US Federal Senate Bill SB1989

US Federal 2025-2026 Regular Session

• Introduced: 6/9/25
• Refer: 6/9/25

Caption

Helping Communities with Better Support Act

Summary

The Helping Communities with Better Support Act would amend Medicaid’s home- and community-based services (HCBS) waiver authority under section 1915(c) of the Social Security Act. It directs the Secretary of Health and Human Services to require more frequent public reporting by states on waiver operations, including waiting lists, screening and re-screening practices, service start times, and the share of authorized hours actually delivered. Beginning in 2028, much of that information would have to be posted publicly on the CMS website. The bill also creates a new waiver pathway allowing states, under specified conditions, to provide HCBS to certain individuals who have not yet received a formal disability determination, so long as the state shows the change will not materially increase wait times for people already determined eligible. States would have to estimate how many people would be served and explain how services for this group may differ from services for others. In addition, HHS would have to issue guidance by January 1, 2026, clarifying how states may cover up to 60 days of HCBS under an interim care plan while a written plan of care is finalized.

Impact

The bill would amend federal Medicaid law, specifically section 1915(c) of the Social Security Act, by adding new transparency requirements and expanding the circumstances under which states may use HCBS waivers. It would affect state Medicaid agencies, CMS, and individuals seeking long-term services and supports, especially people with disabilities and those awaiting formal eligibility determinations. The measure would not directly mandate state participation, but it would change the federal rules governing waiver approval and reporting for participating states.

Sentiment

Based on the bill text and the absence of recorded committee debate or votes in the provided materials, the overall sentiment appears supportive of improving access and accountability in HCBS programs. The bill’s framing emphasizes transparency, faster access to services, and flexibility for states to serve more people. No opposing statements or recorded roll-call votes are provided, so there is no documented partisan or procedural controversy in the available record.

Contention

The main policy tension in the bill is between expanding access to HCBS and protecting existing waiver participants from longer wait times. The new waiver authority for individuals without a formal disability determination is conditioned on a state proving there will be no material impact on wait times for already eligible individuals, reflecting concern that broader eligibility could strain limited waiver capacity. Another likely point of contention is the added reporting burden on states, though the bill presents those requirements as necessary for transparency and oversight. No specific objections from lawmakers or stakeholders are included in the provided materials.