H.R. 4029 — To provide for an emergency increase in Federal funding to State Medicaid programs for expenditures on home and community-based services.

This section increases the Federal medical assistance percentage (FMAP) by 10 percentage points (capped at 95%) for a qualifying HCBS program State's Medicaid expenditures on specified home and community-based services (HCBS)—including home health care, personal care, PACE, behavioral health services, and services under sections 1915(b),(c),(i),(j),(k) or 1115 waivers—furnished during FY2026 and FY2027. A state qualifies as an HCBS program State by submitting an application to the Secretary describing planned activities under subsection (d), with assurances that all attributable federal funds will be expended by September 30, 2029; used to supplement (not supplant) existing state HCBS funding; applied to increase provider reimbursement rates sufficient for workforce recruitment and retention; and subject to adequate oversight. Applications are deemed approved if certified complete within 90 days. Qualifying activities, implemented in partnership with entities such as Area Agencies on Aging and Centers for Independent Living, focus on HCBS improvements including (1) increasing rates for home health agencies and direct support professionals with pass-through to worker compensation; (2) providing paid sick, family, and medical leave; (3) hazard, overtime, and shift differential pay; (4) job stability measures; (5) serving individuals on HCBS waiting lists; (6) emergency supplies and personal protective equipment; (7) worker travel; (8) recruitment; (9) family caregiver support; (10) training; and (11) assistive technologies for community integration. (As background, HCBS enable Medicaid enrollees to receive long-term services and supports in home and community settings as an alternative to institutional care.)