HAMDT 25 — Amendment sought to codify Biden-era guidance to ensure that budget neutrality requirements for section 1115 waivers take into account downstream savings.

AMENDS

AMENDMENT PROGRESS

STEP 3 OF 3

Proposed

Considered

Disposed

Proposed
Considered
Disposed

DISPOSITION

FAILED

JUN 4, 2025

“On agreeing to the Pettersen amendment (A003) Failed by recorded vote: 213 - 213 (Roll no. 150).”

what this changes

This amendment would have required the government to count long-term savings when deciding if state Medicaid experiments are too expensive. It aimed to make recent policy permanent by ensuring that if a program saves money in the future—such as by preventing hospital stays—those savings would count toward the program's budget requirements.

WHY IT MATTERS

When states want to try new ways of running Medicaid, they have to prove the experiment won't cost the federal government extra money. If 'downstream savings' are counted, it is easier for states to get approval for programs that spend money upfront on things like housing or nutrition to save money on emergency room visits later.

WHO IS AFFECTED

This primarily affects state health agencies and Medicaid recipients, as it influences which types of experimental health programs states are allowed to create.

AMENDS

HR 2483BECAME LAW

SUPPORT for Patients and Communities Reauthorization Act of 2025

OTHER AMENDMENTS TO THIS BILL

KEY POINTS

low

Budget Neutrality

State Medicaid experiments are required to be 'budget neutral,' meaning they shouldn't cost more than the original program would have.

low

Downstream Savings

This concept recognizes that an investment in preventative care or social services today can lead to significantly lower medical costs for the government in the future.

low

Codifying Guidance

Turning 'guidance' into law makes it harder for future presidential administrations to change the rules without permission from Congress.

GLOSSARY

Section 1115 Waiver: A provision that allows the federal government to waive certain Medicaid rules so states can test new ways to deliver healthcare services.
Codify: The process of taking a rule or policy and writing it into formal law.

Official sources

HAMDT 25 on Congress.gov

This analysis used: Amendment purpose · Latest action · Amended bill: status

ACTION TIMELINE

6 EVENTS

JUN 4, 25

On agreeing to the Pettersen amendment (A003) Failed by recorded vote: 213 - 213 (Roll no. 150).

FLOOR

JUN 4, 25

FLOOR

JUN 4, 25

Amendment (A003) offered by Ms. Pettersen. (consideration: CR H2454-2457; text: CR H2454)

FLOOR

JUN 4, 25

House Amendment Offered

FLOOR

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Amendment sought to codify Biden-era guidance to ensure that budget neutrality requirements for section 1115 waivers take into account downstream savings.

AMENDS

SUMMARY

KEY POINTS

SPONSORSHIP

ACTION TIMELINE

AMENDMENT INFO

READER REACTIONS

Discussion

Amendment sought to codify Biden-era guidance to ensure that budget neutrality requirements for section 1115 waivers take into account downstream savings.

AMENDS

AMENDMENT PROGRESS

DISPOSITION

WHY IT MATTERS

WHO IS AFFECTED

KEY POINTS

GLOSSARY

Official sources

ACTION TIMELINE

SPONSORS

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Amendment sought to codify Biden-era guidance to ensure that budget neutrality requirements for section 1115 waivers take into account downstream savings.

AMENDS

SUMMARY

KEY POINTS

SPONSORSHIP

ACTION TIMELINE

AMENDMENT INFO

READER REACTIONS

Discussion

Amendment sought to codify Biden-era guidance to ensure that budget neutrality requirements for section 1115 waivers take into account downstream savings.

AMENDS

AMENDMENT PROGRESS

DISPOSITION

WHY IT MATTERS

WHO IS AFFECTED

KEY POINTS

GLOSSARY

Official sources

ACTION TIMELINE

SPONSORS

READER REACTIONS

What do you think?

Discussion