program under title XIX of such Act, or State- 
funded health care programs. 
‘‘(C) Programs funded through the Special 
Supplemental Nutrition Program for Women, 
Infants, and Children. 
‘‘(D) Programs that offer early home vis-
iting services, including the Nurse-Family Part-
nership and the Maternal, Infant, and Early 
Childhood Home Visiting (MIECHV) Program 
(including the Tribal Home Visiting Program). 
‘‘(E) Programs to provide improved and 
affordable access to child care, including pro-
grams funded through the Child Care and De-
velopment Fund, the Temporary Assistance for 
Needy Families program, or a State-funded 
program. 
‘‘(e) NO EFFECT ON OTHER PROGRAMS.—Any as-
sistance or benefits received by a family as a result of a 
project established pursuant to this section shall be dis-
regarded for purposes of determining the family’s eligi-
bility for, or amount of, benefits under any other Federal 
needs-based programs. 
‘‘(f) REPORTS.—As a condition of receiving a grant 
under this section for a fiscal year, the grantee shall sub-
mit to the Secretary, not later than 6 months after the 
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end of the fiscal year, a report that specifies, by month 
and fiscal year, the following: 
‘‘(1) The number of infants and toddlers and 
the age of the infant and toddlers who received as-
sistance from the grantee’s diaper distribution 
project. 
‘‘(2) The number of families that have received 
assistance from the grantee’s diaper distribution 
project. 
‘‘(3) The number of diapers, and the number of 
each type of diapering supply, distributed under the 
grantee’s diaper distribution project. 
‘‘(4) The ZIP Code or ZIP Codes where the 
grantee distributed diapers and diaper supplies. 
‘‘(5) The method or methods the grantee uses 
to distribute diapers and diapering supplies. 
‘‘(6) Such other information as the Secretary 
may specify. 
‘‘(g) EVALUATION.—The Secretary, in consultation 
with each grantee under this section, shall— 
‘‘(1) not later than 2 years after the date of en-
actment of the End Diaper Need Act of 2021— 
‘‘(A) complete an evaluation of the effec-
tiveness of the program carried out pursuant to 
this section; 
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‘‘(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; and 
‘‘(2)(A) not later than 3 years after the date of 
enactment of the End Diaper Need Act of 2021, up-
date the evaluation required by paragraph (1)(A); 
and 
‘‘(B) not later than 90 days after completion of 
the updated evaluation under subparagraph (A)— 
‘‘(i) submit to the relevant congressional 
committees a report describing the results of 
such updated evaluation; and 
‘‘(ii) publish the results of such evaluation 
on the internet website of the Department of 
Health and Human Services. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) DIAPER.—The term ‘diaper’ means an ab-
sorbent garment that— 
‘‘(A) is washable or disposable that may be 
worn by an infant or toddler who is not toilet- 
trained; and 
‘‘(B) 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. 
‘‘(2) DIAPERING
SUPPLIES.—The term ‘dia-
pering supplies’ means items, including diaper wipes 
and diaper cream, necessary to ensure that a child 
using a diaper is properly cleaned and protected 
from diaper rash. 
‘‘(3) 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 family whose self- 
certified income is not more than 200 percent 
of the Federal poverty line. 
‘‘(4) FEDERAL
POVERTY
LINE.—The term 
‘Federal poverty line’ means the Federal poverty line 
as defined by the Office of Management and Budget 
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and revised annually in accordance with section 
673(2) of the Omnibus Budget Reconciliation Act of 
1981 applicable to a family of the size involved. 
‘‘(5) 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. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there is authorized to be appropriated $100,000,000 
for each of fiscal years 2022 through 2025. 
‘‘(2) AVAILABILITY
OF
FUNDS.—Funds pro-
vided to a grantee under this section for a fiscal 
year may be expended by the grantee only in such 
fiscal year or the succeeding fiscal year.’’. 
SEC. 3. IMPROVING ACCESS TO DIAPERS FOR MEDICALLY 
COMPLEX CHILDREN. 
Section 1915(c) of the Social Security Act (42 U.S.C. 
1396n(c)) is amended by adding at the end the following 
new paragraph: 
‘‘(11)(A) In the case of any waiver under this sub-
section that provides medical assistance to a medically 
complex child who has been diagnosed with bowel or blad-
der incontinence, a bowel or bladder condition that causes 
excess urine or stool (such as short gut syndrome or diabe-
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tes insipidus), or a severe skin condition that causes skin 
erosions (such as epidermolysis bullosa), such medical as-
sistance shall include, for the duration of the waiver, the 
provision of 200 medically necessary diapers per month 
and diapering supplies. Such medical assistance may in-
clude the provision of medically necessary diapers in 
amounts greater than 200 if a licensed health care pro-
vider (such as a physician, nurse practitioner, or physician 
assistant) specifies that such greater amounts are nec-
essary for such medically complex child. 
‘‘(B) For purposes of this paragraph— 
‘‘(i) the term ‘medically complex child’ means 
an individual who is at least three years of age and 
for whom a licensed health care provider has pro-
vided a diagnosis of one or more significant chronic 
conditions; 
‘‘(ii) the term ‘medically necessary diaper’ 
means an absorbent garment that is— 
‘‘(I) washable or disposable; and 
‘‘(II) worn by a medically complex child 
who has been diagnosed with a condition de-
scribed in subparagraph (A) and needs such 
garment to correct or ameliorate such condition; 
and 
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‘‘(iii) the term ‘diapering supplies’ means items, 
including diaper wipes and diaper creams, necessary 
to ensure that a medically complex child who has 
been diagnosed with a condition described in sub-
paragraph (A) and uses a medically necessary diaper 
is properly cleaned and protected from diaper rash.’’. 
SEC. 4. 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 adding at the end of subparagraph (A) 
the following: ‘‘For purposes of this subparagraph, 
amounts paid for medically necessary diapers and 
diapering supplies shall be treated as paid for med-
ical care.’’; 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 that is 
washable or disposable worn by an indi-
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vidual needs diapers because they are 
medically necessary, serve a preventative 
medical purpose, or are needed to correct 
or ameliorate defects or physical or mental 
illnesses or conditions which are diagnosed 
by a licenced health care provider. 
‘‘(ii) 
DIAPERING
SUPPLIES.—The 
term ‘diapering supplies’ means items, in-
cluding diaper wipes and diaper creams 
necessary to ensure that a child using a 
medically necessary diaper is properly 
cleaned and protected from diaper rash.’’. 
(b) ARCHER MSAS.—Section 220(d)(2)(A) of such 
Code is amended by adding at the end the following: ‘‘For 
purposes of this subparagraph, amounts paid for medically 
necessary diapers and diapering supplies (as defined in 
section 223(d)(2)(D)) shall be treated as paid for medical 
care.’’. 
(c) HEALTH FLEXIBLE SPENDING ARRANGEMENTS 
AND HEALTH REIMBURSEMENT ARRANGEMENTS.—Sec-
tion 106 of such Code is amended by adding at the end 
the following new subsection: 
‘‘(h) REIMBURSEMENTS
FOR
MEDICALLY
NEC-
ESSARY DIAPERS AND DIAPERING SUPPLIES.—For pur-
poses of this section and section 105, expenses incurred 
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for medically necessary diapers and diapering supplies (as 
defined in section 223(d)(2)(D)) shall be treated as in-
curred for medical care.’’. 
(d) EFFECTIVE DATES.— 
(1) DISTRIBUTIONS FROM HEALTH SAVINGS AC-
COUNTS.—The amendments made by subsections (a) 
and (b) shall apply to amounts paid after December 
31, 2021. 
(2) REIMBURSEMENTS.—The amendment made 
by subsection (c) shall apply to expenses incurred 
after December 31, 2021. 
Æ 
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