HCBS Relief Act Would Increase Federal Medicaid Match

WASHINGTON—U.S. Senator Bob Casey (D-PA), chairman of the Senate Special Committee on Aging, has introduced the Home and Community-Based Services (HCBS) Relief Act to provide support to state programs that fund home- and community-based long-term care services. The bill would provide dedicated Medicaid funds to states for two years to stabilize their HCBS service delivery networks, recruit and retain HCBS direct care workers and meet the long-term service and support needs of people eligible for Medicaid home- and community-based services. 

“A vast majority of seniors and people with disabilities would prefer to receive care at home or in their communities,” said Casey, who led 17 of his Democratic colleagues in introducing the bill. “Unfortunately, because of our nation’s caregiving crisis, home- and community-based care has become increasingly difficult to access. By stabilizing and investing in the caregiving workforce, we can better provide seniors and people with disabilities with a real and significant choice to receive care in the setting of their choosing.” 

Under the HCBS Relief Act, states would receive a 10-point increase in the federal match (FMAP) for Medicaid for two fiscal years to enhance HCBS. Funds could be used to increase direct care worker pay, provide benefits such as paid family leave or sick leave, and pay for transportation expenses to and from the homes of those being served. The additional funds also can be used to support family caregivers, pay for recruitment and training of additional direct care workers and pay for technology to facilitate services. 

The group LeadingAge urged other lawmakers to sign onto the legislation, saying it would help address a crisis in access to care and benefit providers of home health, personal care, PACE and other programs. 

“Home health providers are already forced to reject referrals due to workforce shortages, an extremely competitive labor market, financial pressures, and drastic cuts to Medicare payment rates in 2023 (with more anticipated in 2024),” said LeadingAge President and CEO Katie Smith Sloan. “The kind of support Senator Casey’s bill offers for providers of Medicaid home health and other services is massively needed to keep the country’s ability to support older adults intact.”

It’s not Casey’s first effort to increase federal support for care in the home. In January 2023, he introduced the Better Care Better Jobs Act, along with 41 co-sponsors, to enhance Medicaid funding for homecare services for older adults, people with disabilities and injured workers to help many of the over 650,000 people on waiting lists receive care in the setting of their choice; increase payment rates to promote recruitment and retention of direct care workers, increase wages, and develop and update training opportunities; and provide support to the Centers for Medicare & Medicaid Services to conduct oversight and encourage innovation to benefit direct care workers and care recipients. 

In March, Casey also introduced the HCBS Access Act to address lengthy waiting lists for homecare services.