Timing indeed is everything. President Biden’s State of the Union address brought the cliché home for home care. And it stings a bit.

With his single mention of home care in his one-hour, two-minute speech on Tuesday, Biden seemed to say it all for the field: The moment for big investments certainly may have passed.

Just think about last year at this year at this time (which feels like a decade away, given all that has happened). Fresh off his election victory, Biden’s ambitions seemingly knew no bounds. Barely out of the gate, he passed a $1.9 trillion stimulus package. Next came a massive piece of infrastructure legislation that included $400 billion for Medicaid home- and community-based care. It was no surprise that National Association for Home Care & Hospice President Bill Dombi dubbed 2021 “the year of healthcare at home.”

How things change. Fast forward a few months and that $400 billion had been whittled to $150 billion. An infrastructure bill passed without provisions for home care or other pieces of his domestic program. And, then of course, the bombshell from Sen. Joe Manchin (D-WV): an unofficial no vote on Build Back Better.  

Now the world looks like a very different place. A war in Ukraine, an intractable Senate and inflation arguably have signaled the end for home care’s chances at unprecedented funding. Biden’s State of the Union brought this into sharp clarity. While the speech initially was expected to be about his domestic agenda, the horror in Ukraine seized the spotlight.

Biden referred obliquely to Build Back Better.

“My plan would cut the cost in half for most families and help parents, including millions of women, who left the workforce during the pandemic because they couldn’t afford child care, to be able to get back to work. Generating economic growth,” he said. “But my plan doesn’t stop there. It also includes home and long-term care. More affordable housing. Pre-K for 3- and 4-year-olds.”

I guess the field can be grateful home care received a mention from President Biden. But, oh, what might have been!

Liza Berger is editor of McKnight’s Home Care. Email her at [email protected]. Follow her @LizaBerger19.