What’s in Biden’s Budget

CNN | By Katie Lobosco and Tami Luhby
 
President Joe Biden released his annual budget Thursday, outlining his policy priorities for the year ahead.
 
Make no mistake, the proposed budget has no chance of making it through the Republican-controlled House. But Biden’s plan will frame upcoming political battles on Capitol Hill, where the GOP has yet to unveil its own spending plan.
 
Biden’s budget comes out after the US hit the debt ceiling, a cap set by Congress, earlier this year. The Treasury Department is now taking extraordinary measures to allow the government to keep paying its bills. But the country could start to default on its obligations over the summer if Congress doesn’t address the debt ceiling before then. Republicans are calling for some spending cuts in exchange for voting to raise the cap, while the White House does not want to negotiate on resolving the debt limit drama.
 
 Many of the provisions in the budget rehash the president’s earlier proposals to expand the social safety net and to pay for it by raising taxes on the wealthy and corporations. He wants to restore the expanded child tax credit and make permanent enhanced Obamacare subsidies, both enacted in the American Rescue Plan in 2021. And he wants to provide universal free preschool, make college more affordable and establish a national paid family and medical leave program, which did not make it into prior packages when the Democrats controlled Congress over the past two years.
 
Biden’s spending plan also calls for shoring up Medicare and capping the price of insulin for all Americans.
 
The administration says these proposed policies will result in a nearly $3 trillion reduction in the deficits – the difference between what the government spends and its revenue – over the next decade.
 
Here’s what’s in Biden’s budget proposal

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Biden Pledges $150B for HCBS in New Budget

McKnight’s Home Care | By Diane Eastabrook
 
President Joe Biden is calling for $150 billion in funding for home- and community-based services over the next decade. The money, which is earmarked in his $6.8 trillion 2024 budget unveiled Thursday, would allow older Americans and those with disabilities to receive personal care services in their homes and improve the quality of jobs for home care workers and family caregivers.
 
Biden provided highlights of the budget Thursday afternoon to a crowd in Philadelphia, saying it is important to give seniors the choice to age in place, just as his own parents had.
 
“It’s cheaper if we provide for the ability for them to stay in their homes,” Biden added. “It’s not only the right thing to do, but it’s cheaper for the taxpayers.” 
 
The Home Care Association of America praised the president for recognizing the value of home care in the proposal.
 
“This budget demonstrates the commitment to ensure all Americans have the opportunity to age in their own homes, living as independently as possible,” HCAOA President Vicki Hoak told McKnight’s Home Care Daily Pulse in an email.  
 
Separate from the HCBS funding, the proposed budget also includes additional funding to address the healthcare workforce shortage. It funnels $32 million in training for nurse faculty and $28 million in innovative approaches to recruit, support and train the next generation of healthcare providers. The plan would also expand the National Health Service Corps, which provides loan repayment and scholarships to clinicians working in underserved areas. 
 
This is the second time Biden has made a run at HCBS funding. The president proposed $400 billion in home- and community-based services funding as part of his Build Back Better initiative in 2021. The amount was eventually pared back to $150 billion but stalled in the Senate later that year.
 
Earlier this year, leaders of the National Association for Home Care & Hospice and HCAOA expressed optimism there would be movement in Congress on legislation supporting HCBS. 
 
Still, the president’s budget faces an uphill battle in Congress. Sen. Charles Grassely (R-IA) of the powerful Senate Budget Committee told The New York Times the proposed budget has the “highest sustained levels of taxes, spending and deficits in American history” and is “a roadmap for financial ruin.”

Lawmakers Introduce Bill to Expand Home-Based Care Coverage Under Medicaid

Home Health Care News | By Joyce Famakinwa 

A number of lawmakers – including Sen. Bob Casey (D-Pa.) and Rep. Debbie Dingell (D-Mich.) – introduced a bill Thursday that would expand coverage of home- and community-based services under Medicaid.
 
The HCBS Access Act was introduced by Casey, as a companion bill to the Better Care Better Jobs Act, which was originally unveiled in 2021 and reintroduced in January.
 
“The second bill establishes a permanent funding stream to keep the infrastructure strong and to make sure we’re able to continue to pay direct care professionals at a rate that ensures qualified, reliable services in a qualified reliable workforce into the future,” Casey said during a hearing announcing the bill.
 
The bill would also provide training and support for family or informal caregivers.
 
The legislation would provide grant funding for states, allowing them to expand their capacity for home-based care services.
 
So far, the bill has already received strong support from the Partnership for Medicaid Home-Based Care (PMHC).
 
“PMHC is encouraged by Senator Casey and Representative Dingell’s efforts to continue to bring ongoing focus on the need to treat home-based services as a long-term, viable alternative to facility-based care with sufficient funding to address workforce challenges,” a PMHC spokesperson told Home Health Care News in an email. “Ultimately, we hope to see bipartisan engagement to bring this to fruition to allow us to sustain and improve important long-term supports and services for the people we serve.”

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Fight for Your Agency at NAHC's March on Washington

Home health providers are facing devastating payment cuts. The hospice community is rallying behind targeted efforts to address fraud, waste and abuse in the program. Medicaid HCBS rates continue to be woefully inadequate. Despite unprecedented demand for our services, care-in-the-home providers need more robust policy supports to address these and other pressing challenges facing our community.

This event will be held in-person with a kickoff briefing at the Kaiser Permanente Center for Total Health on March 27, 2023. BUT, you can still participate virtually, and our team will set meetings up for you on March 28, 2023.

SCHEDULE:

• March 27th (4:00-7:00 PM) – Briefing on logistics and issues with staff and Soapbox Consulting to prep you for the day.

• March 28th (Scheduled Appointments) – Head to Capitol Hill to meet with your members of Congress and urge them to help with these vital issues

If you do decide to send someone from your agency to attend in person or if you register to participate virtually, please let HHAC know, so that we can track how Colorado is represented.

REGISTER