SAFE through Medicare Act
HB8749, the SAFE through Medicare Act, would amend the Social Security Act to add a new Medicare-covered benefit for “home resiliency services” for certain beneficiaries who are medically at risk during a climate or manmade disaster. The bill defines these services as items and services that are medically necessary to help a vulnerable Medicare enrollee withstand disaster-related conditions, with examples including heat pumps for people vulnerable to extreme temperatures, solar batteries for patients who depend on electrical medical equipment such as home ventilators, and energy-efficient cold storage for temperature-sensitive medications.
The bill directs the Secretary of Health and Human Services to establish a process, in consultation with NIH, CMS, and NOAA, for determining when an individual is medically at risk in the event of disasters or climate hazards. That process must consider geography-specific climate risks, regional preparedness, the history and projected risk of disasters and infrastructure failures, reliance on power-dependent or temperature-sensitive medical equipment and supplies, and chronic conditions, disabilities, and comorbidities that increase vulnerability. The bill would apply to services furnished on or after January 1, 2027, and would require Medicare to pay 100 percent of the lesser of the actual charge or a Secretary-set fee schedule amount for these services.
If enacted, the bill would expand Medicare coverage under Title XVIII of the Social Security Act by creating a new covered service category for disaster- and climate-related home resiliency measures. It would add a new statutory definition in section 1861 and a corresponding payment rule in section 1833, effectively requiring Medicare to reimburse qualifying home resiliency services at full coverage subject to the fee schedule. The measure would primarily affect Medicare beneficiaries with medical vulnerabilities, as well as providers and vendors of home modifications, backup power, climate-control, and medical-supply preservation equipment.
Based on the bill text and the absence of recorded committee debate or votes in the provided materials, the overall sentiment appears supportive and preventive in nature. The bill is framed as a patient-protection measure aimed at helping medically vulnerable people remain safe during extreme weather, power outages, flooding, and other disasters. Its structure suggests a public-health and preparedness rationale rather than a partisan or punitive one.
No committee transcripts or votes were provided, so there is no recorded floor or committee contention in the materials. Potential points of debate implied by the bill itself include how broadly CMS should define who is “medically at-risk,” how much discretion the Secretary should have in determining covered services, and the cost implications of making Medicare pay for home resiliency upgrades. Another possible area of concern is whether the benefit should be limited to specific disaster-prone regions or extended based on individualized medical need and projected climate risk.