POLISCOPE
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HR2853FEDERALIN_COMMITTEE
High Impact

Expanding Care in the Home Act (H.R. 2853)

Original title: Expanding Care in the Home Act

December 17, 2024

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Where This Stands

Introduced
Committee
Floor Vote
Passed
Signed

Currently IN_COMMITTEE. The next step in the legislative lifecycle is Floor Vote.

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

View official text →

The Frame

What this does

If enacted, this bill would change how Medicare beneficiaries access care by allowing them to receive primary care, dialysis, lab tests, and personal assistance at home, potentially reducing the need for facility-based visits for those with chronic conditions or mobility limitations.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Medicare beneficiaries

Eligible individuals gain access to new home-based clinical, diagnostic, and personal care services.

Primary care providers

Providers may elect to receive monthly capitated payments instead of traditional fee-for-service reimbursement.

Home infusion suppliers

Suppliers become eligible for new per-infusion-day reimbursement under Medicare Part B.

Home-based care workforce

Medical personnel may receive new training and career advancement opportunities through grant-funded programs.

What changed

Current stage: IN_COMMITTEE.

What's next

Floor Vote.

Background

  • The Social Security Act is the foundational federal law that established the Medicare program in 1965. context

Summary

This bill proposes expanding Medicare coverage to include a wider range of clinical, diagnostic, and personal care services delivered directly in a patient's home. It also authorizes $50 million in grants to train home-based care workers and establishes task forces to study nursing and emergency medical service (EMS) roles in home care.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Frequently Asked Questions

Who is eligible for the new personal care assistance benefit?
Beneficiaries must be Medicare-eligible, not Medicaid-eligible, have an income at or below 400% of the Federal Poverty Level, be functionally disabled, and have four or more chronic conditions or a recent qualifying hospital stay.
Does this bill change my current Medicare costs?
For personal care services, a 20% coinsurance applies after the first 30 days of service. The bill specifies that provisions for at-home lab tests and diagnostic imaging should not impact existing coinsurance or physician fee schedule rates.
What is 'staff-assisted home dialysis'?
It is a service where trained professionals, such as nurses or certified technicians, provide in-person assistance to patients performing dialysis at home, specifically for those unable to self-dialyze due to illness or injury.

Why It Matters

If enacted, this bill would change how Medicare beneficiaries access care by allowing them to receive primary care, dialysis, lab tests, and personal assistance at home, potentially reducing the need for facility-based visits for those with chronic conditions or mobility limitations.

News Coverage

No news coverage found yet. Articles are indexed twice daily.

Lobbying Activity

AARP

$4,110,000

2026

HEALTH ISSUESMEDICARE/MEDICAIDLAW ENFORCEMENT/CRIME/CRIMINAL JUSTICEPHARMACY

P.L. 119-21, One Big Beautiful Bill Act H.R. 8867, Planning for Long-term Aging Needs (PLAN) Act H.R. 5861, Legacy Act of 2025 H.R. 9393, the Lower Costs, More Transparency Act. H.R. 9396, the Prior Authorization Accountability Act. S. 4916, the Aging with Artificial Intelligence Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act of 2025. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S. 2120, the Older Americans Act Reauthorization Act of 2025 H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act of 2025. H.R. 3954/S. 4641, Improving Access to Medicare Coverage Act. H.R.5554/S.2831, Stand Strong for Medicare Act. S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act and efforts related to the bill S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act S. 668/H.R. 3183, Supporting Access to Falls Education and Prevention and Strengthening Training Efforts and Promoting Safety Initiatives (SAFE STEPS) for Veterans Act of 2025 CMS-1851-P, Hospice Proposed rule. CMS-1843-P, Skilled Nursing Facility Proposed rule. CMS-1844-P, Home Health Proposed rule. No bill number. Health care transparency. No bill number. Discussed use of artificial intelligence and health data technology. No bill number. Discussed health-related policies and activities around the fall respiratory virus season. No bill number. Discussed health insurance affordability proposals. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed HUD Assisted Living Requirements No bill number. Discussed family caregiving. No bill number. Discussed AARP paper on Medicare Caregiver Training Services. No bill number. Discussed Medicaid community engagement interim final rule, including the family caregiver exemption. No bill number. Discussed the paid direct care workforce in long-term care. No bill number. Discussed the unaffordability of long-term care. No bill number. Discussed Money Follows the Person Rebalancing Demonstration Program and Medicaid HCBS spousal impoverishment protections. No bill number. Discussed Medicaid fraud and family caregivers, Medicaid self-direction programs. No bill number. Discussed sandwich generation family caregiver hearing and submitted a statement for the record discussing family caregivers and sandwich generation caregivers, programs that support them, AARP caregiving resources, and federal policies to support sandwich generation caregivers and caregivers more broadly. No bill number. Discussed long-term care. No bill number. CMS-2453-NC; Medicaid Program; 2028 Medicaid Home and Community-Based Services Quality Measure Set Submitted comments No bill number. Discussed expanding access to home care. No bill number. Discussed the increasing cost of home care No bill number. Discussed HSA use for telehealth chronic care management services/subscriptions. No bill number. Discussed artificial intelligence and technology

Sponsors

Discoveries

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift90% confidence

Shift toward home-based care

The bill represents a comprehensive legislative effort to shift Medicare's focus from facility-centric care to home-based delivery across multiple specialties including dialysis, labs, and primary care.

Connected Entities

organizationSecretary of Health and Human Services (HHS Secretary)Responsible for implementing the bill's provisionsMap →
bill_numberMedicare Part BThe program being amendedMap →
bill_numberPrimary Care Qualified Evaluation and Management Services (PQEM)A specific service covered under the billMap →
otherHome Infusion Therapy (HIT)A key area of coverage expansionMap →
personMrs. DingellCo-sponsored the bill with Mr. Smith of NebraskaMap →
personMr. Smith of NebraskaIntroduced the bill in the House of RepresentativesMap →

Analysis Score

0–100
  • Significance85
    How much this matters to a regular citizen
  • Controversy40
    Intensity of disagreement among stakeholders
  • Entertainment10
    Compellingness for a non-policy-wonk reader
  • Buzz30
    Current news / social attention level

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