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Reps. Debbie Dingell and John Moolenaar introduced the bipartisan PACE Access Improvement Act on Sept. 24, 2026. It would require every state to offer PACE and make coverage effective when an eligible person signs enrollment paperwork, rather than the following month. The bill has not become law, and a Senate companion was expected in November.
Reps. Debbie Dingell and John Moolenaar introduced the bipartisan PACE Access Improvement Act on Sept. 24, proposing changes that could widen access to home-based care for eligible older adults. The bill would require every state to offer the Program of All-Inclusive Care for the Elderly (PACE) and make coverage effective when a participant signs enrollment paperwork, rather than waiting until the first day of the next month.
PACE combines Medicare and Medicaid to provide coordinated services to adults aged 55 and older who meet state criteria for nursing-home-level care and can live safely in the community with program support. Eligibility also requires living within a PACE organization’s service area. The model is designed to support people with complex medical and social needs outside nursing homes.
Under current rules described by Home Health Care News, people may sign up during any part of the month, but coverage begins on the first day of the month after the organization receives the signed enrollment agreement. The legislation would instead start coverage on the day the provider signs the paperwork. It would also make PACE a required Medicaid offering, where it is currently available in 33 states.
Industry leaders say the changes could help providers serve more people and plan new centers. InnovAge CEO Patrick Blair told Home Health Care News that earlier coverage and fewer barriers to opening and expanding centers could improve access. The PACE Association of Michigan’s executive director, Stephanie Winslow, said current restrictions limit providers’ ability to market services before a new center opens.
Faster Enrollment, Wider State Access
The proposed enrollment change could reduce the gap between signing up and receiving coverage. For older adults who qualify and need coordinated support, starting services sooner could make PACE more responsive to care needs. The bill would not change the core eligibility standards described in the report, including the age threshold, care-level certification and requirement to live within a program’s service area.
Requiring all states to offer PACE could create new opportunities for providers to establish programs in places where the model is not currently available. Blair said earlier intervention and preventive care could help some seniors maintain independence and potentially avoid more costly care settings. That is an industry leader’s assessment of possible effects, not a measured outcome of this legislation.
For providers, wider availability could mean a larger potential service area and more demand for centers, staff and transportation. The bill’s effect would depend on implementation and whether states and organizations can build the capacity to serve eligible residents. The source report does not quantify likely enrollment growth or the cost of expansion.
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How PACE Access Works Today
PACE is a joint Medicare-Medicaid program that coordinates care for eligible older adults who would otherwise qualify for nursing-home-level care but can remain safely in the community with support. Services are delivered through local PACE organizations, so availability depends in part on whether a person lives within a program’s service area.
The act addresses several access issues identified by providers: the lag before coverage starts, the limited number of states with programs, and rules that can constrain outreach around new centers. Winslow told Home Health Care News that Michigan providers may have staff, buses and drivers ready before a center opens but cannot do much marketing beforehand. She said earlier outreach could give prospective participants more time to learn about PACE and consider enrollment.
The proposal follows an existing landscape in which 33 states offer PACE, according to the report. InnovAge, based in Denver, operates services in California, Colorado, Florida, New Mexico, Pennsylvania and Virginia. Its footprint illustrates that PACE is operating across multiple states, but does not establish how many additional sites the bill would produce.
““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
Bill Status and Expansion Questions
The bill is a proposal, not a change in current law. The source report says Sen. Mark Warner was expected to introduce a Senate companion in November, but it does not confirm that the companion was introduced or provide details about its text, committee action or prospects for passage.
It is also unclear how quickly states without PACE programs could establish them if the measure became law, or how much funding, staffing and infrastructure would be needed. The report does not provide projected costs, enrollment estimates or a timeline for implementation. Any expansion would also depend on whether providers can open centers and serve eligible people in new areas.
The bill’s proposed enrollment start date is described as the day the provider signs the paperwork. The available report does not specify how that provision would work in every administrative circumstance, or whether lawmakers could revise it as the measure advances.
Senate Proposal and Legislative Path
The next development identified in the report was a Senate companion expected in November, according to the National PACE Association, a supporter of the bill. Whether that measure was introduced, and whether its language matches the House proposal, remains to be confirmed by the source material.
After introduction, the proposals would need to proceed through Congress before any requirements could take effect. Readers should watch for committee consideration, amendments, cost information and any implementation timetable. Until legislation is enacted, states are not required by this bill to launch PACE programs, and the current enrollment coverage rule remains in place.
Key Questions
What would the PACE Access Improvement Act change?
It would require every state to offer PACE and would make coverage begin on the day an eligible participant signs enrollment paperwork with the provider, instead of the following month.
Who can qualify for PACE?
According to the report, applicants must be 55 or older, 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.
Is the bill law now?
No. Reps. Debbie Dingell and John Moolenaar introduced it in the House on Sept. 24, 2026. The source report describes a Senate companion as expected in November, not as enacted legislation.
How many states currently offer PACE?
The source report says 33 states currently offer PACE. The proposal would require every state to offer the program if it became law.
Would the bill guarantee that every eligible older adult can enroll?
No such guarantee is established in the source material. The proposal addresses state availability and the timing of coverage, while eligibility and service-area requirements would still apply. The report does not estimate how many additional people could enroll.
Source: rss
