The Biden administration is proposing significant investments in Medicaid home- and community-based services (HCBS), aiming to improve access to care at home and address workforce shortages in health care. Senator Bob Casey (D-PA) and Representative Debbie Dingell (D-MI) have carried out this proposal in legislative form with the Better Care Better Jobs Act (S.2210/H.R.4131).

Medicaid HCBS is improved in several ways by this legislation. First, it provides funding to state Medicaid programs to prepare them for enhanced investment, and second, it increases the Federal Medicaid Assistance Percentage (FMAP) specifically for Medicaid HCBS by 10%.

In order to qualify for the enhanced 10% FMAP, states would be required to provide coverage for personal care services; expand supports for family caregivers; adopt programs that help people navigate enrollment and eligibility; expand access to behavioral health care; improve coordination with housing, transportation, and employment supports; and develop or improve programs to allow working people with disabilities to access HCBS.

In addition, the bill would strengthen and expand the HCBS workforce by addressing HCBS payment rates to promote recruitment and retention of direct care workers; regularly updating HCBS payment rates with public input; passing rate increases through to direct care workers to increase wages; and updating and developing training opportunities for this workforce as well as family caregivers.

Lastly, the legislation would permanently authorize protections against impoverishment for individuals whose spouses are receiving Medicaid HCBS and make the Money Follows the Person Rebalancing Demonstration permanent.

The Legislative Action Center is an important tool for HCAF's public policy and advocacy efforts. In just a few clicks, you can send an email to your representatives in Congress urging their support for the Better Care Better Jobs Act.

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