Dems warn not to ignore home health services

National Journal: Dems warn not to ignore home health services (January 12, 2023)

While the new Congress may still be settling in, Rep. Debbie Dingell is not waiting to start working on making home-based health services more accessible.

Dingell is already reaching across the aisle to find Republicans who will work with her on home- and community-based services, also known as HCBS, an issue that she championed along with Democratic Sen. Bob Casey last Congress.

Both Dingell and Casey plan to continue pushing proposals from their Better Care Better Jobs Act.

“I haven’t made a final decision but my preference would be do both: Reintroduce the bill in its you might call more-fulsome version, which is what we already introduced in the last Congress, but also to consider breaking up portions of it for those opportunities where you can get bipartisan support on an element of it,” Casey said Monday.

The bill, as introduced in the last Congress, would have made investments into home- and community-based services, including the workforce. Lawmakers proposed providing a bump in federal dollars for Medicaid if states met certain requirements, including improving payment rates for direct-care workers.

The Better Care Better Jobs Act was not the only proposal floated last Congress that advocates are following. Natalie Kean, director of federal health advocacy at Justice in Aging, noted that another draft bill championed by Casey and Dingell, the HCBS Access Act, would make the home-care services under Medicaid mandatory.

Currently, most home- and community-based services are optional benefits under Medicaid that states can choose to cover either through their plans submitted to the federal government or through waivers. Under the waiver option, states can limit how many beneficiaries they serve, resulting in lengthy waiting lists. The Kaiser Family Foundation found 656,000 people waiting for these services in 2021.

But the HCBS Access Act would require all state programs to cover specified services, including personal assistance, nonemergency transportation, and needed nursing services that aren’t otherwise covered.

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