H.R.1509 - Accelerating Kids’ Access to Care Act of 2025 (119th Congress)
Summary
H.R. 1509, the Accelerating Kids’ Access to Care Act of 2025, aims to streamline the enrollment process for out-of-state healthcare providers under Medicaid and CHIP (Children's Health Insurance Program). This bill amends the Social Security Act to facilitate easier enrollment for eligible providers who wish to offer services to qualifying individuals (under 21 years of age) across state lines. The goal is to improve access to healthcare for children enrolled in these programs.
The bill mandates that states adopt processes to allow eligible out-of-state providers to enroll in their Medicaid/CHIP programs with minimal screening requirements. Enrolled providers would remain in the program for a 5-year period, unless terminated or excluded. The changes would take effect three years after the enactment of the Act.
This legislation seeks to reduce administrative burdens and expand the pool of available healthcare providers for children covered by Medicaid and CHIP, potentially addressing shortages in specialized care and improving health outcomes.
Expected Effects
The primary effect of this bill will be to simplify and accelerate the process for out-of-state healthcare providers to enroll in Medicaid and CHIP programs. This should lead to increased access to healthcare services for children, particularly those who may live near state borders or require specialized care not readily available in their home state.
States will be required to modify their enrollment processes to accommodate out-of-state providers, and eligible providers will benefit from a streamlined enrollment process and a guaranteed 5-year enrollment period. This may also incentivize more providers to participate in Medicaid and CHIP programs.
Ultimately, the bill aims to improve the health and well-being of children enrolled in Medicaid and CHIP by expanding their access to a wider range of healthcare providers.
Potential Benefits
- Increased Access to Care: Children in Medicaid and CHIP will have access to a broader network of healthcare providers, especially specialists.
- Reduced Administrative Burden: Streamlined enrollment processes will make it easier for out-of-state providers to participate in these programs.
- Improved Health Outcomes: Greater access to timely care can lead to better health outcomes for children.
- Continuity of Care: The 5-year enrollment period ensures stability and continuity of care for patients.
- Addresses Provider Shortages: Helps mitigate shortages of specialized care in certain geographic areas.
Potential Disadvantages
- Potential for Increased Costs: Streamlined enrollment might lead to increased utilization of services and higher program costs.
- Risk of Fraud and Abuse: Reduced screening requirements could increase the risk of fraudulent or abusive practices by providers, although the bill attempts to mitigate this by defining 'eligible' providers.
- Administrative Challenges for States: States may face challenges in implementing the new enrollment processes and coordinating with out-of-state providers.
- Unintended Consequences: The changes could potentially disrupt existing provider networks or create unforeseen administrative complexities.
- Delayed Implementation: The 3-year delay in implementation means that the benefits will not be immediately realized.
Constitutional Alignment
This bill appears to align with the spirit of the Constitution, particularly the General Welfare Clause (Preamble). By aiming to improve healthcare access for children, it promotes the general welfare of the population.
Furthermore, the bill does not appear to infringe upon any specific rights or liberties guaranteed by the Constitution or its amendments. The federal government's role in regulating interstate commerce (Article I, Section 8) could be interpreted as providing a basis for standardizing enrollment processes across state lines for federal healthcare programs.
However, the Tenth Amendment reserves powers not delegated to the federal government to the states. Some might argue that mandating specific enrollment processes for state Medicaid programs infringes upon state sovereignty, although the federal government's funding role provides a strong basis for such requirements.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).