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HB 1028

relative to the definition of renewable generation facility.

2026 Regular Session Introduced by Bill Bolton and 1 co-sponsor

The bill would seek federal permission to cover housing, nutrition, and other health-related social needs under Medicaid via a Section 1115 waiver.

Committee Report: Inexpedient to Legislate 03/03/2026 (Vote 15-1; RC) HC 10 P. 106
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Bill Summary · HB 1028

HB 1028 — Medicaid coverage for health related social needs

Status: First reading; referred to Committee on Public Health
Introduced: (filed) Nov 12, 2024 — (bill text version cites) Effective date: July 1, 2026
Citation proposed (Indiana): IC 12-15-1.3-26 (new)

Main purpose

Require the state Medicaid agency (the office of the secretary of family and social services) to apply for a Section 1115 Medicaid demonstration waiver to allow Medicaid coverage of certain "health related social needs" (HRSN) services — e.g., housing and nutrition supports — that address social determinants of health.

Key provisions

  • Defines “health related social needs” as an individual’s unmet, adverse social conditions that contribute to poor health outcomes, including examples such as food insecurity, housing instability, unemployment, or lack of transportation.
  • Requires the office of the secretary to submit an application to the U.S. Department of Health and Human Services (CMS) for a Section 1115 demonstration waiver no later than October 1, 2026.
  • Specifies that the waiver application must seek authority to provide Medicaid coverage for at least:
    • Housing supports;
    • Nutrition supports;
    • Any other HRSN services identified by the office of the secretary.
  • Effective date in the bill text: July 1, 2026 (implementation of coverage depends on CMS approval and any conditions negotiated through the 1115 process).

Who would be affected

  • Medicaid enrollees who experience HRSN (potentially eligible for new covered services if and when a waiver is approved and implemented).
  • The state Medicaid agency (responsible for designing and submitting the waiver, negotiating with CMS, and administering any approved demonstration).
  • Providers and organizations that deliver housing, nutrition, transportation, employment supports, and other community-based services (may become Medicaid providers or contractors).
  • State and local budgets: potential changes in Medicaid expenditures and offsets in other health or social program spending, depending on waiver design and federal matching.

Implementation and timeline highlights

  • The statute requires the state to apply by October 1, 2026. CMS approval, negotiation of program terms, and implementation would follow and could take many months or longer.
  • Coverage under Medicaid for HRSN services would only begin after (1) an approved 1115 demonstration is secured and (2) the state implements the approved program elements.
  • The 1115 demonstration process typically requires detailed program design, stakeholder engagement, monitoring and evaluation plans, and federal–state negotiation over costs, authorization scope, and reporting metrics.

Potential policy and fiscal considerations

  • Section 1115 waivers permit federal Medicaid funds to be used flexibly for non‑traditional services that address social determinants of health, but approval is discretionary and typically time‑limited and conditional.
  • Potential benefits: improved health outcomes, reduced acute care utilization, and better care coordination if services are appropriately targeted and integrated.
  • Uncertainties/risks: administrative costs for waiver design and oversight; need for state matching dollars; variability in realized cost savings; provider readiness; and federal approval terms that could limit scope.
  • Fiscal impacts are not specified in the bill and would depend on waiver design, covered services, enrollment, and CMS-negotiated financing.

Bottom line

HB 1028 directs the state Medicaid agency to pursue a federal Section 1115 demonstration to enable Medicaid coverage of health related social needs (notably housing and nutrition supports). The law sets an application deadline (Oct 1, 2026) and an effective date (July 1, 2026) for the statute, but actual program coverage would depend on CMS approval and subsequent program design and implementation.

Compiled from official sources — confirm details with the bill’s official record.

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