While language in the Better Care Better Jobs Act did not mention a dollar amount, many expected it would inject around $400 billion into Medicaid home- and community-based services (HCBS). It turns out the investment may be closer to $150 billion.
That is according to Bill Dombi, president of the National Association for Home Care & Hospice (NAHC).
“We’ve learned just recently that the Better Care Better Jobs Act would not bring $400 billion, it would bring $150 billion. So that’s a creature of the paring down of the so-called ask relative to the White House as well as Congress,” he told McKnight’s Home Care Daily during a podcast interview on a range of subjects.
The Congressional Budget Act has not scored the bill. Sources close to the office of Sen. Bob Casey (D-PA), who introduced the bill, recently shared the estimated cost with NAHC, Dombi said. While the amount is significantly smaller than expected, it still marks a positive step forward for the field, Dombi said.
“You can’t look at $150 billion infused into home care and not smile,” he said. “It is one of the first investments of that kind in home care in many, many years and it sets the stage for a commitment to bring healthcare home to the greatest degree possible.”
Among the provisions that make up the bill, it would provide $100 million for states to expand access to Medicaid HCBS and bolster the home-based care workforce. It also would permanently bump up the Federal Medical Assistance Percentage for states by 10%.
The way the bill is drafted, it “gives a bit of flexibility to the states to use the money to supplement, rather than supplant, existing funding for home- and community-based care,” Dombi said.
This means states can use the money to reduce patient waiting lists for HCBS, and improve Medicaid rates for a stronger and more reliable workforce, he said.
But, he noted, the bill “does not in any way shape or form guarantee an equitable balance in home care options across the states, which we now see as one of the big issues,” Dombi added.
The vehicle for the legislation to pass is the $3.5 trillion reconciliation package now under discussion in Washington, Dombi said.
This article originally appeared on McKnight's Senior Living