ANCOR Announces Support for Significant Investment in HCBS Proposed in ‘Better Care Better Jobs’ Legislation

ANCOR is proud to support the Better Care Better Jobs Act which has been introduced in the House (H.R. 4131) and Senate (S.2210). The legislation would operationalize President Biden’s $400 billion proposal to expand the Medicaid Home and Community-Based Services (HCBS) program, both in terms of funding for the program and the program’s infrastructure. Senators Bob Casey (D-PA), Ron Wyden (D-OR), Chuck Schumer (D-NY), Patty Murray (D-WA), Tammy Duckworth (D-IL), Sherrod Brown (D-OH) and Maggie Hassan (D-NH) are leading it in the Senate, with an additional 26 co-sponsors to date. Representatives Debbie Dingell (D-MI), Frank Pallone (D-NJ), Jan Schakowsky (D-IL) and Doris Matsui (D-CA) are leading the bill in the House.

Why it matters: While not perfect, on the whole this legislation is transformative and reflects decades of advocacy from ANCOR members and national disability organizations to strengthen the direct support workforce and the HCBS program. The bill’s provisions to expand and improve HCBS are receiving an unprecedented level support and attention from the Biden administration and have appeal on both sides of the aisle in Congress. 

What the legislation does:

• Creates a 10-year, 10-percent increase for Medicaid HCBS payments for states that opt-in. States can opt-in by committing to (1) strengthen and expand access to HCBS programs; (2) strengthen and expand the HCBS workforce; (3) show access, workforce and spending improvements over time; and (4) comply with a strong maintenance of effort.
• Creates additional incentives for innovations such as improved coordination between stakeholders and innovations around safety and work quality.
• Funds quality and accountability efforts, such as technical assistance to implement the bill and creating ombudsperson programs.
• Helps states plan implementation, including requiring them to develop plans for implementation with public input.
• Makes permanent the Money Follows the Person program.

Read this fact sheet and section-by-section document for more details. Additionally, we encourage our members to read the email sent earlier by ANCOR CEO Barbara Merrill on this topic to understand some potentially challenging provisions that ANCOR will be monitoring.

More details on the bill’s prospects: Changes to the text of the Better Care Better Jobs Act are likely, especially if it is included in the infrastructure proposal that congressional Democrats are preparing to send through the reconciliation process. Congressional disability champions are advocating for its inclusion in the reconciliation package. At this time, the reconciliation package is separate from the infrastructure deal which President Biden just struck with a bipartisan group of Senators. However, discussions around the bipartisan deal and the reconciliation package are intertwined as each group seeks to expand support for their respective proposals. Both proposals face a tough road ahead amid Democratic inter-party differences and GOP opposition to combining services infrastructure with physical infrastructure funding.

Next steps: ANCOR will be signing on as an official supporter of this legislation even as we work to improve it. We will be launching a grassroots campaign in favor of key disability provisions in the Better Care Better Jobs Act. This is a strategic time for ANCOR members to make their voices heard because the legislation and process by which it moves forward in Congress will be in flux in coming weeks.

Stay tuned for an action alert on this topic later this week. Additionally, please register for our members-only briefing on this legislation at 11am EST on Friday 7/2, which will be held instead of our weekly Friday 12pm EST briefing.