I 
119TH CONGRESS 
2D SESSION 
H. R. 7118 
To amend title XIX of the Social Security Act to clarify that whole genome 
and whole exome sequencing for children with certain medical needs 
is covered under the Medicaid program. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 15, 2026 
Mr. PETERS (for himself, Mr. BILIRAKIS, Mr. VEASEY, Mr. BALDERSON, Mr. 
MULLIN, Mr. CAREY, Ms. HOULAHAN, and Ms. SALAZAR) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend title XIX of the Social Security Act to clarify 
that whole genome and whole exome sequencing for chil-
dren with certain medical needs is covered under the 
Medicaid program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Genomic Answers for 
Children’s Health Act of 2026’’. 
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SEC. 2. CLARIFYING THAT WHOLE GENOME AND WHOLE 
EXOME SEQUENCING FOR CHILDREN WITH 
CERTAIN 
MEDICAL 
NEEDS 
IS 
COVERED 
UNDER THE MEDICAID PROGRAM. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (r)— 
(A) by redesignating paragraph (5) as 
paragraph (6); and 
(B) by inserting after paragraph (4) the 
following new paragraph: 
‘‘(5) Whole genome sequencing and whole 
exome sequencing (as defined in subsection (kk)), 
whether furnished in the inpatient or outpatient set-
ting, if ordered by a physician or other provider act-
ing within the provider’s scope of practice under 
State law as a first-tier test for an individual sus-
pected to have a genetic disorder, rare disease, or a 
health condition of unknown origin, including 1 or 
more congenital anomalies, a global developmental 
delay, or an intellectual disability.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(kk) WHOLE GENOME SEQUENCING AND WHOLE 
EXOME SEQUENCING.—For purposes of subsection (r)(5), 
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the term ‘whole genome sequencing and whole exome se-
quencing’— 
‘‘(1) means the determination of a sequence of 
deoxyribonucleic acid bases in the genome taken or 
derived from an individual, and, if for the primary 
benefit of the individual’s diagnosis or treatment, a 
first degree biological relative or relatives of such in-
dividual for the purpose of determining whether 1 or 
more potentially disease-causing genetic variants are 
present in the genome of such individual or such bio-
logical first-degree relative; and 
‘‘(2) includes— 
‘‘(A) the sequencing of the whole genome 
or the whole exome; and 
‘‘(B) any analysis, interpretation, and data 
report derived from such sequencing.’’. 
(b) ADDITIONAL UPDATES.—Section 1902(a) of the 
Social Security Act (42 U.S.C. 1396a(a)) is amended— 
(1) in paragraph (88), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (89), by striking the period 
and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (89) the fol-
lowing new paragraph: 
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‘‘(90) provide that payment for whole genome 
sequencing and whole exome sequencing (as defined 
in section 1905(kk)) is made separately and is not 
bundled as part of payment for any other medical 
assistance.’’. 
(c) OUTREACH AND EDUCATION.—For purposes of 
promoting awareness of and access to whole genome and 
exome sequencing under section 1905(r) of the Social Se-
curity Act (42 U.S.C. 1396d(r)), the Secretary of Health 
and Human Services shall— 
(1) convene national organizations (including at 
least those organizations representing pediatricians, 
specialists in pediatric rare diseases, children’s hos-
pitals, geneticists, genetic counselors, laboratory test 
developers), States, hospitals and health systems, in-
dividuals with rare diseases, and those national or-
ganizations representing Medicaid managed care or-
ganizations to identify challenges and opportunities 
in implementation of the amendments made by this 
section, including potential best practices that mini-
mize denials of claims for medical assistance under 
the State plan under title XIX of such Act resulting 
from use of prior authorization or administrative re-
quirements; 
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provided as a result of such sequencing, and 
other such relevant information. 
(d) REPORT.—Not later than 2 years after the date 
of the enactment of this Act, the Comptroller General of 
the United States shall do the following: 
(1) Collect and analyze feedback regarding im-
plementation of the amendments made by this Act 
from the organizations and entities described in 
paragraph (1) or (2) of subsection (b), including— 
(A) experiences in accessing whole genome 
sequencing and whole exome sequencing and re-
sults pursuant to such amendments, including 
any barriers to such access; 
(B) changes to care or services furnished 
after such sequencing; 
(C) identification of remaining challenges, 
if any, related to access to such sequencing for 
individuals eligible for early and periodic 
screening, diagnostic, and treatment services 
under the Medicaid program; and 
(D) health professional awareness of such 
amendments. 
(2) Assess the following for impacts on access 
to such sequencing under such program for such in-
dividuals: 
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(A) Prior authorization, which may include 
assessment of impacts related to delay of care 
and uncertainty or surprise of payment. 
(B) Workforce and reimbursement chal-
lenges for genetic counselors. 
(C) The extent to which market cost is 
aligned with the Medicare clinical laboratory fee 
schedule and the degree to which the Secretary 
of Health and Human Services’ adjustment of 
the fee schedule might more accurately reflect 
market realities and support affordability. 
(3) Make recommendations to the Secretary of 
Health and Human Services relating to additional 
guidance or improvements that may be made based 
on the feedback collected under paragraph (1) and 
the assessment described in paragraph (2). 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply beginning January 1, 2027. 
Æ 
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