Sponsor
Andy Kim
Senator · D-NJ
Senator · D-NJ
The bill extends a limited Medicare in‑home personal care benefit and raises worker standards and pay to expand access and improve quality, but it caps hours, increases program costs and premiums, and creates administrative and coverage gaps that could leave high‑need and low‑income beneficiaries shortchanged.
Medicare beneficiaries (seniors and people with disabilities) would gain a new Medicare-funded in‑home personal care benefit for daily living needs, increasing access to paid home care so more people can remain at home instead of relying on private pay or institutional care.
Medicare beneficiaries and patients would receive better clinical oversight and higher care quality because services require a physician/authorized practitioner plan of care and workers/agencies must meet federal qualifications and enrollment standards.
Home care workers would get higher and more stable pay due to a required payment method with a reasonable wage floor, improving worker earnings and potentially reducing turnover.
Medicare beneficiaries with high care needs would be limited to 20 hours/week of covered home care, which is likely insufficient for many and could leave significant unmet daily‑living and medical needs.
Expanding Medicare to cover a new home care benefit and instituting wage floors will increase Medicare spending, which could raise program costs borne by taxpayers or lead to higher premiums/taxes.
Monthly Part B premiums could rise to fund the benefit, putting additional out‑of‑pocket costs on Medicare enrollees and especially straining low‑income beneficiaries who are not eligible for full subsidies.
Based on analysis of 7 sections of legislative text.
Creates a Medicare Part B "home care services" benefit covering up to 20 hours/week of in‑home ADL/IADL assistance, sets eligibility and payment rules, and adjusts Part B premiums.
Official title: Amend title XVIII of the Social Security Act to establish a Medicare home care benefit, and for other purposes.
Introduced August 5, 2026 by Andy Kim · Last progress August 5, 2026
Creates a new Medicare Part B benefit called "home care services" that pays for personal in‑home assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The benefit is limited to eligible Medicare enrollees who are certified as needing help with at least two ADLs or two IADLs (or one of each), is capped at 20 hours per week, and must be furnished under a physician‑established plan of care. Requires the HHS Secretary to set a payment methodology (including a wage floor for home care workers), directs CMS to estimate and adjust the Part B premium to reflect the new benefit’s cost, directs HHS to write implementing regulations within one year, and delays the benefit’s start until a plan year beginning more than two years after enactment.