II
119THCONGRESS
1
STSESSION S. 1227
To require the Administrator of the Centers for Medicare & Medicaid Services
and the Commissioner of Social Security to review and simplify the
processes, procedures, forms, and communications for family caregivers
to assist individuals in establishing eligibility for, enrolling in, and main-
taining and utilizing coverage and benefits under the Medicare, Medicaid,
CHIP, and Social Security programs respectively, and for other purposes.
IN THE SENATE OF THE UNITED STATES
APRIL1 (legislative day, MARCH31), 2025
Mr. M
ARKEY(for himself, Mrs. CAPITO, Mr. HICKENLOOPER, Mrs. HYDE-
S
MITH, Mr. BLUMENTHAL, Mr. TILLIS, Ms. KLOBUCHAR, Mr. SCOTTof
Florida, Ms. B
ALDWIN, Ms. LUMMIS, Mr. KELLY, Mrs. BRITT, Ms.
H
IRONO, Mr. ROUNDS, Mr. WHITEHOUSE, Mr. CASSIDY, Mr. COONS, and
Mr. S
CHMITT) introduced the following bill; which was read twice and re-
ferred to the Committee on Finance
A BILL
To require the Administrator of the Centers for Medicare
& Medicaid Services and the Commissioner of Social
Security to review and simplify the processes, procedures,
forms, and communications for family caregivers to assist
individuals in establishing eligibility for, enrolling in, and
maintaining and utilizing coverage and benefits under
the Medicare, Medicaid, CHIP, and Social Security pro-
grams respectively, and for other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
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SECTION 1. SHORT TITLE. 1
This Act may be cited as the ‘‘Alleviating Barriers 2
for Caregivers Act’’ or the ‘‘ABC Act’’. 3
SEC. 2. REVIEW OF MEDICARE, MEDICAID, CHIP, AND SO-4
CIAL SECURITY TO SIMPLIFY PROCESSES. 5
PROCEDURES, FORMS, AND COMMUNICA-6
TIONS. 7
(a) D
EFINITIONS.—In this Act: 8
(1) A
DMINISTRATOR.—The term ‘‘Adminis-9
trator’’ means the Administrator of the Centers for 10
Medicare & Medicaid Services. 11
(2) CHIP.—The term ‘‘CHIP’’ means the Chil-12
dren’s Health Insurance Program established under 13
title XXI of the Social Security Act (42 U.S.C. 14
1397aa et seq.). 15
(3) C
OMMISSIONER.—The term ‘‘Commis-16
sioner’’ means the Commissioner of Social Security. 17
(4) C
OVERED AGENCIES .—The term ‘‘covered 18
agencies’’ means the Centers for Medicare & Med-19
icaid Services and the Social Security Administra-20
tion. 21
(5) C
OVERED OFFICIALS.—The term ‘‘covered 22
officials’’ means the Administrator and Commis-23
sioner. 24
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(6) COVERED PROGRAMS .—The term ‘‘covered 1
programs’’ means Medicare, Medicaid, CHIP, and 2
the Social Security programs. 3
(7) D
ISABILITY.—The term ‘‘disability’’ has the 4
meaning given such term in section 3 of the Ameri-5
cans with Disabilities Act of 1990 (42 U.S.C. 6
12102). 7
(8) F
AMILY CAREGIVER.—The term ‘‘family 8
caregiver’’ has the meaning given the term in section 9
2 of the RAISE Family Caregivers Act (42 U.S.C. 10
3030s note). 11
(9) M
EDICAID.—The term ‘‘Medicaid’’ means 12
the Medicaid program established under title XIX of 13
the Social Security Act (42 U.S.C. 1396 et seq.). 14
(10) M
EDICARE.—The term ‘‘Medicare’’ means 15
the Medicare program established under title XVIII 16
of the Social Security Act (42 U.S.C. 1395 et seq.). 17
(11) S
TATE.—The term ‘‘State’’ means any of 18
the 50 States, the District of Columbia, the Com-19
monwealth of Puerto Rico, the United States Virgin 20
Islands, Guam, American Samoa, or the Common-21
wealth of the Northern Mariana Islands. 22
(12) S
OCIAL SECURITY PROGRAMS .—The term 23
‘‘Social Security programs’’ means each of the fol-24
lowing: 25
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(A) The programs for old-age and sur-1
vivors insurance benefits and disability insur-2
ance benefits established under title II of the 3
Social Security Act (42 U.S.C. 401 et seq.). 4
(B) The program for supplemental security 5
income benefits established under title XVI of 6
such Act (42 U.S.C. 1381 et seq.). 7
(b) R
EVIEW OFPROGRAMS.— 8
(1) I
N GENERAL.—The Administrator and the 9
Commissioner shall jointly conduct a review of the 10
eligibility determination and application processes, 11
procedures, forms, and communications of Medicare, 12
Medicaid, CHIP, and the Social Security programs. 13
(2) G
OALS OF THE REVIEW.—In conducting the 14
reviews under paragraph (1), the covered officials 15
shall seek ways to— 16
(A) simplify and streamline policies and 17
procedures for determining eligibility for, enroll-18
ing in, maintaining coverage in, and utilizing 19
the full benefits available under the covered 20
programs; 21
(B) reduce the frequency of family care-22
givers having to— 23
(i) provide the same information to 24
covered agencies more than once; 25
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(ii) complete— 1
(I) multiple documents for each 2
covered agency; or 3
(II) documents requesting the 4
same or similar information for mul-5
tiple covered agencies; or 6
(iii) provide information to the cov-7
ered agencies that— 8
(I) the covered agencies already 9
have; or 10
(II) the covered agencies can eas-11
ily receive from other Federal agen-12
cies; and 13
(C) make it easier for family caregivers to 14
work with the covered agencies and the State 15
agencies responsible for administering State 16
Medicaid and CHIP plans by— 17
(i) providing information on eligibility 18
for, enrollment in, maintaining coverage in, 19
and utilizing the full benefits available 20
under the covered programs to family care-21
givers; 22
(ii) improving communications be-23
tween family caregivers and employees of 24
covered agencies by— 25
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(I) decreasing call wait times; 1
(II) ensuring that employees of 2
covered agencies and the State agen-3
cies responsible for administering 4
State Medicaid and CHIP plans pro-5
vide timely answers to the questions 6
of family caregivers; 7
(III) improving the websites of 8
the covered programs— 9
(aa) by making it easier for 10
family caregivers to find informa-11
tion regarding benefit avail-12
ability, eligibility, and how to 13
maintain coverage; and 14
(bb) by designing such 15
websites to align with the re-16
quirements of the Americans 17
with Disabilities Act (42 U.S.C. 18
12101 et seq.) regarding web de-19
sign; 20
(IV) improving the timely access 21
to in-person appointments or meetings 22
between employees of covered agencies 23
and family caregivers; 24
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(V) providing translation or in-1
terpretation services for family care-2
givers for whom English is not their 3
primary language; and 4
(VI) providing information to 5
family caregivers in accessible for-6
mats, including formats compatible 7
with American Sign Language and 8
multiple languages; 9
(iii) ensuring that employees of cov-10
ered agencies and the State agencies re-11
sponsible for administering State Medicaid 12
and CHIP plans understand how the cov-13
ered programs can help family caregivers; 14
(iv) improving the relationship be-15
tween family caregivers and the covered 16
agencies and the State agencies responsible 17
for administering State Medicaid and 18
CHIP plans, which may include regularly 19
meeting with family caregivers, individuals 20
entitled to, receiving services from, or fil-21
ing for, 1 or more of the covered programs, 22
and other stakeholders of the covered pro-23
grams; 24
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(v) ensuring that employees of covered 1
agencies and the State agencies responsible 2
for administering State Medicaid and 3
CHIP plans who are responsible for resolv-4
ing disputes, appeals, and grievances with-5
in the covered programs receive education, 6
training, and guidance on specific issues 7
faced by family caregivers who participate 8
in the covered programs; and 9
(vi) taking other actions the covered 10
officials may identify. 11
(3) I
NPUT FROM FAMILY CAREGIVERS , ORGANI-12
ZATIONS, AND STATE ENTITIES.—In conducting the 13
reviews under paragraph (1), the covered officials 14
shall seek input from— 15
(A) family caregivers, including family 16
caregivers with a disability, that have interacted 17
with the covered programs; 18
(B) State, regional, national, and Tribal 19
organizations representing or working with fam-20
ily caregivers or individuals receiving care from 21
family caregivers; and 22
(C) State Medicaid and CHIP programs. 23
(c) A
CTION.—After the reviews under subsection (b) 24
have been completed, the covered officials shall take ac-25
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tions that will simplify and streamline policies and proce-1
dures that improve customer service for individuals enti-2
tled to, receiving services from, or filing for, any of the 3
covered programs, and family caregivers. 4
(d) R
EPORT TOCONGRESS.— 5
(1) I
N GENERAL.—No later than 2 years after 6
the date of enactment of this Act, the covered offi-7
cials shall each submit a report to the Committee on 8
Finance of the Senate, the Committee on Ways and 9
Means of the House of Representatives, and the 10
Committee on Energy and Commerce of the House 11
of Representatives that details the results of the re-12
spective reviews each covered official conducted 13
under subsection (b). 14
(2) C
ONTENTS OF THE REPORT .—The reports 15
required under paragraph (1) shall contain— 16
(A) issues that the covered officials identi-17
fied in the reviews and their findings; 18
(B) the actions that the covered officials 19
are taking to address the issues in subpara-20
graph (A); 21
(C) an estimate on when the actions in 22
subparagraph (B) will be completed; 23
(D) projected annual costs to implement 24
the actions identified in subparagraph (B); and 25
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(E) any recommended change in Federal 1
law to address any issue identified in subpara-2
graph (A). 3
(3) U
PDATED REPORTS.—The covered officials 4
shall each submit a report 2 years after submitting 5
the report required under paragraph (1) providing 6
an update to the contents identified in paragraph 7
(2). 8
(4) P
UBLICATION OF THE REPORTS .—The cov-9
ered officials shall make the reports required under 10
paragraphs (1) and (3) publicly accessible on the 11
websites of covered agencies. 12
(e) R
EDUCINGREDTAPE FORSTATEMEDICAID AND 13
CHIP P
ROGRAMS.—Not later than 1 year after the date 14
of enactment of this Act, the Administrator shall issue a 15
letter to each State Medicaid and CHIP Director to— 16
(1) encourage State Medicaid agencies to con-17
duct reviews of State Medicaid programs and State 18
CHIP programs similar to the reviews conducted at 19
the Federal level under subsection (b); 20
(2) provide suggestions, informed by the results 21
of such Federal reviews, for promising practices that 22
States could take to reduce administrative burdens 23
on family caregivers in supporting individuals enti-24
tled to, receiving service from, or filing for, 1 or 25
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more of the covered programs in applying for and 1
receiving assistance under State Medicaid programs 2
and State CHIP programs; and 3
(3) identify best practices to support family 4
caregivers. 5
Æ
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