Sponsors (2)
The bill restores prior Section 1115 waiver rules and reduces a targeted appropriation—increasing administrative clarity and lowering federal outlays, but removing funds that could support Medicaid demonstrations and providers and potentially reducing flexibility and coverage for beneficiaries.
State governments, HHS administrators, and Medicaid beneficiaries: Restores the pre-119–21 interpretation of Section 1115 waiver budget-neutrality rules and removes the special statutory modification, returning waiver authority to longstanding law and simplifying administration and predictability for state demonstrations.
Taxpayers and the federal budget: Rescinds the specific appropriated amounts under §71118(b), reducing previously earmarked federal outlays.
State governments and demonstration participants: Eliminates the funding created by §71118(b), which could reduce resources available for Section 1115 demonstration activities and weaken state program capacity.
Medicaid beneficiaries: Reverting waiver budget-neutrality rules to prior law could limit flexibility or change coverage and benefit arrangements that had relied on the §71118 modification.
Hospitals and providers: Loss of the appropriated funds may reduce financial support tied to demonstrations, potentially increasing uncompensated care and administrative strain on providers.
Based on analysis of 2 sections of legislative text.
Repeals a recent amendment to 42 U.S.C. §1315 and rescinds its appropriations, restoring prior-law application of Medicaid section 1115 waivers and removing the related funding.
Official title: To amend Public Law 119-21 to repeal the budget neutrality requirement for certain Medicaid demonstration projects.
Introduced April 9, 2026 by Brittany Pettersen · Last progress April 9, 2026
Repeals a recently added provision to 42 U.S.C. §1315 that changed how Medicaid demonstration (section 1115) waivers operate and that included a specific appropriation tied to that change. The bill directs that section 1115 be applied as if the repealed provision had never been enacted and rescinds the amounts previously appropriated under the repealed provision. The immediate effect is to restore the prior statutory treatment of Medicaid 1115 waivers and remove the one-time funding that had been provided by the repealed provision. That affects federal budget entries and how the Centers for Medicare & Medicaid Services (CMS) and states handle waiver budget-neutrality and related administrative practices established by the earlier law.