Patty Murray

Mamas First Act

This bill requires state Medicaid programs to cover services furnished by doulas, midwives, and lactation support providers, including prenatal, delivery, and postpartum services, in a variety of settings.

This bill prohibits the Department of Defense (DOD) from excluding an individual from military positions or assignments based on gender. It also limits changes to DOD occupational performance standards that address gender neutrality.

First, the bill prohibits the exclusion of members of the Armed Forces from an occupational specialty, career field, or assignment on the basis of gender.

Next, it prohibits DOD from changing an occupational performance standard to increase or decrease the number of individuals in a career field on the basis of gender. (Currently, this prohibition only applies to increasing or decreasing the number of women.)

DOD must also apply occupational standards related to technical, tactical, cognitive, or physical abilities on a gender-neutral basis for positions that require such standards and must determine any such standards after a rigorous scientific process.

In situations where DOD establishes or revises a physical requirement for a military position, a member serving satisfactorily in such a position must be provided at least 18 months to meet the new standard.

Finally, DOD must notify Congress of any proposed changes to the gender-neutral occupational standards for a military position that may result in at least a 10% change in the number of members of any gender who are assigned to or enter that position. (Currently, such notice is required only with respect to a change in the number of female members.) DOD must provide the congressional defense committees with a report on the proposed change, estimated costs, and justification for the change.

This joint resolution prohibits the Centers for Medicare & Medicaid Services (CMS) from testing a new Medicare payment model in certain states that involves a prior authorization process and the use of enhanced technology by third-party contractors to determine whether certain claims should be paid.

Specifically, the joint resolution nullifies a notice issued by the CMS on July 1, 2025, titled Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model. (On May 12, 2026, the Government Accountability Office issued a letter of opinion stating that this notice constituted an agency rule and is therefore subject to the Congressional Review Act.)

The CMS selected six states to participate in this model over a six-year period: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Under the model, contracted companies must process prior authorization requests (i.e., requests for coverage determinations before a service is furnished) for certain services using enhanced technology (e.g., artificial intelligence). Contracted companies are paid based on the share of resulting savings. The CMS aims to test the model's ability to produce accurate results while streamlining the prior authorization process for Medicare claims. The model is based in part on similar processes used for Medicare Advantage claims.

CMS began implementing the model on January 1, 2026. This joint resolution prohibits the CMS from continuing to do so.