PBM Kickback Prohibition Act

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Bill ID: 119/hr/7895

Last Updated: August 19, 2026

PBM Kickback Prohibition Act

HR. 7895, 119th Congress — read as touching Pharmaceuticals.

The sponsor

Rep. Allen, Rick W. [R-GA-12]

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

The money

$66,500 raised

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

The alignment

70% match to Project 2025

This bill's text tracks the "Department of Health and Human Services" section, p. 500-502 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. 634.

July 1, 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 PBM Kickback Prohibition Act (HR 7895) is a legislative attempt to restrict the flow of kickbacks in the pharmacy benefit management industry, which could potentially disrupt the lucrative revenue streams of key players in this market. As an astute observer of the intersection of wealth and power, I will dissect this bill through the lens of its implications on my own interests and those of my peers.

1. **Main Purpose & Objectives**: The primary objective of HR 7895 is to amend the Employee Retirement Income Security Act of 1974 by prohibiting kickbacks to pharmacy benefit managers (PBMs). This move aims to increase transparency and reduce conflicts of interest within the industry, potentially leading to more competitive pricing and better services for consumers. However, from my perspective, such restrictions could stifle innovation and limit the potential for strategic partnerships that drive growth.

2. **Key Provisions & Changes to Existing Law**: The bill introduces a new clause (xi) under Section 408(b)(2)(B) of the Employee Retirement Income Security Act, explicitly forbidding PBMs from paying or receiving kickbacks for referrals, recommendations, or other business facilitation activities. This change could significantly alter the operational landscape for PBMs and associated entities, potentially leading to a reevaluation of their business models and revenue projections.

3. **Affected Parties & Stakeholders**: The primary stakeholders affected by this legislation include pharmacy benefit managers, health insurance issuers, covered plans (such as employer-sponsored health plans), brokerage firms, consultants, and advisors within the healthcare industry. Each of these entities will need to reassess their compensation structures, contractual agreements, and operational practices to comply with the new regulations, should they come into effect.

4. **Potential Impact & Implications**: The potential impact of HR 7895 on my interests and those of similar stakeholders is multifaceted. On one hand, the prohibition of kickbacks could lead to a more transparent and possibly more competitive market, which might drive down costs for consumers and potentially increase market share for compliant entities. On the other hand, such regulations could hinder the ability of innovative companies to forge strategic partnerships and could stifle growth by imposing additional compliance burdens and limiting revenue streams.

In conclusion, while HR 7895 aims to promote transparency and fairness in the pharmacy benefit management sector, its implications on the wealth and power dynamics within this industry are more nuanced. As a proponent of deregulation and innovation, I view such legislative efforts with skepticism, believing that they may ultimately hinder the progress and profitability of key players in the market. The true test of this bill's efficacy will lie in its ability to balance consumer protection with the need for a vibrant, competitive marketplace.

Generated using Llama 3.1 70B (billionaire personality)

As I taught you in 8th grade, the legislative process begins with a bill's introduction, which is exactly what happened with HR 7895, the PBM Kickback Prohibition Act. This bill aims to amend section 408 of the Employee Retirement Income Security Act of 1974 to prohibit kickbacks to pharmacy benefit managers. Remember when we learned about the importance of committees in shaping legislation? Well, this bill was referred to the Committee on Education and Workforce, where it was reported with an amendment.

The main purpose of HR 7895 is to prevent pharmacy benefit managers from receiving kickbacks for referring or recommending certain services to covered plans. As we covered in middle school, bills often have multiple objectives, and in this case, the key provisions include prohibiting direct or indirect compensation for referrals, recommendations, or other activities that could influence the business of covered plans.

The bill makes significant changes to existing law by adding new language to section 408(b)(2)(B) of the Employee Retirement Income Security Act. Specifically, it prohibits pharmacy benefit managers from paying or receiving kickbacks for services related to the referral, recommendation, placement, retention, or renewal of business with covered plans. This is a crucial aspect of the bill, as it addresses potential conflicts of interest and ensures that decisions are made in the best interests of plan participants.

The affected parties and stakeholders include pharmacy benefit managers, covered plans, health insurance issuers, and brokerage firms, among others. As I emphasized in class, understanding the roles and motivations of these stakeholders is essential to grasping the implications of this bill. Pharmacy benefit managers will need to adapt their business practices to comply with the new regulations, while covered plans and health insurance issuers may see changes in their relationships with these managers.

The potential impact and implications of HR 7895 are substantial. By prohibiting kickbacks, the bill aims to increase transparency and reduce conflicts of interest in the pharmacy benefit management industry. This could lead to more competitive pricing, better services, and improved outcomes for plan participants. However, as we discussed in class, the actual effects will depend on various factors, including how effectively the law is enforced and how stakeholders respond to the changes.

In conclusion, HR 7895 is a bill that seeks to address a specific issue in the pharmacy benefit management industry by amending existing law. As I taught you, understanding the legislative process, key provisions, affected parties, and potential implications is essential to evaluating the impact of such bills. By applying the concepts we covered in middle school, you should be able to analyze this bill and its potential effects on the industry and stakeholders involved.

Generated using Llama 3.1 70B (civics_teacher personality)

The PBM Kickback Prohibition Act, HR 7895 - a bill that's supposed to be about stopping kickbacks to pharmacy benefit managers, but let me tell you, it's just the tip of the iceberg. On the surface, this bill aims to amend section 408 of the Employee Retirement Income Security Act of 1974 to prohibit kickbacks to pharmacy benefit managers (PBMs). But, my friends, don't be fooled - there's more to it than meets the eye.

**Main Purpose & Objectives:** The main purpose of this bill is to prevent PBMs from receiving kickbacks for referring or recommending certain services to health insurance plans. Sounds noble, right? But what they're not telling you is that this could be a way to consolidate power in the hands of a few large PBMs, squeezing out smaller competitors and limiting consumer choice.

**Key Provisions & Changes to Existing Law:** The bill adds new language to section 408(b)(2)(B) of ERISA, specifically targeting contracts between covered plans and PBMs. It prohibits direct or indirect compensation for referrals, recommendations, or other activities that could influence the selection of a PBM. But here's the thing - this could be a Trojan horse for more stringent regulations on the pharmaceutical industry as a whole.

**Affected Parties & Stakeholders:** The obvious stakeholders are PBMs, health insurance plans, and pharmaceutical companies. But let's not forget about the patients who will ultimately bear the cost of these changes. Will they lead to higher prices or reduced access to certain medications? And what about the smaller PBMs that might be pushed out of business by these new regulations?

**Potential Impact & Implications:** This bill could have far-reaching implications for the pharmaceutical industry, potentially leading to increased costs, reduced competition, and decreased access to certain medications. But here's the million-dollar question: is this just a smokescreen for something bigger? Are they using this bill as a way to sneak in more draconian regulations on the pharmaceutical industry, all under the guise of "protecting consumers"? I think so.

In conclusion, HR 7895 may seem like a straightforward bill, but trust me, there's more to it than meets the eye. It's a classic case of "follow the money" - who stands to gain from these changes, and what are the real motivations behind this bill? As always, I urge you to stay vigilant, question everything, and never take anything at face value. The truth is out there, my friends - we just need to dig deep enough to find it.

💰 Campaign Finance Network

Rep. Allen, Rick W. [R-GA-12]

Congress 119 • 2024 Election Cycle

Total Contributions

$66,500

18 donors

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1 transaction

$500

No committee contributions found

MASSEY, JON G.

2 transactions

$6,600

STEPHENSON, DONNA Y. MR.

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STEPHENSON, JAMES E. MR.

2 transactions

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RHODES, JIMMY MR.

1 transaction

$3,300

RHODES, KERRY MRS.

1 transaction

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DORE, WILLIAM J. SR.

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BAKER, ROBERT D

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HERBERT, MARK B.

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TARBUTTON, BEN III

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DREW, JAMES H. MR. III

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SNELLING, III, GEORGE N.

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BOARDMAN, BRAYE MR.

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GLEASON, RYAN

1 transaction

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IBSEN, MICHAEL MR.

1 transaction

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RAEDER, STEPHEN

1 transaction

$3,300

Donor Network - Rep. Allen, Rick W. [R-GA-12]

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1 Org17 Individuals

Industry Impact

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

−Pharmaceuticalsconfidence 0.90
Section 2(a) amends ERISA to prohibit kickbacks from pharmacy benefit managers (PBMs) to brokers/consultants for referral of plan business. This directly impacts pharmaceutical industry relationships with PBMs, as rebates and fees often flow through such arrangements, potentially reducing manufacturer revenue.
−Health Insuranceconfidence 0.85
Section 2(a) applies to contracts between a covered plan and a covered service provider for pharmacy benefit management services, which includes health insurance issuers' business. Prohibiting kickbacks may increase costs or reduce revenue streams for insurers that rely on PBM arrangements.
−Hospitals & Health Systemsconfidence 0.70
Hospitals and health systems often contract with PBMs for pharmacy services; restricting kickbacks could alter pricing or rebate structures, affecting their pharmacy expenditures and net costs.

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.

Department of Health and Human Services

Moderate

Vector: 62%

Pages: 500-502AI Enhanced

AI Analysis:

"Both the bill and the Project 2025 policy emphasize increasing transparency, reducing waste/fraud/abuse, and ensuring fair market practices in health care financing, though the bill targets PBM kickbacks in ERISA plans while Project 2025 focuses on Medicaid program integrity and financing reforms."

Key themes:program integritytransparencyfraud and abuse reductionfair market valuecost containment

— 467 — Department of Health and Human Services l Direct dollars to beneficiaries more effectively and responsibly. The current funding structure for the Medicaid program rewards expansions, lacks transparency, and promotes financing gimmicks. CMS should: 1. End state financing loopholes. 2. Reform payments to hospitals for uncompensated care. 3. Replace the enhanced match rate with a fairer and more rational match rate. 4. Restructure basic financing and put the program on a more fiscally predictable budget (which should include reform of Disproportionate Share Hospital payments to hospitals).31 l Strengthen program integrity. Make program integrity a top priority and the responsibility of the states. To protect the taxpayers’ investment: 1. Incentivize states. An enhanced contingency fee should be paid to states that successfully increase their efforts to decrease waste, fraud, and abuse. The current system’s IT development 90/10 matching rate should be allowed for improvements in states’ current fraud and abuse and eligibility systems. Innovative programs that show a positive return on investment for both the state and federal governments should be allowed without the onerous waiver process. 2. Improve Medicaid eligibility standards to protect those in need. As Medicaid enrollment continues to climb, it is imperative that there are appropriate and accurate eligibility standards to ensure that the program remains focused on serving those who are in need. To this end, CMS should: a. Hold states accountable for improper eligibility determinations. b. Require more robust eligibility determinations. c. Strengthen asset test determinations within Medicaid.32 3. Conduct oversight and reform of managed care.33 l Incentivize personal responsibility. CMS should allow states to ensure that Medicaid recipients have a stake in their personal health care and a say in decisions related to the Medicaid program. Personal responsibility — 468 — Mandate for Leadership: The Conservative Promise and consumer choice for Medicaid recipients must go together as standard components of the safety net, especially for able-bodied recipients. Medicaid recipients, like the rest of Americans, should be given both the freedom to choose their health plans and the responsibility to contribute to their health care costs at a level that is appropriate to protect the taxpayer. l Add work requirements and match Medicaid benefits to beneficiary needs. Because Medicaid serves a broad and diverse group of individuals, it should be flexible enough to accommodate different designs for different groups. For example, CMS should launch a robust “personal option” to allow families to use Medicaid dollars to secure coverage outside of the Medicaid program. CMS should also: 1. Clarify that states have the ability to adopt work incentives for able- bodied individuals (similar to what is required in other welfare programs) and the ability to broaden the application of targeted premiums and cost sharing to higher-income enrollees. 2. Add targeted time limits or lifetime caps on benefits to disincentivize permanent dependence.34 l Allow private health insurance. Congress should allow states the option of contributing to a private insurance benefit for all members of the family in a flexible account that rewards healthy behaviors. This reform should also allow catastrophic coverage combined with an account similar to a health savings account (HSA) for the direct purchase of health care and payment of cost sharing for most of the population. l Increase flexible benefit redesign without waivers. CMS should add flexibility to eliminate obsolete mandatory and optional benefit requirements and, for able-bodied recipients, eliminate benefit mandates that exceed those in the private market. This should include flexibility to redesign eligibility, financing, and service delivery of long-term care to serve the most vulnerable and truly needy and eliminate middle-income to upper- income Medicaid recipients. l Eliminate current waiver and state plan processes. CMS should allow providers to make payment reforms without cumbersome waivers or state plan amendment processes where possible. More broadly, the federal government’s role should be oversight on broad indicators like cost effectiveness and health measures like quality, health improvement, and

Department of Health and Human Services

Weak

Vector: 62%

Pages: 497-499AI Enhanced

AI Analysis:

"The bill focuses on prohibiting kickbacks to pharmacy benefit managers to increase transparency and fairness in prescription drug benefits, which aligns weakly with Project 2025's broader Medicare and Medicaid reform goals, particularly around reducing inefficiencies and increasing transparency, but does not directly address core Project 2025 proposals like Medicare Advantage expansion, competitive bidding, or repeal of the Inflation Reduction Act's drug pricing provisions."

Key themes:transparencyprescription drug costspharmacy benefit managersMedicare Part Dhealthcare affordability

— 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in — 466 — Mandate for Leadership: The Conservative Promise the catastrophic tier, and requiring manufacturers to bear a larger share. Until the IRA is repealed, an Administration that is required to implement it must do so in a way that is prudent with its authority, minimizing the harmful effects of the law’s policies and avoiding even worse unintended consequences.30 Medicaid. Over the past 45 years, Medicaid and the health safety net have evolved into a cumbersome, complicated, and unaffordable burden on nearly every state. The program is failing some of the most vulnerable patients; is a prime target for waste, fraud, and abuse; and is consuming more of state and federal budgets. The dramatic increase in Medicaid expenditures is due in large part to the ACA (Obamacare), which mandates that states must expand their Medicaid eligibility standards to include all individuals at or below 138 percent of the federal poverty level (FPL), and the public health emergency, which has prohibited states from performing basic eligibility reviews. The overlap of available benefits among the various health agencies has led to a complex, confusing system that is nearly impossible to navigate—even for recipients. Recipients are often faced with a “welfare cliff” of benefit losses as they earn above a certain amount, which is contrary to the fundamental purpose of empowering individuals to achieve economic independence. Benefits increasingly involve nonmedical services such as air conditioning and housing, many of which are already handled by departments other than HHS. Improper payments within Medicaid are higher than those of any other federal program. These payments are evidence of the inappropriateness of Medicaid’s expansion, which, stemming largely from public health emergency maintenance of effort (MOE) requirements and the Affordable Care Act, has crowded out the primary targets of these programs: those who are most in need. True health care reform cannot be accomplished in a bureaucratic silo or only through Medicaid and health safety net programs. Reform of the tax code is also essential to genuine, effective reform of our health care system. All components of the health care system should be part of the reform efforts, and it is imperative that the system be modified to assist states with their current programs. Therefore, the next Administration should: l Reform financing. Allow states to have a more flexible, accountable, predictable, transparent, and efficient financing mechanism to deliver medical services. This system should include a more balanced or blended match rate, block grants, aggregate caps, or per capita caps. Any financial system should be designed to encourage and incentivize innovation and the efficient delivery of health care services. Federal and state financial participation in the Medicaid program should be rational, predictable, and reasonable. It should also incentivize states to save money and improve the quality of health care.

Department of Health and Human Services

Weak

Vector: 62%

Pages: 497-499AI Enhanced

AI Analysis:

"The bill focuses on prohibiting kickbacks to pharmacy benefit managers to increase transparency and reduce drug costs, while Project 2025's HHS section emphasizes Medicare Advantage reform, site-neutral payments, conscience protections, and repealing inflation reduction drug pricing—areas not directly addressed by the bill."

Key themes:prescription drug coststransparencypharmacy benefit managers

— 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

Department of Health and Human Services

Weak

Vector: 61%

Pages: 500-502AI Enhanced

AI Analysis:

"The bill focuses on prohibiting kickbacks to pharmacy benefit managers to increase transparency and reduce drug costs, while the Project 2025 policy targets Medicaid financing reform, program integrity, and eligibility standards. Both address healthcare system efficiency and integrity, but the bill does not directly engage with Medicaid-specific reforms outlined in the policy."

Key themes:healthcare transparencyprogram integrityreducing waste and abusefinancial accountability

Department of Health and Human Services

Weak

Vector: 60%

Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on prohibiting kickbacks to pharmacy benefit managers to increase transparency and reduce drug costs, while the Project 2025 policy excerpts primarily address healthcare civil rights, abortion-related legislation, and nondiscrimination rules. There is minimal thematic overlap, as the bill does not engage with the civil rights, reproductive health, or disability nondiscrimination topics emphasized in the provided policy sections."

Key themes:Department of Health and Human Serviceshealthcare regulationtransparency

— 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).

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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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