New legislative language for the home care benefits for the elderly and disabled on Medicaid that are part of the administration’s $2 trillion (formerly $3.5 trillion) package, i.e., the “human infrastructure” proposal has now become accessible for comments. It is unclear whether the legislation will be successful in its goals to noticeably emphasize home over nursing home care, and raise the pay of direct care workers. While there is still no score from the Congressional Budget Office, what is clear, however, is that the federal government will pay much more for Medicaid.
A few months ago, I criticized the Biden administration proposal to spend an additional $400 billion on home care benefits for the elderly and disabled eligible for Medicaid. I found that the legislation would cause direct harm to those in the middle-class not on Medicaid, by raising the costs of hiring direct care workers, the cost of nursing home stays, and indirectly raising the cost of competitive labor services such as child care. Lastly, the proposal lacked specificity on how that huge amount of federal money would be spent.
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