II 

118TH CONGRESS 

1ST SESSION S. 2879 

To provide targeted funding for States and other eligible entities through 

the Social Services Block Grant program to address the increased burden 

that maintaining the health and hygiene of infants and toddlers, medically complex children, and low-income adults or adults with disabilities 

who rely on adult incontinence materials and supplies place on families 

in need, the resultant adverse health effects on children and families, 

and the limited child care options available for infants and toddlers 

who lack sufficient diapers and diapering supplies, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 21, 2023 

Ms. DUCKWORTH (for herself, Mr. CRAMER, Ms. SMITH, Mr. CASEY, and Mr. 

KELLY) introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To provide targeted funding for States and other eligible 

entities through the Social Services Block Grant program 

to address the increased burden that maintaining the 

health and hygiene of infants and toddlers, medically 

complex children, and low-income adults or adults with 

disabilities who rely on adult incontinence materials and 

supplies place on families in need, the resultant adverse 

health effects on children and families, and the limited 

child care options available for infants and toddlers who 

lack sufficient diapers and diapering supplies, and for 

other purposes. 


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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘End Diaper Need Act 

5 of 2023’’. 

6 SEC. 2. TARGETED FUNDING FOR DIAPER ASSISTANCE (IN7 CLUDING DIAPERING SUPPLIES AND ADULT 

8 INCONTINENCE MATERIALS AND SUPPLIES) 

9 THROUGH THE SOCIAL SERVICES BLOCK 

10 GRANT PROGRAM. 

11 (a) INCREASE IN FUNDING FOR SOCIAL SERVICES

12 BLOCK GRANT PROGRAM.— 

13 (1) IN GENERAL.—The amount specified in 

14 subsection (c) of section 2003 of the Social Security 

15 Act (42 U.S.C. 1397b) for purposes of subsections 

16 (a) and (b) of such section is deemed to be 

17 $1,900,000,000 for each of fiscal years 2024 

18 through 2027. Each State shall use the increase in 

19 funding the State receives as a result of this section 

20 in accordance with subsection (b) of this section. 

21 (2) APPROPRIATION.— 

22 (A) IN GENERAL.—Out of any money in 

23 the Treasury of the United States not otherwise 

24 appropriated, there is appropriated 


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1 $200,000,000 for each of fiscal years 2024 

2 through 2027, to carry out this section. 

3 (B) RESERVATIONS.— 

4 (i) PURPOSES.—The Secretary shall 

5 reserve, from the amount appropriated 

6 under subparagraph (A) to carry out this 

7 section— 

8 (I) for each of fiscal years 2024 

9 through 2027, not more than 2 per10 cent of the amount appropriated for 

11 the fiscal year for purposes of enter12 ing into an agreement with a national 

13 entity described in subparagraph (C) 

14 to assist in providing technical assist15 ance and training, to support effective 

16 policy, practice, research, and cross17 system collaboration among grantees 

18 and subgrantees, and to assist in the 

19 administration of the program de20 scribed in this section; and 

21 (II) for fiscal year 2024, an 

22 amount, not to exceed $3,000,000, for 

23 purposes of conducting an evaluation 

24 under subsection (d). 


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1 (ii) NO STATE ENTITLEMENT TO RE2 SERVED FUNDS.—The State entitlement 

3 under section 2002(a) of the Social Secu4 rity Act (42 U.S.C. 1397a(a)) shall not 

5 apply to the amounts reserved under clause 

6 (i). 

7 (C) NATIONAL ENTITY DESCRIBED.—A na8 tional entity described in this subparagraph is 

9 a nonprofit organization described in section 

10 501(c)(3) of the Internal Revenue Code of 1986 

11 and exempt from taxation under section 501(a) 

12 of such Code, that— 

13 (i) has experience in more than 1 

14 State in the area of— 

15 (I) community distributions of 

16 basic need services, including experi17 ence collecting, warehousing, and dis18 tributing basic necessities such as dia19 pers, food, or menstrual products; 

20 (II) child care; 

21 (III) child development activities 

22 in low-income communities; or 

23 (IV) motherhood, fatherhood, or 

24 parent education efforts serving low25 income parents of young children; 


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1 (ii) demonstrates competency to im2 plement a project, provide fiscal account3 ability, collect data, and prepare reports 

4 and other necessary documentation; and 

5 (iii) demonstrates a willingness to 

6 share information with researchers, practi7 tioners, and other interested parties. 

8 (b) RULES GOVERNING USE OF ADDITIONAL

9 FUNDS.— 

10 (1) IN GENERAL.—Funds are used in accord11 ance with this subsection if— 

12 (A) the State, in consultation with relevant 

13 stakeholders, including agencies, professional 

14 associations, and nonprofit organizations, dis15 tributes the funds to eligible entities to— 

16 (i) decrease the need for diapers and 

17 diapering supplies and adult incontinence 

18 materials and supplies in low-income fami19 lies and meet such unmet needs of infants 

20 and toddlers, medically complex children, 

21 and low-income adults and adults with dis22 abilities in such families through— 

23 (I) the distribution of free dia24 pers and diapering supplies, medically 


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1 necessary diapers, and adult inconti2 nence materials and supplies; and 

3 (II) improving access to diapers 

4 and diapering supplies, medically nec5 essary diapers, and adult incontinence 

6 materials and supplies; 

7 (ii) carry out community outreach to 

8 assist in participation in diaper distribu9 tion programs or programs that distribute 

10 medically necessary diapers or adult incon11 tinence materials and supplies; and 

12 (iii) increase the ability of commu13 nities and low-income families in such com14 munities to provide for the need for dia15 pers and diapering supplies, medically nec16 essary diapers, and adult continence mate17 rials and supplies, of infants and toddlers, 

18 medically complex children, and low-income 

19 adults and adults with disabilities; 

20 (B) the funds are used subject to the limi21 tations in section 2005 of the Social Security 

22 Act (42 U.S.C. 1397d); and 

23 (C) the funds are used to supplement, not 

24 supplant, State general revenue funds provided 

25 for the purposes described in subparagraph (A). 


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1 (2) ADMINISTRATIVE COSTS.—A State receiving 

2 funds made available under subsection (a) may use 

3 not more than 5 percent of the funds for State ad4 ministrative costs, which may include costs of con5 tracting, monitoring, and reporting. 

6 (3) ALLOWABLE USES BY ELIGIBLE ENTI7 TIES.—An eligible entity receiving funds made avail8 able under subsection (a) shall use the funds for any 

9 of the following: 

10 (A) To pay for the purchase and distribu11 tion of diapers and diapering supplies, medically 

12 necessary diapers, and funding diaper (includ13 ing medically necessary diapers) distribution 

14 that serves low-income families with— 

15 (i) 1 or more children 3 years of age 

16 or younger; or 

17 (ii) 1 or more medically complex chil18 dren. 

19 (B) To pay for the purchase and distribu20 tion of adult incontinence materials and sup21 plies and funding distribution of the materials 

22 and supplies for low-income families with 1 or 

23 more low-income adults, adults with disabilities, 

24 or children with a disability who have attained 

25 3 years of age and have not attained 19 years 


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1 of age, who rely on adult incontinence materials 

2 and supplies. 

3 (C) To integrate activities carried out 

4 under subparagraph (A) with other basic needs 

5 assistance programs serving eligible children 

6 and their families, including the following: 

7 (i) Programs funded by the temporary 

8 assistance for needy families program 

9 under part A of title IV of the Social Secu10 rity Act (42 U.S.C. 601 et seq.), including 

11 the State maintenance of effort provisions 

12 of such program. 

13 (ii) Programs designed to support the 

14 health of eligible children, such as the Chil15 dren’s Health Insurance Program under 

16 title XXI of the Social Security Act, the 

17 Medicaid program under title XIX of such 

18 Act, or State funded health care programs. 

19 (iii) Programs funded through the 

20 special supplemental nutrition program for 

21 women, infants, and children under section 

22 17 of the Child Nutrition Act of 1966. 

23 (iv) Programs that offer early home 

24 visiting services, including the maternal, 

25 infant, and early childhood home visiting 


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1 program (including the Tribal home vis2 iting program) under section 511 of the 

3 Social Security Act (42 U.S.C. 711). 

4 (v) Programs to provide improved and 

5 affordable access to child care, including 

6 programs funded through the Child Care 

7 and Development Fund, the temporary as8 sistance for needy families program under 

9 part A of title IV of the Social Security 

10 Act (42 U.S.C. 601 et seq.), or a State11 funded program. 

12 (vi) Programs funded under part C of 

13 the Individuals with Disabilities Education 

14 Act (20 U.S.C. 1431 et seq.). 

15 (4) AVAILABILITY OF FUNDS.— 

16 (A) FUNDS DISTRIBUTED TO ELIGIBLE

17 ENTITIES.—Funds made available under sub18 section (a) that are distributed to an eligible en19 tity by a State for a fiscal year may be ex20 pended by the eligible entity only in such fiscal 

21 year or the succeeding fiscal year. 

22 (B) EVALUATION.—Funds reserved under 

23 subsection (a)(2)(B)(i)(II) to carry out the eval24 uation under subsection (d) shall be available 


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1 for expenditure during the 3-year period that 

2 begins on the date of enactment of this Act. 

3 (5) NO EFFECT ON OTHER PROGRAMS.—Any 

4 assistance or benefits received by a family through 

5 funds made available under subsection (a) shall be 

6 disregarded for purposes of determining the family’s 

7 eligibility for, or amount of, benefits under any other 

8 Federal needs-based programs. 

9 (c) ANNUAL REPORTS.—A State shall include in the 

10 annual report required under section 2006 of the Social 

11 Security Act (42 U.S.C. 1397e) covering each of fiscal 

12 years 2022 through 2025, information detailing how eligi13 ble entities, including subgrantees, used funds made avail14 able under subsection (a) to distribute diapers and dia15 pering supplies and adult incontinence materials and sup16 plies to families in need. Each such report shall include 

17 the following: 

18 (1) The number and age of infants, toddlers, 

19 medically complex children, and low-income adults 

20 and adults with disabilities who received assistance 

21 or benefits through such funds. 

22 (2) The number of families that have received 

23 assistance or benefits through such funds. 

24 (3) The number of diapers, medically necessary 

25 diapers, or adult incontinence materials and supplies 


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1 (such as adult diapers, briefs, protective underwear, 

2 pull-ons, pull-ups, liners, shields, guards, pads, un3 dergarments), and the number of each type of dia4 pering or adult incontinence supply, distributed 

5 through the use of such funds. 

6 (4) The ZIP Code or ZIP Codes where the eli7 gible entity (or subgrantee) distributed diapers and 

8 diapering supplies and adult incontinence materials 

9 and supplies. 

10 (5) The method or methods the eligible entity 

11 (or subgrantee) uses to distribute diapers and dia12 pering supplies and, adult incontinence materials 

13 and supplies. 

14 (6) Such other information as the Secretary 

15 may specify. 

16 (d) EVALUATION.—The Secretary, in consultation 

17 with States, the national entity described in subsection 

18 (a)(2)(C), and eligible entities receiving funds made avail19 able under this section, shall— 

20 (1) not later than 2 years after the date of en21 actment of this Act— 

22 (A) complete an evaluation of the effective23 ness of the assistance program carried out pur24 suant to this section, such as the effect of ac25 tivities carried out under this Act on mitigating 


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1 the health and developmental risks of unmet di2 aper need among infants, toddlers, medically 

3 complex children, and other family members in 

4 low-income families, including the risks of dia5 per dermatitis, urinary tract infections, and pa6 rental and child depression and anxiety; 

7 (B) submit to the relevant congressional 

8 committees a report on the results of such eval9 uation; and 

10 (C) publish the results of the evaluation on 

11 the internet website of the Department of 

12 Health and Human Services; 

13 (2) not later than 3 years after the date of en14 actment of this Act, update the evaluation required 

15 by paragraph (1)(A); and 

16 (3) not later than 120 days after completion of 

17 the updated evaluation under paragraph (2)— 

18 (A) submit to the relevant congressional 

19 committees a report describing the results of 

20 such updated evaluation; and 

21 (B) publish the results of such evaluation 

22 on the internet website of the Department of 

23 Health and Human Services. 

24 (e) GUIDANCE.—Not later than 180 days after enact25 ment of this Act, the Secretary shall issue guidance reVerDate Sep 11 2014 02:13 Sep 23, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S2879.IS S2879

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1 garding how the provisions of this section should be car2 ried out, including information regarding eligible entities, 

3 allowable use of funds, and reporting requirements. 

4 (f) DEFINITIONS.—In this section: 

5 (1) ADULT INCONTINENCE MATERIALS AND

6 SUPPLIES.—The term ‘‘adult incontinence materials 

7 and supplies’’ means those supplies that are used to 

8 assist adults or adults with disabilities and includes 

9 adult diapers, briefs, protective underwear, pull-ons, 

10 pull-ups, liners, shields, guards, pads, undergar11 ments, disposable wipes, over-the-counter adult dia12 per rash cream products, intermittent catheteriza13 tion, indwelling catheters, condom catheters, urinary 

14 drainage bags, external collection devices, wearable 

15 urinals, and penile clamps. 

16 (2) ADULTS WITH DISABILITIES.—The term 

17 ‘‘adults with disabilities’’ means individuals who— 

18 (A) have attained 18 years of age; and 

19 (B) have a disability (as such term is de20 fined, with respect to an individual, in section 

21 3 of the Americans with Disabilities Act of 

22 1990 (42 U.S.C. 12102)). 

23 (3) DIAPER.—The term ‘‘diaper’’ means an ab24 sorbent garment that— 


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1 (A) is washable or disposable that may be 

2 worn by an infant or toddler who is not toilet3 trained; and 

4 (B) if disposable— 

5 (i) does not use any latex or common 

6 allergens; and 

7 (ii) meets or exceeds the quality 

8 standards for diapers commercially avail9 able through retail sale in the following 

10 categories: 

11 (I) Absorbency (with acceptable 

12 rates for first and second wetting). 

13 (II) Waterproof outer cover. 

14 (III) Flexible leg openings. 

15 (IV) Refastening closures. 

16 (4) DIAPERING SUPPLIES.—The term ‘‘dia17 pering supplies’’ means items, including diaper wipes 

18 and diaper cream, necessary to ensure that— 

19 (A) an eligible child using a diaper is prop20 erly cleaned and protected from diaper rash; or 

21 (B) a medically complex child who uses a 

22 medically necessary diaper is properly cleaned 

23 and protected from diaper rash. 

24 (5) ELIGIBLE CHILD.—The term ‘‘eligible 

25 child’’ means a child who— 


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1 (A) has not attained 4 years of age; and 

2 (B) is a member of a low-income family. 

3 (6) ELIGIBLE ENTITIES.—The term ‘‘eligible 

4 entity’’ means a State or local governmental entity, 

5 an Indian tribe or tribal organization (as defined in 

6 section 4 of the Indian Self-Determination and Edu7 cation Assistance Act), or a nonprofit organization 

8 described in section 501(c)(3) of the Internal Rev9 enue Code of 1986 and exempt from taxation under 

10 section 501(a) of such Code that— 

11 (A) has experience in the area of— 

12 (i) community distributions of basic 

13 need services, including experience col14 lecting, warehousing, and distributing basic 

15 necessities such as diapers, food, or men16 strual products; 

17 (ii) child care; 

18 (iii) child development activities in 

19 low-income communities; or 

20 (iv) motherhood, fatherhood, or par21 ent education efforts serving low-income 

22 parents of young children; 

23 (B) demonstrates competency to implement 

24 a project, provide fiscal accountability, collect 


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1 data, and prepare reports and other necessary 

2 documentation; and 

3 (C) demonstrates a willingness to share in4 formation with researchers, practitioners, and 

5 other interested parties. 

6 (7) FEDERAL POVERTY LINE.—The term ‘‘Fed7 eral poverty line’’ means the Federal poverty line as 

8 defined by the Office of Management and Budget 

9 and revised annually in accordance with section 

10 673(2) of the Omnibus Budget Reconciliation Act of 

11 1981 (42 U.S.C. 9902(2)) applicable to a family of 

12 the size involved. 

13 (8) LOW-INCOME.—The term ‘‘low-income’’, 

14 with respect to a family, means a family whose self15 certified income is not more than 200 percent of the 

16 Federal poverty line. 

17 (9) MEDICALLY COMPLEX CHILD.—The term 

18 ‘‘medically complex child’’ means an individual who 

19 has attained 3 years of age and for whom a licensed 

20 health care provider has provided a diagnosis of 1 or 

21 more significant chronic conditions. 

22 (10) MEDICALLY NECESSARY DIAPER.—The 

23 term ‘‘medically necessary diaper’’ means an absorb24 ent garment that is— 

25 (A) washable or disposable; 


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1 (B) worn by a medically complex child who 

2 has been diagnosed with bowel or bladder incon3 tinence, a bowel or bladder condition that 

4 causes excess urine or stool (such as short gut 

5 syndrome or diabetes insipidus), or a severe 

6 skin condition that causes skin erosions (such 

7 as epidermolysis bullosa) and needs such gar8 ment to correct or ameliorate such condition; 

9 and 

10 (C) if disposable— 

11 (i) does not use any latex or common 

12 allergens; and 

13 (ii) meets or exceeds the quality 

14 standards for diapers commercially avail15 able through retail sale in the following 

16 categories: 

17 (I) Absorbency (with acceptable 

18 rates for first and second wetting). 

19 (II) Waterproof outer cover. 

20 (III) Flexible leg openings. 

21 (IV) Refastening closures. 

22 (11) STATE.—The term ‘‘State’’ means the 50 

23 States, the District of Columbia, the Commonwealth 

24 of Puerto Rico the United States Virgin Islands, 

25 Guam, the Commonwealth of the Northern Mariana 


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1 Islands, American Samoa, the Republic of the Mar2 shall Islands, the Federated States of Micronesia, 

3 and the Republic of Palau. 

4 (g) EXEMPTION OF PROGRAM FROM SEQUESTRA5 TION.— 

6 (1) IN GENERAL.—Section 255(h) of the Bal7 anced Budget and Emergency Deficit Control Act of 

8 1985 (2 U.S.C. 905(h)) is amended by inserting 

9 after ‘‘Supplemental Security Income Program (28– 

10 0406–0–1–609).’’ the following: 

11 ‘‘Targeted funding for States for diaper assist12 ance (including diapering supplies and adult inconti13 nence materials and supplies) through the Social 

14 Services Block Grant Program.’’. 

15 (2) APPLICABILITY.—The amendment made by 

16 this subsection shall apply to any sequestration 

17 order issued under the Balanced Budget and Emer18 gency Deficit Control Act of 1985 (2 U.S.C. 900 et 

19 seq.) on or after the date of enactment of this Act. 

20 SEC. 3. IMPROVING ACCESS TO DIAPERS FOR MEDICALLY 

21 COMPLEX CHILDREN. 

22 Section 1915(c) of the Social Security Act (42 U.S.C. 

23 1396n(c)) is amended by adding at the end the following 

24 new paragraph: 


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1 ‘‘(11)(A) In the case of any waiver under this sub2 section that provides medical assistance to a medically 

3 complex child who has been diagnosed with bowel or blad4 der incontinence, a bowel or bladder condition that causes 

5 excess urine or stool (such as short gut syndrome or diabe6 tes insipidus), or a severe skin condition that causes skin 

7 erosions (such as epidermolysis bullosa), such medical as8 sistance shall include, for the duration of the waiver, the 

9 provision of 200 medically necessary diapers per month 

10 and diapering supplies. Such medical assistance may in11 clude the provision of medically necessary diapers in 

12 amounts greater than 200 if a licensed health care pro13 vider (such as a physician, nurse practitioner, or physician 

14 assistant) specifies that such greater amounts are nec15 essary for such medically complex child. 

16 ‘‘(B) For purposes of this paragraph: 

17 ‘‘(i) The term ‘medically complex child’ means 

18 an individual who has attained age 3 and for whom 

19 a licensed health care provider has provided a diag20 nosis of 1 or more significant chronic conditions. 

21 ‘‘(ii) The term ‘medically necessary diaper’ 

22 means an absorbent garment that is— 

23 ‘‘(I) washable or disposable; 

24 ‘‘(II) worn by a medically complex child 

25 who has been diagnosed with a condition deVerDate Sep 11 2014 02:13 Sep 23, 2023 Jkt 039200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\S2879.IS S2879

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1 scribed in subparagraph (A) and needs such 

2 garment to correct or ameliorate such condition; 

3 and 

4 ‘‘(III) if disposable— 

5 ‘‘(aa) does not use any latex or com6 mon allergens; and 

7 ‘‘(bb) meets or exceeds the quality 

8 standards for diapers commercially avail9 able through retail sale in the following 

10 categories: 

11 ‘‘(AA) Absorbency (with accept12 able rates for first and second wet13 ting). 

14 ‘‘(BB) Waterproof outer cover. 

15 ‘‘(CC) Flexible leg openings. 

16 ‘‘(DD) Refastening closures. 

17 ‘‘(iii) The term ‘diapering supplies’ means 

18 items, including diaper wipes and diaper creams, 

19 necessary to ensure that a medically complex child 

20 who has been diagnosed with a condition described 

21 in subparagraph (A) and uses a medically necessary 

22 diaper is properly cleaned and protected from diaper 

23 rash.’’. 


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1 SEC. 4. INCLUSION OF DIAPERS AND DIAPERING SUPPLIES 

2 AS QUALIFIED MEDICAL EXPENSES. 

3 (a) HEALTH SAVINGS ACCOUNTS.—Section 

4 223(d)(2) of the Internal Revenue Code of 1986 is amend5 ed— 

6 (1) by inserting ‘‘, medically necessary diapers, 

7 and diapering supplies’’ after ‘‘menstrual care prod8 ucts’’ in the last sentence of subparagraph (A); and 

9 (2) by adding at the end the following new sub10 paragraph: 

11 ‘‘(E) MEDICALLY NECESSARY DIAPERS

12 AND DIAPERING SUPPLIES.—For purposes of 

13 this paragraph— 

14 ‘‘(i) MEDICALLY NECESSARY DIA15 PERS.—The term ‘medically necessary dia16 per’ means an absorbent garment which is 

17 washable or disposable and which is worn 

18 by an individual who has attained 3 years 

19 of age because of medical necessity, such 

20 as someone who has been diagnosed with 

21 bowel or bladder incontinence, a bowel or 

22 bladder condition that causes excess urine 

23 or stool (such as short gut syndrome or di24 abetes insipidus), or a severe skin condi25 tion that causes skin erosions (such as 

26 epidermolysis bullosa) and needs such garVerDate Sep 11 2014 02:13 Sep 23, 2023 Jkt 039200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\S2879.IS S2879

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1 ment to correct or ameliorate such condi2 tion, to serve a preventative medical pur3 pose, or to correct or ameliorate defects or 

4 physical or mental illnesses or conditions 

5 diagnosed by a licensed health care pro6 vider, and, if disposable— 

7 ‘‘(I) does not use any latex or 

8 common allergens; and 

9 ‘‘(II) meets or exceeds the quality 

10 standards for diapers commercially 

11 available through retail sale in the fol12 lowing categories: 

13 ‘‘(aa) Absorbency (with ac14 ceptable rates for first and sec15 ond wetting). 

16 ‘‘(bb) Waterproof outer 

17 cover. 

18 ‘‘(cc) Flexible leg openings. 

19 ‘‘(dd) Refastening closures. 

20 ‘‘(ii) DIAPERING SUPPLIES.—The 

21 term ‘diapering supplies’ means items, in22 cluding diaper wipes and diaper creams, 

23 necessary to ensure that an individual 

24 wearing medically necessary diapers is 


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1 properly cleaned and protected from diaper 

2 rash.’’. 

3 (b) ARCHER MSAS.—The last sentence of section 

4 220(d)(2)(A) of such Code is amended by inserting ‘‘, 

5 medically necessary diapers (as defined in section 

6 223(d)(2)(E)), and diapering supplies (as defined in sec7 tion 223(d)(2)(E))’’ after ‘‘menstrual care products (as 

8 defined in section 223(d)(2)(D))’’. 

9 (c) HEALTH FLEXIBLE SPENDING ARRANGEMENTS

10 AND HEALTH REIMBURSEMENT ARRANGEMENTS.—Sec11 tion 106(f) of such Code is amended— 

12 (1) by inserting ‘‘, medically necessary diapers 

13 (as defined in section 223(d)(2)(E)), and diapering 

14 supplies (as defined in section 223(d)(2)(E))’’ after 

15 ‘‘menstrual care products (as defined in section 

16 223(d)(2)(D))’’; and 

17 (2) in the heading, by inserting ‘‘, MEDICALLY

18 NECESSARY DIAPERS, AND DIAPERING SUPPLIES’’ 

19 after ‘‘MENSTRUAL CARE PRODUCTS’’. 

20 (d) EFFECTIVE DATES.— 

21 (1) DISTRIBUTIONS FROM CERTAIN AC22 COUNTS.—The amendments made by subsections (a) 

23 and (b) shall apply to amounts paid after December 

24 31, 2024. 


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1 (2) REIMBURSEMENTS.—The amendment made 

2 by subsection (c) shall apply to expenses incurred 

3 after December 31, 2024. 

Æ 


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