Biden Signals HCBS Must Be Part Of Any Infrastructure Compromise

Inside Health Policy
By Maya Goldman / May 21, 2021 at 6:15 PM
The White House appears to be drawing a sharp line when it comes to including investments in the caregiving economy in a potential infrastructure compromise with Republicans, according to a memo the administration sent Friday (May 21) to Senate Environment and Public Works Committee ranking Republican Shelley Moore Capito (R-WV) offering to cut over $500 billion from its initial package. The memo was obtained by CNN and posted on Twitter.
President Joe Biden’s original $2.25 trillion American Jobs Plan called on Congress to dedicate $400 billion to home- and community-based services under Medicaid and make the Money Follows the Person program permanent. But Republican lawmakers subsequently left out long-term care improvements from their draft infrastructure counterproposal.
White House officials reportedly met with Republican lawmakers involved in infrastructure talks this week to discuss potential compromises.
In Friday’s memo, Biden officials said they do not want a compromise bill to leave out caregiving investments, while they suggested other potential cuts that would bring the bill’s cost down to $1.7 trillion.
The memo prioritizes HCBS funding over manufacturing, research and development and supply chain investments, which the memo says the president is willing to pursue through separate legislation.
“Because the President is taking off the table for purposes of these negotiations a significant category of investment that you have argued is not infrastructure, he believes fairness dictates that you consider investments in areas that he believes are vital but are not currently included in your Roadmap. Specifically, he believes investing in our nation’s care infrastructure is essential to support our seniors and help our parents, particularly women, get back to work,” the memo reads.
The White House and Capito’s office did not respond to requests for comment. In a press call to announce guidance on how states could use the increased federal Medicaid match for HCBS last week, a White House official emphasized the administration’s interest in bolstering home care.
“President Biden believes health care is a right, not a privilege, and that is why he is committed to investing in home- and community-based services, or HCBS, under Medicaid,” said Jessica Schubel, director of Affordable Care Act and healthcare policy for the Domestic Policy Council at the White House...

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