Sponsors (6)
The bill offers a concentrated, short-term federal match to expand HCBS access, strengthen workforce pay/conditions, and improve service quality, but it raises federal Medicaid spending, creates state administrative and implementation challenges, and leaves sustainability uncertain once the temporary boost ends.
Medicaid beneficiaries — especially people with disabilities, older adults, and their families/caregivers — will gain expanded access to home- and community-based services (HCBS) as States receive a 10-percentage-point FMAP boost for FY2026–FY2027, helping reduce waiting lists and fund supports like respite, caregiver pay, supplies, and one-time housing start-up costs.
Home health workers and direct support professionals are likely to see higher wages, better benefits, and improved job stability because States must use increased match to raise reimbursement rates tied to worker compensation, paid leave, hazard/overtime/shift pay, and other workforce supports.
States can use funds to strengthen HCBS infrastructure (training, assistive technology, interpreters, PPE, outreach), which can improve service quality, accessibility, and safety for beneficiaries and providers.
Because the enhanced FMAP lasts only two fiscal years, improvements to workforce, services, and capacity may be difficult to sustain after FY2027, risking renewed waiting lists or service cutbacks for beneficiaries.
Federal outlays for Medicaid will rise during FY2026–FY2027, increasing costs for taxpayers and adding near-term pressure to the federal budget.
Rules requiring that funds only supplement existing HCBS spending and specific allowable uses may limit state flexibility and make it harder for some states to convert the temporary match into durable wage and benefit improvements for workers.
Based on analysis of 2 sections of legislative text.
Temporarily raises the federal Medicaid match by 10 percentage points for qualifying HCBS spending in FY2026–FY2027 (capped at 95%) and requires State plans to use funds for HCBS improvements.
Official title: To provide for an emergency increase in Federal funding to State Medicaid programs for expenditures on home and community-based services.
Introduced June 17, 2025 by Debbie Dingell · Last progress June 17, 2025
Provides a temporary 10 percentage point increase in the federal Medicaid matching rate (FMAP) for states’ home- and community-based services (HCBS) spending for fiscal years 2026 and 2027, capped at 95% FMAP. States must apply to HHS for the enhanced match, agree to spending rules, and use funds to expand and improve HCBS, including higher rates to support workforce recruitment and retention, paid leave, hazard/shift/overtime pay, purchasing emergency supplies, and reducing waiting lists. Funds must supplement, not supplant, existing HCBS spending and be spent by September 30, 2029.