HCBS Funding Is Now in the Congressional Crosshairs

Home Health Care News / By Robert Holly
 
The $400 billion that the Biden administration wanted for strengthening the nation’s home- and community-based services (HCBS) infrastructure is likely in the crosshairs of Congress.
 
Currently, President Joe Biden and senior Democrats are working to figure out what’s included in the large spending legislation they hope to pass through the budget reconciliation process. Early estimates had a $3.5 trillion package touching on health care, education and climate change.
 
In order to pass the domestic investment plan via reconciliation, Democrats need the support of their entire party in the Senate. Yet some Senators, including Joe Manchin of West Virginia, have expressed a desire to get the spending legislation closer to $1 trillion to $1.5 trillion.
 
“Instead of rushing to spend trillions on new government programs and additional stimulus funding, Congress should hit a strategic pause on the budget-reconciliation legislation,” Manchin wrote in a recent Wall Street Journal op-ed. “A pause is warranted because it will provide more clarity on the trajectory of the pandemic, and it will allow us to determine whether inflation is transitory or not.”
 
In addition to the package’s overall price tag, Machin has expressed specific concerns about the plan to spend hundreds of billions of dollars on in-home care, according to a Tuesday report from Axios.
 
Other members of Congress have pushed back against investments in “soft” infrastructure as well.
 
Due to the lack of full-party support at the moment, funding for HCBS, which would likely be carved into the spending legislation through the recently introduced Better Care Better Jobs Act, may end up closer to $150 billion. Sens. Bob Casey of Pennsylvania and Ron Wyden of Oregon are among the key backers of the Better Care Better Jobs Act, along with Rep. Debbie Dingell of Michigan in the House.
 
Another Axios report from Friday [September 10th] said the House Ways and Means Committee was looking to invest $190 billion into HCBS.
 
Even if $400 billion is ultimately reduced to $190 billion, that would be a historic increase for HCBS providers, which for years have struggled with lackluster Medicaid rates and dire labor shortages.
 
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