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Tag: Reform

  • Understanding the Connected MOM Act: Federal Intervention in State Maternal Health Medicaid Coverage

    Understanding the Connected MOM Act: Federal Intervention in State Maternal Health Medicaid Coverage

    Introduction to Medicaid and Maternal Health Coverage

    Medicaid is a healthcare program designed to cover specific medical costs for individuals with lower incomes and limited resources. While the federal government sets baseline regulations and retains oversight authority over Medicaid programs, states maintain primary responsibility for program administration, which leads to variation in Medicaid coverage across the nation. Many state Medicaid programs offer insurance coverage for pregnant individuals through mechanisms such as presumptive eligibility. Presumptive eligibility allows certain vulnerable populations to receive coverage before their application for Medicaid is fully processed. For example, Iowa’s presumptive Medicaid coverage extends Medicaid benefits to all pregnant applicants while their eligibility is being determined, regardless of the final outcome.

    Maternal health remains a critical concern in the United States, where indicators such as preterm births and maternal mortality have continued to rise despite targeted policy interventions. A key factor in improving maternal health outcomes is access to high-quality prenatal care, yet adequate access to prenatal care is declining. A significant reason that many people cannot access adequate prenatal care is a lack of insurance coverage or sporadic insurance coverage during their pregnancy. Research emphasizes that increasing insurance coverage for pregnant people can improve access to prenatal care, which can improve maternal health outcomes.


    While federal regulations mandate certain Medicaid services, including maternal healthcare, the specifics of maternal health coverage are left largely to the discretion of individual states. For instance, Iowa’s presumptive eligibility for pregnant people continues until the applicant receives a determination of full Medicaid eligibility. In contrast, Minnesota’s hospital-based presumptive coverage for pregnant people only lasts for a month. 

    S.141 and the Scope of Federal Intervention

    Introduced on January 16, 2025, S.141—or the Connected MOM Act—aims to identify and address barriers to Medicaid coverage of health monitoring devices in an effort to improve maternal health outcomes. Given that health monitoring devices can expand access to prenatal care by allowing physicians to remotely monitor health metrics, the bill aims to explore how pregnant people might face challenges in obtaining these devices. The bill proposes investigating state-level obstacles to coverage of remote physiologic devices, which include: 

    • Blood pressure cuffs (used to monitor blood pressure)
    • Glucometers (used to assess blood glucose levels)
    • Pulse oximeters (used to measure blood oxygen saturation)
    • Thermometers (used to track body temperature)

    These devices enable at-home monitoring of key health metrics, facilitating earlier intervention for dangerous pregnancy-related conditions. According to legal experts, such investigative efforts generate data that can inform and support future policy development. S.B. 141, which has received bipartisan support, is currently under review by the Senate Finance Committee.

    Perspectives on S.B. 141 and Federal Medicaid Interventions

    Investigative legislation like the Connected MOM Act allocates funding for evidence-gathering to guide future policy decisions. In this case, the bill aims to collect information on how states manage Medicaid coverage for remote physiologic devices that are critical during pregnancy, with the long-term goal of shaping federal Medicaid policies. While supporters of the Connected MOM Act argue that it will provide necessary insights to catalyze Medicaid expansion for pregnant people, others point to the rules and regulations of Medicaid which make it difficult for the federal government to intervene broadly in state Medicaid programs. Given the structural limits on federal influence over state-run Medicaid programs, broad national reforms are often considered too costly or unlikely to yield systemic change. This dynamic was evident in the fate of H.R. 3055—the Black Maternal Health Momnibus Act—which failed to advance beyond the committee stage. Supporters of the Connected MOM Act argue that its incremental, investigative approach will help justify future reforms without being perceived as broad federal overreach. 

    Conclusion

    Each state administers its own Medicaid program, resulting in variations in coverage for certain medical devices, including remote health monitoring devices. Given the importance of these devices in expanding access to prenatal care, S.B. 141 seeks to investigate the best course of action for improving coverage of them across the nation. As it moves through committee, S.B. 141 may give insights on how policymakers can strategically navigate limits on federal power over state health programs.

  • Pros and Cons of Congressional Term Limits

    Pros and Cons of Congressional Term Limits

    Background: What are Congressional Term Limits?

    While members of the U.S. House of Representatives serve two-year terms and U.S. Senators serve six-year terms, all Congresspeople are eligible for re-election indefinitely. As of 2023, U.S. Representatives served an average term of 8.5 years, while U.S. Senators served an average term of 11.2 years. 

    Congressional term limits are a proposed constitutional amendment that would limit the number of terms a member of Congress can legally serve. Under Article V, the Constitution can be amended by either (1) a two-thirds vote of support in both chambers of Congress, or (2) a constitutional convention called by two-thirds of all states and ratified by three-fourths of all states. Term limits reached their highest level of political salience in the 1990s. In 1992, Arkansas voters attempted to impose term limits on their state’s federal congresspeople via an amendment to their state constitution. In U.S. Term Limits, Inc. v. Thornton, the Supreme Court decided that this amendment was unconstitutional and that states cannot impose term limits on their own federal delegation; the only way to impose congressional term limits is to amend the U.S. Constitution. 

    Current Attempts to Impose Congressional Term Limits

    In 2024, Representative Ralph Norman (R-SC) introduced a joint resolution to amend the Constitution and enact a three-term limit for Representatives and a two-term limit for Senators. The resolution died in committee. In January 2025, Senators Ted Cruz (R-TX) and Katie Britt (R-AL) introduced a resolution with the same provisions. Their proposed amendment was co-sponsored by 17 senators, all of whom are Republicans. 

    While the constitution has never been amended through a constitutional convention, some states are also taking that approach to impose congressional term limits due to limited success of prior joint resolutions in Congress. Indiana’s State Senate recently voted to approve a resolution calling for a convention to consider term limits. If the Indiana House passes the resolution, Indiana will become the tenth state to call for a constitutional convention, joining Alabama, Florida, Louisiana, Missouri, North Carolina, Oklahoma, Tennessee, West Virginia, and Wisconsin. 

    Arguments In Favor of Congressional Term Limits

    The case for congressional term limits centers on the following arguments: (1) Term limits motivate politicians to get more done while in office, (2) Congressional turnover eliminates the incumbent funding advantage, (3) Term limits reduce careerism in politics, and (4) Congressional term limits have widespread support.

    One common argument in favor of congressional term limits is that the policy will incentivize politicians to act more efficiently and effectively during their term given the knowledge that they cannot serve indefinitely. Some argue that today, legislators avoid taking immediate action on hot-button issues like immigration and healthcare because they know those issues drive voters to the polls. These proponents argue that congressional term limits would help shift lawmakers’ core objective from winning re-election to creating effective, long-term policy solutions. 

    Advocates for congressional term limits also express concern that members of Congress are unrepresentative of their constituents, especially in terms of economic status. They highlight that funding has become a barrier to becoming an elected official and that incumbency is often linked with disproportionately high campaign funds, making it difficult for newcomer candidates to win against an incumbent. Proponents of term limits say the policy would reduce this incumbent advantage, leveling the funding playing field every two or three terms so that candidates have more of an equal financial footing heading into their race. Supporters also suggest that term limits could indirectly decrease the role of corporate funders in politics by deterring companies from making major investments in lawmakers who will only hold power for a short period. 

    Other proponents of congressional term limits argue that the policy would limit careerism in Congress by making room for people with more real-world expertise to service. They highlight that the average duration of time served in Congress has been steadily increasing from 8.9 years to 11 years, arguing this demonstrates that congressional office is viewed as a career plan instead of a post of service. In the absence of indefinite congressional roles, proponents argue, everyday Americans with more recent connections to the job market would have more opportunities than career politicians who are “insulated from the communities they represent.”

    Finally, proponents of congressional term limits highlight that the majority of Americans support the policy. A 2023 Pew Research Center study found that 87% of respondents favored limiting the number of terms one person can serve in congress. A different 2023 study from the Maryland School of Public Policy found support for congressional term limits transcended political party, with 86% of Republicans, 80% of Democrats, and 84% of Independents in favor of the policy.

    Arguments Against Congressional Term Limits

    The arguments against congressional term limits are primarily built around the three subarguments: (1) Term limits fail to address political corruption, (2) Term limits ignore the value of the incumbency and institutional knowledge, and (3) Frequent congressional turnover shifts power away from the legislative branch. 

    Some opponents argue that congressional term limits fail to curtail political corruption, and may even worsen the problem. They hold that imposing term limits will cause lawmakers to work more closely with lobbyists for two reasons. First, given that term limits will cause a sharp increase in the number of “freshmen” lawmakers with limited legislative experience, critics argue that more politicians will rely more closely on lobbyists and special interest groups to write or recommend laws to “fill [lawmakers’] own informational and policy gaps.” Second, critics warn that term limits will only exacerbate the “revolving door” phenomenon in which retired legislators seek to maintain political influence by securing careers as lobbyists or private sector government affairs consultants. They cite a 2023 study that found that state governments with term limits saw an increase in the frequency of political corruption events. The study observed a “penultimate effect”, where state legislators under a term limitation devoted more of their last term to securing their personal power than to passing policy. Given that the frequency of last terms will increase significantly under term limit policy, opponents worry about an accompanying increase in political corruption. 

    Opponents of term limits also argue that the values of political incumbency in the legislative process are taken for granted. They argue that policymaking is a specialized skill that must be developed over time, highlighting examples of how bills with loopholes and contradictions – the result of unskilled policymaking – harm the American public. They hold that incumbency’s value is its ability to maintain legislative efficiency and institutional knowledge. Given that federal policymaking is a skill that can only be learned on-the-job, critics say incumbency gives lawmakers the opportunity to become the specialized professionals their constituents deserve. They also argue that bipartisan partnerships among lawmakers take years to cultivate, and that term limits would hinder cross-party collaboration. 

    The third core criticism of term limits is that the policy would shift power to the executive and the private sector at the detriment of democracy. As lawmakers are denied longer tenures, opponents argue, lobbyists and staffers become the primary voice of experience in the legislature. Additionally, critics suggest that a decrease in experienced legislators with cross-aisle relationships will further hinder Congress’ ability to efficiently pass legislation, catalyzing an increase in executive orders and other executive branch actions. This will create hurdles to the traditional system of checks and balances. 

    Conclusion 

    The debate over congressional term limits is longstanding and complex. While proponents argue that the policy will increase legislative efficacy, decrease corruption, and represent the will of the people, critics worry that it could have a counteractive effect. As the debate continues, countless questions linger. How much do we value incumbency? How are money and careerism intertwined? Is the legislature representative enough? Is legislative efficiency worth risking? After all of those questions have been asked, there is only one question left: Should Americans be for or against congressional term limits?

  • Pros and Cons of the Patent Eligibility Restoration Act of 2023

    Pros and Cons of the Patent Eligibility Restoration Act of 2023

    Background Information

    Artificial intelligence (AI) is transforming the patent landscape, creating an influx of patent applications that mirrors a rise in modern-day innovation. However, the discussion of patentable inventions under U.S. law lags behind. The Patent Eligibility Restoration Act of 2023 (PERA) aims to address this by reversing court rulings that have narrowed the scope of patent eligibility in emerging fields like AI. Ultimately, PERA stands at the intersection of technology, law, and political ideology, shaping the role of government in maintaining intellectual property (IP).

    Supreme Court decisions in Mayo v. Prometheus and Alice v. CLS are widely recognized as turning points in patent law. The cases, which restricted patent eligibility for abstract ideas and natural laws, marked the first narrowing of patent eligibility since the 1950s. PERA would “eliminate all judicial exceptions” to patent law in an attempt to remedy the confusion caused by the Mayo and Alice rulings. The bill was introduced in the Senate by Senators Thom Tillis (R-NC) and Chris Coons (D-DE) in 2023. Its House companion was introduced by Representatives Scott Peters (D-CA) Kevin Kiley (R-CA) in 2024. While it received bipartisan support and a hearing in the Senate Intellectual Property Subcommittee, PERA ultimately died in committee at the end of the 118th Congress. 

    PERA presents three key advantages: 

    1. Economic and Innovation Benefits: Boosts innovation and economic growth.
    2. International Competitiveness:  Secures U.S. innovation against global competitors.
    3. Expansion of AI and other emerging technologies:  Clarifies AI patent eligibility to strengthen U.S. leadership on the global stage.

    In terms of economic and innovative benefits, the United States Patent and Trademark Office advocates for PERA as a catalyst for innovation. It specifically states that small to medium-sized firms “need clear intellectual property laws that incentivize innovation…[as it’s] critical for job creation, economic prosperity,” in addition to several extended impacts. Furthermore, the American Intellectual Property Law Association (AIPLA), argues that PERA enacts clearer policies that will generate efficient product development and innovation, improving both industry standards and marginal utility for the consumer. Wilson Sonsini, a nonpartisan outlet that conducts the legal analysis, finds that the bill would in fact reverse the stagnation of innovation. In a written testimony submitted to the Senate Subcommittee on Intellectual Property, law professor Adam Mossoff argued that PERA is essential for restoring American dominance in global innovation and patent sectors.

    PERA not only aims to improve U.S. innovation and investment, but also clarifies AI patentability to bolster America’s edge on the global stage. According to Republican Representative Kevin Kiley, the U.S. must expand patentability to compete with China, emphasizing PERA as a key to gaining a competitive edge through clearer patent laws. In an interview with Representative Kiley, the Center for Strategic and International Studies (CSIS) found that China’s approach to intellectual property poses a significant threat to American innovation and prosperity, strengthening the case for PERA. Senator Coons, a PERA co-sponsor, believes that the bill is necessary to help the U.S. catch up to Europe and China in the realm of AI patent law. 

    Other supporters argue that PERA’s expansion of patentability will open the door to advancement in domestic AI technology. A multinational law firm argues that expanding patent eligibility to AI models and business methods is crucial for the development of the U.S. technology industry. By broadening patentability, PERA can reduce the backlog of unsuccessful patents, sparing inventors from having to revalidate their claims. To reinforce this, the global law firm McDermott Will & Emery contends that PERA reduces ambiguity in patent eligibility by defining AI-related patents and human involvement in AI inventions.

    However, while PERA offers significant benefits for innovation, global competitiveness, and emerging technologies, it also raises concerns about potential drawbacks, including the risk of overly broad patents and unintended legal complexities. 

    PERA presents three key disadvantages:

    1. Overbroad Patentability: Risks limiting access to life-saving technologies.
    2. Hurting Small Inventors: Creates an ambiguous legal landscape that only large corporations can afford to navigate.
    3. Ethical and Global Concerns: Conflicts with global patent norms, risking international relations. 

    The NYU Journal of Intellectual Property and Entertainment Law highlights concerns that broadening patent eligibility could negatively impact the life sciences sector by creating barriers between consumers and newly-patented technologies. It argues that PERA undermines the balance between rewards gained from innovation and public accessibility to products they depend on. Another critique from the Center for Innovation Promotion finds that PERA disrupts established legal standards, creating uncertainty in the patent system. Its broad eligibility could stifle innovation by exacerbating patent disruptions instead of encouraging progress and innovation. 

    Other critics worry that PERA could negatively impact small businesses. U.S. Inventor, an inventor’s rights advocacy group, critiques the bill for creating a complex legal landscape that only large corporations can afford to navigate. It argues that PERA lacks definitions for most of its crucial terms will only create more confusion, stating, “Investment into anything that risks falling into PERA’s undefined ineligibility exclusions will be hobbled.”

    PERA also raises ethical concerns, particularly in its treatment of genetic material, which may conflict with international patent standards. According to the NYU Journal of Intellectual Property and Entertainment Law, these discrepancies could lead to tensions between U.S. patent law and global practices, disrupting international collaborations and agreements. The BIOSECURE Report emphasizes PERA’s potential for significant harm to global patent standardization, as countries may struggle to reconcile U.S. policies with their own systems. These challenges could strain international relations, as nations may view PERA’s approach as a threat to their sovereignty and global patent harmony.

    The Status Quo and Future of PERA

    PERA was proposed in a time of heightened awareness and discussion of IP policy. With regard to national security concerns, the Foreign Affairs House Report finds Chinese IP theft against U.S. companies, emphasizing China’s competitive threat in innovation. Similarly, Reuters reports on Tesla’s IP theft case, showcasing ongoing challenges in protecting American technology. These challenges in protecting American innovation set the stage for potential policy shifts under a Trump presidency. According to IP Watchdog, changes in IP law could influence public trust and perceptions of America’s stance on innovation and patent protection. However, as Wolf Greenfield Think Tank notes, broader geopolitical implications, especially regarding competition with China in biotech and AI patents, may not fully align with Trump’s campaign vision. Additionally, Senate Judiciary reports highlight how bipartisan concerns over innovation could shape the future prospects of bills like PERA, with legislative gridlock potentially influencing amendments throughout the current presidential term and beyond. This gridlock could ultimately lead to a slower passing of patent-related legislation.

    Conclusion

    While PERA aims to expand patent eligibility and boost economic growth, critics are wary of overbroad patents, harm to small inventors and businesses, and geopolitical conflicts. Striking a balance between innovation, equity, and competition remains essential to ensuring a patent system that fosters progress without preventing accessibility.