Medicare would pay for the home-delivered meals pilot by taking the cost out of other hospitals’ payments rather than adding new money to the program, under a bill the House Ways and Means Committee advanced on September 16, 2026. H.R. 5439, the Medically Tailored Home-Delivered Meals Program Pilot Act, would direct federal health officials to select at least 40 hospitals to deliver medically tailored meals to chronically ill Medicare patients after a hospital stay, aiming to cut costly readmissions. The committee’s vote was unanimous, 39 yeas to zero nays, but committee approval only starts the bill toward a House floor vote that has not yet been scheduled.
A Bipartisan Sponsor List Behind a Unanimous Vote
The vote on H.R. 5439 came during a markup covering seven separate bills, and the meals measure passed by the widest possible margin, with all 39 members present recording yes votes and none opposed. The committee ordered the bill “reported in the nature of a substitute,” meaning members adopted an amended version of the text before sending it forward, a routine step that still leaves the legislation well short of becoming law.
Representative James McGovern, a Massachusetts Democrat, introduced the bill in September 2025 with Representative Nicole Malliotakis, a New York Republican, as the lead original co-sponsor, and the measure has since drawn more than two dozen additional co-sponsors from both parties, according to the Library of Congress bill-status record. As introduced, the legislation would create a six-year Medically Tailored Home-Delivered Meals Program under Medicare Part A, instructing the Department of Health and Human Services to select the participating hospitals no later than June 30, 2027.
The bill’s expanding sponsor list reflects a bipartisan pattern uncommon on most Medicare legislation. Of the roughly two dozen lawmakers who had signed on as co-sponsors ahead of the September 16 markup, several were Republicans alongside Malliotakis, including Brian Fitzpatrick of Pennsylvania, Andrew Garbarino of New York and Michael Lawler of New York, according to the bill’s official cosponsor list. That mix helped the measure clear committee without opposition, though a lopsided sponsor count in one chamber does not guarantee the floor time or Senate action a bill needs to reach a president’s desk.
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Screening Rules, Hospital Requirements and a Budget-Neutral Design
Under the bill as introduced, a selected hospital would have to screen its own inpatients at discharge with a validated tool to determine whether each patient qualifies, then re-screen every 12 weeks to confirm continued eligibility. A qualifying patient would need a diet-related condition such as kidney disease, congestive heart failure, diabetes or chronic obstructive pulmonary disease, along with limits on at least two daily living activities and no admission to hospice or extended-care services, according to the bill text filed with the Government Publishing Office.
Hospitals would need at least two consecutive fiscal years averaging three stars or higher on the Centers for Medicare and Medicaid Services hospital quality rating before they could even apply, and participating hospitals would then deliver at least two medically tailored meals a day, covering two-thirds of a patient’s daily nutritional needs, for a minimum of 12 weeks after discharge. The bill specifies that patients would receive those meals and accompanying medical nutrition therapy without any deductible, copayment or coinsurance, removing a cost barrier that ordinarily applies to Part A services.
The pilot’s cost is designed to be neutral to the Medicare Hospital Insurance Trust Fund. The bill would require the Secretary to reduce standard inpatient payments to other hospitals by an amount equal to whatever the meals program spends in a given year, so the program’s price tag would be absorbed inside Medicare’s existing hospital budget rather than funded through new spending. That budget-neutral design has helped it move through committee without a fight over new costs, though no Congressional Budget Office score of the version ordered reported on September 16 has yet been published.
The Senate Companion’s Stall and Two Earlier Failed Attempts
Committee passage moves H.R. 5439 onto the House’s list of eligible bills, but it does not schedule a floor vote, and none had been set as of September 20, 2026, according to the House Ways and Means Committee’s own markup record. A companion bill, S. 2834, was introduced in the Senate on September 17, 2025, and referred to the Finance Committee, where the official bill-status record shows no further action has been taken on it in the year since.
That gap between a unanimous committee vote and a functioning Medicare benefit has closed similar meals proposals before. A nearly identical bill introduced in the 118th Congress and another from the 116th Congress each stalled after introduction and never reached a floor vote in their respective chambers. Until the full House and Senate act and a final version is signed, no hospital is authorized to enroll a Medicare patient in this program, and no beneficiary is entitled to a medically tailored meal under H.R. 5439.
The official record from the September 16 markup shows the committee ordered the bill “reported in the nature of a substitute” by a recorded vote of 39 yeas and zero nays, the procedural language confirming that members amended and approved the text rather than sending the original version forward unchanged. That record, last updated by the Library of Congress on September 19, 2026, remains the definitive account of where the pilot program currently stands: advanced out of one committee, in one chamber, with no enacted change to Medicare benefits yet in place.
Pilot Programs and Everyday Medicare Costs
The meals pilot, even if it eventually clears both chambers, would reach a narrow slice of Medicare: patients discharged from one of at most 40 selected hospitals with a specific chronic illness, inside a six-year test window that has not started. For the tens of millions of other Medicare enrollees managing prescription costs, prior-authorization denials and out-of-pocket caps, a committee vote changes nothing about what shows up in the mailbox this month.
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Read the prior-authorization appeal steps in The Medicare Cost & Coverage Protection Kit.
This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
