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Representatives Debbie Dingell and John Moolenaar introduced a bipartisan bill on Sept. 24 that would make PACE a mandatory Medicaid service and change enrollment and provider rules. The proposal has support from aging-services and health organizations, but a supporter says it is unlikely to pass by the end of 2026.
Representatives Debbie Dingell, a Michigan Democrat, and John Moolenaar, a Michigan Republican, introduced a bill on Sept. 24 that would make the Program of All-inclusive Care for the Elderly (PACE) a mandatory Medicaid service in every state. The PACE Access Improvement Act would also change when coverage can begin and remove some limits on enrollment and provider expansion, potentially widening access to care for older adults who qualify.
Under the proposal, PACE enrollment could take effect on any day of the month. Current federal policy generally starts coverage on the first day of the month after a provider receives the enrollment agreement. The bill would also repeal certain marketing restrictions and numerical limits on PACE program agreements, according to the report by Home Health Care News. Those changes are intended to ease administrative and growth constraints; the source does not provide projected enrollment or provider numbers.
The bill would shift PACE from an optional Medicaid program to a required one. The National PACE Association reports that 33 states and the District of Columbia currently offer PACE, with 204 locations. Under the bill’s proposed schedule, states that already have at least one PACE provider would have 180 days after enactment to comply with the new regulations. States without a PACE provider would have three years.
Supporters include the National PACE Association, the Alzheimer’s Association, the Alzheimer’s Impact Movement and the American Association on Health and Disability. Tech-enabled PACE provider Seen Health also supports the legislation, its co-founder and CEO Xing Su told Home Health Care News. The Los Angeles-based organization provides culturally informed PACE services to older adults of Asian and Pacific Islander heritages in Southern California.
A Nationwide Medicaid Requirement
If enacted, the bill would change Medicaid’s role in PACE from a state option to a service states would have to provide. That could affect states that do not currently offer the program and create new opportunities for PACE organizations to establish or expand services, subject to the bill’s requirements and local implementation.
The enrollment timing change could also matter to people waiting for services. Under current policy, the gap between an enrollment agreement and the first day of the next month can delay coverage. The bill would permit coverage to take effect at any time of the month, though the source does not specify how providers would administer start dates or how much time the change might save in individual cases.
PACE combines medical and social services and allows eligible older adults to receive nursing-home-level care while living at home. Supporters argue that expanding the model could give more people access to home and community-based services. The bill’s introduction does not establish how many people would enroll, whether provider capacity would meet demand, or what implementation would cost.
How PACE Works Today
PACE operates under both Medicare and Medicaid. It serves older adults who meet program criteria and coordinates medical and social services intended to support care at home. States currently decide whether to offer PACE through Medicaid, which helps explain why coverage is not available statewide.
Home Health Care News reports that the legislation would also remove limits on applying to become a PACE organization and address constraints on expanding existing organizations. The proposal therefore combines changes to state participation, enrollment timing and provider rules. It was introduced by lawmakers from the same state and has received support from organizations representing aging services, disability and Alzheimer’s interests.
““PACE keeps frail older adults healthy and living at home, and families trust it,””
— Xing Su, Seen Health co-founder and CEO, speaking to Home Health Care News
Passage and Rollout Remain Open
The bill’s prospects in Congress are unclear. LeadingAge, which supports the measure, considers passage by the end of 2026 unlikely, according to Home Health Care News. The report says a Senate companion bill is expected by year’s end, but does not identify its sponsors or give a specific introduction date.
It is also not yet clear whether Congress will change the bill, how states would meet the proposed requirements, or how quickly new PACE locations could open. The source gives current state and location counts, but no forecast for future growth, costs or enrollment. The proposal’s introduction alone does not change current Medicaid coverage rules.
Senate Companion Expected
A companion bill is expected to be introduced in the Senate by the end of 2026. That would give lawmakers another opportunity to consider the proposal, but its timing and contents have not been reported in the source material. The next clear milestones are the Senate bill’s introduction and any subsequent action on the House measure.
If the legislation were enacted, states with existing PACE providers would have 180 days to comply, while states without a provider would have three years. Until Congress acts, the proposed requirement and enrollment changes remain part of the bill rather than current policy.
Key Questions
What would the PACE Access Improvement Act change?
It would require PACE as a Medicaid service in every state, allow enrollment to take effect any day of the month, and repeal certain marketing restrictions and numerical limits on program agreements.
How many states currently offer PACE?
The National PACE Association reports that 33 states and the District of Columbia offer the program, with 204 locations.
When would states have to comply?
Under the bill, states that already have a PACE provider would have 180 days after enactment. States without one would have three years.
Has the bill become law?
No. The source reports that the bill was introduced on Sept. 24, 2026. Its proposed requirements would take effect only if it is enacted.
What happens next in Congress?
A Senate companion is expected by the end of 2026. LeadingAge, a supporter, says passage by the end of that year is unlikely.
Source: rss
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