John Joyce

**Optimizing Research Progress Hope And New Cures Act or the ORPHAN Cures Act** This bill modifies certain provisions under the Medicare Drug Price Negotiation Program with respect to orphan drugs. The Medicare Drug Price Negotiation Program requires the Centers for Medicare & Medicaid Services to negotiate the prices of certain prescription drugs under Medicare beginning in 2026. Among other requirements, drugs must have had market approval for at least 7 years (for drug products) or 11 years (for biologics) to qualify for negotiation. The program does not apply to orphan drugs that are approved to treat only one rare disease or condition. The bill modifies these provisions so as to exclude any period in which a drug was an orphan drug from market approval calculations. It also excludes orphan drugs that are approved to treat more than one rare disease or condition from the program.

**DHS Restrictions on Confucius Institutes and Chinese Entities of Concern Act** This bill restricts funding to an institution of higher education (IHE) that has a relationship with a Confucius Institute, Thousand Talents Program, or Chinese entity of concern. The bill defines (1) *Confucius Institute* as a cultural institute funded by the Chinese government; (2) *Thousand Talents Program* as any technological or educational program funded or administered by China's Ministry of Industry and Information Technology; and (3) *Chinese entity of concern* as generally any university or college in China that is involved in China's military, police, or intelligence activities. Specifically, the Department of Homeland Security (DHS) must ensure that an IHE that has awarded a contract to, entered into an agreement with, or received an in-kind donation or gift from a Confucius Institute, Thousand Talents Program, or Chinese entity of concern is ineligible to receive any funds from DHS, unless the IHE terminates the relationship. The IHE may regain eligibility for these funds upon termination of the relationship.

**Medicare Patient Access and Practice Stabilization Act of 2025** This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026.

**Sustainable Cardiopulmonary Rehabilitation Services in the Home Act** This bill permanently allows services relating to cardiac rehabilitation programs, intensive cardiac rehabilitation programs, and pulmonary rehabilitation programs to be furnished via telehealth at a beneficiary's home under Medicare.

**Abortion Is Not Health Care Act of 2025** This bill excludes amounts paid for an abortion from the itemized tax deduction for qualified medical and dental expenses.  Under current law, individuals who itemize their tax deductions may deduct qualified medical and dental expenses to the extent that such expenses exceed 7.5% of the individual’s adjusted gross income for the tax year. Further, under current law, the calculation of the itemized tax deduction for medical and dental expenses may include amounts paid for a legal abortion.

**Main Street Tax Certainty Act** This bill makes permanent the qualified business income (QBI) tax deduction. Under current law, individuals, estates, and trusts may deduct the lower of (1) 20% of QBI from a qualified business, qualified real estate investment trust dividends, and qualified publicly traded partnership income; or (2) 20% of taxable income less net capital gain. (Some limitations apply.) However, under current law, the QBI tax deduction expires after December 31, 2025.

**Whole Milk for Healthy Kids Act of 2025** This bill revises requirements for milk provided by the National School Lunch Program of the Department of Agriculture (USDA). Currently, schools participating in the program must provide milk that is consistent with the most recent Dietary Guidelines for Americans; USDA regulations require milk to be fat-free or low-fat and allow milk to be flavored or unflavored. The bill modifies these restrictions and instead permits schools to offer students whole, reduced-fat, low-fat, and fat-free flavored and unflavored milk. The milk that is offered may be organic or nonorganic. Further, USDA may not prohibit a participating school from offering students any of these milk choices. Further, schools currently must provide a substitute for fluid milk, on receipt of a written statement from a licensed physician, for students whose disability restricts their diet. Under the bill, a parent or legal guardian may also provide the written statement. In addition, schools currently participating in the program must provide meals that meet certain nutrition requirements; USDA regulations require that the average saturated fat content of the meals offered must be less than 10% of the total calories. Under the bill, fluid milk is excluded from the saturated fat content calculation; milk fat included in any fluid milk provided by the program must not be considered saturated fat for the purposes of measuring compliance with USDA regulations. Finally, the bill prohibits schools participating in the program from purchasing or offering milk produced by Chinese state-owned enterprises.

**Broadband and Telecommunications RAIL Act** This bill establishes a framework for the placement or modification of broadband or telecommunications equipment in a railroad corridor. Specifically, if a broadband or telecommunications provider is seeking to place or modify equipment within a railroad carrier’s right-of-way, the provider must submit an application to the carrier. A carrier must approve or deny an application within 60 days of receipt, and may only deny an application for safety reasons or if the placement or modification would substantially interfere with or damage railroad infrastructure. Once an application is approved, work must be scheduled in coordination with the carrier and generally must begin within 30 days. A provider must pay the railroad carrier for actual costs incurred with respect to the application. However, if a provider has been authorized by a state or local government to place or modify equipment in a public right-of-way in an area that intersects with a railroad corridor, the provider need only notify the relevant railroad carrier and schedule the work in coordination with the carrier. Work must generally begin between 15 and 30 days after the notification is submitted. No fee is required. A provider or carrier may petition the Federal Communications Commission (FCC) for relief if the other has failed to comply with these provisions. The FCC must promulgate regulations to implement these provisions in a manner that ensures railroad safety, provides a timelier process for emergency situations, and prevents substantial interference with railroad infrastructure or operations, among other requirements.