On Friday, the U.S. House of Representatives voted 220-213 to pass the $1.75 trillion budget reconciliation bill, the Build Back Better Act. The vote took place following the release of the Congressional Budget Office (CBO) score for the bill. The CBO score alleviated many concerns of moderate Democrats in the House about the legislation’s impact on the federal deficit. It also confirmed that the Medicaid Home and Community Based Services (HCBS) provision would cost $146.4 billion—in line with the initial $150 billion estimate.
Aside from the increased investment in Medicaid HCBS, there are additional provisions in the Build Back Better Act that impact community-based I/DD service providers, including permanent reauthorization of the Money Follows the Person program, $270 million for a grant program to assist states that choose to phase out 14(c) certificates that enable providers to pay Medicaid beneficiaries subminimum wages, and a $1 billion grant program to invest in strategies to recruit, retain, and advance the direct care workforce.
The Build Back Better legislation next moves to the Senate where negotiations continue over what will be included in its version of the bill. It is likely that the bill will differ significantly from the House version. ANCOR will monitor developments as the bill advances in the Senate and will continue to advocate for inclusion of full funding for Medicaid HCBS.
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