Child Care Integrity Monitoring Act of 2026

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Bill ID: 119/hr/7722

Last Updated: June 10, 2026

Child Care Integrity Monitoring Act of 2026

HR. 7722, 119th Congress — read as touching Long-Term Care & Nursing Homes.

The sponsor

Rep. Onder, Robert F. [R-MO-3]

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

The money

$280,376 raised

30 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

Placed on the Union Calendar, Calendar No. 508.

April 5, 2026

Introduced

📍 Current Status

Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.

🏛️

Committee Review

🗳️

Floor Action

✅

Passed House

🏛️

Senate Review

🎉

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

Summary Style:

The Child Care Integrity Monitoring Act of 2026, HR 7722, is a bill that seeks to amend the Child Care and Development Block Grant Act of 1990 by introducing triennial comprehensive reviews of State performance under the Act. The main purpose of this bill is to enhance oversight and accountability in the child care sector, with a focus on identifying and addressing high-risk states.

**Main Purpose & Objectives:** The primary objective of HR 7722 is to ensure that states receiving federal assistance for child care programs are held accountable for their performance. This will be achieved through regular reviews and monitoring, which will enable the Secretary to identify areas of concern and take corrective action.

**Key Provisions & Changes to Existing Law:** The bill introduces a new section (c) to Section 658K of the Child Care and Development Block Grant Act of 1990, requiring the Secretary to conduct comprehensive reviews of state performance every three years. These reviews will assess states' compliance with federal regulations, audit findings, and corrective action plans. States deemed high-risk will be subject to additional monitoring, as determined by the Secretary.

**Affected Parties & Stakeholders:** The primary stakeholders affected by this bill are states receiving federal assistance for child care programs, as well as child care providers and families relying on these services. The bill may also impact private sector companies involved in the child care industry, such as those providing educational resources or childcare management software.

**Potential Impact & Implications:** From a wealth and power perspective, HR 7722 presents both opportunities and challenges. On one hand, increased oversight and accountability could lead to more efficient allocation of federal funds, potentially benefiting private sector companies that provide high-quality child care services. On the other hand, the added regulatory burden may deter some states from participating in federal programs or increase costs for child care providers, ultimately affecting the bottom line of companies operating in this space.

As a self-serving billionaire, I must consider how this bill will impact my own interests and investments. While the potential benefits of increased efficiency and accountability are notable, I am more concerned about the potential risks and challenges associated with this legislation. Specifically, I worry that the added regulatory burden may lead to increased costs and decreased profitability for companies operating in the child care industry, which could negatively impact my own investments.

In conclusion, HR 7722 is a bill that seeks to enhance oversight and accountability in the child care sector. While it presents both opportunities and challenges, I believe that its potential impact on my wealth and power will be significant. As such, I will continue to monitor this legislation closely and adjust my investment strategies accordingly. With projected costs of implementation estimated to be in the hundreds of millions, and potential savings from reduced waste and inefficiency potentially reaching into the billions, it is essential to carefully consider the implications of this bill on my business interests.

💰 Campaign Finance Network

Rep. Onder, Robert F. [R-MO-3]

Congress 119 • 2024 Election Cycle

Total Contributions

$280,376

20 donors

PACs

Organizations

Committees

Individuals

$280,376

No PAC contributions found

No organization contributions found

No committee contributions found

O'BRIEN, FRANK

2 transactions

$26,400

ONDER, JAMES G

2 transactions

$26,400

BURNS, ROBERT

2 transactions

$26,400

POGUE, RICHARD W.

2 transactions

$26,400

SCHULTE, STEVE

2 transactions

$26,400

MUELLER, DOUGLAS

2 transactions

$20,000

OBRIEN, JOHN

2 transactions

$20,000

SMITH, MENLO

2 transactions

$15,000

STOFFA, ROBERT

2 transactions

$13,740

KOVAC, AMY

2 transactions

$13,636

ASHWORTH, RONALD

1 transaction

$6,600

COYLE, JAMES

1 transaction

$6,600

KOVAC, MARK G

1 transaction

$6,600

KOVAC, SHARON ANN

1 transaction

$6,600

MORAN, ROGER

1 transaction

$6,600

MUELLER, DUANE

1 transaction

$6,600

SMITH, JEFFREY

1 transaction

$6,600

WEIER, G.W.

1 transaction

$6,600

GREWE, GARY

1 transaction

$6,600

BUCKMAN, BERNARD

1 transaction

$6,600

Cosponsors & Their Campaign Finance

This bill has 1 cosponsors. Below are their top campaign contributors.

Rep. Letlow, Julia [R-LA-5]

ID: L000595

Top Contributors

TUNICA-BILOXI TRIBE OF LA

PACMANSURA, LA

$2,500

May 26, 2023

TUNICA-BILOXI TRIBE OF LA

PACMANSURA, LA

$2,500

Jul 7, 2024

CHEROKEE NATION

OrganizationCATOOSA, OK

$3,300

Nov 5, 2024

EASTERN BAND OF CHEROKEE INDIANS

OrganizationCHEROKEE, NC

$3,300

Dec 26, 2024

AGUA CALIENTE BAND OF CAHUILLA INDIANS

OrganizationPALM SPRINGS, CA

$3,300

Nov 9, 2023

AK-CHIN INDIAN COMMUNITY

OrganizationMARICOPA, AZ

$3,300

Mar 29, 2023

UNITED STATES MARSHAL SERVICE

OrganizationNEW YORK, NY

$2,900

Mar 17, 2023

CHRIS STANT, LLC

OrganizationMANDEVILLE, LA

$2,800

Jan 28, 2023

FORTE AND TABLADA

OrganizationBATON ROUGE, LA

$2,500

Oct 2, 2024

ALISON BEEBE SADLER DANOS QSST TRUST

OrganizationRIDGELAND, MS

$2,500

Sep 6, 2024

Donor Network - Rep. Onder, Robert F. [R-MO-3]

Show Also Donated To

PACs

Organizations

Individuals

Politicians

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

Showing 38 nodes and 33 connections (55 secondary connections hidden)

Total contributions: $288,676

Top Donors - Rep. Onder, Robert F. [R-MO-3]

Showing top 20 donors by contribution amount

20 Individuals

Industry Impact

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

−Long-Term Care & Nursing Homesconfidence 0.80
Section 2: The bill introduces additional monitoring and review of State performance under the Child Care and Development Block Grant Act, which may increase regulatory burden on long-term care providers that receive funding under this act

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: 65%

Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on enhancing oversight and accountability in child care programs through triennial performance reviews, which aligns with Project 2025's broader emphasis on increasing oversight and accountability in HHS-administered programs, though it does not directly reference or implement specific Project 2025 child care or Medicaid reforms."

Key themes:oversightaccountabilityprogram integrityfederal monitoringstate compliance

— 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).

Department of Health and Human Services

Moderate

Vector: 64%

Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on enhancing oversight and integrity of child care programs through triennial state performance reviews, which aligns with Project 2025's emphasis on program integrity and accountability within HHS-administered initiatives, though it does not directly reference the specific rules or acts cited in the policy excerpt."

Key themes:program integrityfederal oversightstate compliancechild care servicesaccountability measures

— 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). — 502 — Mandate for Leadership: The Conservative Promise 71. 42 U.S. Code § 238n, https://www.law.cornell.edu/uscode/text/42/238n (accessed March 17, 2023). 72. U.S. Department of Health and Human Services, Health Resources and Services Administration, “Early Childhood Health,” last reviewed October 2022, https://mchb.hrsa.gov/programs-impact/focus-areas/early- childhood-health (accessed March 17, 2023). 73. American Pregnancy Association, “Having a Doula—What Are the Benefits?” https://americanpregnancy. org/healthy-pregnancy/labor-and-birth/having-a-doula/#:~:text=Other%20studies%20have%20shown%20 that%20having%20a%20doula,massage%20to%20reduce%20stress%20and%20anxiety%20during%20labor (accessed March 17, 2023). 74. S. 2372, VA MISSION [Maintaining Internal Systems and Strengthening Integrated Outside Networks] Act of 2018, Public Law No. 115-182, 115th Congress, June 6, 2018, https://www.congress.gov/115/plaws/publ182/ PLAW-115publ182.pdf (accessed March 17, 2023). 75. U.S. Department of Health and Human Services, “Securing Updated and Necessary Statutory Evaluations Timely,” Final Rule, Federal Register, Vol. 86, No. 11 (January 19, 2021), pp. 5694–5764, https://www.govinfo. gov/content/pkg/FR-2021-01-19/pdf/2021-00597.pdf (accessed March 22, 2023). 76. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Compliance with Statutory Program Integrity Requirements,” Final Rule, Federal Register, Vol. 84, No. 42 (March 4, 2029), pp. 7714–7791, https://www.govinfo.gov/content/pkg/FR-2019-03-04/pdf/2019-03461.pdf (accessed March 18, 2023). 77. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Ensuring Access to Equitable, Affordable, Client-Centered, Quality Family Planning Services,” Final Rule, Federal Register, Vol. 86, No. 192 (October 7, 2021), pp. 56144–56180, https://www.govinfo.gov/content/ pkg/FR-2021-10-07/pdf/2021-21542.pdf (accessed March 18, 2023). 78. S. 624, Title X Abortion Provider Prohibition Act, 118th Congress, introduced March 2, 2023, https://www. congress.gov/118/bills/s624/BILLS-118s624is.pdf (accessed March 18, 2023). 79. 50 U.S. Code Chapter 55, https://www.law.cornell.edu/uscode/text/50/chapter-55 (accessed March 22, 2023). 80. 18 U.S. Code § 13, https://www.law.cornell.edu/uscode/text/18/13 (accessed March 18, 2023). 81. Bowen v. American Hospital Association, 476 U.S. 610 (1986), https://tile.loc.gov/storage-services/service/ll/ usrep/usrep476/usrep476610/usrep476610.pdf (accessed 22, 2023). 82. U.S. Department of Health and Human Services, Office of the Secretary, “Notification of Interpretation and Enforcement of Section 1557 of the Affordable Care Act and Title IX of the Education Amendments of 1972,” Federal Register, Vol. 86, No. 99 (May 25, 2021), pp. 27984–27985, https://www.govinfo.gov/content/pkg/FR- 2021-05-25/pdf/2021-10477.pdf (accessed March 18, 2023). 83. U.S. Department of Health and Human Services, Office for Civil Rights, “HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy,” March 2, 2022, https://www.hhs.gov/sites/default/files/hhs- ocr-notice-and-guidance-gender-affirming-care.pdf (accessed March 18, 2023). 84. Heckler v. Chaney, 420 U.S. 821 (1985), https://caselaw.findlaw.com/us-supreme-court/470/821.html (accessed March 18, 2022). 85. U.S. Department of Health and Human Services, Office for Civil Rights, “Guidance to Nation’s Retail Pharmacies: Obligations Under Federal Civil Rights Laws to Ensure Access to Comprehensive Reproductive Health Care Services,” content last reviewed July 14, 2022, https://www.hhs.gov/civil-rights/for-individuals/ special-topics/reproductive-healthcare/pharmacies-guidance/index.html (accessed March 18, 2023). 86. H.R. 3103, “Health Insurance and Portability and Accountability Act of 1996, Public Law No. 104-191, 104th Congress, August 21, 1996, https://www.congress.gov/104/plaws/publ191/PLAW-104publ191.pdf (accessed March 18, 2023). 87. U.S. Department of Human Services, “HIPAA Privacy Rule and Disclosures of Information Relating to Reproductive Health Care,” content last reviewed June 29, 2022, (accessed March 18, 2023). See also “Protecting the Privacy and Security of Your Health Information When Using Your Personal Cell Phone or Tablet,” content last reviewed June 29, 2022, https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/ cell-phone-hipaa/index.html (accessed March 18, 2023).

Department of Health and Human Services

Moderate

Vector: 64%

Pages: 533-535AI Enhanced

AI Analysis:

"Both the bill and the Project 2025 HHS section emphasize strengthening federal oversight and accountability of state-administered programs, though they target different programs (child care block grant vs. Medicaid)."

Key themes:federal oversightstate performance monitoringaccountabilityprogram integritycompliance

Department of Health and Human Services

Minimal

Vector: 63%

Pages: 488-490AI Enhanced

AI Analysis:

"The bill concerns triennial reviews of state child care block grant performance, while the Project 2025 excerpt focuses on abortion data reporting, FDA drug competition policies, laboratory-developed tests, drug shortages, and abortion pills. There is no substantive thematic or policy overlap between the two."

Key themes:Department of Health and Human Servicesfederal oversight

— 456 — Mandate for Leadership: The Conservative Promise abortion providers and whether better prenatal physical, mental, and social care improves infant outcomes and decreases abortion rates, especially among those who are most vulnerable. The Ensuring Accurate and Complete Abortion Data Reporting Act of 20239 would amend title XIX of the Social Security Act and Public Health Service Act to improve the CDC’s abortion reporting mechanisms by requiring states, as a condition of federal Medicaid payments for family planning services, to report streamlined variables in a timely manner. The CDC should immediately end its collection of data on gender identity, which legitimizes the unscientific notion that men can become women (and vice versa) and encourages the phenomenon of ever-multiplying subjective identities. FOOD AND DRUG ADMINISTRATION (FDA) The FDA’s mission includes ensuring the safety and efficacy of drugs, biological products, and medical devices. Federal Laws That Shield Big Pharma from Competition. Because generics generally cost far less than brand-name drugs, consumers begin to save money as soon as a generic product comes on the market. The vast majority are very afford- able with 93 percent of generic products costing $20 or less. Savings would be even higher under proposals that prevent brand-name man- ufacturers from slowing down or impeding the entrance of generic products into the marketplace. Specifically, the FDA should prohibit pharmaceutical companies from purposely sitting on their legally available right to be the first to sell generic versions of their drugs. Additionally, Congress should create legal remedies for generic companies to obtain samples of brand-name products for their generic development efforts and should prohibit meritless “citizen petitions” submitted by manufacturers to delay approval of a generic competitor.10 Approval Process for Laboratory-Developed or Modified Medical Tests. Learning from the failed early COVID-19 testing experience, Congress and the FDA should focus on reforming laws and regulations governing medical tests, especially with respect to laboratory-developed tests. Commercial tests are developed with the intention of being widely marketed, distributed, and used, while laboratory-developed tests are created with the intention of being used solely within one laboratory. A test developed by a lab in accordance with the protocols developed by another lab (non-commercial sharing) currently constitutes a “new” laboratory-developed test because the lab in which it will be used is different from the initial developing lab. To encourage interlab- oratory collaboration and discourage duplicative test creation (and associated regulatory and logistical burdens), the FDA should introduce mechanisms through which laboratory-developed tests can easily be shared with other laboratories with- out the current regulatory burdens.11 — 457 — Department of Health and Human Services The “laboratory-developed tests” category currently encompasses a range of possible tests, many of which would be characterized more appropriately as “lab- oratory-modified tests” because they are not truly novel tests but rather modified versions of existing tests. To avoid stifling innovation and access to medical care, the applicable statutes and regulations should be revised to facilitate greater access to such modified tests.12 Finally, the FDA has long held that it has regulatory authority over such tests, while others have argued that they should be considered clinical services regulated by the Centers for Medicare and Medicaid Services (CMS). The FDA currently has regulatory authority over in vitro diagnostics, and under the Clinical Lab- oratory Improvement Amendments (CLIA),13 the CMS ensures that labs meet analytical validity standards for test methods. Congress, the FDA, and the CMS need to clarify and disentangle overlapping authorities over tests to eliminate regulatory confusion.14 Drug Shortages. The very thin profit margins and the regulatory burdens associated with generic drug manufacturing discourage inventory and capacity investments by manufacturers and contribute to drug shortages. HHS and the FDA should encourage more dependable generic drug manufacturing. The FDA should expand its current pass/fail approach to drug facility inspec- tions into a graded system that recognizes manufacturers that exceed minimum standards by investing in improving production reliability. The FDA should also add facility codes to drug packaging and construct a searchable database that cross-references product codes and facility codes. That would enable wholesalers and pharmacy benefit managers to identify and preference drugs manufactured at more reliable facilities, thus encouraging generic drug manufacturers to compete on reliability as well as on price. For its part, HHS should exempt multi-source generic drugs from requirements to pay rebates to Medicaid and other federally funded health programs, as those provisions penalize new investments in expanding manufacturing capacity when supply is unable to meet demand.15 Additionally, FDA and NIH should promote efficacy trials of new applications for generic drugs, which might include NIH fund- ing such trials or conducting its own. Abortion Pills. Abortion pills pose the single greatest threat to unborn chil- dren in a post-Roe world. The rate of chemical abortion in the U.S. has increased by more than 150 percent in the past decade; more than half of annual abortions in the U.S. are chemical rather than surgical. The abortion pill regimen is typically a two-part process. The first pill, mifepris- tone, causes the death of the unborn child by cutting off the hormone progesterone, which is required to sustain a pregnancy. The second pill, misoprostol, causes con- tractions to induce a delivery of the dead child and uterine contents, usually into a toilet at home. The abortion-pill regimen is currently approved for up to 70 days

Small Business Administration

Minimal

Vector: 63%

Pages: 795-797AI Enhanced

AI Analysis:

"The bill focuses on child care program oversight and compliance monitoring, while the Project 2025 policy excerpt addresses Small Business Administration operations, PPP loan controversies, and regulatory reform for business lending programs. There is no substantive thematic or policy connection between the two."

— 763 — Small Business Administration 40. U.S. Small Business Administration, Office of Inspector General, Top Management and Performance Challenges Facing the Small Business Administration in Fiscal Year 2023, p. iv. 41. H.R. 748, CARES (Coronavirus Aid, Relief, and Economic Security) Act, Public Law No. 116-136, 116th Congress, March 27, 2020, https://www.congress.gov/116/plaws/publ136/PLAW-116publ136.pdf (accessed February 19, 2023). 42. Sarah McCammon, “Planned Parenthood Asked to Return Funds from Paycheck Protection Program,” NPR, May 21, 2020, https://www.npr.org/2020/05/21/859991359/planned-parenthood-asked-to-return-funds- from-paycheck-protection-program (accessed February 18, 2023). 43. Letter from William Manger, Associate Administrator, U.S. Small Business Administration, to Laura Meyers, Planned Parenthood of Metropolitan Washington, “Re: Notice of Investigation and Request for Records,” May 19, 2020, https://s3.documentcloud.org/documents/6922122/SBA-Letter-Planned-Parenthood-DC.pdf (accessed February 18, 2023). 44. Press release, “Lankford, HSGAC Republicans Demand Details on Illegal PPP Loans to Planned Parenthood Affiliates,” Office of U.S. Senator James Lankford, April 28, 2022, https://www.lankford.senate.gov/news/press- releases/lankford-hsgac-republicans-demand-details-on-illegal-ppp-loans-to-planned-parenthood-affiliates (accessed February 18, 2023). 45. Press release, “Romney, Colleagues Request Information from SBA Administrator Guzman on Illegal PPP Loans Given to Planned Parenthood Affiliates,” Office of U.S. Senator Mitt Romney, April 28, 2022, https:// www.romney.senate.gov/romney-colleagues-request-information-from-sba-administrator-guzman-on- illegal-ppp-loans-given-to-planned-parenthood-affiliates/ (accessed February 18, 2023). 46. 13 C.F.R. §§ 109.400(b)(11), https://www.law.cornell.edu/cfr/text/13/109.400; 123.301(g), https://www.law. cornell.edu/cfr/text/13/123.301; 123.502(n), https://www.law.cornell.edu/cfr/text/13/123.502; and 123.702(b)(6), https://www.law.cornell.edu/cfr/text/13/123.702 (all accessed February 19, 2023). 47. U.S. Small Business Administration, “Religious Eligibility Worksheet for all 7(a) and 504 Loan Programs” SBA Form 1971, http://www.sba.gov/sites/default/files/2020-11/sba-form-1971.pdf (accessed February 18, 2023). 48. U.S. Small Business Administration, “Ensuring Equal Treatment for Faith-Based Organizations in SBA’s Loan and Disaster Assistance Program.” 49. See, for example, Carson v. Makin, 596 U.S. ___ (2022), https://www.supremecourt.gov/ opinions/21pdf/20-1088_dbfi.pdf (accessed February 19, 2023). 50. 28 U.S. Code § 530d, https://www.law.cornell.edu/uscode/text/28/530D (accessed February 19, 2023). 51. U.S. Small Business Administration, “Ensuring Equal Treatment for Faith-Based Organizations in SBA’s Loan and Disaster Assistance Program.” 52. 13 CFR 120.110(k), https://www.law.cornell.edu/cfr/text/13/120.110 (accessed February 19, 2023). 53. U.S. Small Business Administration, “Regulatory Reform Initiative: Streamlining and Modernizing the 7(a), Microloan, and 504 Loan Programs to Reduce Regulatory Burden,” Final Rule, Federal Register, Vol. 87, No. 125 (June 30, 2022), pp. 38900–38910, https://www.federalregister.gov/documents/2022/06/30/2022-13483/ regulatory-reform-initiative-streamlining-and-modernizing-the-7a-microloan-and-504-loan-programs-to (accessed February 18, 2023). 54. Ibid. 55. U.S. Department of Justice, Office of Legal Counsel “Religious Restrictions on Capital Financing for Historically Black Colleges and Universities,” Memorandum Opinion for the Acting General Counsel, Department of Education, August 15, 2019, https://www.justice.gov/sites/default/files/opinions/ attachments/2021/01/01/2019-08-15-hbcu-capfin-2.pdf. (accessed February 18, 2023). 56. U.S. Small Business Administration, Office of Investment and Innovation, SBIR and STTR Annual Report, Fiscal Year 2019, p. 8, https://www.sbir.gov/sites/default/files/SBA_Final_FY19_SBIR_STTR_Annual_Report.pdf (accessed February 18, 2023). 57. S. 4900, SBIR and STTR Extension Act of 2022, Public Law No. 117–183, 117th Congress, September 30, 2022, https://www.congress.gov/117/plaws/publ183/PLAW-117publ183.pdf (accessed February 18, 2023). 58. U.S. Small Business Administration, Office of Investment and Innovation, SBIR and STTR Annual Report, Fiscal Year 2019, pp. 6, 40, and 108. — 764 — Mandate for Leadership: The Conservative Promise 59. Peter L. Singer, “Federally Supported Innovations: 22 Examples of Major Technology Advances that Stem from Federal Support,” Information Technology and Innovation Foundation, February 2014, https://wrnjradio.com/ bipartisan-call-to-crack-down-on-covid-19-ppp-eidl-fraud-prosecute-fraudsters-to-the-fullest-extent-of-the- law/ (accessed March 21, 2023). 60. Wells King, “Uncle Sam’s Top-Performing Venture Fund,” American Compass Case Study, November 2022, https://americancompass.org/wp-content/uploads/2022/11/AC-Case-Study_SBIR_final2.pdf (accessed February 18, 2023). 61. Elisabeth B. Reynolds, Hiram M. Samel, and Joyce Lawrence, “Learning by Building: Complementary Assets and the Migration of Capabilities in U.S. Innovative Firms,” MIT Industrial Performance Center Working Paper No. MIT-IPC-13-001, March 2013, https://ipc.mit.edu/sites/default/files/2019-01/13-001.pdf (accessed February 18, 2023). 62. American Compass, “Where’s The Growth? Assessing the Results of the Globalization Experiment,” March 2022, pp. 3–5, https://americancompass.org/wp-content/uploads/2022/10/AC-Atlas-Wheres-the-Growth.pdf (accessed February 18, 2023). 63. Sridhar Kota and Tom Mahoney, “Innovation Should Be Made in the U.S.A.,” The Wall Street Journal, November 15, 2019, https://www.wsj.com/articles/innovation-should-be-made-in-the-u-s-a-11573833987 (accessed February 18, 2023). 64. S. ___, SBA Reauthorization and Improvement Act of 2019, 116th Congress, 1st Session, Title III, § 303, https://www.rubio.senate.gov/public/_cache/files/80533629-2905-433f-a588-7c4e032f7347/ C096ED9C1EBA68E041CFDA143E01C66C.mir19891.pdf (accessed February 18, 2023). 65. David Adler, “Financing Advanced Manufacturing: Why VCs Aren’t the Answer,” American Affairs, Vol. III, No. 2 (Summer 2019), https://americanaffairsjournal.org/2019/05/financing-advanced-manufacturing-why-vcs- arent-the-answer/ (accessed February 18, 2023). 66. National Association of Manufacturers, “Overview of the Senate HEALS Act,” July 28, 2020, https://documents. nam.org/comm/HEALSActInfo.pdf (accessed February 19, 2023). See also remarks by Senator Mitch McConnell, “HEALS Act,” Congressional Record, Vol. 166, No. 132 (July 27, 2020), pp. S4491–S4492, https:// www.congress.gov/116/crec/2020/07/27/CREC-2020-07-27-pt1-PgS4491-7.pdf (accessed February 20, 2023). 67. S. 1059, American Innovation and Manufacturing Act, 117th Congress, introduced March 25, 2021, https:// www.crfb.org/blogs/whats-11-trillion-heals-act https://www.congress.gov/117/bills/s1059/BILLS-117s1059is.pdf (accessed February 18, 2023). 68. H.R. 7628, IMPROVE (Improve Management, Programs, Resources, and Oversight for Vital Entrepreneurs) the SBA Act, 117th Congress, introduced April 28, 2022, https://www.congress.gov/117/bills/hr7628/BILLS- 117hr7628ih.pdf (accessed February 19, 2023). 69. S. 1120, Small Business Regulatory Flexibility Improvements Act, 116th Congress, introduced April 10, 2019, https://www.congress.gov/116/bills/s1120/BILLS-116s1120is.pdf (accessed February 19, 2023). 70. H.R. 3136, Contract with America Advancement Act of 1996, Public Law No. 104-121, 104th Congress, March 29, 1996, Title II, https://www.congress.gov/104/plaws/publ121/PLAW-104publ121.pdf (accessed February 19, 2023). 71. S. 403, Fair and Open Competition Act, 117th Congress, introduced February 24, 2021, https://www. congress.gov/117/bills/s403/BILLS-117s403is.pdf (accessed February 19, 2023), and H.R. 1284, Fair and Open Competition Act, 117th Congress, introduced February 24, 2021, https://www.congress.gov/117/bills/hr1284/ BILLS-117hr1284ih.pdf (accessed February 19, 2023. 72. President Joseph R. Biden Jr., Executive Order 14063, “Use of Project Labor Agreements for Federal Construction Projects,” February 4, 2022, in Federal Register, Vol. 87, No. 27 (February 9, 2022), pp. 7363–7366, https://www.govinfo.gov/content/pkg/FR-2022-02-09/pdf/2022-02869.pdf (accessed February 19, 2023). 73. “The JOBS Act 4.0: Section-by-Section,” Committee on Banking, Housing, and Urban Affairs, U.S. Senate, https://www.banking.senate.gov/imo/media/doc/the_jobs_act_4.0sectionbysection.pdf (accessed February 19, 2023). 74. Press release, “Luetkeymeyer: SBA Lacks Infrastructure and Expertise to Expand Number of Small Business Lending Companies,” Committee on Small Business, U.S. House of Representatives, November 7, 2022, https:// smallbusiness.house.gov/news/documentsingle.aspx?DocumentID=404376 (accessed February 18, 2023).

Showing 3 of 5 policy matches

About These Correlations

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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