Accelerating Kids’ Access to Care Act of 2025

Bill Number: H.R. 1509
Origin Chamber: House
Congress: 119th Congress, Session 1
Policy Area: Health
Status: Introduced
Latest Action: 2025-02-21: Referred to the House Committee on Energy and Commerce.
Last Updated: 2026-06-29T17:13:24Z

AI-Generated Summary

Purpose

The Accelerating Kids' Access to Care Act of 2025 aims to simplify the process for qualified healthcare providers from other states to join a state's Medicaid (health coverage for low-income people) and CHIP (Children's Health Insurance Program) programs. This focuses on improving access to care for children under 21 by reducing administrative hurdles for out-of-state providers.

Key Provisions

Streamlined Enrollment Process: States must create a simple enrollment system for "eligible out-of-state providers" to participate in their Medicaid or CHIP plans (or related waivers). This allows these providers to deliver services, prescribe treatments, or certify eligibility for care to children enrolled in the program.
Enrollment requires only basic information, such as the provider's name and National Provider Identifier (NPI, a unique ID for healthcare providers), without extra screening beyond what's needed for payment.
Once enrolled, providers remain active for 5 years, unless terminated due to issues like exclusion from federal programs.
Eligibility Criteria for Providers:
Must be based in another state (one of the 50 states or the District of Columbia).
Must have a "limited risk" of fraud, waste, or abuse, as determined by either Medicare screening or their home state's Medicaid/CHIP screening, and be actively enrolled in one of those programs.
Cannot have been excluded, terminated, or barred from federal healthcare programs or state plans for reasons like fraud.
Target Beneficiaries: Applies only to "qualifying individuals," defined as children under 21 enrolled in the state's Medicaid or CHIP plan.
Conforming Changes: Updates existing laws to include "enrollment" alongside "screening" requirements in Medicaid and CHIP rules.
Effective Date: Changes take effect 3 years after the bill becomes law.

Significant Changes to Existing Law

Adds a new subsection (10) to Section 1902(kk) of the Social Security Act, which previously focused on provider screening to prevent fraud but did not address streamlined enrollment for low-risk out-of-state providers.
Expands state requirements to include enrollment processes, making interstate participation easier than under current rules, which often impose full screening (background checks, site visits) on all new providers regardless of prior vetting.
Applies the same streamlined approach to both Medicaid (Title XIX) and CHIP (Title XXI), ensuring consistency across children's health programs.

Potential Impacts

On Government Agencies: State Medicaid and CHIP agencies will need to develop and implement new enrollment systems, potentially increasing short-term administrative costs but reducing long-term burdens from redundant screenings. The federal Department of Health and Human Services (HHS) may need to provide guidance on implementation.
On Citizens: Children in Medicaid/CHIP could gain faster access to specialized care from out-of-state providers, especially in rural or underserved areas with provider shortages. Families may face fewer delays in treatment, improving health outcomes for kids.
On International Relations: No direct impact, as the bill focuses on domestic U.S. states and does not involve foreign providers or cross-border issues.
Broader Effects: Could encourage more interstate healthcare collaboration, potentially lowering overall program costs by tapping into a wider pool of providers without extensive re-vetting.

Main Stakeholders Affected

Out-of-State Providers: Healthcare professionals (e.g., doctors, specialists) who meet low-risk criteria benefit from easier entry into other states' programs, expanding their patient base.
Children and Families: Low-income families with kids under 21 in Medicaid/CHIP gain improved access to care, particularly for services not available locally.
State Governments: Medicaid and CHIP administrators must comply, affecting budgeting and operations in all 50 states and the District of Columbia.
Federal Government: HHS oversees enforcement and may see indirect benefits in program efficiency and reduced fraud risks through reliance on existing screenings.

Notable Legal, Constitutional, or Political Implications

Legal: Strengthens anti-fraud protections by limiting enrollment to pre-screened, low-risk providers, while promoting uniformity in interstate healthcare under federal law. It builds on existing Medicare and Medicaid screening frameworks without altering core eligibility rules.
Constitutional: Aligns with federalism principles by giving states flexibility in implementation but mandating a minimum streamlined process, potentially reducing interstate barriers under the Commerce Clause (which allows federal regulation of cross-state activities).
Political: Could appeal to bipartisan support for children's health access, as introduced by representatives from different parties. May spark debates on balancing fraud prevention with administrative efficiency, especially in states with varying provider shortages. No major controversies anticipated, given the focus on low-risk providers and a delayed effective date for preparation.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Trahan, Lori [D-MA-3]

Cosponsors (104)

Rep. Miller-Meeks, Mariannette [R-IA-1], Rep. McCaul, Michael T. [R-TX-10], Rep. Van Drew, Jefferson [R-NJ-2], Rep. Wittman, Robert J. [R-VA-1], Rep. Valadao, David G. [R-CA-22], Rep. Bacon, Don [R-NE-2], Rep. Tonko, Paul [D-NY-20], Rep. Castor, Kathy [D-FL-14], Rep. Schneider, Bradley Scott [D-IL-10], Rep. Schrier, Kim [D-WA-8], Rep. Bishop, Sanford D. [D-GA-2], Rep. Balderson, Troy [R-OH-12], Rep. Crenshaw, Dan [R-TX-2], Rep. Gonzalez, Vicente [D-TX-34], Rep. Carey, Mike [R-OH-15], Rep. Finstad, Brad [R-MN-1], Rep. Graves, Sam [R-MO-6], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Buchanan, Vern [R-FL-16], Rep. Mullin, Kevin [D-CA-15], Rep. Matsui, Doris O. [D-CA-7], Rep. Connolly, Gerald E. [D-VA-11], Rep. Miller, Carol D. [R-WV-1], Rep. Cohen, Steve [D-TN-9], Rep. Khanna, Ro [D-CA-17], Rep. Cleaver, Emanuel [D-MO-5], Rep. Nadler, Jerrold [D-NY-12], Rep. Davids, Sharice [D-KS-3], Rep. Bonamici, Suzanne [D-OR-1], Rep. Lawler, Michael [R-NY-17], Rep. Moore, Tim [R-NC-14], Rep. Nunn, Zachary [R-IA-3], Rep. Mann, Tracey [R-KS-1], Rep. Yakym, Rudy [R-IN-2], Rep. Landsman, Greg [D-OH-1], Rep. McBride, Sarah [D-DE-At Large], Rep. Latimer, George [D-NY-16], Rep. Vindman, Eugene [D-VA-7], Rep. Magaziner, Seth [D-RI-2], Rep. McGarvey, Morgan [D-KY-3], Rep. Bilirakis, Gus M. [R-FL-12], Rep. Auchincloss, Jake [D-MA-4], Rep. Dexter, Maxine [D-OR-3], Rep. Deluzio, Christopher R. [D-PA-17], Rep. Mrvan, Frank J. [D-IN-1], Rep. Kennedy, Mike [R-UT-3], Rep. Castro, Joaquin [D-TX-20], Rep. Smucker, Lloyd [R-PA-11], Rep. Houlahan, Chrissy [D-PA-6], Rep. Carbajal, Salud O. [D-CA-24] and 54 more

Recent Actions

2025-02-21: Referred to the House Committee on Energy and Commerce.
2025-02-21: Introduced in House
2025-02-21: Introduced in House

Bill Versions

Accelerating Kids’ Access to Care Act of 2025 — issued 2025-02-21 — PDF (6 pages)