Six Good Things Congress Should Do Before December 31

Even so, before the shutdown began, Republicans and Democrats in both chambers worked together to advance several common‑sense policy measures with the potential to improve the lives of millions across red and blue districts alike. We highlight six such proposals below. Each enjoys bipartisan, bicameral support and a credible pathway to enactment before year’s end.

Proposals Include

1. Medically Tailored Home-Delivered Meals Program Pilot Act.
2. Renewing Opportunity in the American Dream (ROAD) to Housing Act of 2025.
3. Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act.
4. Long-Term Funding for Teaching Health Centers Graduate Medical Education Program.
5. Fairness for Servicemembers and Their Families Act of 2025.
6. Public Health and Bio-Preparedness Workforce Loan Repayment Reauthorization Act of 2025.

Medically Tailored Home-Delivered Meals Program Pilot Act

The Medically Tailored Home-Delivered Meals Program Pilot Act (S. 2834/H.R. 5439) stands out as a uniquely bipartisan “food is medicine” initiative with momentum in both chambers and both parties. This legislative proposal would expand access to medically tailored meals (MTMs) by creating a pilot program to address the link between diet, chronic diseases, and the health of Medicare enrollees and people with disabilities. Specifically, the bill directs the Centers for Medicare & Medicaid Services (CMS) to run a cost-neutral, six-year demonstration program in which designated hospitals provide medically tailored, home-delivered meals paired with nutrition services to eligible Medicare beneficiaries following hospital discharge. 

The pilot MTM program is structured to operate across a variety of regions, including rural and medically underserved areas, and to rely on experienced providers that meet evidence-based nutrition standards. Hospitals must meet quality and program integrity thresholds to participate, and the US Department of Health and Human Services is required to conduct rigorous evaluations and to report on utilization, readmissions, skilled nursing facility admissions, patient satisfaction, clinical outcomes, and net Medicare spending. The bill creates budget neutrality by offsetting the revenue that hospitals receive for each MTM pilot participant with an equivalent reduction in the amount of per-patient discharge fees from CMS. Most importantly, if enacted, this pilot program will ensure that medically vulnerable seniors and people with disabilities can access nutritionally specific meals to help manage chronic health conditions while also providing invaluable data to further build a resilient and cost-effective health care system.

The legislation builds on momentum from the 118th Congress, when companion House and Senate bills were introduced, and the House Ways and Means Committee unanimously advanced the proposal following its inclusion in H.R. 6780, the American Medical Innovation and Investment Act. In the 119th Congress, S. 2834/H.R. 5439 again features bipartisan sponsorship and bicameral support, reflecting the growing consensus that medically tailored meals can reduce hospitalizations and emergency department visits and lower net health care costs for high-need patients. Sponsors of the companion MTM pilot program bills include Reps. Jim McGovern (D‑MA), Nicole Malliotakis (R‑NY), Chellie Pingree (D‑ME), Brian Fitzpatrick (R‑PA), and Dwight Evans (D‑PA), in addition to Sens. Cory Booker (D-NJ), Roger Marshall (R-KS), Bill Cassidy (R-LA), and Tina Smith (D-MN).

Renewing Opportunity in the American Dream (ROAD) to Housing Act of 2025

This expansive housing package (S. 2296, Division I) includes proposals from every member of the Senate Committee on Banking, Housing, and Urban Affairs. With some 40 measures grouped under seven subtitles, the legislation’s broad aims are to improve Americans’ financial literacy, to expand and preserve housing supply, to improve housing affordability, and to increase oversight and efficiency of federal regulators and housing programs.

Notable provisions of this legislation would establish a pilot program to offer grants or forgivable loans to low- and moderate-income homeowners and small landlords for home repair needs and health hazards. Another pilot program would help communities convert vacant and abandoned buildings into affordable housing.

The legislation includes several provisions aimed at increasing the housing supply. One such section would provide flexible funding to help communities improve infrastructure, construct housing, and supplement water and sewer grants. Another provision would increase the Public Welfare Investment cap to enhance banks’ capacity to support affordable housing. And the US Department of Housing and Urban Development (HUD) would be directed to undertake a comprehensive study of factory-built housing as a solution to housing shortages.

The bill seeks to ensure veterans are made aware of their home loan benefits through the US Department of Veterans Affairs (VA). It would expand access to financing for many potential borrowers by updating Federal Housing Administration (FHA) mortgage lending limits for manufactured housing. It also would require the FHA to study loan limits for FHA multifamily mortgage insurance programs and authorize HUD to adjust those limits to better align with housing market costs.

To help tackle homelessness, the bill would improve coordination between local health care systems, law enforcement, veterans’ programs, and job training services to reduce repeat homelessness and justice system involvement. It would also remove unnecessary federal barriers to individuals’ access to housing and support services and reduce federal red tape that hinders prompt, effective local responses.

The ROAD to Housing Act passed the Senate Banking Committee in July with a unanimous 24-0 vote in what has been reported as the first bipartisan housing markup in over a decade. The legislation was subsequently approved by voice vote for inclusion in the 2026 National Defense Authorization Act (NDAA), which the full Senate approved on October 9. The House and Senate Armed Services Committees are working to resolve differences between the two chambers’ approved versions of the NDAA, and if the House agrees to keep it in the NDAA, this legislation could see Floor consideration before Thanksgiving.

Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act

The Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act (H.R.842/S.339) has the potential to dramatically improve cancer detection, treatment, and outcomes for millions of older Americans who have the highest risk and incidence of cancer. Early detection allows for broader treatment options and increases the chances of better outcomes.

The Nancy Gardner Sewell Act would allow Medicare to pay for US Food and Drug Administration-approved multi-cancer early detection screening tests beginning in 2028 if CMS determines such coverage is appropriate. Under the current version of the House bill, starting in 2029, Medicare beneficiaries aged 65 will be able to access these tests as a covered benefit and each year, the age of Medicare beneficiaries who qualify for the benefit will go up by one year. Coverage would be limited to one test every 11 months. Some younger Medicare beneficiaries would get this benefit under the House bill. (The Senate bill as introduced would start one year earlier and would cover the tests for a slightly broader group of Medicare beneficiaries.)

The House Ways and Means Committee unanimously approved the Nancy Gardner Sewell bill on September 17, and the legislation’s impressive bipartisan, bicameral support — 342 cosponsors in the House and 66 in the Senate — suggests it could be included in a year-end health care package.

Long-Term Funding for Teaching Health Centers Graduate Medical Education Program

Another health care legislative priority deserving Congressional attention as part of a year-end health care policy package is legislation providing long-term funding for the Teaching Health Centers Graduate Medical Education program, which helps cover the costs of medical residency programs in community-based settings in rural and urban areas. A coalition of Teaching Health Centers (THCs) and stakeholder associations led by the American Association of Teaching Health Centers (AATHC) has proposed an appropriation of $2.1 billion over a five-year period, an amount higher than the current baseline but necessary for the growing needs of the program.

This legislation is vital because the United States faces a doctor shortage, with up to 124,000 primary health care physicians needed by 2034. The THC program has over a decade of bipartisan support and is the only federal program investing in the training of future physicians in community settings rather than hospitals. The funding level proposed by the AATHC and its coalition would cover the rising costs associated with medical training in the more than 80 existing THCs, would initiate funding of more than 50 health centers as approved by the Health Resources and Services Administration contingent on new federal appropriations from Congress, and would fund a number of other health care organizations that are nearly ready to begin residency programs. 

A multi-year reauthorization is warranted this year because THCs have demonstrated success, with 86% of program residents becoming primary care physicians, compared to 23% in general medical residency programs. Likewise, 31% of THCs are in rural communities, compared to just 5% of general residency programs. Funding this program is essential to meeting the health care needs of American families.

Fairness for Servicemembers and Their Families Act of 2025

The Fairness for Servicemembers and Their Families Act (H.R.970/S.385) is intended to strengthen the financial safety net for servicemembers, veterans, and their families by ensuring that their life insurance benefits keep up with inflation and the cost of living. Because the maximum coverage available remained unchanged from 2006 to 2023, lagging far behind inflation, this bill would require the VA to review maximum coverage amounts compared to changes in the consumer price index every five years. The results of the review must be provided to Congress and could be used to inform decisions about appropriate increases in available coverage.

Lead sponsors of the Act include Senators John Cornyn (R-TX), Maggie Hassan (D-NH), Ted Cruz (R-TX), and Angus King (I-ME), and Representatives Marilyn Strickland (WA-10) and Keith Self (TX-03). The House approved its version of this legislation by voice vote under suspension of the rules in April. The bill was received in the Senate on April 8 and is pending before the Committee on Veterans Affairs.

Public Health and Bio-Preparedness Workforce Loan Repayment Reauthorization Act of 2025

This bipartisan legislation (H.R.4445) is designed to stabilize and expand the nation’s infectious diseases (ID) and emergency preparedness workforce by alleviating education debt burdens that deter public health professionals from ID careers in underserved areas. The legislation creates a sustainable talent pipeline to meet ongoing and emergent bio-preparedness needs across regions and care settings.

ID specialists play a critical role in caring for patients with HIV and many other infectious diseases. They respond to pandemics and outbreaks and treat infections associated with other health care settings, such as cancer care. Unfortunately, ID physicians are increasingly difficult to find — roughly 80% of US counties have no ID physicians. The ID physician shortage is especially common in underserved areas, leaving many people with serious infections without ID care.

The Public Health and Bio-Preparedness Workforce Loan Repayment Reauthorization Act, introduced by Reps. Jason Crow (D-CO), Mariannette Miller-Meeks (R-IA), Lori Trahan (D-MA), and Brian Fitzpatrick (R-PA), would reauthorize the existing program addressing ongoing and emergent bio-preparedness needs across regions and care settings with loan repayment opportunities for professionals in public health, IDs, HIV, and emergency preparedness who commit to serving in Health Professional Shortage Areas, medically underserved communities, federal health facilities (e.g., VA, community health centers), or Ryan White-funded clinics.

By reauthorizing the Bio‑Preparedness Workforce Loan Repayment Program, Congress can address physician shortages in communities with the greatest unmet need, improve patient outcomes in ID and HIV care through earlier diagnosis and treatment, and curb avoidable downstream costs by strengthening prevention and outbreak response capacity.

ArentFox Schiff has been proud to advocate for several of these measures on behalf of our clients.