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S4358FEDERALin_committee

SAFE through Medicare Act

April 21, 2026

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Where This Stands

Introduced
Committee
Floor Vote
Passed
Signed

Currently in_committee. The next step in the legislative lifecycle is Floor Vote.

Last action
Read twice and referred to the Committee on Finance.Apr 21, 2026

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

View official text →

The Frame

What this does

If passed, this bill would allow Medicare to fully cover the cost of specific home equipment for vulnerable patients to ensure their medical safety during power outages, extreme temperatures, or other disaster-related infrastructure failures starting in 2027.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Medicare beneficiaries

Individuals with chronic conditions or medical equipment reliance may qualify for fully covered home resiliency equipment.

Department of Health and Human Services

The agency is tasked with creating the eligibility determination process and fee schedules for these new services.

What changed

Current stage: in_committee.

What's next

Floor Vote.

Summary

This bill proposes expanding Medicare coverage to include '' for individuals deemed during climate or manmade disasters. These services would include equipment like heat pumps, solar batteries for medical devices, and cold-storage for heat-sensitive medication.

Key Facts

  • The bill creates a new Medicare coverage category for 'home resiliency services' for medically at-risk individuals.
  • Coverage for these services would begin on or after January 1, 2027.
  • Medicare would pay 100% of the lesser of the actual charge or the Secretary-established fee schedule for these services.
  • Examples of covered items include heat pumps, solar batteries for medical equipment, and energy-efficient cold-storage for medical supplies.
  • The Secretary of Health and Human Services must establish a process to determine who qualifies as 'medically at-risk'.
  • The determination process must involve the NIH, CMS, and NOAA.
  • Eligibility criteria must consider geography-specific climate risks and regional infrastructure failure history (past 20 years) or predicted risk (next 20 years).
  • Eligibility criteria must consider patient reliance on electricity-dependent medical equipment and heat-sensitive pharmaceuticals.
  • Eligibility criteria must consider chronic medical conditions and disabilities that increase vulnerability during disasters.

Frequently Asked Questions

What kind of equipment would be covered?
The bill covers items deemed medically necessary for disaster resilience, specifically mentioning heat pumps, solar batteries for medical devices like ventilators, and cold-storage for heat-sensitive medicine.
Who decides if I am 'medically at-risk'?
The Secretary of Health and Human Services will establish a process to determine eligibility, in consultation with the NIH, CMS, and NOAA.
How much of the cost does Medicare cover?
The bill proposes that Medicare cover 100% of the cost, up to a fee schedule established by the Secretary.

Why It Matters

If passed, this bill would allow Medicare to fully cover the cost of specific home equipment for vulnerable patients to ensure their medical safety during power outages, extreme temperatures, or other disaster-related infrastructure failures starting in 2027.

News Coverage

No news coverage found yet. Articles are indexed twice daily.

Lobbying Activity

AARP

$4,110,000

2026

HEALTH ISSUESMEDICARE/MEDICAIDLAW ENFORCEMENT/CRIME/CRIMINAL JUSTICEPHARMACY

P.L. 119-21, One Big Beautiful Bill Act H.R. 8867, Planning for Long-term Aging Needs (PLAN) Act H.R. 5861, Legacy Act of 2025 H.R. 9393, the Lower Costs, More Transparency Act. H.R. 9396, the Prior Authorization Accountability Act. S. 4916, the Aging with Artificial Intelligence Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act of 2025. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S. 2120, the Older Americans Act Reauthorization Act of 2025 H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act of 2025. H.R. 3954/S. 4641, Improving Access to Medicare Coverage Act. H.R.5554/S.2831, Stand Strong for Medicare Act. S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act and efforts related to the bill S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act S. 668/H.R. 3183, Supporting Access to Falls Education and Prevention and Strengthening Training Efforts and Promoting Safety Initiatives (SAFE STEPS) for Veterans Act of 2025 CMS-1851-P, Hospice Proposed rule. CMS-1843-P, Skilled Nursing Facility Proposed rule. CMS-1844-P, Home Health Proposed rule. No bill number. Health care transparency. No bill number. Discussed use of artificial intelligence and health data technology. No bill number. Discussed health-related policies and activities around the fall respiratory virus season. No bill number. Discussed health insurance affordability proposals. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed HUD Assisted Living Requirements No bill number. Discussed family caregiving. No bill number. Discussed AARP paper on Medicare Caregiver Training Services. No bill number. Discussed Medicaid community engagement interim final rule, including the family caregiver exemption. No bill number. Discussed the paid direct care workforce in long-term care. No bill number. Discussed the unaffordability of long-term care. No bill number. Discussed Money Follows the Person Rebalancing Demonstration Program and Medicaid HCBS spousal impoverishment protections. No bill number. Discussed Medicaid fraud and family caregivers, Medicaid self-direction programs. No bill number. Discussed sandwich generation family caregiver hearing and submitted a statement for the record discussing family caregivers and sandwich generation caregivers, programs that support them, AARP caregiving resources, and federal policies to support sandwich generation caregivers and caregivers more broadly. No bill number. Discussed long-term care. No bill number. CMS-2453-NC; Medicaid Program; 2028 Medicaid Home and Community-Based Services Quality Measure Set Submitted comments No bill number. Discussed expanding access to home care. No bill number. Discussed the increasing cost of home care No bill number. Discussed HSA use for telehealth chronic care management services/subscriptions. No bill number. Discussed artificial intelligence and technology

THE NICKLES GROUP, LLC

on behalf of BAXTER HEALTHCARE CORPORATION

The Cleveland Clinic Foundation

on behalf of Cleveland Clinic Foundation

$110,000

2025

HEALTH ISSUESMEDICARE/MEDICAID

Quantum computing 340B Enhanced Premium Tax Credits Immigration Issues Department of Education professional designation definition Alzheimer's Legislation Safe Act

(C) MANAGEMENT INC.

on behalf of Association of Community Cancer Centers

2021

GOVERNMENT ISSUESHEALTH ISSUES

THE TELEHEALTH MODERNIZATION ACT (H.R. 1332/ S.368) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views telehealth expansion as critical for cancer patient access to healthcare providers. THE SAFE STEP ACT (H.R.2163/S.464) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views step therapy in the use of cancer care delivery to be a hinderance to best practice and timely treatment/access of care for patients. THE ACCESS TO GENETIC COUNSELOR SERVICES ACT (H.R. 2144/S.1450) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views genetic counselors as integral members of the cancer care delivery team in oncology programs/practices in the US. THE RESEARCH INVESTMENT TO SPARK THE ECONOMY (RISE) ACT (H.R. 869/S.289) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC understands the importance of research funding for the NIH and oncology investigators to promote clinical trials that impact improving cancer outcomes. THE MEDICARE MULTI-CANCER EARLY DETECTION SCREENING COVERAGE ACT OF 2021 (H.R. 1946) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC advocates for the use and coverage of cancer screening modalities that will diagnose cancer at earlier stages therefore improving patient outcomes. MOST FAVORED NATION (Proposed by Trump Administration at end of 2020) ACCC entered into a lawsuit against HHS in December 2020 opposing the Most Favored Nation proposal tying drug reimbursements to international reference pricing. By lowering reimbursement to cancer programs and practices, patient access to care would be limited as supportive cancer care services limited due to lack of reimbursement to cover positions. ACCC was concerned over programs/practices closing if proposal were to move forward. ACCC met with one Senators office on this topic expressing concern in January 2021. RADIATION ONCOLOGY MODEL (Proposed by CMMI) ACCC met with 1 Senate office and 1 House office over concerns re: this alternative payment model. ACCC has concerns over mandatory nature of Radiation Oncology model testing reimbursement rates and potentially limiting access to care for patients who are recommended radiation for their cancer diagnosis, particularly in rural areas of the U.S.

Sponsors

Discoveries

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift90% confidence

Integration of Climate Risk into Medicare

The bill marks a shift toward using Medicare as a vehicle for climate adaptation and disaster resilience, rather than just direct medical treatment.

Connected Entities

personMr. MarkeySenator who introduced the bill.Map →
organizationNational Oceanic and Atmospheric AdministrationConsulted for determining medically at-risk criteria.Map →
organizationNational Institutes of HealthConsulted for determining medically at-risk criteria.Map →
organizationCenters for Medicare & Medicaid ServicesConsulted for determining medically at-risk criteria.Map →

Analysis Score

0–100
  • Significance65
    How much this matters to a regular citizen
  • Controversy40
    Intensity of disagreement among stakeholders
  • Entertainment10
    Compellingness for a non-policy-wonk reader
  • Buzz25
    Current news / social attention level

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