Summary of HR 4029: Emergency Increase in Federal Funding for Medicaid Home and Community-Based Services

Bill Number: HR 4029

Introduced: June 17, 2025

Status: Introduced in House

Primary Sponsor: Debbie Dingell

Related Bill: S 2076 (companion bill)

Purpose and Intent

HR 4029 aims to provide an emergency increase in federal funding to state Medicaid programs specifically for home and community-based services (HCBS). The bill seeks to enhance the availability and quality of these services, which are crucial for individuals who prefer to receive care in their homes or community settings rather than in institutional facilities.

Key Provisions

1. Increased Federal Medical Assistance Percentage (FMAP):

   • The bill proposes a 10 percentage point increase in the FMAP for states that implement HCBS programs during fiscal years 2026 and 2027.
   • The FMAP for any state cannot exceed 95% as a result of this increase.

2. Eligibility and Application Process:

   • States must submit an application to the Secretary of Health and Human Services (HHS) to qualify for the increased funding.
   • The application must include:
     • A description of planned activities to enhance HCBS.
     • Assurances that federal funds will be used to supplement, not supplant, existing state funding for HCBS.
     • Plans to increase reimbursement rates to support workforce recruitment and retention.

3. Implementation Activities:

   • States are encouraged to collaborate with community partners to implement various activities, including:
     • Increasing pay and benefits for home health workers and direct support professionals.
     • Providing paid leave and hazard pay for these workers.
     • Expanding services to individuals on waiting lists for HCBS.
     • Purchasing emergency supplies and equipment.
     • Supporting family caregivers and enhancing training for workers.

4. Reporting Requirements:

   • States must submit a report to the Secretary by December 31, 2029, detailing how federal funds were utilized and the number of individuals served.

Impact

• Who Would Be Affected:
  • States: States that apply and are approved will receive increased federal funding to enhance their HCBS programs.
  • Individuals: Eligible individuals requiring home and community-based services will benefit from improved access and quality of care.
  • Workforce: Home health workers and direct support professionals will see potential increases in compensation and job stability.

Procedural Aspects

• The bill was referred to the House Committee on Energy and Commerce on the same day it was introduced.
• The Secretary of HHS is required to certify the completeness of state applications within 90 days of submission.

Conclusion

HR 4029 represents a significant effort to bolster home and community-based services through increased federal funding, aiming to improve care for individuals who prefer to remain in their homes while also addressing workforce challenges in the healthcare sector. The bill's focus on collaboration with community partners and specific implementation activities underscores its comprehensive approach to enhancing HCBS.