Bipartisan bill aims to extend hospital at home waiver until 2030

Congress will take another run at cementing one of the pandemic era’s most popular health-care experiments: bringing the hospital to the living room. On Thursday, Rep. Vern Buchanan, Republican of Florida and chair of the House Ways and Means health subcommittee, introduced the Hospital Inpatient Services Modernization Act, a bipartisan, bicameral bill that would keep Medicare’s “hospital-at-home” waiver alive through 2030. Sens. Tim Scott (R-SC), and Raphael Warnock (D-GA), filed companion legislation in the Senate.

“Our nation is getting sicker and sicker, but programs like ‘Hospital at Home’ allow us to treat patients more efficiently while delivering high-quality care at a lower cost,” Mr. Buchanan said in a statement, noting that 23 Florida hospitals now rely on the waiver. 

A model born of crisis, now at an inflection point

Launched by Medicare in November 2020 to relieve overflowing wards, the Acute Hospital Care at Home waiver suspends several long-standing federal rules so that hospitals can monitor and treat eligible patients — often those with heart failure, pneumonia or kidney disease — inside their own homes. The program ballooned from a handful of pilots to 391 approved facilities in 39 states as of March 12, 2025, according to federal data.

A Harvard-led randomized trial found that home-hospital care cut the total cost of an acute episode by 38 percent while reducing readmissions and boosting patient mobility. And an evaluation released by the Centers for Medicare & Medicaid Services last fall reported lower mortality and fewer hospital-acquired infections among at-home patients across the 25 most common diagnoses.

“Hospital-at-home care provides better outcomes for patients while reducing costs,” Sen. Scott said, calling the waiver “a critical tool for families in South Carolina and beyond.” Senator Warnock added that it “protects access to quality health care while lowering costs.” 

Hospitals, still understaffed five years after Covid-19 first hit, have been lobbying hard. In a March letter, nearly 100 provider groups warned lawmakers that a series of short-term extensions — the current waiver expires Sept. 30, 2025 — makes long-range planning impossible. Lisa Kidder Hrobsky of the American Hospital Association praised the new bill for giving “needed stability” to investments in remote monitoring and paramedic house-calls. 

Skeptics see risks for patients — and caregivers

Not everyone is convinced that moving acute care off-site is a bargain. National Nurses United has branded the model “home all alone,” arguing that acutely ill patients belong on wards staffed with 24/7 bedside nurses. 

A tug-of-war over Medicare dollars

The legislation lands as the Trump administration proposes a 6.4 percent cut to traditional home-health payments in 2026, sharpening fears that savings from home-hospital care could simply be clawed back elsewhere. Hospital leaders insist the waiver must be extended for several years — or made permanent — before they can justify the upfront costs of remote patient-monitoring equipment, courier labs and round-the-clock telehealth control centers.

What happens next

The House Ways and Means Committee is expected to mark up the bill later this month; Senate Finance aides said a hearing could follow before the August recess. With bipartisan sponsors in both chambers and strong support from the hospital lobby, aides on Capitol Hill say the measure could be folded into a larger year-end health package — if lawmakers can agree on how to pay for the estimated $1.6 billion in Medicare spending the extension would trigger over five years.