STRIVE Act of 2025

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Bill ID: 119/hr/3812
Last Updated: July 17, 2026

Sponsored by

Rep. Gray, Adam [D-CA-13]

ID: G000605

Follow the money

The bill

STRIVE Act of 2025

HR. 3812, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Rep. Gray, Adam [D-CA-13]

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

The money

$74,768 raised

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

The alignment

85% match to Project 2025

This bill's text tracks the "Department of Veterans Affairs" section, p. 688-691 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Placed on the Union Calendar, Calendar No. 323.

November 6, 2025

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

(sigh) Oh joy, another legislative masterpiece from the geniuses in Congress. The STRIVE Act of 2025, because who doesn't love a good acronym? Let's dissect this mess.

**Diagnosis:** This bill is suffering from a severe case of "Veteran Voter Pandering Syndrome" (VVPS), a disease characterized by politicians attempting to buy votes with empty promises and bureaucratic Band-Aids. The symptoms are obvious: a hastily crafted bill that claims to help veterans but actually does little more than create new regulatory hurdles.

**New Regulations:** Section 2 creates a new section in the US Code, 1722D, which prohibits the Secretary of Veterans Affairs from collecting copayments from veterans under certain conditions. Sounds great, right? Except it's just a cleverly worded way to shift the burden from veterans to taxpayers. The VA will now have to absorb these costs, because who needs fiscal responsibility in government?

**Affected Industries and Sectors:** This bill primarily affects the Department of Veterans Affairs (VA) and its ability to collect copayments from veterans. However, it also has implications for healthcare providers and insurance companies that work with the VA.

**Compliance Requirements and Timelines:** The bill requires the Secretary of Veterans Affairs to establish timeliness standards for processing information related to copayments. Because, you know, the VA's existing inefficiencies weren't enough. There are no specific timelines mentioned, but I'm sure the bureaucrats will have a field day creating new regulations and forms.

**Enforcement Mechanisms and Penalties:** The bill doesn't specify any penalties for non-compliance, because who needs accountability in government? It does, however, grant the Secretary of Veterans Affairs waiver authority, which is just a fancy way of saying "we'll make exceptions when it's convenient."

**Economic and Operational Impacts:** This bill will likely increase costs for taxpayers, as the VA absorbs the copayment burden. It may also lead to increased administrative costs for healthcare providers and insurance companies that work with the VA. But hey, at least veterans might get a few extra dollars in their pockets... until they realize their taxes are paying for it.

**Prognosis:** This bill is a classic case of "legislative theater," designed to make politicians look good without actually solving any problems. It's a Band-Aid on a bullet wound, and I'm not optimistic about its chances of success. But hey, at least the politicians will get some nice photo ops with veterans.

**Treatment:** The only cure for VVPS is a healthy dose of skepticism and critical thinking. Unfortunately, that's in short supply among voters and politicians alike. So, we'll just have to watch this bill go through the motions, pretending to solve problems while actually making things worse. Joy.

Related Topics

Military & Veterans AffairsFederal Budget & Appropriations
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

Rep. Gray, Adam [D-CA-13]

Congress 119 • 2024 Election Cycle

Total Contributions
$74,768
22 donors
PACs
$0
Organizations
$7,449
Committees
$0
Individuals
$67,319

No PAC contributions found

1
ACTBLUE
5 transactions
$3,600
2
ESPARZA FOR BOARD OF EQUALIZATION 2026
1 transaction
$1,000
3
FEDERATED INDIANS OF GRATON RANCHERIA
1 transaction
$1,000
4
TONY THURMOND FOR GOVERNOR 2026
1 transaction
$999
5
TIM GRAYSON FOR SENATE 2024
1 transaction
$500
6
ANGEL BARAJAS FOR SUPERVISOR
1 transaction
$250
7
DEMOCRACY ENGINE
2 transactions
$100

No committee contributions found

1
MINER, DAVID
2 transactions
$13,200
2
HANEY, WILIAM
3 transactions
$11,127
3
SOSNICK, AARON
1 transaction
$3,392
4
BEKENSTEIN, ANITA
1 transaction
$3,300
5
BEKENSTEIN, JOSHUA
1 transaction
$3,300
6
BIRMINGHAM, CYNTHIA
1 transaction
$3,300
7
BRANDT, JANICE
1 transaction
$3,300
8
CLAPP, STEPHEN
1 transaction
$3,300
9
CURRY, THOMAS
1 transaction
$3,300
10
DOSANJH, INDER
1 transaction
$3,300
11
FOUNG, JESSICA
1 transaction
$3,300
12
GEITHNER, TIMOTHY
1 transaction
$3,300
13
GOWEN, HERBERT
1 transaction
$3,300
14
HELLMAN, FRANCES
1 transaction
$3,300
15
HOLLAND, BRUCE
1 transaction
$3,300

Cosponsors & Their Campaign Finance

This bill has 8 cosponsors. Below are their top campaign contributors.

Rep. Takano, Mark [D-CA-39]

ID: T000472

Top Contributors

10

1
SEIU COPE (SERVICE EMPLOYEES INTERNATIONAL UNION COMMITTEE ON POLITICAL EDUCATION)
PACWASHINGTON, DC
$5,000
Mar 30, 2023
2
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$3,300
Jun 28, 2023
3
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$3,300
Jun 28, 2023
4
HABEMATOLEL POMO OF UPPER LAKE TRIBE OF CALIFORNIA
OrganizationUPPER LAKE, CA
$3,300
May 1, 2023
5
MS BAND OF CHOCTAW INDIANS
OrganizationCHOCTAW, MS
$1,000
Oct 10, 2024
6
BECKER, TODD
LAW OFFICES OF TODD B BECKER • ATTORNEY
IndividualPASADENA, CA
$3,300
Oct 17, 2023
7
ELDRIDGE, SEAN
STAND UP AMERICA • PRESIDENT
IndividualNEW YORK, NY
$3,300
Nov 29, 2023
8
HUH, JIHEE
PAFCO • VICE CHAIRMAN
IndividualROLLING HILLS, CA
$3,300
Oct 17, 2023
9
HUH, PETER
PAFCO • CHAIRMAN
IndividualPALOS VERDES PENINSULA, CA
$3,300
Oct 17, 2023
10
LI, LI
MEBO INTERNATIONAL • PRESIDENT
IndividualARCADIA, CA
$3,300
Oct 17, 2023

Rep. Castro, Joaquin [D-TX-20]

ID: C001091

Top Contributors

10

1
CHEROKEE NATION OF OKLAHOMA
OrganizationTAHLEQUAH, OK
$1,000
Dec 13, 2023
2
ALABAMA COUSHATTA TRIBE
OrganizationWOODVILLE, TX
$1,000
Sep 26, 2024
3
QUINONES, KARLA
NOT EMPLOYED • NOT EMPLOYED
IndividualSAN ANTONIO, TX
$5,000
Sep 30, 2024
4
SNEIDER, ARTURO
PRIMESTOR DEVELOPMENT INC. • REAL ESTATE
IndividualCULVER CITY, CA
$3,300
Oct 23, 2024
5
RAMIREZ, DANIEL N.
MONTY & RAMIREZ • ATTORNEY
IndividualHOUSTON, TX
$3,300
Jan 11, 2024
6
PARKER, ALEXANDRA
NOT EMPLOYED • NOT EMPLOYED
IndividualPALO ALTO, CA
$3,300
Mar 22, 2024
7
PARKER, ALEXANDRA
NOT EMPLOYED • NOT EMPLOYED
IndividualPALO ALTO, CA
$3,300
Mar 22, 2024
8
PARKER, SEAN
NOT EMPLOYED • NOT EMPLOYED
IndividualPALO ALTO, CA
$3,300
Mar 22, 2024
9
PARKER, SEAN
NOT EMPLOYED • NOT EMPLOYED
IndividualPALO ALTO, CA
$3,300
Mar 22, 2024
10
SILBEY, ALEX
ATS COMMUNICATIONS • CONSULTANT
IndividualWASHINGTON, DC
$3,300
Mar 29, 2024

Rep. Cohen, Steve [D-TN-9]

ID: C001068

Top Contributors

10

1
SEIU COPE (SERVICE EMPLOYEES INTERNATIONAL UNION COMMITTEE ON POLITICAL EDUCATION)
PACWASHINGTON, DC
$3,000
Nov 5, 2024
2
SEIU COPE (SERVICE EMPLOYEES INTERNATIONAL UNION COMMITTEE ON POLITICAL EDUCATION)
PACWASHINGTON, DC
$2,000
Nov 5, 2024
3
KEENEY, MIKE
LEWIS THOMASON • LEWIS THOMASON
IndividualMEMPHIS, TN
$3,300
Feb 6, 2024
4
RITCHEY, JANICE C
IndividualMEMPHIS, TN
$3,300
Jun 30, 2024
5
RITCHEY, KENT
WOLFCHASE TOYOTA • AUTOMOBILE DEALER
IndividualMEMPHIS, TN
$3,300
Jun 30, 2024
6
WALTON, CHRISTY
IndividualBENTONVILLE, AR
$3,300
Jun 30, 2024
7
KEENEY, MICHAEL
LEWIS THOMASON • ATTORNEY
IndividualMEMPHIS, TN
$3,300
May 25, 2023
8
SEGAL, GORDON
RETIRED • RETIRED
IndividualMEMPHIS, TN
$3,300
Apr 10, 2023
9
SMITH, FREDERICK
FEDEX • CEO
IndividualMEMPHIS, TN
$3,300
Jul 31, 2024
10
BEKTAS, MELIH
SELF EMPLOYED • ENGINEER
IndividualNORTH PROVIDENCE, RI
$3,000
Oct 19, 2023

Rep. Ramirez, Delia C. [D-IL-3]

ID: R000617

Top Contributors

10

1
SIBLANI, ALI EL
NOT EMPLOYED • NOT EMPLOYED
IndividualDEARBORN HEIGHTS, MI
$6,600
Nov 11, 2023
2
ROGERS, JOHN
ARIEL INVESTMENTS LLC • CHAIRMAN
IndividualCHICAGO, IL
$6,600
Jun 29, 2023
3
ALNOBANI, ABDUL
AYAZZ CONSTRCTION LLC • CEO
IndividualMOKENA, IL
$5,600
Nov 19, 2023
4
REHMAN, MOHAMMED
HUBCOM • IT
IndividualNAPERVILLE, IL
$5,000
Nov 19, 2023
5
REZNICK, DEBORAH
POLK BROS FOUNDATION • PROGRAM OFFICER
IndividualCHICAGO, IL
$5,000
Dec 28, 2023
6
ALNOBANI, ABDUL
AYAZZ CONSTRCTION LLC • CEO
IndividualMOKENA, IL
$4,000
Nov 19, 2023
7
ALNOBANI, ABDUL
IndividualMOKENA, IL
$4,000
Dec 4, 2023
8
AKHTER, REHAN
OPTIMA LAB • PRESIDENT
IndividualLAKE FOREST, IL
$3,300
Sep 30, 2024
9
ANWAR, NAVEED
GILLONS INC • MANUFACTURER
IndividualORLAND PARK, IL
$3,300
Sep 30, 2024
10
HORNSTEIN, NORBERT
NOT EMPLOYED • NOT EMPLOYED
IndividualWASHINGTON, DC
$3,300
Sep 10, 2024

Rep. Ross, Deborah K. [D-NC-2]

ID: R000305

Top Contributors

10

1
CHEROKEE NATION
OrganizationTAHLEQUAH, OK
$1,000
Dec 8, 2023
2
COOPER, JOHN D JR.
NOT EMPLOYED • CONTRACTOR/ENGINEER
IndividualRALEIGH, NC
$6,600
May 8, 2023
3
MARTIN, LOUISE PORTER
NOT EMPLOYED • NOT EMPLOYED
IndividualRALEIGH, NC
$4,600
Dec 29, 2023
4
WILKES, NANCY
UNC HOSPITALS • PHYSICIAN
IndividualCHAPEL HILL, NC
$3,300
Oct 31, 2024
5
ALLEN, DIANA
NOT EMPLOYED • NOT EMPLOYED
IndividualCARY, NC
$3,300
Dec 30, 2023
6
ALSOP, JOSEPH
ALSOP LOUIE PARTNERS • VENTURE PARTNER
IndividualBEVERLY, MA
$3,300
Dec 29, 2023
7
ALSUP, WILLIAM B III
NOT EMPLOYED • NOT EMPLOYED
IndividualWASHINGTON, DC
$3,300
Oct 17, 2023
8
BEEUWKES, REINIER
ISCHEMIX • CEO
IndividualCONCORD, MA
$3,300
Dec 31, 2023
9
DEBNAM, CAREY
SELF EMPLOYED • PROPERTY MANAGEMENT
IndividualRALEIGH, NC
$3,300
Dec 21, 2023
10
DEBNAM, SESHA F
DEBNAM PROPERTY MANAGEMENT LLC • PROPERTY MANAGER
IndividualRALEIGH, NC
$3,300
Dec 21, 2023

Rep. Craig, Angie [D-MN-2]

ID: C001119

Top Contributors

10

1
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$3,300
Oct 30, 2023
2
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$3,300
May 23, 2024
3
EASTERN BAND OF CHEROKEE INDIANS
OrganizationCHEROKEE, NC
$3,300
Oct 28, 2024
4
PRAIRIE ISLAND TRIBAL COUNCIL
OrganizationWELCH, MN
$3,300
Oct 21, 2024
5
AK-CHIN INDIAN COMMUNITY
OrganizationMARICOPA, AZ
$3,300
Mar 31, 2023
6
AK-CHIN INDIAN COMMUNITY
OrganizationMARICOPA, AZ
$2,500
Sep 24, 2024
7
THE MORONGO BAND OF MISSION INDIANS
OrganizationBANNING, CA
$1,000
Jun 30, 2024
8
FISCHER, FRANK
NOT EMPLOYED • NOT EMPLOYED
IndividualATHERTON, CA
$6,600
Mar 21, 2024
9
MAKOWER, JOSH
STANFORD UNIVERSITY • PROFESSOR
IndividualLOS ALTOS HILLS, CA
$6,600
Mar 19, 2024
10
BOWEN, DAVID
NOT EMPLOYED • RETIRED
IndividualSAN FRANCISCO, CA
$6,600
Apr 22, 2024

Rep. Jayapal, Pramila [D-WA-7]

ID: J000298

Top Contributors

10

1
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$6,600
Oct 31, 2023
2
CHEROKEE NATION
OrganizationTAHLEQUAH, OK
$3,300
Dec 12, 2023
3
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$3,300
Oct 31, 2023
4
SNOQUALMIE TRIBE
OrganizationSNOQUALMIE, WA
$3,300
Nov 2, 2023
5
MUCKLESHOOT INDIAN TRIBE
OrganizationAUBURN, WA
$3,300
Jun 5, 2023
6
THE TULALIP TRIBES OF WASHINGTON
OrganizationTULALIP, WA
$3,300
Jun 26, 2023
7
MUCKLESHOOT INDIAN TRIBE
OrganizationAUBURN, WA
$3,300
Jun 30, 2024
8
PUYALLUP TRIBE OF INDIANS
OrganizationTACOMA, WA
$3,300
Jun 30, 2024
9
THE TULALIP TRIBES OF WASHINGTON
OrganizationTULALIP, WA
$3,300
Jun 30, 2024
10
CHEROKEE NATION
OrganizationTAHLEQUAH, OK
$3,300
Sep 29, 2024

Rep. Figures, Shomari [D-AL-2]

ID: F000481

Top Contributors

10

1
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Apr 29, 2024
2
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
May 24, 2024
3
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$2,300
May 24, 2024
4
MALDI MA
OrganizationIRVINGTON, AL
$2,000
Apr 6, 2024
5
HILLWOOD LIQUORS LLC
OrganizationMOBILE, AL
$1,000
Feb 14, 2024
6
SIP & SMOKE LLC
OrganizationMOBILE, AL
$1,000
Feb 14, 2024
7
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$1,000
Feb 28, 2024
8
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$1,000
Aug 15, 2024
9
MAA PETROLEUM LLC
OrganizationIRVINGTON, AL
$500
Feb 14, 2024
10
MOWA BAND OF CHOCTAW INDIANS
OrganizationMOUNT VERNON, AL
$500
Apr 6, 2024

Donor Network - Rep. Gray, Adam [D-CA-13]

PACs
Organizations
Individuals
Politicians

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

Loading...

Showing 72 nodes and 45 connections (80 secondary connections hidden)

Total contributions: $132,668

Top Donors - Rep. Gray, Adam [D-CA-13]

Showing top 22 donors by contribution amount

7 Orgs15 Individuals

Industry Impact

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

  • Section 2(a) prohibits the VA from collecting health care copayments from veterans under certain conditions, which reduces revenue loss for VA hospitals and health systems providing care to veterans, thereby benefiting hospitals and health systems that rely on VA payments.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Rep. Gray, Adam [D-CA-13])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

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 Veterans Affairs

Strong
Vector: 65%
Pages: 688-691AI Enhanced

AI Analysis:

"The STRIVE Act directly targets VA copayment collection practices and timeliness standards, aiming to reduce financial burdens on veterans and hold the VA accountable for processing delays—goals that align closely with Project 2025's focus on improving veteran services and VA efficiency."

Key themes:veteran healthcare affordabilityVA accountabilitycopayment waivertimeliness standardsreducing financial burden

— 655 — Department of Veterans Affairs ENDNOTES 1. U.S. Department of Veterans Affairs, Veterans Health Division, VHA Directive 1003, “VHA Veteran Patient Experience,” April 14, 2020, pp. 1 and B-1. 2. S. 2372, VA Mission Act of 2018, Public Law No. 115-182, 115th Congress, June 6, 2018, https://www.congress. gov/115/plaws/publ182/PLAW-115publ182.pdf (accessed January 30, 2023). 3. U.S. Department of Veterans Affairs, VA History Office, “VA History,” last updated May 27, 2021, https://www. va.gov/HISTORY/VA_History/Overview.asp (accessed January 28, 2023). 4. 38 U.S. Code § 1116, https://www.law.cornell.edu/uscode/text/38/1116 (accessed January 28, 2023). 5. S. 3373, Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics Act of 2022 (Honoring Our PACT Act of 2022), Public Law No. 117-168, 117th Congress, August 10, 2022, https://www. congress.gov/117/plaws/publ168/PLAW-117publ168.pdf (accessed January 28, 2023). 6. H.R. 2471, Consolidated Appropriations Act, 2022, Public Law No. 117-103, 117th Congress, March 15, 2022, Division S, Title I, https://www.congress.gov/117/plaws/publ103/PLAW-117publ103.pdf (accessed March 18, 2023). Known variously as the Department of Veterans Affairs Nurse and Physician Assistant Retention and Income Security Enhancement Act and the VA Nurse and Physician Assistant RAISE Act. 7. See note 5, supra.

Department of Health and Human Services

Weak
Vector: 63%
Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on waiving VA copayments for veterans when the VA misses processing deadlines, while the Project 2025 HHS section centers on civil rights, abortion policy, conscience protections, and Medicare/Medicaid regulations. Both involve healthcare payment/administrative rules, but they address different populations and policy goals, resulting only a tangential connection."

Key themes:healthcare accesspayment/administrative policyfederal healthcare oversight

— 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 Veterans Affairs

Weak
Vector: 63%
Pages: 679-681AI Enhanced

AI Analysis:

"The bill focuses on copayment waivers due to VA processing delays, which tangentially relates to Project 2025's emphasis on timeliness and operational efficiency in VA healthcare, but does not directly address core objectives like infrastructure reform, caregiver program overhaul, or innovation office restructuring."

Key themes:timelinessVA healthcare operationsadministrative efficiency

— 646 — Mandate for Leadership: The Conservative Promise 3. Section 121 (developing and administering an education program that teaches veterans about their health care options available from the Department of Veterans Affairs). 4. Section 152 (returning the Office for Innovation of Care and Payment to the Office of Enterprise Integration with a joint governance process set up with the VHA). 5. Section 161 (overhauling Family Caregiver Program expansion, which has gone poorly, so that it focuses on consistency of eligibility and awareness that the most severely wounded or injured may require the program indefinitely). l Require the VHA to report publicly on all aspects of its operation, including quality, safety, patient experience, timeliness, and cost-effectiveness, using standards similar to those in the Medicare Accountable Care Organization program so that the government may monitor and achieve continuous improvement in the VA system more effectively. l Encourage VA Medical Centers to seek out relevant academic and private- sector input in their communities to improve the overall patient experience. Budget l Conduct an independent audit of the VA similar to the 2018 Department of Defense (DOD) audit to identify IT, management, financial, contracting, and other deficiencies. l Assess the misalignment of VHA facilities and rising infrastructure costs. The VHA operates 172 inpatient medical facilities nationally that are an average of 60 years old. Some of these facilities are underutilized and inadequately staffed. Facilities in certain urban and rural areas are seeing significant declines in the veteran population and strong competition for fresh medical staff. In 2018, Congress authorized an Asset Infrastructure Review (AIR) of national VHA medical markets to provide insight into where the VA health care budget should be responsibly allocated to serve veterans most effectively. However, the Senate Veterans Affairs Committee lacked the political will to act on the White House’s nominations of commission members, and this ultimately led to termination of the AIR process. The next Administration should seek out agile, creative, and politically acceptable operational solutions to this aging infrastructure status quo, — 647 — Department of Veterans Affairs reimagine the health care footprint in some locales, and spur a realignment of capacity through budgetary allocations. Specifically: 1. Embrace the expansion of Community Based Outpatient Clinics (CBOCs) as an avenue to maintain a VA footprint in challenging medical markets without investing further in obsolete and unaffordable VA health care campuses. 2. Explore the potential to pilot facility-sharing partnerships between the VA and strained local health care systems to reduce costs by leveraging limited talent and resources. Personnel l Extend the term of the Under Secretary for Health (USH) to five years. Additionally, authority should be given to reappoint this individual for a second five-year term both to allow for continuity and to protect the USH from political transition. l Establish a Senior Executive Service (SES) position of VHA Care System Chief Information Officer (CIO), selected by and reporting to the chief of the VHA Care System with a dotted line to the VA CIO. l Identify a workflow process to bring wait times in compliance with VA MISSION Act–required time frames wherever possible. 1. Assess the daily clinical appointment load for physicians and clinical staff in medical facilities where wait times for care are well outside of the time frames required by the VA MISSION Act. 2. Require VHA facilities to increase the number of patients seen each day to equal the number seen by DOD medical facilities: approximately 19 patients per provider per day. Currently, VA facilities may be seeing as few as six patients per provider per day. 3. Consider a pilot program to extend weekday appointment hours and offer Saturday appointment options to veterans if a facility continues to demonstrate that it has excess capacity and is experiencing delays in the delivery of care for veterans. 4. Identify clinical services that are consistently in high demand but require cost-prohibitive compensation to recruit and retain talent, and examine exceptions for higher competitive pay.

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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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