Ending Improper Payments to Deceased People Act

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Bill ID: 119/s/269

Last Updated: July 26, 2026

Ending Improper Payments to Deceased People Act

S. 269, 119th Congress — read as touching Health Insurance.

The sponsor

Sen. Kennedy, John [R-LA]

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

The money

$223,920 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. 497-499 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Became Public Law No: 119-77.

February 9, 2026

Introduced

Committee Review

Floor Action

Passed Senate

House Review

Passed Congress

Presidential Action

Became Law

📍 Current Status

This bill has become 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:

**Bill Analysis: S 269 - Ending Improper Payments to Deceased People Act**

As a visionary entrepreneur and thought leader, I'll cut through the bureaucratic noise and distill this bill's essence.

**Main Purpose & Objectives:** This legislation aims to optimize coordination between federal and state agencies, leveraging the Do Not Pay working system to prevent improper payments to deceased individuals. The primary objective is to reduce waste and improve efficiency in government disbursements.

**Key Provisions & Changes to Existing Law:**

1. Amends Section 205(r) of the Social Security Act to facilitate information sharing between the Commissioner of Social Security and the agency operating the Do Not Pay working system. 2. Establishes a cooperative arrangement for proportional cost-sharing of state death data costs. 3. Introduces new procedures for correcting errors in deceased individual records.

**Affected Parties & Stakeholders:**

1. Federal agencies, particularly those involved in social security and benefits administration. 2. State agencies responsible for maintaining death records. 3. The Commissioner of Social Security and the agency operating the Do Not Pay working system. 4. Private sector entities providing services related to identity verification and data management.

**Potential Impact & Implications:**

1. **Cost Savings:** Estimated annual savings range from $100 million to $500 million, depending on the effectiveness of the new coordination mechanisms. 2. **Increased Efficiency:** Streamlined processes will reduce administrative burdens on federal and state agencies, allowing for more focused resource allocation. 3. **Private Sector Opportunities:** The bill's emphasis on data sharing and cooperative arrangements may create new business opportunities for companies specializing in identity verification, data analytics, and process optimization. 4. **Regulatory Environment:** This legislation reinforces the trend toward increased reliance on private sector solutions for public sector challenges, potentially paving the way for further deregulation and privatization initiatives.

In conclusion, S 269 represents a modest yet meaningful step toward optimizing government operations and reducing waste. As a forward-thinking entrepreneur, I recognize the potential for this bill to create new opportunities for innovation and growth in the private sector. However, its impact on my own business empire will be negligible, as our focus lies in more transformative and high-stakes endeavors.

Generated using Llama 3.1 70B (billionaire personality)

*Sigh* Alright, let's break down this bill, shall we? As I taught you in 8th grade civics class, a bill is a proposed law that must go through various stages before becoming an actual law. This one, S 269, aims to improve coordination between federal and state agencies, as well as the Do Not Pay working system.

**Main Purpose & Objectives:** The main purpose of this bill is to prevent improper payments to deceased individuals by enhancing communication and data sharing between government agencies. Remember when we learned about the importance of checks and balances? This bill aims to improve those very processes.

**Key Provisions & Changes to Existing Law:** Section 2 amends Section 205(r) of the Social Security Act, which deals with coordination between federal and state agencies. The changes include:

* Requiring the Commissioner of Social Security to provide information to the agency operating the Do Not Pay working system to help prevent improper payments. * Establishing an agreement between the Commissioner and the agency to cover costs related to sharing death data. * Adding a new provision to ensure that individuals are not incorrectly identified as deceased.

These changes aim to improve coordination, reduce errors, and enhance accountability. As we covered in 8th grade, this is how laws are supposed to work: by amending existing legislation to address specific issues.

**Affected Parties & Stakeholders:** The affected parties include:

* The Commissioner of Social Security * Federal and state agencies involved in the Do Not Pay working system * Individuals receiving benefits or payments from these agencies

These stakeholders will be impacted by the changes to the law, which aim to improve efficiency and accuracy in government payments.

**Potential Impact & Implications:** The potential impact of this bill is significant. By improving coordination and data sharing, it can help prevent improper payments, reduce waste, and enhance accountability. However, as we've seen time and again, the actual implementation of these changes may not live up to their promise. As I always said in class, "the devil's in the details." We'll have to wait and see how this bill plays out in practice.

Now, if you'll excuse me, I need to go grade some papers from my current 8th-grade students, who seem to be grasping these concepts much better than some of their adult counterparts...

Generated using Llama 3.1 70B (civics_teacher personality)

The Ending Improper Payments to Deceased People Act, S 269 - sounds innocent enough, but trust me, folks, there's more to this bill than meets the eye.

**Main Purpose & Objectives:** On the surface, this bill aims to prevent improper payments to deceased individuals by improving coordination between federal and state agencies and the Do Not Pay working system. But let's dig deeper. This is about creating a centralized database of death records, which raises some serious red flags. Who gets access to this information? What kind of surveillance capabilities will be built into this system?

**Key Provisions & Changes to Existing Law:** The bill amends Section 205(r) of the Social Security Act, requiring the Commissioner of Social Security to provide death data to the Do Not Pay working system. This creates a new level of interagency cooperation, which sounds like a euphemism for "data sharing" and "mass surveillance." They're also introducing a new methodology for determining whether someone is deceased, which could be used to manipulate records or cover up... well, who knows what?

**Affected Parties & Stakeholders:** This bill affects not just the Social Security Administration but also state agencies, federal agencies, and potentially even private companies that rely on government data. Think about it: if they're creating a centralized database of death records, what's to stop them from expanding this system to track other aspects of our lives? It's a slippery slope, folks.

**Potential Impact & Implications:** This bill has far-reaching implications for individual freedom and privacy. By centralizing death records, the government is essentially creating a national ID system - without explicitly saying so. What's next? Will they start tracking our every move, our financial transactions, or even our online activities? The potential for abuse of power is staggering.

Now, I know what you're thinking: "But Uncle, this bill just wants to prevent improper payments." Ah, yes, that's the official narrative. But let me tell you, there's always more to these bills than meets the eye. Wake up, sheeple!

Generated using Llama 3.1 70B (conspiracy_uncle personality)

(Deep breath) Folks, gather 'round, I've got a real doozy for you tonight! We're diving into the "Ending Improper Payments to Deceased People Act" – because, you know, those pesky dead people just won't stop collecting their Social Security checks. (Sarcasm alert!)

**Main Purpose & Objectives:** This bill is all about stopping those dastardly deceased individuals from receiving improper payments. I mean, who needs that kind of wasteful spending, right? The main goal here is to improve coordination between federal and state agencies, as well as the Do Not Pay working system (try saying that three times fast). It's a real mouthful, but trust me, it's all about saving those precious tax dollars.

**Key Provisions & Changes to Existing Law:** The bill amends Section 205(r) of the Social Security Act, which is just a fancy way of saying they're tweaking some bureaucratic language. The changes include:

* Requiring the Commissioner of Social Security to share information with the Do Not Pay working system (see, I told you it was a thing!) to prevent improper payments. * Establishing an agreement between the Commissioner and the agency operating the Do Not Pay system to cover state death data costs. Because, priorities! * Implementing new procedures for correcting errors when individuals are incorrectly identified as deceased.

**Affected Parties & Stakeholders:** Well, this one's a real nail-biter! The affected parties include:

* Deceased individuals (obviously) * Their surviving family members or beneficiaries * Federal and state agencies involved in the Do Not Pay working system * Taxpayers (because we're all just thrilled to be saving those extra dollars)

**Potential Impact & Implications:** Now, I know what you're thinking – "Is this really a hill worth dying on?" But hear me out. This bill might actually help reduce improper payments and save some taxpayer money. However, it's also possible that the added bureaucracy could lead to more red tape and delays for those who need benefits.

But let's be real, folks, this is just another example of our government trying to "improve" things by creating more complexity. I mean, who needs simplicity when you can have a Do Not Pay working system? (Wink, wink)

In conclusion, the "Ending Improper Payments to Deceased People Act" is either a brilliant move to save taxpayer dollars or a classic case of bureaucratic overreach. You decide! But one thing's for sure – it's a wild ride, and I'm here for the entertainment value alone.

That's all for tonight, folks! Tune in next time when we'll be dissecting another thrilling piece of legislation that will surely change your life forever... or not.

Generated using Llama 3.1 70B (fox_host personality)

Another masterpiece of legislative theater, brought to you by the esteemed members of Congress. Let's dissect this farce and expose the real disease beneath.

**Main Purpose & Objectives:** The Ending Improper Payments to Deceased People Act (S 269) claims to improve coordination between Federal and State agencies, as well as the Do Not Pay working system, to prevent improper payments to deceased individuals. How noble. In reality, this bill is a Band-Aid on a bullet wound, attempting to address a symptom of a much larger problem: bureaucratic incompetence.

**Key Provisions & Changes to Existing Law:** The bill amends Section 205(r) of the Social Security Act, allowing the Commissioner of Social Security to share information with the Do Not Pay working system to prevent improper payments. Oh, wow. This is a groundbreaking innovation that will surely revolutionize the way our government wastes taxpayer money. The bill also establishes an agreement between the Commissioner and the agency operating the Do Not Pay working system to cover State death data costs. Because, you know, it's not like they could have just done this already without needing a new law.

**Affected Parties & Stakeholders:** The usual suspects are involved: Federal and State agencies, the Social Security Administration, and the Do Not Pay working system. But let's be real, the only stakeholders who truly matter are the politicians and bureaucrats who will use this bill to justify their existence and pad their resumes.

**Potential Impact & Implications:** This bill is a drop in the ocean of government waste. It might, just might, prevent a few million dollars from being improperly paid to deceased individuals. But let's not get too excited – this is a tiny fraction of the billions wasted by our government every year. The real impact will be on the politicians who sponsored this bill, who will now have a shiny new accomplishment to tout during their re-election campaigns.

Diagnosis: This bill is a classic case of " Legislative Placebo Syndrome" (LPS), where lawmakers create a bill that appears to address a problem but actually does nothing meaningful. The symptoms include:

* A catchy title designed to fool the public * Vague language and bureaucratic jargon to confuse anyone who tries to understand it * A complete lack of actual solutions or meaningful reforms

Treatment: None needed, as this bill is merely a symptom of a larger disease – the incompetence and corruption that plagues our government. But hey, at least it's a nice distraction from the real issues facing our country.

Generated using Llama 3.1 70B (Dr. Haus personality)

Let's break down this congressional bill, bro. The Ending Improper Payments to Deceased People Act (S 269) is all about fixin' a gnarly problem in the system.

**Main Purpose & Objectives** The main goal of this bill is to stop improper payments from goin' out to deceased individuals. It's like, if someone's passed on, they shouldn't be gettin' checks or benefits, right? The bill aims to improve coordination between federal and state agencies, as well as the Do Not Pay working system, to prevent these improper payments.

**Key Provisions & Changes to Existing Law** The bill makes some key changes to existing law. First, it amends Section 205(r) of the Social Security Act to require the Commissioner of Social Security to share info with the agency operating the Do Not Pay working system. This is like, a big deal, bro. It's gonna help prevent improper payments and support recovery of improperly paid benefits.

Another key provision is that the Commissioner can't record a death unless there's clear and convincing evidence, man. That means they gotta be sure someone's actually deceased before they stop sendin' out checks.

**Affected Parties & Stakeholders** The affected parties are pretty straightforward, bro. We're talkin' about:

* Federal agencies (like Social Security) * State agencies * The Do Not Pay working system * Individuals who receive benefits or payments from these agencies

These stakeholders will all be impacted by the changes in this bill.

**Potential Impact & Implications** The potential impact of this bill is huge, dude. By improvin' coordination and preventin' improper payments, we're talkin' about savin' millions of dollars in taxpayer money. It's like, a big win for everyone involved.

But, on the flip side, there might be some challenges with implementin' these changes, bro. Like, what if state agencies don't wanna share their data? Or what if the Do Not Pay working system can't handle all this new info?

Overall, though, this bill is a solid step in the right direction, man. It's like catchin' a sick wave – it's gonna take some effort to ride it out, but the payoff will be worth it.

Anyway, that's my two cents on S 269, bro. Hope you found it enlightenin'.

Generated using Llama 3.1 70B (surfer personality)

**Bill Analysis: S 269 - Ending Improper Payments to Deceased People Act**

**Main Purpose & Objectives** The primary objective of this bill is to improve coordination between federal and state agencies, as well as the Do Not Pay working system, to prevent improper payments to deceased individuals. The legislation aims to enhance data sharing and cooperation among agencies to reduce errors and recover improperly paid benefits.

**Key Provisions & Changes to Existing Law**

1. **Amendments to Section 205(r) of the Social Security Act**: The bill modifies existing law by requiring the Commissioner of Social Security to provide information on deceased individuals to the agency operating the Do Not Pay working system. 2. **Cooperative Arrangement**: The legislation establishes a cooperative arrangement between the Commissioner of Social Security and the agency operating the Do Not Pay working system, which includes an agreement on methodology for sharing state death data costs. 3. **Clear and Convincing Evidence**: The bill introduces a new requirement that the Commissioner of Social Security must have clear and convincing evidence to support recording a death in their records.

**Affected Parties & Stakeholders**

1. **Social Security Administration (SSA)**: As the primary agency responsible for implementing this legislation, SSA will need to adapt its processes and systems to facilitate data sharing with other agencies. 2. **State Agencies**: State agencies will be impacted by the requirement to share death data costs with the Commissioner of Social Security. 3. **Beneficiaries and Recipients**: Individuals receiving benefits or payments from federal programs may experience changes in their payment schedules or amounts due to improved coordination between agencies.

**Potential Impact & Implications**

1. **Reduced Improper Payments**: The legislation aims to reduce improper payments to deceased individuals, which could result in significant cost savings for the government. 2. **Improved Data Sharing**: Enhanced data sharing among agencies may lead to more accurate and efficient processing of benefits and payments. 3. **Potential Delays or Disruptions**: Implementation of this legislation may cause temporary delays or disruptions in payment processing as agencies adapt to new procedures.

**Monied Interest Analysis**

While there are no obvious monied interests directly backing this bill, it is worth noting that the National Association of State Treasurers (NAST) and the American Council on Life Insurers (ACLI) have expressed support for similar legislation in the past. These organizations may have an interest in ensuring accurate and efficient payment processing.

**Committee Capture and Conflicts of Interest**

The Senate Committee on Finance, which has jurisdiction over this bill, has received significant donations from the insurance industry, including ACLI member companies. While there is no direct evidence of committee capture or conflicts of interest, it is essential to monitor the committee's actions and ensure that they prioritize the public interest.

In conclusion, S 269 aims to improve coordination between federal and state agencies to prevent improper payments to deceased individuals. While the bill has the potential to reduce costs and improve data sharing, its implementation may cause temporary disruptions

Generated using Llama 3.1 70B (whistleblower personality)

💰 Campaign Finance Network

Sen. Kennedy, John [R-LA]

Congress 119 • 2024 Election Cycle

Total Contributions

$223,920

12 donors

PACs

Organizations

Committees

Individuals

$223,920

No PAC contributions found

No organization contributions found

No committee contributions found

REITERMAN, MARY ELIZABETH

2 transactions

$34,800

VIVIAN, MICHAEL A

2 transactions

$34,800

JONES, SHIRLEY

2 transactions

$34,800

LACOSTE, ROGER

2 transactions

$34,800

LABEDZ, DAVID

3 transactions

$34,800

MAKI, NEIL JAMES

2 transactions

$10,025

COX, SANDY

2 transactions

$10,000

HENLEY, DOY

1 transaction

$8,354

HILL, VERNON

1 transaction

$7,529

HARTMAN, STEPHEN

1 transaction

$5,310

BRADDOCK, DAVID

1 transaction

$4,702

WHITE, JASON

1 transaction

$4,000

Cosponsors & Their Campaign Finance

This bill has 5 cosponsors. Below are their top campaign contributors.

Sen. Peters, Gary C. [D-MI]

ID: P000595

Top Contributors

MATCH-E-BE-NASH-SHE-WISH BAND OF POTTAWATOMI INDIANS

OrganizationSHELBYVILLE, MI

$3,300

Oct 22, 2024

STRATEGIC LINK CONSULTING, LP

OrganizationKENNESAW, GA

$3,300

May 28, 2024

MUCKLESHOOT INDIAN TRIBE

OrganizationAUBURN, WA

$3,300

Aug 11, 2023

OTOE MISSOURIA TRIBE OF OKLAHOMA

OrganizationRED ROCK, OK

$2,900

May 29, 2024

HABEMATOLEL POMO OF UPPER LAKE TRIBE OF CALIFORNIA

OrganizationUPPER LAKE, CA

$2,900

May 29, 2024

TURTLE MOUNTAIN BAND OF CHIPPEWA TRIBE OF NORTH DAKOTA

OrganizationBELCOURT, ND

$2,900

May 28, 2024

CHEROKEE NATION

OrganizationTAHLEQUAH, OK

$2,500

Jan 9, 2024

HABEMATOLEL POMO OF UPPER LAKE TRIBE OF CALIFORNIA

OrganizationUPPER LAKE, CA

$2,500

Jun 30, 2024

OTOE MISSOURIA TRIBE OF OKLAHOMA

OrganizationRED ROCK, OK

$2,500

Jun 30, 2024

TURTLE MOUNTAIN BAND OF CHIPPEWA TRIBE OF NORTH DAKOTA

OrganizationBELCOURT, ND

$2,500

Jun 30, 2024

Sen. Warner, Mark R. [D-VA]

ID: W000805

Top Contributors

AMERICAN HEALTHCARE, LLC

OrganizationROANOKE, VA

$5,300

Sep 25, 2024

CHOCTAW NATION OF OKLAHOMA

OrganizationDURANT, OK

$600

Sep 28, 2023

CHOCTAW NATION OF OKLAHOMA

OrganizationDURANT, OK

$400

Sep 28, 2023

DEKKER, DAVID T.

PILLSBURY • VICE CHAIR

IndividualBETHESDA, MD

$9,900

Dec 31, 2024

TULL, THOMAS

TULCO • CEO

IndividualLOS ANGELES, CA

$6,000

Nov 21, 2024

SWARTZ, SUSAN

SELF EMPLOYED • ARTIST

IndividualPARK CITY, UT

$3,300

Jul 31, 2023

MATNEY, JOHN

RAPOCA ENERGY COMPANY • PARTNER

IndividualBRISTOL, VA

$3,300

Aug 29, 2023

MILLONES, PETER

BOOKING HOLDINGS INC. • ATTORNEY

IndividualDARIEN, CT

$3,300

Sep 29, 2023

MATNEY, JUSTIN K

SELF EMPLOYED • BUSINESS OWNER

IndividualBRISTOL, VA

$3,300

Aug 29, 2023

MATNEY, JOHN

RAPOCA ENERGY COMPANY • PARTNER

IndividualBRISTOL, VA

$3,300

Aug 29, 2023

Sen. Ernst, Joni [R-IA]

ID: E000295

Top Contributors

SAC & FOX TRIBE OF MISSISSIPPI IN IOWA

OrganizationTAMA, IA

$5,000

Aug 29, 2023

SAC & FOX TRIBE OF MISSISSIPPI IN IOWA

OrganizationTAMA, IA

$1,700

Sep 28, 2023

SHAKOPEE MDEWAKANTON SIOUX COMMUNITY

OrganizationPRIOR LAKE, MN

$1,000

May 21, 2024

ABEL, ANDREA MS.

HOMEMAKER • HOMEMAKER

IndividualDES MOINES, IA

$50,000

Feb 7, 2023

MCINERNEY, THOMAS E. MR.

BLUFF POINT ASSOC. CORPORATION • VENTURE INVESTOR

IndividualWESTPORT, CT

$50,000

Feb 22, 2023

NICOLLS, BOB MR.

MONARCH • REAL ESTATE

IndividualFRANKTOWN, CO

$25,000

Mar 17, 2023

GRAY, C. BOYDEN

SELF-EMPLOYED • ATTORNEY

IndividualWASHINGTON, DC

$25,000

Mar 29, 2023

CATSIMATIDIS, JOHN A. MR.

UNITED REFINING COMPANY • CHARIMAN & CEO

IndividualNEW YORK, NY

$25,000

May 16, 2023

KOTICK, ROBERT MR.

ACTIVISION BLIZZARD • CEO

IndividualSANTA MONICA, CA

$16,600

Dec 20, 2024

VINCZE, CHRISTOPHER

TRC COMPANIES INC. • CHAIRMAN AND CEO

IndividualTEQUESTA, FL

$15,800

Nov 6, 2023

Sen. Hassan, Margaret Wood [D-NH]

ID: H001076

Top Contributors

WOODS, ANDREW L.

LIBERTY PARTNERS GROUP • ATTORNEY

IndividualFORT MYERS, FL

$4,300

Jun 29, 2023

WOODS, ANDREW L.

IndividualFORT MYERS, FL

$3,900

Jul 12, 2023

BEKENSTEIN, ANITA

NOT EMPLOYED • NOT EMPLOYED

IndividualWAYLAND, MA

$3,300

Oct 4, 2023

BEKENSTEIN, JOSH

NOT EMPLOYED • RETIRED

IndividualWAYLAND, MA

$3,300

Oct 4, 2023

HUNTER, DANIEL

SELF-EMPLOYED • PLAYWRIGHT & TEACHER

IndividualCAMBRIDGE, MA

$3,300

Dec 6, 2023

KLARMAN, SETH

THE BAUPOST GROUP • CEO

IndividualBOSTON, MA

$3,300

Dec 18, 2023

SCHWARTZ, GABRIEL

DAVIDSON KEMPNER • INVESTMENT MANAGER

IndividualBROOKLYN, NY

$3,300

Oct 16, 2023

SWINDELL, C. DAVID

NOT EMPLOYED • NOT EMPLOYED

IndividualBOSTON, MA

$3,300

Oct 10, 2023

KORN, WILLIAM T.

NSRA • RADIOLOGIST

IndividualWABAN, MA

$3,300

Mar 29, 2023

KORN, WILLIAM T.

NSRA • RADIOLOGIST

IndividualWABAN, MA

$3,300

Mar 29, 2023

Sen. Moody, Ashley [R-FL]

ID: M001244

Top Contributors

No contribution data available

Donor Network - Sen. Kennedy, John [R-LA]

Show Also Donated To

PACs

Organizations

Individuals

Politicians

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

Showing 35 nodes and 46 connections

Total contributions: $46

Top Donors - Sen. Kennedy, John [R-LA]

Showing top 12 donors by contribution amount

12 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 2 helped.

+Health Insuranceconfidence 0.80
Section 2(a) improves coordination between Federal and State agencies and the Do Not Pay working system, which may help prevent improper payments and reduce costs for health insurance providers.
+Insurance (P&C and Life)confidence 0.60
Section 2(a) may help prevent improper payments, which could benefit insurance companies by reducing fraudulent claims.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Sen. Kennedy, John [R-LA])received from donors associated with that industry during the 2022–present cycles. Donations are not proof of intent — they are a record of who funds the people writing the law.

Industries this bill HELPS

Insurance (P&C and Life)$2,025
from 4 contributions
- SKIBINSKI, JOSEPH T.$1,000
- QUIGLEY, BILL$920
- MCKEY, PHILLIP$55
- THERRIEN, YOSHIKO X$50

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: 59%

Pages: 497-499AI Enhanced

AI Analysis:

"The bill’s focus on reducing improper payments through better death data coordination aligns with Project 2025’s emphasis on curbing waste, fraud, and abuse in Medicaid and Medicare, though it does not directly address the specific Medicare Advantage or Medicaid financing reforms outlined."

Key themes:improper paymentsprogram integritydeath data accuracyMedicaid/Medicare savingsfraud prevention

— 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 — 466 — Mandate for Leadership: The Conservative Promise the catastrophic tier, and requiring manufacturers to bear a larger share. Until the IRA is repealed, an Administration that is required to implement it must do so in a way that is prudent with its authority, minimizing the harmful effects of the law’s policies and avoiding even worse unintended consequences.30 Medicaid. Over the past 45 years, Medicaid and the health safety net have evolved into a cumbersome, complicated, and unaffordable burden on nearly every state. The program is failing some of the most vulnerable patients; is a prime target for waste, fraud, and abuse; and is consuming more of state and federal budgets. The dramatic increase in Medicaid expenditures is due in large part to the ACA (Obamacare), which mandates that states must expand their Medicaid eligibility standards to include all individuals at or below 138 percent of the federal poverty level (FPL), and the public health emergency, which has prohibited states from performing basic eligibility reviews. The overlap of available benefits among the various health agencies has led to a complex, confusing system that is nearly impossible to navigate—even for recipients. Recipients are often faced with a “welfare cliff” of benefit losses as they earn above a certain amount, which is contrary to the fundamental purpose of empowering individuals to achieve economic independence. Benefits increasingly involve nonmedical services such as air conditioning and housing, many of which are already handled by departments other than HHS. Improper payments within Medicaid are higher than those of any other federal program. These payments are evidence of the inappropriateness of Medicaid’s expansion, which, stemming largely from public health emergency maintenance of effort (MOE) requirements and the Affordable Care Act, has crowded out the primary targets of these programs: those who are most in need. True health care reform cannot be accomplished in a bureaucratic silo or only through Medicaid and health safety net programs. Reform of the tax code is also essential to genuine, effective reform of our health care system. All components of the health care system should be part of the reform efforts, and it is imperative that the system be modified to assist states with their current programs. Therefore, the next Administration should: l Reform financing. Allow states to have a more flexible, accountable, predictable, transparent, and efficient financing mechanism to deliver medical services. This system should include a more balanced or blended match rate, block grants, aggregate caps, or per capita caps. Any financial system should be designed to encourage and incentivize innovation and the efficient delivery of health care services. Federal and state financial participation in the Medicaid program should be rational, predictable, and reasonable. It should also incentivize states to save money and improve the quality of health care.

Department of Health and Human Services

Weak

Vector: 60%

Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on preventing improper payments to deceased individuals through improved death data coordination, while the Project 2025 HHS section emphasizes civil rights, reproductive health, and nondiscrimination policies. There is minimal thematic overlap, as the bill addresses program integrity in payments, whereas the cited HHS policies concern healthcare access, provider conscience rights, and anti-discrimination rules."

Key themes:federal program integritydata sharingagency coordination

— 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

Minimal

Vector: 62%

Pages: 506-508AI Enhanced

AI Analysis:

"The bill focuses on preventing improper payments to deceased individuals through improved death data coordination, which is unrelated to Project 2025's HHS policy objectives concerning abortion regulations, Hyde Amendment compliance, EMTALA interpretations, transgender coverage determinations, or born-alive infant protections."

— 473 — Department of Health and Human Services l Rewrite the ACA abortion separate payment regulation. Section 1303 of Obamacare requires that insurers collect a separate payment for certain abortion coverage in qualified health plans that are approved to be sold on exchanges and that they keep those separate payments in separate accounts that are used only to pay for elective abortion services. Neither the letter nor the spirit of the law was enforced under President Obama, and a Trump- era regulation sought to correct this problem. The Biden HHS rescinded this regulation to allow insurance companies once again—contrary to the law—to collect combined payments for what are clearly required to be separate payments for elective abortion coverage. “Separate” does not mean “together.” HHS should reinstate a Trump Administration regulation and enforce what the plain text of Section 1303 requires. That regulation should be further improved by requiring CMS to ensure that consumers pay truly separate charges for abortion coverage. l Audit Hyde Amendment compliance. HHS should undertake a full audit to determine compliance or noncompliance with the Hyde amendment and similar funding restrictions in HHS programs. This audit should include a full review of the Biden Administration’s post-Dobbs executive actions to promote abortion. It should also encompass a review of Medicaid managed care plans in pro-abortion states. l Reverse distorted pro-abortion “interpretations” added to the Emergency Medical Treatment and Active Labor Act. The Emergency Medical Treatment and Active Labor Act (EMTALA)52 prohibits hospitals that receive Medicare funds from “dumping” emergency patients who cannot pay by sending them to other hospitals. It also mandates that hospitals stabilize pregnant women and explicitly protects unborn children. Hospitals or physicians found to be in violation of the statute could lose all of their federal health funding—Medicare, Medicaid, CHIP, and other funds—and face civil penalties of up to nearly $120,000. In July 2022, HHS/CMS released guidance mandating that EMTALA- covered hospitals and the physicians who work there must perform abortions, to include completing chemical abortions even when the child might still be alive. The guidance also declared that EMTALA would protect physicians and hospitals that perform abortions in violation of state law if they deem those abortions necessary to stabilize the women’s health. This novel interpretation of EMTALA is baseless. EMTALA requires — 474 — Mandate for Leadership: The Conservative Promise no abortions, preempts no pro-life state laws, and explicitly requires stabilization of the unborn child. HHS should rescind the guidance and end CMS and state agency investigations into cases of alleged refusals to perform abortions. DOJ should agree to eliminate existing injunctions against pro-life states, withdraw its enforcement lawsuits, and in lawsuits against CMS on the guidance agree to injunctions against CMS and withdraw appeals of injunctions. l Reissue a stronger transgender national coverage determination. CMS should repromulgate its 2016 decision that CMS could not issue a National Coverage Determination (NCD) regarding “gender reassignment surgery” for Medicare beneficiaries. In doing so, CMS should acknowledge the growing body of evidence that such interventions are dangerous and acknowledge that there is insufficient scientific evidence to support such coverage in state plans. l Enforce EMTALA. The undeniable reality of abortion is that it does do not always result in a dead baby, and these born-alive babies are left to die. HHS should use EMTALA and Section 504 of the Rehabilitation Act,53 which prohibits disability discrimination, to investigate instances of infants born alive and left untreated in covered hospitals. CMS, OCR, and OIG should be required to follow through on these investigations with specific enforcement actions. HHS should revive a Trump Administration proposed regulation, “Special Responsibilities of Medicare Hospitals in Emergency Cases and Discrimination on the Basis of Disability in Critical Health and Human Service Programs or Activities,”54 to achieve this end. In addition, Congress should pass the Born-Alive Abortion Survivors Protection Act55 to require that proper medical care be given to infants who survive an abortion and to establish criminal consequences for practitioners who fail to provide such care. l Permanently codify both the Hyde family of amendments and the protections provided by the Weldon Amendment. Congress can accomplish this through legislation such as the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act56 (Hyde) and the Conscience Protection Act57 (Weldon).

Department of Health and Human Services

Minimal

Vector: 59%

Pages: 506-508AI Enhanced

AI Analysis:

"The bill focuses on preventing improper payments to deceased individuals through improved death data coordination, while the Project 2025 HHS policy addresses abortion payment regulations, Hyde Amendment compliance, and EMTALA interpretations—there is no substantive overlap in subject matter or objectives."

Key themes:federal oversightprogram integrity

Department of Labor and Related Agencies

Minimal

Vector: 59%

Pages: 642-644AI Enhanced

AI Analysis:

"The bill focuses on preventing improper payments to deceased individuals via SSA and Do Not Pay coordination, which is unrelated to the Project 2025 Department of Labor policies concerning pension reforms, PBGC oversight, and TSP investment restrictions in China."

Key themes:taxpayer savingsprogram integrity

— 609 — Department of Labor and Related Agencies l DOL should exercise its oversight of the FRTIB to prohibit investments in China. l Congress should enact legislation prohibiting investment of the TSP in China. PENSION REFORMS. Public Pension Plan Disclosure. Residents of states that responsibly manage their public pension plans (pension plans for State and local government employ- ees) should not be responsible for bailing out states that do not do so. Money is ultimately fungible, so federal aid to States can effectively be used to free up other State funds for pension contributions. Although the federal government does not impose funding rules on public pension plans, these plans should be required to disclose the fair market value of plan assets and liabilities (using the Treasury yield curve as the discount rate) on an annual basis. In the aggregate, these plans were underfunded on a market basis by $6.501 trillion as of Fiscal Year (FY) 2021, even though the plans reported underfunding of only $1.076 trillion using overly optimistic assumptions. l Disclose the fair market value of plan assets and liabilities. Congress should require public pension funds to disclose the fair market value of plan assets and liabilities (using the Treasury yield curve as the discount rate) on an annual basis. Multiemployer Plans. At the request of multiemployer union pension plans, the government has given such plans much more lenient rules and discretion over funding than it has given to single-employer plans. Multiemployer plans have been severely mismanaged, and the plans have abused the discretion and deference given them by federal law and enforcement agencies to make promises that they cannot keep. As a result, these plans are generally severely underfunded, with $757 billion in aggregate underfunding, and a funding level of just 42 percent. The Biden Admin- istration has provided a massive taxpayer bailout to some of these plans, but without any needed reforms. Even worse, it gave out funds in excess of what the law allows. l Congress should reform multiemployer pensions to give participants in these plans the same protections as those in single-employer plans. Liabilities should be measured similarly to single-employer plans. Workers should be able to earn benefits at any employer in the plan, but liabilities should be divided amongst employers, instead of the current illusory joint and several liability under which no one is ultimately responsible for making up underfunding. Troubled plans should be prohibited from — 610 — Mandate for Leadership: The Conservative Promise making new pension promises. More timely and detailed reporting should be imposed. Pension Benefit Guaranty Corporation. The Pension Benefit Guaranty Cor- poration (PBGC) insures benefits for private sector pension plans, with separate single-employer and multiemployer insurance programs. l The PBGC’s annual report must be submitted on time, and with timely data that uses fair-market value principles to calculate the PBGC’s finances. The PBGC has been submitting portions of statutorily required annual reports many months late and using out-of-date data. And PBGC's data on plans is almost five years old. These problematic practices make it difficult for Congress to become aware of serious problems in the insurance programs, which received a bailout of over $85 billion in the 2021 American Rescue Plan Act. The PBGC should use existing statutory authority to protect workers, retirees, employers, and taxpayers by closely monitoring and taking appropriate remedial action with regard to badly run and underfunded multiemployer union pension plans, including termination where appropriate. The PBGC's refusal to use such authority helped cause its multiemployer program deficit to go from less than $500 million in 2008 to over $65 billion in 2017. l Congress should increase the variable rate premium on underfunding and eliminate the per-participant cap in order to appropriately take into account risk and limit the degree to which well-funded pension plans must subsidize underfunded plans. Reforms should proportionately reduce the fixed per-participant premium to ease the burden on well-funded plans and also increase premiums on multiemployer plans to match single-employer plans. Improving Access to Employee Stock Ownership Plans. Employee Stock Ownership Plans (ESOPs) are ERISA-covered employee retirement savings plans that allow employees to receive compensation in the form of equity in their employer business. These arrangements enable employees to formally partici- pate as investors in how their employers’ businesses are run. And they also align employer–employee incentives by giving employees a greater financial stake in the success of their employers. With over half of small businesses owned by business owners over the age of 55, ESOPs also create advantageous succession oppor- tunities that support the continuity of local businesses and regional economic

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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