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Representatives Debbie Dingell and John Moolenaar introduced the PACE Access Improvement Act on Sept. 24, 2026. The bill would make PACE a Medicaid requirement in every state, start coverage when enrollment paperwork is signed, and ease barriers to opening centers; it has not become law.
U.S. Reps. Debbie Dingell, a Democrat, and John Moolenaar, a Republican, introduced the PACE Access Improvement Act on Sept. 24, 2026, proposing changes that could make home- and community-based care available to more older adults. The bill would require every state to offer the Program of All-Inclusive Care for the Elderly (PACE), start coverage on the day enrollment papers are signed, and ease barriers to opening new centers. The proposal is not law, and its effects depend on congressional action and implementation.
PACE is a joint Medicare and Medicaid program that coordinates medical and social support for eligible older adults who need nursing-home-level care but can live safely in the community with PACE services. Eligibility generally requires a person to be at least 55, live in a PACE service area, receive state certification that they need that level of care, and be able to remain in the community with support.
Under current rules described by Home Health Care News, people can submit enrollment paperwork at any time during the month, but coverage typically begins on the first day of the following month after the PACE organization receives the signed agreement. The bill would instead make coverage effective on the day the provider signs the paperwork, potentially shortening the wait after enrollment.
The proposal would also make PACE mandatory under Medicaid, requiring all states to offer a program. Thirty-three states currently offer PACE, according to the report. The bill also aims to reduce obstacles to opening or expanding centers, though the report does not detail every proposed operational change. Industry representatives say earlier outreach could help potential participants learn about a center before it opens.
How Faster Enrollment Could Help
The proposal targets both where PACE is available and how quickly people can begin receiving it. If enacted, a nationwide Medicaid requirement could create a path to services in states that do not currently offer PACE. Starting coverage on the paperwork-signing date could also reduce the interval between enrollment and the beginning of benefits, although the bill’s practical effects would depend on how providers and agencies put the rule into operation.
PACE providers and advocates argue that broader access could help older adults with complex needs receive coordinated care while living in their communities. InnovAge CEO Patrick Blair told Home Health Care News that earlier, coordinated care could help some seniors maintain independence and potentially avoid more costly care settings. That is an industry assessment, not a measured outcome of this legislation. The source report provides no estimate of how many additional people would enroll or what expansion would cost.
For providers, the proposed changes could affect planning for new service areas and centers. Stephanie Winslow of the PACE Association of Michigan said current restrictions limit outreach before a center opens. Earlier contact with prospective participants could give them more time to understand the program and consider enrollment, but the bill’s impact on marketing or center launch schedules is not yet established.
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PACE’s Current Reach and Rules
PACE brings together medical care, social services and support intended to help eligible older adults remain in the community. Enrollment is limited by both individual eligibility and geography: a person must live within a PACE organization’s service area, and the state must certify that the person needs nursing-home-level care. The model’s reach therefore depends on program availability and local capacity, as well as whether an individual qualifies.
The gap between signing an agreement and the next month’s effective coverage date is one specific rule the bill would change. The broader proposal would also make state participation a Medicaid requirement. The National PACE Association says a Senate companion is expected from Sen. Mark Warner, a Virginia Democrat, in November 2026. That expected introduction is a next step, not evidence that the measure has advanced or been approved.
“Allowing seniors to enroll when they need care, rather than waiting until the beginning of the following month, removing unnecessary barriers to opening and expanding centers and making PACE available in every state would meaningfully improve access.”
— Patrick Blair, InnovAge CEO, speaking to Home Health Care News
The Bill’s Path and Practical Effects
The measure’s prospects in Congress remain unclear. The source report says a Senate companion is expected in November, but does not report that it has been introduced, passed by either chamber, or signed into law. No implementation timetable is given.
The report also does not specify how states would meet a new Medicaid requirement, how any added programs would be financed, or how many centers and participants the bill might produce. Its proposed changes may ease access barriers, but the scale and timing of any expansion are unknown. Claims about improved health outcomes or lower costs remain potential benefits cited by supporters, not established results of this legislation.
Senate Companion and Congressional Action
The next reported milestone is the expected Senate companion from Mark Warner in November 2026, according to the National PACE Association. If introduced, it would provide a second version of the proposal for lawmakers to consider; the source does not establish whether its provisions would match the House bill exactly.
After that, the legislation would need to advance through Congress before any new requirements could take effect. Readers should watch for the Senate bill’s text, committee action, votes and any changes to the enrollment, state-coverage or center-opening provisions. Until those steps occur, the proposed expansion remains a possibility rather than a confirmed change to PACE access.
Key Questions
What is the PACE Access Improvement Act?
It is a bipartisan bill introduced by Reps. Debbie Dingell and John Moolenaar on Sept. 24, 2026. It proposes making PACE mandatory under Medicaid in every state, changing when coverage begins after enrollment paperwork is signed, and easing barriers to opening centers.
Would the bill make PACE available in every state immediately?
No. The bill would require all states to offer PACE if enacted, but it has not become law. The timing and process for states to establish programs are not specified in the source report.
How would the proposed enrollment change work?
Under the current rule described in the report, coverage generally starts on the first day of the month after the PACE organization receives a signed enrollment agreement. The bill would make coverage effective on the day the provider signs the paperwork.
Who can qualify for PACE?
Generally, a person must be at least 55, live within a PACE organization’s service area, be certified by the state as needing nursing-home-level care, and be able to live safely in the community with PACE support.
What happens next for the bill?
The National PACE Association says Sen. Mark Warner is expected to introduce a Senate companion in November 2026. The measure would still need to advance through Congress; passage and implementation dates are not confirmed.
Source: homehealthcarenews.com
