SAFE through Medicare Act
- Sponsor
- Rep. Frost, Maxwell [D-FL-10]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- May 12, 2026
Bottom line
The SAFE through Medicare Act seeks to enhance the safety and resilience of Medicare beneficiaries with specific medical vulnerabilities by covering home modifications and equipment essential for disaster preparedness.
What it actually does
This bill amends Title XVIII of the Social Security Act to expand Medicare coverage to include "medically necessary home resiliency services." These services are intended for individuals determined to be "medically at-risk" during climate or manmade disasters, covering items like heat pumps, solar batteries for essential medical equipment, and energy-efficient cold storage for heat-sensitive medications. The bill mandates 100% Medicare payment for these services.
Proponents argue
Proponents argue that this bill is a critical step in protecting vulnerable Medicare beneficiaries from the increasing threats posed by climate change and other disasters. By proactively funding home resiliency measures, the bill could prevent hospitalizations, reduce emergency response burdens, and ultimately save lives, particularly for those reliant on medical equipment or sensitive supplies. They emphasize that this is a cost-effective preventative measure in the long run.
Opponents contend
Opponents might raise concerns about the potential for significant new costs to the Medicare program, especially given the broad definitions of "medically at-risk" and "home resiliency services" which could lead to widespread eligibility. They may also question the federal government's role in funding home infrastructure improvements, arguing it could set a precedent for other non-medical home expenses, or that such services are better handled by other agencies or private insurance.
The bill is very short and straightforward, allowing for a quick and comprehensive understanding of its core provisions.
Section 2(a)(1), amending Section 1861(s)(2) of the Social Security Act.
Establishes Medicare Coverage for Home Resiliency Services
This provision adds "home resiliency services" to the list of items and services covered by Medicare Part B. This coverage is specifically for individuals who are determined by the Secretary to be "medically at-risk" in the event of a climate or manmade disaster. It expands the scope of what Medicare considers a covered medical expense.
Supporters argue
Supporters argue this directly addresses a critical gap in care for vulnerable seniors and individuals with disabilities, ensuring they have the necessary protections against increasingly frequent and severe environmental threats.
Critics contend
Critics might argue this broadens Medicare's mission beyond traditional medical care into home infrastructure, potentially straining the program's finances.
Tradeoffs
Balances the immediate medical needs of vulnerable populations against the broader financial sustainability and scope of the Medicare program.
Section 2(a)(2), adding new subsection 1861(ooo)(1) to the Social Security Act.
Defines "Home Resiliency Services"
This section defines "home resiliency services" as items and services furnished on or after January 1, 2027, that the Secretary determines are medically necessary for an at-risk individual during a climate or manmade disaster. Examples provided include heat pumps for those vulnerable to extreme temperatures, solar batteries for individuals reliant on electrical medical equipment (like ventilators), and energy-efficient cold storage for heat-sensitive medical supplies.
Section 2(a)(2), adding new subsection 1861(ooo)(2) to the Social Security Act.
Establishes Criteria for "Medically At-Risk" Determination
This provision directs the Secretary, in consultation with the Directors of NIH, CMS, and the Administrator of NOAA, to establish a process for determining when an individual is "medically at-risk" in the event of a disaster or climate hazard. The process must consider geography-specific risks, regional disaster history/predicted risk, medical reliance on sensitive equipment/supplies, and chronic medical conditions/disabilities that increase vulnerability.
Section 2(b), amending Section 1833(a)(1) of the Social Security Act.
Mandates Full Medicare Payment for Covered Services
This provision specifies that Medicare will pay 100% of the lesser of the actual charge for home resiliency services or the amount determined under a fee schedule established by the Secretary. This means beneficiaries will not have any out-of-pocket costs (like deductibles or co-insurance) for these specific services.