Sponsors (3)
The bill provides a targeted, temporary federal match to expand HCBS access and bolster the direct-care workforce—benefiting Medicaid beneficiaries, caregivers, and workers—but raises federal costs, imposes state administrative requirements, and risks that gains will fade when the short-term funding ends.
Medicaid beneficiaries and people with disabilities will get expanded access to home- and community-based services (HCBS) as States receive a 10-percentage-point FMAP boost for FY2026–FY2027 to expand services and reduce waiting lists.
Home health workers and direct support professionals are likely to see higher pay and better benefits because funds must be used to raise reimbursement rates tied to worker compensation, paid leave, hazard/overtime/shift pay, and job stability.
Families, caregivers, and people transitioning from institutions will receive more supports—respite, caregiver pay, supplies, and one-time housing start-up costs—easing returns to the community and reducing caregiver strain.
Medicaid beneficiaries and people with disabilities face a risk that improvements (workforce gains, service expansions) will be difficult to sustain after the two-year FMAP boost ends, potentially causing future service instability.
Taxpayers and the federal budget will bear higher Medicaid outlays during FY2026–FY2027 because of the enhanced FMAP, increasing near-term federal spending.
States will face administrative burden from application, reporting, oversight requirements, and a requirement to obligate or spend funds by Sept 30, 2029, which could divert state Medicaid resources and staff.
Based on analysis of 2 sections of legislative text.
Provides a temporary 10-percentage-point FMAP increase for qualifying Medicaid HCBS spending in FY2026–2027 (95% cap) tied to state applications, spending rules, and workforce/oversight conditions.
Introduced June 17, 2025 by Debbie Dingell · Last progress June 17, 2025
Provides a temporary 10-percentage-point increase in the Federal medical assistance percentage (FMAP) for qualifying states’ Medicaid spending on home and community‑based services (HCBS) for fiscal years 2026 and 2027, with a 95% FMAP cap. States must submit an application to HHS describing planned activities, agree to spending rules (including that federal funds supplement, not supplant, existing state HCBS spending), and meet reporting, oversight, and workforce-related conditions before receiving the enhanced matching funds. Funds must be used on specified HCBS improvements—such as raising reimbursement rates tied to worker compensation, paid leave, hazard/overtime/shift pay, reducing waiting lists under 1115/1915 authorities, and buying emergency supplies (including PPE). The Secretary must certify the completeness of state applications within 90 days; certified applications are treated as approved. All federal funds attributable to the FMAP increase must be spent in accordance with the law by September 30, 2029.