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Reps. Debbie Dingell and John Moolenaar introduced a bill on Sept. 24 that would make PACE a mandatory Medicaid program in every state and change rules for enrollment and provider expansion. The bill has support from aging and disability organizations, but its prospects in 2026 are uncertain, and a Senate companion is expected by year-end.
Reps. Debbie Dingell, a Michigan Democrat, and John Moolenaar, a Michigan Republican, introduced the PACE Access Improvement Act on Sept. 24. The bill would make the Program of All-inclusive Care for the Elderly a mandatory Medicaid service in every state and revise rules that affect enrollment and the expansion of PACE organizations.
PACE combines medical and social services for older adults who need a level of care comparable to nursing home care but can receive support at home. The program operates under Medicare and Medicaid. Under current rules described in the bill’s coverage, enrollment generally takes effect on the first day of the month after a provider receives an agreement. The legislation would let enrollment take effect at any time during the month.
The proposal would also repeal certain marketing restrictions and numerical limits on PACE program agreements, while addressing constraints on the expansion of PACE organizations. It would require states to offer PACE through Medicaid. States that already have at least one PACE provider would have 180 days after enactment to comply; states without a provider would have three years. These timelines would begin only if the bill becomes law.
The National PACE Association reports that 33 states and the District of Columbia currently offer PACE, with 204 locations. The bill has support from the National PACE Association, the Alzheimer’s Association, the Alzheimer’s Impact Movement and the American Association on Health and Disability. The technology-enabled provider Seen Health also backs the proposal, according to its co-founder and CEO, Xing Su, who spoke to Home Health Care News.
How the Bill Could Expand PACE
If enacted, the bill would change PACE from a Medicaid option that states may adopt into a program required in every state. That could extend access to a model of home and community-based support in states that do not currently offer it. The legislation’s proposed deadlines give states with existing providers six months after enactment to comply, while states without PACE would have three years.
The enrollment change could also affect when people begin receiving coverage after joining a program. Allowing enrollment to take effect on any day of the month would remove the current wait for the next month’s first day, as described in the source report. Supporters say the changes could help people access care sooner and make it easier for providers to open additional centers. Those are expected effects, not outcomes established by the bill’s introduction.
PACE Rules and Current Availability
PACE serves older adults who meet state standards for nursing home-level care while living in the community. Its combination of medical and social services is intended to support care at home. The model’s reach currently varies by state: according to the National PACE Association figures cited by Home Health Care News, 33 states and Washington, D.C., have PACE programs, with 204 locations.
The proposal comes from lawmakers of different parties representing Michigan. In addition to requiring Medicaid coverage nationwide, it targets rules that supporters say restrict enrollment and the ability of organizations to grow. Los Angeles-based Seen Health, which provides culturally informed PACE services for older adults of Asian and Pacific Islander heritages in Southern California, is among the providers supporting the bill.
““PACE keeps frail older adults healthy and living at home, and families trust it.””
— Xing Su, Seen Health co-founder and CEO, to Home Health Care News
Bill’s Path Through Congress
The proposal’s legislative prospects remain uncertain. LeadingAge, an advocacy association for nonprofit aging-services providers and a supporter of the bill, said it is unlikely to pass by the end of 2026. The source report does not provide a committee schedule, a vote date or an estimate of the bill’s likelihood of passage beyond that assessment.
The bill’s introduction also does not show how states would implement the requirements in practice or how many additional people might enroll if the proposal became law. No projected provider openings, enrollment totals or funding effects are included in the source material. Those details remain unclear.
Senate Companion Expected
A companion bill in the Senate is expected to be introduced by the end of 2026, according to the report. Introduction of a Senate measure would be a next legislative step, but no Senate sponsor or specific date is identified in the source material. Congress would still need to consider and pass the legislation before the proposed state deadlines could take effect.
Key Questions
What would the PACE Access Improvement Act change?
It would require every state to offer PACE through Medicaid, allow enrollment to take effect on any day of the month, repeal certain marketing restrictions and numerical limits on program agreements, and address constraints on provider expansion.
Where is PACE currently available?
The National PACE Association figures cited by Home Health Care News show PACE in 33 states and the District of Columbia, with 204 locations.
When would states have to comply?
If the bill became law, states already served by at least one PACE provider would have 180 days after enactment. States without PACE would have three years.
Has the bill passed?
No. The source report says the legislation was introduced on Sept. 24, 2026. LeadingAge considers passage by the end of 2026 unlikely, and a Senate companion is expected by year-end.
Source: rss
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