S. 2076 — HCBS Relief Act of 2025

This section increases the Medicaid Federal medical assistance percentage (FMAP) by 10 percentage points (not to exceed 95%) for qualifying states' expenditures on specified home and community-based services (HCBS)—i.e., Medicaid services such as home health care, personal care, and waiver services that enable eligible individuals with disabilities or long-term care needs to receive care in home and community settings rather than institutions—during FY2026 and FY2027, notwithstanding certain existing FMAP limits. A qualifying HCBS program state is one whose application to the Secretary—which describes planned improvement activities, assures that additional federal funds will be expended by September 30, 2029, to supplement (not supplant) existing state HCBS funding, to increase reimbursement rates supporting workforce recruitment and retention, and for adequate oversight—is certified complete within 90 days and thus deemed approved. Qualifying states must collaborate with community partners to implement HCBS improvements in the following focused areas: (1) increasing rates for home health agencies and direct support professionals, with required pass-through to worker compensation; (2) providing paid sick, family, and medical leave, plus hazard, overtime, and shift differential pay; (3) enhancing job stability through consistent hours, scheduling, pay, and benefits; (4) serving individuals on section 1115 or 1915 waiting lists; (5) purchasing emergency supplies and equipment such as personal protective equipment; (6) covering worker travel costs; (7) recruiting new workers; (8) supporting family caregivers with pay, respite, supplies, and equipment; (9) funding worker training; and (10) paying for assistive technologies, staffing, and training to promote community integration.