HCBS Access Act
- Bill Number
- H.R. 8540
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-04-28: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, Oversight and Government Reform, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-07-07T08:05:40Z
AI-Generated Summary
HCBS Access Act (H.R. 8540)
Purpose of the legislation This bill aims to mandate coverage of home and community-based services (HCBS) under Medicaid, expand access by eliminating waiting lists, streamline eligibility processes, support direct care workers and family caregivers, and promote community integration for people with disabilities and older adults. It builds on existing Medicaid goals to provide services that help individuals maintain independence and avoid institutional care.
Key provisions outlined
- Title I requires states to cover a broad range of HCBS as a mandatory Medicaid benefit, including personal assistance, supported employment, respite care, case management, home modifications, and behavioral health services. It defines "eligible individuals" based on functional impairments in activities of daily living and expands eligibility to those with incomes up to 150% of the federal poverty level or 300% of the Supplemental Security Income rate.
- The bill establishes a 100% federal medical assistance percentage (FMAP) for HCBS expenditures and requires states to submit implementation plans addressing workforce stability, outreach, and equity. It also mandates quality metrics, an ombudsman office in each state, and permanent extensions of spousal impoverishment protections and the Money Follows the Person program.
- Title II directs revision of the Standard Occupational Classification system to create a distinct category for direct support professionals.
- Title III authorizes grants for direct care workforce development, including recruitment, training, retention, and advancement, plus support for family caregivers through a national technical assistance center.
- Title IV requires a national evaluation of the law's effects on access to services.
Significant changes to existing law introduced
- Amends Title XIX of the Social Security Act to convert HCBS from an optional waiver-based service to a required state plan benefit, effective five years after enactment.
- Increases FMAP to 100% for HCBS and administrative costs related to expansion.
- Repeals mandatory Medicaid estate recovery programs and directs states to withdraw existing liens on beneficiaries' property.
- Modifies eligibility rules to include new income categories and removes certain restrictions on self-directed care models.
- Adds requirements for standardized quality measures and data collection on demographics and disparities.
Potential impacts on government agencies, citizens, or international relations
- Federal and state Medicaid agencies would face increased administrative responsibilities for planning, quality reporting, and workforce infrastructure, with higher federal spending but reduced state matching requirements for HCBS.
- Citizens, particularly people with disabilities and older adults, could gain expanded access to community services, potentially reducing institutionalization and supporting family caregivers who are often women. Direct care workers may see improved compensation, training, and job stability.
- No provisions address international relations.
Main stakeholders affected by this legislation
- Medicaid-eligible individuals with disabilities (including intellectual, developmental, physical, and behavioral health conditions) and older adults.
- Direct care professionals, family caregivers, and their representatives or labor organizations.
- State Medicaid agencies, developmental disabilities offices, and aging agencies.
- Providers, health plans, and organizations serving underserved populations.
Notable legal, constitutional, or political implications
- The legislation alters the federal-state partnership in Medicaid by imposing new mandatory requirements and funding incentives, potentially affecting state flexibility in program design.
- It emphasizes equity in access across race, ethnicity, gender, and geography, with data collection mandates to track disparities.
- Repeal of estate recovery and lien provisions represents a shift in Medicaid financing policy, limiting states' ability to recoup costs from beneficiaries' estates.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (8)
Rep. Schakowsky, Janice D. [D-IL-9], Rep. Simon, Lateefah [D-CA-12], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Davis, Danny K. [D-IL-7], Rep. Larson, John B. [D-CT-1], Rep. García, Jesús G. "Chuy" [D-IL-4], Rep. Grijalva, Adelita S. [D-AZ-7], Rep. Waters, Maxine [D-CA-43]
Recent Actions
- 2026-04-28: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, Oversight and Government Reform, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-04-28: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, Oversight and Government Reform, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-04-28: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, Oversight and Government Reform, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-04-28: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, Oversight and Government Reform, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-04-28: Introduced in House
- 2026-04-28: Introduced in House
Bill Versions
- HCBS Access Act — issued 2026-04-28 — PDF (95 pages)