Summary

Amends the federal grant authority at 42 U.S.C. §1397g to require the Secretary to award at least two eligible demonstration grants per State each grant cycle when enough qualifying applicants exist, and to report to Congress about applications, approvals, and how grants were made in States with fewer than two applicants. Changes take effect October 1, 2025.

• Requires at least two eligible demonstration grants per State per grant cycle when enough qualifying applicants exist.
• Applies to the grant authority in 42 U.S.C. §1397g and excludes U.S. territories from the two-per-State rule.
• Requires the Secretary to report each Congress to the House Ways and Means and Senate Finance Committees on applications and approvals and to describe award decisions in States with fewer than two applicants.
• Mandates notification to Congress when fewer than two eligible entities apply in a State for a grant cycle.
• Redesignates existing subsections of §1397g to incorporate the new subsection.
• Effective date for all amendments is October 1, 2025.
• Does not itself appropriate new funds or change applicant eligibility criteria beyond the award and reporting standards.
• Increases administrative workload for the federal agency managing the grants and may shift how limited funds are allocated across States.