II 

118TH CONGRESS 

1ST SESSION S. 3109 

To require the Administrator of the Centers for Medicare & Medicaid Services 

and the Commissioner of Social Security to review and simplify the 

processes, procedures, forms, and communications for family caregivers 

to assist individuals in establishing eligibility for, enrolling in, and maintaining and utilizing coverage and benefits under the Medicare, Medicaid, 

CHIP, and Social Security programs respectively, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 24, 2023 

Mr. MARKEY (for himself, Mrs. CAPITO, Ms. SINEMA, Ms. COLLINS, Mr. 

CASEY, and Mr. TILLIS) introduced the following bill; which was read 

twice and referred to the Committee on Finance 

A BILL 

To require the Administrator of the Centers for Medicare 

& Medicaid Services and the Commissioner of Social 

Security to review and simplify the processes, procedures, 

forms, and communications for family caregivers to assist 

individuals in establishing eligibility for, enrolling in, and 

maintaining and utilizing coverage and benefits under 

the Medicare, Medicaid, CHIP, and Social Security programs respectively, and for other purposes. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Alleviating Barriers 

3 for Caregivers Act’’ or the ‘‘ABC Act’’. 

4 SEC. 2. REVIEW OF MEDICARE, MEDICAID, CHIP, AND SO5 CIAL SECURITY TO SIMPLIFY PROCESSES. 

6 PROCEDURES, FORMS, AND COMMUNICA7 TIONS. 

8 (a) DEFINITIONS.—In this Act: 

9 (1) ADMINISTRATOR.—The term ‘‘Adminis10 trator’’ means the Administrator of the Centers for 

11 Medicare & Medicaid Services. 

12 (2) CHIP.—The term ‘‘CHIP’’ means the Chil13 dren’s Health Insurance Program established under 

14 title XXI of the Social Security Act (42 U.S.C. 

15 1397aa et seq.). 

16 (3) COMMISSIONER.—The term ‘‘Commis17 sioner’’ means the Commissioner of Social Security. 

18 (4) COVERED AGENCIES.—The term ‘‘covered 

19 agencies’’ means the Centers for Medicare & Med20 icaid Services and the Social Security Administra21 tion. 

22 (5) COVERED OFFICIALS.—The term ‘‘covered 

23 officials’’ means the Administrator and Commis24 sioner. 


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1 (6) COVERED PROGRAMS.—The term ‘‘covered 

2 programs’’ means Medicare, Medicaid, CHIP, and 

3 the Social Security programs. 

4 (7) DISABILITY.—The term ‘‘disability’’ has the 

5 meaning given such term in section 3 of the Ameri6 cans with Disabilities Act of 1990 (42 U.S.C. 

7 12102). 

8 (8) FAMILY CAREGIVER.—The term ‘‘family 

9 caregiver’’ has the meaning given the term in section 

10 2 of the RAISE Family Caregivers Act (42 U.S.C. 

11 3030s note). 

12 (9) MEDICAID.—The term ‘‘Medicaid’’ means 

13 the Medicaid program established under title XIX of 

14 the Social Security Act (42 U.S.C. 1396 et seq.). 

15 (10) MEDICARE.—The term ‘‘Medicare’’ means 

16 the Medicare program established under title XVIII 

17 of the Social Security Act (42 U.S.C. 1395 et seq.). 

18 (11) STATE.—The term ‘‘State’’ means any of 

19 the 50 States, the District of Columbia, the Com20 monwealth of Puerto Rico, the United States Virgin 

21 Islands, Guam, American Samoa, or the Common22 wealth of the Northern Mariana Islands. 

23 (12) SOCIAL SECURITY PROGRAMS.—The term 

24 ‘‘Social Security programs’’ means each of the fol25 lowing: 


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1 (A) The programs for old-age and sur2 vivors insurance benefits and disability insur3 ance benefits established under title II of the 

4 Social Security Act (42 U.S.C. 401 et seq.). 

5 (B) The program for supplemental security 

6 income benefits established under title XVI of 

7 such Act (42 U.S.C. 1381 et seq.). 

8 (b) REVIEW OF PROGRAMS.— 

9 (1) IN GENERAL.—The Administrator and the 

10 Commissioner shall jointly conduct a review of the 

11 eligibility determination and application processes, 

12 procedures, forms, and communications of Medicare, 

13 Medicaid, CHIP, and the Social Security programs, 

14 respectively. 

15 (2) GOALS OF THE REVIEW.—In conducting the 

16 reviews under paragraph (1), the covered officials 

17 shall seek ways to— 

18 (A) simplify and streamline policies and 

19 procedures for determining eligibility for, enroll20 ing in, maintaining coverage in, and utilizing 

21 the full benefits available under the covered 

22 programs; 

23 (B) reduce the frequency of family care24 givers having to— 


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1 (i) provide the same information to 

2 covered agencies more than once; 

3 (ii) complete— 

4 (I) multiple documents for each 

5 covered agency; or 

6 (II) documents requesting the 

7 same or similar information for mul8 tiple covered agencies; or 

9 (iii) provide information to the cov10 ered agencies that— 

11 (I) the covered agencies already 

12 have; or 

13 (II) the covered agencies can eas14 ily receive from other Federal agen15 cies; and 

16 (C) make it easier for family caregivers to 

17 work with the covered agencies and the State 

18 agencies responsible for administering State 

19 Medicaid and CHIP plans by— 

20 (i) providing information on eligibility 

21 for, enrollment in, maintaining coverage in, 

22 and utilizing the full benefits available 

23 under the covered programs to family care24 givers; 


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1 (ii) improving communications be2 tween family caregivers and employees of 

3 covered agencies by— 

4 (I) decreasing call wait times; 

5 (II) ensuring that employees of 

6 covered agencies and the State agen7 cies responsible for administering 

8 State Medicaid and CHIP plans pro9 vide timely answers to the questions 

10 of family caregivers; 

11 (III) improving the websites of 

12 the covered programs— 

13 (aa) by making it easier for 

14 family caregivers to find informa15 tion regarding benefit avail16 ability, eligibility, and how to 

17 maintain coverage; and 

18 (bb) by designing such 

19 websites to align with the re20 quirements of the Americans 

21 with Disabilities Act (42 U.S.C. 

22 12101 et seq.) regarding web de23 sign; 

24 (IV) improving the timely access 

25 to in-person appointments or meetings 


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1 between employees of covered agencies 

2 and family caregivers; 

3 (V) providing translation or in4 terpretation services for family care5 givers for whom English is not their 

6 primary language; and 

7 (VI) providing information to 

8 family caregivers in accessible for9 mats, including formats compatible 

10 with American Sign Language and 

11 multiple languages; 

12 (iii) ensuring that employees of cov13 ered agencies and the State agencies re14 sponsible for administering State Medicaid 

15 and CHIP plans understand how the cov16 ered programs can help family caregivers; 

17 (iv) improving the relationship be18 tween family caregivers and the covered 

19 agencies and the State agencies responsible 

20 for administering State Medicaid and 

21 CHIP plans, which may include regularly 

22 meeting with family caregivers, individuals 

23 entitled to, receiving services from, or fil24 ing for, 1 or more of the covered programs, 


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1 and other stakeholders of the covered pro2 grams; 

3 (v) ensuring that employees of covered 

4 agencies and the State agencies responsible 

5 for administering State Medicaid and 

6 CHIP plans who are responsible for resolv7 ing disputes, appeals, and grievances with8 in the covered programs receive education, 

9 training, and guidance on specific issues 

10 faced by family caregivers who participate 

11 in the covered programs; and 

12 (vi) taking other actions the covered 

13 officials may identify. 

14 (3) INPUT FROM FAMILY CAREGIVERS, ORGANI15 ZATIONS, AND STATE ENTITIES.—In conducting the 

16 reviews under paragraph (1), the covered officials 

17 shall seek input from— 

18 (A) family caregivers, including family 

19 caregivers with a disability, that have interacted 

20 with the covered programs; 

21 (B) State, regional, national, and Tribal 

22 organizations representing or working with fam23 ily caregivers or individuals receiving care from 

24 family caregivers; and 

25 (C) State Medicaid and CHIP programs. 


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1 (c) ACTION.—After the reviews under subsection (b) 

2 have been completed, the covered officials shall take ac3 tions that will simplify and streamline policies and proce4 dures that improve customer service for individuals enti5 tled to, receiving services from, or filing for, any of the 

6 covered programs, and family caregivers. 

7 (d) REPORT TO CONGRESS.— 

8 (1) IN GENERAL.—No later than 1 year after 

9 the date of enactment of this Act, the covered offi10 cials shall each submit a report to the Committee on 

11 Finance of the Senate, the Committee on Ways and 

12 Means of the House of Representatives, and the 

13 Committee on Energy and Commerce of the House 

14 of Representatives that details the results of the re15 spective reviews each covered official conducted 

16 under subsection (b). 

17 (2) CONTENTS OF THE REPORT.—The reports 

18 required under paragraph (1) shall contain— 

19 (A) issues that the covered officials identi20 fied in the reviews and their findings; 

21 (B) the actions that the covered officials 

22 are taking to address the issues in subpara23 graph (A); 

24 (C) an estimate on when the actions in 

25 subparagraph (B) will be completed; 


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1 (D) projected annual costs to implement 

2 the actions identified in subparagraph (B); and 

3 (E) any recommended change in Federal 

4 law to address any issue identified in subpara5 graph (A). 

6 (3) UPDATED REPORTS.—The covered officials 

7 shall each submit a report 1 year after submitting 

8 the report required under paragraph (1) providing 

9 an update to the contents identified in paragraph 

10 (2). 

11 (4) PUBLICATION OF THE REPORTS.—The cov12 ered officials shall make the reports required under 

13 paragraphs (1) and (3) publicly accessible on the 

14 websites of covered agencies. 

15 (e) REDUCING RED TAPE FOR STATE MEDICAID AND

16 CHIP PROGRAMS.—Not later than 1 year after the date 

17 of enactment of this Act, the Administrator shall issue a 

18 letter to each State Medicaid and CHIP Director to— 

19 (1) encourage State Medicaid agencies to con20 duct reviews of State Medicaid programs and State 

21 CHIP programs similar to the reviews conducted at 

22 the Federal level under subsection (b); 

23 (2) provide suggestions, informed by the results 

24 of such Federal reviews, for promising practices that 

25 States could take to reduce administrative burdens 


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1 on family caregivers in supporting individuals enti2 tled to, receiving service from, or filing for, 1 or 

3 more of the covered programs in applying for and 

4 receiving assistance under State Medicaid programs 

5 and State CHIP programs; and 

6 (3) identify best practices to support family 

7 caregivers. 

Æ 


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