Health Care Efficiency Through Flexibility Act

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Bill ID: 119/hr/5347
Last Updated: July 16, 2026

Sponsored by

Rep. Buchanan, Vern [R-FL-16]

ID: B001260

Follow the money

The bill

Health Care Efficiency Through Flexibility Act

HR. 5347, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Rep. Buchanan, Vern [R-FL-16]

Every bill has someone who introduced it. That name is where the paper trail starts.

The money

$66,000 raised

20 itemised contributions to this sponsor, pulled from FEC filings.

The alignment

70% match to Project 2025

This bill's text tracks the "Department of Health and Human Services" section, p. 533-535 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Received in the Senate and Read twice and referred to the Committee on Finance.

July 12, 2026

Introduced

Committee Review

Floor Action

Passed House

Senate Review

📍 Current Status

Next: Both chambers must agree on the same version of the bill.

🎉

Passed Congress

🖊️

Presidential Action

⚖️

Became Law

📚 How does a bill become a law?

1. Introduction: A member of Congress introduces a bill in either the House or Senate.

2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.

3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.

4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.

5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.

6. Presidential Action: The President can sign the bill into law, veto it, or take no action.

7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!

Bill Summary

Another masterpiece of legislative theater, courtesy of the geniuses in Congress. Let's dissect this farce, shall we?

**Main Purpose & Objectives:** The Health Care Efficiency Through Flexibility Act (HR 5347) claims to aim at improving healthcare efficiency through flexibility. How quaint. In reality, it's just a vehicle for special interests to further embed themselves into the system.

**Key Provisions & Changes to Existing Law:** The bill amends the Social Security Act to ensure the availability of "appropriate collection types" for quality reporting under the Medicare Shared Savings Program. Oh, how noble. It also introduces a pilot program for digital quality measure reporting because, you know, throwing more technology at the problem will surely fix it.

**Affected Parties & Stakeholders:** The usual suspects: Accountable Care Organizations (ACOs), healthcare providers, and patients. But let's be real, the only ones who truly matter are the lobbyists and special interest groups who drafted this bill to further their own interests.

**Potential Impact & Implications:** This bill will likely lead to more bureaucratic red tape, increased costs, and a further entrenchment of the status quo. The pilot program for digital quality measure reporting is just a Trojan horse for more data collection and exploitation by private companies. And, of course, the "flexibility" touted in the bill's title is just code for "more opportunities for gaming the system."

In medical terms, this bill is akin to treating a patient with a Band-Aid when they need open-heart surgery. It's a superficial fix that ignores the underlying disease: a corrupt and inefficient healthcare system propped up by special interests and bureaucratic inertia.

To all the politicians and lobbyists involved in crafting this monstrosity, I say: congratulations on managing to make a bad situation worse. You've successfully diagnosed the symptoms of a dysfunctional system and prescribed more of the same poison that's killing it. Bravo. Now, if you'll excuse me, I have better things to do than watch you all pat yourselves on the back for this legislative abomination.

Related Topics

Healthcare & Insurance Reform
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

Rep. Buchanan, Vern [R-FL-16]

Congress 119 • 2024 Election Cycle

Total Contributions
$66,000
15 donors
PACs
$0
Organizations
$0
Committees
$0
Individuals
$66,000

No PAC contributions found

No organization contributions found

No committee contributions found

1
GARCIA, MARIO
2 transactions
$6,600
2
GARCIA, IVIS
2 transactions
$6,600
3
COPELAND, GERRET
2 transactions
$6,600
4
ARISON, MICKY
2 transactions
$6,600
5
ARISON, MADELEINE
2 transactions
$6,600
6
RICHARDS, CHRISTINE
1 transaction
$3,300
7
RICHARDS, DANIEL
1 transaction
$3,300
8
BENJAMIN, STEPHEN
1 transaction
$3,300
9
JOHNSON, TRAVIS
1 transaction
$3,300
10
COPELAND, KYM
1 transaction
$3,300
11
MURRAY, R. CHARLES
1 transaction
$3,300
12
MCGILLICUDDY, DENNIS
1 transaction
$3,300
13
MCGILLICUDDY, GRACI
1 transaction
$3,300
14
ELLER, SCOTT
1 transaction
$3,300
15
RYAN, JOSEPH H
1 transaction
$3,300

Cosponsors & Their Campaign Finance

This bill has 4 cosponsors. Below are their top campaign contributors.

Rep. Panetta, Jimmy [D-CA-19]

ID: P000613

Top Contributors

10

1
ACROSS THE AISLE PAC
PACWASHINGTON, DC
$1,000
Jan 12, 2023
2
ACROSS THE AISLE PAC
PACWASHINGTON, DC
$500
Mar 23, 2023
3
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$3,300
Apr 12, 2023
4
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$3,300
Apr 12, 2023
5
MORONGO BAND OF MISSION INDIANS
OrganizationBANNING, CA
$3,300
Apr 12, 2023
6
EASTERN BAND OF CHEROKEE INDIANS
OrganizationCHEROKEE, NC
$3,300
Oct 16, 2024
7
SYCUAN BAND OF THE KUMEYAAY NATION
OrganizationEL CAJON, CA
$2,500
Nov 9, 2023
8
MORONGO BAND OF MISSION INDIANS
OrganizationBANNING, CA
$1,700
Apr 12, 2023
9
CROWN, LESTER
NOT EMPLOYED • NOT EMPLOYED
IndividualCHICAGO, IL
$6,600
Aug 9, 2024
10
KIM, SOON
IndividualSANTA CRUZ, CA
$4,300
Sep 30, 2024

Rep. Crenshaw, Dan [R-TX-2]

ID: C001120

Top Contributors

10

1
CHEVRON
OrganizationSAN RAMON, CA
$5,000
Sep 4, 2024
2
COMPLETE EMERGENCY CARE HOLDING LLC
OrganizationSOUTHLAKE, TX
$3,500
Mar 11, 2024
3
SANDLIAN REALTY
OrganizationWICHITA, KS
$1,000
Feb 7, 2024
4
ALABAMA-COUSHATTA TRIBE
OrganizationLIVINGSTON, TX
$1,000
Sep 30, 2024
5
RUSSELL W H KRIDEL MD PA
OrganizationHOUSTON, TX
$250
Feb 28, 2023
6
JONES RANCH LLC
OrganizationCORPUS CHRISTI, TX
$250
Mar 13, 2024
7
MAFRIGE, DAVID
SELF • COMMERCIAL REAL ESTATE INVESTMENTS
IndividualHOUSTON, TX
$9,900
Jun 21, 2023
8
MAFRIGE, DAVID
SELF • COMMERCIAL REAL ESTATE INVESTMENTS
IndividualHOUSTON, TX
$9,900
Jun 21, 2023
9
ODEN, KEITH
CAMDEN PROPERTY TRUST • EXECUTIVE VICE CHAIRMAN
IndividualHOUSTON, TX
$9,900
Jun 27, 2023
10
ODEN, KEITH
CAMDEN PROPERTY TRUST • EXECUTIVE VICE CHAIRMAN
IndividualHOUSTON, TX
$9,900
Jun 27, 2023

Rep. LaHood, Darin [R-IL-16]

ID: L000585

Top Contributors

10

1
MORONGO BAND OF MISSION INDIANS
OrganizationBANNING, CA
$3,300
Mar 30, 2023
2
MORONGO BAND OF MISSION INDIANS
OrganizationBANNING, CA
$3,300
Jun 14, 2024
3
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,650
May 15, 2024
4
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,650
Jun 16, 2023
5
SANTA YNEZ BAND OF MISSION INDIANS
OrganizationSANTA YNEZ, CA
$1,300
Oct 28, 2024
6
BARONA BAND OF MISSION INDIANS
OrganizationLAKESIDE, CA
$1,000
Feb 8, 2023
7
ONEIDA NATION
OrganizationONEIDA, WI
$1,000
Mar 30, 2023
8
SALT RIVER PIMA MARICOPA INDIAN COMMUNITY
OrganizationSCOTTSDALE, AZ
$1,000
Mar 31, 2023
9
D CONSTRUCTION, INC.
OrganizationCOAL CITY, IL
$1,000
Mar 29, 2024
10
ONEIDA NATION
OrganizationONEIDA, WI
$1,000
Jun 30, 2024

Rep. Lawler, Michael [R-NY-17]

ID: L000599

Top Contributors

10

1
MURTAGH, COSSU, VENDITTI & CASTRO-BLANCO, LLP
OrganizationWHITE PLAINS, NY
$1,000
Feb 24, 2024
2
BATMASIAN, JAMES
INVESTMENTS LIMITED • OWNER
IndividualBOCA RATON, FL
$6,600
Sep 27, 2023
3
BATMASIAN, JAMES
IndividualBOCA RATON, FL
$6,600
Sep 29, 2023
4
AUSTIN, ROBERT
UNAKA CO., INC. • BUSINESSMAN
IndividualDALLAS, TX
$6,600
Jul 18, 2024
5
SILVERMAN, JEFFREY
RETIRED • RETIRED
IndividualSURFSIDE, FL
$6,534
Feb 15, 2024
6
SILVERMAN, JEFFREY
IndividualSURFSIDE, FL
$6,534
Feb 22, 2024
7
SCALA, MARY ELLEN
RETIRED • RETIRED
IndividualPORT CHESTER, NY
$5,300
Aug 27, 2023
8
DEUTSCH, SHMULEY
SELF • PRESIDENT
IndividualSPRING VALLEY, NY
$3,900
Jun 24, 2024
9
DEUTSCH, SHMULEY
IndividualSPRING VALLEY, NY
$3,900
Jun 25, 2024
10
PERLMUTTER, RAFUEL
GOLDEN TASTE • CEO
IndividualSPRING VALLEY, NY
$3,400
Jun 24, 2024

Donor Network - Rep. Buchanan, Vern [R-FL-16]

PACs
Organizations
Individuals
Politicians

Hub layout: Politicians in center, donors arranged by type in rings around them.

Loading...

Showing 40 nodes and 32 connections (34 secondary connections hidden)

Total contributions: $102,750

Top Donors - Rep. Buchanan, Vern [R-FL-16]

Showing top 15 donors by contribution amount

15 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 1 helped.

  • Section 2 amends the Medicare Shared Savings Program to ensure availability of appropriate collection types for quality reporting and adds a pilot program for digital quality measure reporting, which benefits ACOs (often led by hospitals/health systems) by providing flexibility and reducing reporting burdens.

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.

Department of Health and Human Services

Moderate
Vector: 66%
Pages: 533-535AI Enhanced

AI Analysis:

"HR 5347 seeks to increase flexibility and efficiency in Medicare ACO quality reporting, which aligns with Project 2025's broader goal of reducing regulatory burdens and promoting market‑based efficiencies in health care, though the bill focuses on Medicare rather than the Medicaid‑centric policies emphasized in the Project 2025 excerpt."

Key themes:healthcare efficiencyregulatory flexibilityquality measurement innovationadministrative burden reduction

— 500 — Mandate for Leadership: The Conservative Promise 32. Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net.” 33. Brian Blase, “Managed Care in Medicaid: Need for Oversight, Accountability, and Reform,” Paragon Health Institute Policy Brief, October 13, 2022, https://paragoninstitute.org/wp-content/uploads/2022/10/20221012- Managed-Care-in-Medicaid-Need-for-Oversight-Accountability-and-Reform-FOR-DISTRIBUTION-V2.pdf (accessed February 13, 2023). 34. Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net.” 35. 42 U.S. Code § 1315, https://www.law.cornell.edu/uscode/text/42/1315 (accessed March 17, 2023). 36. Chad D. Savage and Lee S. Gross, “Direct Primary Care: Update and Road Map for Patient-Centered Reforms,” Heritage Foundation Backgrounder No. 3635, June 28, 2021, https://www.heritage.org/sites/default/ files/2021-06/BG3635.pdf. 37. H.R. 133, Consolidated Appropriations Act, 2021, Public Law No. 116-260, 116th Congress, December 27, 2020, Division BB, Title I, https://www.congress.gov/116/plaws/publ260/PLAW-116publ260.pdf (accessed March 17, 2023). 38. Doug Badger, “On Surprise Medical Bills, Congress Should Side with Consumers, Not Special Interests,” Heritage Foundation Commentary, January 31, 2020, https://www.heritage.org/health-care-reform/ commentary/surprise-medical-bills-congress-should-side-consumers-not-special. 39. Edmund F. Haislmaier and Abigail Slagle, “Premiums, Choices, Deductibles, Care Access, and Government Dependence Under the Affordable Care Act: 2021 State-by-State Review,” Heritage Foundation Backgrounder No. 3668, November 2, 2021, https://www.heritage.org/sites/default/files/2021-11/BG3668.pdf. 40. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, “Transparency in Coverage,” Final Rule, Federal Register, Vol. 85, No. 219 (November 12, 2020), pp. 72158–72310, https://www.govinfo.gov/ content/pkg/FR-2020-11-12/pdf/2020-24591.pdf (accessed March 17, 2023). 41. David N. Bernstein and Robert E. Moffit, “New Price Transparency Rule Will Help Transform America’s Health Care System,” Heritage Foundation Commentary, November 1, 2020, https://www.heritage.org/health-care- reform/commentary/new-price-transparency-rule-will-help-transform-americas-health-care. 42. Sluzala and Haislmaier, “Lessons from COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing.” 43. Ibid. 44. Most recently enacted in H.R. 2471, Consolidated Appropriations Act, 2022, Public Law No. 117-103, 117th Congress, March 15, 2022, Division H, Title V, §§ 506–507, https://www.congress.gov/117/plaws/publ103/ PLAW-117publ103.pdf (accessed March 17, 2023). 45. President Joseph R. Biden Jr., Executive Order 14079, “Securing Access to Reproductive and Other Healthcare Services,” August 3, 2022, in Federal Register, Vol. 87, No. 154 (August 11, 2022), pp. 49505–49507, https:// www.govinfo.gov/content/pkg/FR-2022-08-11/pdf/2022-17420.pdf (accessed March 16, 2023). 46. Planned Parenthood, 2020–2021 Annual Report, p. 27, https://www.plannedparenthood.org/uploads/ filer_public/40/8f/408fc2ad-c8c2-48da-ad87-be5cc257d370/211214-ppfa-annualreport-20-21-c3-digital.pdf (accessed March 22, 2023). 47. Ibid., pp. 30 and 31. Total revenue of $1,714.4 million (p. 30) minus $1,580.7 million in total expenses (p. 31) yields $133,7 million. 48. Ibid., p. 28. 49. Ibid., p. 30. 50. H.R. 372, Protecting Life and Taxpayers Act of 2023, 118th Congress, introduced January 17, 2023, https://www. congress.gov/118/bills/hr372/BILLS-118hr372ih.pdf (accessed March 17, 2023). 51. 42 U.S. Code § 18023, https://www.law.cornell.edu/uscode/text/42/18023 (accessed March 17, 2023). 52. H.R. 3128, Consolidated Omnibus Budget Reconciliation Act of 1985, Public Law No. 99-272, 99th Congress, April 7, 1986, Title IX, Subtitle A, Part 1, Subpart B, § 9121, https://www.congress.gov/99/statute/STATUTE-100/ STATUTE-100-Pg82.pdf (accessed March 17, 2023). 53. H.R. 8070, Rehabilitation Act of 1973, Public Law No. 93-112, 93rd Congress, September 26, 1973, https://www. congress.gov/93/statute/STATUTE-87/STATUTE-87-Pg355.pdf (accessed March 17, 2023).

Department of Health and Human Services

Moderate
Vector: 64%
Pages: 497-499AI Enhanced

AI Analysis:

"HR 5347 focuses on enhancing flexibility and accuracy in quality reporting for ACOs under the Medicare Shared Savings Program (MSSP), which aligns with Project 2025’s broader interest in reforming Medicare payment models and promoting value-based care. However, the bill does not directly address the specific Project 2025 proposals such as repealing MSSP, advancing site-neutral payments, or expanding ACO REACH, resulting in moderate thematic overlap rather than direct implementation."

Key themes:Medicare Shared Savings ProgramAccountable Care Organizationsquality reportingvalue-based carehealthcare efficiency

— 464 — Mandate for Leadership: The Conservative Promise l The Risk Adjustment Data Validation (RADV) rule; l The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration; and l The Global and Professional Direct Contracting (GPDC, rebranded as the Accountable Care Organization Realizing Equity, Access, and Community Health or ACO REACH) model. Additionally, regulations should advance site neutrality by eliminating the inpa- tient-only list and expanding the ambulatory surgical center covered procedures list. Medicare generally pays more for inpatient hospital procedures and less for the same procedures performed in an outpatient setting. Whether a medical ser- vice is delivered in a physician’s office, a clinic, or a hospital setting, the Medicare payment for that service should be the same. CMS should expand the application of site-neutral payment options to more settings. Such a policy would level the playing field among providers and remove the financial disabilities for medical professionals who would compete with hospital systems.23 Finally, HHS needs to restore and enhance conscience protection regulations that allow medical practitioners to participate in federal health care programs without being compelled to provide sex changes or similar services. LEGISLATIVE PROPOSALS l Remove restrictions on physician-owned hospitals. The Affordable Care Act (ACA)24 imposed restrictions prohibiting Medicare from reimbursing physician-owned and specialty hospitals. The current restrictions do little more than serve the special interests of large hospital systems and undercut consumer choice of high-quality, specialty care. These restrictions should be removed so that physician-owned hospitals can compete with other hospitals in serving Medicare patients.25 l Encourage more direct competition between Medicare Advantage and private plans. Medicare Advantage (MA), a system of competing private health plans, is the major alternative to traditional Medicare for America’s large and growing cohort of seniors. The program provides beneficiaries with a wide range of competitive health plan choices—a richer set of benefits than traditional Medicare provides and at a reasonable cost. Equally as important, the MA program has been registering consistently high marks for superior performance in delivering high-quality care. Critical reforms are still needed to strengthen and improve the program for the future. Specifically: — 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in

Department of Health and Human Services

Weak
Vector: 64%
Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on improving quality reporting flexibility for ACOs in Medicare, while the Project 2025 HHS section emphasizes Medicaid reform, managed care oversight, and conservative health policy priorities like price transparency and abortion restrictions. There is minimal thematic overlap, as the bill does not address Medicaid, managed care accountability, or the specific reforms highlighted in Project 2025."

Key themes:healthcare quality reportingMedicare programdata collection flexibility

— 500 — Mandate for Leadership: The Conservative Promise 32. Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net.” 33. Brian Blase, “Managed Care in Medicaid: Need for Oversight, Accountability, and Reform,” Paragon Health Institute Policy Brief, October 13, 2022, https://paragoninstitute.org/wp-content/uploads/2022/10/20221012- Managed-Care-in-Medicaid-Need-for-Oversight-Accountability-and-Reform-FOR-DISTRIBUTION-V2.pdf (accessed February 13, 2023). 34. Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net.” 35. 42 U.S. Code § 1315, https://www.law.cornell.edu/uscode/text/42/1315 (accessed March 17, 2023). 36. Chad D. Savage and Lee S. Gross, “Direct Primary Care: Update and Road Map for Patient-Centered Reforms,” Heritage Foundation Backgrounder No. 3635, June 28, 2021, https://www.heritage.org/sites/default/ files/2021-06/BG3635.pdf. 37. H.R. 133, Consolidated Appropriations Act, 2021, Public Law No. 116-260, 116th Congress, December 27, 2020, Division BB, Title I, https://www.congress.gov/116/plaws/publ260/PLAW-116publ260.pdf (accessed March 17, 2023). 38. Doug Badger, “On Surprise Medical Bills, Congress Should Side with Consumers, Not Special Interests,” Heritage Foundation Commentary, January 31, 2020, https://www.heritage.org/health-care-reform/ commentary/surprise-medical-bills-congress-should-side-consumers-not-special. 39. Edmund F. Haislmaier and Abigail Slagle, “Premiums, Choices, Deductibles, Care Access, and Government Dependence Under the Affordable Care Act: 2021 State-by-State Review,” Heritage Foundation Backgrounder No. 3668, November 2, 2021, https://www.heritage.org/sites/default/files/2021-11/BG3668.pdf. 40. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, “Transparency in Coverage,” Final Rule, Federal Register, Vol. 85, No. 219 (November 12, 2020), pp. 72158–72310, https://www.govinfo.gov/ content/pkg/FR-2020-11-12/pdf/2020-24591.pdf (accessed March 17, 2023). 41. David N. Bernstein and Robert E. Moffit, “New Price Transparency Rule Will Help Transform America’s Health Care System,” Heritage Foundation Commentary, November 1, 2020, https://www.heritage.org/health-care- reform/commentary/new-price-transparency-rule-will-help-transform-americas-health-care. 42. Sluzala and Haislmaier, “Lessons from COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing.” 43. Ibid. 44. Most recently enacted in H.R. 2471, Consolidated Appropriations Act, 2022, Public Law No. 117-103, 117th Congress, March 15, 2022, Division H, Title V, §§ 506–507, https://www.congress.gov/117/plaws/publ103/ PLAW-117publ103.pdf (accessed March 17, 2023). 45. President Joseph R. Biden Jr., Executive Order 14079, “Securing Access to Reproductive and Other Healthcare Services,” August 3, 2022, in Federal Register, Vol. 87, No. 154 (August 11, 2022), pp. 49505–49507, https:// www.govinfo.gov/content/pkg/FR-2022-08-11/pdf/2022-17420.pdf (accessed March 16, 2023). 46. Planned Parenthood, 2020–2021 Annual Report, p. 27, https://www.plannedparenthood.org/uploads/ filer_public/40/8f/408fc2ad-c8c2-48da-ad87-be5cc257d370/211214-ppfa-annualreport-20-21-c3-digital.pdf (accessed March 22, 2023). 47. Ibid., pp. 30 and 31. Total revenue of $1,714.4 million (p. 30) minus $1,580.7 million in total expenses (p. 31) yields $133,7 million. 48. Ibid., p. 28. 49. Ibid., p. 30. 50. H.R. 372, Protecting Life and Taxpayers Act of 2023, 118th Congress, introduced January 17, 2023, https://www. congress.gov/118/bills/hr372/BILLS-118hr372ih.pdf (accessed March 17, 2023). 51. 42 U.S. Code § 18023, https://www.law.cornell.edu/uscode/text/42/18023 (accessed March 17, 2023). 52. H.R. 3128, Consolidated Omnibus Budget Reconciliation Act of 1985, Public Law No. 99-272, 99th Congress, April 7, 1986, Title IX, Subtitle A, Part 1, Subpart B, § 9121, https://www.congress.gov/99/statute/STATUTE-100/ STATUTE-100-Pg82.pdf (accessed March 17, 2023). 53. H.R. 8070, Rehabilitation Act of 1973, Public Law No. 93-112, 93rd Congress, September 26, 1973, https://www. congress.gov/93/statute/STATUTE-87/STATUTE-87-Pg355.pdf (accessed March 17, 2023). — 501 — Department of Health and Human Services 54. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Office of Civil Rights, and Office of the Secretary, “Special Responsibilities of Medicare Hospitals in Emergency Cases and Discrimination on the Basis of Disability in Critical Health and Human Service Programs or Activities,” draft of Proposed Rule, January 14, 2021, https://www.hhs.gov/sites/default/files/infants-nprm.pdf (accessed March 17, 2023). 55. H.R. 26, Born-Alive Abortion Survivors Protection Act, 118th Congress, introduced January 9, 2023, https:// www.congress.gov/118/bills/hr26/BILLS-118hr26pcs.pdf (accessed March 17, 2023). 56. H.R. 7, No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2023, 118th Congress, introduced January 9, 2023, https://www.congress.gov/118/bills/hr7/BILLS-118hr7ih.pdf (accessed March 17, 2023). 57. S. 401, Conscience Protection Act of 2021, 117th Congress, introduced February 24, 2021, https://www.congress. gov/117/bills/s401/BILLS-117s401is.pdf (accessed March 17, 2023). 58. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, and Office of the Secretary, “Nondiscrimination in Health Programs and Activities,” Notice of Proposed Rulemaking; Notice of Tribal Consultation, Federal Register, Vol. 87, No. 149 (August 4, 2022), pp. 47824–47920, https://www.govinfo. gov/content/pkg/FR-2022-08-04/pdf/2022-16217.pdf (accessed March 17, 2023). 59. Ibid., p. 47916. 60. The regulation was not finalized before the end of the Administration. U.S. Department of Agriculture, Food and Nutrition Services, “Revision of Categorical Eligibility in the Supplemental Nutrition Assistance Program (SNAP),” Proposed Rule, Federal Register, Vol. 84, No. 142 (July 24, 2019), pp. 35570–55581, https:// www.federalregister.gov/documents/2019/07/24/2019-15670/revision-of-categorical-eligibility-in-the- supplemental-nutrition-assistance-program-snap (accessed March 17, 2023). 61. 45 Code of Federal Regulations § 75.300(c) and (d), https://www.ecfr.gov/current/title-45/subtitle-A/ subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.300 (accessed March 17, 2023). 62. H.R. 1750, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https:// www.congress.gov/117/bills/hr1750/BILLS-117hr1750ih.pdf (accessed March 17, 2023), and S. 656, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https://www.congress.gov/117/bills/ s656/BILLS-117s656is.pdf (accessed March 17, 2023). 63. S. 3949, Trafficking Victims Protection Reauthorization Act of 2022, Public Law No. 117-348, 117th Congress, January 25, 2023, https://www.congress.gov/117/plaws/publ348/PLAW-117publ348.pdf (accessed March 17, 2023). 64. Kelsey Y. Santamaria, “Child Migrants at the Border: The Flores Settlement Agreement and Other Legal Developments,” Congressional Research Service In Focus No. IF11799, April 1, 2021, https://crsreports.congress. gov/product/pdf/IF/IF11799 (accessed March 17, 2023). 65. Report, Building a Happy Home: Marriage Education as a Tool to Strengthen Families, Social Capital Project Report No. 1-22, March 2022, p. 17, https://www.jec.senate.gov/public/_cache/files/3d102525-6f0d-48ed- 92f4-d71edd468ad6/building-a-happy-home.pdf (accessed March 17, 2023). The cover of the report reflects that the Social Capital Project is “[a] project of the Joint Economic Committee – Republicans.” 66. See, for example, Alan J. Hawkins, “Are Federally Supported Relationship Education Programs for Lower-Income Individuals and Couples Working? A Review of Evaluation Research,” American Enterprise Institute, September 2019, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 67. H.R. 8404, Respect for Marriage Act, Public Law No. 117-228, 117th Congress, December 13, 2022, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 68. Madison Marino, “Over 1,000 Safety Violations Mar Head Start. Children Deserve Better,” Heritage Foundation Commentary, November 10, 2022, https://www.heritage.org/education/commentary/over-1000-safety- violations-mar-head-start-children-deserve-better. 69. American Hospital Association v. Becerra, 596 U.S. ___ (2022), https://www.supremecourt.gov/ opinions/21pdf/20-1114_09m1.pdf (accessed March 17, 2023). 70. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, “Coverage of Certain Preventive Services Under the Affordable Care Act,” Notice of Proposed Rulemaking, Federal Register, Vol. 88, No. 22 (February 2, 2023), pp. 7236–7281, https://www. govinfo.gov/content/pkg/FR-2023-02-02/pdf/2023-01981.pdf (accessed March 17, 2023).

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Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.

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