Adrian Smith

More Homes on the Market Act

This bill increases the amount of gain from the sale of a principal residence that an individual may exclude from gross income (for federal tax purposes).

Under the bill, an individual may exclude from gross income gain from the sale of a principal residence of up to $500,000 (currently $250,000), and taxpayers who are married and file a joint federal income tax return may exclude up to $1 million (currently $500.000). The bill also requires these amounts to be adjusted annually for inflation.

Rebuild America’s Health Care Schools Act of 2025

This bill allows hospitals to receive reimbursement under Medicare for certain costs associated with training nursing and allied health students in settings other than the hospital itself.

Currently, hospitals may receive reimbursement under Medicare for the reasonable costs associated with training nursing and allied health students if certain conditions are met; the criteria vary depending on whether the students are enrolled in an educational program that is operated by the hospital or another entity. If the students are part of a program that is operated by another entity, the training must occur at the hospital itself or in areas immediately surrounding the hospital in order to qualify for reimbursement (among other requirements). The bill allows hospitals to receive reimbursement for these costs if the training is conducted at an entity that is related to the hospital (i.e., common ownership or control).

The bill requires the Centers for Medicare & Medicaid Services (CMS) to update regulations to reflect these changes. Additionally, the CMS may not recoup or reduce payments to hospitals with respect to costs that are allowed under the bill and must refund any such recoupments or reductions that occurred during the six-year period prior to the bill's enactment.

Maintaining Investments in New Innovation Act

This bill requires drug products with genetically targeted technology to have had market approval for at least 11 years in order to qualify for the Medicare Drug Price Negotiation Program. (The 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.)

Countering Threats and Attacks on Our Judges Act

This bill allows funds awarded by the State Justice Institute to be used to establish, implement, and operate a judicial threat and intelligence resource center. The State Justice Institute is a private, nonprofit corporation established by federal law to support and improve the administration of justice in state courts.

Rural Community Hospital Demonstration Program Reauthorization

This bill extends the Rural Community Hospital Demonstration Program for an additional five years. The program tests the feasibility of cost-based reimbursement under Medicare for small rural hospitals that are too large to qualify for special payment as critical access hospitals.

The bill specifies that hospitals that participate in the program between December 30, 2024, and January 1, 2027, may continue to participate during the five-year extension period.

Preventing Waste, Fraud, and Abuse in TANF Act

This bill limits how and when states may use Temporary Assistance for Needy Families (TANF) funds and establishes an eligibility threshold for all TANF-funded assistance and services.

Currently, each state sets its own eligibility threshold for TANF-funded cash assistance. The bill establishes an upper limit on eligibility applicable to all assistance and services (including non-cash benefits) funded by TANF family assistance grants. Under this provision, only families with income under 200% of the federal poverty guidelines may receive TANF-funded assistance and services.

Further, the bill generally requires states to obligate TANF funds by the end of the fiscal year after they are paid and to spend funds by the end of the second fiscal year after they are paid. However, states may reserve a specified portion of their TANF funds for future use. (There is currently no requirement to use TANF funds within a specified period.)

The bill also explicitly requires states to use federal TANF funds to supplement, not replace, state and local funding for TANF-supported programs. (Current law requires states to spend a specified minimum amount on TANF-eligible activities and populations, known as the maintenance of effort requirement.)

States must also take specified steps to track and report on improper payments of federal funds (e.g., overpayments, underpayments, payments to ineligible recipients). Within one year of enactment, HHS must submit to Congress a plan to reduce or eliminate improper payments made by states under the TANF program within 10 years.

Title IX Clarification Act of 2026

This bill defines the terms sex, female, and male for purposes of Title IX of the Education Amendments of 1972. Title IX prohibits discrimination on the basis of sex in education programs that receive federal financial assistance.

Specifically, the bill defines sex as an individual’s biologically determined sex, as either male or female. Therefore, Title IX's prohibition on sex discrimination only applies to biological sex under the bill.

The bill defines female, when used with respect to a natural person, as an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes the large gamete (ova) for fertilization.

The bill defines male, when used with respect to a natural person, as an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes the small gamete (sperm) for fertilization.

(A January 20, 2025, executive order stated that it is the policy of the United States to recognize two sexes—male and female—which are not changeable. On February 4, 2025, the Department of Education announced its intent to enforce its Title IX regulations consistent with this executive order. For more information on the status of these regulations, see LBS11279.)

Apples to Apples Comparison Act of 2025

This bill requires additional reporting and disclosures regarding Medicare enrollment and expenditures.

Specifically, the bill requires the Centers for Medicare & Medicaid Services to annually report on and publish information on its website regarding expenditures for Medicare hospital services and medical services, the Medicare prescription drug benefit, and Medicare Advantage (MA), including for those who are enrolled in one program but not others or have supplemental insurance. This information must be broken down by county and metropolitan statistical area for each month over the prior 10-year period and for each month over the next 5-year period.

In addition, the Medicare Payment Advisory Commission must annually analyze and report on expenditures for Medicare beneficiaries who have an MA plan compared to those who do not have an MA plan. The Boards of Trustees for Medicare must annually report on expenditures for (1) Medicare beneficiaries who have either hospital services or medical services but not both, and (2) Medicare beneficiaries who have both hospital and medical services but do not have an MA plan.

Debt Solution and Accountability Act

This bill requires the Department of the Treasury to submit to Congress a debt report and a statement of intent on (1) any date on which the debt subject to limit reaches 99.5% of the federal debt limit, and (2) the date that is one month before the expiration of a suspension of the debt limit.

The debt report must include

• the historical levels of the debt, current amount and composition of the debt, and future projections of the debt;

• the drivers and composition of future debt; and

• how the United States will meet debt obligations.

The statement of intent must include a detailed explanation of

• proposals of the President to reduce or slow the growth of the debt,

• the impact of increasing the debt limit and of leaving the debt limit unchanged, and

• projections of the fiscal health and sustainability of major direct-spending entitlement programs (including Social Security, Medicare, and Medicaid).

Within 180 days after the effective date of an increase in or suspension of the debt limit, Treasury must submit to Congress a detailed report on the progress of implementing the President's proposals to reduce or slow the growth of the debt.

Treasury must make the information required by this bill available to the public on its website.

Upon request, Treasury must submit to Congress specified financial and economic data relevant to determining the amount of the public debt.

This resolution expresses support for the designation of a National Day of Awareness for Missing and Murdered Indigenous Women and Girls.

This resolution expresses support for police officers and other law enforcement personnel.

The resolution further recognizes

• law enforcement officers across the United States in the pursuit of preserving safe and secure communities;

• the need to ensure that such officers have the equipment, training, and resources necessary to protect their health and safety while they are protecting the public; and

• the law enforcement community for acts of sacrifice and heroism.

The resolution expresses condolences and appreciation to the loved ones of each law enforcement officer who has made the ultimate sacrifice in the line of duty.