End Diaper Need Act of 2025
The End Diaper Need Act of 2025, introduced in the Senate by Senators Duckworth (joined by Cramer and Kelly), would create targeted funding within the Social Services Block Grant (SSBG) program to address diaper and adult incontinence supply needs for families with low income, medically complex children, and adults with disabilities. It would authorize an annual appropriation of $200 million for 2026–2029 to be distributed by states to eligible entities (including states, tribes, diaper banks, and other 501(c)(3) nonprofits) to purchase and distribute diapers, diapering supplies, and adult incontinence materials, as well as to fund outreach and coordination with other services. The bill sets reporting requirements, limits administrative costs, and reserves a portion of funding for a national entity to provide technical assistance and evaluation. It also codifies a process for evaluating the program’s effectiveness and requires guidance within six months of enactment. In addition, the bill expands certain tax-advantaged accounts to treat medically necessary diapers and diapering supplies as qualified expenses, effective for expenditures after December 31, 2025. Key design features include: (1) a dedicated but limited new funding stream within the SSBG for diaper-related needs (and its accompanying adult incontinence supplies); (2) eligibility criteria and allowed uses that emphasize direct diaper distribution, access, and integration with other safety-net programs; (3) a national entity and reporting/evaluation framework to monitor impact; (4) definitions to clarify who is served (infants/toddlers, medically complex children, and adults with disabilities) and what qualifies as a “diaper” or “diapering supplies”; and (5) a tax provisions upgrade to expand the use of HSAs, Archer MSAs, and health FSAs/HRA for medically necessary diapers and related supplies.
Key Points
- 1Targeted funding through the Social Services Block Grant program: The bill increases SSBG-related funding specifically for diaper assistance, authorizing $200 million per year for 2026–2029 to support purchase/distribution of diapers, diapering supplies, and adult incontinence materials, with states directing use to eligible entities.
- 2Eligible uses and program design: Funds may be used to buy and distribute diapers and supplies, support distribution to low-income families with young children or medically complex children, and provide adult incontinence materials to low-income adults or adults with disabilities. Activities include outreach and program integration with other safety-net and early-childhood programs (e.g., TANF, CHIP/Medicaid, WIC, home visiting, early care and education programs).
- 3Administration, oversight, and evaluation: Up to 5% of funds may be used for state administrative costs. A national entity (a qualified nonprofit with multi-state experience) may receive up to 2% of the annual appropriation to provide technical assistance and training. $3 million in FY2026 may be used for an evaluation of the program, with ongoing evaluation updates and reporting to Congress and public dissemination.
- 4Reporting requirements: States must include annual reports detailing how funds were used, including numbers served, types and quantities of diapers/supplies distributed, ages, ZIP codes, distribution methods, and other Secretary-specified data.
- 5Definitions and scope: The bill provides specific definitions for adult incontinence materials, medically complex children, medically necessary diapers, diaper banks, eligible entities, and low-income thresholds (200% of the Federal poverty line), and includes a sequestration exemption.
- 6Tax provisions: Diapers and diapering supplies become qualified medical expenses under Health Savings Accounts (HSAs), Archer MSAs, and Health Flexible Spending Arrangements (FSAs) and Health Reimbursement Arrangements (HRAs), effective for distributions/reimbursements after December 31, 2025.
- 7Effective dates: The new diaper-related funding and distribution rules apply to distributions after December 31, 2025; reimbursements for tax-advantaged accounts apply to expenses incurred after that date.