of age, who rely on adult incontinence materials 
and supplies. 
(C) To integrate activities carried out 
under subparagraph (A) with other basic needs 
assistance programs serving eligible children 
and their families, including the following: 
(i) Programs funded by the temporary 
assistance for needy families program 
under part A of title IV of the Social Secu-
rity Act (42 U.S.C. 601 et seq.), including 
the State maintenance of effort provisions 
of such program. 
(ii) Programs designed to support the 
health of eligible children, such as the Chil-
dren’s Health Insurance Program under 
title XXI of the Social Security Act, the 
Medicaid program under title XIX of such 
Act, or State funded health care programs. 
(iii) Programs funded through the 
special supplemental nutrition program for 
women, infants, and children under section 
17 of the Child Nutrition Act of 1966. 
(iv) Programs that offer early home 
visiting services, including the maternal, 
infant, and early childhood home visiting 
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program (including the Tribal home vis-
iting program) under section 511 of the 
Social Security Act (42 U.S.C. 711). 
(v) Programs to provide improved and 
affordable access to child care, including 
programs funded through the Child Care 
and Development Fund, the temporary as-
sistance for needy families program under 
part A of title IV of the Social Security 
Act (42 U.S.C. 601 et seq.), or a State- 
funded program. 
(vi) Programs funded under part C of 
the Individuals with Disabilities Education 
Act (20 U.S.C. 1431 et seq.). 
(4) AVAILABILITY OF FUNDS.— 
(A) FUNDS
DISTRIBUTED
TO
ELIGIBLE 
ENTITIES.—Funds made available under sub-
section (a) that are distributed to an eligible en-
tity by a State for a fiscal year may be ex-
pended by the eligible entity only in such fiscal 
year or the succeeding fiscal year. 
(B) EVALUATION.—Funds reserved under 
subsection (a)(2)(B)(i)(II) to carry out the eval-
uation under subsection (d) shall be available 
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for expenditure during the 3-year period that 
begins on the date of enactment of this Act. 
(5) NO EFFECT ON OTHER PROGRAMS.—Any 
assistance or benefits received by a family through 
funds made available under subsection (a) shall be 
disregarded for purposes of determining the family’s 
eligibility for, or amount of, benefits under any other 
Federal needs-based programs. 
(c) ANNUAL REPORTS.—A State shall include in the 
annual report required under section 2006 of the Social 
Security Act (42 U.S.C. 1397e) covering each of fiscal 
years 2026 through 2029, information detailing how eligi-
ble entities, including subgrantees, used funds made avail-
able under subsection (a) to distribute diapers and dia-
pering supplies and adult incontinence materials and sup-
plies to families in need. Each such report shall include 
the following: 
(1) The number and age of infants, toddlers, 
medically complex children, and low-income adults 
and adults with disabilities who received assistance 
or benefits through such funds. 
(2) The number of families that have received 
assistance or benefits through such funds. 
(3) The number of diapers, medically necessary 
diapers, or adult incontinence materials and supplies 
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(such as adult diapers, briefs, protective underwear, 
pull-ons, pull-ups, liners, shields, guards, pads, un-
dergarments), and the number of each type of dia-
pering or adult incontinence supply, distributed 
through the use of such funds. 
(4) The ZIP Code or ZIP Codes where the eli-
gible entity (or subgrantee) distributed diapers and 
diapering supplies and adult incontinence materials 
and supplies. 
(5) The method or methods the eligible entity 
(or subgrantee) uses to distribute diapers and dia-
pering supplies and, adult incontinence materials 
and supplies. 
(6) Such other information as the Secretary 
may specify. 
(d) EVALUATION.—The Secretary, in consultation 
with States, the national entity described in subsection 
(a)(2)(C), and eligible entities receiving funds made avail-
able under this section, shall— 
(1) not later than 2 years after the date of en-
actment of this Act— 
(A) complete an evaluation of the effective-
ness of the assistance program carried out pur-
suant to this section, such as the effect of ac-
tivities carried out under this Act on mitigating 
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the health and developmental risks of unmet di-
aper need among infants, toddlers, medically 
complex children, and other family members in 
low-income families, including the risks of dia-
per dermatitis, urinary tract infections, and pa-
rental and child depression and anxiety; 
(B) submit to the relevant congressional 
committees a report on the results of such eval-
uation; and 
(C) publish the results of the evaluation on 
the internet website of the Department of 
Health and Human Services; 
(2) not later than 3 years after the date of en-
actment of this Act, update the evaluation required 
by paragraph (1)(A); and 
(3) not later than 120 days after completion of 
the updated evaluation under paragraph (2)— 
(A) submit to the relevant congressional 
committees a report describing the results of 
such updated evaluation; and 
(B) publish the results of such evaluation 
on the internet website of the Department of 
Health and Human Services. 
(e) GUIDANCE.—Not later than 180 days after enact-
ment of this Act, the Secretary shall issue guidance re-
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garding how the provisions of this section should be car-
ried out, including information regarding eligible entities, 
allowable use of funds, and reporting requirements. 
(f) DEFINITIONS.—In this section: 
(1) ADULT
INCONTINENCE
MATERIALS
AND 
SUPPLIES.—The term ‘‘adult incontinence materials 
and supplies’’ means those supplies that are used to 
assist adults or adults with disabilities and includes 
adult diapers, briefs, protective underwear, pull-ons, 
pull-ups, liners, shields, guards, pads, undergar-
ments, disposable wipes, over-the-counter adult dia-
per rash cream products, intermittent catheteriza-
tion, indwelling catheters, condom catheters, urinary 
drainage bags, external collection devices, wearable 
urinals, and penile clamps. 
(2) ADULTS
WITH
DISABILITIES.—The term 
‘‘adults with disabilities’’ means individuals who— 
(A) have attained 18 years of age; and 
(B) have a disability (as such term is de-
fined, with respect to an individual, in section 
3 of the Americans with Disabilities Act of 
1990 (42 U.S.C. 12102)). 
(3) DIAPER.—The term ‘‘diaper’’ means an ab-
sorbent garment that— 
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(A) is washable or disposable that may be 
worn by an infant or toddler who is not toilet- 
trained; and 
(B) if disposable— 
(i) does not use any latex or common 
allergens; and 
(ii) meets or exceeds the quality 
standards for diapers commercially avail-
able through retail sale in the following 
categories: 
(I) Absorbency (with acceptable 
rates for first and second wetting). 
(II) Waterproof outer cover. 
(III) Flexible leg openings. 
(IV) Refastening closures. 
(4) DIAPER BANK.—- The term ‘‘diaper bank’’ 
means a nonprofit organization that— 
(A) is described in section 501(c)(3) of the 
Internal Revenue Code of 1986 and exempt 
from taxation under section 501(a) of such 
Code; 
(B) is established and operating primarily 
for the purpose of collecting or purchasing dia-
pers and diapering supplies; and 
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(C) distributes diapers and diapering sup-
plies either directly or through partnerships for 
eventual distribution to individuals free of 
charge. 
(5) DIAPERING
SUPPLIES.—The term ‘‘dia-
pering supplies’’ means items, including diaper wipes 
and diaper cream, necessary to ensure that— 
(A) an eligible child using a diaper is prop-
erly cleaned and protected from diaper rash; or 
(B) a medically complex child who uses a 
medically necessary diaper is properly cleaned 
and protected from diaper rash. 
(6) ELIGIBLE
CHILD.—The term ‘‘eligible 
child’’ means a child who— 
(A) has not attained 4 years of age; and 
(B) is a member of a low-income family. 
(7) ELIGIBLE
ENTITIES.—The term ‘‘eligible 
entity’’ means a State or local governmental entity, 
an Indian tribe or tribal organization (as defined in 
section 4 of the Indian Self-Determination and Edu-
cation Assistance Act), or a diaper bank or other 
nonprofit organization described in section 501(c)(3) 
of the Internal Revenue Code of 1986 and exempt 
from taxation under section 501(a) of such Code 
that— 
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(A) has at least 1 year of demonstrated ex-
perience in the area of— 
(i) community distributions of diapers 
and diapering supplies and other basic 
need services, such as food or menstrual 
products; 
(ii) child care; 
(iii) child development activities in 
low-income communities; or 
(iv) motherhood, fatherhood, or par-
ent education efforts serving low-income 
parents of young children; 
(B) demonstrates competency to implement 
a project, provide fiscal accountability, collect 
data, and prepare reports and other necessary 
documentation; and 
(C) demonstrates a willingness to share in-
formation with researchers, practitioners, and 
other interested parties. 
(8) FEDERAL POVERTY LINE.—The term ‘‘Fed-
eral poverty line’’ means the Federal poverty line as 
defined by the Office of Management and Budget 
and revised annually in accordance with section 
673(2) of the Omnibus Budget Reconciliation Act of 
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1981 (42 U.S.C. 9902(2)) applicable to a family of 
the size involved. 
(9) LOW-INCOME.—The term ‘‘low-income’’, 
with respect to a family, means a family whose self- 
certified income is not more than 200 percent of the 
Federal poverty line. 
(10) MEDICALLY COMPLEX CHILD.—The term 
‘‘medically complex child’’ means an individual who 
has attained 3 years of age and for whom a licensed 
health care provider has provided a diagnosis of 1 or 
more significant chronic conditions. 
(11) MEDICALLY
NECESSARY
DIAPER.—The 
term ‘‘medically necessary diaper’’ means an absorb-
ent garment that is— 
(A) washable or disposable; 
(B) worn by a medically complex child who 
has been diagnosed with bowel or bladder incon-
tinence, a bowel or bladder condition that 
causes excess urine or stool (such as short gut 
syndrome or diabetes insipidus), or a severe 
skin condition that causes skin erosions (such 
as epidermolysis bullosa) and needs such gar-
ment to correct or ameliorate such condition; 
and 
(C) if disposable— 
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(i) does not use any latex or common 
allergens; and 
(ii) meets or exceeds the quality 
standards for diapers commercially avail-
able through retail sale in the following 
categories: 
(I) Absorbency (with acceptable 
rates for first and second wetting). 
(II) Waterproof outer cover. 
(III) Flexible leg openings. 
(IV) Refastening closures. 
(12) STATE.—The term ‘‘State’’ means the 50 
States, the District of Columbia, the Commonwealth 
of Puerto Rico the United States Virgin Islands, 
Guam, the Commonwealth of the Northern Mariana 
Islands, American Samoa, the Republic of the Mar-
shall Islands, the Federated States of Micronesia, 
and the Republic of Palau. 
(g) EXEMPTION OF PROGRAM FROM SEQUESTRA-
TION.— 
(1) IN GENERAL.—Section 255(h) of the Bal-
anced Budget and Emergency Deficit Control Act of 
1985 (2 U.S.C. 905(h)) is amended by inserting 
after ‘‘Supplemental Security Income Program (28– 
0406–0–1–609).’’ the following: 
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‘‘Targeted funding for States for diaper assist-
ance (including diapering supplies and adult inconti-
nence materials and supplies) through the Social 
Services Block Grant Program.’’. 
(2) APPLICABILITY.—The amendment made by 
this subsection shall apply to any sequestration 
order issued under the Balanced Budget and Emer-
gency Deficit Control Act of 1985 (2 U.S.C. 900 et 
seq.) on or after the date of enactment of this Act. 
SEC. 3. INCLUSION OF DIAPERS AND DIAPERING SUPPLIES 
AS QUALIFIED MEDICAL EXPENSES. 
(a) 
HEALTH
SAVINGS
ACCOUNTS.—Section 
223(d)(2) of the Internal Revenue Code of 1986 is amend-
ed— 
(1) by inserting ‘‘, medically necessary diapers, 
and diapering supplies’’ after ‘‘menstrual care prod-
ucts’’ in the last sentence of subparagraph (A); and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(E) MEDICALLY
NECESSARY
DIAPERS 
AND
DIAPERING
SUPPLIES.—For purposes of 
this paragraph— 
‘‘(i) MEDICALLY
NECESSARY
DIA-
PERS.—The term ‘medically necessary dia-
per’ means an absorbent garment which is 
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washable or disposable and which is worn 
by an individual who has attained 3 years 
of age because of medical necessity, such 
as someone who has been diagnosed with 
bowel or bladder incontinence, a bowel or 
bladder condition that causes excess urine 
or stool (such as short gut syndrome or di-
abetes insipidus), or a severe skin condi-
tion that causes skin erosions (such as 
epidermolysis bullosa) and needs such gar-
ment to correct or ameliorate such condi-
tion, to serve a preventative medical pur-
pose, or to correct or ameliorate defects or 
physical or mental illnesses or conditions 
diagnosed by a licensed health care pro-
vider, and, if disposable— 
‘‘(I) does not use any latex or 
common allergens; and 
‘‘(II) meets or exceeds the quality 
standards for diapers commercially 
available through retail sale in the fol-
lowing categories: 
‘‘(aa) Absorbency (with ac-
ceptable rates for first and sec-
ond wetting). 
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‘‘(bb) 
Waterproof 
outer 
cover. 
‘‘(cc) Flexible leg openings. 
‘‘(dd) Refastening closures. 
‘‘(ii) 
DIAPERING
SUPPLIES.—The 
term ‘diapering supplies’ means items, in-
cluding diaper wipes and diaper creams, 
necessary to ensure that an individual 
wearing medically necessary diapers is 
properly cleaned and protected from diaper 
rash.’’. 
(b) ARCHER MSAS.—The last sentence of section 
220(d)(2)(A) of such Code is amended by inserting ‘‘, 
medically necessary diapers (as defined in section 
223(d)(2)(E)), and diapering supplies (as defined in sec-
tion 223(d)(2)(E))’’ after ‘‘menstrual care products (as 
defined in section 223(d)(2)(D))’’. 
(c) HEALTH FLEXIBLE SPENDING ARRANGEMENTS 
AND HEALTH REIMBURSEMENT ARRANGEMENTS.—Sec-
tion 106(f) of such Code is amended— 
(1) by inserting ‘‘, medically necessary diapers 
(as defined in section 223(d)(2)(E)), and diapering 
supplies (as defined in section 223(d)(2)(E))’’ after 
‘‘menstrual care products (as defined in section 
223(d)(2)(D))’’; and 
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(2) in the heading, by inserting ‘‘, MEDICALLY 
NECESSARY DIAPERS, AND DIAPERING SUPPLIES’’ 
after ‘‘MENSTRUAL CARE PRODUCTS’’. 
(d) EFFECTIVE DATES.— 
(1) 
DISTRIBUTIONS
FROM
CERTAIN
AC-
COUNTS.—The amendments made by subsections (a) 
and (b) shall apply to amounts paid after December 
31, 2025. 
(2) REIMBURSEMENTS.—The amendment made 
by subsection (c) shall apply to expenses incurred 
after December 31, 2025. 
Æ 
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