Articles in this guide describe key features of legislation passed by the House to advance President Biden’s Build Back Better agenda and overhaul social and climate policy in the United States. The bill now moves to the Senate.
In-home care historically has long waitlists and is too expensive for many Americans to pay for out of their pockets. Democrats are aiming to bolster payments to Medicaid, the federal-state health program for low-income and disabled Americans, in an effort to increase the availability of in-home care.
The policy comes after the coronavirus tore through nursing homes, killing over 139,000 residents and exposing the country’s fragmented and antiquated way of paying for elder care. The White House estimates the bill includes roughly $150 billion to boost home and community-based services under Medicaid. Infusing more dollars into the program is a key priority for Biden, who this spring proposed a much larger investment of $400 billion.
The details: The social spending bill would permanently increase by 6 percent the funding the federal government gives each state for in-home and community-based services, as long as the state creates a plan for strengthening and expanding services. The money would largely flow through the Medicaid program, although some would also be given to states to create their own plans to bolster in-home care.
The goal would be to help seniors stay in their homes, for example, by reducing the length of waitlists to get these services and increasing wages for chronically underpaid staff. “The idea is to help states build up their infrastructures to be able to serve more people and be able to support the direct care workforce,” said MaryBeth Musumeci, an associate director with the Kaiser Family Foundation.
The economic package also boosts federal payments to states by 80 percent for the administrative costs of improving in-home and community-based services. The legislation permanently extends several programs, such as one aimed at helping states spend more money on in home-care, as opposed to institutional care, and another that ensures a spouse doesn’t have to drain their finances so that their partner can qualify for in-home services under Medicaid.
Development: The Democrats’ coronavirus relief bill that passed in March raised federal funding for in-home care for the first time since the Affordable Care Act passed 11 years ago, but the hike only lasts for a year. Proponents of the policy, such as consumer groups and the Service Employees International Union, a labor giant, have been pushing hard for Congress to do more.
The latest: House Democrats passed a more than $2 trillion bill to overhaul the country’s health care, climate, education and tax laws.
What’s in it? Here’s a complete guide to what’s in the spending bill and all the ways it would affect America.
Breaking it down: The bill re-envisions the role of government in Americans’ daily lives. Here are details on each of the major parts of the plan: healthcare, taxes, child tax credit, paid family leave, early childhood education, climate change, affordable housing, eldercare, infrastructure and immigration.