Provides temporary extra federal funding to help states expand and improve Medicaid home and community-based services (HCBS). For fiscal years 2026 and 2027, the federal share for qualifying HCBS spending is increased by 10 percentage points (but no higher than 95%), contingent on a state application that describes how the funds will be used. States must meet conditions about permitted uses (such as wage increases for direct care workers, recruitment/retention, expanded services, provider capacity, and infrastructure), follow spending and reporting deadlines, and submit evaluations. The Department of Health and Human Services must review applications, monitor compliance, evaluate results, and share findings with states.
Increase the Federal medical assistance percentage (FMAP) for a qualifying HCBS program State by 10 percentage points for expenditures for home and community-based services provided during fiscal years 2026 and 2027, with a maximum FMAP of 95 percent.
Defines 'HCBS program State' as a State that submits an application required by subsection (b) and has that application approved by the Secretary.
Defines 'home and community-based services' by listing included service types (home health care, behavioral health, personal care, PACE, services under section 1915 subsections, services under section 1115 waivers, and other services the Secretary specifies).
Condition for receiving the FMAP increase: a State must submit an application to the Secretary that includes a description of which activities from subsection (d) the State will implement and how it will implement them.
Assurance that all federal funds attributable to the FMAP increase will be expended by the State in accordance with this section not later than September 30, 2029.
Read twice and referred to the Committee on Finance.
States: Receive higher federal matching funds for Medicaid HCBS for two fiscal years, reducing state Medicaid costs and providing resources to expand services and raise worker pay; must prepare applications, comply with conditions, meet spending deadlines, and produce reports. HCBS providers and direct-care workforce: Likely to receive more funding for wages, benefits, recruitment, training, and capacity-building—improving job conditions and potentially increasing provider supply. Beneficiaries (people receiving HCBS): May see improved access, more service options, and better continuity of care if states allocate funds to expand capacity and quality. Family caregivers: Could receive additional supports if states choose allowed caregiver-support activities. Federal agency (HHS): Increased responsibilities for application review, monitoring, evaluation, and dissemination of results. Fiscal impact: Temporarily raises federal Medicaid outlays relative to baseline for FY2026–2027; state fiscal pressure may be reduced during the period. Administrative burdens: States must track use of enhanced funds and submit evaluations, which increases reporting and compliance workload. Equity and outcomes: If implemented and targeted well, the package can improve workforce stability and beneficiary access, but final impact depends on state choices and the rigor of monitoring and evaluation.
Last progress June 12, 2025 (8 months ago)
Introduced on June 12, 2025 by Ben Ray Luján
Updated 1 week ago
Last progress June 17, 2025 (7 months ago)
