‘Inadequate Medicaid Rates’ Threaten Home Care Providers Amid $15 Minimum Wage Push

In-home care advocates are once again urging the Biden administration and Democratic lawmakers to be cautious in their quest to raise the federal minimum wage to $15.

A $15 an hour minimum wage is just one aspect of President Joe Biden’s $1.9 trillion plan to shore up Americans’ finances as the COVID-19 pandemic continues. Other provisions called for in the plan, which still needs to go through Congress, include $1,400 stimulus checks and continued unemployment add-ons.

While Republicans largely opposed the Biden-led stimulus plan, a process known as reconciliation could pave the way for it to pass.


If that happened, it could have a devastating ripple effect on the home-based care industry, according to the Partnership for Medicaid Home-Based Care (PMHC).

“PMHC strongly supports policy reform that recognizes and protects this dedicated workforce,” the Washnigton, D.C.-based advocacy organization wrote in a Wednesday letter to Congressional leaders. “At present, however, inadequate Medicaid rates prevent these professionals from receiving compensation commensurate with the value they produce for our nation with the majority earning just above current state minimum wage levels.”

For the most part, home-based care operators aren’t arguing against a minimum wage increase. In fact, many recognize the need to raise wages to attract more workers into the profession while retaining the millions already delivering care on the front lines.


Today, home care workers are mostly women and people of color, with immigrants making up nearly one-third of the workforce. Overall, nearly half of the home care workforce lives in a low-income household, with 43% of workers relying on public health care coverage such as Medicaid.

Operators and advocates simply want reimbursement rates to keep up with any wage hikes.

“As you debate increasing the federal minimum wage to $15 per hour, we urge you to incorporate a requirement that state Medicaid programs at least match the federal minimum wage increase with corresponding reimbursement rate increases for Medicaid home- and community-based services (HCBS),” PMHC’s letter continues.

Supporting home care workers and addressing the “workforce crisis” has become one of the pillars of Biden’s long-term care platform.

But without corresponding reimbursement support, that pillar has a good chance of toppling over, according to PMHC.

“If the minimum wage is increased yet there is a failure to require states to increase reimbursement rates for personal care services covered under Medicaid HCBS programs, it will further limit both access to care delivery and significantly limit Medicaid HCBS providers’ ability to recruit home care workers into the health care workforce,” the letter reads.

Home care legal experts earlier this month cited rising minimum wages as one of the biggest concerns for 2021.

Related to wages is also Domestic Workers Bill of Rights legislation, another priority that Democrats may try to advance.

“These laws provide specific requirements that employers within a given jurisdiction must adhere to with regard to minimum wages, overtime wages, discrimination and harassment complaints, training requirements and much more,” Angelo Spinola, co-chair of the home health and home care industry group at Littler Mendelson, previously told Home Health Care News.

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