Referred to the House Committee on Energy and Commerce.
The bill amends Section 1115 of the Social Security Act to let States approve and renew specific Medicaid experimental, pilot, or demonstration projects. Eligible projects allow enrolled individuals to opt into a one-year program where the State provides an EBT card for primary care and medications, returns unused card funds as a cash payment at year-end, and enrolls participants in State-chosen catastrophic insurance covering other services.
Federal oversight: liberals worry rollback, conservatives favor State control
Relative to its intended legislative type, this bill establishes a substantive change to Medicaid waiver authority by enabling State-approved demonstration projects with specific benefit mechanics while shifting approval references to the State, but it leaves significant operational, fiscal, and oversight details to future rulemaking or state discretion.
The bill amends Section 1115 of the Social Security Act to let States approve and renew specific Medicaid experimental, pilot, or demonstration projects.
Eligible projects allow enrolled individuals to opt into a one-year program where the State provides an EBT card for primary care and medications, returns unused card funds as a cash payment at year-end, and enrolls participants in State-chosen catastrophic insurance covering other services.
Projects must be budget-neutral to Federal Medicaid spending and may not fund abortions except for life, rape, or incest exceptions.
Partisan policy content, federalism shift, and abortion restriction reduce prospects; passage would likely require significant compromise.
Relative to its intended legislative type, this bill establishes a substantive change to Medicaid waiver authority by enabling State-approved demonstration projects with specific benefit mechanics while shifting approval references to the State, but it leaves significant operational, fiscal, and oversight details to future rulemaking or state discretion.
Federal oversight: liberals worry rollback, conservatives favor State control
These are examples from the analysis, not a ranked list of the most-affected groups.
Federal oversight: liberals worry rollback, conservatives favor State control
Skeptical of shifting approval authority from the federal government to States and worried this could erode comprehensive Medicaid coverage.
Concerned that cashing out unused benefits and limiting federal oversight could lead to gaps in care and unequal protections across States.
Cautiously open to limited, well-evaluated State pilots that test market-oriented Medicaid options but wary of removing federal safeguards.
Wants clear evidence requirements, strict budget-neutrality verification, and time-limited demonstration authority.
Supports expanding State flexibility and moving approval authority closer to States, valuing consumer choice and reduced federal bureaucracy.
Views EBT plus catastrophic coverage as a market-oriented alternative to traditional Medicaid.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Partisan policy content, federalism shift, and abortion restriction reduce prospects; passage would likely require significant compromise.
The bill has not accumulated any surfaced votes yet.
Federal oversight: liberals worry rollback, conservatives favor State control
Partisan policy content, federalism shift, and abortion restriction reduce prospects; passage would likely require significant compromise.
Relative to its intended legislative type, this bill establishes a substantive change to Medicaid waiver authority by enabling State-approved demonstration projects with specific benefit mechanics while shifting approva…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.