The Government Relations Update for October 2024 covers various initiatives and advocacy efforts by the National Bleeding Disorders Foundation at both the federal and state levels. Grassroots advocacy efforts have been launched through "Voices for Policy Change" to highlight key issues such as the importance of Hemophilia Treatment Centers. Federal efforts include pushing for the issuance of a proposed rule to protect patients from copay maximizers and advocating for enhanced advance premium tax credits under the Affordable Care Act. Additionally, comments have been submitted regarding the U.S. Pharmacopeia classification of drugs for bleeding disorders. State-level advocacy efforts are also highlighted, with various initiatives in New Jersey, New York, North Dakota, and Pennsylvania. Various state chapter advocacy days are scheduled for 2025 to address bleeding disorders issues at the local level. The update emphasizes the importance of civic engagement, including voting in the upcoming November elections to make your voice heard.