Adrian Smith (R-NE)
Strengthening Innovation in Medicare and Medicaid Act
A Republican bill with no cosponsors
Last activity — Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Rules, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
This bill amends the Social Security Act to place new rules and oversight on health care payment and service delivery models tested by the Center for Medicare and Medicaid Innovation (CMI). It sets limits on the scope, duration, and number of models the CMI can test at one time. The legislation also requires the CMI to create hardship waivers for healthcare providers and continuously monitor the real-time impact of models on patients. Furthermore, it gives Congress 45 days to review and potentially block proposed model expansions or modifications through a joint resolution. Finally, the bill reestablishes judicial review so that actions can be challenged to protect program beneficiaries.
Yes· 3 of 8
- Scored +6
Does this make what the government does easier for the public to see?
The bill enhances transparency by requiring advance public notice, 45-day public comment periods, and disclosure of actuarial data used by the Chief Actuary.
- Scored +4
Would people over 65 be better off under this?
Seniors on Medicare benefit from real-time monitoring provisions designed to mitigate adverse impacts and inappropriate reductions in care during model testing.
- Scored +4
Does this make health care easier to get in general?
Section 3 mandates hardship waivers for providers to prevent loss of healthcare access for vulnerable populations and requires continuous real-time monitoring of patient care.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Hardship Waivers for Providers: Section 3 requires the Secretary to create a plan allowing healthcare providers and suppliers to request a waiver from model requirements if those rules would cause undue economic hardship or result in a loss of healthcare access for vulnerable populations. This is positive because it protects community-based, rural, and safety-net providers from unfair financial burdens and safeguards patient access to necessary care.
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Real-Time Monitoring and Protection for Patients: Section 3 directs the Secretary to implement a plan to continuously monitor the effects of models on individuals in real-time, specifically to mitigate adverse impacts like inappropriate reductions in care. This is a positive safeguard to ensure patients are not harmed or cut off from medical services during testing phases.
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Public Input and Transparency: Section 5 mandates that the Secretary use advance public notice and provide a minimum 45-day public comment period regarding the establishment, testing, and expansion of models. This provision is positive because it gives everyday people, patients, and stakeholders a direct voice in healthcare decisions that affect them.
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Access to Actuarial Data: Section 9 requires the Secretary to provide participating providers and suppliers with the specific assumptions and data used by the Chief Actuary when deciding to modify, terminate, or expand a model. This openness is beneficial because it holds officials accountable by showing the math behind major healthcare decisions.
Potential Negative Impacts for People
- Caps on Testing New Models: Section 3 limits Phase I testing of new models to no more than six per fiscal year and restricts mandatory models to no more than five concurrently. While intended to limit overreach, this restriction could potentially slow down the discovery and testing of innovative healthcare solutions that might otherwise help lower costs and improve treatments for patients.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would people over 65 be better off under this? — Seniors on Medicare benefit from real-time monitoring provisions designed to mitigate adverse impacts and inappropriate reductions in care during model testing. Would business owners be better off under this? — Healthcare providers and suppliers can request hardship waivers from model requirements that cause undue economic hardship. Would farmers be better off under this? — Explicit consideration of rural and critical access providers helps protect healthcare delivery infrastructure in agricultural and rural communities. Would households on low incomes be better off under this? — Protections for safety-net and vulnerable populations help preserve healthcare access for low-income individuals relying on Medicare and Medicaid. Would veterans be better off under this, taking everything together? — General improvements to healthcare model oversight and safety-net protections indirectly support veterans who utilize Medicare services.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — The bill enhances transparency by requiring advance public notice, 45-day public comment periods, and disclosure of actuarial data used by the Chief Actuary.
- Healthcare
- Does this make health care easier to get in general? — Section 3 mandates hardship waivers for providers to prevent loss of healthcare access for vulnerable populations and requires continuous real-time monitoring of patient care. Does this put more money into Medicare, the health coverage for people over 65? — The bill provides oversight and accountability structures for Medicare and Medicaid innovation models while ensuring participant protections and hardship waivers.
- 10/1/2026
- Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Rules, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Introduced in House