# What This Bill Does

This bill makes changes to how states handle Medicaid coverage for people who need help living at home instead of in institutions. Right now, Medicaid has strict rules about who can get these services through special programs called "waivers." This bill loosens some of those rules and requires states to be more transparent about how they're managing these programs.

The main practical change is that states can now cover home and community-based services for more people than they currently can. Previously, these services were limited to specific groups of people with certain disabilities or conditions. Under this bill, states can expand coverage to other people who need these services, as long as they prove that doing so won't make wait times longer for people already eligible. This matters because many states have long waiting lists for home care services, and people sometimes wait months or years to get help with things like personal care, housekeeping, or home health aide services.

The bill also requires much better public reporting starting in 2028. States will have to tell the federal government—and the public—specific details about their programs, including how long people wait to get services, how many hours of care people actually receive compared to what was approved, and how they manage their waiting lists. This information will be posted online so anyone can see how their state is doing. Additionally, the bill gives states guidance on providing up to 60 days of temporary coverage while someone's care plan is being finalized, so people don't have gaps in service.

Overall, this bill aims to help more people access home care services while making it easier for the public to see whether states are actually delivering the services they promise.

To amend title XIX of the Social Security Act to increase transparency and expand coverage options with respect to home and community-based services under a Medicaid waiver.