Capitol Correspondence - 11.19.21

BREAKING: House Passes Build Back Better Act, Including Historic Investment in Home and Community Based Services

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Legislation now moves to Senate to face next set of hurdles

This morning, the U.S. House of Representatives voted 220-213 to approve the Build Back Better Act. The 220-213 vote was largely along party lines, with all present Republicans voting against the measure, and just one Democrat, Representative Jared Golden (D-ME), voting no.

This marks a significant step in what has been a months-long process toward passage of the Act, which represents President Biden and congressional Democrats’ social spending priorities. The legislation includes a number of significant health care provisions, most notably a $150 billion investment in the Medicaid Home and Community Based Services (HCBS) program. The legislation also includes substantial investments in universal pre-kindergarten, affordable housing, an expanded child tax credit and several climate change initiatives.

ANCOR members should note the following provisions that, if signed into law, will have a significant impact on community-based I/DD services:

  • An historic Investment of $150 billion for HCBS
  • A six-percentage-point increase in the federal Medicaid match rate over a 10-year period
  • A potential additional two-percentage-point increase in the federal Medicaid match rate for states that implement a program for self-directed care
  • A requirement that states will review payment rates, starting two years after the approval of each state’s HCBS improvement plan and then every three years thereafter
  • Permanent reauthorization of the Money Follows the Person program
  • $270 million for a grant program to assist states that choose to phase out 14c certificates that enable providers to pay Medicaid beneficiaries subminimum wages
  • $1 billion over a 10-year period for a grant program to invest in strategies to recruit, retain, and advance the direct care workforce

The legislation now moves to the Senate for consideration, where it is expected to be taken up after the Thanksgiving holiday.

Although we anticipate that the text of the legislation will change before it reaches the Senate floor, it’s important to recognize the major victory today’s vote in the House represents. It marks the culmination of months of advocacy by ANCOR, its members and its allies, and although the fight isn’t over yet, we have taken a monumental step forward.

For all you have done to enable today’s victory, thank you—we couldn’t do what we do without you!