# 119-hr-8540: HCBS Access Act

119-hr-8540, HCBS Access Act, is a 119th Congress bill sponsored by Rep. Dingell, Debbie [D-MI-6] (D-MI); status introduced; PRIA reads it as touching household money (as of 2026-10-31).

- Canonical: https://policyrisk.com/legislation/119-hr-8540
- As of: 2026-10-31
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-8540
- Congress: 119
- Title: HCBS Access Act
- Status: introduced
- Introduced: 2026-04-28
- Sponsor: Rep. Dingell, Debbie [D-MI-6] (D-MI)
- Cosponsors: 21
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-31

## Summary

**Designates home- and community-based services (HCBS) as a mandatory Medicaid benefit.** This bill would expand who can get HCBS, set national quality and workforce standards, and fund grants and technical help to grow community care and support family caregivers. - Families and people with disabilities would gain broader access to HCBS through higher income limits — up to 150% of the poverty line or 300% of the Supplemental Security Income rate — plus retroactive eligibility for services. - Direct care workers and family caregivers would get training, career pathways, and supports via a national technical assistance center and grant programs, addressing roughly 3.2 million direct care workers and about 63 million unpaid caregivers. - States and providers must submit implementation plans to meet access and workforce rules to qualify for a 100% federal match for HCBS, and the bill authorizes major funding including a $1.0 billion grant program. *This bill would increase federal spending through specified appropriations and by expanding federal Medicaid matching for HCBS.*

## Cosponsors (21)

- Rep. Cleaver, Emanuel [D-MO-5] (D-MO), 2026-10-01T00:00:00.000Z
- Rep. Cisneros, Gilbert Ray [D-CA-31] (D-CA), 2026-10-05T00:00:00.000Z
- Rep. Menefee, Christian D. [D-TX-18] (D-TX), 2026-10-09T00:00:00.000Z
- Rep. McBride, Sarah [D-DE-At Large] (D-DE), 2026-10-15T00:00:00.000Z
- Rep. Williams, Nikema [D-GA-5] (D-GA), 2026-10-29T00:00:00.000Z
- Rep. Deluzio, Christopher R. [D-PA-17] (D-PA), 2026-10-26T00:00:00.000Z
- Rep. Schakowsky, Janice D. [D-IL-9] (D-IL), 2026-04-28T00:00:00.000Z
- Rep. Simon, Lateefah [D-CA-12] (D-CA), 2026-05-11T00:00:00.000Z
- Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC), 2026-05-12T00:00:00.000Z
- Rep. Davis, Danny K. [D-IL-7] (D-IL), 2026-05-13T00:00:00.000Z
- Rep. Larson, John B. [D-CT-1] (D-CT), 2026-05-13T00:00:00.000Z
- Rep. García, Jesús G. "Chuy" [D-IL-4] (D-IL), 2026-05-14T00:00:00.000Z
- Rep. Grijalva, Adelita S. [D-AZ-7] (D-AZ), 2026-06-02T00:00:00.000Z
- Rep. Waters, Maxine [D-CA-43] (D-CA), 2026-07-06T00:00:00.000Z
- Rep. Barragán, Nanette Diaz [D-CA-44] (D-CA), 2026-07-20T00:00:00.000Z
- Rep. Jackson, Jonathan L. [D-IL-1] (D-IL), 2026-07-20T00:00:00.000Z
- Rep. Ansari, Yassamin [D-AZ-3] (D-AZ), 2026-07-27T00:00:00.000Z
- Rep. Moore, Gwen [D-WI-4] (D-WI), 2026-07-27T00:00:00.000Z
- Rep. Casar, Greg [D-TX-35] (D-TX), 2026-07-27T00:00:00.000Z
- Rep. Pocan, Mark [D-WI-2] (D-WI), 2026-08-17T00:00:00.000Z
- Rep. Balint, Becca [D-VT-At Large] (D-VT), 2026-09-14T00:00:00.000Z

## Provisions PRIA read

- Big federal match for HCBS: benefit, high. The bill would set a 100% federal match for qualifying HCBS spending when a State meets detailed access and workforce conditions (like no-wrong-door, presumptive eligibility, rate reviews at least every two years, and pass-throughs to direct care workers). It would give an 80% federal match for HCB…
- Who qualifies for Medicaid HCBS: benefit, high. The bill would make home and community services a required Medicaid benefit starting the first calendar quarter five years after enactment (States may start earlier). You would qualify if you meet the HCBS functional standard and your income is at or below the greater of 150% of poverty or 300% of…
- More funding for care workers: benefit, high. The bill would create a national technical assistance center and a large grant program to grow the direct care workforce and support family caregivers. It authorizes $200 million for FY2026 for state metric work, two $10 million FY2026 amounts for measure work, $1 billion for grants in FY2029, and…
- Help for people leaving institutions: benefit, medium. The bill would make the Money Follows the Person rebalancing demonstration ongoing after 2025 instead of ending in 2027. This would continue federal support for people who move from institutional settings into community living and for States running the demonstration.
- Wider Medicare financing options for states: benefit, low. The bill would broaden Medicare cross-references to allow financing or administration under additional State authorities, such as certain waivers or State plan amendments. This would give States more flexibility in how Medicare-related HCBS costs are financed or administered.
- Separate job code for care workers: benefit, low. The bill would direct the Office of Management and Budget to consider creating a separate occupational code for direct support professionals in the next code revision. If OMB decides not to create the code, it would have to explain the decision to Congress within 30 days after announcing it.
- New provider-tax rules for HCBS: mixed, low. The bill would add home and community services as a specific class for Medicaid provider-tax rules. States could change how they design provider taxes for HCBS providers. The bill itself would not directly raise household taxes or set tax rates.

## Related bills

- 119-hr-7973: Momnibus Act
- 119-hr-51: Washington, D.C. Admission Act
- 119-hr-20: Richard L. Trumka Protecting the Right to Organize Act of 2025
- 119-hr-5390: FAMILY Act
- 119-hr-15: Equality Act
- 119-hr-2743: Raise the Wage Act of 2025

## Sources
- [119-hr-8540 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/8540)

## Related
- [119-hr-7973: Momnibus Act](https://policyrisk.com/legislation/119-hr-7973)
- [119-hr-51: Washington, D.C. Admission Act](https://policyrisk.com/legislation/119-hr-51)
- [119-hr-20: Richard L. Trumka Protecting the Right to Organize Act of 2025](https://policyrisk.com/legislation/119-hr-20)
- [119-hr-5390: FAMILY Act](https://policyrisk.com/legislation/119-hr-5390)
- [119-hr-15: Equality Act](https://policyrisk.com/legislation/119-hr-15)
- [119-hr-2743: Raise the Wage Act of 2025](https://policyrisk.com/legislation/119-hr-2743)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-8540 (as of 2026-10-31).