Restoring Essential Healthcare Act
- Bill Number
- H.R. 4796
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-07-29: Referred to the House Committee on Energy and Commerce.
- Last Updated
- 2026-06-24T08:09:42Z
AI-Generated Summary
Purpose
The Restoring Essential Healthcare Act (H.R. 4796) aims to repeal a restriction in Public Law 119-21 that barred Medicaid payments to specific healthcare entities. By doing so, it seeks to restore federal funding eligibility for medical services provided by these entities under the Medicaid program, which offers health coverage to low-income individuals and families.
Key Provisions
- Short Title: The bill is titled the "Restoring Essential Healthcare Act."
- Repeal of Prohibition: It fully repeals Section 71113 of Public Law 119-21, which had prohibited Medicaid payments for items or services provided by "prohibited entities" (defined in that section, likely referring to certain nonprofit health organizations).
- Retroactive Payments: For services provided by these entities under a state's Medicaid plan (or waiver) from the enactment date of Public Law 119-21 until the enactment of this bill, payments must be made as if the prohibition never existed. This ensures reimbursement for past services without the funding block.
Significant Changes to Existing Law
- Removal of Funding Ban: Public Law 119-21's Section 71113 introduced a prohibition on using Medicaid funds for services from designated entities, effectively defunding them. This bill eliminates that ban entirely, reverting to pre-existing Medicaid payment rules for those providers.
- Retroactive Effect: Unlike a simple repeal, the bill mandates back payments for services during the prohibition period, addressing any financial losses incurred by affected providers and ensuring continuity of coverage.
Potential Impacts
- On Government Agencies: State Medicaid agencies and the federal Centers for Medicare & Medicaid Services (CMS) would need to process retroactive reimbursements and adjust payment systems, potentially increasing administrative workloads and federal spending under Medicaid (a joint federal-state program).
- On Citizens: Low-income individuals relying on Medicaid could regain access to services from previously defunded providers, such as family planning or reproductive health clinics, improving healthcare availability in underserved areas without gaps in coverage.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. healthcare funding.
Main Stakeholders Affected
- Prohibited Entities: Primarily nonprofit health organizations (e.g., those providing reproductive health services) that were barred from Medicaid reimbursements; they stand to recover lost funds and resume full participation.
- Medicaid Beneficiaries: Low-income patients who may have lost access to specific providers due to the funding cut; restoration could enhance their care options.
- State Governments: Responsible for administering Medicaid, they benefit from federal matching funds for restored services but may face short-term costs for processing retroactive claims.
- Federal Government: Through CMS and the Department of Health and Human Services, it would increase Medicaid expenditures, affecting the federal budget.
Notable Legal, Constitutional, or Political Implications
- Legal Implications: The retroactive payment clause could lead to administrative challenges or lawsuits over reimbursement calculations, but it aligns with Medicaid's statutory framework under Title XIX of the Social Security Act, which allows states flexibility in provider payments.
- Constitutional Implications: None directly evident; the bill operates within Congress's spending power under Article I, Section 8, without raising federalism or equal protection concerns.
- Political Implications: As introduced by a large bipartisan group (primarily Democrats) and referred to the House Committee on Energy and Commerce, it reflects ongoing debates over federal funding for sensitive healthcare services like family planning. Repeal could polarize views on government support for specific providers, influencing future appropriations and healthcare policy.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Friedman, Laura [D-CA-30]
Cosponsors (155)
Rep. Williams, Nikema [D-GA-5], Rep. Pappas, Chris [D-NH-1], Rep. Brownley, Julia [D-CA-26], Rep. Cisneros, Gilbert Ray [D-CA-31], Rep. Lieu, Ted [D-CA-36], Rep. Matsui, Doris O. [D-CA-7], Rep. McIver, LaMonica [D-NJ-10], Rep. Scanlon, Mary Gay [D-PA-5], Rep. Sherman, Brad [D-CA-32], Rep. Tlaib, Rashida [D-MI-12], Rep. Casten, Sean [D-IL-6], Rep. Liccardo, Sam T. [D-CA-16], Rep. Davids, Sharice [D-KS-3], Rep. Clarke, Yvette D. [D-NY-9], Rep. DelBene, Suzan K. [D-WA-1], Rep. Deluzio, Christopher R. [D-PA-17], Rep. Fletcher, Lizzie [D-TX-7], Rep. Balint, Becca [D-VT-At Large], Rep. Ramirez, Delia C. [D-IL-3], Rep. Carson, André [D-IN-7], Rep. Doggett, Lloyd [D-TX-37], Rep. Simon, Lateefah [D-CA-12], Rep. Chu, Judy [D-CA-28], Rep. Trahan, Lori [D-MA-3], Rep. Crockett, Jasmine [D-TX-30], Rep. Nadler, Jerrold [D-NY-12], Rep. Correa, J. Luis [D-CA-46], Rep. Carbajal, Salud O. [D-CA-24], Rep. Dexter, Maxine [D-OR-3], Rep. Tonko, Paul [D-NY-20], Rep. Landsman, Greg [D-OH-1], Rep. Bonamici, Suzanne [D-OR-1], Rep. Velázquez, Nydia M. [D-NY-7], Rep. Castor, Kathy [D-FL-14], Rep. McClellan, Jennifer L. [D-VA-4], Rep. Garamendi, John [D-CA-8], Rep. Sewell, Terri A. [D-AL-7], Rep. Titus, Dina [D-NV-1], Rep. Beyer, Donald S. [D-VA-8], Rep. Auchincloss, Jake [D-MA-4], Rep. Tokuda, Jill N. [D-HI-2], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Quigley, Mike [D-IL-5], Rep. Salinas, Andrea [D-OR-6], Rep. Khanna, Ro [D-CA-17], Rep. Huffman, Jared [D-CA-2], Rep. Watson Coleman, Bonnie [D-NJ-12], Rep. Budzinski, Nikki [D-IL-13], Rep. Schakowsky, Janice D. [D-IL-9], Rep. Davis, Danny K. [D-IL-7] and 105 more
Recent Actions
- 2025-07-29: Referred to the House Committee on Energy and Commerce.
- 2025-07-29: Introduced in House
- 2025-07-29: Introduced in House
Bill Versions
- Restoring Essential Healthcare Act — issued 2025-07-29 — PDF (2 pages)