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Washington, dc - Today, Congresswoman Debbie Dingell (MI-12) and Senator Bob Casey (D-PA) introduced the Better Care Better Jobs Act, which would strengthen and expand access to Medicaid home- and community-based services (HCBS) while also supporting stronger benefits for the direct care workforce. This legislation builds on the $12.7 billion in HCBS funding that Dingell and Casey passed as part of the American Rescue Plan and carries forward President Biden’s infrastructure proposal to expand HCBS and strengthen the HCBS workforce.

“No one should have to wait to get the care they deserve, and no care worker should have to live below the poverty line to give this care,” said Rep. Dingell. “This is personal for me – I was so lucky to have my husband John receive care at home. That experience showed me the significant fractures in long-term care, from low wages for workers to thousands on HCBS waitlists to so many people not knowing how to get the care they desperately need. We need a stronger system that supports both care workers and care recipients, and this legislation is a historic step forward to expand HCBS so that seniors and people with disabilities can get the care they need in the setting of their choice, while also ensuring care workers are receiving pay and benefits commensurate with their work.”

For millions of families, and especially for women, home and community-based services are a bridge to work and a bridge to economic security. The Better Care Better Jobs Act would not only enable more older adults and people with disabilities to remain in their homes, stay active in their communities and lead independent lives, it would also create jobs and lead to higher wages for care workers, who are predominantly women and people of color. This legislation is critical to advancing equity, spurring economic recovery and improving quality of life for older adults and people with disabilities,” said Senate Aging Committee Chairman Bob Casey.

“HCBS allows seniors and people living with disabilities to receive the high-quality care they need in their communities and in close proximity to their friends and families. However, far too many people are unable to receive HCBS care because of long waitlists and chronic underinvestment in care workers,”said House Energy and Commerce Chairman Frank Pallone, Jr.“The Better Care Better Jobs Act makes a historic investment that will allow millions of Americans to access home- and community-based care while giving a much-deserved raise to the workers who provide care to our loved ones. I commend Congresswoman Dingell and Senator Casey for their leadership and look forward to getting this vital legislation passed and signed into law this year.”

“For too long, seniors and Americans with disabilities who want the choice of good quality long-term care at home and the workers who provide it have gotten short shrift. This bill lays out a transformational investment through Medicaid that will begin to set that right so receiving good quality care in the comfort and safety of home is a real possibility. It is also critical that the workforce who provides home care receive a livable wage, and that family caregivers have more supports when they provide care to their loved ones. I will continue working with my colleagues and the President to pass this key pillar of the American Jobs Plan,” said Senate Finance Committee Chairman Ron Wyden, an original Senate cosponsor of the bill.

HCBS enables seniors and people with disabilities to remain in their homes, stay active in their communities, and lead independent lives. Yet, currently, coverage, eligibility, and benefit standards vary by state, which leads to large gaps in coverage and caps on the number of individuals who can receive these critical services.

The address these challenges, the Better Care Better Jobs Act would:

• Facilitate statewide planning to develop HCBS infrastructure improvement plans;
• Enhance Medicaid funding for HCBS by providing states a permanent increase in federal Medicaid match if they expand access to HCBS and strengthen the HCBS workforce;
• Incentivize workforce growth through innovative models that benefit direct care workers and care recipients as well as help workers organize;
  
• Support quality and accountability by funding programs through the Centers for Medicare & Medicaid Services and conducting oversight and offering technical assistance to program coordinators; and
• Permanently authorize protection against impoverishment for individuals whose spouses received Medicaid HCBS, as well as the Money Follows the Person program to support individuals transitioning from institutions to home or community-based settings.

Original U.S. House cosponsors of this legislation include: House Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ), Rep. Jan Schakowsky (D-IL), and Rep. Doris Matsui (D-CA).

This legislation is endorsed by the following organizations: SEIU International, National Domestic Workers’ Alliance, National Center for Independent Living, The Arc, National Council on Aging, Justice in Aging, and Little Lobbyists.

"This legislation is game-changing for the women, the majority of whom are women of color, who provide care for the nation's elders and people with disabilities," said Mary Kay Henry, SEIU International President. “It expands access to care for families across the country and transforms home care jobs into high-quality careers by raising wages and providing workers with better opportunities to form a union. I look forward to continuing to work with Congress to build on these policies and get it done.”

“The care economy is the foundation of the entire economy. We have an opportunity to expand access to the critical services millions of Americans depend on to live at home with dignity, and invest in the essential workforce who provide these services. This legislation will strengthen the care infrastructure we all rely on. We urge lawmakers to support this important piece of legislation,” said Ai-jen Poo, the Executive Director of the National Domestic Workers Alliance.

National Center for Independent Living: “The National Council on Independent Living (NCIL) is supportive of the Better Care Better Jobs Act that would provide an unprecedented investment in home and community based services (HCBS). We look forward to working with Congress to strengthen the bill to provide needed support for the role CILs play in transitioning people out of institutional settings and improve reporting requirements in order to ensure all disabled people and older adults have access to the services and supports they need to live independent, self-directed lives.”

The Arc: “The Better Care and Better Jobs Act will be a game changer in supporting people with disabilities, their family caregivers and the direct care workforce. This long overdue investment will support states to build the capacity and infrastructure to support all people in their homes and communities, and The Arc looks forward to working with the sponsors of this legislation to make the BCBJ law.”

National Council on Aging: “The National Council on Aging (NCOA), the national voice for every person’s right to age well, strongly supports the legislation to improve access to Medicaid home and community-based services. The pandemic highlighted the growing and accelerating need for safer, less expensive alternatives to nursing homes and other institutional care. This legislation will help hundreds of thousands of Americans to finally obtain the home care they need, while strengthening the economy by creating new jobs with living wages and better benefits.”

Justice in Aging: “The Better Care Better Jobs Act makes the necessary investments ensure older adults can have equitable access to the services and supports they need to age in their homes and communities. Now is the time for bold investments in the care infrastructure. This bill is fundamental to mend the inequities in our long-term care system and to support the people who provide care. Justice in Aging is committed to working with Congress to enact this transformative legislation so older adults can age in dignity.”

Little Lobbyists: “Little Lobbyists is supportive of the Better Care Better Jobs Act that would provide an unprecedented investment in home- and community-based services. We look forward to working with Congress to strengthen the bill to support our families and to ensure all children with complex medical needs and disabilities have access to the home skilled nursing services and other supports they need to survive and thrive.”

Dingell and Casey have been leading voices on improving access to quality long-term care, as well as strengthening pay and benefits for the direct care workforce. The pair introduced the COVID HCBS Relief Act in 2021 to provide increased HCBS funding during the COVID-19 pandemic, which was enacted as part of the American Rescue Plan. They have also led efforts to extend spousal impoverishment protections and support programs to strengthen the availability and delivery of home and community-based services.

Please find a copy of the Better Care Better Jobs Act here and a one-pager here.