Better Care Better Jobs Act Would Expand Medicaid Funding for HCBS

Home Health

WASHINGTON, DC (June 25, 2021)–New legislation was introduced in the U.S. Senate and House on Thursday that would strengthen and expand access to quality homecare services and support the caregiving workforce that provides them. 

According to a summary of the bill provided by the Senate Committee on Aging, the Better Care Better Jobs Act, a key element of President Biden’s American Jobs Plan, would: 

  • Enhance Medicaid funding for HCBS: States would be eligible for a permanent 10 percentage point increase in the federal Medicaid match for delivering HCBS as well as enhanced funding for administrative activities associated with improvement efforts.

  • Encourage innovative models that benefit direct care workers and care recipients: Provide additional incentives to help states build HCBS workforce programs that register direct care workers; help connect them to seniors and people with disabilities seeking care; facilitate coordination between the state and direct care workers; support care safety and quality; and help workers organize, among other functions.

  • Support quality and accountability: Provide funding to the Centers for Medicare & Medicaid Services to carry out the bill’s programs; conduct oversight and monitoring; and offer technical assistance to states participating in the funding opportunities described above. Additionally, participating states would be required to establish state HCBS ombudsman programs to support care quality. The bill would also require all state Medicaid programs to adopt HCBS quality measures.

  • Facilitate state planning: Provide funding for states to develop HCBS infrastructure improvement plans with public input, to outline how they would expand access to HCBS, strengthen the workforce, and meet requirements tied to increased federal Medicaid funding. States would be required to develop these plans in order to receive enhanced federal Medicaid funding for HCBS.

  • Permanent spousal impoverishment protections: Permanently authorize protections against impoverishment for individuals whose spouses are receiving Medicaid HCBS.

  • Make Permanent Money Follows the Person: Make the Money Follows the Person Rebalancing Demonstration permanent.

Senate introducers of the bill were  Bob Casey (D-PA), chairman of the U.S. Senate Special Committee on Aging; Senate Finance Committee Chairman Ron Wyden (D-OR) and Democratic Leader Chuck Schumer (D-NY), along with Chair of the Health, Education, Labor, and Pensions Committee Patty Murray (D-WA) and Senators Tammy Duckworth (D-IL), Maggie Hassan (D-NH) and Sherrod Brown (D-OH). U.S. Representative Debbie Dingell (D-MI), Chairman of the House Energy and Commerce Committee Frank Pallone (D-NJ) and Reps. Jan Schakowsky (D-IL) and Doris Matsui (D-CA) introduced the House companion bill.

“For millions of families, and especially for women, home and community-based services are a bridge to work and a bridge to economic security. The Better Care Better Jobs Act would not only enable more older adults and people with disabilities to remain in their homes, stay active in their communities and lead independent lives, it would also create jobs and lead to higher wages for care workers, who are predominantly women and people of color. This legislation is critical to advancing equity, spurring economic recovery and improving quality of life for older adults and people with disabilities,” Casey said in a news release.

“For too long, seniors and Americans with disabilities who want the choice of good quality long-term care at home and the workers who provide it have gotten short shrift. This bill lays out a transformational investment through Medicaid that will begin to set that right so receiving good quality care in the comfort and safety of home is a real possibility. It is also critical that the workforce who provides home care receive a liveable wage, and that family caregivers have more supports when they provide care to their loved ones. I will continue working with my colleagues and the President to pass this key pillar of the American Jobs Plan,” Wyden said. 

Read more about the Better Care Better Jobs Act here.

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