Two U.S. senators have proposed a bill to support home- and community-based services.
As Congress reduces Medicaid payments, Senators Jack Reed (D-R.I.) and Ben Ray Luján (D-N.M.) reintroduced the Home and Community-Based Services (HCBS) Relief Act on June 25. This bill would allocate dedicated Medicaid funds for HCBS services for older adults, children and adults with disabilities for two years. The bill was first introduced in Congress in 2023.
The Act aims to reduce the need for placing individuals in care facilities by enabling them to receive services and support in their own homes. It also seeks to strengthen the home care workforce by supporting service provider agencies and direct care workers who deliver home care services.
Specifically, the legislation would allocate dedicated Medicaid funds to states for two years to stabilize their HCBS service networks, recruit and keep HCBS direct care workers, and address the long-term service and support needs of individuals eligible for Medicaid home- and community-based services.
States would get a 10-point boost in the federal medical assistance percentage (FMAP) match for Medicaid for two years. This funding can help states upgrade their HCBS infrastructure and workforce by increasing direct worker pay, offering benefits such as paid family leave or sick leave, covering transportation costs, facilitating staff recruitment, introducing assistive technologies to support person-centered care and providing care to eligible individuals currently on waiting lists.
“Medicaid’s home- and community-based services make independent, inclusive living possible for millions of older adults and people with disabilities,” Reed said in a statement. “This bill is severely needed at a time when Medicaid is facing unprecedented cuts that would force more vulnerable Americans into institutions and untenable living situations, leaving individuals isolated and families in crisis.”
The legislation comes at a time when the Medicaid program is facing steep cuts from a Republican-led bill designed to implement the Trump Administration’s domestic agenda.
According to Reed, the HCBS Relief Act would provide states with dedicated Medicaid funds to stabilize their HCBS service networks, strengthen their HCBS workforce, and ensure the federal government is a dependable partner in reimbursing in-home caregivers and delivering essential support. Rep. Debbie Dingell (D-Mich.) also introduced companion legislation in the House.
“No one should have to wait years to get the care they deserve, and no care worker should have to live below the poverty line to give this care,” Dingell said. “Medicaid is the single largest payer of long-term care in our country. At a time when Medicaid is facing unprecedented, historic cuts, it’s more important than ever that we prioritize home- and community-based services. This legislation will provide much-needed investment in our care workforce, making it easier for those who need care to get it and supporting the caregivers doing this crucial work.”
