H.R. 543House115th Congress (2017-2019)In Committee

Prioritizing the Most Vulnerable Americans Act

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Updated April 15, 2026 at 11:45 AM UTC

The Prioritizing the Most Vulnerable Americans Act amends the Medicaid provisions of the Social Security Act to give preference to demonstration projects that help the most vulnerable patients. It directs the Secretary of Health and Human Services to prioritize projects that improve care for the uninsured, Medicaid‑eligible individuals, or those with household incomes at or below 150 percent of the poverty line. The rule applies to states submitting new or renewed project applications after January 1, 2018, and it affects state Medicaid programs and the vulnerable populations they serve.

Key Provisions

Adds a new subsection to Section 1115 requiring the Secretary to give priority to Medicaid demonstration projects that have proven effective for uninsured people, Medicaid‑eligible individuals, or households earning ≤150% of the poverty line.
Requires states to submit and publicly post health‑outcome data for any demonstration project they propose or renew.
Mandates that projects not duplicate existing federal programs or funding opportunities.
Requires states to submit and publicly share an analysis of whether the project limits private‑sector or charitable efforts to improve health outcomes for the target groups.

Legislative Activity

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HouseIntro Referral Latest Action

Referred to the House Committee on Energy and Commerce.

Energy and Commerce Committee

January 13, 2017

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HouseIntro Referral

Introduced in House

January 13, 2017

HouseIntro Referral

Referred to the House Committee on Energy and Commerce.

Energy and Commerce Committee

January 13, 2017

Bill Text

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Introduced in HouseIssued January 13, 2017

115th CONGRESS

1st Session

H. R. 543

IN THE HOUSE OF REPRESENTATIVES

January 13, 2017

Mr. Collins of New York (for himself, Mr. Mullin, Mr. Guthrie, Mrs. Blackburn, Mr. Bucshon, and Mr. Flores) introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL

To amend title XIX of the Social Security Act for purposes of prioritizing the most vulnerable Medicaid patients.

Short title

This Act may be cited as the Prioritizing the Most Vulnerable Americans Act.

Prioritizing the most vulnerable Medicaid patients

(a)

In general

Section 1115 of the Social Security Act (42 U.S.C. 1315) is amended by adding at the end the following new subsection:

(g)

In making a determination using the authority under paragraph (2)(A) of subsection (a) (relating to treating costs that would not otherwise be included as expenditures under section 1903 and which are not included as part of the costs of projects under section 1110 as expenditures under the State plan or plans approved under title XIX) to approve an application or renewal of any experimental, pilot, or demonstration project undertaken under such subsection to promote the objectives of title XIX (referred to in this subsection as a Medicaid demonstration project), the Secretary shall—

(1)

give priority to Medicaid demonstration projects that have been proven to be effective in improving the medical care and health outcomes of individuals who are uninsured, individuals eligible to receive medical assistance under a State plan under title XIX, or individuals whose household income does not exceed 150 percent of the poverty line (as defined in section 2110(c)(5)) applicable to a family of the size involved;

(2)

require that the State submitting such application or renewal submit to the Secretary, and make publicly available, any available data or metrics regarding the health outcomes for the individuals to be served by such Medicaid demonstration project;

(3)

ensure that such Medicaid demonstration project is not duplicative of any Federal program or funding opportunity; and

(4)

require that the State submitting such application or renewal submit to the Secretary, and make publicly available, an analysis of the degree to which such Medicaid demonstration project, if at all, precludes efforts undertaken by private sector and charitable sector entities to improve medical care and health outcomes for the individuals described in paragraph (1).

(b)

Effective date

The amendment made by subsection (a) shall apply with respect to applications or renewals submitted on or after January 1, 2018.