H.R.936 - Medicaid Improvement and State Flexibility Act of 2025 (119th Congress)
Summary
H.R. 936, the Medicaid Improvement and State Flexibility Act of 2025, proposes amendments to Title XI of the Social Security Act. The bill aims to grant states greater authority in approving and implementing specific waivers under the Medicaid program, particularly concerning experimental, pilot, or demonstration projects. It allows states to approve projects providing electronic benefit transfer (EBT) cards for primary care and medications, coupled with catastrophic insurance coverage.
Expected Effects
The bill's enactment would shift some decision-making power from the federal government to state governments regarding Medicaid waivers. States could implement innovative approaches to Medicaid service delivery, potentially leading to more tailored programs. However, the shift could also result in variations in coverage and access across different states.
Potential Benefits
- Increased State Flexibility: States can tailor Medicaid programs to local needs.
- Potential for Innovation: Encourages states to experiment with different service delivery models.
- Focus on Primary Care: EBT cards incentivize the use of primary care services.
- Cost Control: Aims to maintain or reduce federal expenditures.
- Cash Back Incentive: Individuals receive remaining funds on the EBT card, promoting responsible spending.
Most Benefited Areas:
Potential Disadvantages
- Varied Access: Coverage and benefits may differ significantly between states.
- Potential for Reduced Services: States might limit covered services to stay within budget.
- Administrative Burden: States face increased responsibility for program management and oversight.
- Risk of Inadequate Coverage: Catastrophic insurance may not cover all necessary services.
- Abortion Restriction: Explicitly prohibits the use of funds for abortions (except in cases of life endangerment, rape, or incest).
Most Disadvantaged Areas:
Constitutional Alignment
The bill's alignment with the US Constitution is complex. It touches on the balance of power between the federal government and state governments, potentially implicating the Tenth Amendment. The Tenth Amendment reserves powers not delegated to the federal government, nor prohibited to the states, to the states respectively, or to the people. By granting states more control over Medicaid waivers, the bill could be seen as reinforcing this principle. However, the federal government's role in funding and regulating healthcare raises questions about the extent of state autonomy.
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).