A healthcare worker visiting a senior African-American woman at home, helping her use a mobility walker

Sen. Bob Casey (D-PA) and Rep. Debbie Dingell (D-MI) Thursday reintroduced legislation that would expand access to home- and community-based services (HCBS) for older adults and people with disabilities. The bill represents a slimmer version of its former self. 

The Better Care Better Jobs Act would enhance Medicaid funding and potentially help an estimated 650,000 Americans get off of wait lists for in-home caregivers. A spokesperson from Casey’s office told McKnight’s Home Care Daily Pulse Thursday that the Congressional Budget Office estimates the bill’s value at $300 million. When the legislation first was introduced in 2021, the National Association for Home Care & Hospice estimated its worth at $400 billion and then revised the price tag to $150 billion

“The Better Care Better Jobs Act is a generational investment in home care — it’s about both caring for our loved ones and making the smart economic choice for families and communities across all levels of the government to strengthen this workforce,” Casey said in a statement. “This is not a Democrat or Republican issue. It’s an American issue.”

The legislation would make permanent the 10% increase in Federal Medical Assistance Percentage (FMAP) to states; encourage states to develop innovative models that help states build their direct care workforce; provide additional funding to CMS to monitor and support state HCBS programs; provide funding to states to build out HCBS infrastructure; and make permanent the Money Follows the Person demonstration, which supports state efforts to rebalance long-term care support systems.

Thirty-seven other Democratic lawmakers have co-signed the legislation.

In June 2021, Casey and a bipartisan team of lawmakers first introduced the Better Care Better Jobs Act. It became part of Build Back Better infrastructure legislation. But following the defection of a key supporter, Sen. Joe Manchin (D-WV), the legislation died. A new bill, the Inflation Reduction Act, emerged with parts of Build Back Better, and Congress ultimately passed it. However, it did not include $150 billion in HCBS funding.

Earlier this week, National Association for Home Care & Hospice President and CEO William Dombi expressed optimism at the Home Care 100 conference in Orlando that HCBS funding would become a priority in Washington this year.

“It will come back in 2023, but it won’t be any easy climb getting it passed,” Dombi told the audience.

This is a developing story. Please check back for updates.

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