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Provide for reconciliation pursuant to title II of H. Con. Res. 14 › Section 71121

Making Certain Adjustments to Coverage of Home or Community-Based Services under Medicaid

Section 71121 · Sec. 71121 ·

What this chapter is about

This part lets a state run a standalone home care waiver from July 1, 2028. People need not first qualify for a nursing home. The state must show waits for others will not grow much. It also puts up $150 million over two years.

4 proposals indexed from this chapter.

The document says “canWho acts: Secretary of Health and Human ServicesHow: statuteSec. 71121 in the PDF
What the document says

“Beginning July 1, 2028, notwithstanding paragraph (1), the Secretary may approve a waiver that is standalone from any other waiver approved under this subsection to include as medical assistance under the State plan of such State payment for part or all of the cost of home or community-based services”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121

The section adds a new paragraph (11) to section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) letting the Secretary, from July 1, 2028, approve a standalone waiver covering part or all of the cost of home or community-based services, other than room and board, given under a written plan of care to people the State's needs-based criteria reach. The waiver runs an initial three years and, at the State's request, is extended for further five year periods unless the Secretary finds the requirements were not met.

What the document actually says

“Beginning July 1, 2028, notwithstanding paragraph (1), the Secretary may approve a waiver that is standalone from any other waiver approved under this subsection to include as medical assistance under the State plan of such State payment for part or all of the cost of home or community-based services”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121
That sentence, in plain words

From July 1, 2028 the Secretary may approve a new kind of waiver. It stands on its own. It pays for care at home or in the community.

What this is about

Room and board are not covered. The waiver runs three years at first. It is then extended five years at a time.

No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.

The document says “shallWho acts: State agenciesHow: statuteSec. 71121 in the PDF
What the document says

“The State demonstrates to the Secretary that approval of a waiver under this subsection with respect to individuals described in clause (iii) will not result in a material increase of the average amount of time that individuals”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121

The section requires the State, as a condition of approval, to have its other waivers in order, to show the new waiver will not materially increase how long others wait for services, to set needs-based criteria the Secretary approves for who qualifies without a nursing home level of care determination, to set stricter needs-based criteria for institutional level of care, to attest that average per capita spending will not top that for institutional care, and to give the Secretary data on numbers served and, at least annually, on services furnished, how long people receive them, comparisons with other groups, and how many were served in the year.

What the document actually says

“The State demonstrates to the Secretary that approval of a waiver under this subsection with respect to individuals described in clause (iii) will not result in a material increase of the average amount of time that individuals”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121
That sentence, in plain words

The state must show the Secretary one thing. The new waiver must not add much to how long others wait.

What this is about

That is measured as an average. Six other tests also apply. They cover who may join, what it costs and what data is sent.

No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.

The document says “shall notWho acts: State agenciesHow: statuteSec. 71121 in the PDF
What the document says

“No payments made to carry out this paragraph shall be used by a State to make payments to a third party on behalf of an individual practitioner for benefits such as health insurance, skills training, and other benefits customary for employees, in the case of a class of practitioners for which the program established under this title is the primary source of revenue.”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121

The section bars a State from using money under the paragraph to pay a third party on behalf of an individual practitioner for benefits such as health insurance, skills training and other customary employee benefits, where the program is the main source of revenue for that class of practitioners.

What the document actually says

“No payments made to carry out this paragraph shall be used by a State to make payments to a third party on behalf of an individual practitioner for benefits such as health insurance, skills training, and other benefits customary for employees, in the case of a class of practitioners for which the program established under this title is the primary source of revenue.”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121
That sentence, in plain words

The money may not be paid to a third party. That is a payment on behalf of a single worker. It covers benefits such as health cover or training.

What this is about

The bar bites where the program is the main income source. That is judged for a class of workers. The money must go to the care itself.

No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.

The document says “shallWho acts: Administrator of the Centers for Medicare & Medicaid ServicesHow: statuteSec. 71121 in the PDF
What the document says

“for fiscal year 2026, $50,000,000 for purposes of carrying out the provisions of, and the amendments made by, this section, to remain available until expended; and”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121

The section appropriates $50,000,000 for fiscal year 2026 to carry out the section and $100,000,000 for fiscal year 2027 for payments to States to support systems delivering home or community-based services, each to remain available until expended. State payments are made on the basis of each State's share of the population receiving such services.

What the document actually says

“for fiscal year 2026, $50,000,000 for purposes of carrying out the provisions of, and the amendments made by, this section, to remain available until expended; and”

To provide for reconciliation pursuant to title II of H. Con. Res. 14, Sec. 71121
That sentence, in plain words

Fifty million dollars comes in fiscal year 2026. It pays to carry out this part. The money stays there until it is spent.

What this is about

A further $100 million comes the next year. That goes to the states. Each state's share follows how many people it serves.

No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.

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What This Page Covers, and What It Leaves Out

Each distinct thing the section does: allow the standalone waiver and set its term, set the seven State requirements, bar payments to a third party for practitioner benefits, and appropriate implementation funding with the basis for State payments.

The detailed data reporting items, which are carried in a summary.

The section works by amending section 1915(c) of the Social Security Act and points to section 1115 of that Act, neither of which is indexed here.