# 119-hr-936: Medicaid Improvement and State Flexibility Act of 2025

119-hr-936, Medicaid Improvement and State Flexibility Act of 2025, is a 119th Congress bill sponsored by Rep. Green, Mark E. [R-TN-7] (R-TN); status introduced; PRIA reads it as touching household money (as of 2025-12-21).

- Canonical: https://policyrisk.com/legislation/119-hr-936
- As of: 2025-12-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-936
- Congress: 119
- Title: Medicaid Improvement and State Flexibility Act of 2025
- Status: introduced
- Introduced: 2025-02-04
- Sponsor: Rep. Green, Mark E. [R-TN-7] (R-TN)
- Cosponsors: 1
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2025-12-21

## Summary

**Creates a new state-run Medicaid pilot that gives enrollees an EBT card for primary care, pays out unused balances as cash, and pairs that with catastrophic insurance.** The bill would add a new Section 1115 pathway letting states approve and run these targeted demonstrations. - Families and enrollees: People who opt in would get a state-set EBT card to buy primary care and medications. Any money left at year end would be paid to them in cash and participants must also be enrolled in catastrophic health insurance. - States: States would be able to approve or renew these demonstrations and would be treated as the approving authority. They must design projects so federal Title XIX spending during the project is no higher than it would have been without the project. - Reproductive health: Projects could not spend funds to pay for abortion or to help buy coverage that includes abortion except to save the life of the mother or in cases of rape or incest. *The bill would require federal Medicaid spending for these demonstrations to be no greater than it would otherwise be, aiming to avoid increasing federal costs.*

## Cosponsors (1)

- Rep. Brecheen, Josh [R-OK-2] (R-OK), 2025-02-04T00:00:00.000Z

## Provisions PRIA read

- Medicaid pilot: EBT card and catastrophic plan: mixed, medium. If enacted, States could offer a one-year Medicaid pilot you may choose to join. You would get an EBT card for primary care and medicines; the State sets the dollar amount. Any money left at year end would be paid to you in cash, and you would be enrolled in a State catastrophic plan for other care…
- New rules for state Medicaid waivers: mixed, low. If enacted, State applications under one waiver pathway would need to follow new paragraph (4) rules. Another existing subsection would not apply to the new pilots defined in paragraph (4)(B). These are administrative changes for State Medicaid agencies and would not directly change patient benefit…

## Related bills

- 119-hr-3151: SHIPS for America Act of 2025
- 119-hr-137: TCJA Permanency Act
- 119-hr-21: Born-Alive Abortion Survivors Protection Act
- 119-hr-925: Dismantle DEI Act of 2025
- 119-hr-7: No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2025
- 119-hr-3033: Protecting the Mailing of Firearms Act

## Sources
- [119-hr-936 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/936)

## Related
- [119-hr-3151: SHIPS for America Act of 2025](https://policyrisk.com/legislation/119-hr-3151)
- [119-hr-137: TCJA Permanency Act](https://policyrisk.com/legislation/119-hr-137)
- [119-hr-21: Born-Alive Abortion Survivors Protection Act](https://policyrisk.com/legislation/119-hr-21)
- [119-hr-925: Dismantle DEI Act of 2025](https://policyrisk.com/legislation/119-hr-925)
- [119-hr-7: No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of…](https://policyrisk.com/legislation/119-hr-7)
- [119-hr-3033: Protecting the Mailing of Firearms Act](https://policyrisk.com/legislation/119-hr-3033)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-936 (as of 2025-12-21).