Restoring Essential Healthcare Act
Summary
What This Bill Does
The Restoring Essential Healthcare Act is a targeted Medicaid repeal and retroactivity bill. It repeals section 71113 of Public Law 119-21, which barred Medicaid payments to certain prohibited entities as defined in that section. It also instructs that, for medical-assistance items or services furnished under a state Medicaid plan or waiver by a prohibited entity during the period from Public Law 119-21's enactment through this bill's enactment, payment must be made as if section 71113 had never become law. The bill therefore restores payment eligibility for affected Medicaid providers and tries to make them whole for the interim period, while shifting administrative work to state Medicaid programs and federal Medicaid oversight offices.
Who Benefits and How
Medicaid patients served by prohibited entities benefit because the repeal restores federal Medicaid payment pathways for covered care. Prohibited Medicaid entities benefit because claims for covered items or services must be paid as though the payment ban had not existed. State Medicaid programs benefit from clearer authority to reimburse affected providers under state plans or waivers. Reproductive health clinics benefit if they fall within the providers whose Medicaid payments were blocked by section 71113.
Who Bears the Burden and How
CMS Medicaid administrators must implement the repeal and ensure payment treatment for the interim period. State Medicaid agencies must process or adjust claims for covered services furnished by affected prohibited entities. Federal taxpayers bear the cost of Medicaid payments that Public Law 119-21 would have blocked. Supporters of the Public Law 119-21 payment prohibition lose the statutory exclusion they enacted.
Key Provisions
- Repeals section 71113 of Public Law 119-21.
- Requires Medicaid payment for covered items or services furnished by prohibited entities during the interim period.
- Applies the payment rule as if section 71113 had not been enacted.
- Restores Medicaid reimbursement pathways under state plans and waivers for affected providers.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Repeals Public Law 119-21's prohibition on Medicaid payments to certain prohibited entities and requires Medicaid payment for covered items or services furnished by those entities during the period between Public Law 119-21's enactment and this bill's enactment as if the prohibition had never been enacted.
Key Policy Areas
Medicaid, Health Care, Reproductive Health
Primary Purpose
Repeals Public Law 119-21's prohibition on Medicaid payments to certain prohibited entities and requires Medicaid payment for covered items or services furnished by those entities during the period between Public Law 119-21's enactment and this bill's enactment as if the prohibition had never been enacted.
Policy Domains
Resolution provisions
Identified Gains
- Medicaid patients served by prohibited entities
- Prohibited Medicaid entities
- State Medicaid programs
- Reproductive health clinics
Identified Costs
- CMS Medicaid administrators
- State Medicaid agencies
- Federal taxpayers
- Payment prohibition supporters
Sponsors
Legislative Progress
In CommitteeMs. Friedman (for herself, Ms. Williams of Georgia, Mr. Pappas, …
Referred to the House Committee on Energy and Commerce.
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Medicaid patients served by prohibited entities, State Medicaid programs
Positive-direction: Medicaid patients served by prohibited entities
Negative-direction: State Medicaid programs
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology