House Lawmakers Push Bill for More In-Home Medicare Coverage

A new bipartisan bill introduced in the U.S. House of Representative aims to keep some low-income seniors in their homes longer by giving them access to home care services covered by Medicare Advantage.

H.R. 4006, or the “Community Based Independence for Seniors Act,” would create a new community-based institutional special needs plan (CBI-SNP) demo program for community- and home-based services.

The legislation, which was introduced by Reps. Linda Sánchez (D-CA), Patrick Meehan (R-PA), Kurt Schrader (D-OR) and Leonard Lance (R-NJ), is aimed at expanding Medicare options for seniors who want to stay at home while keeping them off Medicaid and out of costlier skilled nursing facilities (SNFs).


Institutional Special Need Plans (I-SNPs) are Medicare Advantage plans that specifically provide care for people who need skilled or other specialized services in a facility for more than 90 days. This bill would extend some similar coverage to people at home.

“We know that without community-based long-term services and supports, which are not typically covered by Medicare, seniors frequently experience negative health outcomes, lose their ability to live independently, and often turn to Medicaid for coverage of long-term care expenses,” Sánchez said in a statement.

The bill would impact low-income, Medicare-eligible seniors who need help with two or more activities of daily living (ADLs). Those seniors would be able to receive services specific to their needs, such as home-delivered meals, transportation services, adult day care services and homemaker services.


“Too often, we rely on nursing home care as a one-size-fits-all solution for at-risk seniors,” Schrader said in a statement. “By broadening services available to seniors to include vital day-to-day services like home-delivered meals and transportation assistance, we can bring down the costs of care and help seniors in Oregon and across the country stay in their own homes.”

Sens. Chuck Grassley (R-IA) and Ben Cardin (D-MD) introduced a similar bill in the U.S. Senate in 2015. That bill was reintroduced earlier this year.

Read the full text of the legislation here.

Written by Tim Regan