The bill
To advance policy priorities that will break the gridlock.
HR. 1834, 119th Congress — read as touching Health Insurance.
Sponsored by
Rep. McGovern, James P. [D-MA-2]
ID: M000312
Follow the money
The bill
HR. 1834, 119th Congress — read as touching Health Insurance.
The sponsor
Every bill has someone who introduced it. That name is where the paper trail starts.
The money
25 itemised contributions to this sponsor, pulled from FEC filings.
The alignment
This bill's text tracks the "Department of Health and Human Services" section, p. 530-532 of the Mandate for Leadership.
Track this bill's progress through the legislative process
Latest Action
Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 319.
February 9, 2026
📍 Current Status
Next: Both chambers must agree on the same version of the bill.
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!
Another masterpiece of legislative theater, courtesy of our esteemed representatives in Congress. The "Breaking the Gridlock Act" - how quaint. How utterly, mind-numbingly predictable.
**Main Purpose & Objectives:** Ah, yes, let's get to the heart of this exercise in futility. The bill's primary objective is to extend enhanced premium tax credits for health insurance premiums under the Affordable Care Act (ACA). Wow, what a bold move - kicking the can down the road by extending an existing program instead of actually addressing the underlying issues with our healthcare system.
**Key Provisions & Changes to Existing Law:** Section 1 amends the Internal Revenue Code to extend the enhanced premium tax credits through 2028. Because, you know, three more years will magically fix everything. The changes are as follows:
* Clause (iii) of section 36B(b)(3)(A) is amended to strike "through 2025" and insert "through 2028". Oh, the thrill! * Subparagraph (E) of section 36B(c)(1) is also amended to extend the credit to taxpayers whose household income exceeds 400 percent of the poverty line. Because we all know that's the real problem - not enough subsidies for people who can already afford health insurance.
**Affected Parties & Stakeholders:** Ah, the usual suspects:
* Health insurance companies: They'll love this extension, as it ensures a steady stream of government-subsidized customers. * Lobbyists: They're probably popping champagne corks right now, celebrating another successful campaign to maintain the status quo. * Taxpayers: You know, the ones who actually foot the bill for these subsidies. But hey, who needs fiscal responsibility when you can have more free stuff?
**Potential Impact & Implications:** Let's get real here - this bill is a Band-Aid on a bullet wound. It does nothing to address the underlying drivers of healthcare costs or improve the overall efficiency of our system. Instead, it perpetuates the same tired cycle of subsidies and special interests.
The only "gridlock" being broken here is the one that prevents politicians from actually doing something meaningful. This bill is a masterclass in legislative cowardice - a refusal to tackle tough issues and instead opting for more of the same failed policies.
In short, HR 1834 is a symptom of a deeper disease: a Congress addicted to quick fixes and special interest handouts, rather than actual problem-solving. But hey, at least they're consistent.
Rep. McGovern, James P. [D-MA-2]
Congress 119 • 2024 Election Cycle
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Total contributions: $51
Showing top 19 donors by contribution amount
Which industries are materially affected by specific provisions in this bill. 2 helped.
Section 1 extends enhanced premium tax credits through 2028, increasing affordability of health insurance purchased through exchanges, directly benefiting private health insurers by expanding market and subsidies.
By extending premium tax credits, more individuals can afford health insurance, likely increasing demand for hospital services and reducing uncompensated care, benefiting hospitals and health systems.
This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.
AI Analysis:
"HR 1834 aligns with Project 2025's HHS objective of protecting and strengthening equitable access to high-quality, affordable healthcare by extending premium tax credits that reduce financial barriers for low- and moderate-income individuals, including those in underserved communities. The bill supports continued enrollment in ACA marketplace plans, which promotes access to care for populations facing systemic inequities."
— 498 — Mandate for Leadership: The Conservative Promise ENDNOTES 1. U.S. Department of Health and Human Services, Strategic Plan, FY 2018–2022, p. 50, https://aspe.hhs.gov/ sites/default/files/documents/feac346aca967bfadc446398679e14ec/hhs-strategic-plan-fy-2018-2022.pdf (accessed February 7, 2023). 2. “Strategic Goal 1: Protect and Strengthen Equitable Access to High Quality and Affordable Healthcare” in ibid. “In the context of HHS, this Strategic Plan adopts the definition of underserved communities listed in Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities through the Federal Government to refer to ‘populations sharing a particular characteristic, as well as geographic communities, who have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life’; this definition includes individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality. Individuals may belong to more than one underserved community and face intersecting barriers. This definition applies to the terms underserved communities and underserved populations throughout this Strategic Plan.” Ibid. Emphasis in original. 3. Karen Weintraub, “Americans’ Life Expectancy Continues to Fall, Erasing Health Gains of the Last Quarter Century,” USA Today, December 22, 2022, https://www.usatoday.com/story/news/health/2022/12/22/us-life- expectancy-continues-fall-erasing-25-years-health-gains/10937418002/ (accessed February 6, 2023). 4. Apoorva Mandavilli, “The C.D.C. Isn’t Publishing Large Portions of the Data It Collects,” The New York Times, updated February 22, 2022, https://www.congress.gov/117/meeting/house/114450/documents/HHRG-117- IF02-20220302-SD004.pdf (accessed March 22, 2023). 5. Zachary B. Sluzala and Edmund F. Haislmaier, “Lessons from COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing,” Heritage Foundation Backgrounder No. 3696, March 28, 2022, https://www. heritage.org/public-health/report/lessons-covid-19-how-policymakers-should-reform-the-regulation-clinical. 6. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, “Centers for Disease Control and Prevention (C),” https://www.cdc.gov/maso/pdf/cdcmiss.pdf (March 16, 2023). 7. Judith Garber, “CDC ‘Disclaimers’ Hide Financial Conflicts of Interest,” Lown Institute Accountability Blog, November 6, 2019, https://lowninstitute.org/cdc-disclaimers-hide-financial-conflicts-of-interest/ (accessed February 6, 2023). See also U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, “CDC Foundation Active Programs (October 1, 2014–September 30, 2015),” https://www. cdcfoundation.org/sites/default/files/upload/pdf/CDCFoundation-ActivePrograms-FY2015.pdf (accessed February 7, 2023); “CDC Active Programs (October 1, 2015–September 30, 2016),” https://www.cdcfoundation. org/sites/default/files/upload/pdf/CDCFoundation-ActivePrograms-FY2016.pdf (accessed February 7, 2023); “CDC Foundation Active Programs (October 1, 2016–September 30, 2017),” https://www.cdcfoundation.org/ sites/default/files/upload/pdf/CDCFoundation-ActivePrograms-FY2017.pdf (accessed February 7, 2023); “CDC Foundation Active Programs (October 1, 2017–September 30, 2018),” https://www.cdcfoundation.org/sites/default/ files/upload/pdf/CDCFoundation-ActivePrograms-FY2018.pdf (accessed February 7, 2023); “CDC Foundation Active Programs, October 1, 2018–September 30, 2019,” https://www.cdcfoundation.org/sites/default/files/upload/ pdf/CDCFoundation-ActivePrograms-FY2019.pdf (accessed February 7, 2023); “CDC Foundation Active Programs, October 1, 2029–September 30, 2020,” https://www.cdcfoundation.org/CDCF-ActivePrograms-CDC-FY20?inline (accessed February 7, 2023); and “CDC Foundation Active Programs, October 1, 2020–September 30, 2021,” https://www.cdcfoundation.org/CDCF-ActivePrograms-CDC-FY21?inline (accessed February 7, 2023). 8. Joel White and Doug Badger, “In Order to Defeat COVID-19, the Federal Government Must Modernize Its Public Health Data,” Heritage Foundation Backgrounder No. 3527, September 3, 2020, https://www.heritage. org/sites/default/files/2020-09/BG3527_0.pdf. 9. S. 15, Ensuring Accurate and Complete Abortion Data Reporting Act of 2023, 118th Congress, introduced January 23, 2023, https://www.congress.gov/118/bills/s15/BILLS-118s15is.pdf (accessed March 22, 2023), and H.R. 632, Ensuring Accurate and Complete Abortion Data Reporting Act of 2023, 118th Congress, introduced January 30, 2023, https://www.congress.gov/118/bills/hr632/BILLS-118hr632ih.pdf (accessed March 22, 2023). 10. Doug Badger, “How Congress Can Make Real Progress on Drug Prices,” Heritage Foundation Issue Brief No. 5016, December 9, 2019, https://www.heritage.org/sites/default/files/2019-12/IB5016_1.pdf. — 499 — Department of Health and Human Services 11. Sluzala and Haislmaier, “Lessons From COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing.” 12. Ibid. 13. H.R. 5471, Clinical Laboratory Improvement Amendments of 1988, Public Law No. 100-578, 100th Congress, October 31, 1988, https://uscode.house.gov/statutes/pl/100/578.pdf (accessed March 17, 2023). 14. Sluzala and Haislmaier, “Lessons From COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing.” 15. Edmund F. Haislmaier, “Ensuring Americans’ Access to Pharmaceuticals: A Primer and Road Map for Policymakers,” Heritage Foundation Backgrounder No. 3545, October 20, 2020, https://www.heritage.org/ sites/default/files/2020-10/BG3545.pdf. 16. 18 U.S.C. 1461, https://www.law.cornell.edu/uscode/text/18/1461 (accessed March 16, 2023), and 18 U.S.C. 1462, https://www.law.cornell.edu/uscode/text/18/1462 (accessed March 16, 2023). 17. H.R. 1308, Religious Freedom Restoration Act of 1993, Public Law No. 103-141, 103rd Congress, November 16, 1993, https://www.congress.gov/103/statute/STATUTE-107/STATUTE-107-Pg1488.pdf (accessed March 18, 2023). 18. Charles Piller, “Is FDA’s Revolving Door Open Too Wide?” Science, Vol. 361, No. 6397 (July 6, 2018), p. 21, https://www.science.org/doi/epdf/10.1126/science.361.6397.21 (accessed February 6, 2023). 19. Joel Achenbach, “NIH Halts $100 Million Study of Moderate Drinking That Is Funded by Alcohol Industry,” The Washington Post, May 17, 2018, https://www.washingtonpost.com/news/to-your-health/wp/2018/05/17/nih- halts-controversial-study-of-moderate-drinking/ (accessed February 6, 2023). 20. Alexander Tin, “Moderna Offers NIH Co-ownership of COVID Vaccine Patent amid Dispute with Government,” CBS News, November 15, 2021, https://www.cbsnews.com/news/moderna-covid-vaccine-patent-dispute- national-institutes-health/ (accessed February 6, 2023). 21. Informed Consent Action Network, “NIH Officials Profiting from COVID-19 Vaccine,” June 3, 2021, https://www. icandecide.org/nih-officials-profiting-from-covid-19-vaccine/ (accessed February 6, 2023). 22. Adam Andrzejewski, “Substack Investigation: Fauci’s Royalties and the $350 Million Royalty Payment Stream HIDDEN by NIH,” Open the Books Substack, May 9, 2022, https://openthebooks.substack. com/p/faucis-royalties-and-the-350-million?utm_source=/profile/24758236-adam-andrzejewski&utm_ medium=reader2&s=w (accessed February 6, 2023). 23. Robert E. Moffit, “Time to Reverse Hospital Market Consolidation,” Heritage Foundation Commentary, January 5, 2022, https://www.heritage.org/health-care-reform/commentary/time-reverse-hospital-market-consolidation. 24. H.R. 3590, Patient Protection and Affordable Care Act, Public Law No. 111-148, 111th Congress, March 23, 2021, https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdf (accessed March 16, 2023). 25. Brian J. Miller, Robert E. Moffit, James Ficke, Joseph Marine, and Jesse Ehrenfeld, “Reversing Hospital Consolidation: The Promise of Physician-Owned Hospitals,” Health Affairs Forefront, April 12, 2021, https:// www.healthaffairs.org/do/10.1377/forefront.20210408.980640/ (accessed February 13, 2023). 26. Robert E. Moffit, “Medicare’s Future: Challenges and Opportunities,” testimony before the Special Committee on Aging, U.S. Senate, November 21, 2022, https://www.heritage.org/testimony/medicares-future-challenges- and-opportunities. 27. 42 U.S. Code § 256b, https://www.law.cornell.edu/uscode/text/42/256b (accessed March 16, 2023). 28. H.R. 3590, Patient Protection and Affordable Care Act, § 3022. 29. H.R. 5376, Inflation Reduction Act of 2022, Public Law No. 117-169, 117th Congress, August 16, 2022, https:// www.congress.gov/117/plaws/publ169/PLAW-117publ169.pdf (accessed March 16, 2023). 30. Robert E. Moffit, “Reducing Patient Access to New Medications Is the Left’s Latest Medicare Price-Fixing Scheme,” Heritage Foundation Commentary, July 22, 2022, https://www.heritage.org/medicare/commentary/ reducing-patient-access-new-medications-the-lefts-latest-medicare-price-fixing, and Badger, “How Congress Can Make Real Progress on Drug Prices.” 31. Nina Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net,” Heritage Foundation Backgrounder No. 3604, April 14, 2021, https:// www.heritage.org/sites/default/files/2021-04/BG3604_0.pdf, and Brian C. Blase, “Punishing Conservative States: Payment Cuts to Hospitals Where Federal Spending Is Already Low,” Paragon Health Institute, December 2021, https://paragoninstitute.org/wp-content/uploads/2022/06/Punishing-Conservative-States- HTML.html (accessed February 13, 2023).
AI Analysis:
"HR 1834 extends ACA marketplace premium tax credits, whereas Project 2025's HHS section focuses on reforming Medicare Advantage, Medicare fee-for-service, Medicaid financing, and repealing Inflation Reduction Act drug price controls. Both address healthcare affordability, but they target different programs and have divergent policy directions."
— 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.
AI Analysis:
"HR 1834 focuses on extending ACA marketplace premium tax credits to improve affordability for individuals purchasing private insurance, while the Project 2025 HHS section centers on Medicare Advantage reforms, site‑neutral payments, and conscience protections. Both address healthcare access and cost, but they target different programs and populations, resulting only a tangential connection."
— 464 — Mandate for Leadership: The Conservative Promise l The Risk Adjustment Data Validation (RADV) rule; l The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration; and l The Global and Professional Direct Contracting (GPDC, rebranded as the Accountable Care Organization Realizing Equity, Access, and Community Health or ACO REACH) model. Additionally, regulations should advance site neutrality by eliminating the inpa- tient-only list and expanding the ambulatory surgical center covered procedures list. Medicare generally pays more for inpatient hospital procedures and less for the same procedures performed in an outpatient setting. Whether a medical ser- vice is delivered in a physician’s office, a clinic, or a hospital setting, the Medicare payment for that service should be the same. CMS should expand the application of site-neutral payment options to more settings. Such a policy would level the playing field among providers and remove the financial disabilities for medical professionals who would compete with hospital systems.23 Finally, HHS needs to restore and enhance conscience protection regulations that allow medical practitioners to participate in federal health care programs without being compelled to provide sex changes or similar services. LEGISLATIVE PROPOSALS l Remove restrictions on physician-owned hospitals. The Affordable Care Act (ACA)24 imposed restrictions prohibiting Medicare from reimbursing physician-owned and specialty hospitals. The current restrictions do little more than serve the special interests of large hospital systems and undercut consumer choice of high-quality, specialty care. These restrictions should be removed so that physician-owned hospitals can compete with other hospitals in serving Medicare patients.25 l Encourage more direct competition between Medicare Advantage and private plans. Medicare Advantage (MA), a system of competing private health plans, is the major alternative to traditional Medicare for America’s large and growing cohort of seniors. The program provides beneficiaries with a wide range of competitive health plan choices—a richer set of benefits than traditional Medicare provides and at a reasonable cost. Equally as important, the MA program has been registering consistently high marks for superior performance in delivering high-quality care. Critical reforms are still needed to strengthen and improve the program for the future. Specifically: — 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in
Showing 3 of 5 policy matches
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.