Military Families Get Medicaid Continuity: New Bill Protects Long-Term Care Waiting List Spots Starting in 2028

The “Care for Military Kids Act of 2025” is designed to fix a major headache for active duty military families: losing crucial healthcare access every time they get a Permanent Change of Station (PCS) order. Starting January 1, 2028, this bill mandates that when an active duty service member moves to a new state for duty, that new state must treat the service member and their dependents as residents for Medicaid eligibility. The biggest win here is for families relying on long-term care: if a dependent was on a Home and Community-Based Services (HCBS) waiting list in the old state, they don't lose their place—they transfer that waiting list spot to the new state. This protection applies specifically to those already enrolled in Medicaid, receiving HCBS, or on an HCBS waiting list at the time of the move (SEC. 2).

No More Healthcare Blackouts During PCS

Think about the typical PCS move. You’re juggling new schools, new housing, and new jobs. The last thing a military family needs is to battle state bureaucracy just to keep their kid's essential medical coverage. This bill cuts through that by forcing the receiving state to accept the family as residents for Medicaid purposes. For example, if a family moves from Texas to California, California can’t use the move as a reason to deny immediate Medicaid eligibility, assuming they met the financial criteria in Texas. This is a huge stability boost for a population that moves every few years.

Protecting the HCBS Lifeline

The most impactful provision deals with HCBS waiting lists. HCBS covers critical long-term support—things like in-home nursing care or specialized therapies for individuals with disabilities—and these waiting lists can stretch for years. Without this protection, a family moving from State A to State B would drop off State A’s list and have to start at the bottom of State B’s list, potentially losing years of progress. This bill says, nope, that waiting list spot moves with you (SEC. 2). The new state must keep the individual on their list until they complete an eligibility assessment and either approve the services or the individual exhausts their appeals. This means a military parent doesn't have to choose between their service member spouse’s career and their child’s essential care.

The Cost and the Catch

While this is a clear benefit for military families, there are two points worth noting. First, the bill provides $1 million annually from 2026 through 2030 to the Department of Health and Human Services (HHS) to implement these new rules, which is meant to help states transition. However, the financial burden for the actual medical care provided will fall on the new state’s Medicaid program. This could mean a short-term cost increase for states that receive a lot of military transfers. Second, the bill specifies that the new state must pay for the care “as long as that care is available in the new state according to guidance the Secretary of Health and Human Services puts out.” That last part—the HHS guidance—is a bit vague and gives the federal government significant power to define what is considered “available” care, which could potentially narrow the scope of services a family expects to receive.

Finally, while the intent is excellent, the protection only applies if the person was already enrolled in Medicaid or on a waiting list in the prior state. And for states that need to change their own laws to comply, they get a grace period until after their next legislative session ends one year after the bill is enacted. This means the full, nationwide rollout of these protections won't be complete until 2028, leaving a few years of uncertainty.