From: The Honorable Linda T. Sanchez
Sent By:
Bill: H.R. 4212
Date: 6/20/2016

Dear Colleague –

Please consider cosponsoring bipartisan legislation that will have a profound impact on vulnerable Medicare beneficiaries across the country.  The Community Based Independence for Seniors Act (H.R. 4212) would create a Community-Based Institutional Special Needs Plan (CBI-SNP) demonstration program and help low-income, chronically-ill Medicare beneficiaries remain in the community while potentially saving Medicare and Medicaid millions of dollars.

The CBI-SNP is designed to address the significant and unmet needs of low-income Medicare beneficiaries whose health status puts them at risk of nursing facility placement, and whose financial situation places them on the verge of Medicaid eligibility. Under
current policy, Medicare does not cover the Long Term Services and Supports that play an essential role in keeping individuals out of institutional settings and living independently in the community.

The demonstration proposed in H.R. 4212 would provide medically-complex Medicare beneficiaries with incomes at or below 150 percent of the Federal Poverty Level with access to Home and Community Based Services (HCBS). In providing these services to low-income,
frail Medicare beneficiaries, the CBI-SNP aims to prevent these individuals from going into an institution, spending down their limited assets, and becoming duals.  Enabling these seniors to remain in their homes allows them to live where studies show they
want to live when facing health challenges.

Expanding the availability of these benefits to a Medicare-only population would improve quality of life for individuals while reducing Medicaid long term care costs and Medicare acute care costs. Budget modeling by Avalere Health suggests that this demonstration
could generate approximately $60 million in state and federal savings during the demonstration.

This legislation is a tremendous opportunity to deliver critical services to improve the life of frail seniors while providing policymakers with data to support an alternative payment methodology that could re-shape the financing of long term care.

For any questions and to co-sponsor please contact Andrew Noh with Representative Sánchez ( – (202) 225-2965, Julie Nolan with Representative Meehan (
– (202) 225-2011) Stephen Holland with Representative ( – (202) 225-5711) or Molly McDonnell with Representative Lance (
– (202) 225-5361).




Representative Linda Sanchez                                        Representative Pat Meehan


Representative Kurt Schrader                                         Reprehensive Leonard Lance