President Joe Biden is trying to make good on one of his main campaign promises.
The Biden administration on Wednesday unveiled a new $2 trillion infrastructure proposal to create jobs, build roads, fix bridges and more. On top of that, the proposal — officially dubbed the American Jobs Plan — would substantially increase funding for home- and community-based services (HCBS).
“President Biden believes more people should have the opportunity to receive care at home, in a supportive community or from a loved one,” a White House fact sheet on the proposal states.
In order to expand access to HCBS under Medicaid, Biden is specifically calling on Congress to redirect $400 billion toward home-based care. In theory, much of that funding would be used to improve low-wage caregiving jobs, which are often held by women and people of color.
“The HCBS expansion under Medicaid can support well-paying caregiving jobs that include benefits and the ability to collectively bargain, building state infrastructure to improve the quality of services and to support workers,” the fact sheet reads. “This will improve wages and quality of life for essential home health workers and yield significant economic benefits for low-income communities and communities of color.”
Additionally, the American Jobs Plan pushes for the expansion of the popular Money Follows the Person (MFP) program, which allows certain Medicaid users to more seamlessly transition from a nursing home back into the home. MFP was most recently given a $165 million bump in September under the Trump administration.
While campaigning for president, Biden pitched a $775 billion overhaul of the nation’s caregiving infrastructure. At that time, the president described current compensation for most in-home care workers as “unacceptable.”
Apart from $400 billion for HCBS, Biden’s proposal includes $621 billion for transportation, $300 billion for manufacturing and $213 billion for housing, plus $180 billion for research and development. It also includes funding for schools, digital infrastructure and the U.S. water infrastructure, among other areas.
To pay for the American Jobs Plan’s $2 trillion price tag, the White House is proposing to increase the corporate rate to 28%.
For home-based care providers, an injection of funds could boost the caregiver workforce at a time when the demand for care continues to increase.
“This workforce crisis has been ongoing for far too long — and the lack of investment has been going on for far too long,” Esmé Grewal, a board member of the Partnership for Medicaid Home-Based Care (PMHC), told HHCN. “We are at this important stage in our history, where we are soon going to have more folks in the aging population than in the younger population.”
Looking ahead, it’s difficult to predict what will happen with Biden’s proposal, but Grewal points to the history of bipartisan support when it comes to home-based care.
“It’s hard to say how the proposal will play out in Congress,” she said. “However, we’re really fortunate to have a great history of bipartisanship when it comes to home- and community-based services. We have wonderful members in Congress, on both sides of the aisle, who recognize the value of investing in these services. Our hope is that this will continue.”
Specifically, the plan raises the federal matching rate by 10% from April 1, 2021, through March 31, 2022.