Project 2025 Tracker / What’s done, what’s next

14. Department of Health and Human Services · Notable

Launch a Medicaid "personal option" for coverage outside the program

Not started

468 14. Department of Health and Human Services

“For example, CMS should launch a robust “personal option” to allow families to use Medicaid dollars to secure coverage outside of the Medicaid program.”

What has happened

  1. Not started

    No "personal option" was launched. Federal Register full-text search for the phrase since 2025-01-20 returns nothing, no Section 1115 demonstration of that kind appears in the Corpus, and the CMS Innovation Center's 508 model pages contain no such model. The one Medicaid demonstration change of the window runs the other way for a program like this: Public Law 119-21 § 71118 bars the Secretary from approving any Section 1115 project from 2027-01-01 unless the CMS Chief Actuary certifies it will not increase federal spending. Negative search recorded in `docs/research/ch-14.md` under the round-2 (ticket 16) cluster searches.

    No action found yet. This entry is the starting point, not a finding.

Research log

What was searched, and what didn’t count as evidence

Research notes

  • Searched: the Federal Register since 2025-01-20 for the term “personal option” → 0; “section 1115 demonstration” → 8 documents, none a personal-option demonstration; the titles of the bills we keep and search, for “personal option” → 0; the cms.gov sitemap’s model list.
  • Premium assistance under §§ 1906 and 1906A of the Social Security Act is the existing route for Medicaid dollars to buy private coverage; it is untouched in the window. #1284 carries the legislative version of the same idea.
  • Unified Agenda, checked 2026-09-01. Checked against the full HHS agenda on reginfo.gov (183 active RINs in the 2026 Unified Agenda, published 2026-08-14), not the abbreviated version the Federal Register prints. The nearest entry is recorded here; it does not name this ask’s object, so the Status is unchanged: an agenda entry, like a strategic plan, counts only when it names what the ask asks for.
    • “Personal option” appears in none of the 183 entries. The nearest is 0938-AV99 (State Innovation Waivers and Health Care Choice Compacts, CMS-9877, NPRM 07/2026), which updates § 1332 waiver review and would set procedural standards for § 1333 cross-state sales. That is ACA-market machinery, not Medicaid dollars following a family out of the program.
Action
create
Object
Medicaid personal option
ID
1282