7.35% Medicaid Boost Critical for Supporting America’s ‘Fragile’ Home-Based Care Infrastructure, Senators Argue

7When the House Energy and Commerce Committee included new Medicaid provisions to the ever-changing $1.9 trillion relief package, home-based care operators were pleased to see a hefty rate bump for home- and community-based care (HCBS).

The draft legislation specifically called for a 7.35% rate increase for states to enhance HCBS during the pandemic.

There appears to be support for such a move in the Senate as well. On Wednesday, 23 Democratic senators wrote a letter to Senate leadership, urging Congress to keep the provision in the final version of the relief package.


“We are glad that Senate Democratic leadership supports dedicated emergency funding for HCBS and that the [House committee] … has included a 7.35% increase to Federal Medical Assistance Percentages (FMAP) for HCBS in its proposed budget reconciliation legislation for the next COVID-19 relief package,” the letter reads. “We urge that the increased FMAP included in the House proposed legislation remains in the final package.”

Among the signees on the letter were former presidential candidates Corey Booker of New Jersey, Elizabeth Warren of Massachusetts and Kirsten Gillibrand of New York, as well as former vice presidential candidate Tim Kaine of Virginia.

The rate bump would provide necessary relief for Medicaid-funded home-based care providers. It would also help make up for any cuts being implemented to HCBS on state levels.


“This targeted relief funding is essential for older Americans and people with disabilities who live and receive services in their homes, and the workforce that supports them, as well as for state Medicaid programs,” the letter states. “Without these dedicated funds for HCBS, the fragile infrastructure supporting over 4 million older adults and people with disabilities is at risk of collapsing.”

The House draft legislation also included a two-year, 5% FMAP boost for states that recently expanded their Medicaid programs.

The House of Representatives intends to work through February on the relief package, dubbed the “American Rescue Plan,” according to House Majority Leader Steny Hoyer (D-Md.). The package’s provisions would then be enacted in March once the current spending package expires.

“This tragedy has brought to light the urgent need to invest in HCBS,” the letter reads. “Congress and the [Biden administration] must work together to provide this necessary funding for HCBS to support states in meeting this most basic strategy to defeat the spread of the virus.”

The bump in Medicaid rates would send needed help providers’ way, as cash-strapped agencies are dealing with heightened expenses from hazard pay and costly personal protective equipment (PPE).

Even with the 7.35% rate boost, however, these problems will likely still remain.

“It certainly is helpful, in that it probably reduces the issues that providers and state Medicaid budgets are going to have in the upcoming budget year,” Darby Anderson, vice chairman of the Partnership for Medicaid Home-Based Care (PMHC), recently told Home Health Care News. “But it’s probably, in and of itself, not enough to make them all go away.”

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