[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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