A Democratic bill with 21 Democratic cosponsors · See all 21 cosponsors
Last activity — 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.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The HCBS Access Act aims to amend the Social Security Act to expand and require coverage for home and community-based services under Medicaid. It focuses on eliminating waiting lists and increasing the capacity of community services for people with disabilities and older adults. The bill provides for the creation of a national technical assistance center to build the direct care workforce. Additionally, it authorizes grants for the recruitment, training, and advancement of direct care professionals and support for family caregivers. The Act also includes provisions to improve service quality and establish better data collection through national surveys.
Yes· 3 of 42
- Scored +10
Would people over 65 be better off under this?
Eliminates waiting lists and increases funding for older adults to live at home.
- Scored +10
Would people with disabilities be better off under this?
Removes barriers to community living and guarantees HCBS as a mandatory benefit.
- Scored +10
Would retired people be better off under this?
Provides critical long-term supports and protects against spousal impoverishment.
The opposite· 3 of 4
- Scored -8
Does this reduce what the federal government spends?
Significantly increases government spending on Medicaid and workforce grants.
- Scored -5
Does this leave more decisions to the states?
Reduces state discretion by making HCBS a mandatory benefit.
- Scored -5
Does this reduce what the federal government owes?
Increases federal spending through 100% federal matching for HCBS expenditures.
Who it would affect, and how
Potential Positive Impacts for People
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Expanded Service Coverage: The bill requires Medicaid to cover a wide range of home and community-serevices, such as personal assistance, respite services, and housing support, to help individuals live in their communities (Section 102).
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Elimination of Waiting Lists: A primary purpose of the act is to eliminate waiting lists that currently delay access to necessary services for people with disabilities and older adults (Section 101).
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Support for Caregivers: The bill provides grants specifically to support family caregivers through educational, training, or other resources (Section 303).
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Workforce Development: The Act establishes a technical assistance center and provides grants to improve the recruitment, training, and retention of the direct care workforce (Section 302, Section 303).
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Financial Protections: The bill makes permanent the option for States to extend protections against spousal impoverishment for recipients of home and community-based services (Section 108).
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Protection of Assets: The bill requires States to withdraw certain liens and prohibits the recovery of medical assistance that was correctly paid, which protects the assets of beneficiaries (Section 110).
Potential Negative Impacts for People
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Delayed Implementation: Many of the major changes regarding mandatory Medicaid coverage and eligibility modifications are set to take effect five years after the Act is enacted (Section 102, Section 103).
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Increased Requirements for States: States are required to submit detailed implementation plans, which include explaining how they will operationalize new definitions and address workforce issues (Section 104).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would people with disabilities be better off under this? — Removes barriers to community living and guarantees HCBS as a mandatory benefit. Would retired people be better off under this? — Provides critical long-term supports and protects against spousal impoverishment. Would people over 65 be better off under this? — Eliminates waiting lists and increases funding for older adults to live at home. Would households on low incomes be better off under this? — Expands eligibility to 150% of the poverty line and provides 100% federal funding for services. Would Native Americans be better off under this? — Includes specific requirements for consultation with Indian tribes and tribal organizations. Would women be better off under this? — Directly supports female-dominated direct care workforce and unpaid family caregivers. Would Black Americans be better off under this? — Aims to eliminate race-based disparities in HCBS access. Would Asian Americans be better off under this? — Aims to eliminate race-based disparities in HCBS access. Would children be better off under this? — Expands eligibility for those under 21 and provides home-based services for children with disabilities. Would Hispanic Americans be better off under this? — Aims to eliminate race-based disparities in HCBS access. Would immigrants be better off under this? — Supports the immigrant-heavy direct care workforce through training and advancement grants. Would men be better off under this? — Increases access to home-based care and functional support. Would people in middle age be better off under this? — Provides critical support for adults with functional impairments. Would people in rural areas be better off under this? — Ensures equitable geographic distribution of workforce grants. Would people in cities be better off under this? — Ensures equitable geographic distribution of workforce grants. Would veterans be better off under this, taking everything together? — Improves access to HCBS and includes disabled veterans' organizations in policy advisory. Would white Americans be better off under this? — Increases overall access to home and community-based services. Would people in their twenties and thirties be better off under this? — Increases access to home-based services and supported employment. Would LGBTQ people be better off under this? — Targets the reduction of disparities based on sexual orientation and gender identity. Would union members be better off under this? — Promotes neutrality regarding labor organization and emphasizes workforce standards. Would middle-income households be better off under this? — Creates new eligibility categories for those above standard poverty levels. Would students be better off under this? — Provides training and apprenticeship programs for those entering the direct care profession.
- Social Issues And Justice
- Does this expand the rights of people with disabilities? — Guarantees access to community-based services and eliminates waiting lists for people with disabilities. Is this likely to lift people out of poverty? — Protects families from spousal impoverishment and prohibits estate recovery liens. Does this make housing cost less? — Includes housing support and transitional housing for unhoused individuals as covered services. Does this narrow racial gaps in how people are treated? — Specifically aims to prevent unnecessary institutionalization of black and brown individuals. Is this likely to reduce homelessness? — Provides wrap-around and transitional housing services for unhoused individuals. Does this narrow the gap between how men and women are treated? — Provides support and training for the disproportionately female direct care workforce. Does this expand the rights of LGBTQ people? — Mandates tracking and reducing disparities in access for LGBTQ individuals.
- Healthcare
- Does this put more money into Medicaid, the health coverage for people on low incomes? — Provides 100 percent federal matching for home and community-based services. Does this make health care easier to get in general? — Eliminates waiting lists and expands eligibility for home and community-based services. Does this make mental health care easier to get? — Includes behavioral health and crisis intervention services in HCBS coverage. Does this lower what a hospital stay costs? — Reduces unnecessary institutionalization by expanding home-based care. Does this help veterans get medical care? — Expands access to HCBS for disabled veterans through Medicaid.
- Environment Energy And Infrastructure
- Does this improve buses, trains and other public transport? — Mandates coverage of non-emergency non-medical transportation for community integration. Does this invest in rural communities? — Requires equitable geographic diversity in grant distribution, including rural areas.
- Governance And Ideology
- Does this give the federal government more power? — Imposes mandatory benefits and strict federal implementation requirements on state Medicaid plans. Does this make what the government does easier for the public to see? — Requires public publication of quality measures and HCBS utilization data. Does this leave more decisions to the states? — Reduces state discretion by making HCBS a mandatory benefit.
- National Security And Foreign Policy
- Does this increase the pay, pensions or support veterans receive? — Increases home-based care options and accessibility for disabled veterans.
- Economy And Finance
- Is this likely to create jobs? — Provides grants for recruiting and training a larger direct care workforce. Does this strengthen the rights of workers to organise? — Requires states to be neutral regarding workers joining labor organizations. Is this likely to grow the economy? — Invests in the healthcare workforce and expands service access. Does this reduce what the federal government spends? — Significantly increases government spending on Medicaid and workforce grants. Does this reduce what the federal government owes? — Increases federal spending through 100% federal matching for HCBS expenditures. Does this make the government pay for what it commits to? — Substantially increases federal liabilities via full cost-sharing of HCBS.
- 10/29/2026
- 1 Cosponsor added.
- 10/26/2026
- 1 Cosponsor added.
- 10/15/2026
- 1 Cosponsor added.
- 10/9/2026
- 1 Cosponsor added.
- 10/5/2026
- 1 Cosponsor added.
- 10/1/2026
- 1 Cosponsor added.
- 9/14/2026
- 1 Cosponsor added.
- 8/17/2026
- 1 Cosponsor added.
- 7/27/2026
- 3 Cosponsors added.
- 7/20/2026
- 2 Cosponsors added.
- 7/6/2026
- 1 Cosponsor added.
- 6/2/2026
- 1 Cosponsor added.
- 5/14/2026
- 1 Cosponsor added.
- 5/13/2026
- 2 Cosponsors added.
- 5/12/2026
- 1 Cosponsor added.
- 5/11/2026
- 1 Cosponsor added.
- 4/28/2026
- 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.
- 1 Cosponsor added.
- Introduced in House
3 bills Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Yassamin AnsariDemocrat · Arizona
Nanette BarragánDemocrat · California
Becca BalintDemocrat · Vermont
Emanuel CleaverDemocrat · Missouri
Gilbert CisnerosDemocrat · California
Greg CasarDemocrat · Texas
Danny DavisDemocrat · Illinois
Christopher DeluzioDemocrat · Pennsylvania
Jesús GarcíaDemocrat · Illinois
Adelita GrijalvaDemocrat · Arizona
Jonathan JacksonDemocrat · Illinois
John LarsonDemocrat · Connecticut
Gwen MooreDemocrat · Wisconsin
Sarah McBrideDemocrat · Delaware
Christian MenefeeDemocrat · Texas
Eleanor NortonDemocrat · District of Columbia
Mark PocanDemocrat · Wisconsin
Janice SchakowskyDemocrat · Illinois
Lateefah SimonDemocrat · California
Maxine WatersDemocrat · California
Nikema WilliamsDemocrat · Georgia