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Reps. Debbie Dingell and John Moolenaar introduced the bipartisan PACE Access Improvement Act on Sept. 24, 2026. It would require all states to offer PACE, make coverage effective when enrollment paperwork is signed and ease barriers to opening or expanding centers; the bill has not become law.
U.S. Reps. Debbie Dingell and John Moolenaar introduced the bipartisan PACE Access Improvement Act on Sept. 24, 2026, proposing to require every state to offer the Program of All-Inclusive Care for the Elderly and to make enrollment coverage effective sooner. The bill could widen access to coordinated, home-based care for eligible older adults, but it is a proposal, not a change in current law.
The bill would change when coverage begins for people who enroll. Under current rules described by Home Health Care News, people may sign up at any time during the month, but coverage begins on the first day of the following month after the PACE organization receives the signed enrollment agreement. The proposal would instead make coverage effective on the day the provider signs the paperwork. That change could reduce the wait between enrollment and access to services.
The legislation would also make PACE mandatory under Medicaid, requiring all states to have programs. Thirty-three states currently offer PACE, according to the report. The measure also aims to ease barriers to opening and expanding centers, although the report does not specify the full set of proposed regulatory changes.
PACE combines Medicare and Medicaid services for eligible adults who are at least 55, live in a PACE organization’s service area, are certified by their state as needing nursing-home-level care and can live safely in the community with PACE support. Services are coordinated to help participants receive care at home rather than in a nursing home.
How Faster Enrollment Could Expand Care
For older adults who meet PACE eligibility rules, the proposed start-date change could shorten the interval between signing enrollment documents and receiving coverage. The state mandate could also bring the program to places where it is not currently available, while center-opening changes could affect how quickly providers can establish local services.
PACE organizations and their supporters say broader access could benefit people with complex medical and social needs and give providers a larger potential service area. InnovAge CEO Patrick Blair told Home Health Care News that PACE reaches only a small fraction of older adults who might benefit. The actual scale of any expansion would depend on the bill’s final terms, state implementation and providers’ ability to develop programs.
The issue matters to home-based care providers because PACE relies on coordinated services delivered in the community. If enacted and implemented, the proposal could create opportunities to serve more eligible adults outside nursing homes. That is a possible effect, not a guaranteed outcome: the source material provides no estimate of new participants, centers, costs or savings.
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PACE Rules and Current Reach
PACE is a joint Medicare and Medicaid program that provides coordinated support for older adults who need nursing-home-level care but can live safely in the community with program services. Eligibility depends on age, residence within a program’s service area, state certification and the person’s ability to remain safely in the community with support.
The central access issue identified in the report is that enrollment can happen during the month while coverage generally starts the following month. The bill would change that timing and seek to make PACE available in every state. At the time of the report, 33 states had PACE programs. InnovAge, a provider cited in the report, operated in California, Colorado, Florida, New Mexico, Pennsylvania and Virginia.
In Michigan, PACE providers also face limits on outreach before a new center opens, according to Stephanie Winslow, executive director of the PACE Association of Michigan. She said staff, vehicles and drivers may be ready before a center can promote its services. Earlier outreach could give prospective participants more time to learn about the program before a site opens, she said.
“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, CEO of InnovAge, speaking to Home Health Care News
The Bill’s Scope and Prospects
The source report describes the legislation’s goals but does not provide its full text or a detailed account of how it would ease center-opening barriers. The bill’s implementation requirements, costs and effects on state budgets and provider capacity are not established in the material available here.
It is also unclear whether Congress will advance or pass the bill, whether its provisions will change during consideration, and how quickly states without PACE programs could establish them. Claims that earlier care could help seniors maintain independence or avoid more costly settings are supporters’ expectations; the report provides no measured savings or outcomes attributable to the proposed legislation.
Senate Companion and Legislative Action
The National PACE Association said a Senate companion measure from Sen. Mark Warner, D-Va., was expected in November 2026. The report does not confirm that it was introduced. The next developments to watch are the companion bill’s introduction, committee consideration and any changes to the proposal as it moves through Congress.
Until Congress acts and any law is implemented, current enrollment start dates and state program availability remain in place. Further details on regulations, funding and timelines would be needed to assess how the proposal might affect older adults and PACE providers in practice.
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 wider state availability of PACE, earlier coverage after enrollment and changes intended to ease barriers to opening or expanding centers.
Would the bill make PACE available in every state?
The proposal would make PACE mandatory under Medicaid, requiring every state to offer a program. The report says 33 states currently offer PACE. The bill has not become law, so nationwide availability is not yet in effect.
When would PACE coverage start under the proposal?
Under the bill, coverage would begin on the day the PACE provider signs the enrollment paperwork. Under the current rule described in the report, coverage starts on the first day of the month after the organization receives the signed agreement.
Who can qualify for PACE?
Eligibility described in the report requires a person to be at least 55, live within a PACE organization’s service area, have state certification that they need nursing-home-level care and be able to live safely in the community with PACE services.
Has a Senate version of the bill been introduced?
The National PACE Association said Sen. Mark Warner was expected to introduce a companion bill in November 2026. The source report does not confirm that the introduction took place.
Source: homehealthcarenews.com
