[Congressional Record Volume 170, Number 148 (Monday, September 23, 2024)]
[House]
[Pages H5575-H5576]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 MEDICAID STATE PLAN REQUIREMENT FOR DETERMINING RESIDENCY OF MILITARY 
                                FAMILIES

  Mr. BUCSHON. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 8108) to amend title XIX of the Social Security Act to add a 
Medicaid State plan requirement with respect to the determination of 
residency of certain individuals serving in the Armed Forces, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 8108

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. MEDICAID STATE PLAN REQUIREMENT FOR DETERMINING 
                   RESIDENCY AND COVERAGE FOR MILITARY FAMILIES.

       Section 1902 of the Social Security Act (42 U.S.C. 1396a) 
     is amended--
       (1) in subsection (a)--
       (A) in paragraph (86), by striking ``and'' at the end;
       (B) in paragraph (87), by striking the period at the end 
     and inserting ``; and''; and
       (C) by inserting after paragraph (87) the following new 
     paragraph:
       ``(88) beginning January 1, 2028, provide, with respect to 
     an active duty relocated individual (as defined in subsection 
     (uu)(1))--
       ``(A) that, in determining eligibility for medical 
     assistance under the State plan (or waiver of such plan), the 
     relocation described in such subsection is deemed to be a 
     temporary absence for purposes of section 435.403(j)(3) of 
     title 42, Code of Federal Regulations (or any successor 
     regulation);
       ``(B) that if, at the time of such relocation, such active 
     duty relocated individual is on a home and community-based 
     services waiting list (as defined in subsection (uu)(2)), 
     such individual remains on such list until--
       ``(i) the State completes an assessment and renders a 
     decision with respect to the eligibility of such individual 
     to receive the relevant home and community-based services at 
     the time a slot for such services becomes available and, in 
     the case such decision is a denial of such eligibility, such 
     individual has exhausted the individual's opportunity for a 
     fair hearing in accordance with paragraph (3); or
       ``(ii) such individual elects to be removed from such list; 
     and
       ``(C) payment for medical assistance furnished under the 
     State plan (or a waiver of the plan) to such active duty 
     relocated individual in the temporary relocation State (as 
     referred to in subsection (uu)(1)) in accordance with such 
     guidance as the Secretary may issue to ensure access to such 
     assistance.''; and
       (2) by adding at the end the following new subsection:
       ``(uu) Active Duty Relocated Individual; Home and 
     Community-based Services Waiting List.--For purposes of 
     subsection (a)(88) and this subsection:
       ``(1) Active duty relocated individual.--The term `active 
     duty relocated individual' means an individual enrolled under 
     the State plan (or waiver of such plan)--
       ``(A) who--
       ``(i) is a member of the Armed Forces engaged in active 
     duty service and is temporarily relocated (as specified by 
     the Secretary) to another State (in this subsection referred 
     to as the `temporary relocation State') by reason of such 
     service;
       ``(ii) at any point during the preceding 1-year period, was 
     such a member so engaged in such service and was temporarily 
     relocated to the temporary relocation State by reason of such 
     service, but is no longer so engaged in such service 
     (including by reason of retirement from such service); or
       ``(iii) is a dependent (as defined by the Secretary) of a 
     member described in clause (i) or (ii) who temporarily 
     relocates to the temporary relocation State with such member; 
     and
       ``(B) who--
       ``(i) was receiving home and community-based services (as 
     defined in section 9817(a)(2)(B) of the American Rescue Plan 
     Act of 2021) at the time of such relocation; or
       ``(ii) if the State maintains a home and community-based 
     services waiting list, was on such home and community-based 
     services waiting list at the time of such relocation.
       ``(2) Home and community-based services waiting list.--The 
     term `home and community-based services waiting list' means, 
     in the case of a State that has a limit on the number of 
     individuals who may receive home and community-based services 
     under section 1115(a) or section 1915(c), a list maintained 
     by such State of individuals who have applied to receive such 
     services under either such section but for whom the State has 
     not yet completed an assessment and rendered a decision with 
     respect to the eligibility of such individuals to receive the 
     relevant home and community-based services at the time a slot 
     for such services becomes available due to such limit.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Indiana (Mr. Bucshon) and the gentleman from New Jersey (Mr. Pallone) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Indiana.


                             General Leave

  Mr. BUCSHON. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous material into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Indiana?
  There was no objection.
  Mr. BUCSHON. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I thank Mrs. Kiggans for bringing forth such an 
important solution for our military families.
  H.R. 8108 would ensure that military families can maintain access to 
essential care when they are required to move States for Active Duty.
  According to the Medicaid and CHIP Payment Access Commission, as many 
as 867,000 Medicaid enrollees have primary insurance through TRICARE, 
including as many as 220,000 children.
  In most instances, servicemembers rely on TRICARE as their insurer to 
cover most of their needs, but for individuals who also have a 
disability--take, for example, a military family with a child with a 
disability--Medicaid will often step in to cover additional care, like 
home and community-based services. Those services help with daily 
living activities and are essential to keeping people with disabilities 
healthy and independent in their communities.
  Unfortunately, many State Medicaid programs limit access to home and

[[Page H5576]]

community-based services and often do so by creating waiting lists. It 
can take years for a patient to get off the wait list and get the level 
of care that they need.
  For military families who rely on Medicaid to pay for home and 
community-based services, moving from one State to another requires the 
family to join the new State's waiting list and start the whole process 
over again.
  H.R. 8108 makes clear that Active-Duty military families required to 
move across the country for their service to this country cannot lose 
access to current home and community-based services or lose their spot 
in line on their home State's waiting list.
  These necessary changes will help reaffirm our commitment to our 
military families who don't need additional hoops to jump through or 
stress in a time of reassignment.
  Mr. Speaker, I thank Mrs. Kiggans for her leadership on this 
important issue. I encourage my colleagues to support this bill, and I 
reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 8108, a bill that would 
amend title XIX of the Social Security Act to add a Medicaid State plan 
requirement regarding the determination of residency of people serving 
in the armed services.
  Medicaid is the primary payer for home and community-based services, 
serving as the safety net for people with long-term care needs, 
including military families. Medicaid provides coverage for home and 
community-based services when other insurers, including TRICARE, do 
not.
  Military families face unique stressors when a family member has a 
need for home and community-based services and needs to relocate for 
military service. For example, when a child with disabilities is 
receiving home and community-based services covered by the Medicaid 
program in the same State in which they live, there is no guarantee 
that the child will continue to receive care in the State where the 
family is being relocated.
  In many States, families wait years on a waiting list to receive 
these services, and once they are finally able to access the care they 
need, the time may come to move again. Military families in this 
position may face a difficult choice: Do they keep their family 
together, knowing that their child may lose access to care in the State 
in which they are moving, or do they separate the family to ensure 
their child is able to access the care they need? These are decisions 
that military families simply should not have to make.
  H.R. 8108 would lessen the burden military families face by requiring 
States to continue to provide Medicaid coverage to dependents of 
Active-Duty military servicemembers who are receiving Medicaid home and 
community-based services and must move out of State due to military 
service. It also allows families that are on waiting lists to maintain 
their place on those lists so they, too, are not forced to start over.
  While H.R. 8108 does not address the many underlying issues with our 
patchwork long-term care system, including those that have led to the 
existence of waiting lists, I am pleased that it will help ease some of 
the challenges that military families face in receiving the care they 
need.
  Mr. Speaker, I thank Representatives Kiggans and Kaptur for their 
leadership on this very important issue, and I encourage my colleagues 
to vote ``yes'' on H.R. 8108.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BUCSHON. Mr. Speaker, I yield 5 minutes to the gentlewoman from 
Virginia (Mrs. Kiggans).
  Mrs. KIGGANS of Virginia. Mr. Speaker, I rise today in support of 
H.R. 8108, the Medicaid State Plan Requirement for Determining 
Residency of Military Families, that I introduced earlier this year to 
ensure servicemembers can maintain critical healthcare coverage and 
medical services for their children no matter where their service takes 
them.
  Americans with disabilities often need long-term care services to 
help them with everyday activities, such as eating, walking, medical 
equipment management, and more. TRICARE does not cover long-term care 
services, leaving military families with children in need of those 
services to apply for Medicaid. However, Medicaid is operated State by 
State, which puts individuals and their families at risk of losing 
services when they leave their State.
  This particularly impacts our military families, who frequently 
transfer locations as part of their commitment to serving our country. 
As a Navy spouse, mom of four, and a veteran who served for nearly 10 
years myself, I know how hard these relocations can be for military 
families.

                              {time}  1500

  Those who serve our country shouldn't have to worry about whether 
their children will be able to access critical healthcare services when 
they get to their next duty station.
  That is why I introduced the Medicaid State Plan Requirement for 
Determining Residency of Military Families.
  My bipartisan bill would guarantee dependents of Active-Duty 
servicemembers can continue to receive long-term care services through 
a State-administered Medicaid plan should their family be stationed in 
another State.
  Our men and women in uniform already sacrifice so much for our 
country. Their children should never have to forego critical care 
because of their selfless decision to serve.
  I thank Congresswoman Marcy Kaptur for joining me in this important 
effort, and I encourage my colleagues on both sides of the aisle to 
support our bipartisan legislation.
  Mr. PALLONE. Mr. Speaker, this is an important bill for individuals 
serving in the Armed Forces and their families, so I urge my colleagues 
to vote for it on a bipartisan basis.
  Mr. Speaker, I yield back the balance of my time
  Mr. BUCSHON. Mr. Speaker, in closing, I encourage everyone to vote 
``yes'' on this bill, and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Lopez). The question is on the motion 
offered by the gentleman from Indiana (Mr. Bucshon) that the House 
suspend the rules and pass the bill, H.R. 8108, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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