Helping Communities with Better Support Act
Sponsored By: Senator Eric Schmitt
Introduced
Summary
Expand transparency and access to Medicaid home and community-based services. This bill would create a new waiver pathway in the Medicaid statute (section 1915(c)) to let states cover part or all of home and community-based services as medical assistance for certain people with disabilities, and it would require yearly public reporting plus rules for interim coverage while written care plans are finalized.
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- Families and caregivers: Could get faster access to needed supports because the Department of Health and Human Services must issue guidance by January 1, 2026 allowing up to 60 days of interim HCBS coverage from eligibility determination until a written plan of care is finalized.
- People with disabilities and applicants: People who meet the Americans with Disabilities Act or Section 504 disability definitions but do not have a prior 1915(c)(1) determination could be served under the new waiver. Payments must be tied to a written plan of care and exclude room and board.
- States and oversight: States must demonstrate the waiver will not materially increase average wait times, provide estimates of how many people will be served, and describe service differences. Starting January 1, 2028, CMS must post annual data on waitlist management, average time from approval to service start, and the share of authorized HCBS hours actually furnished.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
More Medicaid home care help
If enacted, the bill would let states ask CMS to pay for some home and community services as medical assistance for more people with disabilities. Room and board would still be excluded. The new coverage would only apply to people who meet the ADA or section 504 disability definitions and who do not already have the usual waiver eligibility determination. States must show the change will not materially increase average wait times and must give estimates of how many people and what services would be provided. You would only get these services if your state applies and the Secretary approves the waiver.
Public reporting on home care access
If enacted, the bill would make states report certain HCBS waiver data at least once a year. Beginning January 1, 2028, CMS would post specified data on its website. Required items include how states keep and screen waitlists, average wait times for approved people, average time from approval to service start, and the percent of authorized HCBS hours actually provided. The rule also requires service-specific metrics for homemaker, home health aide, and personal care services for the most recent year.
Short interim home care coverage
If enacted, the bill would require HHS to issue guidance by January 1, 2026 on interim HCBS. The guidance would let states with active waivers provide up to 60 days of interim home care under a temporary plan. The interim period would start when your eligibility is decided and end when your written plan of care is finalized. This could reduce short gaps and out-of-pocket costs while plans are completed.
Sponsors & CoSponsors
Sponsor
Eric Schmitt
MO • R
Cosponsors
Dan Sullivan
AK • R
Sponsored 6/30/2025
Roll Call Votes
No roll call votes available for this bill.
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