Lower Health Care Costs Act

H.R. 4464/ S. 3204, Preventive Health Savings Act H.R. 5145, S. 3385, Bipartisan Premium Tax Credit Extension Act H.R. 5283/S. 2759, Healthcare Workforce Resilience Act S. 2824, A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium credits. U.S. Department of Education Negotiated Rulemaking Committees [Docket ID ED-2025-OPE-0151-0001] U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) U.S Department of Health and Human Services, Centers for Medicare & Medicaid ServicesAdvance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CMS-2026-0034) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883-P) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule (RIN 0955-AA09) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Request for Information: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care (RIN 0955-AA13)

Client expense: $200,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Health care reform issues, including S.3385 - Lower Health Care Costs Act; legislative issues related to Title X family planning funding and reproductive health care access at the Veterans Administration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Fiscal Year 2026 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with implement strategies to mitigate coverage losses due to the OBBBAs work requirements and more frequent eligibility redeterminations for the ACA expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. H.R.5582/S.2355 - Patients Deserve Price Tags Act H.R.9393 - Lower Costs, More Transparency Act of 2026 H.R.9390 - Prices on the Wall Act of 2026 Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. H.R.9504 - Tax Exempt Hospital Transparency Act Issue: Oppose efforts that increase duplicative and burdensome reporting requirements on tax exempt hospitals through expanded IRS reporting measures. H.R.3514/ S.1816 - Improving Seniors' Timely Access to Care Act of 2025 Issue: Support efforts to decrease the burden of prior authorization in Medicare Advantage plans Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. H.R.8163 - Provider Reimbursement Stability Act of 2026 Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Client expense: $821,438 · Firm income: Not reported

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

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

Lobbied in support of universal health care, including Medicare for All (Medicare for All Act, H.R. 3069) and the Medicine for the People Act (H.R. 7854). Lobbied in support of reforms to Medicare Advantage. Lobbied in support of the Protecting Health Care and Lowering Costs Act (H.R. 4849) and extending Affordable Care Act subsidies, including S. 3385.

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

Government targets: 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

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

H.R. 1834, Breaking the Gridlock Act S. 3385, Lower Health Care Costs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5145, Bipartisan Premium Tax Credit Extension Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to ACA premium tax credits S. 3385, Lower Health Care Costs Act, provisions related to the ACA and premium tax credits H.R. 6575, CommonGround for Affordable Health Care Act, provisions related to ACA tax credits H.R. 6501, Bipartisan Health Insurance Affordability Act, provisions related to ACA premium tax credits Draft/Enhanced Premium Tax Credits extension Community preceptors for medical students and residents/National tax credit or deduction

Client expense: $7,970,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

H.R. 2332, States Handling Access to Reciprocity for Employment (SHARE) Act of 2025, all provisions H.R. 1521, Dental and Optometric Care (DOC) Access Act of 2025, all provisions H.R. 929, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 526, Pharmacy Benefit Manager Transparency Act of 2025, all provisions S. 1767, Physician and Patient Safety Act, all provisions H.R. 2767, Bolstering Research And Innovation Now (BRAIN) Act, all provisions S. 1330, Bolstering Research And Innovation Now (BRAIN) Act, all provisions H.R. 1520, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S. 1782, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S. 3315, Health Care Cybersecurity and Resiliency Act of 2026, all provisions S. 3097, Health Information Privacy Reform Act, all provisions H.R. 4583, Living Donor Protection Act of 2025, all provisions S. 1552, Living Donor Protection Act of 2025, all provisions H.R. 2850, Youth Sports Facilities Act of 2025, all provisions S. 1419, Youth Sports Facilities Act of 2025, all provisions S. 1701, Strategic Teams for Organized Response Mobilization (STORM) Act, all provisions H.R. 4849, Protecting Health Care and Lowering Costs Act of 2025, all provisions H.R. 247, Health Care Affordability Act of 2025, all provisions H.R. 5145, Bipartisan Premium Tax Credit Extension Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to ACA premium tax credits S. 3385, Lower Health Care Costs Act, provisions related to the ACA and premium tax credits H.R. 6703, Lower Health Care Premiums for All Americans Act, all provisions H.R. 3492, Protect Childrens Innocence Act, all provisions H.R. 5861, Legacy Act of 2025, provisions related to advanced medical directives S. 3315, Health Care Cybersecurity and Resiliency Act of 2026, all provisions H.R. 7868, Expanding Support for Living Donors Act of 2026, all provisions H.R. 628, Honor Our Living Donors Act, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to artificial intelligence (AI) H.R. 1909, Preventing Maternal Deaths Reauthorization Act of 2025, all provisions S. 2621, Preventing Maternal Deaths Reauthorization Act of 2025, all provisions S. 3204, Preventive Health Savings Act, all provisions H.R. 7602, State of Mens Health Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions H.R. 6294, Childhood Diabetes Reduction Act of 2025, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions H.R. 3170, Improving Access to Workers Compensation for Injured Federal Workers Act, all provisions Joint resolution of Disapproval on CMS reg Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability (Effort to repeal a regulation under the Congressional Review Act) Drafts/The Republic Unifying Meritocratic Performance Advancing Machine Intelligence by Eliminating Regulatory Interstate Chaos Across American Industry Act (TRUMP AMERICA AI) Act Draft/Enhanced Premium Tax Credits extension Drug shortages Gender affirming care Dental plans/The Employee Retirement Income Security Act of 1974 (ERISA) Prior authorization Licensure portability Artificial Intelligence (AI) services/payment AI use in prior authorization Womens health issues Health Insurance Portability and Accountability Act (HIPAA) Pharmacy Benefits Managers AI Deepfake/legislative framework Mental health chatbots/regulatory guardrails Cybersecurity/small physician practices Fuel economy standards/proposed rollback Postpartum hypertension Vaccines Nutrition Menopause education Insurance plans/downcoding Out-of-Network physician payment cut

Client expense: $7,970,000 · Firm income: Not reported

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

H.R. 2332, States Handling Access to Reciprocity for Employment (SHARE) Act of 2025, all provisions H.R. 1521, Dental and Optometric Care (DOC) Access Act of 2025, all provisions H.R. 929, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 526, Pharmacy Benefit Manager Transparency Act of 2025, all provisions S. 1767, Physician and Patient Safety Act, all provisions H.R. 2767, Bolstering Research And Innovation Now (BRAIN) Act, all provisions S. 1330, Bolstering Research And Innovation Now (BRAIN) Act, all provisions H.R. 1520, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S. 1782, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S. 3315, Health Care Cybersecurity and Resiliency Act of 2026, all provisions S. 3097, Health Information Privacy Reform Act, all provisions H.R. 4583, Living Donor Protection Act of 2025, all provisions S. 1552, Living Donor Protection Act of 2025, all provisions H.R. 2850, Youth Sports Facilities Act of 2025, all provisions S. 1419, Youth Sports Facilities Act of 2025, all provisions S. 1701, Strategic Teams for Organized Response Mobilization (STORM) Act, all provisions H.R. 4849, Protecting Health Care and Lowering Costs Act of 2025, all provisions H.R. 247, Health Care Affordability Act of 2025, all provisions H.R. 5145, Bipartisan Premium Tax Credit Extension Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to ACA premium tax credits S. 3385, Lower Health Care Costs Act, provisions related to the ACA and premium tax credits H.R. 6703, Lower Health Care Premiums for All Americans Act, all provisions H.R. 3492, Protect Childrens Innocence Act, all provisions H.R. 5861, Legacy Act of 2025, provisions related to advanced medical directives S. 3315, Health Care Cybersecurity and Resiliency Act of 2026, all provisions H.R. 7868, Expanding Support for Living Donors Act of 2026, all provisions H.R. 628, Honor Our Living Donors Act, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to artificial intelligence (AI) H.R. 1909, Preventing Maternal Deaths Reauthorization Act of 2025, all provisions S. 2621, Preventing Maternal Deaths Reauthorization Act of 2025, all provisions S. 3204, Preventive Health Savings Act, all provisions H.R. 7602, State of Mens Health Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions H.R. 6294, Childhood Diabetes Reduction Act of 2025, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions H.R. 3170, Improving Access to Workers Compensation for Injured Federal Workers Act, all provisions Joint resolution of Disapproval on CMS reg Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability (Effort to repeal a regulation under the Congressional Review Act) Drafts/The Republic Unifying Meritocratic Performance Advancing Machine Intelligence by Eliminating Regulatory Interstate Chaos Across American Industry Act (TRUMP AMERICA AI) Act Draft/Enhanced Premium Tax Credits extension Drug shortages Gender affirming care Dental plans/The Employee Retirement Income Security Act of 1974 (ERISA) Prior authorization Licensure portability Artificial Intelligence (AI) services/payment AI use in prior authorization Womens health issues Health Insurance Portability and Accountability Act (HIPAA) Pharmacy Benefits Managers AI Deepfake/legislative framework Mental health chatbots/regulatory guardrails Cybersecurity/small physician practices Fuel economy standards/proposed rollback Postpartum hypertension Vaccines Nutrition Menopause education Insurance plans/downcoding Out-of-Network physician payment cut

Client expense: $7,970,000 · Firm income: Not reported

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

H.R. 5145, Bipartisan Premium Tax Credit Extension Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to ACA premium tax credits S. 3385, Lower Health Care Costs Act, provisions related to the ACA and premium tax credits H.R. 6575, CommonGround for Affordable Health Care Act, provisions related to ACA tax credits H.R. 6501, Bipartisan Health Insurance Affordability Act, provisions related to ACA premium tax credits Draft/Enhanced Premium Tax Credits extension Community preceptors for medical students and residents/National tax credit or deduction

Client expense: $7,970,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

Health care reform issues, including S.3385 - Lower Health Care Costs Act; legislative issues related to Title X family planning funding and reproductive health care access at the Veterans Administration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied in support of H.R. 4849, the Protecting Health Care and Lowering Costs Act. Lobbied in support of extending Affordable Care Act health insurance subsidies, including S. 3385. Lobbied in favor of universal health care, including H.R. 3069, the Medicare for All Act.

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

Government targets: HOUSE OF REPRESENTATIVES

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Fiscal Year 2026 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with strategies to mitigate coverage losses in light of the implementation of work requirements and more frequent eligibility redeterminations for the ACA expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. S.2355 - Patients Deserve Price Tags Act Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Client expense: $577,720 · 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

Work on medical research funding, telehealth and extension of advanced premium tax credits. In addition, work on health insurance reforms including H.R. 6703, the Lower Health Care Premiums for All Americans Act; and S. 3385, the Lower Health Care Costs Act.

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

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

Client expense: $174,259 · 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. 4464/ S. 3204, Preventive Health Savings Act H.R. 5145, S. 3385, Bipartisan Premium Tax Credit Extension Act H.R. 5283/S. 2759, Healthcare Workforce Resilience Act S. 2824, A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium credits. U.S. Department of Education Negotiated Rulemaking Committees [Docket ID ED-2025-OPE-0151-0001] U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) U.S Department of Health and Human Services, Centers for Medicare & Medicaid ServicesAdvance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CMS-2026-0034) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883-P) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule (RIN 0955-AA09) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Request for Information: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care (RIN 0955-AA13)

Client expense: $200,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Reproductive healthcare in FY26 federal spending bills; A federal right to abortion; Federal issues related to state abortion bans and abortion access in the United States; Administrative actions that restrict abortion access; H.R.4611 and S.2377, the Equal Access to Abortion Coverage in Health Insurance (EACH) Act of 2025, regarding access to affordable health insurance plans that cover abortion; Abortion-coverage restrictions, including restrictions related to ACA premium tax credits; Extension of ACA enhanced premium tax credits, including S.3385, the Lower Health Care Costs Act; S.3386, the Health Care Freedom for Patients Act of 2025; Issues related to Medicaids free-choice-of-provider provision; Defunding Planned Parenthood; H.R.5925, the Reproductive and Sexual Health Ombuds Act; Access to evidence-based medication abortion care; The Endometriosis CARE Act (not yet introduced); Veterans access to reproductive health care, including H.R.4876 The Reproductive Freedom for Veterans Act; Healthy pregnancy and post-partum period; Family and medical leave, including paid leave; Gender equity and sex discrimination; Empowering and informing young people about sexual and reproductive health, including gender identity and LGBTQ+ inclusion in sex ed curriculum; LGBTQI+ rights; Discrimination against LGBTQI+ people; Bans and restrictions on gender affirming care, including. S.2907 and H.R. 5483, the Chloe Cole Act, and H.R.3492, the Protect Childrens Innocence Act; Issues related to workplace fairness and gender discrimination.

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage and electronic health information/technology. H.R.247 - Health Care Affordability Act of 2025 S.46 - Health Care Affordability Act of 2025 H.R.1 - To provide for Reconciliation H.R. 2483 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 6703 - Lower Health Care Premiums for All Americans Act H.R. 6248 - Healthy Competition for Better Care Act S. 3385 - Lower Health Care Costs Act

Client expense: $730,000 · Firm income: Not reported

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

H.R. 1834, Breaking the Gridlock Act S. 3385, Lower Health Care Costs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1834, Breaking the Gridlock Act S. 3385, Lower Health Care Costs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to health care delivery and health insurance coverage, mental health and substance use disorder care and coverage and electronic health information/technology. H.R.247 - Health Care Affordability Act of 2025 S.46 - Health Care Affordability Act of 2025 H.R.1 - To provide for Reconciliation H.R. 2483 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 6703 - Lower Health Care Premiums for All Americans Act H.R. 6248 - Healthy Competition for Better Care Act S. 3385 - Lower Health Care Costs Act

Client expense: $730,000 · Firm income: Not reported

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

H.R. 1834, Breaking the Gridlock Act S. 3385, Lower Health Care Costs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3492- Protect Children's Innocence Act Addressing Rising Health Care Costs S 2954- Health Care Workforce Expansion Act HR 6166- Lowering Drug Costs for American Families Act Robert F. Kennedy Jr. Nomination for HHS, oppose Dr. Mehmet Oz for CMS Administration, oppose S 46, HR 247- Health Care Affordability Act of 2025 S 750, HR 1683- Protecting America's Seniors Access to Care Act HR 2528- Association Health Care Plans Act HR 3415, S 1709- Nurse Staffing Standards for Hospital Patient Safety HR 5145- Bipartisan Premium Tax Credit Extension Act S 2824- Bill to extend ACA tax credits (2 years) HR 4849, S 2556- Protecting Health Care and Lowering Costs Act of 2025 HR 5228- HCBS Worker Protect Act HR 6703- Lower Health Care Premiums for All Americans Act S 3385- Lower Health Care Costs Act HR 3971, S 3396- Domestic Worker Bill of Rights SJ Res 82, HJ Res 25- Richardson Waiver Congressional Review Act House discharge No. 10- Jeffries ACA discharge petition

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied in support of H.R. 4849, Protecting Health Care and Lowering Costs Act. Lobbied in support of extending Affordable Care Act health insurance subsidies, including supporting S.3385.

Client expense: $20,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

Issues related to the ACA enhanced premium tax credits Opposition to the Health Care Freedom for Patients Act would harm millions by cutting Medicaid, threatening ACA coverage, increasing costs for vulnerable groups, and redirecting funds from patients to insurers Opposition to H.R. 6703, the Lower Health Care Premiums for All Americans Act which would allow health plans to provide stripped-down coverage that does not comply with ACA essential benefits requirements in order to lower premium costs and claims expenses for employers and insurers S. 3385 The Lower Health Care Costs Act would extend enhanced Affordable Care Act (ACA) premium tax credits (subsidies) through 2028

Client expense: $457,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Thomas Bell, of Virginia, to be Inspector General, Department of Health and Human Services (PN 55-7) Brian Christine, of Alabama, to be an Assistant Secretary of Health and Human Services, vice Rachel Leland Levine, resigned. (PN 55-14) Michael Stuart, of West Virginia, to be General Counsel of the Department of Health and Human Services, vice Samuel R. Bagenstos, resigned. (PN25-52) Health Care Freedom for Patients Act of 2025 (S. 3386) Lower Health Care Costs Act (S. 3385) Lower Health Care Premiums for All Americans Act (H.R. 6703) Protect Childrens Innocence Act (H.R. 3492) Do No Harm in Medicaid Act (H.R. 498) Breaking the Gridlock Act (H.R.1834) Affordable Care Act (ACA) tax credits extension proposals CommonGround for Affordable Health Care Act (H.R.6575) Rep. Ansari reproductive health package (not yet introduced) Endometriosis CARE Act (H.R. 6682) Health Information Privacy Reform Act (S. 3097) SUSTAIN 340B Act (not introduced)

Client expense: $94,048 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Thomas Bell, of Virginia, to be Inspector General, Department of Health and Human Services (PN 55-7) Brian Christine, of Alabama, to be an Assistant Secretary of Health and Human Services, vice Rachel Leland Levine, resigned. (PN 55-14) Michael Stuart, of West Virginia, to be General Counsel of the Department of Health and Human Services, vice Samuel R. Bagenstos, resigned. (PN25-52) Health Care Freedom for Patients Act of 2025 (S. 3386) Lower Health Care Costs Act (S. 3385) Lower Health Care Premiums for All Americans Act (H.R. 6703) Protect Childrens Innocence Act (H.R. 3492) Do No Harm in Medicaid Act (H.R. 498) Breaking the Gridlock Act (H.R.1834) Affordable Care Act (ACA) tax credits extension proposals

Client expense: $7,513 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2531 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act HR 2550 Support for Protect Americas Workforce Act HR 3069 Support for Medicare for All Act HR 3261Support for VA Employee Fairness Act HR 3415 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act HR 4313 Oppose the Hospital Inpatient Services Modernization Act HR 6703 Oppose Lower Health Care Premiums for All Americans Act , specifically any proposal that does not include a clean 3-year extension of the enhanced Affordable Care Act (ACA) subsidies. HR 783 Support for Sustainable Cardiopulmonary Rehabilitation Services in the Home Act H Res. 876 Support and endorse Rep. Tlaib's Resolution Recognizing the Genocide of the Palestinian People in Gaza S 851 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act S 1506 Support for Medicare for All Act S 1650 The VA Employee Fairness Act S 1709 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act S 1920 Oppose Continuous Skilled Nursing Quality Improvement Act of 2025 S 2228 Oppose Modern Worker Empowerment S 2444 Support for the End Polluter Welfare Act of 2025 S 2750 Oppose Strengthening Artificial intelligence Normalization and Diffusion By Oversight and Experimentation Act (SANDBOX) S 2857 Endorsed the Protecting Free Vaccines Act S 2997 Endorsed the Right to Override Act S 3385 Support the Lower Health Care Costs Act Urge edits to No Robot Bosses Act Oppose VA contract termination Endorse Senator Markey and Congresswoman Lee's letters related to TRAPs. Support Representative Ro Khanna on leading letter to UC management on recent contract negotiations with outreach across CA delegation. Oppose Trump Admin proposed rule to strip nurses of professional degree classification for graduate degree loan eligibility Support Sen. Patty Murray's Seniors Deserve SMARTER Act that prohibits the use of prior authorization in Medicare Support ending Israeli military operations and blockade, and demand U.S. immediately recognize Palestines sovereignty Communicate issues to support UC Nurses Support for alternate congressional action to expand and strengthen nursing education programs Support and advocate for Markey and Lees letters to agencies to protect workers from TRAPs. Support for Medicare for All Support for Rep. Khanna prior authorization bill to prevent the use of the WISeR model that would allow for prior authorization in Medicare Oppose the Affordable Care Act (ACA) health care cost hikes Support science-based vaccines and immunization practices, and make recommendations

Client expense: $130,000 · 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), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Personnel Management (OPM), SENATE, Veterans Affairs, Dept of (VA)

HR 3069 Support for Medicare for All Act HR 6703 Oppose Lower Health Care Premiums for All Americans Act , specifically any proposal that does not include a clean 3-year extension of the enhanced Affordable Care Act (ACA) subsidies. S 1506 Support for Medicare for All Act S 2857 Endorsed the Protecting Free Vaccines Act S 3385 Support the Lower Health Care Costs Act Support Sen. Patty Murray's Seniors Deserve SMARTER Act that prohibits the use of prior authorization in Medicare Support for Medicare for All Support for Rep. Khanna prior authorization bill to prevent the use of the WISeR model that would allow for prior authorization in Medicare Oppose the Affordable Care Act (ACA) health care cost hikes Support science-based vaccines and immunization practices, and make recommendations

Client expense: $130,000 · Firm income: Not reported

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

HR 20 Support for Richard L. Trumka Protecting the Right to Organize Act HR 2531 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act HR 2550 Support for Protect Americas Workforce Act HR 3261 Support for VA Employee Fairness Act HR 3415 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act HR 4313 Oppose the Hospital Inpatient Services Modernization Act HR 6014 Support for Right to Representation for Department of Veterans Affairs Workers Act of 2025 HR 6703 Oppose Lower Health Care Premiums for All Americans Act , specifically any proposal that does not include a clean 3-year extension of the enhanced Affordable Care Act (ACA) subsidies. HR 783 Support for Sustainable Cardiopulmonary Rehabilitation Services in the Home Act S 851 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act S 852 Support for Richard L. Trumka Protecting the Right to Organize Act S 1506 Support for Medicare for All Act S 1650 The VA Employee Fairness Act S 1709 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act S 1920 Oppose Continuous Skilled Nursing Quality Improvement Act of 2025 S 2228 Oppose Modern Worker Empowerment S 2750 Oppose Strengthening Artificial intelligence Normalization and Diffusion By Oversight and Experimentation Act (SANDBOX) S 2837 Support for Protect Americas Workforce Act S 2857 Endorsed the Protecting Free Vaccines Act S 3385 Support the Lower Health Care Costs Act Oppose VA contract termination Endorse Senator Markey and Congresswoman Lee's letters related to TRAPs. Oppose Trump Admin proposed rule to strip nurses of professional degree classification for graduate degree loan eligibility Support for alternate congressional action to expand and strengthen nursing education programs Support and advocate for Markey and Lees letters to agencies to protect workers from TRAPs. Support science-based vaccines and immunization practices, and make recommendations

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Occupational Safety & Health Administration (OSHA), Office of Personnel Management (OPM), SENATE, Veterans Affairs, Dept of (VA)

HR 20 Support for Richard L. Trumka Protecting the Right to Organize Act HR 2531 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act HR 2550 Support for Protect Americas Workforce Act HR 3069 Support for Medicare for All Act HR 3261 Support for VA Employee Fairness Act HR 3415 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act HR 4313 Oppose the Hospital Inpatient Services Modernization Act HR 6014 Support for Right to Representation for Department of Veterans Affairs Workers Act of 2025 HR 6703 Oppose Lower Health Care Premiums for All Americans Act , specifically any proposal that does not include a clean 3-year extension of the enhanced Affordable Care Act (ACA) subsidies. HR 783 Support for Sustainable Cardiopulmonary Rehabilitation Services in the Home Act H Res. 876 Support and endorse Rep. Tlaib's Resolution Recognizing the Genocide of the Palestinian People in Gaza S 851 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act S 852 Support for Richard L. Trumka Protecting the Right to Organize Act S 1506 Support for Medicare for All Act S 1650 The VA Employee Fairness Act S 1709 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act S 1920 Oppose Continuous Skilled Nursing Quality Improvement Act of 2025 S 2228 Oppose Modern Worker Empowerment S 2444 Support for the End Polluter Welfare Act of 2025 S 2750 Oppose Strengthening Artificial intelligence Normalization and Diffusion By Oversight and Experimentation Act (SANDBOX) S 2818 Support for the Tax Excessive CEO Pay Act of 2025 S 2837 Support for Protect Americas Workforce Act S 2857 Endorsed the Protecting Free Vaccines Act S 2997 Endorsed the Right to Override Act S 3385 Support the Lower Health Care Costs Act Support for the Corporate Tax Dodging Prevention Act Support for the Tax on Wall Street Speculation Act Support for the 99.5 Percent Act Support for Ending Corporate Greed Act Support for End Polluter Welfare Act Support for Tax Excessive CEO Pay Act Urge edits to Stop Spying Bosses Act Urge edits to No Robot Bosses Act Urge edits to AI Civil Rights Act Oppose VA contract termination Endorse Senator Markey and Congresswoman Lee's letters related to TRAPs. Support Representative Ro Khanna on leading letter to UC management on recent contract negotiations with outreach across CA delegation. Oppose Trump Admin proposed rule to strip nurses of professional degree classification for graduate degree loan eligibility Support Sen. Patty Murray's Seniors Deserve SMARTER Act that prohibits the use of prior authorization in Medicare Support ending Israeli military operations and blockade, and demand U.S. immediately recognize Palestines sovereignty Communicate issues to support UC Nurses Support for alternate congressional action to expand and strengthen nursing education programs Support and advocate for Markey and Lees letters to agencies to protect workers from TRAPs. Support for Medicare for All Support for Rep. Khanna prior authorization bill to prevent the use of the WISeR model that would allow for prior authorization in Medicare Oppose the Affordable Care Act (ACA) health care cost hikes Support science-based vaccines and immunization practices, and make recommendations

Client expense: $130,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Veterans Affairs, Dept of (VA)

HR 20 Support for Richard L. Trumka Protecting the Right to Organize Act HR 2531 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act HR 2550 Support for Protect Americas Workforce Act HR 3069 Support for Medicare for All Act HR 3261 Support for VA Employee Fairness Act HR 3415 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act HR 4313 Oppose the Hospital Inpatient Services Modernization Act HR 6014 Support for Right to Representation for Department of Veterans Affairs Workers Act of 2025 HR 6703 Oppose Lower Health Care Premiums for All Americans Act , specifically any proposal that does not include a clean 3-year extension of the enhanced Affordable Care Act (ACA) subsidies. HR 783 Support for Sustainable Cardiopulmonary Rehabilitation Services in the Home Act H Res. 876 Support and endorse Rep. Tlaib's Resolution Recognizing the Genocide of the Palestinian People in Gaza S 851 Support for Workplace Violence Prevention for Health Care and Social Service Workers Act S 852 Support for Richard L. Trumka Protecting the Right to Organize Act S 1506 Support for Medicare for All Act S 1650 The VA Employee Fairness Act S 1709 Support for Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act S 1920 Oppose Continuous Skilled Nursing Quality Improvement Act of 2025 S 2228 Oppose Modern Worker Empowerment S 2444 Support for the End Polluter Welfare Act of 2025 S 2750 Oppose Strengthening Artificial intelligence Normalization and Diffusion By Oversight and Experimentation Act (SANDBOX) S 2818 Support for the Tax Excessive CEO Pay Act of 2025 S 2837 Support for Protect Americas Workforce Act S 2857 Endorsed the Protecting Free Vaccines Act S 2997 Endorsed the Right to Override Act S 3385 Support the Lower Health Care Costs Act Support for the Corporate Tax Dodging Prevention Act Support for the Tax on Wall Street Speculation Act Support for the 99.5 Percent Act Support for Ending Corporate Greed Act Support for End Polluter Welfare Act Support for Tax Excessive CEO Pay Act Urge edits to Stop Spying Bosses Act Urge edits to No Robot Bosses Act Urge edits to AI Civil Rights Act Oppose VA contract termination Endorse Senator Markey and Congresswoman Lee's letters related to TRAPs. Support Representative Ro Khanna on leading letter to UC management on recent contract negotiations with outreach across CA delegation. Oppose Trump Admin proposed rule to strip nurses of professional degree classification for graduate degree loan eligibility Support Sen. Patty Murray's Seniors Deserve SMARTER Act that prohibits the use of prior authorization in Medicare Support ending Israeli military operations and blockade, and demand U.S. immediately recognize Palestines sovereignty Communicate issues to support UC Nurses Support for alternate congressional action to expand and strengthen nursing education programs Support and advocate for Markey and Lees letters to agencies to protect workers from TRAPs. Support for Medicare for All Support for Rep. Khanna prior authorization bill to prevent the use of the WISeR model that would allow for prior authorization in Medicare Oppose the Affordable Care Act (ACA) health care cost hikes Support science-based vaccines and immunization practices, and make recommendations

Client expense: $130,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

HR 498 "Do No Harm in Medicaid Act," all provisions. S 222 / HR 649 "Whole Milk for Healthy Kids Act," all provisions. S 2875 "Custom Health Option and Individual Care Expense (CHOICE) Act," all provisions. S 3385 "Lower Health Care Costs Act," all provisions. S 3418 "COMPETE Act," all provisions. S 3238 "Conscience Protections for Medical Residents Act," all provisions.

Client expense: $20,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 891, Bipartisan Health Care Act, all provisions H.R. 2332, States Handling Access to Reciprocity for Employment (SHARE) Act of 2025, all provisions H.R. 929, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 526, Pharmacy Benefit Manager Transparency Act of 2025, all provisions S. 1767, Physician and Patient Safety Act, all provisions H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, provisions relating to scope of practice S. 232, Preventing Algorithmic Collusion Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act (PL 119-21), provisions relating to ACA Marketplace H.R. 4849, Protecting Health Care and Lowering Costs Act of 2025, all provisions H.R. 247, Health Care Affordability Act of 2025, all provisions S. 3385, Lower Health Care Costs Act, all provisions H.R. 6703, Lower Health Care Premiums for All Americans Act, all provisions S. 1701, Strategic Teams for Organized Response Mobilization (STORM) Act, all provisions H.R. 3492, Protect Childrens Innocence Act, all provisions H.R. 5861, Legacy Act of 2025, all provisions H.R. 4313, Hospital Inpatient Services Modernization Act, all provisions S. 2237, Hospital Inpatient Services Modernization Act, all provisions S. 3315, Health Care Cybersecurity and Resiliency Act of 2025, all provisions S. 3097, Health Information Privacy Reform Act, all provisions H.R. 5469, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2025, all provisions S. 2858, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2025, all provisions S.J.Res.84, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Market Integrity and Affordability,/Congressional Review Act repeal effort Drug shortages Prior Authorization Sleep Apnea/H3 Standard Maternal health Licensure portability issues Data privacy/cybersecurity Toxic Substances Control Act/chemical risk evaluation Health Insurance Portability and Accountability Act (HIPAA)/Electronic health records ACA/Enhanced Advanced Premium Tax Credit 2026-2030 dietary guidelines Downcoding by insurance plans Drug and medical device/recalls Medical products/tariffs Artificial Intelligence

Client expense: $5,480,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, U.S. Trade Representative (USTR)

S. 3385, Lower Health Care Costs Act, provisions relating to healthcare premium tax credit H.R. 6575, CommonGround for Affordable Health Care Act, provisions relating to ACA premium tax credit H.R. 6501, Bipartisan Health Insurance Affordability Act, provisions related to ACA premium tax credit H.R. 5145, Bipartisan Premium Tax Credit Extension Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to ACA premium tax credit S.J.Res.84, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Market Integrity and Affordability,/Congressional Review Act repeal effort S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to ACA premium tax credit ACA/Enhanced tax credit extension

Client expense: $5,480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1834 - Breaking the Gridlock Act (provisions related to the enhanced premium tax credits) H.R.247/S.46 - Health Care Affordability Act of 2025 H.R.6703 - Lower Health Care Premiums for All Americans Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7, S. 186 No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2025; H.R. 6501, Fitzpatrick Discharge Petition #12 Bipartisan Health Insurance Affordability Act; H.R. 6575, Gottheimer Petition #13 Common Ground for Affordable Health Care Act; H.R. 1834, Jeffries Discharge Petition #10 Breaking the Gridlock Act; Patient Protection and Affordable Care Act; Abortion funding; S. 2882 Continuing Appropriations and Extensions and Other Matters Act, 2026; S.3385 Lower Health Care Costs Act; H.R.5371 Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026; Contraception Issues; IVF Issues; S.3389 Lowering Health Care Costs for Americans Act; S.3011 Prohibiting Abortion & Transgender Procedures on the Exchanges Act; S.3264, H.R.6538 More Affordable Care Act; H.R. 6703 Lower Health Care Premiums for All Americans Act; S.3391 Accountability for Better Care Act of 2025; S. 3386 Health Care Freedom for Patients Act of 2025; H.R.6512 To Empower American Families with Direct Control Over Healthcare Dollars, Codify President Trump's Proven Reforms for Flexibility and Choice, Prohibit Taxpayer Funding for Abortion and Gender Transition Procedures, Eliminate Waste and Fraud in the Affordable Care Act, and Reject Extensions of Enhanced Subsidies to Insurance Companies; H.R.1157 Affordable Care and Comprehensive Economic Support through Savings (ACCESS) Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1 One Big Beautiful Bill Act; H.R.2557 IVF For Military Families Act; S.2035 Protect IVF Act; H.R.6797 To amend title 10, United States Code, to provide fertility treatment under the TRICARE; Shield laws, chemical abortion drugs, H.R. 7, S. 186 No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2025; Dismemberment Abortion Ban Act; H.R. 5485 Second Chance at Life Act of 2025; H.R. 6501, Fitzpatrick Discharge Petition #12 Bipartisan Health Insurance Affordability Act; H.R. 6575, Gottheimer Petition #13 Common Ground for Affordable Health Care Act; H.R. 1834, Jeffries Discharge Petition #10 Breaking the Gridlock Act; S.2955 , H.R.6466 Forced Abortion Prevention and Accountability Act; Patient Protection and Affordable Care Act; Abortion funding; S. 2882 Continuing Appropriations and Extensions and Other Matters Act; S.3385 Lower Health Care Costs Act; H.R.5371 Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act; Contraception issues; IVF issues; National Defense Authorization Act; Supreme Court Decisions; S. 1631, H. R. 5646 Restoring Safeguards for Dangerous Abortion Drugs Act; H.R. 629 Ending Chemical Abortions Act; H.R. 679 To nullify the modifications made by the Food and Drug Administration in January 2023 to the risk evaluation and mitigation strategy for the abortion pill mifepristone, and for other purposes; H.R. 795 Pregnancy Is Not an Illness Act; H.R. 796 Second Chance for Moms Act; H.R. 1349 Womens Protection in Telehealth Act; H.R. 1525 Protecting Life from Chemical Abortions Act; H.R. 627 Ensuring Accurate & Complete Abortion Data Reporting Act; H.R. 6466 Forced Abortion Prevention and Accountability Act; H.R. 729 Teleabortion Prevention Act of 2025; S.3389 Lowering Health Care Costs for Americans Act; Presidential Administration Actions; S.3011 Prohibiting Abortion & Transgender Procedures on the Exchanges Act; S.3264, H.R.6538 More Affordable Care Act; H.R. 6703 Lower Health Care Premiums for All Americans Act; S.3391 Accountability for Better Care Act of 2025; S. 3386 Health Care Freedom for Patients Act of 2025; H.R.6512 To Empower American Families with Direct Control Over Healthcare Dollars, Codify President Trump's Proven Reforms for Flexibility and Choice, Prohibit Taxpayer Funding for Abortion and Gender Transition Procedures, Eliminate Waste and Fraud in the Affordable Care Act, and Reject Extensions of Enhanced Subsidies to Insurance Companies; H.R.1157 Affordable Care and Comprehensive Economic Support through Savings (ACCESS) Act; H.R.2589 Consensual Donation and Research Integrity Act of 2025; H.R.5969 LABEL Act; H.Res.803 Urging the Director of the Food and Drug Administration to reevaluate the safety of all chemical abortion drugs in light of recent independent studies, and for other purposes; H.R. 6372 D.C. Shield Law Repeal Act; H.R.6359 Pregnant Students Rights Act; H.R. 6191 No Taxpayer Funded Abortion Travel for Illegal Aliens Act

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

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

H.R. 1 One Big Beautiful Bill Act; H.R. 7, S. 186 No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2025; Patient Protection and Affordable Care Act; Abortion Funding; S. 2882 Continuing Appropriations and Extensions and Other Matters Act, 2026; S. 5371 Continuing Appropriations and Extensions Act, 2026; Administration Personnel and Judicial Nominees; S.3385 Lower Health Care Costs Act; S.3264, H.R.6538 More Affordable Care Act; H.R. 6703 Lower Health Care Premiums for All Americans Act; S.3391 Accountability for Better Care Act of 2025; S. 3386 Health Care Freedom for Patients Act of 2025; H.R.6512 To Empower American Families with Direct Control Over Healthcare Dollars, Codify President Trump's Proven Reforms for Flexibility and Choice, Prohibit Taxpayer Funding for Abortion and Gender Transition Procedures, Eliminate Waste and Fraud in the Affordable Care Act, and Reject Extensions of Enhanced Subsidies to Insurance Companies; H.R.1157 Affordable Care and Comprehensive Economic Support through Savings (ACCESS) Act

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

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

Reproductive healthcare in FY26 federal spending bills; A federal right to abortion; Federal issues related to state abortion bans and abortion access in the United States; Administrative actions that restrict abortion access; H.R.4611 and S.2377, the Equal Access to Abortion Coverage in Health Insurance (EACH) Act of 2025, regarding access to affordable health insurance plans that cover abortion; Abortion-coverage restrictions, including restrictions related to ACA premium tax credits; Extension of ACA enhanced premium tax credits, including S.3385, the Lower Health Care Costs Act; S.3386, the Health Care Freedom for Patients Act of 2025; Issues related to Medicaids free-choice-of-provider provision; Defunding Planned Parenthood; H.R.5925, the Reproductive and Sexual Health Ombuds Act; Access to evidence-based medication abortion care; The Endometriosis CARE Act (not yet introduced); Veterans access to reproductive health care, including H.R.4876 The Reproductive Freedom for Veterans Act; Healthy pregnancy and post-partum period; Family and medical leave, including paid leave; Gender equity and sex discrimination; Empowering and informing young people about sexual and reproductive health, including gender identity and LGBTQ+ inclusion in sex ed curriculum; LGBTQI+ rights; Discrimination against LGBTQI+ people; Bans and restrictions on gender affirming care, including. S.2907 and H.R. 5483, the Chloe Cole Act, and H.R.3492, the Protect Childrens Innocence Act; Issues related to workplace fairness and gender discrimination.

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1 One Big Beautiful Bill Act (Rep. Arrington) - Restore eligibility for immigrant children in the Child Tax Credit and defend against removing US citizen children from current credit. - Expand the CTC to reach children left out because their parents dont earn enough - Oppose EITC pre-certification - Support Direct File program - Oppose AI moratorium H.R.5371 Continuing Appropriations and Extensions Act, 2026 (Rep. Cole) - oppose Continuing resolution with a 7-week stopgap funding because if fails to extend ACA EPTCs 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 H.R.5450/ S.2882 - Continuing Appropriations and Extensions and Other Matters Act, 2026 (Rep. DeLauro/Sen. Murray) - Support 4 week continuing resolutions that permanently extends provisions that expanded the premium tax credit, and repeals health care provisions that were included in HR1 H.R.5145 - Bipartisan Premium Tax Credit Extension Act (Rep. Kiggans) - Oppose one year extenstion of ACA EPTCs 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 extension of ACA ePTCs H.R.6703 - Lower Health Care Premiums for All Americans Act - Oppose House Republicans alternative approach to addressing rising health insurance costs without extending ACA ePTCs Discharge Petition No. 12 (Fitzpatrick) - Oppose two year extension of EPTCs. Adds $5 minimum for incomes up to 200% FPL American Family Act H.R.2763/S.1393 - Support Child Tax Credit and Earned Income Tax Credit Expansion Tax Cut for Workers Act H.R.2764/S.1372 - Support Child Tax Credit and Earned Income Tax Credit Expansion Worker Relief and Credit Reform Act H.R.2338 - Support Child Tax Credit and Earned Income Tax Credit Expansion FISC Act HR 1308 - Support Child Tax Credit and Earned Income Tax Credit Expansion HR1968 - Support Full IRS funding and oppose provisions to block free tax filing in Financial Services and General Government Appropriations Get your money back act (Rep Sykes Draft leg, no # assigned yet) - Oppose Budget Resolutions that increase tax breaks for the wealthy and cut essential programs. Working Families Tax Cut Act (not yet introduced) - Raise taxes on wealthy people to pay for tax cuts for working families

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5371 Continuing Appropriations and Extensions Act, 2026 (Rep. Cole) - oppose Continuing resolution with a 7-week stopgap funding because if fails to extend ACA EPTCs 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 H.R.5450/ S.2882 - Continuing Appropriations and Extensions and Other Matters Act, 2026 (Rep. DeLauro/Sen. Murray) - Support 4 week continuing resolutions that permanently extends provisions that expanded the premium tax credit, and repeals health care provisions that were included in HR1 H.R.5145 - Bipartisan Premium Tax Credit Extension Act (Rep. Kiggans) - Oppose one year extenstion of ACA EPTCs 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 extension of ACA ePTCs H.R.6703 - Lower Health Care Premiums for All Americans Act - Oppose House Republicans alternative approach to addressing rising health insurance costs without extending ACA ePTCs Discharge Petition No. 12 (Fitzpatrick) - Oppose two year extension of EPTCs. Adds $5 minimum for incomes up to 200% FPL 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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE