[House Report 118-874]
[From the U.S. Government Publishing Office]
118th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 118-874
======================================================================
THINK DIFFERENTLY DATABASE ACT
_______
December 16, 2024.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mrs. Rodgers of Washington, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany H.R. 670]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 670) to amend title IV of the Public Health
Service Act to direct the Secretary of Health and Human
Services to establish a clearinghouse on intellectual
disabilities, and for other purposes, having considered the
same, reports favorably thereon with amendments and recommends
that the bill as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Committee Action................................................. 3
Committee Votes.................................................. 3
Oversight Findings and Recommendations........................... 5
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 5
Statement of General Performance Goals and Objectives............ 5
Duplication of Federal Programs.................................. 5
Related Committee and Subcommittee Hearings...................... 5
Committee Cost Estimate.......................................... 5
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 6
Advisory Committee Statement..................................... 6
Applicability to Legislative Branch.............................. 6
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill, as Reported............ 6
The amendments are as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Think Differently Database Act''.
SEC. 2. PROMOTING AWARENESS OF AVAILABLE RESOURCES FOR INDIVIDUALS WITH
DISABILITIES.
(a) In General.--Not later than 3 years after the date of the
enactment of this Act, the Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall establish and
update periodically a publicly-available website to provide information
with respect to resources and information for people with a disability
and the caregivers and families of such people. Such website shall
include--
(1) information on eligibility to receive medical assistance
under a State plan under the Medicaid program under title XIX
of the Social Security Act (42 U.S.C. 1396 et seq.) (or a
waiver of such plan) based on a qualifying disability,
including--
(A) general information about eligibility under
subclauses (XIII), (XV), (XVI), and (XIX) of section
1902(a)(10)(A)(ii) of the Social Security Act (42
U.S.C. 1396a(a)(10)(A)(ii));
(B) which States offer Medicaid buy-in programs; and
(C) the specific eligibility requirements of each
such program;
(2) information about how to contact each State's Medicaid
office for information about Medicaid and Children's Health
Insurance Program eligibility, including links and phone
numbers for State contacts;
(3) information on Medicaid-covered long-term services and
supports available to individuals eligible for medical
assistance under a State plan under the Medicaid program under
title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
(or a waiver of such plan); and
(4) where applicable, the duration of wait lists to receive
the services described in paragraph (3).
(b) Promotion.--The Secretary shall, as applicable and appropriate,
identify and disseminate promotional activities to improve, among
people with a disability and the caretakers and families of such
people, the awareness of the resources included in the website
established under subsection (a), such as through collaboration with
the Social Security Administration during its annual updates to the Red
Book.
(c) Model.--In establishing the website under this section, the
Secretary may use the website thinkdifferently.net as a model.
(d) Nonapplication of Paperwork Reduction Act.--Chapter 35 of title
44, United States Code (commonly referred to as the ``Paperwork
Reduction Act of 1995''), shall not apply to the implementation of this
section.
Amend the title so as to read:
A bill to direct the Secretary of Health and Human Services
to establish a website to promote awareness of available
resources for individuals with disabilities, and for other
purposes.
PURPOSE AND SUMMARY
H.R. 670 would require the Department of Health and Human
Services (HHS) to establish and maintain a publicly available
website that is focused on improving the accessibility of
information regarding Medicaid covered services available to
individuals with disabilities.
BACKGROUND AND NEED FOR LEGISLATION
The Medicaid program provides health coverage to nearly 80
million people.\1\ Among those eligible for Medicaid are people
with disabilities. For example, in 2021, an estimated 9.5
million people were enrolled in Medicaid on the basis of their
disability\2\ and many more individuals living with
disabilities are eligible for Medicaid via other eligibility
pathways.\3\
---------------------------------------------------------------------------
\1\37.6 million children were enrolled in Medicaid or the
Children's Health Insurance Program (CHIP) as of August 2024. Centers
for Medicare & Medicaid Services, ``August 2024: Medicaid and CHIP
Eligibility Operations and Enrollment Snapshot'', 2024, https://
www.medicaid.gov/medicaid/national-medicaid-chip-program-information/
downloads/august-2024-medicaid-chip-enrollment-trend-snapshot.pdf.
\2\Medicaid and CHIP Payment Access Commission, ``Section 3:
Program Enrollment and Spending--Medicaid Overall, EXHIBIT 14'',
MACSTATS: Medicaid and CHIP Data Book, 2023, https://www.macpac.gov/wp-
content/uploads/2023/12/EXHIBIT-14.-Medicaid-Enrollment-by-State-
Eligibility-Group-and-Dually-Eligible-Status-FY-2021.pdf.
\3\Medicaid and CHIP Payment and Access Commission, ``People with
disabilities,'' 2021, https://www.macpac.gov/subtopic/people-with-
disabilities/.
---------------------------------------------------------------------------
To access long-term services and supports and other
Medicaid covered services, individuals with disabilities, their
families, and caregivers must navigate a patchwork of federal
and state information to understand what services are available
to them in their respective state. As a jointly funded federal-
state program, Medicaid program features can differ
significantly from state to-state--including who is eligible,
what services they are eligible for, whether there is a
waitlist to access certain services such as home and community-
based services, and what steps they will need to take to apply.
These differences make it difficult for people with
disabilities and those who care for them to understand their
options. One caregiving report found that online information
about caregiving services can be ``hard-to-find, confusing,
inconsistent, and not consumer-oriented.''\4\
---------------------------------------------------------------------------
\4\Cure SMA, ``Stuck Inside: A national report on caregiving for
individuals with spinal muscular atrophy,'' 2024, https://
www.curesma.org/wp-content/uploads/2024/01/Advocacy
_Report_Stuck_Inside_vFnl_Web.pdf.
---------------------------------------------------------------------------
The Think Differently Database Act would require HHS to
create a consumer-facing website to provide state-by-state
information for people with disabilities related to Medicaid
eligibility under pathways related to disability, available
services, waitlist duration for certain services (where
applicable), and other critical information to support
individuals with disabilities and their families and caregivers
in accessing Medicaid-covered services. The Think Differently
Database Act also would require HHS to take steps to make the
public website known to people who could benefit from its use
(for example, by referencing it in the Social Security
Administration's ``Red Book,'' which provides information about
the employment-related provisions of Social Security Disability
Insurance and Social Security Income programs).
COMMITTEE ACTION
On April 30, 2024, the Subcommittee on Health held a
hearing on H.R. 670. The title of the hearing was ``Legislative
Proposals to Increase Medicaid Access and Improve Program
Integrity.'' The Subcommittee received testimony from:
Daniel Tsai, Deputy Administrator and
Director, Center for Medicaid and CHIP Services.
On May 16, 2024, the Subcommittee on Health met in open
markup session and forwarded H.R. 670, as amended, to the full
Committee by a record vote of 20 yeas and 0 nays.
On September 18, 2024, the full Committee on Energy and
Commerce met in open markup session and ordered H.R. 670, as
amended, favorably reported to the House by a record vote of 41
yeas and 0 nays.
COMMITTEE VOTES
Clause 3(b) of rule XIII requires the Committee to list the
record votes on the motion to report legislation and amendments
thereto. The following reflects the record votes taken during
the Committee consideration:
OVERSIGHT FINDINGS AND RECOMMENDATIONS
Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of
rule XIII, the Committee held a hearing and made findings that
are reflected in this report.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
Pursuant to clause 3(c)(2) of rule XIII, the Committee
finds that H.R. 670 would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
CONGRESSIONAL BUDGET OFFICE ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII, at the time this
report was filed, the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974 was not available.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to improve
the awareness and accessibility of health care services and
resources for individuals with disabilities, their families,
and caregivers.
DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 670 is known to be duplicative of another Federal program,
including any program that was included in a report to Congress
pursuant to section 21 of Public Law 111-139 or the most recent
Catalog of Federal Domestic Assistance.
RELATED COMMITTEE AND SUBCOMMITTEE HEARINGS
Pursuant to clause 3(c)(6) of rule XIII, the following
hearing was used to develop or consider H.R. 670:
On April 30, 2024, the Subcommittee on
Health held a hearing on H.R. 670. The title of the
hearing was ``Legislative Proposals to Increase
Medicaid Access and Improve Program Integrity.'' The
Subcommittee received testimony from:
Daniel Tsai, Deputy Administrator
and Director, Center for Medicaid and CHIP
Services.
COMMITTEE COST ESTIMATE
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974. At the time this report was
filed, the estimate was not available.
EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 670 contains no earmarks, limited tax
benefits, or limited tariff benefits.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
Section 1 provides a short title of ``Think Differently
Database Act''.
Section 2. Promoting awareness of available resources for individuals
with disabilities
Section 2 directs the Secretary of Health and Human
Services to establish and routinely update a publicly available
website that provides specified information pertaining to
resources and health care services available to individuals
with disabilities and their caregivers.
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
This legislation does not amend any existing Federal
statute.