S. 3956 — Make Billionaires Pay Their Fair Share Act

This section imposes a new annual wealth tax of 5% on the net value of assets (i.e., fair market value of all worldwide property minus debts) exceeding $1 billion held on the last day of the calendar year by applicable taxpayers, defined as individuals or trusts meeting the threshold (with married couples treated as one taxpayer and inflation adjustment to the threshold after 2026 based on cost-of-living increases using calendar year 2025 as the base). It requires inclusion of assets held by the taxpayer's children under age 18 and directs the Secretary of the Treasury to establish valuation rules similar to those for estate tax purposes (with an election available for hard-to-value assets limited to once every other year). Special rules apply as follows: (1) proration for deceased individuals based on days lived in the year; (2) grantor trusts and incomplete gifts attributed to the grantor, with aggregation rules for other trusts; (3) nonresident noncitizens taxed only on net domestic assets (with married couples included only if both qualify); and (4) covered expatriates taxed through the day before expatriation.

This section requires the Secretary of the Treasury to audit not less than 50% of taxpayers required to pay the tax imposed under new section 2901 of the Internal Revenue Code of 1986 in each calendar year. The section also appropriates, for each fiscal year after enactment, amounts equal to 1% of revenues attributable to that tax for Internal Revenue Service enforcement activities to determine and collect taxes owed under the section.

This section revises Section 6428B of the Internal Revenue Code of 1986—previously titled "2021 recovery rebates to individuals" and providing one-time advance refundable tax rebates of up to $1,400 per eligible individual ($2,800 for joint filers) based on 2019 income—to instead provide affordability rebates for taxable year 2026 based on 2024 income. The affordability rebate amount is $3,000 ($6,000 in the case of a joint return) plus $3,000 multiplied by the number of taxpayer dependents. It increases phaseout thresholds in subsection (e)(2) to $3,000 for individuals, $6,000 ($2,800 previously) for joint filers, and $3,000 ($1,400 previously) per dependent. It updates subsection (g) references throughout to 2024 (from 2019) as the base year, January 1, 2026 (from January 1, 2021) for advance payments, December 31, 2026 (from December 31, 2021) as the termination date, and 2025 (from 2020) and 2026 (from 2021) for special rules applicable to certain individuals. (Thus, rebates are reconciled on 2026 tax returns, similar to the original section's mechanism for 2021 rebates.)

This section repeals subtitle B of title VII of Public Law 119-21—enacting various health care provisions—and requires laws and regulations referenced therein to be applied as if the subtitle and its amendments had not been enacted, except for sections 71202, 71306, and 71401 of such Act. It further amends the rural health transformation program (i.e., subsection (h) of section 2105 of the Social Security Act, 42 U.S.C. 1397ee(h), providing states with allocated funds for initiatives to improve rural health care delivery and outcomes), as follows: (1) revises the heading of paragraph (1)(B) to "Availability of" (from "Unexpended or unobligated"); (2) strikes clauses (i) through (iii) of paragraph (1)(B) and inserts new clause (i) stating that funds allocated to a State from amounts appropriated under subparagraph (A) remain available until expended (subject to clause (ii)); (3) redesignates clause (iv) as clause (ii); and (4) updates a cross-reference in paragraph (2)(C) to "paragraph (1)(B)(ii)" (from "paragraph (1)(B)(iv)"). (Thus, state-allocated program funds no longer lapse under prior unexpended or unobligated restrictions.)

This section eliminates the 400 percent of federal poverty level (FPL) income limit on eligibility for the premium tax credit (PTC) under section 36B of the Internal Revenue Code. (As background, the PTC subsidizes health insurance premiums purchased through Affordable Care Act marketplaces based on a required contribution percentage of household income, sliding on an income tier scale relative to FPL.) The section revises the applicable percentage table in section 36B(b)(3)(A) as follows: (1) up to 150 percent of FPL, 0 percent; (2) 150-200 percent of FPL, 0-2.0 percent; (3) 200-250 percent of FPL, 2.0-4.0 percent; (4) 250-300 percent of FPL, 4.0-6.0 percent; (5) 300-400 percent of FPL, 6.0-8.5 percent; and (6) 400 percent of FPL and higher, 8.5 percent. (Thus, households above 400 percent of FPL become eligible for PTC with required contributions capped at 8.5 percent of income.) The section also strikes related affordability provisions in sections 36B(c)(1)(E), 36B(c)(2)(C)(iv), and 36B(c)(4)(F). The amendments apply to taxable years beginning after December 31, 2025.

This section establishes Medicare Part B coverage for dental and oral health services (as defined in new subsection 1861(ooo)) furnished by dentists or oral health professionals on or after January 1, 2028 (or January 1, 2027, for dentures). Such services include (1) preventive and screening services (i.e., oral exams, cleanings, x-rays, fluoride treatments); (2) procedures and treatments for oral disease (e.g., fillings, crowns, root canals, periodontal scaling, extractions); and (3) dentures and dental prosthetics (i.e., complete/partial dentures, implants), excluding services permissible under current law prior to enactment and non-covered cosmetic services. This section sets payment for such services at 80% of the lesser of the actual charge or a new fee schedule amount (100% for preventive/screening services), with the fee schedule equal to 70% of the national median fee from the 2020 American Dental Association Survey (or 85% thereof for oral health professionals other than dentists), geographically adjusted and annually updated by the CPI-U minus productivity adjustment. The Secretary must consult annually with dental organizations in establishing the fee schedule. (As background, Medicare Part B covers outpatient services for beneficiaries aged 65 and older or disabled individuals but has excluded most routine dental care absent medical necessity.)

This section expands the scope of Medicare Part B audiology services under section 1861(ll) beginning January 1, 2028, to include hearing aid examination services and treatment services (i.e., aural rehabilitation, vestibular rehabilitation, and cerumen management) furnished by qualified audiologists or, for hearing aid examinations, by qualified hearing aid professionals (i.e., state-licensed hearing aid dispensers, specialists, or instrument dispensers who are nationally accredited or meet Secretary-determined standards); eliminates the physician order requirement for such audiology services; and establishes payment at 80% of the lesser of the actual charge or 85% of the physician fee schedule amount for hearing aid examinations by qualified hearing aid professionals. This section further includes qualified audiologists and qualified hearing aid professionals among practitioners eligible for Medicare payments on an assignment-related basis beginning January 1, 2028. This section includes hearing aids as prosthetic devices under Medicare Part B section 1861(s)(8) for individuals with moderately severe, severe, or profound hearing loss beginning January 1, 2028, furnished by qualified hearing aid suppliers and limited to once per ear every five years for Secretary-determined appropriate types pursuant to a written order from a physician, qualified audiologist, qualified hearing aid professional, physician assistant, nurse practitioner, or clinical nurse specialist; requires such payments only on an assignment-related basis; and caps the payment basis at a rate to be determined by the Secretary.

This section provides Medicare Part B coverage for vision services—defined as routine eye examinations to determine the refractive state of the eyes, furnished on or after January 1, 2028, by or under the supervision of an authorized ophthalmologist or optometrist—limited to one examination every two years and paid under the physician fee schedule. It expands coverage of conventional eyeglasses from one pair only subsequent to cataract surgery with intraocular lens insertion (previously the sole coverage) to also include one pair every two years regardless of surgery (with an additional pair allowed post-cataract in that period if furnished on or after January 1, 2028), subject to competitive acquisition beginning no later than January 1, 2030; caps payment at the updated 2021 General Services Administration Federal Supply Schedule rate; and excludes deluxe eyeglasses and conventional reading glasses. (As background, Medicare Part B previously excluded routine vision care except for post-cataract eyeglasses or lenses.) It conforms Medicare exclusions by prohibiting payment for vision services furnished more frequently than every two years and exempting covered vision services from the general eye exam exclusion.

This section establishes a special rule under Medicare Part B (i.e., supplementary medical insurance for physician and outpatient services) to phase in, for enrollees age 65 and older, the impact of expanded dental coverage on the monthly actuarial rate used to determine (1) the monthly premium rate (generally 50% of the actuarial rate), (2) the part B deductible, and (3) the premium subsidy and monthly adjustment amount, for calendar years 2027 through 2031. For each such year, the Secretary must determine an alternative monthly actuarial rate—in lieu of the standard rate determined under current law—that equals (1) for 2027 and 2028, the rate computed as if the dental coverage amendments did not apply (i.e., 0% of added dental costs); and (2) for 2029 through 2031, that nondental rate plus 25%, 50%, or 75% (respectively) of the difference between the standard rate and the nondental rate. (Thus, beneficiaries' premiums, deductibles, and related amounts reflect none of the added dental costs in 2027-2028 and a gradually increasing share thereafter.)

This section authorizes appropriations of $85,647,000,000 for each of fiscal years 2026 through 2035 to the Housing Trust Fund. (As background, the Housing Trust Fund, otherwise funded by allocations from Fannie Mae and Freddie Mac, provides grants to states to increase and preserve rental housing for extremely low- and very low-income families, including homeless families, and to increase homeownership for such families.)

This section establishes a birth-through-five child care and early learning entitlement program, incorporating definitions from the Child Care and Development Block Grant Act of 1990 and adding definitions for child care certificate (i.e., payment issued directly to a parent), child experiencing homelessness, eligible activity (e.g., employment, job training or search, education, health treatment, or certain leave), eligible child, and eligible child care provider. An eligible child is an individual under age six who is not yet in kindergarten, whose family income does not exceed 250% of the state median income (for FY2026 and subsequent years), and who either (1) resides with a parent engaged in an eligible activity, (2) is included in a vulnerable population identified by the lead agency (at minimum, children with disabilities, infants and toddlers with disabilities, children experiencing homelessness, children in foster care or kinship care, or children receiving or needing child protective services), or (3) resides with a parent over age 65; eligibility continues without reverification until age six or kindergarten entry. An eligible child care provider is a licensed center-based, family, or other compensated provider that participates in the state's quality tiered system no later than three years after the state receives funds and meets other requirements (e.g., those under CCDBG); providers eligible under CCDBG on the application date are deemed eligible for three years if they remain compliant.

This section states the purposes of the title, which are to (1) ensure public elementary and secondary school teachers earn a livable and competitive salary, including a starting annual base salary of not less than $60,000 that increases regularly throughout a teacher’s career; (2) increase federal investments in public schools; and (3) call upon states and local governments to increase investments in public education to ensure every public school student is taught by a qualified teacher.

This section establishes definitions for terms used in this title, including "annual base salary" (excluding additional compensation such as bonuses or stipends); "average teacher salary baselines" based on full-time teachers' salaries at 0, 3, 5, 10, 15, 20, and 25 years of service; "Consumer Price Index" as defined in section 478(f) of the Higher Education Act of 1965 (20 U.S.C. 1087rr(f)); "minimum salary for teachers," requiring states to compensate full-time teachers at specified annual base salary minimums that increase with experience and are at least $60,000 for first-year teachers in FY2027 through FY2031 (adjusted every five fiscal years thereafter—beginning with FY2032 through FY2036—by the greater of the aggregate annual adjustment percentage over the prior five years or 2% of the prior period's amount); "Secretary" (of Education); and "teacher" (full-time certified elementary or secondary school teachers and certain other personnel paid on the teacher salary schedule). It incorporates definitions of "elementary school," "outlying area," and "secondary school" from the Elementary and Secondary Education Act of 1965.

This section establishes a grant program to enable states to ensure that full-time teachers employed by local educational agencies receive an annual base salary that is at least a state-established minimum salary, increases throughout the teacher's career, and is commensurate—to the greatest extent practicable—with salaries for college-educated professionals with similar experience in the region. It appropriates $14.5 billion for FY2027 (increasing each succeeding fiscal year by the annual adjustment percentage) and authorizes such sums as necessary thereafter. From annual appropriations, the Secretary reserves 0.5% for outlying areas, 0.5% for Bureau of Indian Education-funded schools, and 1% for program administration, technical assistance, and data collection (with special rules exempting such recipients from other requirements under this section and §702). The remainder is allotted to states with approved plans: 50% according to states' shares of prior-year Title I basic grants (20 U.S.C. 6335) and 50% according to prior-year Education Finance Incentive Grants (20 U.S.C. 6337). To comply, states must adopt policies such as a statewide salary schedule ensuring salaries are not less than the minimum and increase with experience, or a statewide minimum salary for first-year teachers.

This section provides rules of construction clarifying that section 703—(1) does not alter rights, remedies, or procedures for school or local educational agency (LEA) employees under federal, state, or local laws (including regulations or court orders) or collective bargaining agreements, but does not exempt states, LEAs, or schools from complying with section 703 or negotiating in compliance with state labor laws; and (2) does not prevent states or LEAs from supplementing the annual base salary of teachers or other staff for additional skills, knowledge, duties, or responsibilities; through supplemental pay systems; or via bonuses, stipends, or awards.

This section appropriates $130 million for FY2027, to remain available until expended, for the Secretary of Health and Human Services to award home and community-based services (HCBS) improvement planning grants to all qualifying states within 12 months of enactment, and an additional $5 million for related technical assistance, guidance, and administrative expenses. States must use grant funds to develop and submit an HCBS improvement plan—including assessments of HCBS access barriers, payment rates, direct care worker workforce, the percentage of long-term services and supports expenditures for HCBS, and compliance with the HCBS Improvement Program (established under new SSA §1905(ll))—within 24 months for Secretary approval; states may also use funds for plan implementation activities but not as the non-federal Medicaid match. (As background, HCBS are Medicaid services enabling eligible individuals to receive long-term care in home or community settings rather than institutions.) The section defines key terms, including direct care worker (e.g., nurses, personal care attendants, home health aides), HCBS Improvement Program State (a grant recipient with an approved plan), HCBS (specific Medicaid services such as home health, personal care, and §1915 waivers), and Medicaid eligible individual.

This section establishes an increased Federal Medical Assistance Percentage (FMAP) of 8 percentage points (not to exceed 95%) for Medicaid expenditures on home and community-based services (HCBS) furnished by HCBS Improvement Program States for fiscal quarters beginning on or after the date the state attains such designation, provided the state meets nonsupplantation and maintenance-of-effort requirements. (As background, HCBS enable Medicaid-eligible individuals—who otherwise require institutional care—to receive long-term services and supports in home or community settings under state plan options or section 1915(c) waivers.) It further increases the HCBS FMAP by an additional 2 percentage points (not to exceed 95%) during the first six fiscal quarters in which such a state implements an approved HCBS improvement program; separately, through September 30, 2036, makes specified administrative costs for HCBS expansion and enhancement (e.g., workforce training and data infrastructure) eligible for 80% FMAP (or the state's otherwise applicable rate if higher), even prior to meeting state requirements; and excludes these FMAP increases from calculations of the Children's Health Insurance Program enhanced FMAP.

This section appropriates $40 million to the Secretary for FY2027, in addition to amounts otherwise available and to remain available until expended, to carry out section 802 (including the amendments made by such section) related to Medicaid home and community-based services (HCBS). The funding supports issuance of necessary guidance and technical assistance to states and conducting program integrity and oversight efforts.

This section appropriates $25 million to the Secretary for FY2027, to remain available until expended, for developing—in consultation with nongovernmental stakeholders with expertise in home and community-based services (HCBS), including recipients and providers—a recommended set of HCBS quality measures that reflect the full range of HCBS and their recipients. (HCBS are Medicaid-funded long-term services and supports that enable elderly and disabled individuals to receive care in home and community settings rather than institutions.)

This section permanently extends and expands Medicaid spousal impoverishment protections—under which states disregard certain income and resources of a community spouse when the institutionalized or home and community-based services (HCBS) spouse applies for or receives Medicaid long-term care—to additional categories of HCBS recipients. Specifically, it requires states to apply the protections to individuals eligible for HCBS under SSA section 1915(c), (d), or (i); section 1115 waivers; section 1915(k) attendant services and supports; section 1902(a)(10)(C); section 1902(f); or income disregard for medical costs (previously optional and limited to those described in section 1902(a)(10)(A)(ii)(VI)). It also replaces the September 30, 2027, sunset date with the date of enactment of this Act.

This section permanently extends the Money Follows the Person Rebalancing Demonstration program (from through FY2029). (As background, the program provides Medicaid grants to states to facilitate transitions of eligible individuals from institutional settings, such as nursing facilities, to home and community-based long-term care.)