ensure continued R&D investments into small molecule medicines. Support H.R. 5256, 340B ACCESS Act to reform the 340B drug pricing program. Oppose extending the Affordable Care Act subsidies. Support H.R.6703 - Lower Health Care Premiums for All Americans Act designed to cut health costs by, among other things, expanding Association Health Plans (AHPs) for small businesses, creating new "CHOICE" arrangements for tax-free health spending, allowing stop-loss insurance for employers, increasing PBM transparency, and funding marketplace cost-sharing. Support President Trump's Great American Healthcare Plan.

Client expense: Not reported · Firm income: $5,250

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Potential changes in authorizations for nurse education, workforce, and research programs as a result of workforce reductions and reorganization of agencies and programs within the Department of Health and Human Services Policies related to the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, child vaccine recommendations and schedule, the Vaccines For Children Program, and the Vaccine Injury Compensation Fund Cancellation of federal nursing workforce grants Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Use of provider-neutral and inclusive language in federal documents, forms, and surveys Reintroduction of the Primary and Behavioral Health Care Access Act Reauthorization of the Child Nutrition Act Implementation of 42 USC 300gg-5(a) regarding provider non-discrimination by health plans Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Mental health services and violence prevention Tobacco and vaping prevention and cessation Implementation of provisions of the One Big, Beautiful Bill Act (PL 119-21) H.R. 1197/S. 1562, PREEMIE Reauthorization Act H.R. 1435/S. 3714, Family-to-Family Reauthorization Act of 2025 H.R. 1627, Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 1735/S. 779, Early Action and Responsiveness Lifts Youth Minds (EARLY Minds) Act H.R. 1834, Breaking the Gridlock Act H.R. 1909/S. 2621, Preventing Maternal Deaths Act H.R. 2223, Building Capacity for Care Act H.R. 3333, Magnifying Opportunities to Recruit and Educate (MORE) Nurses Act H.R. 3492, Protect Childrens Innocence Act H.R. 3701, Family Vaccine Protection Act H.R. 3884/S. 2011, Telemental Health Care Access Act H.R. 4262/S. 4110, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act H.R. 4340/S. 921, Tyler's Law H.R. 4564, Dillons Law H.R. 4709, Newborn Screening Saves Lives Reauthorization Act of 2025 H.R. 5145, Bipartisan Premium Tax Credit Extension Act H.R. 5434/S. 2826, 988 LGBTQ+ Youth Access Act of 2025 H.R. 5469/S. 2858, Stillbirth Health Improvement and Education (SHINE) for Autumn Act H.R. 5629, To provide that the HHS final rule titled Medications for the Treatment of Opioid Use Disorder (except the portion relating to accreditation of opioid treatment programs) shall have no force or effect H.R. 6088/S. 3281, Restoring Food Security for Families & Farmers Act of 2025 H.R. 6252, Food Assurance and Security Act H.R. 6396, Kid Providing Resources for Optimal Outcomes against Fatalities (Kid PROOF) Act of 2025 H.R. 6561, PREVENT HPV Cancers Act of 2025 H.R. 6703, Lower Health Care Premiums for All Americans Act H.R. 6844, Tobacco TRACE Act H.R. 6845/S. 3569, S.T.O.P. Illegal Vaping Act H.R. 6945/S. 4242, Supporting Pregnant and Parenting Women and Families Act H.R. 7092, Raising Awareness for Youth Suicide (RAYS) Prevention Act H.R. 7567, Farm, Food, and National Security Act of 2026 H.R. 7757, Kids Internet and Digital Safety (KIDS) Act H.R. 7973, Momnibus Act H.R. 8089/S. 4186, Perinatal Workforce Act S. 222/H.R. 649, Whole Milk for Healthy Kids Act of 2025 S. 266/H.R. 929, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. 272, Protect Infant Formula from Contamination Act S. 278, Kids Off Social Media Act S. 705, Innovations in Pediatric Drugs Act S. 836/H.R. 6291, Children and Teens Online Privacy Protection Act (COPPA 2.0) S. 891, Bipartisan Health Care Act S. 1157/H.R. 2319, Women and Lung Cancer Research and Preventive Services Act of 2025 S. 1885, Stop the Scroll Act S. 1261, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025 S. 1482, National Nursing Workforce Center Act of 2025 S. 1599/H.R. 6394, Midwives for Maximizing Optimal Maternity Services (MOMS) Act of 2025 S. 1748/H.R. 6484, Kids Online Safety Act S. 1874/H.R. 3593, Title VIII Nursing Workforce Reauthorization Act of 2025 S. 2169, Rural Hospital Cybersecurity Enhancement Act S. 2857/H.R. 5448, Protecting Free Vaccines Act S. 2954, Health Care Workforce Expansion Act of 2025 S. 3199, 988 Lifeline Location Improvement Act of 2025 S. 3315, Health Care Cybersecurity and Resiliency Act of 2025 S. 3386, Health Care Freedom for Patients Act of 2025 S. 3853, End the Vaccine Carveout Act S. 4088, Welcome Back to the Health Care Workforce Act S. 4189, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act

Client expense: Not reported · Firm income: $24,000

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

P.L. 119-21 (H.R. 1): One Big Beautiful Bill Act; provisions related to Title VII, Subtitle B H.R. 946: Orphan CURES Act; all provisions H.R. 2214: DRUG Act; all provisions H.R. 4317: PBM Reform Act of 2025; all provisions H.R. 6703: Lower Health Care Premiums for All Americans Act; provisions related to Pharmacy Benefit Management (PBM) S. 864: HELP Copays Act; all provisions S. 882: Patients Before Middlemen Act; all provisions S. 891: Bipartisan Health Care Act; provisions related to Titles I, II, VIII, and IX S. 1862: Orphan CURES Act; all provisions S. 3345: PBM Price Transparency and Accountability Act; all provisions Executive Order: Expanding Access to In Vitro Fertilization; all provisions of the order Executive Order: Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients; all provisions of the order General discussions related to Pharmacy Benefit Manager (PBM) policy issues General discussions related to Healthcare supply chain policy issues General discussions related to Drug cost and pricing policy issues General discussions related to caregiving support and awareness policy issues

Client expense: $820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Issues related to employer, small group and individual insurance markets. H.R. 2214, the Delinking Revenue from Unfair Gouging (DRUG) Act H.R. 5433 - The Patients Over Profits Act S. 2836 - The Patients Over Profits Act H.R. 4409 - The Fair Pharmacies for Federal Employees Act of 2025 H.R. 6703, Lower Healthcare Premiums for All Americans Act H.R. 6610, The Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act] S. 3822, Break Up Big Medicine Act

Client expense: $3,320,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE