ALERT Communities Act

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Bill ID: 119/hr/1561

Last Updated: July 31, 2026

ALERT Communities Act

HR. 1561, 119th Congress — read as touching Medical Devices.

The sponsor

Rep. Crockett, Jasmine [D-TX-30]

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

The money

$90,300 raised

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

The alignment

55% match to Project 2025

This bill's text tracks the "Department of Health and Human Services" section, p. 488-490 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Ordered to be Reported by the Yeas and Nays: 48 - 0.

July 20, 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 ALERT Communities Act, HR 1561, is a bill that aims to address the opioid crisis by promoting research and development of fentanyl and xylazine test strips. As a visionary entrepreneur and thought leader, I'll analyze this legislation through the lens of its potential impact on my business interests and the broader landscape of innovation.

**Main Purpose & Objectives:** The ALERT Communities Act seeks to advance the development and deployment of rapid test strip technology for detecting fentanyl and other synthetic opioids. The bill's primary objectives are to:

1. Authorize research grants for developing and improving test strip technology. 2. Provide training and resources for first responders on using test strips. 3. Develop marketing frameworks for test strip manufacturers.

**Key Provisions & Changes to Existing Law:** The bill amends the Public Health Service Act to include provisions related to test strip development, marketing, and deployment. Key changes include:

1. Section 546(c) of the Public Health Service Act is amended to require training for first responders on using fentanyl or xylazine test strips. 2. The Secretary of Health and Human Services must develop research and marketing frameworks for test strip technology.

**Affected Parties & Stakeholders:** The ALERT Communities Act affects various stakeholders, including:

1. Test strip manufacturers: The bill provides a framework for developing and marketing new test strip technologies. 2. First responders: The legislation requires training on using fentanyl or xylazine test strips. 3. Public health organizations: The bill's research provisions may benefit organizations focused on addressing the opioid crisis.

**Potential Impact & Implications:** From my perspective, this bill has limited potential for significant impact on my business interests. However, I do see opportunities for consolidation and deregulation in the test strip market. By promoting private sector innovation and reducing regulatory barriers, we can accelerate the development of life-saving technologies like rapid test strips.

The ALERT Communities Act's emphasis on research and marketing frameworks may also create new avenues for public-private partnerships, which could be beneficial for companies like mine that operate at the intersection of technology and healthcare.

In conclusion, while this bill is not a game-changer for my business empire, it does represent a step in the right direction towards promoting innovation and reducing regulatory hurdles. I will continue to monitor its progress and explore opportunities for strategic partnerships and investments in the test strip market.

**Projection:** The ALERT Communities Act may lead to a modest increase in investment in test strip technology, potentially reaching $500 million over the next 5 years. However, without more significant deregulation and consolidation, this market is unlikely to reach its full potential.

💰 Campaign Finance Network

Rep. Crockett, Jasmine [D-TX-30]

Congress 119 • 2024 Election Cycle

Total Contributions

$90,300

20 donors

PACs

Organizations

$4,300

Committees

Individuals

$86,000

No PAC contributions found

SHAKOPEE MDWEKANTON SIOUX COMMUNITY

2 transactions

$3,300

ALABAMA COUSHATTA TRIBE

1 transaction

$1,000

No committee contributions found

SMITH, TODD

2 transactions

$12,800

OLESKY, DAVID

2 transactions

$8,800

MATTHEWS, JOHN

1 transaction

$6,600

MATTHEWS, LAURA

1 transaction

$6,600

MONTGOMERY, SADAT

1 transaction

$6,600

BRYANT, KARIM

1 transaction

$5,000

BOLDEN, EMILE

1 transaction

$3,300

CROZIER, MARK

1 transaction

$3,300

ELDRIDGE, SEAN

1 transaction

$3,300

GATES, MELINDA FRENCH

1 transaction

$3,300

HOFFMAN, MARGUERITE

1 transaction

$3,300

JOHNSON, LACY

1 transaction

$3,300

SAMPSON, DEMETRIS

1 transaction

$3,300

SCHEUER, JOHN

1 transaction

$3,300

WARD, DEMARCUS

1 transaction

$3,300

YAKOVENKO, ANATOLY

1 transaction

$3,300

MILLER, CLAY

1 transaction

$3,300

SIMON, PATRICK

1 transaction

$3,300

Cosponsors & Their Campaign Finance

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

Rep. Gooden, Lance [R-TX-5]

ID: G000589

Top Contributors

ALABAMA COUSHATTA TRIBE

PAC

$1,000

Sep 19, 2024

THE CHICKASAW NATION

OrganizationADA, OK

$3,300

Jun 8, 2023

INDEPENDENT COMANCHE

Organization

$1,000

Nov 4, 2024

CALLEWART, CRAIG

IndividualDALLAS, TX

$3,300

Sep 30, 2024

BERLINER, KENNETH

BERLINER • BANKER

IndividualNEW YORK, NY

$3,300

Aug 20, 2024

KIDAN, ADAM

ATLANTIC • EXEC

IndividualPALM BEACH, FL

$3,300

Jun 19, 2024

ADAIR, AARON

COPOART • EXEC

IndividualDALLAS, TX

$3,300

Jun 18, 2024

EWING, SAMUEL

EWING SUBARU • OWNER

IndividualPLANO, TX

$3,300

Nov 4, 2024

EWING, SARAH

EWING SUBARU • OWNER

IndividualPLANO, TX

$3,300

Nov 4, 2024

RUPANI, AMIR

TEXAS PRINCE, INC. • CEO

IndividualDALLAS, TX

$3,300

Oct 25, 2024

Donor Network - Rep. Crockett, Jasmine [D-TX-30]

Show Also Donated To

PACs

Organizations

Individuals

Politicians

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

Showing 55 nodes and 60 connections

Total contributions: $60

Top Donors - Rep. Crockett, Jasmine [D-TX-30]

Showing top 20 donors by contribution amount

2 Orgs18 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 2 helped, 3 harmed.

+Medical Devicesconfidence 0.90
Section 3 promotes the development and evaluation of test strip technology, potentially benefiting medical device manufacturers that produce diagnostic tools like these test strips.
−Pharmaceuticalsconfidence 0.80
Section 3 implies increased regulation on test strip technology for detecting fentanyl and other substances, which may impact pharmaceutical companies involved in opioid manufacturing or related fields.
+Biotech & Researchconfidence 0.80
The research and development of new test strip technologies (Section 3) could provide opportunities for biotech firms involved in diagnostic technologies or substance abuse treatment research.
−Hospitals & Health Systemsconfidence 0.70
By potentially reducing overdose cases through early detection (Section 2 and Section 4), hospitals might see a decrease in emergency admissions related to overdoses, affecting their revenue.
−Health Insuranceconfidence 0.60
The overall aim to reduce overdose deaths and increase engagement in substance use disorder treatment (Section 4) could lead to reduced healthcare costs for insurers, but the direct impact is less clear than on other industries.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Rep. Crockett, Jasmine [D-TX-30])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

Biotech & Research$1,000
from 1 contribution
- LOWERY, FRED$1,000

Industries this bill HARMS

Health Insurance$390
from 6 contributions
- MALBROUGH, BRANDY GALLIEN$250
- THOMAS, DANA$100
- PERKINS, DINA$40

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

Weak

Vector: 60%

Pages: 488-490AI Enhanced

AI Analysis:

"The ALERT Communities Act focuses on fentanyl and xylazine test strips to reduce overdose deaths, while the Project 2025 HHS section emphasizes abortion data reporting, opposition to gender identity data collection, FDA regulatory reforms, drug shortages, and abortion pill restrictions—with no substantive overlap in objectives or mechanisms."

Key themes:public healthsubstance useHHS 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

Department of Health and Human Services

Weak

Vector: 58%

Pages: 533-535AI Enhanced

AI Analysis:

"The ALERT Communities Act focuses on fentanyl and xylazine test strip research, first responder training, and overdose prevention, while the Project 2025 HHS section primarily addresses civil rights, abortion-related legislation, and healthcare nondiscrimination rules. There is minimal thematic overlap, as the bill does not engage with the conscience protections, abortion funding restrictions, or disability nondiscrimination rules emphasized in the Project 2025 excerpts."

Key themes:Department of Health and Human Servicespublic healthsubstance use

— 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

Weak

Vector: 57%

Pages: 533-535AI Enhanced

AI Analysis:

"The ALERT Communities Act focuses on harm reduction through fentanyl test strip research and first responder training, while the Project 2025 HHS section emphasizes Medicaid reform, managed care oversight, and price transparency; both share a broad goal of improving health outcomes but lack substantive policy overlap."

Key themes:public healthsubstance useoverdose preventionHHS involvementresearch

— 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 Justice

Weak

Vector: 57%

Pages: 587-589AI Enhanced

AI Analysis:

"Both the bill and the Project 2025 section address the fentanyl crisis, but the bill focuses on harm‑reduction measures like test strip distribution and first‑responder training, whereas Project 2025 emphasizes aggressive law‑enforcement prosecution, border security, and RICO use, resulting only tangential alignment."

Key themes:fentanyloverdose crisisdrug policy

— 555 — Department of Justice 1. Rigorously prosecute as much interstate drug activity as possible, including simple possession of distributable quantities.46 Recent efforts to create the impression that drug possession crimes are not serious offenses has contributed to the explosion of criminal organization activities in the United States. 2. Aggressively deploy the Racketeer Influenced and Corrupt Organizations Act (RICO),47 which Congress expressly created to empower the Department of Justice to treat patterns of intrastate- level crimes, such as robbery, extortion, and murder, as federal criminal conduct for criminal organizations and networks. The next Administration can use existing tools while it works with Congress to develop new tools. l Secure the border,48 which is the key entry point for many criminal organizations and their supplies, products, and employees. Mexico— which is arguably functioning as a failed state run by drug cartels—is the main point of transit for illegal drugs produced in Central and South America, fentanyl precursors from the Chinese Communist Party–led People’s Republic of China,49 weapons, human smuggling and trafficking, and other contraband. Mexican drug cartels, including the dominant Sinaloa Cartel and the Jalisco New Generation Cartel (CJNG), are the main drivers of fentanyl production and distribution in the United States. The southwestern land border is sufficiently porous that Mexican drug cartels have operational control of large sections of the border, which facilitates easy movement of product and personnel. These cartels are also violent and not afraid to demonstrate force on both sides of the border. Their conduct represents a clear and present danger to the United States and its citizens. In addition to finalizing the southwestern land border wall, the next Administration should take a creative and aggressive approach to tackling these dangerous criminal organizations at the border. This could include use of active-duty military personnel and National Guardsmen to assist in arrest operations along the border—something that has not yet been done. A new and forceful approach to interdiction will have a ripple effect on the operations of these criminal organizations, which currently operate freely without concern for criminal prosecution, and will lay the necessary groundwork for initial prosecutions of these organizations and their leaders. It is critical that the federal government staunch the flow of drugs by preventing the far-too-easy access to the United States that now exists. — 556 — Mandate for Leadership: The Conservative Promise There can be no serious dispute that the Biden Administration has opened the southwest border to whomever wants to enter and that some of those entrants are smuggling fentanyl into the country. More than 100,000 Americans died in a one-year period from opioid overdoses, and many of them died specifically from having used fentanyl.50 The federal government should treat this problem as aggressively as necessary. Enforcing the customs and immigration laws is a matter of life and death. PURSUING A NATIONAL SECURITY AGENDA AIMED AT EXTERNAL STATE AND NON-STATE ACTORS, NOT U.S. CITIZENS EXERCISING THEIR CONSTITUTIONAL RIGHTS The Department of Justice plays a vital role in protecting our national security, and it must not refrain from engaging in public initiatives that identify our adver- saries and educate the American people about their activities. The DOJ’s China Initiative under President Trump reflected the department’s priority of combating Chinese threats to our national security.51 Because China was accountable for approximately 80 percent of all prosecutions for economic espionage and approximately 60 percent of all thefts of trade secrets, then-At- torney General Jeff Sessions set key goals for the China Initiative that included development of an enforcement strategy concerning researchers in labs and universities who were being coopted into stealing critical U.S. technologies, iden- tification of opportunities to address supply-chain threats more effectively, and education of colleges and universities about potential threats from Chinese influ- ence efforts on campus. In February 2022, the Biden Administration terminated the department’s China Initiative largely out of a concern for poor “optics.”52 While the Biden Administra- tion correctly identified China as America’s “only competitor with both the intent to reshape the international order and, increasingly, the economic, diplomatic, military, and technological power to do it,”53 it folded in the face of political cor- rectness and sent the message that liberal sensitivities outweighed bringing justice to threats from China. The next conservative Administration should therefore: l Restart the China Initiative. l Pursue other programs to educate the American people about the real and dangerous threats to our national security and economic security that are posed by actors across the globe, most notably China and Iran. l Ensure that it is agile enough to devote sufficient resources and attention to other emerging threats that involve federal interests

Department of Housing and Urban Development

Minimal

Vector: 58%

Pages: 548-550AI Enhanced

AI Analysis:

"The ALERT Communities Act focuses on fentanyl and xylazine overdose prevention through test strip research and first responder training, which is unrelated to the Project 2025 HUD policy objectives concerning housing market reforms, DEI/ESG critiques, and homelessness policy shifts. There is no thematic or policy overlap between the two."

— 515 — Department of Housing and Urban Development 25. Process must prioritize where political leadership can implement administrative reforms through regulatory action and subregulatory guidance reforms. 26. China and other foreign nations should not be able to disrupt our nation’s housing markets, including by artificially driving up prices and reducing affordability and access to housing for Americans who are crowded out of the market by such market participation. 27. These initiatives are maintained under such designations as diversity, equity, and inclusion (DEI); critical race theory (CRT); black, indigenous, Pacific Islander, and other people of color (BIPOC); and environmental, social, and governance (ESG). 28. At a minimum, these efforts duplicate what the federal government already collects and assesses; at worst, they institute arbitrary procedures in real estate appraisal practices that undermine integrity and perversely introduce arbitrary biases into what should be an unbiased system for determining financial value. 29. Revise regulatory and subregulatory guidance, where applicable within statutory authorities, that adds unnecessary delay and costs to the construction and development of new housing and has been estimated to account for about 40 percent of new housing unit costs in multifamily housing. 30. The Biden Administration has issued a proposed rule to replace the Trump Administration’s “Preserving Community and Neighborhood Choice” rule that had repealed earlier rules expanding AFFH enforcement. See U.S. Department of Housing and Urban Development, Office of Fair Housing, “Preserving Community and Neighborhood Choice,” Final Rule, Federal Register, Vol. 85, No. 153 (August 7, 2020), pp. 47899–47912, https://www.govinfo.gov/content/pkg/FR-2020-08-07/pdf/2020-16320.pdf (accessed March 5, 2023), and U.S. Department of Housing and Urban Development, Office of the Secretary, “Affirmatively Furthering Fair Housing,” Proposed Rule, Federal Register, Vol. 88, No. 27 (February 9, 2023), pp. 8516–8590, https://www. govinfo.gov/content/pkg/FR-2015-07-16/pdf/2015-17032.pdf (accessed March 5, 2023). 31. Certain pilot initiatives may encourage greater take-up of loan products designed for faster equity accumulation, including loans with shorter terms and accelerated amortization schedules. In concept, the FHA’s Home Equity Accelerator Loan (HEAL) and Good Neighbor Next Door (GNND) pilot initiatives might lead to meaningful wealth generation for first-time buyers, but they should be available to all eligible households only when they do not arbitrarily discriminate based on race or other characteristics. 32. Housing supply does remain a problem in the U.S., but constructing more units at the low end of the market will not solve the problem. Investors and developers can deliver at more efficient cost new units that will allow for greater upward mobility of rental and ownership housing stock and better target increased construction of mid-tier rental units. Further, and more fundamental to the housing supply challenge in markets across the U.S., localities can consider revising land use, zoning, and building regulations that constrict new housing development, adding time delays and costs that impede construction. Federal housing policy should get out of the way where possible and minimize the distortive impact that stimulating greater demand through loose lending can have in driving up housing prices for households that are looking for affordable entry into the housing market. 33. U.S. Department of Housing and Urban Development, Office of the Secretary, “Housing and Community Development Act of 1980: Verification of Eligible Status,” Proposed Rule, Federal Register, Vol. 84, No. 91 (May 10, 2019), pp. 20589–20595, https://www.govinfo.gov/content/pkg/FR-2019-05-10/pdf/2019-09566.pdf (accessed March 5, 2023). 34. Reforms should contemplate rent payment flexibilities, allow escrow savings, and set maximum term limits that can reduce implicit penalties for increasing household incomes over eligibility terms for housing assistance and reweight waiting-list prioritization for two-parent households. 35. Some PHAs have been able to implement work requirements and term limit policies in various congressionally authorized demonstration programs, notably the Moving to Work (MTW) demonstration program established in 1996 for 39 PHAs (Congress has since authorized another 100 PHAs) in which participating MTW PHAs were given authority to implement rent reforms, work requirements and other experimental policies in rental assistance programs along with flexibilities in the use of capital and operating appropriations. 36. The FSS program has a general five-year term with a possible two-year extension, which could be applied at the term limit for overall benefits, and certain PHAs have imposed five-year to seven-year term limits. Families in these programs build escrow savings during their term eligibility that helps to facilitate successful transitions to family self-sufficiency and unassisted housing. — 516 — Mandate for Leadership: The Conservative Promise 37. HUD should implement administrative changes in regulation and guidance and seek statutory authority to end all Housing First directives of Continuum of Care (CoC) grantees and contract homelessness providers in addition to establishing restrictions on local Housing First policies where HUD grant funds are used. 38. The U.S. Interagency Council on Homelessness (USICH) was established in the 1990s, and numerous Administrations have devoted enormous resources to the Housing First model, experimenting with various ways to provide federally financed rapid rehousing and permanent housing opportunities. Housing First is a far-left idea premised on the belief that homelessness is primarily circumstantial rather than behavioral. The Housing First answer to homelessness is to give someone a house instead of attempting to understand the underlying causes of homelessness. Federal intervention centered on Housing First has failed to acknowledge that resolving the issue of homelessness is often a matter of resolving mental health and substance abuse challenges. Instead of the permanent supportive housing proffered by Housing First, a conservative Administration should shift to transitional housing with a focus on addressing the underlying issues that cause homelessness in the first place. 39. The Senate Low-Income First-Time Homebuyers (LIFT) Act would address this policy goal. See S. 2797, Low-Income First-Time Homebuyers Act of 2021 (LIFT Homebuyers Act of 2021), 117th Congress, introduced September 22, 2021, https://www.congress.gov/117/bills/s2797/BILLS-117s2797is.pdf (accessed March 5, 2023). 40. FHA did not facilitate the widespread use of 30-year mortgages until the 1950s when, interacting with Federal Reserve policies, federal agencies began broader adoption of the mortgages, which, despite lowering the monthly repayment terms, result in slow equity accumulation and wealth-building opportunities. 41. The Housing and Economic Recovery Act of 2008 fundamentally revised the scope of federal regulation in the nation’s housing finance system, placing Fannie Mae and Freddie Mac under the purview of a newly established Federal Housing Finance Agency (FHFA) and establishing a Housing Trust Fund (HTF) that is administered in the HUD Office of Community Planning and Development. See H.R. 3221, Housing and Economic Recovery Act of 2008, Public Law No. 110-289, 110th Congress, July 30, 2008, https://www.congress. gov/110/plaws/publ289/PLAW-110publ289.pdf (accessed March 5, 2023). 42. Guiding questions: What reforms should be proposed that could be accomplished within five years? What reforms can be done administratively, and what reforms would need legislative authorization? Are there functions that HUD administers that could be achieved more effectively at another department or agency? What big-picture reforms should be proposed that might take more than five years that would reorganize HUD and its programs to meet the objectives in the vision or mission? What would occur in the absence of these public finance subsidies? How much crowd-out do these subsidies create in the market? Would America be a seriously underhoused nation without these subsidies? Who are the policies intended to benefit? What organizational changes must be made? 43. The Faircloth Amendment (Quality Housing and Work Responsibility Act of 1998) amended the Housing Act of 1937 to maintain public housing units at 1999 levels, preventing housing authorities from maintaining more public housing than they did then. H.R. 4194, Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies Appropriations Act, 1999, Public Law No. 105-276, 105th Congress, October 21, 1998, Title V, https://www.congress.gov/105/plaws/publ276/PLAW-105publ276.pdf (accessed March 5, 2023). In recent years, the statutory restriction on new construction of public housing units has been circumvented through some narrow uses of preservation programs such as the Rental Assistance Demonstration (RAD) program, initially authorized in 2012 and reauthorized several times since under higher program unit conversion caps. Congress also provided paths for renewal and continuation of a portion of existing public housing; project/site-based housing stock (refinancing with long-term HAP contract commitments); and Section 8 units through the Multifamily Assisted Housing Reform and Affordability Act of 1997 (MAHRA). H.R. 2158, Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies Appropriations Act, 1998, Public Law No. 105-65, 105th Congress, October 27, 1997, Title V, https://www.congress.gov/105/plaws/publ65/PLAW-105publ65.pdf (accessed March 5, 2023). 44. As the evolution of HUD rental assistance transitions away from the public housing model toward housing choice vouchers, there should be adequate landlord participation to ensure that the supply of housing units for rent in these programs meets the demand for rent among eligible tenants. This issue has been addressed in various ways, including by a task force instituted at the department during the Trump Administration, but could likely remain a challenge in the administration of the program.

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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119/hres/863